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소아마비 후유증에 의한 사지 및 구간근육 마비분포에 대하여

Distribution of the paralysis in the extremities and the trunks late effects of poliomyelitis

대한정형외과학회지 1968년 3권 1호 p.23 ~ 28
권칠수, 안병훈,
소속 상세정보
권칠수 ( Kwon Chil-Soo ) - National Medical Center Department of Orthopedic Surgery
안병훈 ( Ahn Byung-Hoon ) - National Medical Center Department of Orthopedic Surgery

Abstract


Introduction
The paralysis resulted from an attack of poliomyelitis has a striking diversity. However, the existence of a certain order in the distribution of the permanent paralysis in late effect of pationbelitis were observed by Wickman(1963), and described that although a variety of combination of paralysis were found, certain types appeared more often than others; in the leg the personnel group and certain muscles of the thigh- in his experience the quadriceps femoris especially tended to be implicated.
Lovett, and Lucas(1908), Lovett(1915, 1917) Jahss(1917), Mitchell(1925) and Legg(1927, 193 7) studied of frequency of the paralysis and paresis in the muscles of the lower limb. Since many of patient with permanent paralysis of the extremities by late effect of poliomyelitis have been treated at the Orthopedic Department, National´ Medical Center, Seoul Korea. It was felt that a review of distribution of the paralysis in late effect of poliomyelitis might be of interest.
Material
Two hundred and two patients who were examined and treated for their permanent paralysis or paresis of the exteremities and trunks as sequlae of poliomyelitis in the years 1958 to 1966 at the Orthopedic Department National Medical Center were analyzed.
The scheme of Daniel´s muscletest, which classified the power of the muscles in five different
grades was used ´ins the assessment of the muscle
power in this material.
Sex, age distribution and duration of the paralysis
Of 202 patients 105 were male and 97 were female. Among 105 males six were affected in the upper limbs and 99 were affected in the lower limbs. Among 97 females, 13 were affected in the upper limbs and 84 were in the lower limbs (Table 1).
Table 1 Sex distribution
Male I Female ( Total Upper limbs 6 13´ 19 Lower limbs - 99 84 183 Total 105 97 202
The ratio of affected number of limbs between female and male was 2.1. to 1.0 in the upper limbs and it was 0.8 to 1.0 in the lower limbs. The ratio in total number of affected limbs between male and´ female was no difference in this material.
Table 2 Age distribution
Age Upper Lower Total
(years) ` limb limb
0-2 8 94 102
3-5 5 52 . 57
6-10 4 17 21
Over 10 2 6 8
Unknown 0 14 14
Total 19 183 202
Majority of the cases 159 out of 202 were involved under the age of five in this series. 14 cases with unknown ages were orphans (Table 2)
of the wrist had higher frequency of paralysis compared with that of extensors. Apparently no valuable differences were found between affected muscles of the lower limbs.
Paralysis of adductors of the hips were most frequently associated with that of other muscles of the hip. Paralysis of the tibialis muscles were frequently associated with that of muscles of the knees. The paralysis of the short and the long peroneal and tibial muscles were frequently associated with one another respectively.

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