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小兒의 急性 化膿性 股關節炎 Clinical Observation of Acute Suppurative Arthritis of Hip in children

대한정형외과학회지 1977년 12권 3호 p.423 ~ 428
張宗鎬, 宋柱浩,
소속 상세정보
張宗鎬 (  ) 
가톨릭醫科大學 整形外科學校室

宋柱浩 (  ) 
가톨릭醫科大學 整形外科學校室

Abstract


The authors did clinical analysis of 34 cases of suppurative athritis of hip for period of three years from Tan. 1973 to Jan. 1976 at Dept. of Orthopedics, Catholic Medical Center.
Through this study following results were obtained.
1. Most of the patients were under the age of 6 years including twenty-six males and eight females.
2. Lag period to treatment in 10 cases was within 3 days, 14 cases within a week: most of these series were treated within a week.
3. Frequent clinical symptom and signs were pain on hip 34 cases, fever 30 cases, limited motion of hip 24 cases and flexion contracture 8 cases.
4. Causative micro-organism was isolated in the cases of diseased hip: Staphylococcus aureus in24 cases, hemolytic streptococcus in 8, pneumococcus 1, and Gram positive bacillus 1 cases.
5. The laboratory findings included leucocytosis over 15.000 per mm in 31 cases, increased erythrocyte sedimentation rate 15mm per hour in 33 cases. All the cases were leucocytosis with increased ESR but 5 were only increased ESR
6. In author´s experience early incision and drainage with specific antibiotics were a choice of treatment in the acute supprative arthritis of hip
7. Result become progressibly less satisfactory in proportion in the length of time after onset at which treatment is started.
a) When sufficient time has elapsed for adhesion to develop the pocket to the head thus can not be drained properly by the active movements. Indeed, it is possible, that may be actually harmful in promoting absorption from such pocket.
b) In case of long standing erosion of cartilage with denuded bone areas hinder or prevent efficient active movements.
c) In case of long duration, blood stream infection is an ever present danger, as well as a aggrevation of existing organic disease by the infective process.

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