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小兒의 骨 關節結核에 對한 臨床的 考察

Clinical Review of Bone and Joint Tuberculosis in Korean Children

소아과 1969년 12권 11호 p.21 ~ 29
김병길,
소속 상세정보
김병길 (  ) - 연세대학교 의과대학 소아과학교실

Abstract


Bone and joint tuberculosis, the most common one among the extrapulmonary tuberculosis, has been frequently observed in out-patient dispensaries or inpatient wards in Korea. There are many clinical reviews about that in Korean literatures. But almost of them are the review of tuberculous spine. Few -of them are the review of bone and joint tuberculosis of the adult. None of the review of bone and joint tuberculosis of children were published in Korea
I have summarized 274 pediatric patients of bone and joint tuberculosis who were observed at Wonju TUnion Christian Hospital, Wonju, Kang Won Do, a branch hospital of our Severance.
The following results were obtained;
1. For 9 years and 3 months from Jan. 1960 to March of 1969, 274 patients of bone and joint tuberculosis were observed which was 5.4955 of the total admitted pediatric patients (4.991) during the al;ove period.
2. The youngest one was : 6 month old male infant of tuberculous spondylitis. One third of patients were between 3 and 6 years of age. Only 1.7% were under one year of age. 30.9% were the school age group, from 6 to 12 years of age. Tuberculosis of spine and hip were observed from infancy but that of rib and shoulder were from teen-age group.
3. The ratio of male to female was 1.74 : 1.
4. The most common site of involvement was the spine which was 52.9% of the total bone and joint tuberculosis. The next were hip (28. 9%), knee (9.8%), ankle (3.6%), elbow (1. 8%), rib (0.7%) -etc.
5. Their chief complaints on admission were vertebral bending (40.2%), local pain (36.3%), local -swelling and tenderness (29.0%), walking and/or standing disturbance (28.8%), limitation of motion (19.2%) etc in that order.
6. Vertebral lesions were found from C 2 to Sl but Li was the most common site of lesion. Major -of lesions were located on lower thoracic and lumber vertebrae. Lumbar spondylitis were found in 44.7 % of all patients of the tuberculous spine. Average involvement was 2.3 vertebrae per patient. 47.2% .of patients had 2 vertebral lesions. Three was the next (20.3961).
7. The left side of bone and joint were frequently involved comparing the right side. 3. Pulmonary tuberculosis was the most common complication in bone and joint tuberculosis. All complications were found in 59.4% of the total patients.
9. Treatment was done by triple therapy with IINH, PAS, SM in all recorded cases. Cast was applied frequently than surgical fusion therapy.

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