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末梢骨 및 關節結核에 對한 臨床的 考察

A Clinical Observation of Perapheral Bone and Joint Tuberculosis

최신의학 1966년 9권 12호 p.85 ~ 89
이기린,
소속 상세정보
이기린 (  ) - 서울대학교 대학원 의학과 외과학전공

Abstract


The tuberculosis is world wide disease, and the majority of bone and joint tuberculosis attacks fairly well children and young person, which results in miserable crippling, if early and intensive treatment is not given.
With the introduction of antituberculous chemotherapy, great progress has been made in the treatment of bone and joint tuberculosis. However, there is still many patients suffering from this crippling illness.
A clinical observation was made for 100 patients who was admitted to our orthopedic depai talent under the diagnosis of bone and joint tuberculosis sparing spine, from Jan 1959 till Aug 1966.
1. Age distribution was peak in first decade of life being 31%, and majority of patient was under 30 years old as 88%.
2. 59 %´bf patients had more than one year of duration of illness.
3. Affected site was peak in hip joint as 45%, which had more incidence in left, and knee occupied nextas 29%.
4. In history analysis, 86% of patient had pain as chief complaint, and 25% of all patients had a high fever at the onset of illness. 37% of rnale7and 25% of female had trauma on affected area at onset.
5. Physical examination urc)vered tenderness, and swelling in 22% of all, and 18% had tenderness and swelling with local heat. Mild limitation of range of motion was observed in one third of all patients, and moderate in one fourth.
6. At the time of admission, mean Hb was 12.1 gm per dl in male and 11.5 mg in female. 14.5% in male, and 91, in female had Hb below 10 gm per dl. Corrected ESR revealed 21=30 mm/hr in 32.6%, and 84.6% of all had above 10 mm. Leucocytosis was present in 27.7%, and 5 case had more than 20.000 per cubic millimeter without secondary infection. 40.2% showed lymphocytosis.
7. Most frequent associated lesion was fistula as 25%, and next was pulmonary tuberculosis being 15%.
8. Type of treatment was fusion in 50%, curettage in 1%, and synovectomy in 11%. Conservative treatment performed in 17 cases,
9. 4 case was complicated by post-operative infection.

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