RISS 검색 - 국내학술지논문 상세보기

다국어 초록 (Multilingual Abstract)

Roughly one third of medical problems in children are related to the musculoskeletal system. Most of these problems are common and can be precisely diagnosed. For these problems, nonoperative treatment or reassurance can be given by the pediatrician. Occasionally, a problem needs surgical treatment, but a precise diagnosis must be made. There is little agreement about what types of orthopedic problems a primary care pediatrician should understand in order to effectively care for children. Many pediatric residencies lack an organized teaching curriculum that effectively covers these topics or that includes a required pediatric orthopedic rotation. In this article the authors delineate pediatric orthopedic problems that require recognition and urgent surgical treatment and are relatively common, but have different treatment options (observation, conservative treatment, and surgery) depending on their natural history. Whenever possible, the diagnosis should be made before a decision to refer is made. An accurate diagnosis allows the pediatrician to discuss the natural history of the condition properly. Referral to the wrong specialty can needlessly generate expensive tests and further delay in treatment or generate inappropriate treatment. The parents can be reassured rather than waiting to hear the same information from another physician. In particular, orthopedic problems are known to generate pressure from the parents to seek specialty consultation for reassurance. It is important to communicate to the specialist that the reason for the referral is for parental reassurance rather than for further work-up or treatment. After a proper diagnosis, communication directly between the pediatrician and the appropriate specialist can often avoid an unnecessary referral, and avoid unnecessary tests. The authors reviewed our experience at our outpatient clinic over last 1 year and found that it is useful to classify conditions as common or uncommon, and whether they require surgical or nonsurgical treatment. Many conditions fall in between. The following is a discussion of some of these more important or common conditions. (Korean J Pediatr 2008;51:122-128)

번역하기

참고문헌 (Reference)

1 Zionts LE, "Treatment of congenital dislocation of the hip in children between the ages of one and three years" 68A : 829-, 1968

2 Spock A, "Transient synovitis of the hip joint in children" 24 : 1042-, 1959

3 Edwards E, "Transient synovitis of hip joint in children" 148 : 30-, 1952

4 Haueisen DC, "The characterization of "transient synovitis of the hip" in children" 6 : 11-, 1986

5 Thompson GH, "Surgical management of resistant congenital talipes equinovarus deformities" 64A : 652-, 1982

6 Bensahel H, "Surgery in residual club foot" 7 : 145-, 1987

7 Atlas S, "Some new aspects in the pathology of clubfoot" 149 : 224-, 1980

8 Price CT, "Non-operative treatment of congenital club-foot. A long-term follow-up study" 2 : 213-, 1978

9 McKay DW, "New concept of and approach to club foot treatment. Section I. Principles and morbid anatomy" 2 : 347-, 1982

10 Staheli LT, "Lower-extremity rotational problems in children: normal values to guide management" 67A : 39-, 1985