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両側性ペルテス病にどのような臨床的特徴があるか,特に発症にかかわる要因について検討を加えた.三重県立草の実リハビリテーションセンターで経験したペルテス病81例のうち,典型的な両側例は5例10関節であり,発生率は6.2%であった.初期治療別に両側性の発生をみると,無治療の6例中3例,通院にて片側型装具で治療の13例中発症が2例であり,初期治療を入院にて免荷型外転装具を中心に,確実なcontainment療法を施行した62例に両側例は皆無であった.両側の十分なcontainment療法と安静は,反対側の発症を予防している可能性が示唆された.
We studied the clinical features of bilateral Perthes' disease, especially the factor of occurrence. We treated 81 cases of Perthes' disease, in which we had 5 cases of bilateral Perthes' disease (6.2%). The initial treatment of Perthes' disease was classified into three groups as follows. 1)untreated patients:6 cases. 2)outpatients treated in a unilateral brace:13 cases. 3)inpatients mainly treated in an abduction brace:62 cases. Patients who had bilateral involvement accounted for 3 in group 1, 2 in group 2, and none in group 3. The application of an abduction brace on an inpatient basis confirms the containment therapy, and this may prevent the subsequent contralateral onset of Perthes' disease.
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