제4, 5 중수골 기저부 관절 내 골절의 조기 고정술과 지연 유합술간의 비교 = Comparison of Early Fixation and Late Fusion of 4, 5th Carpometacarpal Joint in the Intra-Articular Fractures of 4th and 5th Metacarpal Base

국문 초록 (Abstract)

목적: 제4, 5 중수골 기저부 관절 내 골절에 대해 조기 고정술을 시행한 군과 지연 중수-수근관절유합술을 시행한 군의 임상적 결과를 비교해 보고자 하였다. 대상 및 방법: 2002년 3월부터 2006년 12월까지 조기 고정술을 시행한 21예와 골절 후 발생한 불유합의 치료로 수근-중수관절 유합술을 시행한 11예를 대상으로 하였다. 추시기간은 평균 39.9개월, 최종 추시 시 단순방사선 사진으로 골유합 여부를 확인하고 DASH-questionnaire, VAS pain scale, 악력 및 제4, 5수지 중수-수지 관절의 운동 범위 측정을 시행하였다. 결과: 조기 고정군과 지연 유합군 모두에서 방사선 검사상 골유합 소견이 관찰되었다. 임상적 결과 중 관절운동 범위, DASH-questionnaire, VAS pain scale에서 조기 고정군이 지연 유합군에 비해 유의하게 우수한 결과를 보였다 (p-value＜0.05). 결론: 제4, 5수지 중수골 기저부 관절 내 골절은 조기 고정술이 지연 유합군에 비해 좋은 임상적 결과를 보이므로, 조기 진단에 따른 적절한 고정술을 통하여 환자의 빠른 회복을 도모하는 것이 필요하다.

다국어 초록 (Multilingual Abstract)

Purpose: To evaluate clinical results between early fixation group and delayed fusion group in treatment of intraarticular fracture of 4th, 5th metacarpal base. Materials and Methods: From March 2002 to December 2006, 21 cases of early fusion and 11 cases of delayed fusion of 4, 5th carpometacarpal joint were reviewed retrospectively or were included in this study. Average follow up period is 39.9 months. Bony union was checked by plain films at follow up. DASH-questionnaire, VAS pain scale, grip power and range of motion of 4th, 5th metacarpophalangeal joint were also checked at last follow up. Results: In radiologic study, bony union was confirmed in all cases of two groups. Early fixation group showed better outcomes than delayed fusion group in range of motion, DASH-questionnaire and VAS pain scale with statistical significant (p＜0.004). Conclusion: Because early fixation group showed better clinical outcomes than delayed fusion group, early diagnosis and proper surgical treatment are important for better outcomes in treatment of intraarticular fracture of 4th, 5th metacarpal base.

참고문헌 (Reference)

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