선천성 무지 저형성증의 수술적 치료

국문 초록 (Abstract)

목적: 선천성 무지 기형에 대한 수술적 치료의 결과와 합병증을 분석하였다.
대상 및 방법: 2002년부터 2011년까지 부산대학교병원에서 9예의 무지를 수술적 치료하였다. 남아가 5예, 여아가 4예였다. 수술 당시 나이는 평균 4.7세로 5세 이하가 7예, 10세 이상이 2예였다. 5예의 Blauth 제5형 저형성증(무형성증)은 무지 형성술(Buck-Gramcko technique)로 치료하였고 4예의 제1, 2형 저형성증에 대해서는 무지 대립 성형술(opponensplasty)과 건이전술(신전력 및 외전력 보강)로 치료하였다. 치료 결과 평가는 Mehta의 점수 체계를 사용하였다.
결과: 9예 중 우수 5예, 양호 3예, 불량 1예의 결과를 보였다. 무지 무형성증 중 3예, 저형성증 중 1예 등 총 4예에서 근력 약화, 중수지 관절(metacarpo-phalangeal joint)의 아탈구로 인해 대립근 성형술, 중수골 단축술 등 재수술이 필요했다. 최종 운동범위는 전 예에서 무지 외전이 40o 이상, 집게능력(pinch power)은 정상 측에 비교하여 40% 이상이었다.
결론: 무지 무형성증 및 저형성증에 대해 무지 형성술, 무지 대립 성형술과 근력 약화에 대한 추가 수술로 기능 및 외관상 양호한 결과를 얻었다.

다국어 초록 (Multilingual Abstract)

Purpose: We evaluated the results and complications of surgical treatment for congenital thumb abnormalities.
Materials and Methods: Between 2002 and 2011, nine thumbs were surgically treated (Pusan National University Hospital, Busan, Korea). There were five males and four females. The mean age of patients at the time of operation was 4.7 years (seven patients were under five years old and two patients were over 10). Five cases of Blauth type V hypoplasia (aplasia) were treated by pollicization (using the Buck-Gramcko technique). Four cases of type I or II hypoplasia were treated by opponensplasty and tendon transfer (for extensor and abductor augmentation). The Mehta scoring system was used for analysis of outcomes.
Results: Among nine cases, outcomes were good in five cases, fair in three cases, and poor in one case. Second operations were required due to muscle weakness and metacarpo-phalangeal joint subluxation in three cases of aplasia and one case of hypoplasia. In all cases, the range of active abduction of the thumb was more than 40° and pinch power was at least 40% of that on the normal side at the latest follow up.
Conclusion: Surgical reconstruction using pollicization and opponensplasty for congenital thumb aplasia and hypoplasia, with additional surgery for muscle weakness, provided good results both functionally and cosmetically.

목차 (Table of Contents)

• 서론
• 대상 및 방법
• 결과
• 고찰
• 결론
• REFERENCES

참고문헌 (Reference)

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