삼각섬유 연골 복합체 척골 기시부 손상에 대한 관혈적 봉합술의 임상 결과 = Clinical Outcomes of Open Surgical Repair for Triangular Fibrocartilage Complex Foveal Detachment

국문 초록 (Abstract)

목적: 삼각섬유 연골 복합체 기시부 손상의 관혈적 봉합술의 임상 결과를 분석하고, 관혈적 봉합술의 유용성을 알아보고자 하였다방법: 삼각섬유연골 복합체 기시부 손상으로 관혈적 봉합술을 시행하였던 8예를 대상으로 하였다. 평균나이는 34세 였으며, 남자는 5명, 여자는 3명이었다. 결과 분석은 modified Mayo wrist score (MMWS)와 disabilities of the arm, shoulder and hand (DASH), 통증-visual analogue scale (VAS)를 사용하였으며, 이학적 검진을 통해 원위 요척관절불안정성 유무를 분석하였다.
결과: 평균 추시 기간은 36.5개월(범위, 12?64개월)이었다. MMWS는 평균 52.5 (범위, 25-85)에서 82.5 (범위, 75- 100)으로 향상되었으며(p=0.02), DASH 점수는 평균 39.6 (범위, 65-13.5)에서 13.4 (범위, 2.5-33.3)으로 향상되었다(p=0.012). 동통은 통증-VAS 4.6 (범위, 6-3)에서 2 (범위, 0-3)로 감소하였다(p=0.016). 4예에서 수술 전 원위 요척관절 불안정성이 관찰되었으며, 수술 후 불안정성이 남아있는 경우는 없었다.
결론: 삼각섬유연골 복합체 기시부 손상에 대한 관혈적 봉합술의 임상결과는 만족스러우며, 삼각섬유연골 복합체 된 4 예에서도 추가 술식 없이 불안정성이 호전되는 것을 확인하였다.

다국어 초록 (Multilingual Abstract)

Purpose: To investigate short term clinical outcomes of the open surgical repair for triangular fibrocartilage complex (TFCC) foveal detachment.
Methods: We retrospectively reviewed 8 patients (5 men, 3 women) who had been treated with open surgical repair of the TFCC type 1B injury, from 2005 to 2013 and who were followed up for more than one year after surgery. Mean age at time of surgery was 34 years. The right side was involved in 3 patients, and the left in 5. The clinical results of surgery were assessed with modified Mayo wrist score (MMWS), disabilities of the arm, shoulder and hand (DASH) score and pain-visual analogue scale (VAS). Physical examination was performed to evalu- ate the prescence of distal radioulnar instability, preoperatively and at the latest follow-up.
Results: The mean follow up period were 36.5 months (range, 12-64 months).
The mean MMWS improved from 52.5 (range, 25-85) preoperatively to 82.5 (range, 75-100) postoperatively (p=0.02). The mean DASH score improved from 39.6 (range, 65-13.5) preoperatively to 13.4 (range, 2.5-33.3) postoperatively (p=0.012). The preoperative mean pain-VAS was 4.6 (range, 6-3); these value was reduced to mean 2 (range, 0-3) at the latest follow-up (p=0.016). There were no patients remaining instability after the surgery, although four patients showed distal radioulnar joint (DRUJ) instability before surgery.
Conclusion: The surgical outcomes of open repair for TFCC foveal detachment (type 1B) was contentable. Also, in cases of type 1B injury associated with DRUJ instability were managed sucessfully without additional procedure.

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