절개 변형한 척측 구형성 부목을 이용한 제5중수골경부 골절의 치료 = Modified Split Ulnar Gutter Splint for Treatment of Fifth Metacarpal Neck Fractures

국문 초록 (Abstract)

목적: 전통적인 척측 구형성 부목(ulnar gutter splint)의 문제점을 보완한 절개 변형한 척측 구형성 부목(modified split ulnar gutter splint)을 이용하여 보존적으로 치료한 제5중수골 경부골절 환자의 방사선학적 결과를 분석하고자 하였다.
방법: 2008년 12월부터 2014년 5월까지 본원에서 치료 받은 17명, 18예를 대상으로 하여 방사선학적 결과를 분석하였다. 수술 전, 직후 및 최종 추시의 사면 및 측면 방사선 사진에서 각형성을 측정하여 교정각 및 고정의 안정성을 평가하였다. 평균 고정 기간은 4.9주(범위, 4-7주)였고, 평균 추시 기간은 17.1 주(범위, 8-80주)였다.
결과: 전체 17명, 18예에서 골유합이 관찰되었고, 사면 방사선 사진상 정복 전 각변형이 평균 27􀆆에서 정복 후 평균 17􀆆 로 교정되었고, 측면 방사선 사진상에서도 21􀆆에서 10􀆆도로 교정되어 만족할 만한 결과를 보였다(p<0.001). 최종 추시시의 사면 방사선 사진상의 교정각의 변화는 평균 3􀆆, 측면 방사선 사진상 1􀆆로 우수한 골절 고정력을 보였다.
결론: 제5중수골 경부 골절 치료로 영상 증폭 관찰하에서 도수 정복 후 절개 변형한 척측 구형성 부목(modified split ulnar gutter splint) 고정술은 고정력이 우수하여 보존적 치료의 적응증을 넓힐 수 있을 것으로 생각된다.

다국어 초록 (Multilingual Abstract)

Purpose: To evaluate radiological results of the modified split ulnar gutter splint for the fifth metacarpal neck fracture.
Methods: Between December 2008 and May 2014, 17 patients (18 cases) with fifth metacarpal neck fractures were managed with our modified split ulnar gutter splint. Radiological outcomes in oblique and lateral radiographs were evaluated. Mean immobilization period was 4.9 weeks (range, 4-7) weeks.
Mean follow-up period was 17.1 week (range, 8-80 weeks).
Results: All of 18 fractures were completely united. The average of prereduction dorsal angulation, 27° in the oblique radiographs and 21° in the lateral radiographs, were corrected to 17° in the oblique radiographs and 10° in the lateral radiographs after closed reduction. At the last follow-up, they were 14° and 11° respectively. The mean difference of angulation deformity between in postreduction and final follow-up radiograms were 3° in the oblique radiographs and 1° in the lateral radiographs, which was not significantly different.
Conclusion: Immobilization using modified split ulnar gutter splint will be a reliable option for the fifth metacarpal neck fractures in selected patients, which will avoid the surgeries.

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