Archives of Hand and Microsurgery

The Korean Society for Surgery of the Hand (대한수부외과학회)
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Outcome of Suture Suspension Arthroplasty for Thumb Carpometacarpal Joint Arthritis

무지 수근중수 관절염에 대한 현수 봉합 관절성형술의 결과

  • Kim, Sehun (Department of Orthopaedic Surgery, Seoul National University College of Medicine) ;
  • Gong, Hyun Sik (Department of Orthopaedic Surgery, Seoul National University College of Medicine) ;
  • Lee, Se Yeon (Department of Orthopaedic Surgery, Seoul National University College of Medicine) ;
  • Lee, Minho (Department of Orthopaedic Surgery, Seoul National University College of Medicine) ;
  • Kim, Jihyeung (Department of Orthopaedic Surgery, Seoul National University College of Medicine) ;
  • Baek, Goo Hyun (Department of Orthopaedic Surgery, Seoul National University College of Medicine)
  • 김세훈 (서울대학교 의과대학 정형외과학교실) ;
  • 공현식 (서울대학교 의과대학 정형외과학교실) ;
  • 이세연 (서울대학교 의과대학 정형외과학교실) ;
  • 이민호 (서울대학교 의과대학 정형외과학교실) ;
  • 김지형 (서울대학교 의과대학 정형외과학교실) ;
  • 백구현 (서울대학교 의과대학 정형외과학교실)
  • Received : 2018.07.24
  • Accepted : 2018.10.06
  • Published : 2018.12.01
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Abstract

Purpose: A number of procedures were introduced to stabilize the 1st metacarpal bone after resection of the trapezium in the thumb carpometacarpal joint (CMCJ) arthroplasty. However, some surgical procedures may inevitably damage normal structures, such as harvesting tendons or drilling of a bone for tendon passage. Suture suspension arthroplasty is relatively less invasive and easier to perform than the previously described surgical methods. The purpose of this study was to report the therapeutic efficiency of the suture suspension arthroplasty. Methods: We retrospectively reviewed 12 patients who underwent suture suspension arthroplasty for the treatment of thumb CMCJ arthritis. Pain visual analogue scale (VAS), satisfaction about surgical outcomes, and the disabilities of the arm, shoulder and hand (DASH) scores were measured to evaluate the functional outcomes and the Trapezial Space Ratios were measured. Satisfaction was measured in the range of "very dissatisfied" (0) to "very satisfied" (10). Results: The mean follow-up period was 23 months. Pain VAS score improved significantly from 7.0 to 2.9 (p<0.05). And mean satisfaction scale was 6.9. However, there was no significant difference in DASH scores between before and after surgery (p=0.06). The mean trapezial space ratio was calculated to be 0.45 before surgery, 0.33 immediately after surgery, 0.23 at the last follow-up. Conclusion: Suture suspension arthroplasty is a satisfactory surgical procedure. And compared with other procedures, there is no significant difference in the reduction of the trapezial space. It may be useful in advanced thumb CMCJ arthritis.

목적: 무지 수근중수 관절염(thumb carpometacarpal joint arthritis)에 대한 관절성형술로 대다각골을 제거한 후 중수골을 안정시키는 여러 방법이 소개되어 있다. 현수 봉합 관절성형술은 덜 침습적이면서 술식이 쉬운 장점이 있다. 본 연구는 무지 수근중수 관절염 환자에서 이 술식을 이용하여 수술한 결과를 알아보고자 한다. 방법: 무지 수근중수 관절염으로 진단받고 현수 봉합 관절성형술을 시행한 환자 12명을 대상으로 후향적으로 연구하였다. 시각통증척도, 수술만족도, DASH (disabilities of the arm, shoulder and hand) 점수를 조사하였고, 단순방사선 검사에서 대다각골 공간 비율을 계측하였다. 결과: 평균 추시 기간은 23개월이었다. 수술 전후 통증 점수는 7.0에서 2.9로 유의하게 감소하여 호전을 보였고 (p<0.05), 수술만족도는 평균 6.9였다. 그러나 수술 전후 DASH 점수는 유의한 차이가 없었다(p=0.06). 평균 대다각골 공간 비율은 수술 전 0.45, 수술 직후 0.33, 마지막 추시 시 0.23이었다. 결론: 현수 봉합 관절성형술은 수술 결과가 만족스럽고, 다른 술식과 비교하여 중수골 침강에 의한 대다각골 공간의 감소도 큰 차이가 없어 진행된 무지 수근중수 관절염 환자에서 유용하게 사용될 수 있을 것으로 생각한다.

Keywords

References

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