Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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A Clinical Study of Intercostal Neuropathy after Rib Fracture

늑골 골절 후 발생한 늑간 신경병증의 임상적 연구

  • Kang, Jung-Hun (Department of Rehabilitation Medicine, College of Medicine, Chosun University) ;
  • Lee, Seog-Ki (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Chosun University) ;
  • Seo, Min-Bum (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Chosun University) ;
  • Na, Jeong-Yeop (Department of Rehabilitation Medicine, College of Medicine, Chosun University) ;
  • Jang, Jae-Hyouk (Department of Rehabilitation Medicine, College of Medicine, Chosun University) ;
  • Kim, Kweon-Young (Department of Rehabilitation Medicine, College of Medicine, Chosun University)
  • 강정훈 (조선대학교 의과대학 재활의학교실) ;
  • 이석기 (조선대학교 의과대학 흉부외과학교실) ;
  • 서민범 (조선대학교 의과대학 흉부외과학교실) ;
  • 나정엽 (조선대학교 의과대학 재활의학교실) ;
  • 장재혁 (조선대학교 의과대학 재활의학교실) ;
  • 김권영 (조선대학교 의과대학 재활의학교실)
  • Received : 2009.09.25
  • Accepted : 2009.11.11
  • Published : 2010.02.05
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Abstract

Background: The purpose of this study is to evaluate intercostal neuropathy after rib fracture and to determine the severity of intercostal neuropathy with using a numerical rating scale and according to the duration of pain and the body mass index. Material and Method: We measured the positive sharp wave and fibrillation on the intercostal and paraspinal muscles in the thoracic region by performing needle electromyography in 47 patients who had intercostal neuralgia after rib fracture and who had needed daily analgesic for more than three months. Result: We diagnosed 11 cases as intercostal neuropathy among the 47 cases. Of the total 11 cases, 8 were male and 3 were female and they were most often of an active generation in the community. The common location of intercostal neuropathy was the intercostal space below the rib fracture and from the 7th to the 12th intercostal rib area. The incidence of intercostal neuropathy was significantly related with multiple rib fracture rather than single rib fracture. The symptoms observed were chest pain (90.9%), sensory change (81.8%), paresthesia and numbness (63.6%), back pain (27.2%) and muscle atrophy (18.2%). The numerical rating scale, the duration of pain and the body mass index showed no significant correlation with the severity of intercostal neuropathy. Conclusion: We concluded that the electrodiagnostic approach with considering the affecting factors and the clinical findings will be helpful for diagnosing and treating persistent intercostal neuralgic pain (more than 3 months) after rib fracture.

배경: 이 연구는 늑골 수상 후 발생하는 늑간 신경병증에 대한 평가를 위하여 숫자통증등급, 통증 기간 및 체질량 지수에 따른 늑간 신경병증에 대한 심한 정도를 알고자 하였다. 대상 및 방법: 늑골 골절 수상 후 3개월 이상 동안 보존적인 치료에도 불구하고 심한 통증을 호소하는 환자 47명을 대상으로 근전도 검사를 시행하여 흉부의 늑간 및 척추 주위 근육에 대한 평가를 하였다. 결과: 47명 중에서 11명에 대하여 늑간 신경병증의 진단을 얻을 수 있었으며, 남자 8명과 여자 3명이었으며, 그 연령은 직업적으로 활동적인 연령대였다. 늑간 신경병증이 호발하는 부위는 7번부터 12번 부위 늑골 골절의 늑간이었다. 그 빈도는 단일 골절보다는 다발성 골절과 밀접한 상관 관계를 알 수 있었다. 그 증상으로는 흉통(90.9%), 감각이상(81.8%), 무감각(63.6%), 후부 흉통(27.2%), 그리고 근위축(18.2%) 순이었다. 근전도에 의한 숫자통증등급, 통증 기간 및 체질량 지수와 관계는 없었다. 결론: 늑골 골절수상 후 3개월 이상 지속적인 통증을 호소하는 환자에서 지속적인 늑간 신경통에 대한 진단을 위한 평가로 근전도가 도움이 될 수 있다.

Keywords

Acknowledgement

Supported by : 조선대학교

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