Journal of Trauma and Injury

  • 제27권4호
  • /
  • Pages.139-144
  • /
  • 2014
  • /
  • 2799-4317(pISSN)
  • /
  • 2287-1683(eISSN)
대한외상학회 (The Korean Society of Traumatology)
권호 표지

응급실에서 손가락의 힘줄 손상에 대한 초음파의 유용성

The Utility of Ultrasonography in the Emergency Department for the Diagnosis of Finger Tendon Injury

  • 박정우 (을지대학교 의과대학 응급의학교실) ;
  • 이장영 (을지대학교 의과대학 응급의학교실) ;
  • 이원석 (을지대학교 의과대학 응급의학교실) ;
  • 성원영 (을지대학교 의과대학 응급의학교실) ;
  • 서상원 (을지대학교 의과대학 응급의학교실) ;
  • 양중일 (을지대학교 의과대학 응급의학교실)
  • Park, Jung Woo (Department of Emergency Medicine, College of Medicine, Eulji University) ;
  • Lee, Jang Young (Department of Emergency Medicine, College of Medicine, Eulji University) ;
  • Lee, Won Suck (Department of Emergency Medicine, College of Medicine, Eulji University) ;
  • Sung, Won Young (Department of Emergency Medicine, College of Medicine, Eulji University) ;
  • Seo, Sang Won (Department of Emergency Medicine, College of Medicine, Eulji University) ;
  • Yang, Jung Il (Department of Emergency Medicine, College of Medicine, Eulji University)
  • 투고 : 2014.08.11
  • 심사 : 2014.09.02
  • 발행 : 2014.12.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: Detection and determination of tendon injury in the finger or hand is not easy. Therefore, we aimed to study and evaluate the accuracy and the effectiveness of ultrasonography for the diagnosis of finger tendon injury. Methods: In this study, we enrolled patients, regardless of age and sex, with lacerations on their fingers. Patients with invisible wounds were excluded. We evaluated the accuracy and the effectiveness of ultrasonography and compared the results obtained from ultrasonography and with those obtained by visual observation of the injuries. Results: The sensitivity, the specificity and the accuracy of ultrasonography were found to be 66.7%, 100% and 91.3%, respectively (p<0.001) while those of physical examination were 71.4%, 98.3% and 91.3%, respectively. Small differences were observed between the sensitivities and specificities of the two examinations; however, the accuracies were the same (p<0.001). The area under the receiver operating characteristic (ROC) curve, which was used for diagnosis of tendon rupture using ultrasonography, was found to be 0.985 (95% confidence interval CI: 0.929-0.999),while that of physical examination was 0.938 (95% CI: 0.861-0.980). Conclusion: Ultrasonography can be used an effective diagnostic tool for patients with finger tendon injury.

키워드

참고문헌

  1. Lee SW, Lee JW, Park SH, Kim JW. Comparison of Compliance, Time Required for Diagnosis and Pain of Patients withComparison of Compliance, Time Required for Diagnosis and Pain of Patients with Finger Tendon Injury Between Gross and Ultrasonographic Confirmation. J Korean Soc Traumatol 2010; 23: 83-8.
  2. Harrison BP, Hilliard MW. Emergency department evaluation and treatment of hand injuries. Emerg Med Clin North Am 1999; 17: 793-822. https://doi.org/10.1016/S0733-8627(05)70098-5
  3. Hart RG, Uehara DT, Kutz JE. Extensor tendon injuries of the hand. Emerg Med Clin North Am. 1993; 11: 637-49.
  4. Rockwell WB, Butler PN, Byrne BA. Extensor tendon: anatomy, injury, and reconstruction. Plast Reconstr Surg 2000; 106: 1592-603. https://doi.org/10.1097/00006534-200012000-00024
  5. Santiago FR, Plazas PG, Fernandez JM. Sonography findings in tears of the extensor pollicis longus tendon and correlation with CT, MRI and surgical findings. Eur J Radiol 2008; 66: 112-6. https://doi.org/10.1016/j.ejrad.2007.05.007
  6. Wang PT, Bonavita JA, Delone FX Jr., McClellan RM, Witham RS. Ultrasonic assistance in the diagnosis of hand flexor tendon injuries. Ann Plast Surg 1999; 42: 403-7. https://doi.org/10.1097/00000637-199904000-00009
  7. Choi CY, LH, Choi HJ, Kim MS. The usefulness of Ultrasound Diagnosis of Acute Tendon Injury in Hand. J Korean Soc Plast Reconstr Surg 2008; 35: 729-34.
  8. Chung MS, Baek GH. Hand surgery. Seoul: Koonja; 2005: 259-62.
  9. Park JR, Youn CS, So BH, Kim JH, Kim HM, Park KN, Et al. The Efficacy of Ultrasound Diagnosis of a Partial Tendon Injury by Emergency Doctors: Using a Swine Model. J Korean Soc Emerg Med 2010; 21: 82-7.
  10. Zanetti M, Hodler J. Ultrasonography and magnetic resonance tomography of tendon injuries. Orthopade 1995; 24: 200-8.
  11. Ebrahim FS, De Maeseneer M, Jager T, Marcelis S, Jamadar DA, Jacobson JA. US diagnosis of UCL tears of the thumb and Stener lesions: technique, pattern-based approach, and differential diagnosis. Radiographics 2006; 26: 1007-20. https://doi.org/10.1148/rg.264055117
  12. De maeseneer M, Marcelis S, Osteaux M, Jager T, Machiels F, Van Roy P. Sonography of a rupture of the tendon of the extensor pollicis longus muscle: initial clinical experience and correlation with findings at cadaveric dissection. AJR Am J Roentgenol 2005: 184: 75. https://doi.org/10.2214/ajr.184.1.01840075
  13. Peimer CA. Surgery of the hand upper extremity. New York: McGraw-Hill; 1996. p.1163-88.
  14. Elson RA. Rupture of the central slip of the extensor hood of the finger. A test for early diagnosis. J Bone Joint Surg Br 1986; 68: 229-31.
  15. Swen WA, Jacobs JW, Hubach PC, Klasens JH, Algra PR, Bijlsma JW. Comparison of sonography and magnetic resonance imaging for the diagnosis of partial tears of finger extensor tendons in rheumatoid arthritis. Rheumatology (Oxford). 2000; 39: 55-62. https://doi.org/10.1093/rheumatology/39.1.55
  16. Wu TS, Roque PJ, Green J, Drachman D, Khor KN, Rosenberg M, et al. Bedside ultrasound evaluation of tendon injuries. Am J Emerg Med 2012; 30: 1617-21. https://doi.org/10.1016/j.ajem.2011.11.004
  17. Bianchi S, Cohen M, Jacob D. Tendons: traumatic lesions. J Radiol 2005; 86: 1845-57. https://doi.org/10.1016/S0221-0363(05)81534-3
  18. Bianchi S, Martinoli C, Abdelwahab IF. Ultrasound of tendon tears. Part 1: general considerations and upper extremity. Skeletal Radiol 2005; 34: 500-12. https://doi.org/10.1007/s00256-005-0956-1