Archives of Hand and Microsurgery

The Korean Society for Surgery of the Hand (대한수부외과학회)
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Comparison between Chronic Ulnar and Radial Collateral Ligament Repairs in the Metacarpophalangeal Joint of the Thumb

무지 중수지 관절의 만성 파열된 척측, 요측 측부 인대 봉합술 후 결과 비교

  • Lee, Sanglim (Department of Orthopedic Surgery, Inje University Sanggye Paik Hospital) ;
  • Ha, Jiyun (Department of Orthopedic Surgery, Inje University Sanggye Paik Hospital) ;
  • Kim, Ji Yeong (Gunganhan Orthopedic Surgery Clinic) ;
  • Jeon, Suk Ha (Department of Orthopedic Surgery, National Medical Center)
  • 이상림 (인제대학교 상계백병원 정형외과) ;
  • 하지윤 (인제대학교 상계백병원 정형외과) ;
  • 김지영 (건강한 정형외과의원) ;
  • 전숙하 (국립중앙의료원 정형외과)
  • Received : 2018.09.07
  • Accepted : 2018.10.25
  • Published : 2018.12.01
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Abstract

Purpose: Favorable results have been reported after the direct repair of chronic ulnar collateral ligament ruptures of the thumb metacarpophalangeal (MP) joint, but the results for radial ligament seem rather controversial. The purpose of this study is to compare the results of ligament reattachment between chronic rupture of the ulnar and the radial collateral ligament (RCL) of the joint. Methods: We reviewed retrospectively the radiologic and clinical results of ligament reattachment with suture anchors for chronic (more than 6 weeks) rupture of the collateral ligament of the thumb MP joint with averaged 22-month follow-up. The data between 6 radial and 8 ulnar ligament repairs were compared statistically. Results: The average of postoperative ulnar deviation angle was $13.3^{\circ}$ in radial ligament and $2.0^{\circ}$ in ulnar ligament (p=0.020) in the last follow-up plain X-ray. Postoperative ligament instability was positive in 4 out of the 6 radial repairs and no case with instability was observed in ulnar ligament. In postoperative follow-up, sustained joint subluxation was observed only in 2 out of the 6 radial repairs. Conclusion: The delayed repair of the RCL of the thumb MP joint resulted in less favorable outcomes and ligament instability was observed postoperatively in more than half of the cases.

목적: 무지 중수 수지 관절의 척측 측부 인대의 만성 파열에서의 직접 봉합술은 양호한 결과가 보고되고 있으나 요측 측부 인대에서의 결과는 논란이 있다. 본 연구의 목적은 무지 중수 관절의 척측과 요측 측부 인대의 만성 파열에서 인대 재부착술의 결과를 비교하는 것이다. 방법: 무지 중수 수지 관절의 6주 이상된 측부 인대 파열에서 봉합 앵커를 이용해서 재부착술을 시행한 요측 6예 및 척측 8예의 평균 22개월 추적한 방사선적 및 임상 결과를 후향적으로 검토하고, 통계적으로 비교하였다. 결과: 수술 후 평균 척측 변위 각은 요측 측부 인대에서 $13.3^{\circ}$, 척측 측부 인대에서 $2.0^{\circ}$였다(p=0.020). 수술 후 인대 불안정성은 요측 인대 6예 중 4예에서 관찰되었으나, 척측 인대에서는 관찰되지 않았다. 수술 후 경과 관찰에서 관절의 아탈구는 요측 인대 2예에서만 관찰되었다. 결론: 무지 중수 수지 관절의 요측 측부 인대의 지연 봉합은 덜 양호한 결과를 나타내며, 반 이상에서는 수술 후 인대의 불안정성이 관찰된다.

Keywords

Acknowledgement

Supported by : Inje University

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