| Project/Area Number |
16K10876
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Orthopaedic surgery
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| Research Institution | Tokyo Medical University |
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Principal Investigator |
Nishida Jun 東京医科大学, 医学部, 教授 (20198469)
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| Co-Investigator(Kenkyū-buntansha) |
立岩 俊之 東京医科大学, 医学部, 講師 (00424630)
鎌滝 章央 弘前大学, 医学研究科, 助教 (60360004)
東儀 季功 東京医科大学, 医学部, 助教 (60532322)
三又 義訓 岩手医科大学, 医学部, 助教 (40740717)
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| Project Period (FY) |
2016-04-01 – 2021-03-31
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| Project Status |
Completed (Fiscal Year 2020)
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| Budget Amount *help |
¥4,680,000 (Direct Cost: ¥3,600,000、Indirect Cost: ¥1,080,000)
Fiscal Year 2019: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
Fiscal Year 2018: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2017: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Fiscal Year 2016: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
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| Keywords | 腱・腱鞘間 / 屈筋腱腱鞘炎 / 滑走抵抗 / 腱腱鞘間滑走抵抗 / 弾発指 / 腱・腱鞘間滑走抵抗 / 腱損傷 / 腱鞘損傷 / 腱再建 / 腱鞘再建 / 腱鞘炎 / 屈筋腱再建 / 屈筋腱狭窄性腱鞘炎 / 腱・腱鞘再建 / 腱移植 / ヒアルロン酸 / 滑膜細胞培養 |
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| Outline of Final Research Achievements |
45 trigger fingers with PIP joint contracture from 41 patients treated by ulnar slip superficialis tendon resection were reviewed. The mean follow-up period was 12 months. We evaluated the preoperative and postoperative grip strength (GS), PIP joint flexion (Flex), and extension angles (Ext), and DASH scores of each finger. Tendon proximal phalanx axial area ratios at the proximal 20% region (Ratio) compared with age and sex-matched control were also calculated from the CT images. The 2 groups were compared using the Student t-test.
Postoperatively, GS was 85.6% of the unaffected side compared with 63.3% preoperatively, and the Flex improved to an average of 92.8° compared with an average of 81.9° preoperatively (p<0.05). The Ext improved to -8.4° compared with an average of -25.1° preoperatively (p<0.05). The DASH scores improved from an average of 31.1 points to 15.5 (p<0.05). On CT imaging, the preoperative Ratio was significantly larger, with a healthy Ratio of 161% (p <0.05).
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| Academic Significance and Societal Importance of the Research Achievements |
通常A1腱鞘切離・切除術が行われているPIP関節屈曲拘縮を伴う弾発指例は、手術成績が不良である例が多いことが知られている。病態としてFDSの肥厚があり、A1腱鞘のみならず、A2腱鞘間との、滑走障害が起こっているため、従来の方法では屈曲拘縮と疼痛がが残存しやすく、浅指屈筋腱尺側半腱切除術が有効と考えられた。
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