@article{oai:ryotokuji-u.repo.nii.ac.jp:00000497,
 author = {養父, 琴美 and Yofu, Kotomi and 桐林, 俊彰 and Kiribayashi, Toshiaki and 上野, 大樹 and Ueno, Taiki and 倉持, 桃子 and Kuramochi, Momoko and 田村, 哲也 and Tamura, Tetsuya and 下小野田, 一騎 and Shimoonoda, Kazuki},
 issue = {16},
 journal = {了德寺大学研究紀要, The Bullentin of Ryotokuji University},
 month = {},
 note = {手指基節骨骨折は，掌側凸の屈曲変形を呈し整復及びその保持に難渋することが多い．また，骨の周囲
を腱が走行するため骨折部での癒着が起こしやすい．今回我々は，掌側凸変形が著明な左第5指基節骨基
部骨折に対し，早期仕事復帰を目的に早期運動療法（ナックルキャスト）を用いて良好な結果を得た症
例を報告する．本症例は，49歳，男性，歩行時転倒し受傷し，同日当院を受診した．初回レントゲン撮
影写真（X-ray photograph,以下XPとする）で29°の掌側凸変形を認めた．徒手整復を行い，シーネ固定
を行った．整復後のXPで掌側凸変形は0°となった．受傷1週後に環指とのバディーテープとナックルキャ
ストを施行した．キャスト施行後から仕事に復帰，手指の運動を積極的に行うよう指導した．受傷4週後
にXPにて転位がないことを確認し，固定を除去，受傷8週後に骨癒合を認めた．遠位指節間関節（distal
interphalangeal joint，以下DIP関節とする）・近位指節間関節（proximal interphalangeal joint，以下PIP
関節とする）・中手指節関節（metacarpophalangeal joint，以下MP関節とする）関節可動域は，PIP関節
で10°の伸展制限を認めるが，その他関節では屈曲伸展ともに健側対比100％となり，握力は健側40kgと
くらべ30kgと健側に対し10kgの低下を認めた．Visual Analogue Scale（以下VASとする）は，初回受診
時10が最終評価時で0となった．患者が強く望んでいた仕事をしながらの骨癒合の獲得，早期運動療法が
実現でき良好な結果が得られた．, Fractures of the proximal phalanx of the fingers present with flexion deformity of the volar side and are often
difficult to reduce and maintain. In addition, since the tendon runs around the bone, adhesion at the fractured part is
likely to occur. Here, we report a case in which good results were obtained by using early exercise therapy (knuckle
cast) for the purpose of early return to work for a fracture of the proximal phalanx of the left fifth finger with
10
marked volar convex deformation. This case was a 49-year-old man who fell and was injured while walking and
visited our hospital on the same day. The first X-ray photograph (hereinafter referred to as XP) showed a 29 ° volar
convex deformation. He performed manual reduction and fixed the splint. In XP after reduction, the volar convex
deformation was 0 °. One week after the injury, a buddy tape with the ring finger and a knuckle cast were performed.
After the cast, he returned to work and was instructed to actively exercise his fingers. Four weeks after the injury, XP
confirmed that there was no dislocation, the fixation was removed, and bone fusion was observed 8 weeks after the
injury. Distal interphalangeal joint (hereinafter referred to as DIP joint), proximal interphalangeal joint (hereinafter
referred to as PIP joint), metacarpophalangeal joint (hereinafter referred to as MP joint) Joint range of motion A 10 °
extension restriction was observed in the PIP joint, but in the other joints, both flexion and extension were 100% of
the healthy side, and the grip force was 30 kg compared to the healthy side and 10 kg different from the healthy side.
The Visual Analogue Scale (hereinafter referred to as VAS) at the fractured part was 10 at the first visit, but became
0 at the final evaluation. We were able to obtain bone union and early exercise therapy while doing the work that the
patient strongly wanted, and good results were obtained.},
 pages = {9--14},
 title = {第5指基節骨基部骨折においてナックルキャストを用いた一症例},
 year = {2022},
 yomi = {ヨフ, コトミ and キリバヤシ, トシアキ and ウエノ, タイキ and クラモチ, モモコ and タムラ, テツヤ and シモオノダ, カズキ}
}