Bouchard結節に対する機能的スプリント療法の効果

Efficacy of Functional Splint Therapy for Bouchard's Nodes

　背景：Bouchard結節は症例数が少なく，治療効果を報告しているものは少ない．

　対象と方法：Bouchard結節のある15指に対しスプリントを作製し，スプリント装着前後に手指proximal interphalangeal(PIP)関節の屈曲角度，握力，痛みvisual analogue scale(VAS)，動かしやすさVASを計測し比較した．

　結果：スプリント装着前後で手指PIP関節の屈曲角度と痛みVASは有意に減少したが，握力と動かしやすさVASは変化は認められなかった．

　まとめ：今回考案したスプリントによって握力と手指の動かしやすさに影響を及ぼさない程度で運動制限したことにより疼痛が軽減した．

　Background：Osteoarthritis of the hands is common in the elderly, and it is well known that it leads to hand dysfunction.　There have been very few reports on the efficacy of treatment for Bouchard's nodes, because Bouchard's nodes are less common than other manifestations of osteoarthritis of the hand such as osteoarthritis of the carpometacarpal joints and distal interphalangeal joints.　We developed a functional splint for treating fingers with a Bouchard's node, and the purpose of this study was to assess the effectiveness of the splint as a means of treating Bouchard's nodes.

　Methods：We enrolled 13 patients who had a total of 15 painful PIP joints in their fingers.　The flexion angle of the PIP joints, grip strength, visual analogue scale (VAS) for pain, and VAS for flexibility were assessed before and after wearing the splint.

　Results：The results showed that the flexion angle of the PIP joints and pain VAS were significantly lower after wearing the splint, but grip strength and the flexibility VAS were not significantly reduced.

　Conclusion：Wearing the functional splint reduced pain and flexion angle of PIP joints, but it did not affect grip strength or the flexibility VAS.　The splint was effective as a means of treating fingers affected by Bouchard's nodes.