母指変形性CM関節症に対する短母指対立装具療法における効果判定の試み

The efficacy of short opponens splint for thumb carpometacarpal joint osteoarthritis

要旨：母指変形性CM関節症に対し短母指対立装具を作成した42例47手（経過観察期間5ヵ月）を対象として，疼痛の変化，装具装着状況，生活障害に対して上肢機能評価（以下，Hand 20）・Patient-Rated Wrist Evaluation（以下，PRWE），手術移行例の疼痛変化・装具装着状況・生活障害を調査した．疼痛は6ヵ月で半数以上が軽減し，装着状況は半数以上が6ヵ月間装着していた．Hand20・PRWEはスコアが減少し，疼痛軽減とADL改善につながった．Eaton分類（以下，stage）別の疼痛変化では全stageで約7割以上の疼痛が軽減したものの，stage 3，4では悪化例もみられ，短母指対立装具はその効果に限界があるが病期に関わらず初期治療として有効であると考える．

　Forty-seven hands of forty two patients who had thumb carpometacarpal joint osteoarthritis were investigated about the efficacy of short opponens splints. The mean follow-up periods of the study were every 5 months in which the investigators evaluated pain, the rate of wearing splint, the upper extremity function for the activity of daily life using Hand20 and Patient-Rated Wrist Evaluation (PRWE), and the cases which required surgical intervention. More than half of the patients experienced pain relief and wore the splint for six-month periods. Hand20 and PRWE score were decreased, suggesting pain relief and improved activities of daily living. More than 70% of the patients experienced pain relief, whereas a few patients at Eaton's stage 3 and 4 felt increased pain. Although the effectiveness of short opponens splint for carpometacarpal osteoarthritis was limited in a few cases, it can be an appropriate initial treatment for all stages.