슬라이드 1

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1 김태원, 최영 *, 원성훈, 박문석 *, 정진엽 * 울산병원, 분당서울대병원 *, 국군함평병원

2 Background Buddy taping is a well known useful method for treating dislocations, and other injuries of finger or toe.

3 Background Buddy taping is a well known useful method for treating dislocations, and other injuries of finger or toe. Act of bandaging a damaged finger or toe together with a healthy one. Healthy digit acts as a splint, keeping the damaged one in a natural position for healing.

4 Background Useful method for treating sprains, dislocations, and other injuries of finger or toe especially 5 th metacarpal fracture 1,2 1. van Aaken J, Kampfen S, Berli M. Hand (N Y). 2007;2(4): Braakman M, Oderwald EE, Haentjens MH. Injury. 1998;29(1):5-9.

5 Background Comparative studies of casting versus taping to treat the 5 th metacarpal fracture reported that taped patients recovered quicker and with superior functional than those in the cast group VS Braakman M, Oderwald EE, Haentjens MH. Injury. 1998;29(1):5-9.

6 Background However, often see complications associated with buddy taping such as necrosis of skin, infection, loss of fixation, and limited of joint motion

7 Purpose To report the current consensus on treating finger and toe injuries and complications of buddy taping within specialists by using a specifically designed questionnaire

8 Methods Exempted IRB Manufactured by Korean 7-item questionnaire regarding treatment of finger, toe, metacarpal bone, and metatarsal bone injury The questionnaire was completed through direct interviewing (Korean Pediatric Orthopedic Association and Korean Society for Surgery of the Hand in 2012)

9 Methods 3-items : Age, board certificate annual, joined society 4-items : Buddy taping use, purpose, indication, complication, type of tape

10 Methods Appendix I 4. 수지및족지손상의치료에동반테이프고정을사용하시나요? 1) 아니오 2) 예 3) 과거에는사용하였으나, 현재는사용하지않는다 사용하신다면치료중어느단계에서사용하시나요? 4-2. 사용하신다면다음중사용하는적응증을모두선택하여주세요 사용하지않으신다면이유는?

11 Methods Appendix II 4-1. 사용하신다면치료중어느단계에서사용하시나요? 1) 골절의고정에사용한다. 2) 부목이나캐스트치료후운동치료나물리치료단계에서사용한다. 3) 골절의전위정도에따라두단계모두사용한다.

12 Methods Appendix II 4-2. 사용하신다면다음중사용하는적응증을모두선택하여주세요. 1) 수지지골골절 2) 수지중수골골절 3) 수지중수수지관절탈구및인대손상 4) 수지근위지간관절탈구및인대손상 5) 수부중수수근관절의골절및탈구 6) 족지지골골절 7) 족지중족골골절 8) 족지근위지간관절탈구및인대손상 9) 기타

13 Methods Appendix II 4-3. 사용하지않으신다면이유는? 1) 고정력이불충분하다 2) 환자의순응도가떨어진다 3) 피부의손상 4) 감염 5) 관절운동범위의제한이자주발생한다. 6) 기타 :

14 Methods Appendix I 5. 동반테이프고정을사용하시면서겪으신합병증이나부작용을모두선택해주세요. 1) 테이프부착부위의피부의손상 2) 테이프부착부위의감염 3) 점진적인고정력의약화로인한골절전위 4) 이환수지의관절운동범위제한 5) 인접수지의관절운동범위제한 6) 이환수지와인접수지사이의피부접촉에의한피부손상 7) 감염 8) 환자의자가테이프제거 : 불량한순응도

15 Results

16 Results Demographics of participationts Age (years) n(%) 31 to (51) 40 to (35) 51 8 (15) Duration of board certificate (years) < 5 12 (22) 5 to 10 8 (15) (33) Joined societies Korean Pediatric Orthopedic Association 20 (36) Korean Society for Surgery of the Hand 34 (62) Korean Shoulder and Elbow Society 9 (16) Korean Fracture Society 17 (31) Korean Society of Plastic and Reconstructive Surgeons 6 (11)

17 Results use Using Not using Not presently using but used in the past

18 Results purpose Immobilization of fracture Physical or Exercise therapy Using both steps according to displacement of fracture

19 Results indication Finger fracture Toe fracture MCP injury PIP injury of foot Metacarpal fracture CMC injury Metatarsal fracture

20 Results complication Low compliance of patients Skin injury on adhesive area of tape Skin injury between injured finger and healthy one Displacement of fracture Limited motion on injured finger Limited motion of healthy finger Infection

Results type of tape 70 60 50 40 30 20 10 0

21 Results type of tape Plaster Coban Velcro Custom made Band Rubber bandage

22 Discussion

23 Discussion Surgeons were almost (87%) always using Buddy taping to treat finger and toe injury Compliance of patients is important for success of conservative treatment on hand injury Previous studies - Most important factor in the success of splint treatment for mallet finger or 5 th metacarpal fracture is patient compliance Anderson D. Aust Fam Physician. 2011;40(1-2):47-8. Perron AD et al. Am J Emerg Med. 2001;19(1):76-80.

24 Discussion Skin complication was also an important factor Geiger et al. reported three cases of skin necrosis beneath the dorsal pad of the metacarpal brace. Animal studies in which pressure as low as 100 mm Hg sustained for more than 6 hours could produce tissue necrosis. Geiger KR, Karpman RR. J Bone Joint Surg Am. 1989;71(8):

25 Discussion Recommended applying gauzes between the injured finger and healthy one to prevent skin injury, and educated patients to reapply buddy taping.

26 Conclusions Buddy taping is widely used in broad cases Low compliance and skin injury should be considered when the clinician treats finger and toe injury by using buddy taping. More evidence and investigations will be needed

27 THANK YOU FOR YOUR ATTENTION!!!

12이문규

12이문규 Review on Conservative Treatment of Spinal Scoliosis Moon-kyu Lee, O.M.D., Gil-jae Lee, O.M.D., Yun-kyung Song, O.M.D., Hyung-ho Lim, O.M.D. Dept. of Oriental Rehabilitation Medicine College of Oriental