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재발성 족외과 점액낭염에 대한 도침요법: 증례 보고
Effects of Acupotomy Treatment on Relapsed Lateral Malleolar Bursitis: A Case Report 원문보기

Korean journal of acupuncture, v.36 no.4, 2019년, pp.300 - 307  

김재훈 (대구한의대학교 부속 한방병원 침구의학과) ,  이정희 (대구한의대학교 부속 한방병원 침구의학과) ,  이윤규 (대구한의대학교 부속 한방병원 침구의학과) ,  이현종 (대구한의대학교 부속 한방병원 침구의학과) ,  김재수 (대구한의대학교 부속 한방병원 침구의학과)

Abstract AI-Helper 아이콘AI-Helper

Objectives : This study details on a case of acupotomy for relapsed lateral malleolar bursitis. Methods : A 71-year-old woman with lateral malleolar bursitis was treated with acupotomy twice in an outpatient setting. A sterilized, disposable, blade width 0.5 mm × needle length 50 mm sized acu...

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제안 방법

  • The conclusions of studies focusing on corticosteroid injections as a conservative treatment method could not reach a consensus regarding the methodology. Each study used different kinds of corticosteroids and different volumes for injection, creating variability in the results analyses. Corticosteroid injections could be indeed effective to treat bursitis.
  • The symptoms and size of lateral malleolar bursitis were evaluated and measured at each outpatient visit. The clinical results were assessed by response evaluation criteria that were modified from the guidelines of the response to treatment for a solid tumor4,11). These response evaluation criteria include the state of fluctuation, shrinkage of the bursa, and swelling of the soft tissue, scored as ‘Complete Response’, ‘Partial Response’, and ‘No Response’ (Table 1).
  • The status of patient was evaluated just before treatment at each outpatient visit by identical assessor. The symptoms and size of lateral malleolar bursitis were evaluated and measured at each outpatient visit. The clinical results were assessed by response evaluation criteria that were modified from the guidelines of the response to treatment for a solid tumor4,11).

대상 데이터

  • A sterilized, disposable acupotomy (DongBang Acupuncture Inc., Republic of Korea; 0.5 × 50 mm, whole length 105 mm, length of acupuncture body 75 mm, length of acupuncture head 25 mm, length of cylindrical apex 5 mm, and radius 0.5 mm) was used.
  • However, it relapsed after repetitive, hard household labor in June 2019. She was brought to the outpatient department of Daegu Hanny university traditional Korean medical hospital without having received any treatment.
  • A 71-year-old woman who has swelling at the lateral malleolus of the right ankle as a main complaint, was diagnosed with lateral malleolar bursitis of the right ankle at a local hospital in 2017, but refused surgical recommendation at that moment. Then, she visited the Daegu Hanny university traditional Korean medical hospital. Her symptoms including pain and discomfort of the right ankle had relieved after several conservative treatments, allowing her to maintain her daily life activities comfortably.
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참고문헌 (18)

  1. Hernandez PA., Hernandez WA., Hernandez A. Clinical aspects of bursae and tendon sheaths of the foot. J Am Podiatr Med Assoc. 1991 ; 81(7) : 366-372. doi: 10.7547/87507315-81-7-366 

  2. Ruangchaijatuporn T., Gaetke-Udager K., Jacobson J. A., Yablon C. M., Morag Y. Ultrasound evaluation of bursae: anatomy and pathological appearances. Skeletal Radiol. 2017 ; 46(4) : 445-462. doi: 10.1007/s00256-017-2577-x 

  3. Avci S, Sayli U. Lateral premalleolar bursitis as a result of sitting on the foot. Foot Ankle Int. 2001 ; 22 : 64-66. doi: 10.1007/s00256-017-2577-x 

  4. Park KH, Lee J, Choi WJ, Lee JW. OK-432 sclerotherapy for malleolar bursitis of the ankle. Foot Ankle Int. 2013 ; 34(10) : 1389-1394. doi: 10.1177/1071100713488091 

  5. Choi JH, Lee KT, Lee YK, Kim DH, Kim JR, Chung WC, et al. Endoscopic versus open bursectomy of lateral malleolar bursitis. Knee Surg Sports Traumatol Arthrosc. 2012 ; 20(6) : 1205-1208. doi: 10.1007/s00167-011-1581-2 

  6. Woo SH, Kim JS, Son SM, Shin WC. Triamcinolone acetonide injections for lateral malleolar bursitis of the ankle. J Korean Foot Ankle Soc. 2019 ; 23(1) : 12-17. [In Korean] doi: 10.14193/jkfas.2019.23.1.12 

  7. Yuk DI, Kim KM, Jeon JH, Kim YI, Kim JH. A review of trends for acupotomy. The Acupunct. 2014 ; 31(3) : 35-43. [In Korean] doi: 10.13045/acupunct.2014041 

  8. Jun SA, Park MS, Oh SJ, Lee JH, Gong HM, Choi SH, et al. Efficacy and safety of miniscalpel acupuncture in knee degenerative osteoarthritis patients: a study protocol for a randomized controlled pilot trial. Korean J Acupunct. 2016 ; 33(2) : 67-74. doi: 10.14406/acu.2016.010 

  9. Yoon SH, Kwon CY, Leem J. Adverse events of miniscalpel-needle treatment in Korea: A systematic review. European Journal of Integrative Medicine. 2019 ; 27 : 7-17. doi: 10.1016/j.eujim.2019.02.002 

  10. Kwon CY, Yoon SH, Lee B. Clinical effectiveness and safety of acupotomy: An overview of systematic reviews. Complementary Therapies in Clinical Practice. 2019 ; 36 : 142-152. doi: 10.1016/j.ctcp.2019.07.002 

  11. Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, et al. New guidelines to evaluate the response to treatment in solid tumors. J Natl Cancer Inst. 2000 ; 92(3) : 205-216. doi: 10.1093/jnci/92.3.205 

  12. Lee HJ, Lee SS, Lee YH. The study of pain and functional disability scales for low back pain. J Korean Acupunct Moxib Soc. 2002 ; 19(2) : 137-148. [In Korean] (no doi) 

  13. Treg DB, Thomas EV, Lyle JM. Malleolar bursitis in figure skaters: indications for operative and nonoperative treatment. Am J Sports Med. 2000 ; 28(1) : 109-111. doi: 10.1177/03635465000280010301 

  14. Jang HS, Choi HJ. Surgery for synovial fistula after excision of the lateral malleolar bursitis of the ankle: a case report. J Korean Foot Ankle Soc. 2015 ; 19(3) : 118-121. [In Korean] doi: 10.14193/jkfas.2015.19.3.11 

  15. Hashimoto I, Yoshinaga R, Toda M, Nakanishi H. Intractable malleolar bursitis treated with lateral calcaneal artery adipofascial flap. Br J Plast Surg. 2003 ; 56(7) : 701-703. doi: 10.1016/S0007-1226(03)00363-1 

  16. Nichols AW. Complications associated with the use of corticosteroids in the treatment of athletic injuries. Clin J Sport Med. 2005 ; 15(5) : 370-375. doi: 10.1097/01.jsm.0000179233.17885.18 

  17. Korean Acupuncture & Moxibustion Medicine Society. The Acupuncture and Moxibusition Medicine. 4th edition. Seoul (Korea): Jipmoon. 2012 ; 193 

  18. Kang CS, Yang HM. Acupotomy and Clinic. Seoul (Korea): DAU. 2011 ; 98-112 

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