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Alternative Technique Using Opencast for Early Return to Play after Operation in Patients with Bony Mallet Finger by Sports Injury: A Retrospective Study in a Tertiary Hospital in South Korea
Korean J Sports Med 2024;42:113-118
Published online June 1, 2024;  https://doi.org/10.5763/kjsm.2024.42.2.113
© 2024 The Korean Society of Sports Medicine.

Kyung Ho Lee, Sung Yoon Jung, Ji Woong Kim

Department of Orthopedic Surgery, Dong-A University College of Medicine, Busan, Korea
Correspondence to: Sung Yoon Jung
Department of Orthopedic Surgery, Dong-A University College of Medicine, 32 Daesingongwon-ro, Seo-gu, Busan 49201, Korea
Tel: +82-51-240-2757, Fax: +82-51-254-6757
E-mail: jsyshil2@naver.com
Received December 11, 2023; Revised February 21, 2024; Accepted March 13, 2024.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Purpose: Bony mallet finger is commonly seen in the young sports population, and surgical intervention is often necessary in cases where the joint surface is compromised. After surgical treatment, compliance with wound management tends to be poor and return to sports activities is delayed, resulting in decreased patient satisfaction. Therefore, the authors suggest that early return to sports can be facilitated through the modified Kirschner wire (K-wire) extension block technique and wound management.
Methods: From March 2022 to February 2023, surgical treatment was performed on 24 patients with bony mallet fingers who had closed fractures with more than one-third involvement of the joint surface or subluxation of the distal interphalangeal joint. Surgeries were conducted within 2 weeks of the injury, employing the K-wire extension block technique. At the first outpatient department follow-up after 1 week, suture knots were removed, medical skin adhesive bonds were applied and an opencast was utilized to fix only distal interphalangeal joint allowing for immediate showering and engagement in physical activities.
Results: All patients expressed satisfaction from both functional and cosmetic perspectives and were able to return to sports activities early. According to Crawford evaluation criteria, the results were as follows: excellent in 68.8%, good in 25.0%, and fair in 6.2%. There were no cases of poor outcomes.
Conclusion: In cases where early return to sports activities is desired, the K-wire extension block technique with burying the K-wires beneath the skin and employing opencast can be an alternative method that can facilitate early return to sports.
Keywords : Bony mallet finger, Extension block technique, Phalanx fracture, Opencast
꽌 濡

怨⑥꽦 異붿 怨⑥젅 솢룞쟻씤 젇 뿰졊뿉꽌 留롮씠 諛쒖깮븯硫 理쒓렐 뱾뼱 泥댁쑁 솢룞쑝濡 씤븳 넀긽씠 留롮씠 뒛뼱굹怨 엳떎1,2. 뿬윭 뿰援ъ뿉꽌 닔닠쟻 移섎즺 鍮꾩닔닠쟻 移섎즺 媛꾩뿉 李⑥씠媛 뾾떎怨 蹂닿퀬븯怨 엳쑝굹3 紐낇솗븳 移섎즺쓽 쟻쓳利앹뿉 븳 뿰援ш 異⑸텇븯吏 븡 긽솴씠硫, 뿬윭 뿰援ъ뿉꽌 3遺꾩쓽 1 씠긽쓽 愿젅硫댁쓣 移⑤쾾븯怨 엳嫄곕굹 썝쐞 吏媛 愿젅쓽 븘깉援ш 愿李곕릺뒗 寃쎌슦 닔닠씠 븘슂븯떎怨 蹂닿퀬븯떎4-7.

씠뿉 빐 닔닠쟻 移섎즺瑜 떆뻾븷 寃쎌슦 李쎌긽 愿由ъ뿉 븳 닚쓳룄媛 넂吏 븡 臾몄젣媛 엳떎. 삉븳 젇怨 솢룞쟻씤 솚옄뱾 뒪룷痢 솢룞쑝濡쒖쓽 議곌린 蹂듦瑜 씗留앺븯굹, 怨좎젙릺뼱 엳뒗 Kirschner 媛뺤꽑(K-媛뺤꽑) 諛 李쎌긽, 洹몃━怨 뱶젅떛 젣옱濡 씤빐 씠 李⑥꽌 뵾遺 移⑥뿰(maceration)씠 諛쒖깮븷 닔 엳쑝硫8 깶썙뿉룄 臾몄젣媛 엳뼱 議곌린 蹂듦媛 뼱졄떎. 씠뿉 옄뱾 쇅긽쑝濡 諛쒖깮븳 怨⑥꽦 異붿뿉 빐 2媛쒖쓽 K-媛뺤꽑쓣 씠슜븯뿬 蹂삎븳 뿰빀 K-媛뺤꽑 떊쟾 젣븳踰9쑝濡 닔닠븯怨, K-媛뺤꽑쓣 뵾遺 궡뿉 留ㅻぐ떆궓 뮘 닠 썑 1二쇱씪吏 李쎌긽뿉 쓽猷뚯슜 뵾遺 遊됲빀 蹂몃뱶瑜 궗슜븳 썑 媛쒕갑삎 꽍怨 遺紐(opencast)쓣 씠슜븯뿬 怨좎젙븯떎. 씠濡쒖뜥 利됱떆 뒪룷痢 蹂듦瑜 媛뒫븯寃 븳 醫뗭 寃곌낵瑜 뼸뿀湲곗뿉 臾명뿄쓣 蹂닿퀬븯뒗 諛붿씠떎.

뿰援 諛⑸쾿

1. 뿰援 긽

蹂 뿰援щ뒗 룞븘븰援먮퀝썝 엫긽뿰援 쑄由 떖쓽 쐞썝쉶쓽 듅씤 쓣 諛쏆븯쑝硫(No. DAHIRB-23-214) 뿰援 긽 솚옄뱾쓽 룞쓽瑜 諛쏆븘 썑뼢쟻쑝濡 뿰援ы븯떎. 2022뀈 3썡遺꽣 2023뀈 2썡源뚯 룞븘븰援먮퀝썝쓣 諛⑸Ц븳 怨⑥꽦 異붿 솚옄 以 룓뇙삎 怨⑥젅, 愿젅硫 移⑤쾾씠 3遺꾩쓽 1 씠긽씠嫄곕굹 썝쐞 吏媛 愿젅쓽 븘깉援ш 엳뒗 24紐낆쓽 솚옄뱾뿉 빐 닔닠쟻 移섎즺瑜 떆뻾븯떎. 媛쒕갑꽦 怨⑥젅, 썝쐞 닔吏 愿젅 諛곕쓽 遺덈웾븳 뵾遺 긽깭, 怨좊룄쓽 遺꾩뇙 怨⑥젅, 洹몃━怨 떦눊 벑 쐞뿕 怨좎쐞뿕援곗쓣 젣쇅븯떎. 씠以 뒪룷痢좊줈 씤븳 넀긽씠 16紐낆씠뿀떎(異뺢뎄 10紐, 냽援 4紐, 뵾援 2紐). 닔닠 닔긽 썑 2二 씠궡뿉 떆뻾븯쑝硫 K-媛뺤꽑쓣 씠슜븳 떊쟾 젣븳踰뺤쓣 궗슜븯떎.

2. 諛⑹궗꽑 諛 엫긽 룊媛

紐⑤뱺 솚옄뱾뿉 빐 怨⑥쑀빀源뚯 냼슂맂 떆媛꾩쓣 룊媛븯쑝硫, 6媛쒖썡吏몄뿉 엫긽쟻 룊媛濡 떆媛 븘궇濡쒓렇 泥숇룄(visual analogue scale)瑜 씠슜븯뿬 옍뿬 넻利앹쓣 痢≪젙븯怨 goniometer瑜 씠슜븯뿬 썝쐞 吏媛 愿젅쓽 愿젅 슫룞 踰붿쐞瑜 痢≪젙븳 썑 Crawford criteria濡 룊媛븯떎. 떊쟾 젣븳(extension lag) 썝쐞 吏媛 愿젅씠 뒫룞쟻쑝濡 以묐┰ 쐞移섍퉴吏 떊쟾릺吏 븡 젙룄뿉 빐 痢≪젙븯쑝硫. 援닿끝 젣븳(flexion loss) 嫄댁륫怨 鍮꾧탳븯뿬 痢≪젙븯떎.

3. 닔닠 諛⑸쾿

紐⑤뱺 怨쇱젙 닔吏 떊寃 留덉랬 븯뿉 씠룞떇 諛⑹궗꽑 닾怨 옣鍮꾨 씠슜븯뿬 떆뻾븯떎. 臾닿퇏 냼룆쓣 떆뻾븳 뮘 닔닠슜 옣媛묒쓣 씠슜븳 怨좊Т 吏삁瑜 嫄곗튂븯怨, 留덉랬맂 긽깭뿉꽌 닾떆 옣鍮 븯뿉 썝쐞 吏媛 愿젅쓣 吏곸뿬꽌 怨⑥젅렪씠 吏곸씠뒗吏 솗씤븯떎. 吏곸씠吏 븡뒗 寃쎌슦뿉뒗 怨⑥젅렪쓽 以묒븰 遺쐞濡 떊쟾嫄 痢〓갑 醫낅쭚嫄(lateral end)쓽 넀긽뿉 二쇱쓽븯硫 1.1 mm K-媛뺤꽑쓣 궫엯븯뿬 寃쏀솕맂 怨⑦렪 삉뒗 媛먯엯맂 뿰遺 議곗쭅뿉 빐 냼뙆닠쓣 떆뻾 썑 썝쐞 吏媛 愿젅쓣 吏곸뿬 怨⑥젅렪씠 吏곸씠뒗吏 솗씤븯떎. 씠썑뿉 1.1 mm K-媛뺤꽑쓣 썝쐞 吏媛 愿젅쓣 理쒕븳 寃ъ씤 썑 援닿끝 븳 긽깭濡 옣異 以묒븰 遺쐞뿉꽌 2 mm 젙룄 痢〓뿉꽌 옣異뺤뿉 30° 媛곷룄濡 以묒쐞吏 怨⑤몢뿉 빐 옣痢 뵾吏덇낏쓣 넻怨쇳븷 븣源뚯 궫엯븯떎. 씠썑 2踰덉㎏ K-媛뺤꽑쓣 1踰덉㎏ K-媛뺤꽑怨 쟾썑硫 긽뿉꽌 옣異뺤뿉 移릺뒗 媛곷룄뿉꽌 痢〓 궗吏꾩뿉꽌 룊뻾븯寃 옣痢 뵾吏덇낏쓣 넻怨쇳븯룄濡 궫엯븯떎. 씠썑뿉 썝쐞 吏怨⑥쓣 寃ъ씤븳 긽깭濡 떊쟾븯뿬 2媛쒖쓽 K-媛뺤꽑씠 떊쟾쓣 젣븳븯뒗 빆젰(counterforce)쑝濡 옉슜븯룄濡 븯뿬 怨⑥젅렪씠 젙蹂듬릺룄濡 븯떎. 씠썑뿉 0.9 mm K-媛뺤꽑쓣 痢〓갑 醫낅쭚嫄댁뿉 넀긽릺吏 븡룄濡 二쇱쓽븯硫댁꽌 옣異 以묒븰꽑 遺洹쇱뿉꽌 닔吏곸씤 諛⑺뼢쑝濡 諛뼱 怨⑥젅렪씠 吏곸씠吏 븡룄濡 븯怨 1.1 mm K-媛뺤꽑쓣 怨⑥젅꽑뿉 닔吏곸씠 릺룄濡 怨⑦렪 궡 궫엯븯뿬 옣痢 뵾吏덇낏쓣 넻怨쇳븯룄濡 븯떎. 씠썑뿉 썝쐞 吏媛 愿젅쓣 쟾썑/痢〓㈃ 긽뿉꽌 愿젅硫댁뿉 씪移섑븯寃 젙蹂듭쓣 쑀吏븳 긽깭濡 0.9 mm K-媛뺤꽑쓣 썝쐞 吏怨 泥⑤뿉꽌 옣異뺤쓽 以묒븰 遺쐞瑜 뵲씪꽌 썝쐞 吏媛 愿젅쓣 넻怨쇳븯뿬 以묒쐞 吏怨 洹쇱쐞遺 1/3源뚯 쐞移섑븯룄濡 怨좎젙븯떎(Fig. 1). 씠썑 듅닔븳 젅떒湲(Fig. 2)瑜 씠슜븯뿬 뵾遺 諛묒뿉 븿紐곕릺룄濡 吏㏐쾶 옄瑜닿퀬 옒由 K-媛뺤꽑 쐞뒗 nylon 5-0濡 遊됲빀븳 썑 洹쇱쐞 吏媛 愿젅源뚯 븣猷⑤몃뒆 遺紐⑹쓣 씠슜븯뿬 怨좎젙븯떎.

Fig. 1. (A) Release soft tissue with fracture gap site using Kirschner wire (K-wire). (B) Fix the two K-wires to the dorsal side maintaining the distal interphalangeal (DIP) joint at 90°. (C) Extend the DIP joint, compress the bone fragment using a pin, and then fix the bone fragment using a K-wire. (D) The K-wire is passed through and fixed to the middle phalanx while the DIP joint is extended.

Fig. 2. Kirschner wire (K-wire) cutter (empty). (B) K-wire cutter with K-wire.

4. 닔닠 썑 泥섏튂

1二 씠썑뿉 쇅옒 諛⑸Ц 떆 遊됲빀궗 젣嫄 諛 쓽猷뚯슜 뵾遺 遊됲빀 蹂몃뱶濡 援먯껜 썑 媛쒕갑삎 遺紐⑹쓣 씠슜븯뿬 썝쐞 吏媛 愿젅留 怨좎젙맂 긽깭濡 援먯껜븯怨 怨㏓컮濡 뒪룷痢 솢룞쑝濡 蹂듦븯쑝硫 媛쒕갑삎 遺紐⑹쓣 李⑹슜븳 긽깭濡 깶썙룄 뿀슜븯떎. 씠썑 醫낆갹씠 媛먯냼븯硫댁꽌 媛쒕갑삎 遺紐⑹씠 뿉嫄곗썙吏 닔 엳湲곗뿉 1二쇱씪 媛꾧꺽쑝濡 쇅옒 異붿떆瑜 븯硫 愿李고븯怨, 媛 6–7二 寃쎌뿉 떒닚 諛⑹궗꽑 궗吏꾩긽뿉꽌 怨⑥냼二쇨 뿰寃곕맂 냼寃ъ씠 愿李곕릺硫 怨⑥젅 遺쐞쓽 븬넻씠 궗씪議뚯쓣 븣 젣嫄곗닠쓣 떆뻾븯떎. 堉 諛뽰쑝濡 吏㏐쾶 굹 엳뼱 닔닠떎뿉꽌 젣嫄고븯떎. 씠썑뿉 쓣 젣嫄고븳 遺쐞뒗 쓽猷뚯슜 뵾遺 遊됲빀 蹂몃뱶瑜 諛붾Ⅴ怨 李쎌긽 븞젙솕瑜 쐞빐 1二쇨컙 媛쒕갑삎 遺紐⑹쓣 異붽濡 李⑹슜븳 뮘 젣嫄고븯怨 愿젅 슫룞쓣 떆옉븯떎.

寃 怨

紐⑤뱺 솚옄뿉꽌 怨⑥쑀빀쓣 뼸쓣 닔 엳뿀쑝硫 怨⑥쑀빀源뚯 냼슂맂 湲곌컙 룊洹 6.2二(踰붿쐞, 5–8二)떎. 2삁뿉꽌 긽諛 뵾遺뿉 몴옱꽦 媛먯뿼씠 諛쒖깮븯뒗뜲, 1삁뒗 닠 썑 12씪吏몄뿉, 떎瑜 1삁뒗 닠 썑 16씪吏몄뿉 몴옱꽦 媛먯뿼씠 굹궗떎. 2삁 紐⑤몢 씪二쇱씪媛 븘紐⑹떆떎由 怨꾩뿴 寃쎄뎄 빆깮젣 蹂듭슜 諛 씪二쇱씪뿉 2쉶 룷鍮꾨룉-븘씠삤뵖 諛 빆깮젣 뿰怨좊 룄룷븯뒗 뱶젅떛쑝濡 쉶蹂듬릺뿀떎. 2삁 紐⑤몢 썝쐞 吏媛 愿젅쓽 젣븳씠 엳뿀쑝굹 6媛쒖썡 吏몄뿉뒗 1삁뿉꽌 20° 媛웾쓽 援닿끝 젣븳씠 엳뿀뜕 寃 쇅뿉뒗 紐⑤몢 쉶蹂듯븯떎.

紐⑤뱺 솚옄뒗 湲곕뒫쟻, 誘몄슜쟻 痢〓㈃뿉꽌 留뚯”븯怨 議곌린뿉 뒪룷痢 솢룞쑝濡 蹂듦븷 닔 엳뿀떎. Crawford쓽 룊媛 湲곗뿉 쓽嫄고븯뿬 븘二 留뚯”(excellent)씠 68.8%, 留뚯”(good)씠 25.0%, 醫뗭쓬(fair)씠 6.2%떎. 遺덈웾 뾾뿀떎(Table 1).

Table 1 . A summary of 16 cases

Case No.SexAge (yr)Mechanism of injuryPeriod to radiologic union (wk)Residual pain*Extension lag (°)Flexion loss (°)OutcomeComplication
1Male21Soccer6000ExcellentNone
2Male23Soccer5000ExcellentNone
3Male20Soccer5000ExcellentNone
4Male17Basketball5000ExcellentNone
5Male30Soccer7000GoodNone
6Female14Dodgeball6050GoodNone
7Male32Basketball7000ExcellentNone
8Male26Soccer8050GoodNone
9Male34Soccer5000ExcellentNone
10Male38Basketball6000ExcellentNone
11Male20Soccer6000ExcellentPin site superficial infection
12Female16Dodgeball7050GoodNone
13Male22Basketball6000ExcellentNone
14Male23Soccer7050GoodPin site superficial infection
15Male21Soccer5000ExcellentNone
16Male22Soccer8000ExcellentNone

*Visual analogue scale, Crawford evaluation criteria.



1. Case No. 4

17꽭 궓옄 솚옄媛 냽援ы븯뜕 以 醫뚯륫 2踰덉㎏ 넀媛씫쓣 떎爾먯꽌 궡썝븯떎. 珥덇린 諛⑹궗꽑 궗吏꾩긽뿉꽌 醫뚯륫 젣2닔吏 썝쐞 吏怨 湲곗遺 40% 愿젅硫 移⑤쾾쓣 룞諛섑븳 怨⑥꽦 異붿 냼寃ъ씠 愿李곕릺뼱 3씪 뮘 닔닠쓣 떆뻾븯떎. 2媛쒖쓽 諛곗륫 젣븳 K-媛뺤꽑쓣 씠슜븯뿬 젙蹂듭쓣 쑀吏븳 뮘 怨⑥젅硫댁뿉 닔吏곸씠 릺寃 K-媛뺤꽑 1媛쒕 異붽濡 궫엯븯怨 썝쐞 吏怨 泥⑤뿉꽌 썝쐞 吏媛 愿젅쓣 넻怨쇳븯룄濡 옣異뺤쓣 뵲씪 K-媛뺤꽑 1媛쒕 뜑 怨좎젙븯떎. 젅떒湲곕줈 K-媛뺤꽑쓣 吏㏐쾶 옄瑜닿퀬 뵾遺 븘옒뿉 븿紐곕릺룄濡 븳 썑 nylon 5-0瑜 씠슜븯뿬 遊됲빀븯떎. 1二 씠썑 媛쒕갑삎 遺紐⑹쑝濡 援먯껜븯쑝硫 6二쇱㎏뿉 怨⑥쑀빀 냼寃ъ씠 愿李곕릺뼱 젣嫄곗닠쓣 떆뻾븯떎(Fig. 3).

Fig. 3. (A) Initial lateral radiograph. (B) Intraoperative clinical image. (C) Postoperative lateral radiograph. (D) Opencast application at the first outpatient department follow-up after 1 week. (E) Postoperative 6-week lateral radiograph shows radiologic union.
怨 李

怨⑥꽦 異붿뒗 썝쐞 吏젅 愿젅뿉꽌 쇅긽쑝濡 씤븳 怨쇱떊쟾 삉뒗 怨쇨뎬怨 湲곗쟾쑝濡 씤븯뿬 썝쐞 닔吏 諛곕媛 寃ъ뿴 怨⑥젅맖쑝濡쒖뜥 썝쐞 吏젅 愿젅쓽 뒫룞쟻 떊쟾 湲곕뒫씠 냼떎맂 긽깭瑜 留먰븳떎. 떊쟾 寃곗넀뿉 쁺뼢쓣 二쇰뒗 삁썑씤옄瑜 遺꾩꽍븳 蹂닿퀬뿉 뵲瑜대㈃ 愿젅硫댁쓽 移⑤쾾 젙룄 怨⑦렪쓽 겕湲곌 옉쓣닔濡 떊쟾 吏뿰씠 諛쒖깮븷 媛뒫꽦씠 넂떎怨 븯떎10.

씪諛섏쟻쑝濡 愿젅硫댁쓽 1/3 씠븯瑜 移⑤쾾븳 怨⑥젅쓽 寃쎌슦 썝쐞吏 愿젅쓣 怨쇱떊쟾븳 긽깭濡 遺紐 怨좎젙쓣 빟 6–8二쇨컙 떆뻾븯뒗 蹂댁〈쟻씤 諛⑸쾿쑝濡 移섎즺븷 닔 엳쑝굹, 겙 怨⑦렪씠굹 깉援щ 룞諛섑븳 怨⑥젅쓽 寃쎌슦 異붿떆 以묒뿉 蹂삎씠굹 룞넻쓽 썝씤씠 맆 닔 엳떎11. Stern怨 Kastrup12 蹂댁〈쟻 移섎즺瑜 떆뻾븳 84삁 以 39삁(45%)뿉꽌 뵾遺 沅ㅼ뼇, 移⑥뿰, 뵾遺 븣윭吏 벑쓽 뵾遺 愿젴 빀蹂묒쬆씠 諛쒖깮뻽떎怨 蹂닿퀬븯떎.

留앹튂 닔吏 怨⑥젅쓽 닔닠 怨쇱젙뿉꽌 愿젅硫댁쓣 留욎텛뼱 二쇰뒗 寃껋씠 以묒슂븳 泥 踰덉㎏ 씠쑀뒗 愿젅 硫댁쓽 씪移섎룄(congruency)瑜 넂뿬 愿젅 蹂삎 諛 諛깆“ 紐 蹂삎쓣 理쒖냼솕븷 닔 엳湲 븣臾몄씠硫, 몢 踰덉㎏뒗 怨⑥젅렪쓽 겕湲곗 臾닿븯寃 愿젅硫댁쓣 씪移섏떆耳쒖빞 怨⑥젅 遺쐞쓽 젒珥 硫댁쟻씠 꼻뼱吏怨 鍮좊Ⅸ 쑀빀씠 媛뒫븯湲 븣臾몄씠떎13. 닔닠쟻 移섎즺 諛⑸쾿쑝濡쒕뒗 愿삁쟻 諛⑸쾿쑝濡 怨⑥젅렪쓽 K-媛뺤꽑 怨좎젙닠14-17, 븬諛 怨좎젙닠18, 굹궗 怨좎젙닠19, 怨⑥닔媛뺣궡 媛뺤꽑 怨좎젙닠, 寃ъ씤 泥좎궗 슂踰뺤쓣 씠슜븳 怨좎젙닠20, 8옄삎 湲댁옣 媛뺤꽑쓣 씠슜븳 怨좎젙닠21, pull-out 遊됲빀닠22, pull-in 遊됲빀닠23, Hook 湲덉냽뙋 怨좎젙닠24 벑씠 엳怨, 鍮꾧삁쟻 諛⑸쾿쑝濡 蹂삎맂 떊쟾 젣븳 K-媛뺤꽑 怨좎젙닠25-27怨 umbrella handle technique28씠 엳떎. 1997뀈 Ishiguro 벑29씠 떊쟾 젣븳踰뺤쓣 씠슜븳 怨⑥꽦 異붿쓽 鍮꾧삁쟻 닔닠諛⑸쾿쓣 냼媛쒗븳 씠썑 씠瑜 씠슜븳 移섎즺媛 꼸由 뻾빐吏怨 엳떎. 씠뒗 닠湲곌 媛꾨떒븯怨, 怨⑥젅遺瑜 끂異쒗븯吏 븡븘 엫긽쟻 寃곌낵媛 슦닔븯硫, 썝쐞 吏怨 븘깉援щ 젙蹂듯븷 닔 엳떎. 삉븳 떊쟾 諛⑹ 媛뺤꽑뿉 쓽븳 媛꾩젒쟻씤 젙蹂 쑀吏30濡 怨⑦렪쓽 뙆떒씠 쟻寃 諛쒖깮븯怨, 닠 썑 씤젒 愿젅쓽 슫룞쓣 뿀슜븷 닔 엳뒗 벑쓽 옣젏씠 엳떎.

湲곗〈쓽 Ishiguro technique 븯굹瑜 怨좎젙븯怨 썝쐞 吏媛 愿젅쓣 援닿끝떆궎湲 븣臾몄뿉 떊쟾 寃곗넀씠 諛쒖깮븷 媛뒫꽦씠 넂쑝硫, 븯굹留뚯쑝濡 諛곗륫 怨⑦렪쓣 븬諛뺥븯寃 릺뼱 諛곗륫 怨⑦렪쓽 겕湲곌 겕嫄곕굹 쟾쐞릺뼱 엳嫄곕굹 怨⑦렪씠 렪痢≪쑝濡 쉶쟾븳 寃쎌슦 젙蹂듭씠 옒 릺吏 븡뒗 寃쎌슦媛 留롮븘, 씠瑜 洹밸났븯怨좎옄 18寃뚯씠吏 二쇱궗 諛붾뒛쓣 씠슜븳 젙蹂 쑀吏踰뺤씠굹 2媛쒖쓽 諛곗륫 K-媛뺤꽑쓣 씠슜븳 젙蹂듬쾿룄 냼媛쒕릺뿀떎5,31.

洹몃윭굹 K-媛뺤꽑쓣 닔닠 5–6二 썑뿉 젣嫄고븯뒗 寃껋씠 蹂댄렪쟻씠硫, K-媛뺤꽑쓣 옣湲곌컙 뵾遺 諛뽰뿉 嫄곗튂븳 寃쎌슦 뵾遺 議곗쭅 넀긽, 媛먯뿼 벑쓽 빀蹂묒쬆씠 留롮씠 蹂닿퀬릺怨 엳떎5. 삉븳 뵾遺 諛뽰뿉 엳뒗 K-媛뺤꽑뿉 븳 뱶젅떛 젣옱 븣猷⑤몃뒆 遺紐⑹쑝濡 씤빐 씠 留롮씠 굹 뵾遺媛 移⑥뿰맆 닔 엳뼱 議곌린뿉 뒪룷痢 솢룞뿉 蹂듦븯湲곌 뼱졄떎.

씠뿉 옄뱾 뻼 K-媛뺤꽑쓣 씠슜븯뿬 젙蹂듭쓣 떆뻾븳 썑 뵾遺뿉 留ㅻぐ븯怨, 異붿떆 1二쇱씪吏 媛쒕갑삎 꽍怨 遺紐⑹쓣 떆뻾븯뿬 뵾遺 빀蹂묒쬆씠 媛먯냼븿 臾쇰줎 Crawford 룊媛뿉꽌 슦닔븳 寃곌낵瑜 뼸쓣 닔 엳뿀떎. 긽泥섎 돺寃 꽭泥숉븷 닔 엳뼱 뒪룷痢 솢룞쑝濡쒖쓽 蹂듦 삉븳 븵떦湲 닔 엳뿀떎. 씠踰 뿰援ъ쓽 쓽쓽뒗 怨⑥꽦 異붿뿉꽌 떊쟾 젣븳 K-媛뺤꽑 怨좎젙닠쓣 떆뻾븯怨 怨좎떇쟻씤 泥섏튂媛 븘땶 媛뺤꽑쓣 뵾遺궡 留ㅻぐ븯怨 媛쒕갑삎 遺紐⑷퀬젙쓣 떆뻾븿쑝濡쒖뜥 뒪룷痢 솢룞 씤援ъ쓽 넂 뒪룷痢 슂援щ룄瑜 異⑹”떆궎湲곗뿉 醫뗭 諛⑸쾿씠씪怨 깮媛곷맂떎. 蹂 뿰援ъ쓽 젣븳젏쑝濡쒕뒗 (1) 鍮꾧탳쟻 쟻 닔쓽 솚옄뱾쓣 긽쑝濡 븯怨, (2) 湲곗〈 닠떇怨쇱쓽 議곌뎔 뿰援щ 넻븳 鍮꾧탳媛 뾾뿀怨, (3) 옣湲곌컙쓽 異붿떆 愿李곗쓽 遺議깊븯쑝硫, (4) K-媛뺤꽑쓣 뵾遺 諛묒뿉 븿紐고븯湲 쐞빐 吏㏐쾶 옒씪 쇅옒뿉꽌 젣嫄고븯湲곌 뼱졄怨 떎떆 닔닠쓣 빐빞 븳떎뒗 떒젏씠 엳떎.

닔닠쟻 泥섏튂媛 븘슂븳 怨⑥꽦 異붿 솚옄뿉꽌 떊쟾 젣븳 K-媛뺤꽑 怨좎젙닠 썑 젙솗븳 빐遺븰쟻 젙蹂듭쓣 떆뻾븷 닔 엳쑝硫 議곌린뿉 뒪룷痢 솢룞쑝濡 蹂듦瑜 썝븯뒗 寃쎌슦 K-媛뺤꽑쓣 뵾遺뿉 留ㅻぐ븯怨 媛쒕갑삎 遺紐⑹쓣 씠슜븯뒗 寃껋 議곌린 蹂듦瑜 媛뒫븯寃 븯뒗 븞씠 맆 닔 엳떎.

Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Author Contributions

Conceptualization, Methodology, Project administration, Resou-rces, Software, Supervision, Validation, Visualization: KHL, SYJ. Data curation, Formal analysis, Investigation: all authors.

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