Scaphocapitate fracture syndromeの1例

Scaphocapitate Fracture Syndrome. Case Report

　症例は19歳，男性．舟状骨，有頭骨骨折を認め，有頭骨近位骨片は約180°回転転位していた．手関節背側より骨折部を展開し，有頭骨骨片を整復し，screw固定を行った．術後7カ月の現在，手関節可動域は良好で日常生活に支障はない．本例は稀な手根部外傷であるが，手関節過伸展時に橈骨背側縁が有頭骨背側に衝突して骨折し，手関節を中間位に戻すと近位骨片が回転転位する機序が考えられている．無腐性壊死や偽関節の予防のためには早期の観血的整復固定が重要であり，長期的には変形性関節症の合併に注意が必要である．

　We report a 19-year-old man with scaphoid and capitate fractures. The proximal fragment of the capitate rotated through 180°. The dorsal wrist was explored to reduce the capitate fracture, followed by screw fixa-tion. As of this writing 7 months after surgery, the range of motion of his wrist is so good that he pursues daily life without disability. The onset of such injury is thought as follows：When the radial dorsal border collides with the capitate dorsal side during hyperextension of the wrist, fractures occur and, when the wrist returns to a neutral position, rotatory translocation of the proximal fragment of the capitate occurs. To prevent avasucular necrosis and pseudoarthrosis, it appears important to make open reduction as soon as possible. Attention must also be paid to osteoarthritis as a complication orer the long term.