腓骨神経麻痺と膝外側側副靱帯不全を伴った特発性近位𦙾腓関節亜脱臼の1例

Idiopathic Proximal Tibiofibular Joint Subluxation with Peroneal Nerve Palsy and Fibular Collateral Ligament Insufficiency. Case Report

　特発性近位𦙾腓関節亜脱臼に腓骨神経麻痺と外側側副靱帯不全を合併した症例を経験したので報告する．症例は72歳の男性で膝外側の痛みと下腿のしびれ感を主訴に来院した．ストレステストで近位𦙾腓関節前方不安定性および膝外側不安定性がみられた．膝腓骨神経딵離術，腓骨骨幹部骨切り術，近位𦙾腓関節固定術を行い自覚症状は消失した．しかし初回手術で骨癒合が得られず再手術を要した．近位𦙾腓関節固定術においては強固な固定性を得るため固定材料や固定方法，外固定期間などを慎重に検討する必要がある．

　We report a case of idiopathic proximal tibiofibular joint subluxation with peroneal nerve palsy and fibular collateral ligament insufficiency. A 72-year-old man reported lateral knee pain and lateral calf numbness. We conducted peroneal nerve release,fibular diaphysectomy,and proximal tibiofibular arthrodesis with a single screw. The screw loosened early after surgery,however,necessitating additional surgery. In proximal tibiofibular arthrodesis,rigid fixation with multiple screws and prolonged external fixation is essential to achieving joint fusion.