高校野球選手に発生した肩甲関節窩離断性骨軟骨炎の1例

Osteochondritis Dissecans of the Glenoid Cavity in a High-school Baseball Player. Case Report

　症例は17歳，男性で，右肩投球時痛を主訴に来院した．肩甲関節窩離断性骨軟骨炎と診断した．野球への早期復帰を希望し手術を行った．関節鏡視では，関節窩中央に軟骨딵離を認め，吸収性ピンで軟骨片を固定した．再鏡視では軟骨片は固定されておらず，これを切除した．その後，投球時痛は消失し，野球に復帰した．本症例では外傷歴がなく，関節面に限局した病変であり，離断性骨軟骨炎と診断した．早期の競技復帰を望む症例に対しては，軟骨片切除は効果的な治療法である．しかし，将来的には変形性関節症の発生が危惧される．

　A 17-year-old male high school baseball player complained of shoulder pain, when he threw the ball and a diagnosis of osteochondritis dissecans (OCD) of the glenoid cavity was made. Surgery was chosen as the method of treatment, because he wanted to return to baseball as soon as possible. Arthroscopy revealed flap-like cartilage avulsion in the center of the glenoid cavity. The fragment was fixed with two absorptive pins, but second-look arthroscopy revealed that the fragment had absorbable not healed, and it was removed. At present he is free of throwing pain and has returned to baseball. Since there had been no traumatic episodes and the lesion was localized, this case was diagnosed as OCD. Resection of flap-like cartilage fragments is an optional procedure for athletes who want to return to their sport immediately, but it may lead to degenerative osteoarthrosis of the shoulder.