高齢者に発生した外傷性胸骨骨折に対して手術的治療を施した1例

Open Reduction and Fixation of a Sternal Fracture in an Elderly Woman. Case Report

　症例は84歳，女性．坂道で転倒して受傷した．遠位骨片が近位骨片前方に乗り上げた胸骨体部横骨折と第4胸椎骨折を認めた．亀背も強く上半身を起こすとさらに骨折部は転位した．胸骨骨折部の不安定性と疼痛に対し，reconstruction plateによる骨接合術および，骨移植術を施行した．術後疼痛は軽快し，2日目でベッド上ギャッジアップが可能となり，7カ月目で骨癒合を認めた．渉猟しえた限り外傷性胸骨骨折の80歳以上の手術報告例はなく，手術による固定は高齢者における早期ADL改善に非常に有効であった．

　We report a rare case of surgical treatment for a sternal fracture in an 84-year-old woman. The patient fell down a slope and subsequently complained of pain in the front and back of her chest. Radiographs showed a sternal fracture in which the lower fragment overlapped forward and a compression fracture of the T 4 vertebra body. The displacement of the fracture gradually increased when she got up. An open reduction and fixation using a reconstruction plate and a bone graft was performed to treat the instability and severe sternal pain. The patient's pain dramatically improved, and she was able to get up after the removal of her chest tube. Fracture union was seen 7months after the surgery. Surgical reduction and fixation of traumatic sternal fractures in patients older than 80 years has not been previously reported. Surgical treatment may be very useful for the early improvement of daily life activities in elderly patients.