妊婦一過性大腿骨頭萎縮症で骨頭下骨折を生じた1例

Femoral Subcapital Fracture Associated with Transient Osteoporosis of the Hip in Pregnancy. Case Report

　一過性大腿骨頭骨萎縮症（TOH）で骨頭下骨折を生じた1例を報告する．症例は33歳の女性．左股関節痛で妊娠35週に当科を初診した．TOHを疑ったが，妊娠中でありX線検査を施行せず経過観察とした．妊娠39週時に転倒し，当院に搬送された．X線像で左大腿骨骨頭下骨折および大腿骨頭の骨萎縮を認めた．受傷翌日に帝王切開術を施行した．さらに翌日，骨接合術を施行した．術後7カ月の現在，疼痛なく独歩可能である．X線像上骨癒合し，骨萎縮も改善している．TOHの疑いが強いときは，X線検査により診断を確定させ，骨折の危険性を考え安静入院も考慮すべきである．

　We report the case of a 33-year-old expectant woman who suffered a femoral subcapital fracture associated with transient osteoporosis. She first reported left coxalgia in her 35th week of pregnancy, but did not undergo X ray imaging because of pregnancy. We suspected transient osteoporosis and ordered rest and observation. She fell in her 39th week of pregnancy and incurred a left femoral subcapital fracture. Caesarean section was conducted the day after injury and osteosynthesis for the injury two days later. Seven months after surgery, she has no coxalgia and can walk. We suggest that if transient osteoporosis of the hip is strongly suspected, Xray and diagosis be undertaken. We recommend hospitalzation for rest because of the considerable fracture risk.