上腕骨顆上部偽関節に低出力超音波治療器とアレンドロネートを併用した1例

Pseudoarthrosis of the Distal End of the Humerus Treated with Low-intensity Pulsed Ultrasound and Alendronate

　上腕骨顆上部の偽関節に対し，低出力超音波治療器とアレンドロネートを併用し骨癒合を得た1例を報告する．症例は78歳，女性である．上腕骨遠位端粉砕骨折を受傷し，観血的骨接合術を施行した．その後骨癒合が得られず，術後6カ月から低出力超音波治療器を開始した．骨粗鬆症による腰痛があり，術後7カ月からアレンドロネート内服を開始した．両者併用1.5カ月で偽関節部に仮骨が認められ，併用8カ月で骨癒合が得られた．低出力超音波治療器とアレンドロネートの併用が，骨粗鬆症のある偽関節に対して有効であったと考えられた．

　We report a case of pseudoarthrosis of the distal humerus treated with low-intensity pulsed ultrasound (LIPUS^®) and alendronate. A fracture in a 78-year-old woman was initially treated with open reduction and internal fixation using two plates on the medial and lateral sides. Six months after surgery, the fracture had not healed, screws had loosened, and a gap appeared in the fracture. LIPUS^® was applied for pseudoarthrosis of the distal humerus and alendronate was used for osteoporosis. Callus formation appeared a few months after starting these treatments, and the fracture healed eight months later. Twenty-two months after starting treatment, metal was removed and solid union was confirmed. We have shown that LIPUS^® with alendronate may be effective in pseudoarthrosis with osteoporosis.