サッカーで非接触性に発生した股関節脱臼骨折の2症例

Fracture-Dislocation of the Hip in the Absence of Player Contact During a Soccer Game : Report of Two Cases

　抄録：サッカープレー中，他人と接触することなく股関節脱臼骨折を生じた2症例を経験した．症例1：23歳，男性．ドリブル中に誤って空気の抜けかかったボールを踏みつけ足部はその場で静止して，右膝は完全伸展位となり，骨頭骨折を伴う右股関節脱臼となった．症例2：32歳，男性．足部が非常に滑りにくい状況で棒立ちの状態でいたところ，フェイントをかけた相手につられて右へ体重移動した瞬間，相手が左へ方向を変えたため，患者は右への体重移動を止めようと右足でふんばった．この時に臼蓋骨折を伴う右股関節脱臼を生じた．2例とも骨密度は正常範囲内で関節の弛緩性はなかった．類似報告との発生状況の共通点として，①足部ロック，②膝関節完全伸展，③股関節軽度屈曲，があげられ，これらの条件がそろうと容易に股関節脱臼骨折が発生しうると考えられた．

　We report two cases of fracture-dislocation of the hip that occurred during a soccer game in the absence of any contact with other players. (Case 1) A 23-year-old player erroneously trod on an air-leaking ball while dribbling. His right foot was fixed in position, and his right knee was completely extended, when his right hip became dislocated and he sustained a fracture of the femoral head. (Case 2) A 32-year-old player was standing erect with his feet in a stable position. when an opponent dribbler used a feinting tactic, the patient moved his body weight toward the right. At that instant the opponent turned toward left, the patient therefore braced his right leg to stop the shift of his body weight to the right. (That is, when his body weight was shifting to the right, he attempted to change the direction of the weight shift to the left by bracing his right leg.) Then, his right hip became dislocated and an acetabular fracture occurred. The bone density of both patients was within the normal range, and no joint laxity was detected. The characteristics of these two cases shared with similar cases reported in the past were：1）foot locked in position, ：2）knee in full extention, and 3）slight flexion of the hip. These findings suggest that there is a very high risk of fracture-dislocation of the hip occurring when all three of these conditions converge.