経皮的骨穿孔術が奏効した足舟状骨疲労骨折の1例

Stress Fracture of Tarsal Navicular Treated by Percutaneous Drilling : Case Report

　抄録：比較的稀な足舟状骨疲労骨折に対して，経皮的骨穿孔術が奏効した症例を経験した．症例は14歳，女性のバスケットボール部員で右足背部痛を主訴として来院した．発症から初診までの期間は約2カ月で，単純X線像では診断は困難であったが，病歴，圧痛点から舟状骨疲労骨折を疑い，CTで診断を確定した．約6週間の保存的治療によっても症状は改善しなかったため，経皮的骨穿孔術を施行し良好な結果が得られた．短期間の治療により早期にスポーツ復帰を望む若年スポーツ選手において，低侵襲である経皮的骨穿孔術は舟状骨疲労骨折においても有効な手段と思われた．患者の年齢や競技レベル，骨折型を十分考慮したうえで治療法を選択することが肝要である．

　We experienced a case that percutaneous drilling was useful for uncommon stress fracture of tarsal navicular. The patient was 14 years old and a member of female basketball club, complained of pain on her dorsum of right foot. Interval between the onset and initial diagnosis ranged about 2months. Diagnosis by routine radiographs was difficult but we suspected stress fracture of tarsal navicular from clinical history and pressure spot, we confirmed diagnosis by computerized tomography. Because foot pain was not improved by conservative treatment for about 6 weeks, she was treated by percutaneous drilling. The result of treatment was good. For the youth sports player who expected to return sports activity by a treatment of a short term, we think that the low aggressive percutaneous drilling is one of the useful procedure for stress fracture of tarsal navicular. It is important to choose appropriate treatment by the fracture type, patient's age and competition level.