骨系統疾患に合併した環指MP関節ロッキングの1例

Locking of the Metacarpophalangeal Joint of the Ring Finger in a Patient with Skeletal Dysplasia : Case Report

　抄録：骨系統疾患に合併した右環指MP関節ロッキングの1例を経験したので報告する．症例は，28歳，男性，主訴は右環指MP関節伸展障害である．物を握った際，環指MP関節のロッキングが出現，徒手整復にて解除されるも，その後もロッキングを数回繰り返したため，手術治療を行った．中手骨頭の骨棘と副靱帯を切除し，ロッキングは解除された．術後，若干のMP関節拘縮を認めるが，ロッキングの再発はない．われわれの渉猟し得た218例のMP関節ロッキング中，環指は16例と稀で，また骨系統疾患合併例は自験例が最初である．

　We report a rare case of locking of the metacarpophalangeal joint of the ring finger. The patient was a 28-year-old man with skeletal dysplasia who complained of loss of extension of the metacarpophalangeal joint of his right ring finger. The locking occurred during a gripping action. Gentle manipulation under local anesthesia was successful in releasing the locked joint, but locking recurred several times and was finally treated surgically. An ulnar accessory ligament was found to have caught on an osteophyte on the ulnar aspect of metacarpal head. Resection of the ligament and the osteophyte restored the normal range of extension. Mild contracture of the metacarpophalangeal joint developed postoperatively, but there have been no recurrences of the locking. The ring finger has only been no involved in 16 of the 218 cases of locking of metacarpophalangeal joints described in the literature, and this is the first case ever reported in a patient with skeletal dysplasia.