末期Kienböck病に合併した伸筋腱皮下断裂の2例

Advanced-Stage Kienböck's Disease Complicated by Rupture of the Extensor Digitorum Tendon : Report of Two Cases

　抄録：Kienböck病に続発した伸筋腱皮下断裂の2例を経験した．症例1は環指伸筋腱断裂を合併したLichtman分類stageⅣでGraner変法および腱移行術を施行した．症例2は環指伸筋腱断裂を合併したLichtman分類stageⅣで月状骨の背側骨片を切除後，腱移行術を施行した．術後両者ともに環指の伸展は可能であり良好な成績が得られた．末期Kienböck病に合併した手指伸筋腱皮下断裂は比較的稀であり，本症の原因として圧潰した月状骨骨片の背側転位および遠位橈尺関節の関節症性変化によるものと考えられた．

　We treated 2 cases of subcutaneous rupture of the extensor tendon secondary to Kienböck's disease. Patient 1 had Lichtman stage-Ⅳ Kienböck's disease complicated by rupture of the extensor tendon in the ring finger. Surgical treatment consisted of the modified Graner procedure and tendon transfer. Patient 2 also had stage-ⅣKienböck's disease complicated by rupture of the extensor tendon in the ring finger, and tendon transfer was performed after extraction of the dorsal lunate bone fragment. In both cases, extension of the ring finger recovered after surgery, and the results of treatment were favorable. Although subcutaneous rupture of extensor tendons in fingers is a relatively rare complication of late Kienböck's disease, it can be caused by dorsal prominent of the dorsal lunate bone piece and arthropathic changes in distal radioulnar joint.