大腿骨頭後方回転骨切り術にて治療した股関節前方脱臼を伴う骨頭陥没骨折の1例

Transtrochanteric Posterior Rotational Osteotomy for Indentation Fracture of the Femoral Head Associated with Anterior Dislocation of Hip Joint : Case Report

　抄録：われわれは股関節前方脱臼に大腿骨頭陥没骨折を合併した1症例を経験した．杉岡式大腿骨頭後方回転骨切り術を行い陥没した骨頭を荷重部分から完全に外した．術後2年にて臨床上股関節痛はなく，股関節単純X線写真，MRIで，骨頭の壊死，関節症変化は出現していない．股関節前方脱臼に大腿骨頭陥没骨折が伴いうることを念頭に置くことは診断上重要である．またその治療として大腿骨頭回転骨切り術は有用な治療法の1つである．

　We report a case of anterior dislocation with a large indentation fracture of the femoral head. We successfully treated it with transtrochanteric posterior rotational osteotomy. A 120 degrees posterior rotation moved the area with the depression to the posterior and completely out of the weight bearing zone. At the 2 year follow-up, neither osteoarthrosis nor a vascular necrosis were observed. Orthopaedic surgeons must be aware of these fractures which occur with anterior dislocation so as to avoid overlooking these severe injuries. This osteotomy could be chosen as an alternative treatment in cases where a large defect is detected in the weight bearing area.