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低リン血症性ビタミンD抵抗性くる病(X-linked hypophosphatemic rickets:以下XLH)は,わが国で最も頻度の高いくる病である.われわれは,XLHに合併したGarden分類でStage Ⅲの大腿骨頚部病的骨折に対し,観血的骨接合術を行った1例を経験した.症例は42歳の女性である.軽微な外傷後から左股関節痛を自覚して,当科を受診した.血液生化学検査と画像所見から,XLHに伴った大腿骨頚部病的骨折と診断した.活性型ビタミンD3投与による低リン血症の補正後に,コンプレッションヒップスクリュー(compression hip screw:CHS)による骨接合術を行い,術後7カ月の時点で骨癒合が得られた.術後3年の時点では,骨頭壊死や新たな骨折の発生も認められず,経過良好である.
X-linked hypophosphatemic rickets (XLH) is the most frequent type of rickets in Japan. We report a case of pathological femoral neck fracture that (Garden classification stage Ⅲ) secondary to XLH that was treated surgically with compression hip screws (CHSs). The patient was a 42-year-old female. Her chief complaint was persistent pain in the left hip after a minor injury. Her diagnosis of femoral neck fracture complicating with XLH was made on the basis of the blood biochemistry and radiological findings. Fracture union required seven months. No femoral head necrosis or new fractures have occurred during the three years of follow-up.
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