踵骨アキレス腱付着部裂離骨折の治療経験

Treatment of Avulsion Fractures of the Calcaneus

　アキレス腱付着部踵骨裂離骨折の7例を経験した．年齢は46～83歳（平均61.5歳），男性4例，女性3例であった．受傷原因は転倒4例，転落2例，交通事故1例であった．うち5例を手術的に，2例を保存的に加療した．手術例では3例に術後再転位が，1例に皮膚潰瘍・壊死がみられたがいずれも保存的に経過良好であった．疼痛の残存はなかった．これに対し保存例では2例ともに骨癒合はみられたが疼痛が残存した．術後の再転位ならびに皮膚壊死予防のため正確で確実な整復・固定が必要と考える．

　We report seven cases of avulsion fracture of the calcaneus (four males and three females). The mean age of the patients was 61.5 years (range：46-83 years). The causes of the injury were falls (six cases) and a traffic accident (one case). Surgery was performed in five patients, and two patients were treated conservatively, because they did not wish to undergo surgery. Among the surgical cases, the fragment migrated postoperatively in three patients, and necrosis of the overlying skin developed in one patient. The pain resolved in every patient. Among the non-surgical cases, bone union occurred in every patient, but their complaints of pain persisted. We should choose appropriate methods of surgery and external fixation to prevent from displacement of the fragment and skin necrosis.