小児骨形成不全症にみられた肘頭骨折

Olecranon Fractures in Chidren with Osteogenesis Imperfecta

　小児における肘頭骨折は稀である．今回われわれは，骨形成不全症の小児に発生した肘頭骨端線損傷を経験したので報告した．症例は，2例3骨折，全例女児でSillence分類ではⅠA型であった．骨折型はすべてSalter-Harris Ⅱ型であり，1例は両側骨折であった．治療はすべて観血的（tension band wiring）に行ったが，骨癒合は良好で機能障害を残したものはなかった．骨形成不全症の小児が肘頭骨端線損傷を起こした場合，対側損傷の危険性が高いことから注意が必要である．

　Olecranon fractures are rare in children. We report two case (three fractures) of fracture of the apophysis of the olecranon in chidren with osteogenesis imperfecta. Both patients were girls with a definitive diagnosis of osteogenesis imperfecta type ⅠA. One patient had bilateral fractures, and all of the rediographs showed Salter-Harris type Ⅱ fractures. All three fractures were treated by open reduction and internal fixation (tension band wiring), and good bone union was achieved with no impairment of function. Because of the high rate of bilateral fractures, children with osteogenesis imperfecta who sustain a fracture of the olecranon should be counseled regarding the risk of injury to the opposite side.