手根骨に囊腫状陰影を来した5例

Cystic Lesion in Carpal Bones

　手根骨に囊腫状陰影を認めた5例を経験した．有痛性の4例は疼痛の改善を目的に，無症状の1例は病的骨折の予防を目的として，掻爬骨移植術を施行した．術中に骨囊腫内から採取した組織と手術成績について調査した．採取した組織の病理所見は，線維組織が3骨，粘液が2骨，滑膜組織が1骨であった．手術施行側の手関節痛は，4例では消失し，1例では改善した．術後の囊腫状陰影は，2例では消失し，3例では一部残存した．有痛性のものには掻爬骨移植術が有効であり，無症状でも病的骨折の危険があるものには手術を検討すべきである．

　Six cystic lesions in carpal bones of five patients were treated surgically. Five lesions in 5 patients underwent curettage and iliac bone graft to decrease wrist pain in 5 lesions and to decrease a risk of pathological fracture in one lesion. The average follow-up period in these cases was 52.4 months (range, 19-154 months). At the final examination, all but one case were completely free of pain. X-ray showed almost complete obliteration of the cystic lesions in 2 cases and partial healing of the lesions in three. Curettage and iliac bone graft provided satisfactory outcome for cystic lesion in carpal bones. Surgery should be recommended to symptomatic cystic lesion in carpal bones, and care must be taken to prevent pathological fracture of the carpal bone with a large cystic lesion.