先天性橈尺骨癒合症の3例

Congenital Radioulnar Synostosis. Report of Three Cases

　先天性橈尺骨癒合症3例に対して橈骨遠位1/3で回旋骨切り術を行い良好な成績を得た．代表症例は8歳の女児で，両側の先天性橈尺骨癒合症であり，右前腕は120°回内位強直，左前腕は中間位強直であった．右前腕に対して手術を行い，術後2年2カ月の現在，右前腕は30°回内位強直である．先天性橈尺骨癒合症に対する手術は授動術と回旋骨切り術に大別される．橈骨遠位での回旋骨切り術は手術手技が容易であり，合併症も少なく優れた方法である．われわれは骨切り後の転位予防のためK-wireによる髄内釘固定を追加している．

　We report three cases of congenital radioulnar synostosis.　All three patients had difficulty writing, holding a rice bowl, and washing their face because of limited supination.　Rotation osteotomy of one third of the radius was performed, and a Kirschner wire was inserted intramedullarly.　The patients were satisfied with results.　There are two methods of treating congenital radioulnar synostosis.　One method consists of a mobilization to increase range of motion, and the other is rotation osteotomy to acquire a more functional position.　We selected rotation osteotomy at distal one third of the radius because the method is relatively simple and safe.　We inserted a Kirschner wire intramedullarly to prevent displacement of the fragments.