両側の足関節外果に相次いで発生した小児骨端内骨折の1例

Bilateral Intraepiphyseal Injury to the Lateral Malleolus of the Ankle in a Child. Case Report

　骨端線損傷において骨端内に限局した骨折の報告は少ない．今回われわれは骨端内骨折が両側足関節外果に相次いで発生した稀な1例を経験したので報告する．症例は9歳の女児で，サッカーで遊んでいて右足関節外果骨端内骨折を生じ，その1年後に交通事故により左足関節外果にも骨端内骨折を生じた．本骨折はSalter-Harris分類には相当するものがなく，Ogden分類のtype7に該当すると考えられた．転位が軽度であったために両側とも保存的に加療し臨床経過も良好であったが，単純X線上骨癒合が得られにくいという特徴を有した．

　Intraepiphyseal injuries are rare.　We report a case of bilateral intraepiphyseal injury to the lateral malleolus of the ankle.　A 9-year-old girl sustained an intraepiphyseal fracture of the right lateral malleolus while playing soccer, and one year later she sustained the same type of fracture of her left ankle in a traffic accident.　These fractures cannot be classified according to the Salter Harris system, but can be classified as type 7 epiphyseal injuries as described by Ogden.　Because there was no significant displacement, treatment was nonoperative.　The results were excellent, but radiographs showed delayed union.