舟状骨結節部偽関節の2例

Nonunion of the Scaphoid Tubercle. Report of Two Cases

　舟状骨結節部は血流が豊富で，骨癒合が得られやすいとされる．今回，観血的治療を要した舟状骨結節部偽関節の2症例を経験したので報告する．2例とも初期治療を受けておらず，それぞれ受傷後4カ月，2年で疼痛が残存するため手術療法を選択した．骨片が大きく，また舟状大菱形骨関節面を含むため，骨片切除ではなく骨接合術を行った．1例目は海綿骨移植を併用したが，2例目は骨移植をしなかった．2例とも骨癒合が得られ，術前の症状は軽快した．

　Fractures of the scaphoid tubercle usually heal uneventfully.　We report 2 cases of scaphoid tubercle pseudarthrosis that required surgical treatment.　Neither fracture was immobilized at the time of the injury, and the patients' pain persisted for four months and for 2 years, respectively.　Osteosynthesis was selected instead of resection of the fragment, because the tubercle fragment was quite large and contained the scaphotrapezium joint surface.　Autologous cancellous bone was grafted in the first case, but bone grafting was not performed in the second case.　Bone union was achieved in both cases, and the clinical results were satisfactory.