踵骨骨折における腓骨筋腱脱臼の合併率―3D-CTを用いた検討

Calcaneal Fracture Combined with Peroneal Tendon Dislocation. A Study Using 3D-CT

　Three-demensional computed tomography(3D-CT)を用いて踵骨骨折に伴う腓骨筋腱脱臼を検討した．踵骨骨折の手術症例43例を対象とし，術前にCTを撮影した．43例中9例に腓骨筋腱脱臼が認められた．機序として，上腓骨筋支帯の断裂や，足関節外果の靱帯付着部の剝離骨折により，腓骨筋腱の前方要素の不安定性を生じて腓骨筋腱脱臼が生じると考えられた．踵骨骨折の治療においては，腓骨筋腱脱臼の合併の有無を検査する必要がある．また，3D-CTは腓骨筋腱脱臼の有無を確認するのに有用である．

　We report a series of cases of peroneal tendon dislocation and calcaneal fracture diagnosed by 3-dimentional computed tomography (3D-CT).　In this study, a total of 43 calcaneal fracture patients were treated surgically after CT examinations, and peroneal tendon dislocation was present in 9 of them.　Rupture of the superior peroneal tendon retinaculum and avulsion fracture of the lateral malleolus of the ankle is likely to have caused instability of the anterior element of the peroneal tendon and resulted in dislocation of the peroneal tendon.　Patients with a calcaneal fracture should be examined for peroneal tendon dislocation.　The results of this study demonstrate that 3D-CT is useful as a means of detecting peroneal tendon dislocation in patients with a calcaneal fracture.