橈骨神経断裂を伴った小児上腕骨顆上骨折の1例

Radial Nerve Laceration and Supracondylar Humerus Fracture in a Child. Case Report

　症例は6歳の男児で自宅のソファから転落し，受傷した．前医で橈骨神経麻痺を伴うGartland type Ⅲの上腕骨顆上骨折と診断された．翌日，神経麻痺の改善がみられず，当科に紹介された．観血的整復を行ったところ，橈骨神経の完全断裂を認めた．ワイヤー固定後，橈骨神経は端々縫合を施行した．術後6カ月の時点で骨癒合は良好で，肘関節の可動域制限はない．手関節背屈徒手筋力テスト4と橈骨神経麻痺は回復傾向である．小児上腕骨顆上骨折で転位が大きく，神経の完全麻痺を認める場合は神経断裂の可能性を念頭に置くべきである．

　We report a case of supracondylar humerus fracture and radial nerve laceration.　The patient was a 6-year-old boy who fell off a sofa and was brought to our hospital, where the initial physical examination revealed a supracondylar fracture of the left elbow and complete radial nerve palsy.　At surgery the radial nerve was found to have been completely lacerated at the fracture site, and a primary anastomosis was performed.　At the 6-month postoperative follow-up examination motor function recovery in the form of wrist extension was observed.　The possibility of radial nerve laceration should be kept in mind when a patient presents with a supracondylar fracture and complete radial nerve palsy.