若年の長距離走者に発症した転位を伴う大腿骨頚基部疲労骨折の1例

Displaced Basicervical Stress Fracture of the Femoral Neck in an Adolescent Distance Runner. Case Report

　今回われわれは若年の長距離走選手に発症した大腿骨頚基部疲労骨折の稀な症例を経験したので報告する．症例は16歳の男性で，長距離走の練習中に誘引なく左股関節痛が出現し，その4日後，ランニング中に転位を伴う大腿骨頚基部疲労骨折を発症した．受傷2日後に髄内釘による観血的整復術を施行された．骨癒合は得られたが，受傷後1年3カ月の単純X線像で大腿骨頭壊死を認め，骨頭の圧潰が徐々に進行したため，高度後方回転骨切り術を施行した．骨頭の再圧潰は認めず，経過良好である．本症例につき文献的考察を加えて報告する．

　We report a rare case of displaced basicervical stress fracture of the femoral neck in a distance runner.　The patient was a 16-year-old male who engaged in long distance running daily who one day experienced left hip pain while running.　Four days later he experienced sharp pain in his left hip while running and was unable to walk.　Radiographs revealed a displaced basicervical fracture of the femoral neck, and internal fixation was performed two days after he was first examined.　Bone union was achieved one year after operation, but 15 months after operation osteonecrosis was observed in the left femoral head.　Because the femoral head had collapsed, we performed a high-degree posterior rotational osteotomy of the patient's left hip.　No evidence of progression of the collapse sign was observed after the osteotomy.　We review the literature and discuss stress fractures of the femoral neck.