根治的頸部郭清術後に生じた鎖骨疲労骨折の1例

Stress Fracture of the Clavicle Following Radical Neck Dissection:A Case Report

　はじめに

　根治的頸部郭清術後の合併症として皮膚壊死，感染，血腫，リンパ漏，乳糜漏，神経麻痺，胸鎖関節亜脱臼などが知られているが^1），鎖骨骨折までに至る例は少ない。

　今回われわれは，根治的頸部郭清術後に生じた鎖骨疲労骨折の1例を経験したので報告する。

A 58-year-old man with hypopharyngeal cancer was irradiated (61.2Gy/34 days) in October 1993. Approximately 2 years later, in August 1995, lymphnode metastasis was found in his right neck, and a radical neck dissection was performed subsequently. Eight months after the surgery, the patient com-plained of a swelling and pain on the proximal end of his right clavicle. X-ray, CT, and MRI examina-tions revealed fracture in the clavicle. Stress frac-ture in this case was presumably induced by the disruption of the well balanced forces acting on the clavicle due to the resection of sterno-cleido-mas-toid muscle and spinal accessory nerve.