鎖骨遠位端切除を要した化膿性肩鎖関節炎の2例

Septic Arthritis of the Acromioclavicular Joint which Requiring the Distal Clavicle Resection. Report of Two Cases

　保存的治療を行うも改善が認められず，鎖骨遠位端切除を要した化膿性肩鎖関節炎の2例を経験したので報告した．ともに術後1年時点で疼痛は消失し，肩関節の機能障害も認めず経過良好である．本報告の2例は感染鎮静化後も疼痛は残存しており，感染後の軟骨変性が疼痛残存の原因と考えられた．化膿性肩鎖関節炎に対する鎖骨遠位端切除は肩関節機能障害を起こしにくく，初期治療の選択肢として考慮してもよいと考えられた．

　We report 2 cases of septic arthritis of the acromioclavicular joint that we treated by distal clavicle resection, because conservative therapy had not been effective.　At one year postoperatively there was no pain or limitation of the range of motion of the shoulder, and the postoperative course had been satisfactory.　Although the patients' inflammation had improved in response to antibiotic therapy, local incision, and drainage, the distal clavicle was resected because the pain persisted.　We considered cartilage degeneration to be the cause of the persistent pain.　According to previous reports shoulder joint dysfunction is less likely to occur if resection of the distal clavicle is performed to preserve the coracoclavicular ligament.　It was considered taking into account the residual pain due to cartilage degeneration, and may be considered the distal clavicle resection early in septic arthritis of the acromioclavicular joint.