臨床整形外科49巻2号

2014年02月発行

臨床経験

Trephineを用いた舟状骨偽関節手術

著者： 畑中均¹ 高崎実¹

所属機関： ¹九州労災病院整形外科

ページ範囲：P.165 - P.171

　背景：舟状骨偽関節に対して楔状骨移植術は広く用いられる術式であるが，手技的には必ずしも容易ではない．Leungらは初めて舟状骨偽関節に対してtrephineを用いた術式を報告した．本調査の目的は，Leungらの術式に小改変を加えて，その術後成績を調査することにあった．

　方法：Trephineを舟状骨偽関節部に存在する瘢痕組織や壊死骨の掻爬および円柱形の移植骨の採取に用いた．Leungらとは異なって，移植骨を腸骨翼ではなく腸骨稜から採取した．

　結果：平均で15カ月の経過観察を行い，DASH score・健側比較力・健側比可動域・Cooney scoreはそれぞれ5点，91％，89％，83点であった．

　まとめ：本調査の結果はLeungらのそれと同等であり，小改変を加えたLeungらの術式は舟状骨偽関節手術に対して有効であることを示している．

参考文献

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