臨床整形外科56巻5号

2021年05月発行

増大号特集 整形外科　外来・当直　エマージェンシーマニュアル 外傷編 前腕—手の外傷

舟状骨骨折／［COLUMN］舟状骨骨折を見逃すな！

著者： 林洸太¹

所属機関： ¹JA山口厚生連小郡第一総合病院整形外科

ページ範囲：P.494 - P.497

舟状骨骨折を疑う事前情報

受傷機転：舟状骨骨折の多くは，スポーツ中(59％)，または手関節背屈位，いわゆるoutstretched handでの転倒(35％)などの低エネルギー損傷によって生じる¹⁾．

疼痛部位・変形：手関節橈側の疼痛と腫脹，手関節伸展負荷による疼痛を主訴とする場合が多い．

参考文献

1) Lee SK. Chapter 16:Fractures of the Carpal Bones. In:Wolfe SW, eds. Green's Operative Hand Surgery 7th ed. Vol.1. Philadelphia:Elsevier;2017, p.588-652.

2) Duckworth A. Chapter 43:Carpal Fractures and Dislocations. In:Tornetta Ⅲ P, eds. Rockwood and Green's Fractures in Adult. 9th ed Vol.1. Philadelphia:Wolters Kluwer Health;2020, p.1591-664.

3) Garala K, Taub NA, Dias JJ. The epidemiology of fractures of the scaphoid:Impact of age, gender, deprivation and seasonality. Bone Joint J 2016;98-B(5):654-9.

4) Parvizi J, Wayman J, Kelly P, et al. Combining the clinical signs improves diagnosis of scaphoid fractures. A prospective study with follow-up. J Hand Surg Br 1998;23(3):324-7.

5) Duckworth AD, Buijze GA, Moran M, et al. Predictors of fracture following suspected injury to the scaphoid. J Bone Joint Surg Br 2012;94(7):961-8.

6) Stevenson JD, Morley D, Srivastava S, et al. Early CT for suspected occult scaphoid fractures. J Hand Surg Eur 2012;37(5):447-51.

7) Rua T, Malhotra B, Vijayanathan S, et al. Clinical and cost implications of using immediate MRI in the management of patients with a suspected scaphoid fracture and negative radiographs results from the SMaRT trial. Bone Joint J 2019;101-B(8):984-94.

8) Doornberg JN, Buijze GA, Ham SJ, et al. Nonoperative treatment for acute scaphoid fractures:A systematic review and meta-analysis of randomized controlled trials. J Trauma 2011;71(4):1073-81.

9) Singh HP, Taub N, Dias JJ. Management of displaced fractures of the waist of the scaphoid:Meta-analyses of comparative studies. Injury 2012;43(6):933-9.

10) Alnaeem H, Aldekhayel S, Kanevsky J, et al. A systematic review and meta-analysis examining the differences between nonsurgical management and percutaneous fixation of minimally and nondisplaced scaphoid fractures. J Hand Surg Am 2016;41(12):1135-44. e1.

11) Dias JJ, Brealey SD, Fairhurst C, et al. Surgery versus cast immobilisation for adults with a bicortical fracture of the scaphoid waist (SWIFFT):A pragmatic, multicentre, open-label, randomised superiority trial. Lancet 2020;396(10248):390-401.

12) Geoghegan JM, Woodruff MJ, Bhatia R, et al. Undisplaced scaphoid waist fractures:is 4 weeks' immobilisation in a below-elbow cast sufficient if a week 4 CT scan suggests fracture union? J Hand Surg Eur 2009;34(5):631-7.