多骨性Fibrous Dysplasiaに伴う上腕骨小結節骨折変形治癒に対する骨切り術の１症例

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We report on a case of malunion of the lesser tuberosity after humerus surgical neck fracture with polyostotic fibrous dysplasia which caused limitation of range of motion.<BR>A 38-year old man fell down on a ski slope. Original radiographs and CT showed Neer classification proximal humerus type 3-part fracture with severe displacement of the lesser tuberosity and he was affected with polyostotic fibrous dysplasia. First we had difficulty treating fibrous dysplasia by surgery, we made the choice of non-operative treatment. The facture was healed after seven months, but the limitation of ROM remained. CT showed that there was a malunion of the lesser tuberosity, resulting in limitation of adduction and internal rotation. The lesser tuberosity with subscapularis tendon was osteotomied from the humeral head. The lesser tuberosity was re-attached to its original part of humeral head with pull-out technique where we used the stronger type suture (#2, UltrabradeTM, Smith & Nephew) and processed spider staple (Japan MDM).<BR>Bone defect caused by the resection and curettage of bone tumor was filled with artificial bone paste and β-TCP.<BR>Bone union was obtained within four months. At 6 months follow up, he had returned to work and demonstrated a significant improvement in ROM.<BR>The proximal humerus fractures in bones affected with fibrous dysplasia often don't require operations since they heal without difficulty. But if there is malunion of the lesser tuberosity which causes limitation of range of motion, pull-out technique with the strong type suture and processed spider staple is a useful method.

多骨性Fibrous Dysplasiaに伴う上腕骨小結節骨折変形治癒に対する骨切り術の１症例

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多骨性Fibrous Dysplasiaに伴う上腕骨小結節骨折変形治癒に対する 骨切り術の１症例

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多骨性Fibrous Dysplasiaに伴う上腕骨小結節骨折変形治癒に対する骨切り術の１症例