アブストラクト
| Title | 肘関節不安定症 |
|---|---|
| Subtitle | 特集 : 肘関節脱臼・骨折 私の治療法 |
| Authors | 岩部昌平* |
| Authors (kana) | いわぶしょうへい |
| Organization | *済生会宇都宮病院整形外科 |
| Journal | MB Orthopaedics |
| Volume | 34 |
| Number | 6 |
| Page | 49-58 |
| Year/Month | 2021 / 6 |
| Article | 報告 |
| Publisher | 全日本病院出版会 |
| Abstract | [Abstract] 肘関節後外側回旋不安定症(posterolateral rotatory instability; PLRI)は, 橈尺骨が一体で後外側に回旋しながら脱臼・亜脱臼する不安定症で, 外側側副靱帯複合体(lateral collateral ligament complex; LCLC)のうち, 外側尺側側副靱帯(lateral ulnar collateral ligament; LUCL)の損傷により生じるとされている. しかし, バイオメカの実験ではLUCLだけの損傷ではPLRIは生じず, 実際もPLRIと診断されるほとんどの症例はLCLCの上腕付着部の損傷である. 新鮮例では, 手術による修復が推奨される. 陳旧例では, LUCLもしくはLCLC近位部の再建を行う. 肘関節後内側回旋不安定症(posteromedial rotatory instability; PMRI)は, complex elbow instabilityの1つで, 橈尺骨が一体で後内側に回旋しながら亜脱臼する不安定症で, LCLCの損傷と鉤状突起の前内側面の骨折が主な損傷部である. 放置すると早期に関節症となる予後不良の病態であり, 適切な診断と手術治療が必要となる, 鉤状突起前内側面の骨折の診断にはCT撮影が必須である. 後内側回旋不安定性の確認には, ストレス撮影が必要なこともある. 治療は, 手術的に鉤状突起骨折の整復固定とLCLCの修復を行う. |
| Practice | 臨床医学：外科系 |
| Keywords | 肘関節後外側回旋不安定症 (posterolateral rotatory instability; PLRI), 外側側副靱帯複合体 (lateral collateral ligament complex; LCLC), 外側尺側側副靱帯 (lateral ulnar collateral ligament; LUCL), 肘関節後内側回旋不安定症 (posteromedial rotatory instability; PMRI), 鉤状突起骨折 (coronoid process fracture) |
- 全文ダウンロード： 従量制、基本料金制の方共に968円(税込) です。
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