肋骨の共骨症およびmalunionの手術的管理。症例報告

Operative Management of Rib Synostosis and Malunion: A Case Report.

• Erick M Marigi
• Anthony J Dugarte
• Peter A Cole

抄録

症例:

肋骨非接合、肋骨異所性骨化（HO）による肋骨-肋骨共骨接合、肋骨不和を含む複数の左側肋骨病理を有する56歳男性の複雑な症例を紹介する。大規模な前四肢外傷を受け、保存的管理に失敗した後、肩甲骨再建と肋骨再輪郭形成を行った後、肋骨癒合症の外科的切除、肋骨非接合の再建、肋骨非接合の輪郭形成を行った。この患者は最終手術後1年間臨床的に経過観察され、機能的転帰に著しい改善がみられた。

CASE: We present a complex case of a 56-year-old man with multiple left-sided rib pathology including nonunion, rib heterotopic ossification (HO) forming a rib-to-rib synostosis, and rib malunion. After a major forequarter trauma and failed conservative management, followed by scapula reconstruction and rib recontouring, the surgical resection of the rib synostosis, reconstruction of a rib nonunion, and contouring of rib malunions are described. The patient was followed up clinically for 1 year after the final procedure and demonstrated marked improvement in functional outcome.

結論:

複雑な前四分位のmalunionとnonunionの設定では、痛みを伴う肋骨nonunionとsynostosisの解決は、HO切除と肋骨再建で効果的に管理することができます。

CONCLUSION: In the setting of complex forequarter malunion and nonunion, resolution of painful rib nonunion and synostosis can be effectively managed with HO resection and rib reconstruction.