大腿骨内側顆からの血管柄付き遊離骨移植と筋間中隔を用いて再建したSideswipe injuryの1例

抄録

　A 55-year-old man sustained a right elbow sideswipe injury in a car accident, resulting in loss of the lateral collateral ligament (LCL) , extensor tendons, and the bony origin of the LCL. Emergency debridement and negative-pressure wound therapy were performed on the day of injury, followed by delayed reconstruction. A vascularized bone graft, a cancellous bone block, and the intermuscular septum were harvested from the medial femoral condyle. The cancellous and vascularized bones were used to sandwich the septum, which was interposed under tension at the lateral epicondyle to reconstruct the origin of the LCL. Active range-of-motion exercises began four weeks postoperatively. Bone union was achieved within three months. At final follow-up, the patient achieved elbow extension to –15°, flexion to 130°, supination to 90°, pronation to 75°, and grip strength of 36 kg, without instability on stress radiography or donor site complaints. This case demonstrates that a vascularized bone graft combined with a cancellous bone block can effectively reconstruct the origin of the LCL in elbow sideswipe injuries. Vascularized grafts may reduce the risk of bone resorption and nonunion in blind-ended bone defects, contributing to stable and functional recovery.