整形外科と災害外科
Online ISSN : 1349-4333
Print ISSN : 0037-1033
ISSN-L : 0037-1033
最悪の経過をたどった放射線骨壊死後の人工関節置換例
猪原 史敏奥江 章熊谷 洋幸高妻 雅和和田 文夫友兼 尚之浅川 康司呉 哲也
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1983 年 31 巻 4 号 p. 851-853

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We experienced a miserable case of postirradiation femoral head necrosis. Osteomyelitis due to a screw penetration into the cecum was followed by total hip replacement.
The patient is a sixty seven years old woman. As she was injured by inoperable uterus cancer at fifty one years old, 60Co irradiation therapy was done. As postirradiation necrosis occured 5 years after irradiation, total hip replacement (Mckee-Farrar type) was done. However, bone necrosis area in iliac bone due to irradiation progressed gradually, and anchoring screw migrated proximally into the cecum. Then the fistel formed at the region of rt. major trochanter. In fistelography, contrast medium leaked out into the cecum. So after iliocecectomy and anastomosis of colon, removal of prosthesis and local continuous suction irrigation was done twice. Since then, there has been no recurrence.

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