@article{oai:jichi-ir.repo.nii.ac.jp:00000043,
 author = {宗藤, 正理 and 豊田, 明宏},
 journal = {自治医科大学紀要, Jichi Medical University Journal},
 month = {Mar},
 note = {放置された末節骨の骨髄炎の１例を経験した｡症例は17歳の男性，バスケットボールで受傷後右小指爪基部が剥離するも放置｡創が治らないため開業の皮膚科を受診。抗生剤の内服薬，抗生剤入り軟膏の処置を受けていた｡更に近隣の外科医受診後当科を紹介された｡外来で末節骨の骨髄炎と診断｡局麻下に患部を掻爬した｡末節骨は基部と末梢を残す形となり，爪甲を利用して縫合固定，術後入院。二次的な治療も考慮していたが，経過良好，治癒と判定，現在通院もしていない｡
　糖尿病等の合併症が無く，外傷を契機として発症した手指末節骨の化膿性骨髄炎はまれである｡開放創後の感染のほとんどが不適切な初期治療によると考えられる｡幸いなことにこの症例は掻爬後骨癒合した｡若年者はまず十分に骨掻爬して経過を見るのが良いと考えられた｡些細な外傷でも骨髄炎となる可能性を考え，外科系一般臨床医にも初期治療の重要さを認識していただきたい症例であった。, Here we report a case of osteomyelitis of the distal phalanx of the right fifth finger following a basketball injury in a 17-year-old male. The nail was completely separated from its base and then was left untreated.
　The wound did not heal spontaneously, so the patient consulted a dermatologist, who prescribed an oral antibiotic and antibiotic ointment. Next, a surgeon in his neighborhood was seen.
　6 weeks after the injury the patient was seen at our hospital as an ambulatory patient. A diagnosis of osteomyelitis of the distal phalanx of the right fifth finger was made, and curettage of the affected area was performed under local anesthesia. Leaving the base and peripheral part of the injured distal phalanx intact, the tip fixation was accomplished using the original nail. The patient was hospitalized after surgery. A secondary treatment was considered, but healing proceeded more satisfactorily than expected.
　This is a rare case of suppurative osteomyelitis of a distal phalanx of a finger that was triggered only by external injury of a healthy young person having no concurrent complications such as diabetes. The infection of the external wound might have been caused by inadequate primary care. Fortunately, in this case, bone union occurred after curettage.
　For young people, bone curettage should be performed and then progress should be closely monitored. This case clearly demonstrates that even a trifling wound can result in development of osteomyelitis, prompting us to emphasize, especially to surgeons and general clinicians, the importance of appropriate initial treatment.},
 pages = {107--109},
 title = {骨掻爬のみで改善した，放置された小指末節骨骨髄炎の１例},
 volume = {35},
 year = {2013}
}