The Journal of Bone and Joint Surgery (Br) 87-B: 1203-1209, 2005 大腿骨転子部不安定性骨折の内固定の補強に用いる生体吸収性セメント前向き無作為多施設共同研究 Resorbable cement for the augmentation of internally-fixed unstable trochanteric fractures A prospective, randomised multicentre study P. Mattsson, MD*, A. Alberts, MD, PhD, G. Dahlberg, MD, M. Sohlman, MD, H.C. Hyldahl, MD, PhD, and S. Larsson, PhD, MD Abstract: 要約： We undertook a multicentre, prospective study of a series of 112 unstable trochanteric fractures in order to evaluate if internal fixation with a sliding screw device combined with augmentation using a calcium phosphate degradable cement (Norian SRS) could improve the clinical, functional and radiological outcome when compared with fractures treated with a sliding screw device alone. Pain, activities of daily living, health status (SF36), the strength of the hip abductor muscles and radiological outcome were analysed. Six weeks after surgery, the patients in the augmented group had significantly lower global and functional pain scores (p < 0.003), less pain after walking 50 feet (p < 0.01), and a better return to the activities of daily living (p < 0.05). At follow-up at six weeks and six months, those in the augmented group showed a significant improvement compared with the control group in the SF36 score. No other significant differences were found between the groups. We conclude that augmentation with calcium phosphate cement in unstable trochanteric fractures provides a modest reduction in pain and a slight improvement in the quality of life during the course of healing when compared with conventional fixation with a sliding screw device alone. 大腿骨転子部不安定性骨折患者 112 例を対象として前向きの多施設共同研究を実施し，分解吸収性リン酸カルシウムセメント（Norian SRS）による補強と sliding screw の併用により内固定術を行った場合，sliding screw のみで治療した骨折例と比較して，臨床的，機能的，X 線学的な成績が向上するか否かを検討した．疼痛，日常生活動作，健康状態（SF-36），股関節外転筋の筋力，X 線学的成績について解析を行った．術後 6 週目では，補強群のほうが，全体的スコアと機，50 フィート歩能的疼痛スコアが有意に低く（p＜0.003）行後の疼痛は少なく（p＜0.01），日常生活動作への復帰状況が良好であった（p＜0.05）．6 週目および 6 ヵ月目の追跡評価において，補強群の SF-36 スコアには対照群よりも有意な改善が認められた．その他の項目については 2 群間で有意差はみられなかった．大腿骨転子部不安定性骨折に対してリン酸カルシウムセメントによる補強を行うと，sliding screw のみを用いる従来の固定術と比較して，骨折治癒の過程で疼痛に軽度の改善と，QOL にわずかな改善が得られると結論できる． *Department of Orthopaedics, Uppsala University Hospital, S-75185 Uppsala, Sweden. Reproduced with permission and copyright of The British Editorial Society of Bone and Joint Surgery [J Bone Joint Surg Br. 2005; 87: 1204]