Abstract
Medical care in remote rural areas is becoming a serious issue of concern in Japan. Medical services at Ibuki clinic, located on an isolated island, are provided by part-time doctors of internal medicine and orthopaedic surgery. In this study, we investigated the satisfaction of patients with orthopaedic problems and the characteristics of the patients' disabilities at the clinic. A questionnaire revealed that 23 patients were satisfied with the treatment they had received at the clinic. We analyzed the prevalence rate of musculoskeletal ambulation disability symptom complex, chief complaints, plain roentgenogram, and JOA score of 19 patients who constantly visited the clinic. There were 2 males and 17 females, with a mean age of 81 years. Fourteen patients had musculoskeletal ambulation disability symptom complex. Their chief complaints were knee pain (50%), lower back pain (25%) and shoulder stiffness (13%). All sixteen patients with knee pain were diagnosed as having osteoarthritis. No statistically significant correlation between Kellgren-Lawrence Grade and JOA score was observed. Among 7 patients with lower back pain, including duplications, there were 5 cases of osteoporotic vertebral compression fracture, 4 cases of spondylosis of the lumbar spine, 3 cases of lumbar spinal canal stenosis, and one case of postoperative adjacent spinal segment disorder.
In remote rural areas, orthopedic surgeons play important roles in the welfare of elderly people with locomotive syndrome.
