The spinal irritation is not a initial symptom of spondylitis tuberculosa nor its latent form Though it has been considered for long that the lack of vitamine B1 is one of the possible causes of this disease, the result of the Sawada's test for beriberi upon patients with spinal irritation failed to coincide with this theory. This disease occurs mostly in a man with higher proportional sitting height and hypersensitivity. From the results of the operation findings, the Thorn's test, transplantation of hypophysis and others, it can be reasonably assumed that the spasm of muscles attached to the spinal presumably due to the physical and constitutional disposition is the essential causative factor of this disease. A standing fact that the much more Japanese people suffer from this disease than the Europian can be attributed to the racial characteristics and physical features.
This short article is author's experiences during the war on the rehabilitation of the amputees from the viewpoint of orthopedic surgery. The author first deals with amputees' training in the use of the prosthesis and then describes the importance of proper guidance and encouragement. Long hospitalization without any fixed scheme and activity and to let the will to work remain dormant, is far more harmful to the patient than the amputation itself. The stronger the will power to work and for recovery, the quicker is the resumption of activitey and the development of the compensatory function of extremities. In such case the speed of attaining vocational skill is phenomenal too and he will soon resume his activity in the community to which he once belonged. According to the author's investigation on 409 war injured veterans, he found among them 12%, whose will for labor is very insufficient. The causes of this lack are classified as follows: 1. site of amputation 51.9% 2. character 48.7% 3. short stump 13.4% 4. severity of the disability 13.4% 5. bad fitting of. prosthesis 30.8% 6. insufficient vocational guidance 44.2% According to the author's investigation on 652 war injured veterans in 1943, the distribution of occupation was as following tables.
Thirty-nine cases of the congenital dislocation of this hip joint treated by abduction diaper were classified as follows: number of cases; period from birth 27 1-6 months old 7 7-12 months old 5 1-3 years old Of these cases, 33 recovered completely and 4 had to be adopted the abduction plaster. Epiphysitis of femoral head occured in 2 cases of the series.
I tried operative redressment by decancellation for congenital club feet of two boys, aged 5 years and 1 month and 2 years and 10 months. In relatively 15 and 6 months after operation, the redressed feet had almost normal form and some mobilization. Thereby I think that this treatment is excellent method to ensure a good result in old and relapsed cases.
A male, aged 23 years, was suffering from sciatic pain sinee two years ago. Subjective and abiective syomptom mere No. 8 differeut from other ardinary sciatie pavn. At Iaminektomy, no protruded miclei and thickened ligamentum flavum mere reeoginezed, But there was the varix of intervertebral vein, mhieh pressured the 5th. lumbar nc rye roan althaugh this vorix had been compressed only by small muscle flap, the seiatic pain mas relieved almost completely. I emphasize that the manaiment of lamineetomy must be done carefully and more attention be pay upon the inter vcrtebnal Vein.
Female, aged 64 years, was extracted her right eye-ball by lachrymal cancer about two years ago. Aftcr the two years duration, she had severe pain in the right hip and thigh, and she was diagnosed as metastased cancer to spine and pelvis by biopsy. She had no signs of cancer in the other organs by means of various clinical examinations.
Suction Socket of the artificial limb takes advantage of the air-pressure instead of the waist-shoulder belts. The patient can move his artifiical limb with suction socket lightly and actively as if a part of his own body. The belts are not used, the amputation-stump is very easily put into the socket. Ventilation in the socket is taking place by walking. Amputator can escape from the sweating and inflammation of the skin. This is effective at the warm and humid region. Tightnes of the socket depends on the fittness of the stump, and fittness can regulate by covering the inside of the socket with the leather. Suction socket is useful for most cases except the brevity stump.
Among the cases with a fracture of spinal column without an injured spinal cord who have enterd the hospital and consulted doctors during these three years, excluding 4 cases suffering from a re-fracture of a column out of 49 cases who have been to the hospital for injuiry, we have. investigated the 45 cases' conditions of reversion to their former occupation and got the following results: (1) Injured spinal column does not differ much from that of booklet informed hitherto. (2) The period from the injury to the investigation was three years one month and a half on the average and perhaps due to the short period, we can not perceived the year-by-year recovery informed by Matti and Häumann. (3) The rate of reversion to former occupation complete reversion, incomplete reversion and non-reversion was one third one third respectively. (4) As for the relation between age and deversion to former occupation the rate of the young was higher than of of the old. (5) Reversion to former occupation had nothing to do with change of appearance and the restriction motion. But none of the cases with a side-curvature of the spine could returned to their former occupation. Few of the cases with pain could returned to that and many of them could not. The power of the back muscles of the young had shown the regular order of reversion but that of the old the irregular one. (6) The then conditions through X-rays, the conditions of recovery and making of randspicule had no relation with reversion but according to the distinction of the parts, the rate of reversion of the cases of the lower part of breastspine and the upper part of waistspine was bad and that of those of the lower part of breast-waistspine was the best. (7) As for compensation for injury, the degree of reversion was in according with the order of grade but these were many exceptions. (8) Reversion to former occupation greatly depended on personal or social condition.
Three cases of compression-fracture of the vertebral body caused by electric shock convulsion are studied. The site of predilection is the middle part of the thoracic spine, one is the fourth, another the fifth, and a third the seventh vertebra. These accidents occurred in 0.17per cent of the patients who were treated by electric shock.
Author has treated fine cases of tuberculous Meningitis combined with bone and joint tuberculosis with streptromycin this one year. The results of all cases up to now are favorable, however, in one case a severe deafness is observed and the following conclusions are obtained. (a) The adequate local treatments of bone and joint tuberculosis are required as well as the treatment of tuberculous meningitis. (b) As the clinical course of tuberculous meningitis is long, we cannot hope the recovery before the treatment is continued with perseverance.
Union did not occured, when the 1/3 of radius on rachitic rabbits together with periostium had been excised. Triple calcium phosphate and calcium carbonate, boiled bone powder, boiled bone cip und autogenous bone chip, as the bone elements, were inserted in its gaps. The rabbits that rachitic changes were slight or middle taked union, though the healing of fractures were some delayed, but the rabbits indicated the changes of high degree scheu union after 9-10 weeks occationally. As entcalcificated bone cip was inserted in its gaps, union was not indicated. The rate of speed on the healing of fractures in the rickets was not influenced by kinds of bone elements and indicated union in propotion to intensification of rachitic changes.
Recently, I have studied on calcium determination by Yanagizawas' method. It makes use of property that Sunchromin Fast Blue M. B produces a special colour (violet) in existence of calcium in the alkaline solution. (1) Total calcium concentration: It must be taked more examinations to compare with other methods (to determine the total calcium concentration in serum), but I have believed that it is fairly reliable method for clinical determination. In 30 cases of the normal adult, the average of the total calcium concentration in serum was 10.3mg/dl. (2) diffusible calcium concentration: I could not get a satisfactory result from this method about the determination of diffusible calcium concentration. It is believed that the clinical worth is doubtful in present day.
Experimental transplantation of the homogenous epiphyseal bone was studied in the upper end of the tibia of dog. All of the cells in transplants was necrotic fibrillary degeneration of the articular cartilage occurred rapidly. Replacement was performed by pannus which formed scar tissue. At least for eighteen weeks, the graft-unite and the function of joint were satisfactorily
It is said that subtrochanteric osteotomy is the treatment of choice for irreducible congenital and pathological dislocation of the hip joint, though it is a conservative treatment. We examined 11 cases (14 hips) which had elapsed one year or more after operation, in making this report the length of follow-up has been too short. The results are not so good as we expected, particularly the flexion of several hips was restricted remarkarbly. This bad mobility of the operated hips is due to the excessive anterior angulation at the site of osteotomy which is caused during the fixation in cast of paris and not due to the operative failure. Therefore, by the use of internal fixation and postoperative lateral roentgenograms the fragments can be efficiently maintained in the desired proper position and the good mobility of the hip can be secured.
Acrylic resin, which is harmiess to the living body and unchangeable in the on account of its superior physical, chemical, and mechanical characteristics, is now widely appslied in the various fields of clinics. But this resin has the disadvantages being fusible at rather low er degree of the heat and difficult to be sterilised. I made the Judet's artificial femoral head of acrylic resin in accordance with the general method by which a tooth-plate is made, using as its material polymethyl-metacrylate made in our country. The point to which I had to pay the most careful attention in the making of this artificial femoral head was how to cure the material and get best article having no foam in it. For this purpose, I at first boiled the material untill the heat of 70°C spending about an hour, and then kept it being boiled at the same heat for an hour and at the heat of 100°C for the same hour respectively; spending three hours in all. The femoral head of my own device has 8 holes of 0.3cm diametre at its rin, by which its fixation can be strengthened.
So far a number of the non-and delayed union has been found on the treatment of the fractures, and various investigations on the causes of them have been published by many workers. We investigated 242 cases of the non-union and 21 cases of the delayed-union, of tatal 263 cases, who had visited from Jan. 1937 to April 1952 the Orthopaedic Clinic of Kyushu University, and the results obtained were as follows. (1) It was found that 21 percent of the fractures was on the humerus and 18 percent of them, the neck of the femoris and the forearms. (2) About the causes of these fractures, especially the regional causes, the most part be longed to the compound fracture and the others were those diagnosed wrongly, of the unsuitable operations or of the bad fixations and etc. (3) Classifying with regard to sex and age, the male was abundent and the adult was more frequency. With the development of treatment of the fractures, we expect the better results than at present.
Küntscher's or Hansen-Street's intramedullary nail was inserted into the tibia of rabbits, which corticalis had been previously injured transversely with the saw 1mm in width, and then the mechanisms of the repair for these cortical defects with the medullary nailing and of the only injured as the contrast were histologically examined during one to four weeks after the procedure. In the cases of medullary nailings, the organization of the procallus in and around the defect by osteogenic tissue was later represented in the early stage one week after injury, but soon later after two weeks proceeded more vigorously the ossification of the uniting callus mainly than the contrast. In the consequence of these histological findings, it might be concluded that these medullary nailings take part also in the acceration of the healing process of fracture of the long bone.