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森 英治, 森久 喜八郎, 柴田 玄彦, 太田 佳介, 河村 誠一
1987 年 35 巻 4 号 p.
1286-1289
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
Three cases with painful transient osteoporosis of the hip are reported. A 24-year-old female, a 38-year-old female in the ninth month of her first pregnancy, and a 43-year-old male were involved in the left, right, and left hip respectively. There was tenderness and pain with use of the involved hip, however swelling, erythema, and warmth were not noted in all cases. The roentgenographic examination showed osteoporosis of the hip without narrowing of joint space and destructive change. They were treated conservatively and spontaneous recovery occurred with subsequent remineralization of the hip in all cases. The features of the episodes among present cases are similar enough to suggest a clinical syndrome.
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香田 英俊, 大宮 和郎, 山村 正統
1987 年 35 巻 4 号 p.
1290-1293
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
A case of a 43-year-old man who had multiple avascular osteonecrosis is reported.
He had four neurosurgical episodes and steroid therapy (4, 397mg as predonisolon).
The sites of osteonecrosis were both sides of humeral head, femoral head, femoral condyle and talus. The transtrochanteric rotational osteotomy of the right femoral head was performed first, and six months later, the other side osteotomy was done.
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大平 博人, 日高 博文, 山野 耕一郎, 原田 省吾, 谷口 良康
1987 年 35 巻 4 号 p.
1294-1297
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
Chiari medial displacement osteotomy has been performed for 50 hips diagnosed pre, early and progressive osteoarthritis with acetabular dysplasia since 1977. Of 32 cases, 29 were females and 3 were males with average age of 20.4 years. The average term of follow-up study was 6 years and 3 months. The results were evaluated by the scale for osteoarthritis of the hip joint adopted by the Japanese Orthopaedic Association. Radioogical study was performed in sharp and CE angle, ratio of medial displacement, changing of joint space, ATD and femoral head between pre- and postoperation.
Excellent or good results (over 80 points) were obtained in 28 cases (87.5%), and poor in 4 cases (12.5%). Preoperative coxalgia was remarkably improved from average point of 24.7 to 35.3. The radiological examination showed that the ratio of medial displacement has effective influence on clinical good results.
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乗松 尋道, 知念 弘, 呉屋 勲, 森 諭史, 新垣 晃, 親泊 元信
1987 年 35 巻 4 号 p.
1298-1301
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
Two cases of adolescent osteoarthritic hip from purulent arthritis, who were treated by muscle release operation, were reported. First case was a 12 year-old-girl, who suffered purulent arthritis on her left hip at 3 years, and began to have ambulatory pain from 12 years. The second case was a 12 and 1/2-year-old girl. She suffered purulent arthritis on her left hip at 12 years and received capsulotomy and drainage. After 6 months she complained of hip pain and gait difficulty. The two cases were treated by muscle release operation following Voss's or O'Malley's procedure. After the operation they obtained good range of motion and excellent X-ray findings on their affected hips.
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中野 哲雄, 池田 天史, 甲斐 信, 加藤 悌二
1987 年 35 巻 4 号 p.
1302-1306
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
An experimental study was performed on the rotational displacement of the femoral head in intracapsular femoral neck fractures. The changing trabecular pattern in accordance with the degree of rotation was observed roentgenographically, using the rotation of an excised femoral head. When the degree of rotation was below 45 degrees, axial view was prefered and when it was above 45 degrees, antero-posterior view was prefered.
Clinical study was done by using the above criteria. It became apparent that higher degree of displacement was seen on axial view in cases of Garden stage II, over 50 degrees of rotational displacement was present in cases of Garden stage III, and that rotational displacement was almost none in cases of Garden stage IV and over traction might be induced when traction had been performed. These findings may be useful as the markers of classification of the fracture.
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日高 滋紀, 亀山 博生, 松元 信輔
1987 年 35 巻 4 号 p.
1307-1311
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
Hemiplegic patients tend to suffer from femoral neck fractures. Furthermore some of them are very difficult to treat in the course of postoperative rehabilitation because they have aphasia or disorientation of space.
We surveyed clinical features of femoral neck fracture occurred in hemiplegic patients. We also surveyed the walking ability of the patients as a clinical result of operative treatment. Nine out of eleven hemiplegic patients (72.7%) have walking ability after one year and two months from operation. Therefore active operative treatment should be done on the patients with femoral neck fracture even if they have hemiplegia.
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生存率とADLの状態について
亀山 博生, 日高 滋紀, 松元 信輔
1987 年 35 巻 4 号 p.
1312-1315
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
From July on 1983 to Februaly on 1986, we operated 60 cases for femoral neck fracture, and we examined that how many patient lived and what degree they obtained ADL. In the group without complication, two-third of all, they recovered to the same level before injury.
In remained group with complication that is dementz, paralysis, and heart disease, one-third of all, postoperative ADL is not related to age, type of fracture and operation.
At this study, 15 cases were already dead, their life period after operation is from 15 days to 2 yaer 4 month-mean period 6.6 month. Nobody died during operation.
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Ender 釘とCHSの比較
和田 研, 徳永 純一, 小林 晶, 福元 敬二郎, 王 亨弘, 吉本 隆昌, 井上 善博, 多治見 新造
1987 年 35 巻 4 号 p.
1316-1324
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
Seventy-four patients with trochanteric fractures of the femur were treated with Ender rods and thirty-eight patients with Compression Hip Screw.
Comparison was made between the two devices to acertain either of which is better.
Operative blood loss was less and operative time was shorter for the Ender method than for the Compression Hip Screw. But Ender method offered high level of problems, such as backout of the rods, external rotation, varus deformity of the femoral neck, and especially knee pains.
Conclusively, Compression Hip Screw system is more preferable to use in the treatment of trochanteric fractures of the femur.
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深沢 俊裕, 弓削 大四郎, 宮近 信彦, 三村 寛, 衛藤 正雄, 秋山 寛治
1987 年 35 巻 4 号 p.
1325-1327
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
The femoral subtrochanteric fractures requires exact reduction and rigid internal fixation. In our hospital, Judet's condyle plate was applied to 20 fractures from 1971. The age of patients ranged from 19 to 88 years. 11 cases were caused by motor accident and 3 were pathological. 14 cases except for pathological fractures gained fracture healing at 5-8 months after operation.
Re-operative 5 cases were added Judet's décortication.
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河村 誠一, 森久 喜八郎, 柴田 玄彦, 太田 佳介, 森 英治, 牟田口 啓介
1987 年 35 巻 4 号 p.
1328-1330
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
Fracture of the posterior process of talus has been reported mainly as one of the sport injuries in the ankle. Fracture of the medial tubercle of the posterior process of talus is a rare injury. We experienced such a injury. We used the computed axial tomography (CAT) scan for it and obtained the useful information. Initially, we chose the plastic cast immobilization for the patient, but her symptoms did not improve. We, therefore, excised the fractured fragment. At follow up she was well satisfied.
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浅野 正也, 上崎 典雄, 松永 大助, 村上 陽太郎, 西崎 博巳, 西田 民夫, 濱 渉, 高嶋 明彦, 浅野 茂利
1987 年 35 巻 4 号 p.
1331-1335
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
Twenty-five patients with twenty-nine fractures of the calcaneus involving the thalamic portion were investigated. There were no difference in reduction of sabtalar joint between Westhues method and open reduction.
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手術例と保存例の対比
多治見 新造, 徳永 純一, 小林 晶, 福元 敬二郎, 王 享弘, 吉本 隆昌, 井上 善博, 和田 研
1987 年 35 巻 4 号 p.
1336-1338
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
We have reviewed 75 cases of fifth metatarsal base fracture treated both surgicaly and conservatively since 1973. 22 of 75 cases were operated by “Zuggurtung” osteosynthesis. It was fixed by two C-wires and figure of eight circumferential wires. Postoperatively at one week the patient was permitted to walk without any support. On the other hand, 53 of 75 cases were treated conservatively. Immobilization such as plaster cast, plaster splint, foot plate apparatus or elastic bandage continued from two to ten weeks, depending upon the duration of pain.
Results of the surgery revealed no pain and good union of the fracture in all cases. The patients could go back working again within two weeks postoperatively. Very satisfactory results were gained. While as for the result of the conservative treatment, non-union occurred in two cases accompanied with pain. We stress that in treatment of fifth metatarsal base fracture surgery is recommendable to patients who want to go back to work as early as possible.
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増田 頼昭, 加茂 洋志, 徳久 銀一郎, 猪原 史敏, 帖佐 博文, 野村 茂治
1987 年 35 巻 4 号 p.
1339-1345
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
Thirty-seven children with injuries of the distal tilial epiphysis were treated during the past ten years in our hospital. Twenty-seven out of the thirty-seven patients were followed-up and their prognosis concerning growth disturbance was studied.
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野村 一俊, 水岡 二郎, 栄 輝巳, 田嶋 光, 匂坂 正明, 森本 敬三
1987 年 35 巻 4 号 p.
1346-1350
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
We have treated two cases of rupture of ligamentum patellae with avulsion fracture of the patella.
Case 1: On May 29, 1985, an 11-year-old boy suddenly fell to the ground while roller skating. Subsequently he was unable to walk.
On May 33, 1985, he was admitted to our hospital.
Examination revealed left swollen knee with patella alta and loss of tension of ligamentum patellae. Roentgenogram revealed patella alta and a small bony fragment shadow. A diagnosis of rupture of ligamentum patellae was made.
On June 4, 1985, operation was performed. At the operation, ligamentum patellae was ruptured with avulsion fracture of the patella. Fragment was excised and end to end suture was performed.
Postoperatively plaster cast was applied and two weeks after operation he was allowed crutch gait with cylinder cast. Six weeks after operation cast was removed
Six months after operation he had no complaints in his left kee joint.
Case 2: On October 14, 1985, 11-year-old boy had severe right knee joint pain at the time of high jump. Subsequently, he was unable to walk.
On October 18, 1985, he was admitted to our hospital.
Physical examination and roentgenogram revealded rupture of ligamentum patelle with avulsion fracture of the patella.
On October 22, 1985, operation was performed by the same procedure as the former case and postoperative treatment was done by the same schedule.
Six months after operation he had no complaints in his right knee joint.
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梅木 義臣, 奥苑 直行, 林 広三郎, 鹿島 信之, 神代 敏之, 金 強中
1987 年 35 巻 4 号 p.
1351-1353
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
We reported a patient with bilateral simultaneous rupture of the quadriceps tendon. Her medical history revealed chronic renal failure with haemodialysis.
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有田 親史, 福岡 善平, 上妻 隆秀, 喜名 政浩, 利光 哲也
1987 年 35 巻 4 号 p.
1354-1357
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
A forty-seven-year-old farmer felt being kicked in the left heel while he was running around a corner during an athletic event and he complained of difficulty in walking. He had always been healthy and there was no history of injury. On admission there was tenderness and a firm bean-sized mass palpated 5cm proximal to the Achilles tendon insertion. Squeezing the calf produced almost no plantar flexion of the foot. Roentgenographic examination of the left ankle revealed an area of ossification just at the site of the tumor about 0.5cm in diameter. There can be little doubt, in retrospect, that this was an avulsion fracture. Roentgenograms of the right Achilles tendon showed no ossification.
At operation the medial fibers of the tendon were ruptured partially and the avulsed fragments of the calcaneus were densely adherent to the lateral fibers of the tendon. The fracture was set in place and held with a wire. The ruptured tendon was repaired. With the knee in 40 degrees of flexion and the ankle in 20 degrees of plantar flexion, a cast of plaster was applied for four weeks, and followed by gradually increasing activity.
At review seven months after operation, he had no complaints regarding the left heel and no restriction of motion in any direction.
The avulsion fracture of the medial part of insertion of the calcaneal tendon may have been produced by a combination of muscle contraction, medial-sided stretch force produced by eversion stress and the existence of an osteophyte. After the avulsion fracture .the intact tendon fibers lateral to the fracture may have ruptured.
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平野 真子, 森沢 佳三, 下村 義文, 北川 敏夫, 鬼木 泰博, 原田 正孝
1987 年 35 巻 4 号 p.
1358-1361
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
Between April 1979 and December 1985, forty-eight patients with stress fracture of lower extremities were treated in our hospitals.
Twenty-nine cases were male and nineteen cases were female. The average age of the patients was 15.3 years. The diagnosis of stress fracture was based on the clinical symptoms, local findings and radiographic changes. In this study, the bones most commonly involved were the tibia (twenty-six cases), metatarsals (thirteen cases) and fibula (ten cases). Our data on localization are similar to other studies. All the fractures were treated by rest from athletic activities. All the athletes returned to their sports.
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川口 徳久, 大森 俊一, 山形 健治, 山本 清司
1987 年 35 巻 4 号 p.
1362-1365
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
The tibial shaft fracture is the most usual fracture of the long bones. Many methods of treatment of the tibial shaft fracture have been reported, which are cast immobilization, P. T. B. brace, plate fixation, intramedullary nailing, etc. The closed Ender nailing is the most useful method of them.
Since July 1982, 20 patients with the tibial shaft fracture were treated with Ender nailing, 11 were male and 9 were female, and their ages ranged from 11 to 87 years. There were 3 fractures in the proximal third of the tibial shaft, 5 in middle third and 14 in the distal third. Postoperation, in principle, the patient was not immobilized in casts, allowed full weight-bearing without brace at two weeks and discharged from hospital at four weeks.
It has been our experience that advantages of Ender nailing are relative ease of nailing, good fixation and alignment of the fracture fragment without periosteal stripping, no necessity of external fixation postoperatively, early full weight-bearing, and decrease the duration of hospitalization.
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向坂 彰二郎, 井上 雅文, 賀茂 和典, 高松 徹, 後藤 琢也
1987 年 35 巻 4 号 p.
1366-1368
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
Out of 61 cases of open fractures of the tibial shaft, 13 cases with extensive soft tissue damage were treated by external fixation with Hoffmann's device for the past 4 years from 1982 to 1985.
Six cases with soft tissue damage of Campbell's type 2 healed without further bone operation except one, at an average of 12.2 (6 to 16) weeks.
Seven cases of Campbell's type 3 all required the secondary bone operation. with an average of 27 (16 to 36) weeks of healing period.
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林 泰夫, 鈴木 睦朗, 上村 光治, 外園 不二夫, 泉 清治, 小糸 博文, 伊達 徹, 片岡 泰文, 前川 和道, 堀川 廣通, 小川 ...
1987 年 35 巻 4 号 p.
1369-1374
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
Forty-eight cases of delayed union and eighteen cases of nonunion were surgically treated with success. At the shaft of long bones, intramedullary fixation with Küntscher nail, multiple Kirschner wires and Ender nails or plating with a KU plate and an AO plate were applied.
At the end of long bones, blade plates of KU and AO type or tension band wiring were applied.
Bone grafts and décortication technique were accompanied for some cases and electrical stimulation was applied for a few cases.
On the infectious cases, external fixation was applied and infection was inhibited with local application of bone cement beads containing antibiotics.
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高木 茂, 平良 誠, 川島 重明, 錦戸 崇久, 山内 達朗, 桃崎 和彦
1987 年 35 巻 4 号 p.
1375-1378
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
Fifty-four cases of multiple fractures included lower extremities were studied during the past eight years in our hospital.
The total number of fractures were two hundred (lower extremities 129, upper extremities 38, and bodies 33).
Fifty were open fractures. Five out of 54 cases were treated by conservative management, 35 by operative management and 9 by both. Complications were skull injuries (8 cases), thoracic injuries (2 cases), abdominal injuries (9 cases) and the others (3 cases).
Those caused a long duration of hospitalization and time to healing. The end result was poor for ten of twelve patients of simultaneous ipsilateral femoral and tibial fractures; so called “floating knee fracture”.
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佐々部 富士男, 河合 伸也, 小田 裕胤, 海永 泰男, 五十嵐 憲司, 淵上 泰敬, 白石 元
1987 年 35 巻 4 号 p.
1379-1381
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
Electrophysiological evaluation of the cauda equina or nerve roots has been recently applied in diagnosis of lumbar disorders.
The monopolar catheter electrode was inserted into the epidural space at the levels of L
3-4, L
4-5, and L
5-S. The recordings were made on stimulating the tibial and the peroneal nerves at the bilateral popliteal fossae.
The cauda equina action potentials (CEAP) were recorded in 42 cases with various kinds of lumbar disorders, including lumbar disc herniation, lumbar canal stenosis, chronic low back pain and the control was taken in case with cervical or thoracic spine without lumbar problem.
The nerve action potentials (NRAP) was recorded intraoperatively at the nerve roots by monopolar catheter electode in 10 cases with either lumbar disc hernation or lumbar canal stenosis.
In eight cases of eleven of disc herniation. the voltage decreased more than 30% at the affected level. In six of seven roots in disc herniation, NRAPs demonstrated polyphasic.
The results suggests that CEAP and NRAP are useful for diagnosis of the affected nerve roots, and that further research will be necessary to obtain more accurate evaluation more.
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坂本 正, 河野 清, 野田 基博
1987 年 35 巻 4 号 p.
1382-1384
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
The purpose of this paper is to introduce our technique to perform correct positioning of the needle into the center of the disc for discography by means of CT analysis, and also to clarify usefulness of CT discography for diagnosis of lumbar disorders.
The technique we have been using for discography is nearly same as reported, except in positioning of the needle into the disc we have taken CT analysis in order to determine correct place and angle of inserting the neelde.
The subjects of this study are 105 discs of 58 cases with lumbar disorders.
Comparative study of the findings among myelograms, discograms and CT-discograms was investigated.
The results indicated that CT-discograms demonstrated the most clear findings among them and was useful in diagnosis of the lumbar disorders, especially in obtainning detail observation of herniated discs.
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高木 久雄, 井上 明生, 永田 見生, 清永 寛一郎, 百武 靖之, 古賀 俊彦, 森松 康文, 蓮尾 ゆか子
1987 年 35 巻 4 号 p.
1385-1390
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
Twenty-five patients with cervical or lumbar herniated intervertebral disks were examined with magnetic resonance (MR) imaging. MR images were classified to four types and two subtypes according to the appearance of disk material, and were compared with myelogram, CTM, and operative finding.
In type IV, segmentation of disk material, disk herniation was confirmed in twenty-four disks (92.3%) at operation.
In type II, flattening disk, and in type III a, bulging only, disk herniation was confirmed merely one disk (25%).
For demonstrating the herniated disk, MRI was superior to CTM or myelogram in 42.1% of cases, about equal to CTM or myelogram in 18.3%, and inferior to CTM or myelogram in 39.5%.
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仲宗根 栄作, 高良 宏明, 仲宗根 朝洋, 国吉 真也, 金城 幸雄, 茨木 邦夫, 関谷 透, 大城 隆
1987 年 35 巻 4 号 p.
1391-1395
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
Eighty three patients with the spine and spinal cord disorders were examined by magnetic resonance imaging (MRI). The results were as follows:
1) At present time, myelography and CT myelography have some advantages over MRI in a mode of representation of disorders on the spine and spinal cord.
2) But MRI was excellent in the detection of intraspinal cord lesions such as syringomyelia and hematomyelia, and lesions at craniocervical junction.
3) MRI can be used routinely for clinical screening evaluation, from its noninvasive and simple property.
In conclusion, MRI can be accepted as a beneficial diagnostic device and reevaluation must be done on various methods of imaging including MRI.
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松本 光司, 柴田 堅一郎, 大賀 正義, 林 和生, 後藤 健志, 岸川 陽一, 杉岡 洋一
1987 年 35 巻 4 号 p.
1396-1400
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
Fourteen patients with spinal cord lesion were studied using MRI (Magnetic Resonance Imaging). The findings in the plain roentgenogram, CT and myelography were compared with those in MRI. MRI revealed abnormal contours of the spinal cord in case of intramedullary tumor, atlanto-axial dislocation and A-V malformation. In the diagnosis of intrathecal extramedullary tumor and disc herniation, MRI seems to be less valuable then myelography from the viewpoint of demonstrating precise obstructed level of the spinal canal.
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宮下 裕行, 馬場 逸志, 石田 了久, 住田 忠幸, 大田 修, 佐々木 宏, 林 雄三
1987 年 35 巻 4 号 p.
1401-1404
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
An enterogenous cyst of the spinal canal has the interior wall composed of tissue that is similar to the epithelium of the digestive or respiratory organ system, and is considered to be produced by a developmental abnormality in the early embryonal period. This is a rare disease, and this time we have experienced a case of an enterogenous cyst, occurring in the cervical canal, with a favorable course with improvement of symptoms after an operation.
The case is a 13-year-old female complaining of numbness and weakness of the right hand, weakness of the right lower limb, and disturbance of gait. Present illness revealed stretch gymnastics from the beginning of December. She developed upper back pain, then pain in the ulnar side of the right hand, weakness in the right hand and lower limb, inability to stand up, and disturbance of urination. She was admitted as an emergency on 31 Dec. From the findings of myelography, CTM and MRI, an intradural extramedullary cystic tumor was suspected. Total excision was attempted from the posterior approach, but the wall ruptured and the tumor reduced. Only the wall was excised, the pathological examination revealed irregular papillary tissue composed of a single cubical-cylindrical epithelium, or partly stratified arrangement with cilia, suggesting an enterogenous cyst. At present she is back to school.
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後藤 健志, 江口 正雄, 柴田 堅一郎, 大賀 正義, 林 和生, 杉岡 洋一
1987 年 35 巻 4 号 p.
1405-1408
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
We reported a case of the thoracic spinal cord tumor recurred 15 years after operation. The tumor lies both in extradural and intradural spaces and has a contiguity through dura mater.
Macroscopically neurinoma and meningioma are suspected in the same region, but histologically the tumor was not apparently diagnosed.
After operation the patient's symptoms gradually subsided and now she can walk alone and is hardly aware of any difficulty in active daily life.
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佐貫 浩一, 早川 宏, 杉田 浩志, 市本 裕康
1987 年 35 巻 4 号 p.
1409-1412
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
At our hospital, we have recently diagnosed and treated a patient with a combination of ailments: Hüftlendenstrecksteife (HLS), benign osteoblastoma, and scoliosis. The patient, a ten-year-old girl, had been suffering from lower back pain as well as pain in her left thigh since February of 1985. She was directed to this hospital and approached us on April 24th, 1985. The results of tendon reflex measurements were low. The following information was recorded: muscle weakness (-); sensory disturbance (-); SLR rt. 60°(+), SLR lt. 40°(+) and HLS was found. Radiographic images of the spine showed that scoliosis only was present. We performed a myelography but still found no other abnormalities. Computer Tomography (CT) of the spine, however, revealed valuable information. It showed a lowdensity area in the left lamina of L4. We performed an operation on this area. Her discomfort and pain have diminished as a result of the operation.
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北島 隆治, 渡辺 英夫, 川口 宗義, 熊谷 洋幸
1987 年 35 巻 4 号 p.
1413-1416
発行日: 1987/04/25
公開日: 2010/02/25
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フリー
A 10-year-old girl with “vertebra plana” at the third lumbar spine was reported. She was hospitalized with severe lumbago. Remarkable tenderness and knock pain at the third lumbar spine and tenderness at the right paravertebral muscles were observed. Radiograph revealed a compressive and destructive change at the third spine which showed “vertebra plana” appearence on a short period. Computed tomogram revealed a paravertebral mass. Laboratory data showed inflammatory reaction. Lumbago and inflammatory finding were decreased gradually at rest. It changed “vertebra plana” on a radiograph after 5 weeks. She dosen't complaint of lumbago now and repair of vertebral body is found on a radiograph.
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北川 守, 吉良 秀秋, 新村 哲也, 山田 正幸
1987 年 35 巻 4 号 p.
1417-1422
発行日: 1987/04/25
公開日: 2010/02/25
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フリー
A fifty-year-oldman was admitted to our hospital on 9 October 1985, because of severe pain in his low back radiating down to the left leg. On admission he couldn't move his left ankle and toe dorsally. About a week after admission he couldn't move his both knees and ankles and toes at all, and developed urinary and fecal incontinence. His knee and ankle jerks were absent bilaterally. There was an area of hypesthesia in the segmental area of L4-L5.
Myelography demonstrated a complete block at the level between L3 and L5. On 24 October a laminectomy from L3 to L4 was performed. We couldn't see any abnormality in epidural space. But in the intradural space we could see many small tumors attaching to the cauda equina.
We removed them as much as possible.
They were diagnosed pathologically that the metastasis of renal cell carcinoma.
After operation his severe pain diminished and he came to able to walk on crutches with short leg brace. But We think his recurrence of the tumor is inevitable and we must observe it.
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斉鹿 稔, 河合 伸也, 小田 裕胤, 海永 泰男, 住浦 誠治, 中原 庸夫, 白石 元
1987 年 35 巻 4 号 p.
1423-1426
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
Recent advance in treatment for malignant tumor has made it possible for some of the patients with metastatic spinal tumor to survive for more than one year, or even more. In our clinic 100 cases of metastatic spinal tumor have been treated so far, in which 28 cases were treated surgically; decompression of the cord and/or stabilization.
After surgery, myelopathy, pain and activities of daily life improved, but the prognosis was generally poor. However, there are some cases, who survived for more than one year, in which 3 cases required re-operation because of recurrence of tumor.
The cases of re-operation will be anticipated to increase more, therefore, it will be necessary to consider the possibility of re-operation at the time of initial operation in cases where the tumor is slowly progressive or the tumor can be managed by chemotherapy, radiation therapy or other therapy.
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種窪 康, 津江 和成, 深堀 勝之, 浦野 正之, 河合 伸也, 小田 裕胤
1987 年 35 巻 4 号 p.
1427-1429
発行日: 1987/04/25
公開日: 2010/02/25
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フリー
Senile round backs are mostly due to osteoporosis, wedge vertebrae and narrowing of the disc, and often associated with back pain. The accurate causes of the back pain are still obscure. 101 cases of senile round back were investigated to clarify the mechanism of the back pain. They were classified into 2 groups according to the types of round back, namely 1) the upper group in which the apex of kyphosis is located in the middle thoracic spine, and 2) the lower group in which the apex is the thoracolumbar junction.
Most of the cases in two groups demonstrated similar clinical symptoms. The pain was located at bilateral paravertebral regions including the area close to lumbar spinal process and at the gluteal region.
Facet block with xylocain at the lumbar spine produced relief of the pain in 76% of 34 cases, which suggests that one of the main causes of chronic back pain of senile round back originates from the lumbar facet joints.
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豊海 隆, 冨永 積生, 伊達 和友, 大内 啓司, 片山 稔, 万代 恵治, 秋穂 靖
1987 年 35 巻 4 号 p.
1430-1434
発行日: 1987/04/25
公開日: 2010/02/25
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フリー
This paper is based on a study of 64 stable fractures of the thoracic and lumbar vertebral bodies occurring in 58 patients during the period from 1976 to 1986 inclusive. 46 patients were treated with anatomical reduction and then casting, 12 patients with application of a brace after placing the patient in slight hyperextension on the bed for about four weeks.
The purpose of the present study is to investigate the relationship between clinical and radiological results.
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植田 尊善, 佐々木 邦雄, 芝 啓一郎, 前山 叙之, 菊地 哲次郎, 村尾 哲, 下永吉 耕一, 角田 信昭
1987 年 35 巻 4 号 p.
1435-1437
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
On 21 cases, when admitted on our hospital the volantary contraction of lower extrimities had complete disappeared, and then volantary contraction appeared, we studied the recovery process of the lower extrimities.
Initial volantary contraction appeared from the day of injuries to 145 days after injuries. Ten of 14 cases that the volantary contraction had appeared within 13 days could ambulate. No cases that the volantary contraction had appeared after 14 days could ambulate.
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佐々木 邦雄, 芝 啓一郎, 植田 尊善, 前山 叙之, 菊地 哲次郎, 村尾 哲, 下永吉 耕一, 角田 信昭
1987 年 35 巻 4 号 p.
1438-1441
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
We studied the complications of surgical treatment for acute cervical cord injuries. 193 patients were operated on within one month after the injuries. Operation was performed under general anesthesia. 74 patients sufferd from complete lesion, 29 motor complete and sensory incomplete, 73 incomplete lesion. 17 patients were normal neural status.
One patient deteriorated neurologically after the operation, but her paralysis was two segments above the bony damage before the operation. 6 patients died within three months after the operation. But the causes of death did not relate to the operative intervention. 5 patients failed in bone grafts and were reoperated. Respiratory problem, needed prolonged intubation or tracheostomy, existed in thirty patients. 15 suffered from intestinal bleeding.
Surgical treatment for acute cervical cord injuries requires attention to the general status after paralysis. Early decompression and rigid fixation gives good condition to paralysed patients.
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井原 成男, 鈴木 勝己, 伊地知 正光, 小林 靖幸, 伊藤 謙三, 永田 善之, 中田 肇
1987 年 35 巻 4 号 p.
1442-1447
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
When viewing some aging changes of bones and joints on a X-ray film, it is difficult to determine whether it is physiological or pathological. Therefore, the authors have been attempting to gain a more complete knowledge concerning “physiological” aging of bones and joints in the general population by examining X-ray films of intact extremities in our outpatients who suffered mainly from trauma.
Each bone and joint was evaluated regarding four items, that is, osteoporosis, narrowing of joint space, subchondral bone sclerosis and spur formation, and rated 0-no changes, 1-some changes, and 2-prominent changes.
The results were as follows.
1) Osteoporotic changes of the upper extremities, or in women, were more prominent than those of the lower extremities or in men.
2) On the other hand subchondral osteosclerosis and spur formation were more prominent in the lower extremities, or in men when compared with the upper extremities, or in women.
3) Osteoporotic changes were grater in the left upper extremity.
4) The difference between male and female, the upper and lower extremities, and the right and left side were considered as some factors influencing physiological aging of bones and joints.
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矢野 寛一, 真角 昭吾, 麻生 邦一, 福永 拙, 藤原 亨
1987 年 35 巻 4 号 p.
1448-1451
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
we have reviewed the influence of arterial occulusive diseases upon the femoral head. Then we produced the experimental vascular occulusion model by arterial ligatation in rabbits, and studied the histologic changes of bone. The first ischemic changes were recognized in leucocyte series of marrow cells. The decrease in intensity of staining or disappearance of the nuclei were found in these cells. The second change of ischemia was recognized in fatty marrow. In fat cells, blurred cellular outline and disappearance of nuclei were charactaristic findings. On the other hand in the bone trabeculae, it was not possible to distinguish between living and dead by wheather the lacuna is empty or not.
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藤川 勝正
1987 年 35 巻 4 号 p.
1452-1461
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
Tennis can be analysed mechanically just as the movement of objects.
(1) Calculation of acceleration;
The locus of the center of gravity of a whole body and that of the center of gravity of a racket and an arm, the speed and the acceleration are calculated. At every 1/24 second, the action of tennis-swings and the locus of the center of gravity are photographed from two directions. The measure making a datumline is photographed mixed with the optical printer.
(2) The acceleration of the center of gravity of a racket and an arm, and the movement of a whole body.
The movements of tennis can be deviled into three parts.
Takeback; 24 scenes 1.0 sec.
Forehand-ground-stroke; 9 scenes 0.37 sec.
Followthrough; 13 scenes 0.58 sec.
The vector of the acceleration of the center of gravity of a racket and an arm is shown at every 1/24 sec. as to the horizontal and vertical dimentions. The relation between the change of angles of the joint of a right arm, knee-joints and joints of legs and the accceleration is to be examined.
The actions of muscles around shoulder-blades are to be examined with the examination of electric-muscle-graphs.
(3) Functional classification of muscles of arms around shoulder-blades. (From the analyses of tennis)
A; Muscle rising arm
B; Muscle turning arm back
C; Muscle turning arm front
D; Muscle rotating arm in or out side
E; Muscle for tensile force
(4) Analyses of the influence of tennis on spines
The center of gravity of a racket and the right arm in tennis makes a locus similar to an oval.
The shoulder turns 192.0° on the axis of spines, and the pelvis turns 123.6°. The rotation movement of the center of gravity of a racket and an arm is done in a balanced relation between the centrifugal force mv
2/r and the gravity mg and tensile force T. r means the diameter of the rotation between the upper-spines and the center of gravity of a racket and an arm.
This tensile force T is made by trapezius-upper and muscle rising shoulder in turn.
T makes its maxim the instance a racket is swung.
The tensile force of muscle rising shoulder reaches its maxim at the beginning of follow-through. The movement of rotation to left of cervical spines is easily caused with this tensile force of muscle rising shoulder made from the rear node of side process of upper cervical spines.
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伊勢 紘平, 隈元 一仁, 坂本 公宣, 赤崎 幸二, 広田 耕三, 束野 通志, 園田 英器
1987 年 35 巻 4 号 p.
1462-1464
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
The cancellous screw (long neck type) is used up to this time with M type and AO type. This type of screw has a haxagonal head so that it is occasionary destroyed when it is pulled out. We made a new type of screw originated from KU Screw. This new screw has a cross-shaped head and a contrary tap. This screw showed a good result in clinical use of arthrodesis or osteosynthesis.
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松崎 昭夫, 舌間 憲二, 太田 圭介, 荒木 義雄
1987 年 35 巻 4 号 p.
1465-1467
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
Porous Hydroxyapatite was implanted in socket, each measuring 5×5×10mm, that was made in the tibia of the adult dogs. Six months after the operation the dogs were sacrificed and implant tissue specimens were examined radiologically and histologically. Any abnormal findings were not seen on the radiograms. Histologically, the block of hydroxyapatite was contact with bone trabeculae directly and there was no pseudomembrane between them. Neither inflammatory cells nor foreign body reaction was seen. Porous of hydroxyapatite were filled with bone trabeculae and bone marrow. The findings show that the hydroxyapatite has favorable affinity to bone.
Three cases of clinical application of hydroxyapatite were presented. All cases have had no problem.
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林 和生, 松口 信行, 中川 悟, 後藤 建志, 杉岡 洋一, 金丸 孝昭, 野田 岩男
1987 年 35 巻 4 号 p.
1468-1471
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
Statistical analysis is essential for the evaluation of biocompatibility, so we should section the bone with implant in place and prepare for examination by light microscopy. Hydroxyapatite coated composite had the best biocompatibility in both stainless steel and titanium alloy as a base alloy.
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峯 孝友, 河合 伸也, 松岡 彰, 城戸 研二, 田口 敏彦, 芦田 一郎, 秋野 龍明
1987 年 35 巻 4 号 p.
1472-1475
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
Psychogenic reactions play an important part in many diseases, even in orthopedic field.
This is to report on evaluation of depressive state as one of the Psychogenic factors associated with orthopedic disease, using the Yamaguchi Self-rating Depressive Scale (YSDS).
The subjects are 185 patients in our clinic, consisting of 88 males and 97 females, ranging in age from 15 to 85 years old. There are 22 cases with cervical spine disorders, 33 lumbar disorder, 35 RA, 10 OA, 49 trauma and others. The results are as follows:
1. 53 out of 185 patients (35.3%) are assessed to be in depressive state.
2. The patients who suffer from disorders of spine and rheumatoid arthritis are likely to demonstrate depressive state in high frequency.
3. Depressive state tends to improve when symptoms improve after operations.
These results suggest that depressive state is correlated with severity of diseases and dysfunction of activates.
And it is emphasized that an accurate evaluation of patients in both physical and psychogenic condition and good relationship between doctors and patients are essential for management of diseases in orthopedic field.
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星状神経節ブロックの末梢循環動態
田中 正一, 片伯部 裕次郎, 合志 勝子, 緒方 甫
1987 年 35 巻 4 号 p.
1476-1480
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
Skin temperature (surface and muscle; biceps·brachioradialis the ring finger) and plethysmograph on the forefinger is recorded before and after stellate ganglion block in five stroke patients with post-hemiplegic shoulder-hand syndrome under the artificial weather room (temperature 30°C, humidity 60%).
The results obtained can be summarized as follows,
(1) plethysmographic pulse wave height of the affected finger is indefinite before and after stellate ganglion block.
(2) skin temperature is not always elevated after the stellate ganglion block.
Therefore it is suggested that there is abnormal peripheral hemodynamics and the effect on stellate ganglion block is dependent not only on the efferent (sympathetic fiber) interruption but also on the afferent one.
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村尾 哲, 佐々木 邦雄, 芝 啓一郎, 植田 尊善, 溝口 知行, 前山 叙之, 菊地 哲次郎, 吉村 豊暢, 下永吉 耕一, 角田 信昭 ...
1987 年 35 巻 4 号 p.
1481-1484
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
Since the founding of the spinal injeries center in Iizuka, an early operative decompression, reduction and fusion have been used in the management of spinal injuries. In this paper, we reported a return to community of 101 cases of paraplegics with complete (67 cases) and incomplete lesions (34 cases). A 60 percents of 101 cases had returned to community. Almost all of them depended on a wheel-chair. There was a high percentage of return to community in adolescent workers, students and patients with a drivers licence. In this analysis, we found that it was most important in management of paraplegics to admit them to a specialized spinal cord injuries unit as soon as possible.
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河野 淳亮, 原 寛道, 渡邊 浩一, 岸川 陽一, 池田 凡美
1987 年 35 巻 4 号 p.
1485-1487
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
Since hammer toes in cerebral paralysis are hyperflexed, body weight bears on the nails. It causes severe pain and finally gait disturbance. We treated three cases of hammer toe in cerebral paralysis. All of them were above 15 years of age showed and rigo-spastic type paralysis, or so-called double hemiplegia. They were treated by lengthening of digital flexor tendon, arthrodesis of PIP joint or both. One case resulted in good. Another case resulted in nothing. The last case needed revision.
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呉屋 勲, 乗松 尋道, 森 諭史, 茨木 邦夫, 親泊 元信
1987 年 35 巻 4 号 p.
1488-1491
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
Three cases of congenital vertical talus were reported. The first case was a year and a month-old girl with multiple anomalies on her face and extremities. The second case was a year and 10 month-old girl with no complication. The last case was a 4 year and 4 month-old boy with arthrogryposis multiplex congenita. Posteromedial and anterolateral releases were performed on these cases by reposition of the talus on the calcaneus and navicula using Kirschner wire fixation, and elongation of the heel cord, extensor digitorum longus, and peroneal tendons was combined. Every case got an excellent functional result after the operation.
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太田 剛, 野村 茂治, 上田 恵亮, 安部 秀顕, 増田 頼昭, 斎藤 仲道
1987 年 35 巻 4 号 p.
1492-1494
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
Charcot-Marie-Tooth disease, which was reported separately by Charcot, Marie and Tooth in 1886, is also called progressive neural muscular atrophy or peroneal muscular atrophy.
This disease is considered to develop usually in patients over 20 years of age, beginning with paralysis of legs, especially common fibular nerve-supplied region, and then progressing slowly in the central direction, but with good vital prognosis. It is also indicated well for orthopedic functional reconstructive operation because of its paralysis involving only legs below knee joints.
This time, we experienced a genealogical case of such disease presenting autosomal dominant inheritance, and reported here the results of its examination.
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佐藤 直人, 奥野 徹子, 井上 明生, 戸次 鎮昭
1987 年 35 巻 4 号 p.
1495-1498
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
A case of a 9-year-old boy with recessive, severe form of pseudoachondroplasia was reported. Diagnosis was made based on short-limbed dwarfism amnifesting after 2 years of age, normal face, stubby digits, contracture of shoulders and elbows, and characteristic X-ray findings.
Roentgenograms of long bones revealed irregularity and delayed maturation of epiphyses and marked widening of metaphyses. Additional roentgenograms of spine revealed platyspondyly and anterior ‘beaking’.
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久芳 昭紘, 岩崎 勝郎
1987 年 35 巻 4 号 p.
1499-1504
発行日: 1987/04/25
公開日: 2010/02/25
ジャーナル
フリー
An adult case of hypochondroplasia was reported. In differentiating hypochondroplasia from similar disorders in terms of clinical and radiographic findings, achondroplasia and pseudoachondroplasia should also be taken into account.
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