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門脇 哲郎, 陣内 卓雄, 永尾 光一, 川崎 正章
1989 年 38 巻 2 号 p.
832-835
発行日: 1989/10/25
公開日: 2010/02/25
ジャーナル
フリー
A case of rubber bands and a strap embedded under the skin of the neck, in a 2-year and 2-month-old girl was presented. The superficial and deep ulceration was present in the neck.
A follow-up evaluation at one year and 4 months showed that the patient had no problem.
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青野 猛, 村田 英昭, 大慈弥 裕之
1989 年 38 巻 2 号 p.
836-838
発行日: 1989/10/25
公開日: 2010/02/25
ジャーナル
フリー
The treatment of degloving injury hand is often difficult, because the bone, nerve and vessel of fingers are exposed. For the reconstruction of such fingers we have used a vascularized free skin flap obtained from the posterolateral side of the lower leg. This flap is supplied by the cutaneous branches of the peroneal artery, drained by the accompanying venae comitantes. A case of this free peroneal flap transfer was reported.
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碓井 良弘, 岩永 正彦
1989 年 38 巻 2 号 p.
839-844
発行日: 1989/10/25
公開日: 2010/02/25
ジャーナル
フリー
We evaluated the esthetic results of donor site of full-thickness skin graft, and gained following conclusions.
1) The scar of longitudinal direction over the anterior iliac spine tends to become hypertrophic.
2) The scar of posterior area of the trunk tends to become hypertrophic more than the one of anterior.
3) Longitudinal scar looks longer than transverse one.
4) The scar of mid-lateral area of the trunk is inferior esthetically to inside area of the thigh.
5) Taking above facts, into consideration the operative methode to take full-thickness skin graft from abdomen transeversely and from inguinal area to inside of the thigh obliquely is best.
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奥野 徹子, 井上 明生, 川崎 正章
1989 年 38 巻 2 号 p.
845-847
発行日: 1989/10/25
公開日: 2010/02/25
ジャーナル
フリー
We report here a case demonstrating Charcot Joints at the lumber spine and ankle joints. The patient was a 27-year-old female, presenting the characteristic clinical and radiologic features of neurogenic arthropathy, but with no overt neurologic symptoms. In addition, she had a past history of fractures without pain, and her parents were consanguineous first cousins. A sural nerve biopsy showed normal findings in both the myelinated fibers and the unmyelinated fibers. We accordingly diagnosed the patient as having a subclinical inherited neuropathy, first reported by Dyck in 1983.
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高橋 修一朗, 米満 弘之, 山永 裕明, 中西 亮二
1989 年 38 巻 2 号 p.
848-850
発行日: 1989/10/25
公開日: 2010/02/25
ジャーナル
フリー
Fifty-one patients who had equinovarus and hammer toe deformities due to spastic paresis were operated on between June, 1986 and August, 1988. The average age of the thirty-six men and fifteen women was 55 years old (range, twelve to seventy-eight years old).
Vulpius procedure and tenotomy of the flexor digitorum longus and flexor hallucis longus were performed at the same time. In almost all cases, the operation showed good results. In our experience, this operative treatment has proved useful and safe for older patients with some complications.
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岩永 博隆, 瀬良 敬祐, 竹下 豊秋, 梅木 義臣, 乗松 敏晴, 藤田 雅章, 松坂 誠應
1989 年 38 巻 2 号 p.
851-856
発行日: 1989/10/25
公開日: 2010/02/25
ジャーナル
フリー
On 49 cases (51 ankle joints) of lateral collateral ligament injury of the ankle joint treated by Gould's method, the authors performed postoperative evaluation based on replies given by individual patients to a questionnaire. Of the 49 cases, fresh ones were 11 (11 ankle joints) and old ones 38 (40 ankle joints). Male patients were 18 and the female 31. These patients were aged 12 to 59, or 22.8 years old on the average. The period of follow-up study ranged from 7 months to 6 year, or 2 years and 10 months on the average.
The pastoperative results determined through the above follow-up study were evaluated in accordance with Fujita's criteria. The results of evaluation were that of the fresh cases, 81.8% were excellent and 18.2% good while 55.0% were excellent and 45.0% good with the old cases, the entire cases being rated better than good.
The Gould's method is a highly useful operative procedure without sacrificing the tendon and limited in operative stress and yet with relatively good results.
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松坂 誠應, 乗松 敏晴, 寺本 司, 藤田 雅章, 大城 昌平, 平野 英二
1989 年 38 巻 2 号 p.
857-860
発行日: 1989/10/25
公開日: 2010/02/25
ジャーナル
フリー
A special orthosis as an alternative to ankle taping was manufactured for the patients with injury of the lateral ligaments of the ankle. The device was applied over a cotton sock and tightened over the malleoli, the foot resting on a plastic sole with lateral strap. It was designed to hold the ankle in a neutral position avoiding inversion, dorsiflexion and plantar flexion of the ankle necessary for play.
The effects of the orthosis were evaluated from the viewpoint of the mechanical and functional instability. X-ray stress examination was performed as assessment of mechanical instability. Talar tilt angle and anterior displacement improved significantly using the orthosis from 11.4 degrees to 2. 5 degrees, and from 7mm to 3.6mm respectively. Stabilometry was used for quantitative assessment of functional instability. Stabilometric value improved significantly from 172mm
2 to 130mm
2 using the orthosis.
These results indicated that this orthosis is very useful for injury of the lateral ligaments of the ankle.
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梅木 義臣, 瀬良 敬祐, 竹下 豊秋, 岩永 博隆, 乗松 敏晴, 鈴木 良平
1989 年 38 巻 2 号 p.
861-864
発行日: 1989/10/25
公開日: 2010/02/25
ジャーナル
フリー
In the past 8 yesrs, the authors have treated 4 cases of traumatic dislocation of peroneal tendons in Nagasaki Mitsubishi Hospital. All of these were old cases, and they were treated by operative therapy with Du Vries' method. Even through a long period of follow-up, there was no evidence of mobile bone fragment absorption. Neither was there a complaint about limited range of ankle motion, nor were the incidents of pain and redislocation observed. With all the cases, therefore, the results were highly satisfactory. Du Vries' method, limiting the dislocation of the peroneal tendon from outside the joint and yet capable of completely preventing the dislocation of tendon, can be said to be an excellent technique.
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白石 光一, 弓削 大四郎, 河野 昌文, 三村 寛, 前原 洋二, 大上 仁志, 吉原 由樹
1989 年 38 巻 2 号 p.
865-868
発行日: 1989/10/25
公開日: 2010/02/25
ジャーナル
フリー
We reviewed 12 cases of tibial pilon fractures treated operatively. Seven cases had good or excellent results and one case had a fair result, but other four cases were not examined. On the lateral view of the X-ray film, it appeared that the fixation of antero-posterior direction prevented the dislocation of tibial fragments.
It is conceivable that the Dupuis' plate is a useful material for the surgical treatment of tibial pilon fractures.
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離断性骨軟骨炎
吉本 隆昌, 小林 晶, 徳永 純一, 王 享弘, 後藤 元徳, 福元 敬二郎
1989 年 38 巻 2 号 p.
869-874
発行日: 1989/10/25
公開日: 2010/02/25
ジャーナル
フリー
We reviewed seven cases (eight ankles) with the diagnosis of osteochondritis disscecans or osteochondral fracture of the talus.
Four patients were male and three were female. In four patients the lesions were on the left, in two patients on the right and one patient on the bilateral. Five ankles had a history of trauma.
There were five medial, and three lateral lesions of the talus.
Seven lesions were treated operatively: five were treated curettage and drilling, one by curettage and auto genous bone graft, and one by fixation with bone peg.
Seven lesions which were treated by operation had good results. One patient had only follow-up observation without any treatment.
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宮崎 昌利, 田口 厚, 中嶋 裕, 伊藤 京衛, 山田 正幸, 吉田 伍一, 平野 徹
1989 年 38 巻 2 号 p.
875-880
発行日: 1989/10/25
公開日: 2010/02/25
ジャーナル
フリー
We present two cases of rheumatoid arthritis and two cases of osteoarthrosis of the ankle whose ankle joints were treated with the ceramic total ankle prosthesis.
All the cases were female with the age ranged from 38 to 73 years. They were followed for one year and six months to six years and three months.
In all cases, the clinical symptoms were improved except for range of motion after surgery, but the roentgenograms revealed the clear zone arround the tibial component and the Varying degrees of sinking of the component which appeared to progress with time.
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小田 光義, 野村 一俊, 平野 真子, 千田 治道, 匂坂 正明, 水岡 二郎
1989 年 38 巻 2 号 p.
881-884
発行日: 1989/10/25
公開日: 2010/02/25
ジャーナル
フリー
We studied the cause, therapy, and prognosis of nineteen cases of the anserin's pain. The cases were treated from January 1984 to April 1988. Of these, eleven cases were anserina bursitis, four were exostosis of the medial condyle of the tibia and four were another disease. Five cases of the anserina bursitis were assosiated with minor trauma and sports. It is important not to overlook the anserina bursitis cases who have trauma and osteoarthritis. Three of four cases of bursitis were given symptomatic relief by injection of adrenocortical steroids. The patients with bursitis and exostosis, who were treated operatively (by removal) because conservative therapy was not effective, obtainal satisfactory relief of pain.
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後藤 武史, 稗田 寛, 金沢 親良
1989 年 38 巻 2 号 p.
885-888
発行日: 1989/10/25
公開日: 2010/02/25
ジャーナル
フリー
Subtalar dislocation of the foot is an uncommon injury involving simultaneous dislocation of the talonavicular and talocalcaneal joint. Smith found only seven cases (1.3%) in a review of 535 consecutive dislocations of all types, and Leitner found 42 cases (1%) among 4215 dislocations.
Two cases of subtalar dislocations are reported.
Casel: A 55-year-old man with medial subtalar dislocation was treated by closed reduction under general anesthesia. At 4 years and 8 months after injury, the patient had no complaint in his foot, and roentgenograms could not confirm avascular necrosis of the talus, however, it confirmed osteoarthritic changes of the talocalcaneal joint.
Case2: A 17-year-old man with laterl subtalar dislocation associated with large osteochondral fracture of the talus was treated by closed reduction using a wire-traction method under spinal anesthesia. At 1 year and 6 months after injury, roentgenograms confirmed solid union of talus fracture, and that avascular necrosis of the talus had not occurred. The patient could run fast, and he had no complaint in his daily activity.
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島田 信治, 芝 啓一郎, 香月 正昭, 植田 尊善, 白澤 建蔵, 大田 秀樹, 森 英治, 檜田 伸一
1989 年 38 巻 2 号 p.
889-893
発行日: 1989/10/25
公開日: 2010/02/25
ジャーナル
フリー
Artificial embolization therapy for spinal cord arteriovenous malformation (AVM) has progressed remarkably with the advancement of selective spinal angiography.
We experienced two cases. In case 1, good result was obtained. But in case 2, neurological deterioration occurred just after embolization by use of Gelfoam. Neurological deterioration seemed to be caused by the occlusion of normal anterior spinal artery. After some recovery of neurological deterioration, we added embolization by use of Ivalon Particles for the insufficient embolization of AVM. In this additional trial, good embolization was obtained without any neurological deterioration.
In embolization, we have to embolize the AVM carefully under angiographic control, confirming the neurological symptoms and subjective complaints.
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原田 博文, 泊 一秀, 真角 昭吾
1989 年 38 巻 2 号 p.
894-897
発行日: 1989/10/25
公開日: 2010/02/25
ジャーナル
フリー
A review was made of eighteen cases of degenerative lumbar spinal canal stenosis. Cases associated with spondylolisthesis were excluded. Seventeen males and one female had a mean age of sixty-five years.
Intermittent claudication in seventeen cases, sensory disturbance in seventeen cases, low back pain in fourteen cases, muscle weakness in ten cases, and B-B dysfunction in four cases were the preoperative clinical manifestations.
Myelography revealed total thirteen complete blocks in the intervertevral spaces of the eleven cases, incomplete blocks in the spaces of the fifteen cases.
All were treated surgically with the method so called “multiple fenestration”, including fenestration of the inter-laminae space, superior and inferior facetectomy and resection of the yellow ligament. Fusion was not made simultaneously. Marked improvement of the clinical symptoms was noted postoperatively in all of the cases.
Multiple fenestration without fusion was a useful technique in case of degenerative lumbar spinal canal stenosis.
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安部 哲一, 直野 敬, 川村 秀哉, 諫山 哲郎, 小野 正彦, 安部 秀顕, 高下 光弘
1989 年 38 巻 2 号 p.
898-901
発行日: 1989/10/25
公開日: 2010/02/25
ジャーナル
フリー
This is a clinical study of tuberculous spondylitiss in our department in the past ten years. 18 cases were investigated: 6 cases treated conservatively and 12 cases operatively.
On the whole, we had good results both on the conservative and operative treatment, but the average period of bed rest and hospitalization was longer in the non-operative than in the operative treatment. Biopsy seemed to be most reliable method to get diagnosis of tuberculous spondylitis in early stages, although there were some cases which could not be diagnosed with biopsy only. Once diagnosis of tuberculous spondylitis is made, operative treatment should be taken in consideration.
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横山 庫一郎, 篠原 典夫, 近藤 正一, 三浦 裕正, 長嶺 隆二, 佐田 正樹
1989 年 38 巻 2 号 p.
902-904
発行日: 1989/10/25
公開日: 2010/02/25
ジャーナル
フリー
A case of malignant fibrous histiocytoma of a hand carpal bone is reported in a 37-year-old male. This represents the first reported case of malignant fibrous histiocytoma at this site.
The patient complained of right wrist discomfort or dull pain of two years duration. X-rays were read as showing well defined osteolytic lesion with marginal sclerosis of the lunate. A diagnosis of intraosseous ganglion was made and it was treated by curettage and bone graft. However, the lesion showed no evidence of ganglion. Histologic examination of the tissue obtained revealed dense aggregates of atypical cells suggestive of metastatic carcinoma. Reevaluation including immunohistological studies concluded the tumor to be a variant of malignant fibrous histiocytoma. He was treated by amputation of the distal forearm and started on chemotherapy with the following scheme: cyclophosphamide 500mg/m
2 on day 1 of each cycle; adriamycin 50mg/m
2 on day 1; DTIC 200mg/m
2 on days 1, 2, 3, 4 and 5. Cycles were repeated every 4 weeks lasting 6 months. The patient is free of disease for ten months.
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横山 庫一郎, 篠原 典夫, 近藤 正一, 筒井 秀樹, 長嶺 隆二
1989 年 38 巻 2 号 p.
905-907
発行日: 1989/10/25
公開日: 2010/02/25
ジャーナル
フリー
Most patients with soft tissue sarcomas of relatively small size are firstly treated by primary doctor with simple local excision or enucleation because of the relative rarity of malignant soft tissue tumors and the unfamiliarity of this breed. Seventeen patients with soft tissue sarcomas initially treated by simple local excision were managed by additional surgical procedure of wide curative resection. Although three patients of trunk sarcomas had local recurrence again, the rest 14 were free from the tumor locally.
Many quetions remain unanswered regarding how much surgery is enough, what is the best adjunct and what is the better method of curative surgical management. Additional management is capable of either suppressing or eradicating micro- or macro-residual tumors. Local conservative procedures augumented by adjunctive management have less recurrences than simple local excision alone has had in the past. More patients live longer and have good prognosis because of additional management.
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吉田 健治, 田中 博之, 井上 博, 山中 健輔, 井上 明生
1989 年 38 巻 2 号 p.
908-911
発行日: 1989/10/25
公開日: 2010/02/25
ジャーナル
フリー
The recognition of carpal instability as a clinical entity is relatively recent. The relationship between perilunate dislocation and dorsiflexed intercalated segment instability of the wrist is a matter of controversy.
In the wrists of seventeen patients treated by closed reduction or open reduction, fourteen perilunar dislocations with fractures of the scaphoid and other bones and three perilunar dislocations without fractures, a roentgenographic analysis was carried out. After injury, twelve of the seventeen patients had open reductions of their dislocations and five of the seventeen had closed reduction.
From these studies, it was concluded that the cases of the Perilunate dislocations with non-union of the scaphoid had the tendency to leave with a carpal deformity characteristic of dorsiflexion instability.
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柴山 慶, 小宮 節郎, 田中 秀武, 黒崎 省吾
1989 年 38 巻 2 号 p.
912-914
発行日: 1989/10/25
公開日: 2010/02/25
ジャーナル
フリー
The OMNIFIT prosthesis has been used in the last three years in our clinic for 16 elderly patients with fractures of the intracapsular femoral neck.
This prosthesis designed to fit intramedullary in three dimentions provided a good stability.
All patients returned to activity and avoided complications because of immediate weight bearing.
For the elderly patients with a limited life expectancy, it seems just important to gain a immediate return to activity without a fear of unpredictable avascular necrosis or nonunion in case of internal fixation.
We recommend prosthetic replacement for fresh fractures of the femoral neck of elderly patients for that reason.
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原 正文, 竹下 満, 緑川 孝二, 尾上 敏博, 高岸 直人
1989 年 38 巻 2 号 p.
915-917
発行日: 1989/10/25
公開日: 2010/02/25
ジャーナル
フリー
It was possible to enucleate elbow joint mice arthroscopically in 2 cases using a Watanabe No. 24 arthroscope, the main advantage of which was to enable patients to resume their work routine as early as possible.
Case 1. A male (16 years old) had played softball from 4th grade to 6th grade in elementary school. Around September 1986, while throwing handball, his right elbow began to ache, a symptom which disappeared after three days, and during the first ten days of November, 1987, painful movement and limited elbow motion occurred at the elbow joint. The faint, transparent pictures of the capitulum humeri and several joint mice were examined by radiography, and the condition was diagnosed as osteochondritis dissecans of the right elbow. This condition was further examined arthroscopically using a posterior radial approach, and the joint mice were enucleated, using a supraolecranal radial approach. The occurrence of limited elbow motion and the painful movement disappeared 6 days after surgery, which enabled the patient to leave the hospital to resume his daily work routine successfully.
Case 2. The right elbow of a 28-year-old male began to ache without any apparent cause during 1985, thereafter, locking syndrome occurred several times a year, but the faint transparent pictures of the capitulum humeri and the joint mouse were examined by radiography, and the condition was diagnosed as osteochondritis dissecans. Enucleation of the joint mouse was therefore performed using an arthroscope adopting a similar approach as for case 1. The painful movement and limited elbow motion disappeared 3 days after surgery, which resulted in the patient resuming his daily work routine.
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檜田 伸一, 芝 啓一郎, 香月 正昭, 植田 尊善, 白澤 建蔵, 大田 秀樹, 森 英治, 島田 信治
1989 年 38 巻 2 号 p.
918-920
発行日: 1989/10/25
公開日: 2010/02/25
ジャーナル
フリー
We reported a seventeen-year-old woman with Chance type fracture in the lumber spine which was caused by a slight injury three years after Harrington Instrumentation. Harrington Instrumentation combined with posterior fusion with bone grafting is now a common and basic method for the scoliosis. However, it still causes several problems in a long period of follow-up.
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下永吉 耕一, 上崎 典雄, 松永 大助, 村上 陽太郎, 西崎 博己, 西田 民夫, 上妻 隆秀, 山本 裕之, 南島 広治, 山口 宏治
1989 年 38 巻 2 号 p.
921-924
発行日: 1989/10/25
公開日: 2010/02/25
ジャーナル
フリー
We performed hip arthroplasty for osteoarthritis using bipolar endoprosthesis combined with bone grafting acetabuloplasty on 4 hips and reviewed them. Grafted bones were survived and remodeled in all cases and results of them were almost good. Especially, they were improved in pain. Bone grafting was performed expecting more than 10° of CE angle. For the correction of leg lengh discrepancy, we consider that it is necessary to place the cup in the original acetabulum as proximally as possible.
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緑川 孝二, 竹下 満, 原 正文, 岩本 英明, 高岸 直人
1989 年 38 巻 2 号 p.
925-929
発行日: 1989/10/25
公開日: 2010/02/25
ジャーナル
フリー
Arthroscopic operation, e. g, . debridement and arthroscopic subacromial decompression (abbreviated to ASD), was performed in both cases of rotator cuff tear; where open rotator cuff suture was not indicated
The subjects comprised 12 paitents (14 shoulders) with rotator cuff tear, 10 (12 shoulders) with a complete tear and 2 (2 shoulders) with a joint surface tear; they were all male and ranged in age from 18 to 81 years with a mean of 61.0 yeaas.
The follow-up period ranged from 105 to 18 months with an average being 6.3 months. Pre-and post-operative results were evaluated according to the “Shoulder evaluation of J. O. A.” By this scoring system, the resuls increased in score of 15.2 on average.
From these results it seems inferable that arthroscopic operation, being less invasive, is indecated in senile individuals in whom rotator cuff suture has been considered contraindicated and, moreover, is absolutely indicated even in those patients who are unable to elevate the affected shoulder due to severe pain if the ability to elevate the shoulder is restored after injection of procaine into the affected area. Arthroscopic operation maythus be concluded to have great advanatages of being less invasive and permitting early initiation of rehabilitation program postoperatively and early discharge from the hospital.
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原 雄人, 内藤 英俊, 田所 英二, 太田 剛, 村川 義康, 河野 渉, 原 武郎
1989 年 38 巻 2 号 p.
930-932
発行日: 1989/10/25
公開日: 2010/02/25
ジャーナル
フリー
In view of possible involvement of susceptible kind, degree or mode of living in the onset of osteoarthritis of the knee, we examined by questioning 104 patients with primary osteoarthritis of the knee for their occupations, modes of living, etc. before the onset.
The results revealed obesity as the most responsible factor, but not the causal predominance of hard labors. Acute onset and night pain have been experienced by 30% and more than 50% of the patients, respectively.
These results suggested progressive narrowing of articular fissures, on one hand and bone necrosis preceeded by sudden bone destruction leading to rapid deformity, on the other.
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1989 年 38 巻 2 号 p.
933-941
発行日: 1989/10/25
公開日: 2010/02/25
ジャーナル
フリー
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1989 年 38 巻 2 号 p.
942-949
発行日: 1989/10/25
公開日: 2010/02/25
ジャーナル
フリー
