Authors investigated the hip joints and skulls of the seemingly normal 352 infants. The results obtained were as follows; 1) Congenital dislocations of hip joints were found in one male and 5 females, acetabular hypoplasias in 53 infants, cranio-tabeses in 54, and enlarged fontanels in 63. 2) Relationship between the findings of hip joints and skulls is showed in following table. 3) Serum-chemistry in infants with craniotabes reserved the average amount of 2.67mg/dl of phosphrus, 10.86mg/dl of calcium and 7.7 units of alkaline phophatase.
I experienced a case of humerus varus which was comparatively rare. The patient was 15 years old high school girl. Symptoms: 1. Limitation of movement of the left shoulder joint. (80 degrees in abduction.) 2. The left upper arm is 3.5cm shorter than the right. X-ray photography: Upper humerus end is varum and backward refracted, but no detraction or atrophy of bone. Treatment: I tried osteotomy at the neck of humerus, transplantation of bone and fixation by plaster cast. I believe that the defect comes from abnormal growth of proximal epiphyseal plate which has been expounded by many authors.
The statistical observation of fresh fractures, treated at Onoda Municipal Hospital for 21 months from January 1953 to September 1954 are as follows; 1. The objects of examination were 228 patients, namely 282 fractures. 2. At positional distinction, fractures of legs and arms were the most frequent, then feet and hands. 3. Spinal fractures were overwhelming majority to coal miner. 4. Observing the age distinction, fractures of children to 15 years old occupied more than 30% of all fractures and decreased gradually, on the but increased ages there was a tendency to increase again at above 50 years. 5. Fractures of children were the most frequent at the vicinity of elbow. 6. The most frequent causes of fractures were downfalls, next falling rocks, falls of weight articles, overturings and traffic accidents. 7. Conservative treatment in 164 cases and operative treatment in 40 cases were performed. 8. Duration of medical treatment, patients of labourer accident compensational insurance are longer than general patients, but it can not be helped in the present compensational institution.
The statistic observation about 474 cases of fractures, which were treated for the last four years in a coal mine are as follow; 1. The occupational injuries are on the decrease year by year, but the cases of fractures are on the increase. 2. Fractures occured mostly in December and May; the cases of fractures were more numerous on the beginning of week, but few on the weekend. 3. Fractures occured most frequent during the midday, next at the beginning and the end of work. 4. Fractures occured mostly in the twenties, then in the thirties and fourties. But it happened still in the fourties, in spite of their services of long years in the mine. 5. Fractures occured 80% in a mine. The cases of the worker, who had remained at a workshop for a while, were numerous, but anyone else few. 6. Fractures arised mostly from fallen masses of earth, then waggons and falls of workmaterials. 7. The lower limbs were most frequent and next is upper limbs, as it approached towards the limbs end, the more fractures occured frequent. 8. The term of the recuperation of fractures of coal miner was longer than the other occupations.
515 patients are observed about their qualitative and quantitative attitude in callus formation. Several differences are found according to its localization the grade of dislocation and operative injuries. 1. Callus formation are richer in the dislocated than not dislocated. 2. Generally they are in the bridge form and are richer in the concave side. 3. They are good produced in the side of comparatively richer soft supporting tissue and poor in the operative injured. As a conclusion, callus formation are much influenced not only by the mechanodynamic factor but also the local anatomical factor.
We investigated the patients of spinal injuries which occured according to labour accidents in Fukuoka Prefecture from August 1948 to May 1954. Results were as follows; 1) In the each year, the number of the spinal injured were about 400 persons. The patients of spinal cord injury occured in about 30-40 persons, Fractures and dislocations of vertebral bodies happened on about 250 persons. 2) Causes of accidents were much happened in the pit and 71.5% of cases occured according to the accidents in the coal-mine similarly. 3) The injuries of vertebrae were the most frequent in the vertebra thoracica XII and lumbalis I. 4) Fractures of processus costarius were most injured in vertebra lumbalis III and in the left side. 5) The duration of treatment were 6 monthes in many people who had fracture and dislocation of vertebrae, except the spinal coal injured.
Comparing trauma between Kappe mining method, new method, imported from Germany after the war and old mining method, the trauma frequency in new method have been decreased very much. Seeing about the kinds of working, the trauma owing to shoveling and packing have been so much decreased. Seeing about the kinds of cause, the trauma owing to roof fall have been decreased very much and owing to side wall collapse, iron prat and wooden prot have been decreased. Seeing about a part, the trauma of head and shoulder have been decreased so much, on the contrary, trauma of waist, shoulder and hand tend to increase. Amount of coal produced have risen from 8.12 ton to 11.8 ton per a man, namely have risen 45.5 percent. As above, new methods show the excellent results in production and safety.
In recent three years, we have observed statistically about the socalled “lowback pains” in the Yonago district. 1) There are 559 cases (10.9%) of the patients who complain the low-back pain, in the total out-patient 5559. 2) An overwhelming majority of the patients have the so-called “low-back pain.” 3) A great number of them are from 21 to 40 years old in males, and from 21 to 30 years old in females. Males are more than females at the proportion of 1.6 to 1. 4) One-third of their occupation are the agriculture. 5) Their anamnesis and proximate causes are not worth special mentions. 6) A number of them find difficulty in bend the back before and behind. 7) A great many of the low-back pain are slow and not change by the repose. 8) The past treatments of many patients are nothing, acupuncture, or moxacautery. 9) The objective symptomes of a number of the patients are only oppressive pain. This inquiry is about the so-called Low-back Pain except from specific diseases of the spine.
1) On the proximal ends of the tibiae of rabbits, merthiolate bone ends of dogs were transplanted. A total of 34 rabbits were operated on. Thirteen rabbits among them survived and were satisfactory for study. Roentgenograms were obtained at regular intervals, and the animals sacrified at intervals varying from 10 days to one year, and then the histological changes in the joints were followed. 2) A satisfactory range of motion, apparently without pain, is demonstrable during the course of these experiments. 3) All of the cells in transplants died. Revasculation and active osteogenesis in transplants gradually progressed By three months, this creeping replacement was accomplished. 4) Two months postoperative, enchondral ossification in the articular cartilage was observed. On the other hand, the articular cartilage degenerated and became thin more and more until to the thin fibrous membrane which covered the bone end. 5) Six months postoperatively, in the transplants replaced by new bones osteoarthritic changes occured. Usually, however, satisfactory function persisted, and, surprisingly enough, the rabbits continued to bear weight even when roentgenograms showed extensive degenerative changes.
I have experimented on bony growth, changes of epiphyseal cartilages in 35 days old rats, killed after 10 Weeks treatment. Summary of the results: 1. Teststeron prop. 0.1mg every day; The bony growth was promoted feebly, but body weight and length was unconstantly. Testis was atrophied. 2. Estradiol benz. 0.1mg every day; I have observed after 3 weeks the epiphyseal discs become narrower the body length and weight inhibited hardly. The endosteal ossification was accelerated. The ovary atrophied, adrenal was hypertrophied. 3. Thyradin 0.5 every day; The bony growth of rat and calcification was accelerated. Thyroid was atrophied, hypophysis had no changes. 4. Thymus ext.; I have treated 2gr 5 weeks and 1gr 3 or 10 weeks. The earlier period, the bony growth was promoted, but long after it has been no changes. Gonads was hypertrophied.
For the purpose to measure the accurate angles of forearm rotation, the authors designed gravity goniometer Two hundred and seventy eight sound forearms and fourty two fractured were measured by our goniometer. The results obtained were as follows; 1) In the sound forearms, the average degrees of rotation were about 170°, and the differences between the male and female and the right and left side were insignificantly. The average ranges of pronation were 70% of supination, and they were about 15 to 20 degrees larger in passive rotation than in active. 2) The rotation, especially pronation, was restricted after the fractures of both bones of forearm and Monteggia's fractures, and the loss of rotation after the former fractures increased together with ages. The restrictions of rotation were slightly after the Colles' fractures and the shaft fractures of single bone of forearm.
We carried out the walk-training for the non-recoverable paralysis in both the lower extremities, according to the spinal cord injury, under the schedule following. 1. Exercise to squat down on knees on the bed. 2. Active motion of the upper extremities and the body. 3. Motion of the lower extremities and the pelvic. 4. Standing-and walking-exercise by the walking helper. 5. Going-exercise by the crutches. Generally, non-recoverable paralysis in the both the lower limbs, considered as a crippled persons, can walk alone by the crutches, and decrease the complications and more and more acquire a occupational ability, by our exercise. Authors examined 34 cases of the paralysis 16 cases can walk by the crutches, and 12 cases contained in those 16 cases can walk a rough road.
1st case: Brachial plexus and median nerve paralysis following the poisoning of Allobarvital and Bonodorin-Na. 2nd case: Peroneal nerve paralysis following the poisoning of Adolum. 3and case: Ulnar nerve paralysis following the poisoning of Brovarin. We conclude that these peripheral nerve lesion are radiculoneuritis caused by poisoning of sleeping drugs. The reasons are as follows. Sensory paralysis was extensiver than motor paralysis. Pressure pain was noticed not only on the total length of paralyzed nerve, but on the other nerves of paralyzed extremity, In the first case the nerve lesion increased by prescription of Allobarvital 0.1gr.. In all cases the neuralgical pain was noticed, and vitamin B1 took effect.
Author experienced recently two cases of tuberculous osteomyelitis of the greater trochanter, and these patients had tuberculous diseases of other organs in the past. In one case it was believed that the latent foci of tuberculosis had got activity by local bud —heavy-strength, and trauma. This disease advanced slowly. On the contrary in the another case the latent foci got activity by the general bud, tuberculosis of other organs. Patient had healed up at a few months, by excision, and these developed favorably.
The statistic observation concerning the chemotherapy in the infantile bone and joint tuberculosis treated in our clinic during the last about three years has been made. Among these patients, 85 per cent recieved the chemotherapy, and six cases of whom were discovered at the early stage and observed for relatively long times after. Clinically and roentgenologically, four of these patients were cured almost completely, two showed the bud results while they had having better courses during the first year period and it is supposed that the subsequent treatment was unjustifiable. It seems that the chemotherapy in bone and joint tuberculosis is less effective than those in lung tuberculosis, and should be used during or after the operation of tuberculosis. But in the infantile patients, moreover at the early stage as has been previously mentioned, author believes that the chemotherapy should be able to stop the progressive changes of tuberculosis, to get the local immunization, and to reduced the periods of the treatment. But of course, early diagnosis, early treatment, and strict retention by classic methods are the indispensable condition in order to get the best results.
During this three months, we have experienced 10 cases of tumors, that are 1.6% of all consulted patients, a great percentage compared with 0.25 percentage of Keio University and 0.9% of Niigata University. It is very interesting that about a half of these tumors were fibrocystic disease including fibrous dysplasia. Primary sarcoma of 3rd lumbal vertebra and metastatic hypernephroma were also very interesting.