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大坪 義昌, 藤田 雅章, 泉 賢太郎, 吉原 由樹, 本岡 勉, 伊藤 茂, 藤井 秀治
1993 年 42 巻 4 号 p.
1579-1582
発行日: 1993/09/25
公開日: 2010/02/25
ジャーナル
フリー
Metastatic tumor to the intradural-extramedullary region of the cauda equina is very rarely reported with only a few cases previously reported in Japan.
We report a rare case of metastatic tumor to the cauda equina derived from lung cancer.
A 41 year-old-man had radiation therapy and chemotherapy for lung cancer in our hospital. Three months later, he developed lumbago and this gradually worsened until he was, finally admitted to our department complaining of muscle weakness in both legs, gait disturbance and urinary disturbance.
A nodular mass was found in the dural sac at the level of L3 vertebrae on MRI. The myelogram showed total block at the level of the L3 vertebrae.
Surgery (Laminectomy and resection of the tumor) was performed and the histological diagnosis of the tumor was adenocarcinoma. Clinical symptoms hardly improved and the patient died three months later.
Although it is very rare, should be kept in mind the possibility of metastatic tumor to the cauda equina in patients with primary malignant tumors.
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西良 浩一, 遠藤 寿男, 辺見 達彦, 中野 俊次
1993 年 42 巻 4 号 p.
1583-1586
発行日: 1993/09/25
公開日: 2010/02/25
ジャーナル
フリー
Foramen magnum tumors produce many bizarre symptoms, and several reports have mentioned the pitfalls in diagnosing such tumors. In this report, we confirm such a tumor causing motor disturbance of the contralateral extremities. A 64-year-old male with a 2-year history of numbness of the right extremities and motor disturbance of the left extremities presented to our hospital. Neurological findings were as follows: hypoesthesia of the right hand and both lower legs, weakness of the left extremities, hyperactive deep tendon reflexes in the left upper and lower extremities, and Hoffmann's and Babinski's signs on the left side were present. On MR images, myelogram and CT-myelogram a dumbbell shaped tumor, which showed compression of the cervical spinal cord from the right side at the level of C1-C2, was noted. The tumor was surgically resected, and on histological examination it was diagnosed as a neurinoma. In this case the tumor was situated at C1-C2 below decussation, however, weakness and increased deep tendon reflexes were found in the contralateral extremities. The main function of the upper cervical spine is rotation. The spinal cord is compressed by contralateral lamina during rotational motion of the upper cervical spine. Thus, as noted in the present study, contralateral motor disturbance may occur.
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寺本 弘, 永田 高見, 谷脇 功一, 木屋 博昭, 弓削 孝雄, 越智 龍弥
1993 年 42 巻 4 号 p.
1587-1590
発行日: 1993/09/25
公開日: 2010/02/25
ジャーナル
フリー
Meningioma is well known to develop histologic calcification and ossification. However, these lesions are seldom revealled radiographically. We report a case with ossification evident radiographically such that the tumor shadow was confirmed by a simple roentgenogram. A 70-year-old woman on admission had good to fair MMT in both lower extremities and slight spastic paralysis and rigidity. Sensory disturbance was observed at Th4 and lower. On MRI, a mass lesion which was slightly enhanced by Gd-DTPA with low density on T1 and T2, was found in the vertebral canal at the level of C7. A round tumor-like shadow was also found at the same position by simple X-ray analysis. The tumor was extirpated and found to be thumb sized, spheroidal, bony hard and gray matter. Most of the tumor consisted of bone trabeculae, although whorl formation and psammoma bodies were observed in some of the tissue leading to the diagnosis of osseous meningioma.
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秋元 伸之, 麻生 邦一, 真角 昭吾, 近藤 稔, 川嶌 眞人, 直野 敬, 酒井 公範, 多治見 新造, 吉田 盛治
1993 年 42 巻 4 号 p.
1591-1594
発行日: 1993/09/25
公開日: 2010/02/25
ジャーナル
フリー
Twenty-eight patients with injuries associated with physeal injury of the distal radius were reviewed radiologically and clinically. Fracture of the ulnar styloid process was found in twenty cases, fracture of the distal ulna in seven, and physeal injury of the distal ulna in one. Fracture of the distal ulna was united in all cases, but fracture of the ulnar styloid process was united in only five of fourteen cases which were followed from four months to nine years. However, none of the cases with non-union of the ulnar styloid process were symptomatic. We emphasize that fracture of the ulnar stybid process often does not unite, and must be followed for a long time.
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浦野 正之, 土井 一輝, 酒井 和裕, 安部 幸雄, 片岡 秀雄, 河合 伸也, 伊藤 孝, 山本 久司
1993 年 42 巻 4 号 p.
1595-1597
発行日: 1993/09/25
公開日: 2010/02/25
ジャーナル
フリー
We studied 13 patients who were surgically treated for malunion of fractures of the distal end of the radius. Results were analyzed according to the McBride evaluation system, as reported by Sarmiento, and radiographic comparison of final and pre-operative X-ray films was made. On the basis of radiographic and functional evaluation, results were judged to be good to excellent in 92%. When there was over 20 degrees of dorsal or palmar tilt, open wedge osteotomy was performed. When there was greater than 5mm of ulnar variance, Milch's method or Kapandji's method were used. At follow-up, dorsal tilt or palmar tilt following open wedge osteotomy was less than 7 degrees. Ulnar variance following treatment using Milch's or Kapandji's method was almost zero.
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前田 和成, 本川 哲, 矢部 嘉浩, 原田 真一, 真子 安二
1993 年 42 巻 4 号 p.
1598-1602
発行日: 1993/09/25
公開日: 2010/02/25
ジャーナル
フリー
We treated 10 fractures of the distal end of the radius using an anatomical radius plate (ARP). Two patients were male and eight were female, ranging in age from 18 to 85 years (mean, 60.7 years) at the time of injury.
The radiological degree of dorsal tilt, radial angle, and radial length were measured from the time of injury to the last follow-up examination to evaluate the anatomical result. Clinical prognosis was evaluated using Saito's method of assessment. Furthermore patients treated by cast fixation or percutaneus pinning and cast, had radiological measurement and clinical evaluation carried out.
In the group treated with ARP the final degree of dorsal tilt was 5.2°, and the change in radial length, representing redisplacement of radial shortening, was 0.9mm. Compared with other therapeutic groups, the radiological results of this group were assessed as better and even their clinical results were superior to others.
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北川 守, 田代 直輔, 宮崎 洋一, 古市 格, 青柳 孝彦, 前田 謙而, 岩崎 勝郎
1993 年 42 巻 4 号 p.
1603-1607
発行日: 1993/09/25
公開日: 2010/02/25
ジャーナル
フリー
Comminuted fractures of the distal end of the radius are difficult to align and reduction of the fracture is difficult to maintain. Since 1983 we have treated such cases by external pin fixation. Twelve patients were evaluated. In the roentgenographic evaluation final radial angle averaged 22.8°, radial length averaged 9.4mm, and ulnar variance averaged 3.3mm. These figures are close to the average of the uninjured side. Five patients showed dorsal angulation. Wrist dorsal flexion averaged 68.3°, and volar flexion averaged 63.8°. Supination and pronation were almost in the normal range. We used Saitou's point system to assess the patient and according to this five patients had excellent results: 6 patients, were good; and only one patients was assessed as fair. External pin fixation was very useful for treating comminuted fractures of the wrist.
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玉井 誠, 田嶋 光, 下村 義文, 糸永 一朗, 福元 隆史, 吉田 浩次, 植村 理恵, 本田 和美, 亀尾 香珠代
1993 年 42 巻 4 号 p.
1608-1614
発行日: 1993/09/25
公開日: 2010/02/25
ジャーナル
フリー
Median nerve palsy is a well known complication associated with fractures of the distal radius.
However due to their low frequency, we sometimes hesitate in making therapeutic decisions about them.
We analyzed 11 cases of median nerve palsy associated with distal radius fractures, from the view point of diagnoses, course and therapeutic results.
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井樋 直孝, 佐々木 賀一, 新井 堅, 山本 裕之, 寺戸 一成, 石橋 裕一, 星野 秀士
1993 年 42 巻 4 号 p.
1615-1617
発行日: 1993/09/25
公開日: 2010/02/25
ジャーナル
フリー
We report a case of extensor pollicis longs tendon entrapment in a fracture of the distal radius. A 17-year-old man fell from his motorcycle suffering a Smith's fracture of the right radius. The patient was treated with surgical reduction and internal fixation. The management of severely displaced Smith's fracture requires that any patient with loss of thumb extension should be observed closely. If there is no improvement, surgical exploration should be necessary.
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三原 栄一, 野口 雅夫, 前田 公
1993 年 42 巻 4 号 p.
1618-1622
発行日: 1993/09/25
公開日: 2010/02/25
ジャーナル
フリー
This study evaluated the surgical results achieved in patients with olecranon fractures.
Patients comprised 11 men and 8 women with an average age of 47 years who were followed up for 6 months to 6 years 4 months (mean: 2 years 4 months). The fractures were grouped according to Wadsworth's classification. The method of fixation was tension band wiring technique (Zuggurtung) for all cases of type I and type II fractures and tension band wiring technique plus reconstruction plate fixation with screw fixation for many cases of type III and IV fractures. Postoperative results were assessed using the Japanese Orthopaedic Association's criteria. The average score at follow-up was 87.6 points and almost all the results were satisfactory.
Results depended upon the fracture type, that is, results tended to be not as good in communited fractures and open fractures in comparison with simple fractures and closed fractures.
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仁科 博志, 角 典洋, 川崎 正章, 南谷 和仁, 藤田 彰, 西岡 英次
1993 年 42 巻 4 号 p.
1623-1625
発行日: 1993/09/25
公開日: 2010/02/25
ジャーナル
フリー
Fracture of the capitellum humeri is uncommon and the diagnosis depends on accurate lateral radiographic views.
We experienced four cases of this fracture. Three cases were treated by open reduction and internal fixation. The follow up period ranged from 8 to 18 months (mean; 11 months). The Type III case according to Grantham's classification achieved a poor result due to adhesion of the joint capsule. Results of treatment were affected by many factors with a good anatomical reduction of the dislocated fragment and early internal fixation thought to be essential for rehabilitation to obtain a satisfactory result.
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古市 格, 前田 謙而, 田代 直輔, 北川 守, 青柳 孝彦, 宮崎 洋一, 常岡 武久
1993 年 42 巻 4 号 p.
1626-1630
発行日: 1993/09/25
公開日: 2010/02/25
ジャーナル
フリー
Two cases of traumatic radio-ulnar synostosis were treated by excision of the cross union and interposition of a free fat transplant.
The first case, a 48-year-old woman developed a radio-ulnar synostosis in 20° supination after proximal radial and ulnar fractures. At 29 months post-operative follow-up, active range of motion was 10° pronation and 80° supination. There was no evidence of recurrence of the synostosis.
The second case was a 32-year-old man who developed a radio-ulnar synostosis in neutral position after fractures of the proximal radius and ulna. At 19 months post-operative follow-up, active range of motion was 80° pronation and 70° supination. There was no evidence of recurrence of the synostosis.
Computerised tomography was carried out at 19 months post-operatively, showing the fat to be still present.
The functional result of the two cases was excellent, thus this is a successful method of treatment to use in such cases.
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藤井 裕之, 河合 伸也, 小田 裕胤, 斉鹿 稔, 川上 不二夫, 浦野 正之, 豊田 耕一郎
1993 年 42 巻 4 号 p.
1631-1633
発行日: 1993/09/25
公開日: 2010/02/25
ジャーナル
フリー
This study investigated whether cervical bone mineral density (BMD) measured by Dual-Energy X-Ray Absorptiometry (DEXA) was a reliable parameter for estimation of local bone metabolism of the cervical spine in patients with symptomatic cervical disorders.
We examined the reproducibility of quantifying cervical BMD by DEXA, and cervical BMD was compared with lumbar and right femoral neck BMD. Cervical BMD was measured in 23 normal females. The precision of lateral BMD measurement of the cervical spine by DEXA (CV=2.77%) was as good as that of the lumbar spine and right femoral neck (respectively, CV=2.02% and 2.37%). Age-related BMD changes seen between 20 and 60 years of age in cervical spines were similar to those in the lumbar spines. Correlation between C
5 BMD and L
3 BMD was highly significant in normal females (r=0.67, p<0.001).
These results suggest that cervical BMD reflects the general bone mineral content movement. Therefore, we concluded that DEXA can be a powerful tool for estimation of local bone mineral content movement of cervical spine.
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西原 彰彦, 岡野 徹, 岸本 英彰, 萩野 浩, 山本 吉藏
1993 年 42 巻 4 号 p.
1634-1637
発行日: 1993/09/25
公開日: 2010/02/25
ジャーナル
フリー
We evaluated bone atrophy in 79 female patients with femoral neck fractures (45 trochanteric, 34 cervical) and 47 healthy female controls by radiographic morphometry. On the femoral radiographs, the following measurements were taken: Singh index; width of the calcar femorale just above the lesser trochanter; lateral cortical width (FTCW) near the level of the lesser trochanter; total width (FTW) and cortical width (FCW) at the midshaft of the femur, where the cortical width was maximal; and the ratio (FCW/FTW) of cortical width to total width at the midshaft of the femur.
There was no significant difference in Singh index between the three groups. Width of calcar femorale, FTCW, FCW and FCW/FTW were significantly lower in two fracture groups than in controls. There was no significant difference in all measurements between two fracture groups. However, using multiple linear regression analysis, calcar femorale width, Singh index and FCW/FTW were significant in trochanteric fracture patients and only calcar femorale width was significant in cervical fractures.
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成田 修吾, 小宮 節郎, 金江 浩, 山中 健輔, 井上 明生
1993 年 42 巻 4 号 p.
1638-1641
発行日: 1993/09/25
公開日: 2010/02/25
ジャーナル
フリー
Bone mineral density (BMD) was measured by dual energy X-ray absorptiometry in seventy-seven females with rheumatoid arthritis (RA). BMD in RA patients decreased with increasing age, especially after menopause. There was no statistical correlation between the duration of disease and BMD. BMD of the femoral necks decreased according to the stage and class of RA, although the rate of decrease was low.
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藤原 明, 緑川 孝二, 柴田 陽三, 伊崎 輝昌, 松浦 一平, 緒方 公介, 原 正文
1993 年 42 巻 4 号 p.
1642-1646
発行日: 1993/09/25
公開日: 2010/02/25
ジャーナル
フリー
Shoulder arthrography is a simple diagnostic technique used in shoulder disorders. However shoulder arthrography has been forgotten recently because of development of CT and MRI. We experimented with a new technique of shoulder arthrography using 10% urografin.
We used the technique in cases with rotator cuff tears, recurrent dislocation and intra-capsular lesions.
Contrast medium of 45% urografin is usually used for single contrast arthrography, or double contrast arthrography.
The low density contrast medium of 10% urografin evaluated in this study was made by using 3ml of 60% urografin and 15ml of 0.5% xylocain.
We evaluated the low density medium in comparison to the usual contrast agent in coses with rotator cuff tears, recurrent dislocations and intra-capsular lesions.
We concluded that low density single contrast arthrography (using 10% urografin ) was useful for diagnosing shoulder disease.
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口石 保博, 柴田 陽三, 伊崎 輝昌, 緑川 孝二, 深堀 雄蔵, 岩本 英明, 松浦 一平, 藤原 明, 緒方 公介, 竹下 満
1993 年 42 巻 4 号 p.
1647-1650
発行日: 1993/09/25
公開日: 2010/02/25
ジャーナル
フリー
We evaluated shoulder muscle strength using the Cybex340 (Lumex Co. Ltd) in normal shoulders which were examined in internal and external rotation while in the standing position.
Fourteen normal volunteers (non sports group) with a mean age of 25 years were assessed and compared to 14 baseball players (sports group) with a mean age of 18.8 years. Peak torque of internal and external rotation was examined at an angular velocity of 60deg/sec, 180deg/sec and 240deg/sec.
The relationship between peak torque and body weight, the ratio of non-dominant versus dominant side and endurance ratio were studied.
There was no significant relationship between peak torque and body weight. The dominant side of the non-sports group was from 104% to 110% in internal rotation and from 108% to 113% in external rotation compared with the non dominant side.
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柴田 陽三, 伊崎 輝昌, 緑川 孝二, 深堀 雄蔵, 岩本 英明, 口石 保博, 松浦 一平, 藤原 明, 緒方 公介, 竹下 満
1993 年 42 巻 4 号 p.
1651-1654
発行日: 1993/09/25
公開日: 2010/02/25
ジャーナル
フリー
Modified Boytchev's procedure was found to be a satisfactory operation for treatment of recurrent anterior shoulder dislocation, with a 4% re-dislocation rate in our series and a 92% rate of return to sports activity among those cases who wanted to play sports.
Muscular strength before and one year after modified Boytchev's procedure was evaluated in nine men with a mean age at the time of operation of 25.2 years (range; 17 to 42 years). Using Cybex 340, we examined internal and external rotation muscle strength in the standing position. The angular testing velocity was 60deg./sec, 180deg./sec and 240deg./sec.
Post-operative peak torque increased in both the uninvolved and involved side. In order to assess the post-operative probability for recurrent anterior dislocation, examinations should be carried out pre-and post-operatively. Peak torque during internal rotation in the preoperative state was lower on the involved side (Ave. 4ftlb p<0.05). In comparison there was no statistical difference in the postoperative peak torque during internal rotation between the involved or non-involved side. Peak torque of internal rotation on the involved side increased an average of 4 ft lb postoperatively compared with the preoperative level. Preoperatively the endurance ratio of internal rotation on the involved side (56%) was lower than on the uninvolved side (62.5%). Post-operatively, there was no statistical difference between the uninvolved and involved side.
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伊藤 信之, 衛藤 正雄, 鈴木 暢彦, 岩崎 勝郎
1993 年 42 巻 4 号 p.
1655-1658
発行日: 1993/09/25
公開日: 2010/02/25
ジャーナル
フリー
Although the ROM of the glenohumeral joint is rarely disturbed after humeral fractures due to a very wide range of motion of this joint, when such disturbance does occur we try to maintain the anatomical position as much as possible during treatment. There are reports of using CT scans to measure the humeral axis by CT scan but this is inconvenient in practical use. This paper presents a convenient method of examination using ultrasound sonography.
The examinee is positioned in a supine position with the elbow in 90 degrees of flexion. The shoulder is rotated until the bicipital groove faces upward, and this is monitored by ultrasound sonogram. The angle between the axis of the forearm and perpendicular line through the examination table is then measured.
In younger subjects, the measured angle was about five degrees, but with increasing age to adulthood it reached to approximately 15 degrees and then remained constant.
This method and results are thought to be useful in treating humeral shaft fractures or in correcting axillar deformities after supracondylar fractures.
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術中所見との比較検討
有永 誠, 松崎 昭夫, 城戸 正喜, 足達 祐, 今井 一彦
1993 年 42 巻 4 号 p.
1659-1662
発行日: 1993/09/25
公開日: 2010/02/25
ジャーナル
フリー
Sonography of the shoulder joint has developed into an established examination technique in diagnosis of periarticular lesions of the shoulder. We investigated the correlation between sonographic and anatomic changes of the rotator cuff of the shoulder in 24 cases.
All patients were examined in the hyperextended internal rotation view.
Patients were diagnosed as having a rotator cuff tear if one of three criteria was met: (1) absence of the cuff (2) thinning of the cuff, and (3) an echogenic focus at the discontinuity edge of the tendon.
Twenty-two cases had full thickness tears and 2 cases had partial thickness tears, both of which had not been detected by sonography before arthrography was performed.
Operative finding were similar to sonography, except in the two cases with partial tears.
We concluded that sonography is an effective modality for the assesment of full thickness tears, but not for partial thickness tears.
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山口 和博, 伊藤 信之, 衛藤 正雄, 岩崎 勝郎, 明島 淳民
1993 年 42 巻 4 号 p.
1663-1666
発行日: 1993/09/25
公開日: 2010/02/25
ジャーナル
フリー
我々は外傷性三角筋断裂と腱板断裂を合併した1例を経験した. 症例, 69歳, 女性, 職業: 農業. 現病歴, 1987年頃より両側の肩関節痛とこれに伴う運動制限が出現し, 近医で局麻剤と steroid の注射を肩甲上腕関節および肩峰下滑液包に数回受けていた. 局注後は両側とも160度外転可能であった. 1991年10月すべって左肩を木壁で打撲し, 左肩痛と著明な左上肢挙上制限が生じたため, 1992年6月当科を初診した. 初診時, 肩峰及び大結節の異常突出を認めた. 自外転運動は20度 (他動運動は160度) であった. 三角筋断裂と腱板断裂と診断し三角筋縫合術と腱板縫合術を行った. 術中, 三角筋は肩峰より約2cm遠位部筋腹で断裂し, また棘上筋腱と棘下筋腱の大断裂を確認した.
腱板断裂がある場合, 外転運動における三角筋の重要性を示した例と考えた.
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伊崎 輝昌, 柴田 陽三, 緑川 孝二, 緒方 公介, 竹下 満
1993 年 42 巻 4 号 p.
1667-1671
発行日: 1993/09/25
公開日: 2010/02/25
ジャーナル
フリー
We treated a 42-year-old woman who had an intratendinous tear of the supraspinatus tendon. Although intratendinous tears are rare in clinical reports, they are not so infrequently seen in cadaver studies. It is difficult to diagnose intratendinous tears because it cannot be confirmed by ordinary examinationas i. e. arthrography or bursography. MRI or us have been suggested as possibly useful methods for diagnosing intratendinous tears, however the diagnosis rate for incomplete tears is still low using these techniques. The diagnosis of intratendinous tear can only be made at surgery. It is important to diagnose intratendinous tears based not only on MRI or US findings but also on a carefully taken history and clinical findings i. e. limitation of range of motion, impingement signs or painful arc on active shoulder elevation.
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衛藤 正雄, 伊藤 信之, 岩崎 勝郎
1993 年 42 巻 4 号 p.
1672-1675
発行日: 1993/09/25
公開日: 2010/02/25
ジャーナル
フリー
Imaging of glenoid labrum pathology in cases with reccurent dislocation of the shoulder is useful for diagnosis and help in planning surgical repair. We compared magnetic resonance (MR) imaging with computed arthrotomography (CAT), and investigated the usefulness of MR and CAT for diagnosis in nine patients with reccurent anterior dislocation of the shoulder and 5 patients with reccurent anterior subluxation of the shoulder. All patients underwent arthroscopy and modified Bristow's operation. There were 10 males and 4 females, ranging in age from 14 to 59 years (mean: 24.4 years at the time of operation).
CAT and MR imaging demonstrated 100per cent sensitivity, specificity and accuracy in the diagnosis of Hill-Sachs lesion, bony Bankart and anterior labral defects. In the diagnosis of anterior labral tears or cracks, CAT demonstrated 75per cent sensitivity, 100per cent specificity and 93per cent accuracy, and MR imaging demonstrated 100per cent sensitivity, 90per cent specificity and 93per cent accuracy. CAT findings of the labrum were almost the same as MR images, but CAT was easier than MR to determine the shape of the labrum. CAT could disclose detachment of the anterior capsule which was not detected by MR. In two cases with anterior subluxation, MR displayed high intensity of the anterior labrum but a normal shape was seen in CAT. Pathologic finding of one of the cases showed degenerative change and inflammation. It was suggested that MR is also capable of displaying pathologic conditions of the labrum in anterior subluxation of the shoulder.
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肱岡 昭彦, 鈴木 勝己, 柳 英裕, 小林 靖幸
1993 年 42 巻 4 号 p.
1676-1679
発行日: 1993/09/25
公開日: 2010/02/25
ジャーナル
フリー
Between 1981 and 1991, we treated 19 patients with a Putti-Platt operation for recurrent anterior dislocation of the shoulder. All patients had a history of initial trauma. Fifteen of the 19 patients were followed-up and the other 4 were interviewed by telephone. Reccurence of subluxation was found in only one case (5.8%). ADL disorder was not found in any cases but 3 patients complained of light pain during sports activity. A decrease in ROM was found in flexion, external rotation and internal rotation. External rotation was most limited with an average range of 68% of the non-operated shoulder. In conclusion, the Putti-Platt technique is recommended for the treatment of recurrent dislocation of the non-documented shoulder.
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城戸 正喜, 松崎 昭夫, 足達 裕, 有永 誠, 古賀 崇正, 松永 和剛, 太田 佳介, 佐藤 哲紀
1993 年 42 巻 4 号 p.
1680-1683
発行日: 1993/09/25
公開日: 2010/02/25
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We report our experience using the arthroscopic Bankart suture repair with Habermeyers Bankart operation for unidirectional recurrent traumatic anterior dislocation of the shoulder without signs of general ligamentous laxity in 6 patients.
Four patients were male and two were female, whose ages ranged from 16 to 23 years (mean, 20 years).
This method uses instrumentation manutactured by the Arthrex company (Germany) and has the safety advantages of advancement of the inferior glenohumeral ligament complex to the previously abraded glenoid neck using the Cannulated Grasping Stitcher and the transglenoid suture is completed by using a Percutaneous Knot Pusher.
At follow up, one patient felt some dull pain occasionally but no patients had any dislocation.
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坂梨 謙一, 中村 雅史, 別府 五郎, 東 威志, 脇坂 匠
1993 年 42 巻 4 号 p.
1684-1689
発行日: 1993/09/25
公開日: 2010/02/25
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Four cases of chronic complete acromioclavicular dislocation were treated by the contrived coracoid process transfer method. We report the operative procedure and clinical results.
The coracoid process, with its attached coracoacromial ligament and the conjoined tendons, is partially osteotomized and transferred to the clavicle. The scarred acromioclavicular ligament is repaired by the coracoacromial ligament and the conjoined tendons are substituted for the coracoclavicular ligament. The acromioclavicular joint is fixed by a Kirschner wire for eight weeks.
This surgical procedure was applied to four patients who had been classified as type III by Tossy's classification. The follow-up period ranged from 11 months to 3 years and 2 months.
One case required re-operation because of breakage of the transferred coracoid process. But now, all patients have returned to previous activities and there have been no problem with ADL.
The clinical results of all patients were judged to be satisfactory.
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森 輝男, 吉國 長利, 酒匂 崇, 川内 義久, 簗瀬 光宏
1993 年 42 巻 4 号 p.
1690-1692
発行日: 1993/09/25
公開日: 2010/02/25
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We have performed multiple muscle transfer for the reconstruction of paralyzed shoulder due to traumatic brachial plexus injury in a 19-year-old man. Preoperatively, muscle atrophy was seen in the deltoid, supraspinatus and infras pinatus muscles, active flexion of the shoulder joint was 20 degrees, abduction was 55 degrees, and there was an almost full range of passive motion. We carried out the following reconstruction techniques; the deltoid by the trapezius, the supraspinatus by the levator scapulae and subscapularis by the pectoralis minor. Postoperatively, active flexion angle improved to 150 degrees and a full range of abduction angle was achieved. We conclude that multiple muscle transfer surgery is a good method for regaining elevational power of the shoulder.
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柿添 光生, 小宮 節郎, 平岡 弘二, 井上 明生
1993 年 42 巻 4 号 p.
1693-1695
発行日: 1993/09/25
公開日: 2010/02/25
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フリー
Periosteal cells were obtained from rabbit tibia and transferred to cell culture and subcultured. Periosteal cells from 6 to 9 passages were seeded in flexible-bottomed culture plates and a cyclic tensile stress of 3 cycles per minute of 0-24% elongation was applied, using a flexor cell strain unit. After this stress, periosteal cells were reoriented perpendicularly to the direction of the strain field and an increase in cell division and DNA synthesis was shown. Production of PGE
2 from the cells was also increased. We conclude that cyclic tensional deformation may stimulate cultured periosteal cells in vitro.
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西村 謙一, 簗瀬 光宏, 川内 義久, 米 和徳, 酒匂 崇, 吉田 義弘
1993 年 42 巻 4 号 p.
1696-1698
発行日: 1993/09/25
公開日: 2010/02/25
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フリー
Pseudohypoparathyroidism is an uncommon disease with hypocalcemia and hyperphosphoremia as in the case of primary hypoparathyroidism. Many investigators suggested that poor sensitivity of target organs to parathyroid hormone causes this disease. Most cases of pseudohypoparathyroidism are diagnosed in their childhood due to characteristic general findings. We report a case of pseudohypoparathyroidism with multiple vertebral compression fracture diagnosed in an adult.
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秋元 伸之, 川嶌 眞人, 田村 裕昭, 岡 治道, 久我 哲也
1993 年 42 巻 4 号 p.
1699-1701
発行日: 1993/09/25
公開日: 2010/02/25
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フリー
We experienced a case of fulminant malignant hyperthermia in a 13-year-old boy. He was operated upon becase of a solitary bone cyst in his distal fibula. His maximum temperature reached approximately 43°C before he died. It is very important that treatment should be started as soon as possible in case of malignant hyperthermia.
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高野 信一, 松岡 彰, 城戸 研二, 中村 克巳, 野村 耕三, 河合 伸也
1993 年 42 巻 4 号 p.
1702-1704
発行日: 1993/09/25
公開日: 2010/02/25
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フリー
Nineteen cases treated by arthoroscopic meniscal suture with a mean post-operative follow-up of 40 months were retrospectively studied and the factors influential to the prognosis were investigated. Three cases re-injured the operated menisci, and they were excluded from this study. Sixteen cases were evaluated by the Japan Orthopedics Association scoring system (JOA score) and were divided into two groups according to their JOA score. (The first group≥90, and the second≤89) The two groups were compared and statistically analyzed using eleven factors such as age, sex, involved meniscus, history of sports, method of suture, rehabilitation, etc.
The results showed the following factors tended to have a good influence on the post-operative results: 1) age (younger patients had better recovery rates), 2) severity of complications (good recovery corresponded to lack of serious complications), 3) pre-op clinical symptoms (more serious pre-op clinical symptoms corresponded to lower recovery scores), 4) history of involvement in sports (athletes had better recovery scores, particularly those involved in non-competitive, recreational sports).
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井上 敏生, 藤井 敏男, 高嶋 明彦, 太田 剛, 柳田 晴久
1993 年 42 巻 4 号 p.
1705-1709
発行日: 1993/09/25
公開日: 2010/02/25
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フリー
We radiologically evaluated 53 feet which had either postaxial polydactyly or polysyndactyly which had been surgically treated. In regard to the decision as to which toe should be resected, we thought it was better to resect the 5th toe rather than the 6th toe when the 5th toe was occupying an extreme medial position in relation to the 5th metatarsus. When the toe was not in an extreme position, we considered other factors before choosing. Concerning the age at surgery, we believe it is best to wait until the shape of the phalanx can be fully seen on X-ray before operating.
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田口 敏彦, 弓削 大四郎, 三村 寛, 前原 洋二, 橋口 隆, 田口 勝規
1993 年 42 巻 4 号 p.
1710-1712
発行日: 1993/09/25
公開日: 2010/02/25
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We report the clinical results of surgical treatment for thoracolumbar spinal fractures due to osteoporosis. Subjects included 3 men and 3 women with an average age at operation of 66 years (range: 58 to 73 years). Our operative indications for this condition are as follows; Progression of spinal kyphotic deformity, spinal compression revealed by Myelography, CT scan or MRI and neurological deficits. All patients had anterior spinal decompression and fusion performed. Three patients had Roy-Comille plates and 2 patients used Kaneda devices. Follow-up for an average of 21 months (range: 4 to 30 months) showed neurological improvement and goad stabilty of spine in all cases.
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1993 年 42 巻 4 号 p.
1713-1721
発行日: 1993/09/25
公開日: 2010/02/25
ジャーナル
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1993 年 42 巻 4 号 p.
1722-1723
発行日: 1993/09/25
公開日: 2010/02/25
ジャーナル
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