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梅村 愛, 渡辺 英夫, 森澤 佳三, 浅見 豊子, 伊藤 由美
1995 年 44 巻 4 号 p.
1394-1397
発行日: 1995/09/25
公開日: 2010/02/25
ジャーナル
フリー
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井上 敏生, 吉村 一朗, 緒方 公介, 花田 弘文
1995 年 44 巻 4 号 p.
1398-1400
発行日: 1995/09/25
公開日: 2010/02/25
ジャーナル
フリー
Yamamuro distance “a” and “b” are values which can be easily measured from an X-ray of the hip in infancy. They are often used to show the degree of dislocation in the developmental dysplasia of the hip. Yamamuro reported that in the normal hip, distance “a” was constant at any age before four years of age and distance “b” was the same before one year of age. The purpose of our study was to find whether distance “a” and “b” are influenced by the size of the pelvis.
We measured distance “a”, “b” and the size of the pelvis in 173 radiographically normal hips before twelve months of age, and evaluated the correlation between both distance “a” and distance “b” with the size of the pelvis.
The correlation coefficient of distance “a” and the size of the pelvis was -0.15, showing no correlation. The correlation coefficient of distance “b” and the size of the pelvis was -0.21, again with no correlation. We concluded that distance “a” and “b” in the normal infant hip was not influenced by the size of the pelvis.
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野口 康男, 福岡 真二, 杉岡 洋一, 井原 和彦
1995 年 44 巻 4 号 p.
1401-1403
発行日: 1995/09/25
公開日: 2010/02/25
ジャーナル
フリー
Radiological results of 74 congenitally dislocated hip joints, which had been reduced by the Pavlik harness or manual reduction were assessed using Severin's classification at the ages of 6, 10, and 15 years or later. Although approximately a half of the joints showed a temporary improvement in Severin's grading at the age of 10 years, there was no uniform pattern of growth-related change for classification. The results of this study reconfirmed the importance of follow-up until skeletal maturity.
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大迫 浩文, 酒匂 崇, 松永 俊二, 武富 栄二, 瀧下 純夫, 有島 善也, 肥後 勝
1995 年 44 巻 4 号 p.
1404-1406
発行日: 1995/09/25
公開日: 2010/02/25
ジャーナル
フリー
We reviewed the results of operative treatment in 20 patients (23 hips) with congenital dislocation of the hip. Patients age at surgery raged from 11 months to 4 years. Average follow-up period was 8.1 years. The surgical procedure included open reduction, derotation and varus femoral osteotomy and femoral shortening. Salter pelvic osteotomy was later added in 9 hips.
The postoperative clinical results were excellent or good in all whole patients. Radiographic evaluation using the Severin grading system revealed excellent or good results in 13 of 17 hips (76%).
We found no evidence of avascular necrosis of the femoral head. These results show that decompression by femoral shortening is important to prevent avascular necrosis of the femoral head.
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小田 純爾, 岩崎 勝郎, 高橋 克郎, 手島 鍛
1995 年 44 巻 4 号 p.
1407-1410
発行日: 1995/09/25
公開日: 2010/02/25
ジャーナル
フリー
Twenty-four unaffected abuld hips with contralateral congenital dislocation of the hip (CDH), who had never been treated for dislocation were evaluated radiologically. And they were compared with sound side of 16 patients who were treated with Pavlik Harness for unilateral CDH. CE angle of wiberg were 28.8±5.2 degrees in no treatment group and 25.3±2.1 degrees in the treated group (p<0.05, unpaired t-test). Acetabular head index (AHI) were 82.2±3.9% and 78.0±3.0% (p<0.001) respectively. We compared these values with the indexes for normal Japanese population. CE angle and AHI showed not significant difference between no treatment group and the indexes, but in treated group showed significant decrease in values compared with the indexes. From this study, it can be thought that the Pavlik Harness did not aid in the progress the acetabular development.
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吉見 洋士, 肥後 勝, 宮内 裕史
1995 年 44 巻 4 号 p.
1411-1413
発行日: 1995/09/25
公開日: 2010/02/25
ジャーナル
フリー
We reviewed twenty-six patients (twenty-seven affected hips) who had had Perthes disease to determine the results of treatment using the abduction weight-bearing brace. Average age of patients was 5.1 years (range, 2-7 years) at the time of diagnosis. The patients wore the orthosis for an average of 13.4 months (range, 6-21 months). Mean follow-up period was 6 years 5 months (range, 3.6-9 years). Five patients had Catterall group II-III, eight group III and fourteen group IV involvement.
At follow-up, the radiographic results were evaluated according to Stulberg's criteria, with eight hips in class I, fifteen hips in class II, two hips in class III and two hips in class IV. All patients had no clinical symptoms and radiographically good congruency of the hip joint. We believe this weight-bearing abduction brace is indicated in patients younger than seven years with Perthes disease with femoral head subluxation and good hip joint mobility during treatment.
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柳田 晴久, 佐竹 孝之, 中村 英次郎, 石谷 栄一, 城戸 秀彦
1995 年 44 巻 4 号 p.
1414-1419
発行日: 1995/09/25
公開日: 2010/02/25
ジャーナル
フリー
We evaluated the results of surgical treatment of hip deformity in patients with cerebral palsy. We operated on 81 hip joints of 43 cerebral palsied patients (28 men, 15 women, mean age at surgery was 9.2 years) between 1985 and 1993. Operative methods included lengthening of the psoas and rectus femoris for flexion deformity, release of gracilis with or without adductor longus & brevis for adduction deformity, and additional surgery such as Modified Barr's operation (6), osteotomies (4), open reductions (2) and obturator neurectomy (1). In many cases deformities were well corrected, but in cases of adductor longus & brevis tenotomies, their important antigravity function was lost. Adductor longus & brevis should be preserved when the patient has the possibility of walking.
Subluxation and dislocation appeared at a mean of 5 years of age, and in patients operated on before 7 years of age, their hip joints were well reduced. While in patients operated on after aged 7 years, subluxation or dislocation remained because the acetabulum couldn't grow anymore. In cases of subluxation or dislocation, we should consider osteotomies if the patient is older than 7 years.
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上原 敏則, 平 宏章, 粟国 敦男
1995 年 44 巻 4 号 p.
1420-1429
発行日: 1995/09/25
公開日: 2010/02/25
ジャーナル
フリー
Osteopetrosis associated with renal tubular acidosis and cerebral calcification was established as an autosomal recessive inheritant syndrome, caused by a deficiency of carbonic anhydrase II (CA II) in 1983. Only 3 cases have been reported in Japan.
We describe a family with this syndrome. Proband is a 31 year old female, who presented with pathological fracture of the femoral, tibial and fibullar shafts, renal tubular acidosis and cerebral calcification. She was treated with intramedullary nailing and long leg cast followed by PTB brace. Bone biopsy was done from the iliac wing. Pathology showed irregular thickening of trabecular bone and unresorbed persistent calcified cartilage. Only a few osteoclast and fibroblast cells were found, suggesting poor bone remodeling.
Her two sisters are short and the elder one is affected with mild mental retardation. Both have osteopetrosis, renal tubular acidosis, cerebral calcification, and a history of long bone fracture. Her parents are not affected and not consanguineous. CA II activity was measured from erythrocyte hemolysates in all of the family. CA II activities from the mother, father, and three sisters were 57%, 40%, 13%, 15%, and 18% each, compared to the normal control. We consider these three sisters are homozygotes of CA II deficency and their parents heterozygotes.
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高野 晴夫, 前川 清継, 坂田 浩章, 岡嶋 啓一郎, 相良 孝昭, 大島 卓
1995 年 44 巻 4 号 p.
1430-1432
発行日: 1995/09/25
公開日: 2010/02/25
ジャーナル
フリー
We report a case of primary oxalosis with pathological fracure of the femoral neck, in which the diagnosis was made after 7 years of hemodialysis.
The patient was a 40-year-old man who developed renal stones at the age of 22. Hemodialysis was initiated because of chronic renal failure when he was 33. He reported pain of his left hip joint from May 1994, which increased and became unbearable.
On admission, radiographic findings revealed extensive nephrocalcinosis, marked bone sclerotic change and fracture of the femoral neck.
We performed universal femoral neck replacement with bone cement.
At bone marrow biopsy, the most striking finding was proven calcium oxalate crystals.
The pathological diagnosis was primary oxalosis.
Bone marrow biopsy is mandatory if we encounter a case showing nephrocalcinosis and radiographic findings mimicking hyperparathyroidism.
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野澤 洋平, 吉見 洋志, 溝口 成朋, 児玉 太郎, 新門 裕三, 鬼丸 高茂, 今給黎 尚典, 長野 芳幸
1995 年 44 巻 4 号 p.
1433-1436
発行日: 1995/09/25
公開日: 2010/02/25
ジャーナル
フリー
We experienced two cases of pustuloticarthro-osteitis (PAO) with hyperostosis. The first case was a sixty-year-old female who developed a protrusion in the left sternocastoclaiclar side with pain and swelling. Pathological finding following biopsy of the protrusion revealed inflammatory granulation tissue. After admission, she had pusturosis palmaris et plantaris (p. p. p) and diagnosed her as having PAO. The second case was a forty-six-year-old female who presented with a protrusion on the left side of her sternocastoclavicular joint with pain and swelling in addition to fever and neck pain. She showed abnormal X-rays in the spine, and sternocastoclavicular joint. Pathological biopsy findings of the protrusion revealed inflammatory granulation tissue. After admission, she had P. P. P. thus we diagnosed this case as PAO.
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鳥越 雄史, 寺本 司, 中村 智, 岩崎 勝郎, 鈴木 良平
1995 年 44 巻 4 号 p.
1437-1441
発行日: 1995/09/25
公開日: 2010/02/25
ジャーナル
フリー
Hypertrophy of the abductor hallucis muscle is a very rare disorder. We report two cases with a mass on the plantar surface of their foot. Case 1 was a 16 month-old girl who presented to our hospital with a difference in size of the foot which had been present from birth. On examination, flat foot was observed and a soft mass was palpated on the medial aspect of the right foot. On plain radiographs, swelling of the soft tissue was noted. CT scan showed hypertrophy of the muscle, but the muscle could not be distinguished. Biopsy examination revealed normal muscle structure. At surgery, hypertrophy of the abductor hallucis muscle was diagnosed.
In the second case, a ten-month-old male, a similar difference in the size of the foot was noticed by the parents. Also in this case a soft palpable mass was found around the same site. Difference in the size of the foot size, in length and width was observed. MRI examination revealed hypertrophy of the muscle and the site of the muscle coincided with the position of the abductor hallucis muscle. However, this mass showed no signal intensity similar to tumour. Surgery was not carried out in this case.
In the first case with flat foot, the cause of the hypertrophy of the abductor hallucis muscle could not clearly distinguished. However, in the second case, this may be due to hemi-hypertrophy of the foot.
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井原 秀俊, 吉田 拓也
1995 年 44 巻 4 号 p.
1442-1445
発行日: 1995/09/25
公開日: 2010/02/25
ジャーナル
フリー
Ten patients with acute lateral ligament injuries were treated by early non-bracing mobilization which involved early weight bearing and dynamic joint control training. No functional orthosis was needed using this method. A paired Student's t test was used to compare side-to-side difference on stress radiograph. Significant decrease occurred for both mean talar tilt angle from 10.9° to 1.0° (p<0.0001) and mean anterior drawer distance from 4.3mm to 0.3mm (p<0.0005). This early motion seems to have resulted in a number of benefits. It mechanically stimulated the injured ligaments to heal, and enabled immediate neuromuscular coordination retraining and financial savings compared to other methods. Early mobilization and weight bearing is considered as the method of choice and provided quick recovery in ankle mobility.
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山口 登, 井上 雅文, 緒方 達也
1995 年 44 巻 4 号 p.
1446-1448
発行日: 1995/09/25
公開日: 2010/02/25
ジャーナル
フリー
In our hospital between 1992 and 1994, there were 14 patients who sustained an injury to the lateral ligament of the ankle and were operated on in the early stages. In 9 of these cases we performed an end to end suture in the torn parenchyma area and in 5 cases a soft tissue attachment device STATAK (Zimmer) was used for the torn talar area our post-operative observations which were based on Selingson's scale indicated that in all 14 cases the results were excellent without any instability of the ankle area.
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入江 学, 原口 和史, 香月 一朗, 田山 尚久, 藤田 秀一, 岡本 安弘
1995 年 44 巻 4 号 p.
1449-1452
発行日: 1995/09/25
公開日: 2010/02/25
ジャーナル
フリー
Ten torn anterior talofibular ligaments repaired with fibular periosteal flap reinforcement were studied.
The operative results were evaluated by measurements of stress X-ray photos and using Seligson's scale as a clinical score.
In most of these cases, roentgenographic instability of the ankles was reduced.
The average talar tilt angle improved from 14.7° to 4.7°, and the average distance of the anterior drawer test (Landeros method) was 8.0mm to 6.5mm.
Clinical scores were rated from 8 to 10 points by the Seligson scale.
Repair of the anterior talofibular ligament reinforced with a fibular periosteal flap is a useful method in cases of insufficient repair with a simple suture.
The possibility of ossification and the tensile weakness of the perioteal flap have already been reported. No disadvantages were found in this series.
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桝田 理, 小川 浩司, 富 雅男, 大庭 健
1995 年 44 巻 4 号 p.
1453-1456
発行日: 1995/09/25
公開日: 2010/02/25
ジャーナル
フリー
Dysplasia of the ankle malleolus is uncommon but it may result in osteoarthritis. We developed a new treatment for dysplasia of the ankle malleolus using the Ilizarov apparatus. In the reconstruction of medial malleolus, a rectangular fragment is osteomized from the tibia and then it is moved medially and distally in the Ilizarov apparatus. When the fragment comes to the correct anatomical position, it is united to the medial cortex of the tivia with an Ilizarov olive wire. In the reconstruction of the lateral malleolus, the shortened fibula is osteomized and lengthened distally in the apparatus. Two patients had their ankle reconstructed using this technique with very satisfactory results. Although dysplasia of the ankle malleolus is often associated with leg length discrepancy and foot deformity, the simultaneous correction cannot be done with the conventional procedures reported by Gruca, Serafin and other authors. We conclude that this procedure be considered as the definitive operation because these conditions can be treated at one stage.
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井手 康人, 秋山 徹, 上野山 和秀, 西田 民夫, 泊 真二, 小澤 慶一
1995 年 44 巻 4 号 p.
1457-1460
発行日: 1995/09/25
公開日: 2010/02/25
ジャーナル
フリー
Lesions of the rheumatoid cervical spine are mainly observed in the upper cervical spine. We experienced a case of rheumatoid cervical spondylosis assumed to be traceable to Luschka's joint of the lower cervical spine. The case was a 50 years-old female who had suffered from rheumatoid arthritis for 18 years. On 25th May, 1993, she developed numbness of her left hand. On 29th July, 1993, muscle weakness of her left lower extremity and urinary retention appeared. On admission, manual muscle testing revealed the bilateral upper extremities to be 0 to 1, right lower extremity 1 to 3, left lower extremity 5. Sensory disturbance was observed on bilateral upper extremities and left foot. Hyperreflexia of the deep tendon reflexes of the upper and lower extremities were observed. X-ray films showed narrowing of C4/5 disc space and anterior subluxation of C4. Myelography showed compression from the anterior and left side at C4/5. CT-myelography showed destructive change of bone and compression from antero-left side at C4/5. Postero-lateral fusion and anterior decompressive fusion were performed. During Surgery, bone destruction assumed to be traceable to rheumatoid granulation and posterior prominence of granulation tissue were observed. Post surgery, neurological symptoms remarkably improved.
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柳田 晴久, 佐々木 邦雄, 清水 敦, 松田 和浩, 福岡 真二, 本松 伸一, 冨重 治
1995 年 44 巻 4 号 p.
1461-1466
発行日: 1995/09/25
公開日: 2010/02/25
ジャーナル
フリー
We report the results of treatment for burst fracture of the thoracolumbar spine due to osteoporosis. 20 patients (17 women and 3 men) with a mean age of 71.8 years wrere followed-up for a mean period of 1 year 5 months.
13 patients were treated conservatively and results were excellent except for one case who did not have external fixation applied at early stage. 7 were treated operatively because of neurological disturbances (3), back pain due to delay of union (2), and instability (2). 6 patients were operated with posterior fixation and 1 was operated with anterior and posterior fixation. Neurological disturbances improved and pain was relieved by surgical treatment in all cases.
We need to classify spinal fractures at the time of diagnosis to select the best treatment.
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三宅 基夫, 枝重 恭一, 西山 徹, 川添 建生
1995 年 44 巻 4 号 p.
1467-1470
発行日: 1995/09/25
公開日: 2010/02/25
ジャーナル
フリー
As the coming era of old age society, femoral neck fracture with underlying osteoporosis is increasing.
As a principle, for preventing long bed rest, early operation and early ambulation is important.
However, the orthopaedic surgeon frequently hesitates to perform relatively in vasive operation because of serious complications.
In the past two years, we treated 10 of 32 cases with femoral neck fractures by so-called semi-open reduction with cannulated cancellous hip screw.
Postoperative results ar excellent, smaller operative invasions are also anticipative.
It is favorable for the old age and the poor risk patients.
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安食 孝士, 冨永 積生, 大内 啓司, 片山 稔, 重冨 充則, 長弘 行雄, 日浦 泰博, 金子 昇
1995 年 44 巻 4 号 p.
1471-1473
発行日: 1995/09/25
公開日: 2010/02/25
ジャーナル
フリー
6 patients who had on avulsion fracture of the tibial tuberosity were reviewed. The mean age of subjects was 14 years and 2 months (range, 11 to 16 years).
5 of 6 patients had surgical treatment; 3 screwing, one tension band wiring, and one suturing. Another patient had conservative treatment. The final results at a mean follow-up of 4 years and 6 months (range, 6 months to 8 years and 6 months) were exellent.
One case (Watson-Jones classification, Type II) was diagnosed only by magnetic resonance imaging (MRI) because of the slight displacement of the fracture fragment. He also suffered from anterior compartment syndrome.
Anterior compartment syndrome rarely occurs in this fracture, therefore it is necessary to carefully observe the physical signs during the fracture treatment.
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大藤 晃, 河合 伸也, 淵上 泰敬, 白石 元, 金子 和生, 豊田 耕一郎, 土田 聖司
1995 年 44 巻 4 号 p.
1474-1476
発行日: 1995/09/25
公開日: 2010/02/25
ジャーナル
フリー
Drop foot occur by peroneal nerve palsy, lumbar disease, motor neuron disease and so on. We examined 19 patients of drop foot and it was useful for diagnosis.
The anomaly of M wave is classified in to three types, conduction slowing, conduction block, and low ampulitude type. The spinal disease (3 lumbar canal stenosis, 2 lumbar disc herniation, 2 Charcot Marie Tooth disease, 1 syringmyelia and 1 tetherd cord syndrome) all showed low ampulitude type and peroneal nerve palsy (10) showed 4 conduction block and 6 low ampulitude type.
If the M wave was of the low ampulitude type, we examined somatosensory evoked potential which was recorded from lumbar surface region (mainly L4/5). To use this methord we could diagnose peroneal nerve palsy to spinal disease. Electrophysiological tests are useful for the diagnosis of the drop foot.
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奥村 徹, 村松 慶一, 砂金 光藏, 土井 一輝, 伊原 公一郎, 河合 伸也
1995 年 44 巻 4 号 p.
1477-1481
発行日: 1995/09/25
公開日: 2010/02/25
ジャーナル
フリー
We analysed the effect of adriamycin and cisplation, which are the most common anti-neoplastic agents for treatment of malingnant bone and soft tissue tumors, on peripheral nerve regeneration.
The left sciatic nerve of Wistar rats was elected for the site of neurorrhaphy. Three groups of rats were prepared as follows,
Group 1: Adriamycin of 5mg/kg weekly was administered through the lateral illiac artery after neurorrhaphy.
Group 2: Cisplatin 5mg/kg was administered in the same manner.
Group 3: Saline was injected in the same manner as a control. Each group consisted of 30 rats, and they were functionally assessed using the sciatic functional index. After 6 and 8 weeks they were sacrificed and each specimen was electrophysiologically and histologically evaluated.
The results showed significant differences among the three groups, and any adverse effect of anti-neoplastic agents on nerve regeneration was proved.
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平 博文, 秋元 伸之, 麻生 邦一, 工藤 修己, 岡 治道, 中村 英次郎
1995 年 44 巻 4 号 p.
1482-1484
発行日: 1995/09/25
公開日: 2010/02/25
ジャーナル
フリー
Fracture of the hook of hamate is a rare condition, with the patient usually complaining of local pain and swelling. This fracture is important because subcutaneous rupture of the flexor tendon sometimes takes place secondary to the fracture. We describe a case who had disturbance of active flexion of the ring finger.
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高原 一洋, 平野 英二, 木村 和也, 今村 宏太郎
1995 年 44 巻 4 号 p.
1485-1488
発行日: 1995/09/25
公開日: 2010/02/25
ジャーナル
フリー
From 1987 to 1992, eighty-four elbows of seventy-six patients with cubital tunnel syndrome who had surgical intervention were reviewed. Sixty-two elbows were from male patients and twenty-two were from female patients. In fifty-three elbows the right side was involved, the left side in thirty-one elbows and in eight cases both sides were affected. The average period from the onset of symptoms to the time of operation was two years and five months (range; one month to twenty years). Pre-operatively patients were graded into three groups according to symptoms and clinical examination as mild, moderate and severe into which there were 11, 63 and 10 cases respectively.
In all cases, subcutaneous translocation of the ulnar nerve was performed along with a local fat flap. The follow-up period ranged from one year to six years and four months. During follow-up patients were evaluted according to Ikuta's criteria. There were 20 excellent, 56 good and 8 fair with no poor results, which was very satisfactory. These results led us to conclude that subcutaneous translocation of the ulnar nerve with a local fat flap is an effective method for treating cubital tunnel syndrome caused by vorious mechanisms due to its ability to produce a wide visual field allowing the ulnar nerve to be observed in detail.
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橋口 隆, 弓削 大四郎, 三村 寛, 田口 敏彦, 渡邊 精一郎, 鈴木 暢彦, 大塚 健
1995 年 44 巻 4 号 p.
1489-1491
発行日: 1995/09/25
公開日: 2010/02/25
ジャーナル
フリー
We report the clinical evaluation of upper and middle lumbar radiculopathy. Subjects comprised 6 male patients ranging in age from 48-75 years old with a mean of 62 years. The level of the radiculopathy was L1; 1 case, L2; 1 case, L3; 2 cases, L4; 2 cases. Clinically, almost patients complained of lumbago and, thigh or knee pain. Nerve root infiltration was most useful for diagnosis of the level.
Two patients had partial laminectomy and 4 patients had osteoplastic laminectomy. Origin of the radiculopathy were disc herniation (sequestration type); 4 cases, OFL; 1 case, pedicular kinking; 1 case, disc herniation + facet; 1 case. The average length of follow-up was and the mean 19 months improvement rate according to the JOA-score was 68%.
Anatomically, lumbar nerve roots of L1, 2, 3, 4 emerged lower to disc level compared with L5, S1 roots. Therefore, upper and middle lumbar nerve root radiculopathy is due to a variety of causes. We recommend osteoplastic laminectomy for treatment of upper and middle lumbar radiculopathies.
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野口 蒸治, 阿部 隆伸, 副島 崇, 田中 信博, 井上 明生, 堀部 秀二
1995 年 44 巻 4 号 p.
1492-1494
発行日: 1995/09/25
公開日: 2010/02/25
ジャーナル
フリー
We investigated the loss of motion (LOM) after anterior cruciate ligament (ACL) reconstruction. 105 patients underwent ACL recons space truction between 1989 and 1993. LOM was defined as a loss of extension of more than 10° or flexion of less than 125° at 3 months after Surgery. The incidence of LOM was identified in 19 patients (18%). Risk factors were associated with females and the type of graft (patella tendon>semitendinosus). The etiology of LOM at postoperative arthroscopy was classified as intercondylar notch scarring in 11 of 13 patients (85%). All of these patients underwent arthroscopic debridement and all improved. We concluded that arthroscopic debridement is useful for patients who develop LOM after ACL reconstruction.
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森田 雅和, 永田 見生, 大橋 輝明, 安部 淳, 石橋 和順, 佐藤 公昭, 井上 明生
1995 年 44 巻 4 号 p.
1495-1497
発行日: 1995/09/25
公開日: 2010/02/25
ジャーナル
フリー
The purpose of this study was to investigate the operative results and the problems for elderiy patients with cervical myelopathy. Sixty seven patients (65 years or older) were compared with another 140 patients (younger than 65 years). Pre-and post-operative JOA scores of the Young-group were significantly higher than in the Old-group. The frequency of achieving restoration in the cord in the Old-group was significantly lower than that in the Young-group, according to postoperative MRI. The most significat factor affecting the clinical results was the disease duration prior to surgery. We conclude that in elderly patients, it is neccessary to perform decompression surgery as soon as possible after onset of progressive myelopathy.
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田代 博之, 松崎 昭夫, 城戸 正喜, 足達 裕, 池田 正一, 有永 誠, 入江 豊, 石田 高康
1995 年 44 巻 4 号 p.
1498-1502
発行日: 1995/09/25
公開日: 2010/02/25
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フリー
A follow-up study was performed investigating 236 patients aged over 65 years who had been operated on for femoral neck fractures. Patients over 80 years old with extra capusular fractures showed poorer functional results and higher mortality than patients with intracapsular fractures. The most important complication resulting in a poor prognosis was dementia with cardiovascular disease. The influence of the fracture and its treatment on mortality was primarily seen in the first year after surgery.
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荒木 崇一, 森澤 佳三, 井手 淳二, 北村 歳男, 山鹿 眞紀夫, 高木 克公
1995 年 44 巻 4 号 p.
1503-1505
発行日: 1995/09/25
公開日: 2010/02/25
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The purpose of this study was to evaluate the results of arthroscopic synovectomy for patients with rotator cuff tears.
Patients comprised 13 males and 13 females, ranging in age from 41 to 82 years (mean: 66 years). The mean follow-up period was 20 months (range, 5-48 months).
Arthroscopic synovectomy for treatment of rotator cuff tears can achieve a better result (81%). However, five cases did not respond and three cases had surgical rotator cuff repair.
Our indications for arthroscopic synovectomy with rotator cuff tears included inactive patients over 65 years old, in whom forward flexion could be relieved by a procaine test, and who had pain which did not improve with conservative treatment.
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吉野 和孝, 安松 英夫, 栄 輝巳, 束野 通志, 坂口 満, 田嶋 光, 下村 義文, 松原 三郎, 生田 拓也, 朴 珍守, 内田 洋 ...
1995 年 44 巻 4 号 p.
1506-1508
発行日: 1995/09/25
公開日: 2010/02/25
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To analyze the frequency of methicillin resistant staphylococcus aureus (MRSA) infection, we investigated the cases who were infected with MRSA in our hospital. From 1989 to 1993, 9906 cases of hospitalized patients were available for investigation. Of these 8372 cases required surgical treatment. There were 31 cases whose wounds were infected. Of these 10 cases were identified as having MRSA infection. Wound infection with MRSA increased in association with the increase in usage of third generation cephem antibiotics after surgical treatment. Another 10 cases, aged from 62 to 92 years (average 78.4 years), contracted MRSA infections, although they had not had not any surgical treatment although all of these patients were compromised hosts. The mortality rate of MRSA pneumonia was 33.3%. For prevention of nosocomial MRSA infection, systemic organization of an MRSA infection team is very important.
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酒井 健次, 上崎 典雄, 山口 司, 櫻井 日出也, 坂本 央, 利光 哲也, 北方 明, 奥山 清隆, 生田 光, 古賀 隆弘
1995 年 44 巻 4 号 p.
1509-1513
発行日: 1995/09/25
公開日: 2010/02/25
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We treated 28 complete acromioclavicular dislocations by the modified Phemister procedure (14 cases), Cadenat procedure (5 cases), modified Neviaser procedure (3 cases), and reconstruction of the coracoclavicular ligament using the Leeds-Keio artificial ligament (6 cases) from 1980 to 1993. All cases were evaluated as type 3 according to Tossy's classification. We assessed the results of the 4 procedures in terms of pain, ROM, cosmetic deformity, and radiographic subluxation of the acromioclavicular joint.
The follow-up period ranged from 2 months to 14 years. Subluxation of the acromioclavicular joint occurred in 17 cases (60%). Relief of pain and improvement in shoulder ROM sufficient for ADL were obtatined in all cases except three treated by the modified Phemister procedure.
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大嶋 直人, 萩原 博嗣, 中家 一寿, 岸川 陽一
1995 年 44 巻 4 号 p.
1514-1516
発行日: 1995/09/25
公開日: 2010/02/25
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We report on seven humeral neck fractures treated by Hackethal stacked intramedullary nailing. All fractures were reduced and Kirschner-wires were inserted retrograde through a distal posterior cortical window. Follow-up was possible in 5 patients. The average age of patients was 65 years and the average follow-up was one year and 5 months. The average ROM of the shoulder was 138 degrees in flexion, 154 degrees in abduction and 71 degrees in external rotation. According to Neer's criteria, 4 cases were judged to be excellent and 1 case was satisfactory. Hachethal stacked nailing was a relatively atraumatic method for stabilization of the humeral neck fracture and patients could start early exercize of the shoulder. This method proved effec-tive in stabilization of neck and shaft fractures and pathological fractures.
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1995 年 44 巻 4 号 p.
1517-1526
発行日: 1995/09/25
公開日: 2010/02/25
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1995 年 44 巻 4 号 p.
1527-1530
発行日: 1995/09/25
公開日: 2010/02/25
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