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Comparison with the Compression Hip Screw
Takeo Otuki, Akira Fukushima, Joji Nio, Noriyuki Takasu, Makoto Enokid ...
1996 Volume 45 Issue 1 Pages
199-203
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
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A total of 107 peritrochanteric fractures were treated operatively, with the Gamma Nail in 45 cases and Compression Hip Screw (CHS) in 62.
Fracture stability was assessed by the Evans' classification system.
At final review, sliding of the lag screw with the Gamma Nail averaged 4.6mm in stable fractures and 5.6mm in unstable fractures. The CHS showed an average sliding of 2.1mm in stable fractures and 9.0mm in unstable fractures. In unstable fractures, decreased sliding is seen with the lag screw of the Gamma Nail compared with that of the CHS.
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Toshio Kawahara, Masao Noguchi, Syuuzi Nakanishi, Hironori Hara, Toshi ...
1996 Volume 45 Issue 1 Pages
204-208
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
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We have treated twenty custom fractures of the femoral shaft with Interlocking Intramedullary Nailing since 1992. Five fractures were transverse or shot oblique or with a small additional fragment. The other 15 fractures were long oblique or with a big fragment or were more severely comminuted.
For all patients this was the first operation for their fractures. We fixed eleven severely comminuted fractures with static locking and nine with dynamic locking.
The median time untio full weight-bearing was 7.4 weeks (range, three to eleven weeks). Except for one patient radiographic consolidation was seen by 16.9 week after operation (range, five to eighty-one weeks).
The patients were followed for 15.5 months (range, four to thirty months) and evaluated both clinically and radiologically.
There were no severe complications obtained in eighteen fractures. and results in these cases were classified as excelllent in fourteen, good in two, fair in one. No patients were judged to have poor results.
We concluded that Interlocking Intramedullary Nailing was an effective method for treating various types of femoral fractures.
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Takayasu Ishida, Yasushi Soejima, Norio Tago, Mitiya Hara, Kousuke Oga ...
1996 Volume 45 Issue 1 Pages
209-213
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
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We report seven supracondylar fractures treated using the Intramedullary Supracondylar Nail (IMSC nail). The mean age of patients was 70.3 years (33 to 87 years)and the mean period of follow-up was 3.9 months (range, 1 to 11 months). They were classified according to Müller's classification into type A2 (3 cases), Type A3 (2 cases), type C1 (1 case), Type C2 (1 case). Three cases were treated with the open technique, and four with the closed technique. (two of these with arthroscopic surgery).
Breakage of the nail occurred in 1 case, but therre were no cases of infection. IMSC Nail was useful for treating with minimal invasion and providing stable fixation thereby allowing early mobilization.
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Manabu Taguchi, Hiroshi Mizuta, Kenji Kubota, Minoru Shiraishi, Noriyo ...
1996 Volume 45 Issue 1 Pages
214-217
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
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Supracondylar fracture of the femur after total knee arthroplasty is a serious complication and the management for this complication is controversial. We have experienced two cases using external fixation to treat this fracture. Both patients had osteopenia and we could not find surgical encroachment of the anterior femoral cortex. Activities of daily living of these patients returned to prefracture level following treatment.
The external fexation allows early range-of-motion exercises at the knee without the need for prolonged bed rest and extensive surgical exposure. We concluded that this technique is useful for treating this fracture.
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Kenji Yamamoto, Daishiro Yuge, Hiroshi Mimura, Toshihiko Taguchi, Kats ...
1996 Volume 45 Issue 1 Pages
218-221
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
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This paper describes the clinical results of fractures of the femoral shaft after total hip replacement (T. H. R.).
Between 1985 and 1994, we treated 7 patients, 8 femoral shaft fractures after T. H. R. Subjects included 1 male and 6 females with an average age of 60.9 years. The mean follow-up period after the final operataion was 47 months (12 months to 96 months).
Treatment of the patients depended on their type of fracture. If they had no signs of loosening of the stem, we treated with osteosynthesis using a plate. It is possible to insert screws into the bone in the presence of cement and a stem. In cases with loosening of the stem, we choose to perform the revision using cementless long stem added bone grafts.
At Follow-up 3-6 months after surgery, bone union was completely achieved in all of the cases and favorable clinical results were achieved.
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Osamu Miyagi, Tsuneo Miyagi, Kazuyuki Noda, Hiroyuki Tanaka, Hiroshi I ...
1996 Volume 45 Issue 1 Pages
222-225
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
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We report three cases of depression fracture of th femoral condyle in the adolescent.
The etiological mechanism was assumed to be abduction (Valgus) stress or a combined compression force in the knee as occurs with fractures of the tibial plateau.
All cases achieved satisfactory results, with no problems. Treatment of the fracture should be selected according to the degree of the depression, and associated meniscal lesion or soft tissue and ligament injury.
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Sukeaki Kabayama, Jun Kubota, Youhei Nozawa, Narutomo Mizoguchi, Hirom ...
1996 Volume 45 Issue 1 Pages
226-228
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
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We evaluated the results of tibial Plateau fractures.
Subjects consisted of 22 patients (22 knees) between the age of 16 and 75 years (average: 54 years).
Twenty fractures were treated by surgery and two treated by cast.
The fractures were classified according to Hohl's classification.
The clinical results were evaluated according to Hohl and Luck's criteria.
In terms of anatomical criteria, 77.3% of the cases were good or excellent, 86.3% were good or excellent in functional creteria.
In some cases, the depressed parts were noted to sink suring the treatment.
Most of the fractures were in the middle or posterior aspect of the joints.
3 dimensional CT was useful to obtain a more accurate evaluation of the depressed area.
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Takuya Ikuta, Akira Fujiwara, Osami Kudoh, Mitsuru Sakaguchi
1996 Volume 45 Issue 1 Pages
229-234
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
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Thirteen cases of ipsilateral fractures of the femur and tibia were treated. they were classified according to Fraser's classification into type I (8 cases), II
a (3 cases), II
b (1 case), II
c (1 case). Using the criteria for assessment described by Karlström, cases were graded as excellent, good, acceptable and poor. Excellent results were achieved en 8 cases, good in one, acceptable in three and poor in one. Cases with injury of the knee joint achieved relatively poor results.
We concluded that repair of the knee joint is the most important factor for successful treatment of ipsilateral fractures of the femur and tibia.
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Hiroyuki Tanaka, Hisashi Hoshiko, Takeshi Goto, Akio Inoue, Ryo Sakai
1996 Volume 45 Issue 1 Pages
235-237
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
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The load bearing function of the patellar tendon bearing (PTB) brace was studied using the F-SCAN system of foot pressure analysis.
A high frequency response, ultra-thin sensor insole was used to measure plantar pressure at the sole of the foot in normal subjects.
The major obfectives of this study were as follows:
1) Measurement of the load bearing function of the PTB brace.
2) Evaluation of the pressure reducing or increasing effect of the weight bearing board.
3) Evaluation of the lower leg component of the PTB brace.
The following results were obtained:
1) 100% of non-loading was obtained by the PTB brace.
2) 82% of non-loading was obtained at the starting point of the weight bearing board. Increasing the board height increases plantar pressure (64% of non-loading at + 5mm, 36% of non-loading at +10mm). Plantar pressures were also reduced by the lower board (91% of non-loading at -5mm, 96% of non-loading at -10mm).
3) Lower leg component of the PTB brace had the great load bearing function.
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Nobuhiro Kaku, Makoto Sasaki, Yoshihiro Noro, Shunji Mori, Hirofumi Ta ...
1996 Volume 45 Issue 1 Pages
238-243
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
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There are many methods for tibial fracture treatment. We report good results with Ender Nailing for treating tibial fractures.
We researched 45 legs off 45 patients who were followed up for more than 6 months between January 1989. and October 1994.
Regarding the cause of injury, traffic accidents were the most common (46.7%) and the next most common was fast trauma in Workers. There were 34 (75.6%) closed and 11(24.4%) open tibial fractures. The average operating time per fracture was 59 minutes and the estimated blood loss per fracture was less than 20ml. There were no cases of nonunion or infection.
According to Anderson's estimation this approach achieved an excellent result in 44.4% and good in 37.8%. Using Edward's classification excelent results were found in 76.9%.
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Yasuhiro Kuchiishi, Yuzoh Fukahori, Toshiya Hiratuka, Hironobu Nisitan ...
1996 Volume 45 Issue 1 Pages
244-250
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
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We recently encountered a case of a tiibial fracture treated by intramedullary nailing in which the nail was broken after treatment. The nail was broken through the proximal screw hole. The proximal portion of the nail was removed easily, using the appropriate extraction hook, however distal the portion of the canal was filled with callus naking it difficult to remove the remaining fragment. We were not able to use the extraction hook. Fenestration was performed at the distal screw hole with the impactor used and a hammer to strike out to the proximal end of the screw hole, enabling us to remove the distal fragment. The broken part of the nail represented stress-raisers.
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Narutomo Mizoguchi, Youhei Nozawa, Sukeaki Kabayama, Hiromi Sinkado, T ...
1996 Volume 45 Issue 1 Pages
251-253
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
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This study evaluated the results of surgery for patients with Pilon fractures. Subjects consisted of 9 patients with an average age of 49 years. We classified these fractutrs according to Ruedi. Post operative radiographic and clinical results were evaluated using Burwell & Charnley's criteria. We suggest anatomical reduction of the joint surface is important in the treatment of Pilon fractutes.
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Keitaro Yamamoto, Shinji Morita, Junji Kanai, Naoya Tajima, Shigeru Ku ...
1996 Volume 45 Issue 1 Pages
254-257
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
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Subsepsis allergica (Wissler-Fanconi syndrome) is a vary rare disease characterized by fever, exanthema amd arthralgia. A 39-years-old man with remittent fever and polyarthralgia visited our hospital in October 1994. His left knee joint and left second toe showed swelling and tenderness, but there were no signs of bone disease on Xray and MRI. Blood examination showed hyperleukocytosis with neutrophilia, hyperpositive CRP, hyperacceleration of ESR, and liver dysfunction. Exanthema with effusion appeared on his left elbow and left dorsum manus. The patient's symptoms were not remitted by antibiotics, but by steroids.
In the majority of patients with these symptoms, the differential diagnosis is an infective disease, malignant tumor, collagen disease, toxic disease, and so on. This syndorome is labelled as adult Still's desease.
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Takeshi Kanamiya, Minoru Ikeda, Hiroyuki Iida, Gen Emoto, Kosuke Ogata
1996 Volume 45 Issue 1 Pages
258-261
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
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We experienced a case that showed generalized destructive arthritis of the distal and proximal interphalangeal joints which was difficult to diagnose and treatment.
A 48-year-old woman gradually developed the clinical features of polyarthritis of the hands, feet, with recurrent intraarticular effusions of the knees. Small skin nodules were observed. She had pain and swelling in the interphalangeal joints of effected fingers for the first 4-years. Her fingers, on physical examination revealed inflammatory synovitis with mild functional impairment. Hands of the patient showed soft tissue thickening due to the presence of cutaneous nodules. Radiographic appearance of finger interphlangeal joints showed articular erosions, expansion of joint space, and well preserved bone density. Laboratory test results including full blood count, ESR, were all within normal range and total cholesterol was slightly increased (253mg/dl↑). Other biochemistry values were within the normal range. Rheumatoid factor was negative but antinuclear antibody was positive. A nodule of skin was biopsied. Histologic examination showed fibrous tissue without histiocytes and multinucleated giant cells.
We had suspected multicentric reticulohistiocytosis but this was not supported by histologic examination. We can not yet make a definitive diagnosis, and we will observe the patient's course.
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Tetsuhiko Arita, Akio Matsuzaki
1996 Volume 45 Issue 1 Pages
262-264
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
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We report a case of hypertrophic pulmoary osteoarthoropathy. A 44 year-old man presented cpmplaining of swelling and pain on his bilateral wrist, elbow, knee ankle joints. His fingers showed clubbing deformity, and knee x-ray showed subperiosteal new bone formation in bilateral distal diaphysis of femur, proximal and distal diaphysis of tibia. We suspected pulmonary disease and chest X-ray was performed which showed an abnormal shadow on the right upper labe. The tumor was pathologically diagnosed as an adenocarcinoma and a right upper lobectomy was perfomed. After operation, the pain rapidly improved. 20 month after his first visit, fingers were almost normal and no articular signs and symptoms, includin arthralgias, stiffness, joint swelling, and effusions. But on X-ray, periosteal proliferation of femur and tibia still remained.
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Katushi Kudoh, Kouhei Ise, Hiroshi Kikuchi
1996 Volume 45 Issue 1 Pages
265-267
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
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We report a rare case of a Brown tumor in a 42-year-old woman with severe secondary hyperparathyrodism who had been undergoing hemodialysis for 12 years.
Brown tumors contains fibrous tissue, giant cells, osteoclasts and blood. It is important to discriminate brown tumor from bone tumor and amyloid osteopathy. Brown tumors appear as single or multiple well defined lesions, commonly found within the mandible, pelvis, and femur.
With removal of rhte offending parathyroid the Brown tumor may heal, leaving increased radiodensity on X-ray films.
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Takeshi Uchida, Zuidou Chou, Manabu Kusida
1996 Volume 45 Issue 1 Pages
268-271
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
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Post-pregnancy osteoporosis, which was reported for the first time by Nordin in 1955 originates from back pain and vertebral compression fracture during pregnancy or delivery. This disease is so rare that only a few reports are available in the literature. According to these reports, subjects as young as 20-30 years at the onset are predominant and about 80% of them develop the osteoporosis following their first experience of pregnancy. There is a strong correlation with lactation, which is, however, not always responsible for the present disease. The disease is self-limiting, and interruption of lactation and conservative treatment lead to remission within several months with a favorable prognosis.
Recently, we experienced a 32-year-old woman who developed back pain 2 months after delivery of her second child and had a lumbar compression fracture, which, however, was relieved by conservative treatment. We would like to report the present case with particular emphasis on the change in bone mineral density, as measured using Dual energy X-ray Absorptiometry and a review of the relevant literature.
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Masahiro Nakamura, Masaru Higo, Hirofumi Miyauchi
1996 Volume 45 Issue 1 Pages
272-275
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
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We reviewed our experience of multiple osteotomies with realignment and intramedullary rod fixation of deformed bones in 3 patients with osteogenesis imperfecta. There were one 7-year-old boy and two 6-year-old girls who were twins. The average duration of follow-up was 4.3 years. A further five operations were needed for treatment of complications which included one of femoral non-union, three of anterior placement of the rods and bony angular deformities in the distal part of the tibia, and one of proximal migration of the proximal end of the femoral rod. Satisfactory revisions for these had been carried out.
Another complication was cessation of elongation in six rods due to slight bending of the rods from 2.5 to 3 years postoperatively. No patients suffered a fracture after rodding. Prior to surgery none of the subjects had been able to walk. After surgery the boy was able to walk with braces and the twins walked using braces and walkers at the time of review. Dispite a high rate of complications, Bailey-Dubow rods are considered to be a useful treatment for growing children suffering from osteogenesis imperfecta.
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Kohichi Tanaka, Masateru Ijichi, Junji Aguni, Hiroshi Miyazaki, Akira ...
1996 Volume 45 Issue 1 Pages
276-278
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
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Patients of myelomas often first visit orthopaedic surgeons complaining of bone pain.
We report 10 cases of myelomas that were diagnosed in our hospital in the last 5 years. Patients included 6 males and 4 females with a mean age of 64.8 years. The initial clinical symptoms were lumbago in 4 cases, thigh pain in 2 cases, rib pain in 2 cases, neck pain in 1 case, and sacral pain in 1 case. X-ray findings included osteolytic changes in 6 cases, pathological fractures in 2 cases. However 2 cases only showed bone atrophy. Blood biochemistry revealed, 9 cases with abnormal values. Five cases underwent operative therapy to maintain their quality of life.
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Taro Kodama, Takashi Sako, Hiroshi Ito, Norio Morimoto
1996 Volume 45 Issue 1 Pages
279-281
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
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Twenty-nine cases of osteosarcoma have been treated since 1982 to 1994 in Kagosima University Hospital. Chemotherapy consisted of thirteen cases receiving the Compadri V protocol, twelve were lealed with Posen T10 ot T12 and one with high dose ifosfamide. Disease free rate assouated with the Rosen T10 or T12 protocol was a little higher than that for Compadri V. Operations performed included twelve cases reguring amputation or disarticulation and fourteen limb-salvage poeratons. There was no significant difference between disease free rate of subject having amputation or disarticulation and that of limb-salvage operation. Five years surveval rate of all cases was 50.7% and that of IIb was 55.6% by Kaplan-Meier method, and five year disease free rate was 45.2%. There was no correlation between plain X-ray evaluation of sadjuvant chemotherapy and prognosis. It was suggested that high dose fosfamide chemotherapy was effective for metastic osteosarcomas.
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Tsuyoshi Okudaira, Toru Hirano, Goichi Yoshida, Katsuro Iwasaki
1996 Volume 45 Issue 1 Pages
282-284
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
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In order to investigate age-related changes in clinico-radiological findings of osteosarcoma, we divided 34 patients into the following 3 groups according to their age: Group 1; 16 patients less than 18 years, Group 2; 11 patients from 19 to 49 years and Group 3; 7 patients more than 50 years.
The values of serum alkaline phosphatase in Group 1, 2 and 3 were 532±355, 740±709 and 344±198, respectively. Statistical analysis disclosed a significant decrese of the value in Group 3. The ratio of sclerotic and mixed types in radiographic appearances of the tumors was 87.5%, 63.7% and 57.2% in Group 1, 2 and 3, respectively. The typical periosteal reactions like Codman's triangle and spicula were observed frequently in Group 1, 2 and 3 in that order.
This study suggested that clinico-radiographic appearances of osteosarcoma in elderly patients differed from those in younger subjects in regard to their capability for tumoral and periosteal bone formation.
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Taro Mawatari, Norio Shinohara, Koichiro Yokoyama, Masakazu Kondoh, Ta ...
1996 Volume 45 Issue 1 Pages
285-291
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
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We evaluated 10 cases of endoprosthetic reconstruction for selected bone tumors of the distal femur and proximal tibia. Kotz Modular Femur and Tibia Reconstruction (KMFTR) system were used in 9 patients and Kyo- cera Tumor Prosthesis were used in 1 patient.
The average age of the patients was 59.3 years, and the average duration of follow-up was 43.5 months. Patients were assessed according to their latest condition and both the radiological results and the functional results were exellent or good in most cases. Considering that the KMFTR system is a monocentric simple hinge joint, these results were better than we expected.
The major complication was breakage of the polyethylene hinge bushes, although improvement of this technical problem was carried out in 1992.
The KMFTR system is satisfactry for limb-salvage surgery although careful consideration of indications is required. However we prefer arthrodesis using banked bone in younger patients who are considered to be curable.
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Katsumi Harimaya, Yukihide Iwamoto, Toshihiro Izumi, Yoichi Sugioka, H ...
1996 Volume 45 Issue 1 Pages
292-296
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
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IFO, one of the oxazaphosphorines, has great antitumor activity against a variety of neoplasms. However, urotoxicity has also been reported as one of the doselimiting factors of IFO. Mesna has been found effective in protecting the bladder from the renal toxicity of the oxazaphosphorines including IFO. Therefore, we used mesna in the chemotherapy of nine patients with malignant bone and soft tissue tumors in order to prevent the side effects of IFO. When we administered IFO without mesna, hemorrhagic cystitis was observed in all patient. The patients were given higher doses of IFO with mesna than those given IFO alone. However, hemorrhagic systitis was not observed in any patient given IFO with mesna.
Six out of nine patients had primary or metastatic lesions in which chemotherapeutic effects could be evaluated on CT or MRI. Of these patients complete response in one case and the partial responses in two cases were observed. It should be noted that the case with a complete response was that of a synovial sarcoma, which usually does not respond well to chemotherapy.
Based on the present study, we conclude that high-dose IFO therapy with mesna is safe and is likely to be effective for treating synovial sarcoma.
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Hiroaki Hanzawa, Osamu Inoue, Yoshisada Shingaki, Hiroyuki Shimabukuro ...
1996 Volume 45 Issue 1 Pages
297-302
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
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Synovial hemangioma is an uncommon lesion which mainly occurs in the knee joint. We report two cases of typical synovial hemangioma of the knee.
Case 1: A two year-old boy suffered from swelling of his right knee on which a cutaneous hemangioma had been observed from birth. X-ray showed no phlebolith or calcification in the tumor. Angiography revealed venous blood pooling in the tumor. Resection of the tumor along with the synovium was performed. Recurrence of the hemangioma occurred around the knee joint ten years later.
Case 2: An eight year-old boy suffered from swelling and gonalgia. MRI revealed an intraarticular tumor which was isointense on T
1 images T
2 high. Capsulo-synovectomy of the upper pouch was performed recently.
Although synovial hemangioma in childhood may recur extensive synovectomy should be avoided, because of unpredictable osteoarthrotic changes in the future.
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Yumi Itoh, Keizo Morisawa, Akihiko Asami, Hideo Watanabe, Nobuhisa Yon ...
1996 Volume 45 Issue 1 Pages
303-305
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
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Hidehiro Matsumoto, Yasuyuki Kobayashi, Hiromichi Tanaka, Takaaki Naga ...
1996 Volume 45 Issue 1 Pages
306-309
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
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We report a case of malignant hemangioendothelioma which occurred in the thoracodorsal artery. This tumor ruptured, making a giant tumor on the patient's back. MRI was useful in recognizing the area and size of this tumor. Lastly we discuss the histology, prognosis and treatment of the hemangioendothelioma.
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Katsumi Yano, Nobuyuki Ito, Toru Hirano, Masao Eto, Tadashi Tomonaga, ...
1996 Volume 45 Issue 1 Pages
310-313
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
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A 39-year-old male presented with pain and swelling of his arm. At first, we diagnosed this lesion as rupture of the biceps tendon or soft tissue tumor. Five years later, functional disturbance of the right elbow appeared. Computed tomography, magnetic resonance imaging and angiography were used to diagnose this tumor. We diagnosed it benign and it was treated surgically. The histology of this tumor was neurilemmoma.
The tumor was heterogeneous in computed tomography and magnetic resonance imaging and hypervascular in angiography, therefore making it difficult to diagnose it as benign.
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Nobuhiko Watanabe, Sansen Yoh, Teruto Isayama, Gen Emoto, [in Japanese ...
1996 Volume 45 Issue 1 Pages
314-317
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
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Magnetic resonance imaging is useful fr diagnosing bone and soft tissue tumors. We report a patient with a schwannoma which gradually grew into a huge mass over a 12 year period. The deagnosis was possible using CT imaging, MRI, amgiogrephy, scintigraphy, and biospy. We recommend that MRI (especially, Gd-enhanced MRI) is useful for detecting the solid area of a huge systic mass for biopsy.
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Osam Suenaga, Masaru Toda, Ryuuji Kuroki, Syouiti Watanabe, Naoya Taji ...
1996 Volume 45 Issue 1 Pages
318-321
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
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This is a case report of intraosseous ganglion of the lunate, which is very rare.
Case; A 39-year-old man complained of right wrist pain. Radiograph showed a small tumor of the lunate and MRI showed characteristic appearance of a cystic tumor. At surgery, we found a syst in the lunate, which was filled with a jelly like substance. There was no connection to the outside of the bone. Curretage and bone graft were performed. Pathologically, the tumor was composed of fibro-vascular tissue showing hyalinization and calcification.
Loose myxoid matrix pools were found to be scattered in the fibrous tissue. We diagnosed this as an intraosseous ganglion of hte lunate and believed it occurred in the bone, because there was no connetion to the outside of the bone.
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Yasuhito Ide, Koji Matsumoto, Kunio Kobayashi, Toshio Tokuhisa, Masaka ...
1996 Volume 45 Issue 1 Pages
322-325
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
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There are only a few reports following the osteomyelitis using MRI. We experienced a case of bacterial osteomyelitis of the femur which formed a broad subperiosteal abscess.
We used MRI for the diagnosis and follow up and found it to be useful.
The case was a 12 year old male, who presented with a 40°C fever and swelling and local heat of his right thigh were observed. On blood examination, WBC number was decreased, with a shift to the left, and CRP was strongly positive. MRI T2WI showed a broad high intensity area in the subperiosteal space. Puncture showed bloody abscess and the patient was hospitalized for examination and treatment. Bacterial culture of the abscess and blood were performed and both of which were positive for Staphylocossus aureus.
We performed an irrigatim of the abcsess fenestration of the bone, and continuos intramedullary drip infusion of antibiotics. MRI was also useful for observation of the recovery stage.
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Kazuyuki Okamura, Yoshiyasu Taniguchi, Shinya Maki, Yuujirou Hamasato, ...
1996 Volume 45 Issue 1 Pages
326-328
Published: March 25, 1996
Released on J-STAGE: July 01, 2010
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Twenty patients with osteomyelitis and infectious arthritis who were treated by continuous suction irrigation were examinated. Subjects comprised 13 with chronic osteomyelitis or infectious arthritis, six infections of total joint arthroplasty cases and one case of acute osteomyelitis. The course of the infections were as follows: eight enthicillin resistent Staphylococcus aureus (MRSA) cases, five methicillin sensitive Staphylococcus aureus (MSSA), four staphylococcus epidermidis cases and three cases with other bacteria. The average irrigation period was 18.7 days.
Healing was obtaind in twelve cases (60%). The infection relapsed in haef of the MRSA cases and two cases requied amputation of the infected limb.
Erythrocyte segnentation rate (ESR) seems to be most useful marker of osteomyelitis and infectous arthritis.
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Hiroshi Ito, Takashi Sakou, Jun-ichiro Nishi
1996 Volume 45 Issue 1 Pages
329-331
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
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In order to prevent MRSA (methicillin-resistant Staphylococcus aureus) hospital infection, we have to know when and how inpatients become carriers. To clarify these issues, becteriological examination of nasal mucosa of orthopedic inpatients was perfomed. When MRSA was detected, coagulase type and genotype based on the size of the mec-associated hypervariable region were investigated. Nineteen persons from 138 inpatients were postive for MRSA. The risk of becoming a carrier was higher in the postoperative period than the former period. Various types of MRSA were detected in preoperatively infected inpatients, but almost a single type of MRSA was noted in postoperatively infected patients. The type of MRSA taken from the medical staff and the ward environment were generally different from that detected in inpatients.
In conclusion, our effort to prevent medical staff-mediated MRSA hospital infection is thought to be somewhat effective. The infectious route of becoming MRSA carriers is still obscure.
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Shouichi Uchinou, Mituhiro Takasita, Kei Hirakawa, Mitukane Kumagi, Sh ...
1996 Volume 45 Issue 1 Pages
332-335
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
JOURNAL
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We treated three cases of psoas abscess by echo-guided percutaneous drainage of the abcess. These patients recovered well. Echo-guided percutaneous drainage combined with appropriate antibiotic therapy is the first choice procedure for treatment of a psoas abscess if the patient's condition is poor.
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Masatoshi Hayase, Yoshihisa Kawauchi, Takuro Koji, Takashi Sakou
1996 Volume 45 Issue 1 Pages
336-338
Published: March 25, 1996
Released on J-STAGE: February 25, 2010
JOURNAL
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We report a case of psoas abscess. The case os a 66-years old male with a principal complaint of low back pain. Physical wxamination revealed posas stellung. Posoas abscess was dignosed by gallium scan-computed tomography (CT) and by mangetic resonance imaging (MRI). Culture of the purulent material obtained by puncture, revealed Staphylococcus aureus. Incision and drainage of the abscess were carried out under genaral anesthesia. Postoperative course was satisfactory. MRI was very useful for the diagnosis and postoperative follow up of psoas absess.
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