-
浅見 昭彦, 森澤 佳三, 渡辺 百合子, 渡辺 英夫, 鶴田 敏幸
1996 年 45 巻 3 号 p.
862-867
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
手における靱帯・腱損傷は症例によっては端々縫合が不可能なことがあり, pull out wire 法や腱の advancement 法などを要することが多い. しかし, これらは固定性が弱く, その他の合併症を生ずることもある. 我々はこれらの症例にマイテック・ミニ・アンカーを用いた修復術を行い, 良好な成績を得ているので報告する.
対象は陳旧性槌指3例, 母指MP関節橈側側副靱帯断裂1例, 同尺側側副靱帯断裂1例, 小指PIP関節尺側側靱帯断裂1例, 環指PIP関節掌側板損傷・中節骨基部剥離骨折1例の計7例である.
手術成績は陳旧性槌指の3例は10度以下のDIP関節の伸展不全を呈したため良であったが, 他の症例は全て優であった.
今回使用したミニ・アンカーは強固な間定性が得られ, しかも解剖学的位置で修復でき, 二次的手術の必要性もなく, 治療期間も短縮できる有用な方法であると思われた.
抄録全体を表示
-
豊原 一作, 金谷 文則, 安里 潤, 座間味 伸, 茨木 邦夫, 外間 浩
1996 年 45 巻 3 号 p.
868-871
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
we report on 11 patients with calcific tendinitis and periarthritis found distal to the elbow joint. Subjects comprised 9 women and 2 men. Age at onset of symptoms ranged from 21 to 60 years, with a mean of 43 years. All patients showed acute onset of inflammation except for one patient with a chronic calcified mass causing carpal tunnel syndrome. Calcification occurred in the thumb in 7, MP joint of long finger in 2 and in carpal tunnel and elbow joint in 1 each. Although all patients received correct diagnosis, acute infection or avulsion fracture should be considered in the differential diagnosis. All patients were initially treated conservatively. Mean period of pain subsidence was 14 days in 1 patient treated with rest only, 4 days in 2 patients treated with anti-inflammatory drugs, 1.4 days in 5 patients treated with aspiration or injection combined with anti-inflammatory drugs. Three patients required surgical resection. Of them, 2 were resistant to conservative treatment and 1 patient had chronic calcification causing carpal tunnel syndrome. Length of calcific deposits positively correlated with the duration of pain subsidence. Aspiration with antiinflammatory drugs gave earlier pain relief among conservative treatments.
抄録全体を表示
-
吉田 健治, 佐藤 直人, 八木 雅春, 山田 康人, 井上 明生, 山中 健輔, 井上 博
1996 年 45 巻 3 号 p.
872-876
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
Thirteen hands in twenty one cases with Dupuytren's contracture treated surgically between 1973 and 1994 are reported. Subjects included 18 males and 3 females ranging in age from 34 to 88 years, with a mean of 63.1 years. The duration between onset and surgery ranged from one month to 10 years with an average of 3.7 years. Surgical treatment was performed in 8 cases with the right side affected, 4 with the left and 9 were bilaterally affected. Preoperative grade was classified according to Einarsson's modification of Meyerding's classification. Of the 32 hands, there were no hands of grade 0, 12 hands were grade I, 6 hands were grade II, 13 hands were grade III and 1 hand was grade IV. As to the types of surgical treatment, limited fasciectomy, including z-plasty or skin graft, was performed in 12 hands. The follow-up period lasted from one to 20 years, and averaged 6.4 years.
The results were evaluated according to Tubiana's classification. They were very good in 10 hands (31.3%), good in 12 hands (37.5%), fair in 2 hands (6.3%) and poor in 8 hands (25.0%). The clinical results were significantly better in the limited fasciectomy group than in the fasciotomy group.
抄録全体を表示
-
黒沢 治, 戸田 勝, 黒木 龍二, 工藤 勝司, 田島 直也
1996 年 45 巻 3 号 p.
877-880
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
We experienced two patients with locking of the MP joint in the index finger and one patient with locking of the MP joint in the thumb. All cases were treated surgically. We discuss the causes of locking of the MP joints with reference to differences in age, sex and site between a sports group and a group with locking of the MP thumb joint.
抄録全体を表示
-
園田 広典, 多田 勝弘, 中村 道利, 内納 正一
1996 年 45 巻 3 号 p.
881-885
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
Synovial chondromatosis in the wrist is an uncommon lesion. We report a case of a 45-year-old man who showed pain on motion and swelling of his left wrist. A smooth and elastic hard mass was palpable at the distal radioulnar joint. Roent genograms showed diffuse, discrete, small calcifications around the ulnar head and the distal radioulnar joint. MRI suggested that there was a mass lesion around the ulnar head. At surgery, hundreds of small, white free bodies were seen. Cartilagenous nodules surrounded by synovial tissue with no ossification were seen in histological examination to distinguish synovial chondromatosis from chondrosarcoma. Due to similarity between clinical and histological features it is difficult. Eight months after surgery, the patient had a full range of joint motion without pain, and no signs of recurrence.
抄録全体を表示
-
平 博文, 川嶌 眞人, 田村 裕昭, 佐々木 誠人, 野呂 純敬
1996 年 45 巻 3 号 p.
886-889
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
The solitary bone cyst is not a rare condition, but its treatment has not been standarized yet. We report two cases of solitary bone cyst treated by cannulated cancellous screw. The first case is a eleven-year-old female who complained of right foot pain with no traumatic history. And the second is a ten-year-old male with a pathological fracture of the left femoral neck after exercise. In both cases, bone formation was seen after decompression.
This method is easily administerd, less invasive and a bone graft is not necessary, so we recommend this method as a first choice in children.
抄録全体を表示
-
田爪 陽一朗, 中村 誠司, 川越 正一, 作 良彦, 田島 直也
1996 年 45 巻 3 号 p.
890-894
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
We experienced two relatively rare cases of calcifying enchondoroma. The first case was locateed in the proximal humeral shaft and the second in mid-shaft of the femur. In both cases, localized calcification in the medullary of the bone was observed on plain X-ray. MRI showed low intensity on T1WI and mixed intensity of low and high intensity on T2WI. MRI seems to be useful in differential diagnosis between enchondroma and other calcified lesion, such as bone infarction or chondosarcoma.
抄録全体を表示
-
濱中 秀昭, 柏木 輝行, 帖佐 悦男, 桑原 茂, 田島 直也
1996 年 45 巻 3 号 p.
895-900
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
To investigate the usefulness of magnetic resonance imaging, MRI, of bone tumors, we retrospectively reviewed 32MRI examination already diagnosed pathologically. Subjects included 18 males and 14 females, ranging in age from 5 to 63 years, with a means of 29.3 years. These included 25 benign bone tumors and 7 malignant bone tumors. The accuracy of a qualitative diagnosis was observed in giant cell tumor, osteoid osteoma, fibrous dysplasia and ossifying fibroma. In malignant bone tumors, it is difficult to accurately diagnose with MRI, although MRI was useful in showing interaction of the tumor and host tissue, extension, edema and reactive zone.
抄録全体を表示
-
今村 寿宏, 大賀 正義, 田丸 卓弥, 有馬 準一, 生田 光, 江崎 幸雄, 吉兼 浩一, 冨重 守
1996 年 45 巻 3 号 p.
901-904
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
Secondary hyperparathyroidism is a well-known complication of renal failure. A rare manifestation of secondary hyperparathyrodism is the “Brown tumor” of bone. A 44-year-old woman who suffered from a pathological fracture due to Brown tumor is described. We perform osteosynthesis soon after injury allowing the patent to move by herself and significantly improving her quality of life. We consider that it is necessary to prepare bone cement, bank bone to support the weakness of bone structure.
抄録全体を表示
-
半澤 浩明, 井上 治, 新垣 宜貞, 大城 亙, 島袋 博之, 茨木 邦夫, 戸田 隆義
1996 年 45 巻 3 号 p.
905-909
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
Merkel cell carcinoma (MCC), first described by Toker in 1972, is a rare superficial subcutaneous carcinoma presumably derived from neurotactile cells of the dermis. Lymph node metastasis is frequent, but bone metastasis is rarely reported. A 66 year-old man was referred showing an osteolytic destructive lesion in his right proximal tibia. Simple resection of a left buttock tumor had been performed in another hospital two years previously. Open biopsy revealed small round cell carcinoma, positive to EMA, NSE, S-100, and negative to keratin, LCA, which all concurred with the primary buttock tumor. After knee rotation-plasty by segmental amputation, six courses of chemotherapy with adriamycin and ifosfamide was performed, diffuse metastasis in the pelvis was reduced by lineac 46 Gy irradiation. In our study, MCC is thought to be neurogenic as well as epithlial. Electron microscopy revealed multiple membrane bound neurosecretory granules.
抄録全体を表示
-
高橋 嗣明, 大石 陽介, 田中 幸一, 大西 英生, 鈴木 勝己, 久岡 正典, 岡本 好司
1996 年 45 巻 3 号 p.
910-913
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
It is a rare that tumor induces DIC in the orthopedic field. We report a case of liposarcoma in the left inguinal region, which may have been responsible for inducing phlegmon of the left lower extremity and consequently DIC.
The patient was a fifty-four year old male, who had three resections of a left femoral liposarcoma from 1983 to 1988. In 1993, recurrence of the left femoral fumor was found, though it had not been treated, In July 1995, his left leg showed remarkable swelling and redness with abnormal ESR, CRP and coagulation system in his serological examination indicating left extremity infection with DIG. Medication comprising FOY and antibiotics was given for about three weeks with improvement.
It appeared that obstruction of lymph fluid and venous return in his left extremity caused by the femoral liposarcoma may have caused the infection complicated by DIC.
抄録全体を表示
-
新垣 宜貞, 井上 治, 島袋 博之, 半澤 浩明, 大城 亙, 茨木 邦夫, 戸田 隆義
1996 年 45 巻 3 号 p.
914-916
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
We analyzed ten cases of extra-abdominal desmoid tumor (EAD) seen in the past ten years. Histologically two groups were classified ; an “immature cell group” characterized by predominant proliferation of plump nucleated tumor cells with poor interstitial collagen, or a “mature cell group” characterized by predominant proliferation of mature spindle nucleated tumor cells rich in collagen matrix. In the immature cell group, the patient's age ranged from 10-20 years (average 14.0 years), while in the mature cell group, patient's ranged in age from 33-51 years (average 40.6 years). Recurrence of two cases out of five (40%) was found in the immature cell group, while there were no recurrent cases in the mature cell group. Occurrence of mitosis seen in histological specimens was significantly high in the immature cell group (two to five per 100 high power fields, average 3.2±0.447) compared to the mature cell group (zero to three, average 1.0±1.732). It is suggested that histologically the immature type of EAD occurs at a younger age and is more locally aggressive.
抄録全体を表示
-
山口 鉄生, 平野 徹, 吉田 伍一, 岩崎 勝郎
1996 年 45 巻 3 号 p.
917-921
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
We studied the relationship between quadriceps muscular defects and limb functions in 12 patients with soft tissue sarcomas around the thigh who had undergone wide resections. To determine the degree of muscular defects, we divided the quadriceps muscle into 4 compartments, namely, rectus femoris, vastus medialis, vastus intermedius and vastus lateralis. The lower limb function was evaluated according to the criteria of the Musculo-Skeletal Tumor Society, Japan Orthopaedic Association. Twelve patients were divided into the following 3 groups, Group 1; 1 compartment, Group 2; 2 compartments, and Group 3; 3 and 4 compartments. Of 12 patients, Group 1, 2, and 3 included 6, 3 and 3 patients, respectively.
The average total scores in Group 1, 2 and 3 were 24, 22 and 17 points out of 25 points, respectively. The decrease in the average total scores with the increase in muscular defects was affected by the scores in function, walking ability and gait appearance. This study suggests that limb function after resection of the quadriceps can be predicted.
抄録全体を表示
-
薬師寺 俊剛, 米村 憲輔, 西田 公明, 高木 克公, 土屋 立昭, 宮本 健史
1996 年 45 巻 3 号 p.
922-925
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
We report a case of dedifferentiated parosteal osteosarcoma in the right distal femur. In this case, the dedifferentiation occurred 7 years after diagnosis without any surgical treatment during this period. The patient was treated by wide excision of the tumor and reconstruction with Kotz modular system followed by multidrug chemotherapy. The postoperative course was uneventful.
Dedifferentiated lesion was clearly detected by magnetic resonance imaging in which it was shown as having iso signal intensity with T1-weighted images, high signal intensity with T2-weighted images. Additionally, intramedullary invasion was more precisely demonstrated by MRI than by CT. Radiographically, MRI was the most helpful in evaluating the extent of dedifferetiated lesion.
It has been reported that in most cases dedifferentiation of parosteal osteosarcomas occurred after several recurrences. Therefore this case demonstrates the natural history of a parosteal osteosarcoma over a 7 year untreated period.
抄録全体を表示
-
伊藤 博史, 児玉 太郎, 亀沢 克彦, 和田 正一, 酒匂 崇, 森本 典夫
1996 年 45 巻 3 号 p.
926-928
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
We report a rare case of primitive neuroectodermal tumor (PNET) of bone.
A 25-year-old woman complained of pain and swelling in her left upper leg. An elastic hard mass, which was tender and hot was palpable. Roentgenographically, an irregularly marginated radiolucent area with cortical destruction at the epi-metaphysis of the left tibia was noted. On microscopic examination, the tumor was made up of sheets of closely packed round to ovoid cells. Apparent structual features such as rosette formation were absent. Glycogen granules were negative for PAS stain. Immunohistochemically, neural markers including NSE, myogenic markers, vascular markers were all negative except focally weakly positive for MIC-2 gene product.
This tumor is thought to be poorly differentiated and appears to have characteristics between Ewing's sarcoma and PNET.
抄録全体を表示
-
平野 徹, 吉田 伍一, 岩崎 勝郎, 村上 隆一, 藤井 徹
1996 年 45 巻 3 号 p.
929-933
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
We treated 5 patients who suffered from deep infection in preserved limbs after limb salvage procedures for malignant bone tumors. Sites included the femur in 2 patients and the proximal tibia in 3 patients. For reconstruction of the affected limbs, a prosthesis and an allograft had been used in 2 patients. In the remaining 3 patients, the involved bone and joint around the lesions had been preserved by radical control of the tumor utilizing intraoperative or preoperative radiotherapy.
Under administration of various antibiotics, the infection was successfully treated in the 3 patients who underwent surgical debridement following a repeated wet gauze packing everyday for 3 to 5 weeks, and wound closure using a muscle flap or a vascularized fibula osteocutaneous flap. However, the remaining 2 patients required amputation because they had wide-spread damage of the surrounding soft tissues.
抄録全体を表示
-
再注入例の検討
佐藤 公昭, 永田 見生, 大橋 輝明, 石橋 和順, 安部 淳, 森田 雅和, 廣橋 昭幸, 井上 明生
1996 年 45 巻 3 号 p.
934-936
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
We investigated the changes in pathology and intradiscal pressure after repeat intradiscal drug injection in the mature rabbit, Chymopahain (500pku/ml) or 10% hypertonic saline was injected into five lumbar intervertebral discs of 9 rabbits. The injection volume was 0.02ml/disc, and a repeat injection was performed 4 weeks after the first injection. Rabbits were sacrificed at 1 week, 4 weeks, and 8 weeks after the repeat injection. They were classified into 3 groups; the HH group received hypertonic saline twice, the HC group was first injected with hypertonic saline and with chymopapain at the second injection, and the CC group received chymopapain twice. The intradiscal pressure changed depending on the degree of disc degeneration and on any regeneration. When hypertonic saline was injected first (HH and HC groups), the degeneration in the disc was slight compared to when chymopapain was injected first (CC group), and the intradiscal pressure was further decreased by the second injection of hypertonic saline (HH group). In comparison, when chymopapain was injected first (CC group), marked degeneration and disc narrowing were observed with a marked decrease in pressure compared to when hypertonic saline was injected first (HH and HC groups). Following a second injection of chymopapain (CC group) there was further degeneration but there was no additional decrease in pressure. Disc regeneration was observed in the HH group, but not in the HC or CC groups.
抄録全体を表示
-
DXAを用いた検討
黒木 浩史, 田島 直也, 平川 俊一, 久保 紳一郎, 井上 篤
1996 年 45 巻 3 号 p.
937-941
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
We measured bone mineral density (BMD) of the femoral neck before and after lumbar spinal surgery by dual energy X-ray absorptiometry (DXA) to investigate the effect of postoperative bed rest on bone mineral content (BMC).
The study involved 7 males and 3 female patients ranging in age from 43 to 73 years, average age 54 years. Disorders comprised 4 lumbar spinal canal stenosis, 3 lumar spondylolytic spondylolisthesis, and one case each of lumbar degenerative spondylolisthesis, lumbar disc herniation and spinal arachnoid cyst. The period of postoperative bed rest ranged from 23 to 35 days (mean 27 days).
BMDs of femoral neck, Wards triangle, and trochanter decreased 1 month after surgery but were not significant. After reambulation, they demonstrated positive slopes but had not recovered completely by 3 months after surgery.
Postoperative bed rest for 1 month adds to loss in BMD. Once the BMC had decreased, it was difficult to recover to the preoperative level at follow-up 2 months after reambulation.
抄録全体を表示
-
松田 秀一, 佐々木 邦雄, 弓削 至, 大宮 克弘, 城戸 秀彦, 岡崎 賢, 植田 博也
1996 年 45 巻 3 号 p.
942-944
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
A new questionnaire has been developed to assess the severity of leg pain and evaluated to determine whether it offered measurement advantages over the JOA score. Thirty-one patients who suffer from leg pain due to lumbar soinal disorders were included in this study. The questionnaire is divided into eight sections (pain intensity, numbness, rest pain, sleeping, the effect of analgesics, walking, standing, and social life). The questionnaire score was compared with the JOA score.
The total questionnaire score correlated well with the JOA score (p=0.0344). Each individual score in all but two sections also correlated with the leg pain score in the JOA socre. The rest pain score (p=0.9731) and the sleeping score (p=0.2498) did not correlate with the JOA leg pain score.
The results of this study suggest that it is difficult to evaluate sleep disturbance and rest pain only with the JOA score. Since both symptoms are often related to compression of the dorsal root ganglion, they should not be ignored when diagnosing and treating patients with lumbar spinal disorders.
抄録全体を表示
-
角田 信昭
1996 年 45 巻 3 号 p.
945-948
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
We performed a radiological study to assess morphological features of the lumbo-sacral spine contribute to posterior slip of the lumbar spine. Padiological measurements were carreid out in 147 cases of retrolisthesis, 30 cases of retro-position of L5 spine and a control group of 408 cases of low cack pain. The incidence of posterior slip in the controls was 26%.
The average age was younger in the posterior slip group compared to the control group, and the retro-position group were younger than the retrolisthesis group.
A higher incidence of lumbo-sacral transitional vertebrae was noted in the posterior slip group than in a control group. Also the angle between the superior surface and the posterior border of the sacral vertebral body was lower in the posterior slip group.
The laminar angle was similar in the posterior slip group and controls.
In conclusion, special morphological features such as low posterior superior sacral angles and the existence of lumbo-sacral transitional vertebrae were considered to be risk factor for the development of posterior slip.
抄録全体を表示
-
前川 清継, 坂田 浩章, 岡嶋 啓一郎, 高野 晴夫, 浦田 伸一, 川添 泰弘
1996 年 45 巻 3 号 p.
949-953
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
We report on 305 patients operated on for lumbar disc herniation between 1989 and 1994.
There were 6 cases (5 males, 1 female) with lumbar disc herniation and urinary retention. These patients had an average age of 47.1 years (range 22-62 years). Follow-up was for an average of 3.7 years.
5 patients underwent laminectomy with posterolateral fusion and one underwent Love's method.
We report on their post-operative results and prognos for urinary retention.
抄録全体を表示
-
橋川 健, 瀬良 敬祐, 中村 昌一, 宮原 健次
1996 年 45 巻 3 号 p.
954-957
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
We studied 22 cases of lumbar disc herniation which had compressed the adjacent nerve root at surgery. Of these, 16 were male and 6 were female, ranging in age 23 to 74 years (mean; 43.2 years). The case of compression of the adjacent rerve root were upward migration of nucleus pulposus (12 cases), downward migration of nucleus pulposus (4 cases), lateral lumbar disc herniation (1 case) and nerve root anomaly (5 cases). It was possible to diagnose upward and downward migration of nucleus pulposus by preoperative neurological, myelographic, CT myelographic and magnetic resonance imaging (MRI) findings. However it was difficult to diagnose nerve root anomaly using these methods.
抄録全体を表示
-
65才以上の手術症例について
小柳 英一, 成尾 政圀, 浦門 操, 野上 俊光, 田岡 祐二
1996 年 45 巻 3 号 p.
958-962
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
We report on 71 cases of lumbar disc herniation (H group) and spinal canal stenosis (S group) with acute symptoms who were clinically investigated. Herniation was observed in 39 cases (55%) and stenosis in 32 cases (45%) at surgery.
Clinical symptoms and physical signs
Lumbago, leg pain and SLR (or FNS) Test were reported more in the H group compared to the S group. In comparison intermittent claudication was higher in the S group. Motor weaknes was seen in over 50% of both groups. Recto-vesical dysfunction was seen in 10% of the H group and 22% of the S group.
Surgical method
Unilateral clinical signs were found in 79% of the H group and 53% of the S group. But Love, hemi fenestration or hemi laminectomy were done in only 23% of the H group and 10% of the S group. In most cases, laminectomy was done for decompression of the Dura mater and nerve Root.
抄録全体を表示
-
永島 英樹, 森尾 泰夫, 山本 吉藏
1996 年 45 巻 3 号 p.
963-966
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
We evaluated the clinical findings of lateral lumbar disc herniation (LLDH) in four patients (three male and one female) whose mean age at the time of surgery was 39.3 years (range, 31-47 years). The L4 root was affected by L4-5 herniation in two patients, the L3 root by an L3-4 hernation in one, and the L5 root by an L5-S herniation in one. Operative findings were positive for foraminal disc herniation in three cases and for foraminal and extraforaminal disc herniation in one.
Clinically, all patients had difficulty in walking and remaining supine. Four patients had sensory impairment and three showed muscular weakness. Femoral nerve stretch test was pisitive in two patients and straight leg raising test was positive in two.
The patients were evaluated using the JOA score and compared with fourteen patients with intracanal lumbar disc herniation (ILDH) whose mean age at the time of operation was 39.6 years (range, 19-60). The average total JOA scores in LLDH and ILDH were 6.5 and 13.0 points, respectively (p<0.05). The scores of objective findings and activities of daily living were not significantly different between the two groups, however that of subjective findings in LLDH were significantly lower than in ILDH (p<0.01).
抄録全体を表示
-
大江 浩一郎, 有村 一盛, 城間 啓治, 笹岡 博文, 荒木 崇一
1996 年 45 巻 3 号 p.
967-970
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
518 cases of lumbar disc herniation were surgically treated over the past 16 years. Of these, we report 6 cases of extraforaminal disc herniation (1.2%). The mean age of the patients at surgery was 54.8 years. We used on two surgical approaches; anterior approach (anterior spinal fusion) and posterior approach (hemi-facetectomy, laminectomy and osteoplastic hemi-laminectomy). One case in whom we performed a laminectomy achieved a poor result. In that patert we diagnosised extraforaminal lumber disc herniation. All other cases achieved good or excellent results.
抄録全体を表示
-
大橋 輝明, 永田 見生, 石橋 和順, 廣橋 昭幸, 佐藤 公昭, 井上 明生
1996 年 45 巻 3 号 p.
971-973
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
We review our conservative or operative treatment for 9 cases of lumbar disc herniation. The patients included 7 males and 2 females, with a mean age of 51 years. The level of disc lesion was L3/4 in 1, L4/5 in 2 and L5/S1 in 6 cases. All patients complained of neurological deficits, and severe pain in the lower extremities. Surgical treatment was lateral fenestration and total facetectomy in 5, and partial laminectomy without fusion in 1. The clinical results were excellent in 3, good in 5, and reguiring repeat surgery in 1. An accurate diagnosis of lateral herniation was made using axial MRI views an CT-discography. Selective root block was effective for accurately detecting the level of the disc lesion.
抄録全体を表示
-
特に前方固定術の有用性について
岡嶋 啓一郎, 前川 清継, 坂田 浩章, 高野 晴夫, 浦田 紳一, 川添 泰弘
1996 年 45 巻 3 号 p.
974-976
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
We experienced 8 cases (7 surgically treated) of extraforaminal lateral lumbar disc herniation. Symptoms were femoral neuralgia in one patient with on L3-4 lesion and for most patients with L4-5 lesion; sciatic neuralgia for two patients with L5-S lesions, some patients with L4-5 lesions complained of both types of neuralgia. We operated using the posterior approach for 3 patients, but 2 required re-operation due to residual low back pain. All patients operated on with the anterior approach achieved good recovery. Anterior spinal fusion appears suitable for extraforaminal lateral lumbar disc herniation especially for degenerated segments above the L4-5 disc level, after first excluding sequestrated types of hernia.
抄録全体を表示
-
原 真一郎, 鳥越 雄喜, 高須賀 良一, 小西 宏昭, 太田 雄三, 吉田 省二, 山口 和博, 奥村 正彦, 鈴木 暢彦
1996 年 45 巻 3 号 p.
977-979
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
We reviewed 10 cases of extraforaminal lumber disc herniation.
In 5 cases of suspected herniation, we used oblique X-ray pictures of radiculography which were effective for accurately identifying and precisely locating extraforaminal lumber disc herniation. 3 cases were treated conservativery with root block and 7 cases were treated with a surgical procedure.
抄録全体を表示
-
生田 光, 大賀 正義, 田丸 卓弥, 有馬 準一, 江崎 幸雄, 吉兼 浩一, 今村 寿宏, 冨重 守
1996 年 45 巻 3 号 p.
980-984
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
We report on 10 cases with lateral lumber disc herniation who were surgically treated. Of these, 9 were male and 1 female ranging in age from 19-73 years (mean; 48.7 years). The level of herniation was L3/4 in 2, L4/5 in 5, L5/S1 in 3 cases. All patients complained of severe pain in lower extremities. Axial, sagittal, coronal views of MRI and selective root block were useful for accurate diagnosis of lateral herniation.
Facetectomy with posterolateral fusion in 7 cases, osteoplastic hemilaminectomy in 2 cases, and lateral fenestration in 1 case were performed.
Excellent and good results were achieved in all cases.
抄録全体を表示
-
吉田 拓也, 浅倉 敏明, 田中 憲治, 名護 秀, 吉田 健治
1996 年 45 巻 3 号 p.
985-987
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
Ipsilaterral intracapsular and extracapsular fracture of the hip is rare and is clinically difficult. We managed three patients who had had a primary fixation using a Gamma locking nail, out of 107 cases of femoral neck fractures from October 1993 to July 1995. Two of three cases had excessive sliding of their screws, and screws cutting through the femoral head. After treatment, they were finally able to walk with their pre-trauma gait, with or without hemiarthroplasty.
抄録全体を表示
-
尾上 英俊, 野見山 宏, 松永 和剛
1996 年 45 巻 3 号 p.
988-990
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
We experienced 3 cases of subtrochanteric fractures arising as a complicationfollowing osteosynthesis of femoral neck fractures with the cannulated cancellous screw.
Screw over tightening applies very high stress, possibly leading to micro-fractures in the lateral cortex of the femur.
We suspected that micro-fracture and early weight bearing caused these subtrochanteric fractures.
抄録全体を表示
-
古川 敬三, 吉良 秀秋, 大里 裕治, 貝田 勇治, 藤樹 宏
1996 年 45 巻 3 号 p.
991-993
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
We investigated the results of surgical teatment of 169 peritrochanteric fractures using the compression hip screw and compression hip screw with brim supporter. According to the classification of Evans, 101 cases were stable and 68 cases were unstable. In the unstable group, 83% of the patients who used the compression hip screw with brim supporter regained their pre-injury mobility. In comparison 65% of the patients who used the compression hip screw regained their pre-injury level of mobility.
Treatment using the compression hip screw with brim supporter is recommended for unstable peritrochanteric fractures of the femur.
抄録全体を表示
-
峯苫 貴明, 可徳 三博, 宮崎 真一
1996 年 45 巻 3 号 p.
994-997
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
This report evaluates the technical problems inherent in using the intramedullary hip screw and instrumentation for treating peritrochanteric fractures. We used the Gamma nail in 13 fractures and intramedullary hip screw in 11 fractures from 1993 to 1995. Major cmplications we have experienced the intramedullary hip screw were fracture of the femoral shaft at the distal end of the nail seen in two cases and cutting out of the lag screw seen in one case. Gamma nail offers advantages over the intramedullary hip screw in regard to shortened surgical time, less blood loss and decrease in angle of inclination. However we concluded that further improvement in the instrumentation and device are needed.
抄録全体を表示
-
山本 尚幸, 古市 格, 田代 直輔, 青柳 孝彦, 石井 孝子, 前田 謙而
1996 年 45 巻 3 号 p.
998-1001
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
This study is a prospective analysis of the discharge predictions of elderly patients with intertrochanteric hip fractures. The objectives were to analyze some of the factors that predispose these individuals to permanent nursing home or hospital placement.
We operated on 46 patients with intertrochanteric hip fractures during the period January 1993 to May 1994. One year after surgery, 23 patients remained institutionalized, 23 had returned to their own homes. We investigated complications, fracture types, ability of gait and living environment for these patients. We found that permanent nursing home or hospital residents generally had poorer communicative skills and some degree of mental confusion.
抄録全体を表示
-
桂 久和, 藤井 康成, 野口 義夫
1996 年 45 巻 3 号 p.
1002-1004
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
Recently intramedullary nailing has become popular as a surgical technique for treating fractures of the femoral diaphysis, but many reports on the complications of this technique have been published. We report a case of corrective surgery for rotatory deformity after intramedullary nailing. The patient was a 24-year-old man. He was injured because in a motorcycle accident in July 1989. We performed osteosynthesis using an Ender condylocephalic nail. Since the result of bone union was good, no further treatment was needed. We noted limitation of excursion (internal rotation 90°, external rotation 0°) because of an internal rotatory deformity at the right hip joint, when he was follow-up in April 1994. In ADL he can neither sit straight nor sit cross-legged and fregently fell down when running due to crossing of both legs. We performed correction of rotation using an Ace interlocking intramedullary nail in June 1994. We made a transverse incision at the site of the previous fracture and after correction carried out a static fixation. Post-operative results of bone union are favorable, straight sitting and cross-legged sitting have become possible and the patient is very satisfied with the results.
抄録全体を表示
-
山田 雅彦, 後藤 琢也, 山下 寿, 森田 雅和, 原 秀, 内川 知也, 田中 邦彦, 春島 正美
1996 年 45 巻 3 号 p.
1005-1008
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
Thirty-nine patients with 39 open femoral shaft fractures were treated surgically. Intranmedullary nailing was used in 38 fractures (17 Interlocking nails, 9 No locking nails and 12 Ender nails), and another procedure in one case. The union rate was 87%. Complications included two infections (5%). Shortening of more than two centimeters occurred in six patients (15%) and malun ion of more than 15 degrees was observed in one patient (3%).
The best clinical results were achceved in patients treated with interlocking nail and Nolocking nail.
抄録全体を表示
-
名護 秀, 浅倉 敏明, 田中 憲治, 吉田 拓也, 吉田 健治, 安藤 則行, 副島 崇, 石田 漂太
1996 年 45 巻 3 号 p.
1009-1012
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
Eleven fractures of the distal femur were treated with the intramedullary supracondylar nail. According to AO classification, there were three A2 fractures, two A3 fractures, five C2 fractures and one C3 fracture.
Postoperative results were evaluated using Neer's criteria.
Four knees (36.4%) had excellent results, four knees (36.4%) had satisfactory results, one knee (9%) had an unsatisfactory result, and two knees (18.2%) had poor results. The percutaneous technique provides significant advantages to extensive surgical dissection and provides a fixation of the distal femoral fracture with minimal blood loss and minimal surgical trauma.
抄録全体を表示
-
生田 拓也, 蔵重 芳文, 中村 英次郎, 坂口 満
1996 年 45 巻 3 号 p.
1013-1016
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
Twenty-seven cases with intra-articular fractures of the leg were treated surgicaly using hydroxy-apatite graft.
All cases achieved good bone union with no problems associated with the hydroxy-apatite.
Application of hydroxy-apatite graft for intra-articular fractures can be used to make-up any lack from an autografty.
抄録全体を表示
-
石田 高康, 深堀 雄蔵, 田原 尚直
1996 年 45 巻 3 号 p.
1017-1020
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
We reviewed 10 patients with tibial fractures treated with an AO unreamed nail during the period April 1994 to August 1995. The average follow-up was 10.7 months (range; 4-18 months). There were 6 closed and 4 open fractures.
The average time for the procedure was 56 minutes (range; 37-75 minutes). Full weight-bearing patients started in all patients, 4-6 weeks after the operation. Union of the tibial fracture occurred within 24 weeks in 9 patients except that one had a delayed union. All patients had good leg function. A deep infection occurred in one case. one proximal screw and two distal screws were broken.
抄録全体を表示
-
春島 正美, 後藤 琢也, 山下 寿, 森田 雅和, 原 秀, 内川 知也, 田中 邦彦, 山田 雅彦
1996 年 45 巻 3 号 p.
1021-1024
発行日: 1996/09/25
公開日: 2010/03/16
ジャーナル
フリー
Eighty fresh tibial shaft fractures in seventy nine patients were treated with an interlocking nail. The series included 21 open fractures and 69 comminuted fractures. The union rate was 97%. The average time to fracture union was 20, 5 weeks. The average time to partial weight bearing gait was 4, 7 weeks. Non union requiring bone grafts occurred in 3% following interlocking nailing. Infection developed in one fracture. Malunion of more than 5 degrees was noted in one fracture. The main advantage of interlocking nails is that surgery can be performed using closed nailing techniques, allowing early protected weight bearing and joint motion. The rates of non union are very low.
Note to Author Average times listed 20, 5 and 4, 7 do you mean 20·5 and 4·7 please confirm.
抄録全体を表示
