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大城 亙, 金谷 文則, 普天間 朝上, 茨木 邦夫, 新垣 宜貞
1999 年 48 巻 2 号 p.
572-576
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
Periosteal chondroma is a rare, slow growing cartilaginous tumor arising on the surface of tubular bones. In this paper, we reported a case of periostealchondroma occurring at the proximal phalanx of the index finger representing the scalloping of the cortex and the curvature of the phalanx in the opposite direction of the tumor. The patient was a four-year-old boy. His mother noticed a mass in the right index finger when he was two years old and it slowly grew in size. On the first visit to our clinic, a hard subcutaneous mass was palpable at the ulnar aspect of the proximal phalanx of the right index finger. The tumor was immobile without adhesion to the skin and 25×18mm in size. On the radiogram, a semi-translucent mass was found adjacent to the cortex of the proximal phalanx. Scalloping and sclerosis of the cortex were seen. The proximal phalanx was also curved by 15 degrees in the opposite direction of the tumor. Resection of the tumor together with the overlying periosteum was performed. Pathological diagnosis was periosteal chondroma characterized by proliferation of cartilaginous cells with middle grade atypism and myxoid degeneration of the matrix. No recurrence was found after six months.
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神崎 直人, 松崎 昭夫, 入江 豊
1999 年 48 巻 2 号 p.
577-580
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
We present a case in which a osteochondroma on the distal ulnar end of the third metacarpal bone of both hands caused subluxation of the proximal phalanx and resulted in the osteoarthritis of both third metacarpophalangeal (MP) joints. The patient was a 49-year-old man who complained of pain of the third MP joint of both hands. On examination, he had a hard nonmobile mass on the dorso-ulnar side of the third metacarpal bone of both hands. There was a restriction of flexion and extension of the MP joint. Radiographs demonstrated exostosis based on the distal dorso-ulnar surface of the head of the metacarpal bone of both middle fingers. There was subluxation of the proximal phalanx and osteoarthritc change in the MP joint. He underwent excision of the osteocartilaginous mass and reattachment of the collateral ligament for each hand. Pathologic examination revealed a cartilaginous-cap with bony traveculae, consistent with an osteochondroma. Early excision of osteochondroma as well as correction of deformity are required to prevent deformity of the finger for such cases.
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喜山 克彦, 金谷 文則, 普天間 朝上, 茨木 邦夫
1999 年 48 巻 2 号 p.
581-586
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
We report 3 cases of the osteoid osteoma of the phalanx. 1 male patient and 2 female patients whose age at surgery was 29, 60 and 64 year-old. Osteoid osteoma occurred in the diaphysis of the proximal phalanx of the ring finger, the epiphysis of the metacarpal of the thumb, and the metaphysis of the proximal phalanx of the thumb. All patients had swelling and point tenderness, and decreased range of motion in adjacent joints. Two patients had motion pain and night pain. Radiographs showed nidus and surrounding sclerosis in all patients and the widening of the phalanx in 2 patients. En bloc resection and iliac bone graft were performed for osteoid osteoma in the diaphysis and metaphysis. Curettage and cancellous bone graft were performed for 1 tumor in the epiphysis. Follow-up ranged from 6 months to 1 year and 5 months. All 3 patients had complete relief of pain, decreased swelling, improved range of motion of the joint and reduced sclerosis. 2 patients whose phalanx had widened by sclerotic cortex reduced in width.
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伊東 大介, 大坪 義昌, 和田 政浩, 伊藤 茂, 岡崎 威
1999 年 48 巻 2 号 p.
587-589
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
5 patients with enchondromas in the hand skeleton had simple curettage of the tumor without bone grafting. Radiographic evaluation was carried out in these patients, with a mean follow-up of 9 months (range from 6 to 15 months) after operation.
On average, new bone formation was observed at 6 weeks after surgery, and remodeling of the lesion was observed at 5 months after surgery. There were no patients with post-operative fracture and reoccurrences. We conclude that simple curettage without bone grafting is an effective treatment of enchondroma in the hand.
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吉田 正一, 前田 勇一, 緒方 宏臣, 入江 弘基, 加藤 悌二
1999 年 48 巻 2 号 p.
590-593
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
We report two cases of cubital tunnel syndrome due to rare causes.
Case 1: A 74-year-old man with ulnar nerve palsy. Radiographic examinations demonstrated osteoarthritic changes in his right elbow. A ganglion in the cubital tunnel retinaculum and another ganglion under the floor of the cubital tunnel were observed during the operation.
Case 2: A 45-year-old woman had a fracture in her left elbow. Two weeks later from the fixation of the olecranon with tension band wiring, she complained of numbness of her ring and small fingers. Radiographic examinations demonstrated heterotopic ossification at the cubital tunnel, operation was performed to release the cubital tunnel. Heterotopic ossification was seen under the floor of the cubital tunnel and compressed ulnar nerve.
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小田 裕造, 藤尾 圭司, 山中 三知夫, 土屋 隆之, 後藤 公志
1999 年 48 巻 2 号 p.
594-597
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
Open twin incision has been performed for 200 cases of carpal tunnel syndrome since 1990. The operation is performed with twin skin incisions; a proximal incision is made on the distal wrist crease and a distal incision is made on the thenar crease. The proximal flexor retinaculum is excised and the proximal median nerve is explored. The distal flexor retinaculum is excised, and the superficial palmar artery, digital nerve, and thenar branch of the median nerve are exposed. The transverse carpal ligament is incised subcutaneously with our new device. The device has a round curved tip and long shaft with groove in order to prevent complications. The 200 cases who underwent the open twin incision technique with our new device were analyzed. There were no operative complications and residual symptoms disappeared within a month. We recommend our new device for the open twin incision technique for carpal tunnel syndrome.
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前原 博樹, 金谷 文則, 井上 治, 普天間 朝上, 喜山 克彦, 茨木 邦夫
1999 年 48 巻 2 号 p.
598-602
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
Plexiform schwannoma is a rare benign neurogenic tumor. Multinodular schwannoma is a subdivision and occurs in the proximal nerve trunk. We report a case of multinodular schwannoma arising from the left sciatic nerve. The patient was a 42-year-old man, who complained of tumor in the left posterior thigh. Pathological diagnosis by open biopsy performed at another hospital indicated cellular neurilemmoma. MRI revealed multiple tumors in the sciatic nerve, which was iso-intensity on T1WI, high intensity on T2WI, and was enhanced with Gd-DTPA. The tumor was multinodular and was composed of 46 tumors in the sciatic nerve. It consisted of multiple nodules surrounded by a perineurium-like tissue. The histological feature was identical with Antoni A and B type schwannoma. At 7 months after resection of the tumor, the patient was free from neurological deficit and recurrence.
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畠山 英嗣, 伊藤 謙三, 中光 紳一, 竹内 一哉
1999 年 48 巻 2 号 p.
603-607
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
We report a case of a 40-years-old man diagnosed with osteopetrosis at the age of 11. Since 11 years old, he had sustained 11 long bone fractures and these previous fractures were all successfully treated conservatively. He also had osteomyelitis of the right mandible since he was 19 years old.
In Janualy 1996, he had suffered a subtrochanteric fracture of the right femur after a minor contusion, and it was treated consevatively but bone union was not achieved. In October 1996, he was referred to our hospital for right thigh pain and severe anemia. Physical examination revealed anemia on the palpebral conjunctiva, syrinx of the right jaw, contracture of the right hip and bilateral coxa vara. Laboratory findings demonstrated severe anemia, and an elevated level of serum acid phosphatase. Skeletal roentgenograms showed the classic features of osteopetrosis; generalized osteosclerosis, bone within a bone appearance, sandwiched vertebrae, etc.
He refused an operative treatment for the nonunited fracture, so we treated conservatively with a long leg brace. To date, the fracture has not united yet.
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内田 潤郎, 中村 英一, 水田 博志, 水本 圭彦, 白石 稔, 工藤 智志, 中村 孝文, 高木 克公
1999 年 48 巻 2 号 p.
608-612
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
We investigated the change in the difficulties in carrying out activities of daily living (ADL) before and after lengthening of the lower limbs in four patients with achondroplasia and hypochondroplasia. We examined these patients using our ADL evaluation form referred to that of the New York University Medical Center and the Japanese Association of Rehabilitation Medicine. And we also evaluated the degree of satisfaction for the operation using a visual analoge scale. Their preoperative heights were all less than 130cm. After operation, the increases in height were from 6.8cm to 15.5cm. These patients had a significant improvement of their difficulties existing preoperatively due to the shortening of the lower limbs and short stature. And all four patients were satisfied with the conditions after surgery. On the other hand, there were three cases who experienced new subtle difficulties in putting on their socks, tying the shoelaces, manicuring their nails, and one of the three had a shight difficulty in getting on all fours. The results of this study suggested that lengthening of the lower limbs may be an effective strategy for patients with achondroplasia and hypochondroplasia less than 130cm height in order to improve their various ADL difficulties.
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宮城 知之, 利光 哲也, 野口 康男
1999 年 48 巻 2 号 p.
613-615
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
Patients with osteogenesis imperfecta are characterized by proneness to fractures, which often results in malunion. In this paper, we report two children with osteogenesis imperfecta who had femoral shaft fractures which showed progressive flexion deformity due to non-union. Correction wedge osteotomies were performed on those children and good bone union with normal alignment were obtained. Femoral wedge osteotomy is thought to be a good choice for the treatment of progressive deformity after a diaphyseal fracture in mild osteogenesis imperfecta cases.
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松田 秀雄
1999 年 48 巻 2 号 p.
616-619
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
6 cases of pathologic fractures of the calcaneus were reported. All the patients were female and their mean age was 70.0 years old (62-80). They first experienced pain at the heel on walking without any prior traumatic accident. Physical examination showed local heatness, swelling, and tenderness at the heel. Lateral radiograph demonstrated a posterolateral oblique fracture line at the calcaneus. After 3 to 4 weeks of conservative treatment, symptoms significantly improved. Senile osteoporosis was thought to be the pathological condition of the bone to cause these fractures.
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有島 善也, 松永 俊二, 山内 常人, 砂原 信彦, 酒匂 崇
1999 年 48 巻 2 号 p.
620-621
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
In order to clarify the low frequency of fractures in patients with ossification of the posterior longitudinal ligament (OPLL), the incidence of the fractures in women whit OPLL of the cervical spine was compared with that in women without OPLL.
69 women with OPLL and 94 women without OPLL (control) were used for the study. The ages of the patient with OPLL ranged from 52 to 86 years old and averaged 70.1 years old, whie the ages of the women without OPLL ranged from 60 to 75 years old and averaged 68 years old. For these women, we surveyed the past history of the fractures of spine, hip or distal forearm. In some of these women, bone mineral density (BMD) were measured using dual energy X-ray absorptiometry (DEXA).
In the OPLL group, only 8 patients (11.6%) had fractures wheras in the ccontrol group, 23 women (24.5%) had fractures. There was a significant difference (p<0.05) between these two groups. BMD of the lumbar spine in the OPLL group was higher than that of the control group.
In conclusion, there was a tendency for a low frequency of fractures in OPLL patients.
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西村 誠介, 原田 真一, 大塚 和孝, 林 拓男, 田出 公克, 宮田 康好
1999 年 48 巻 2 号 p.
622-626
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
We compared and examined normal subjects as a contrast with the target change at the time of our passing the bone density of hemodialysis patients.
The patients were receiving hemodialysis due to chronic renal failure. They unsisted of 39 males and 26 females. Their ages ranged from 41 to 88, averaging at 64 years old.
The dialysis period was 6 to 20 years, and 1 year on average.
The target change was measured by using the SXA method at the time of the calcaeus bone density of the dialysis patient and the passing and the calcaeus bone densities of 65 normal subjects 65 classified by sex and age to become similar were compared as a contrast.
As a result, the bone density of the dialysis group was intentionally low for both male and female.
No relation between the bone density, age, and dialysis period was seen for male petiunts.
Both the dialysis and normal groups showed negetive correlation between the bone density and age for female patients.
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藤原 明, 緒方 公介, 原 道也, 佐伯 和彦, 金宮 毅, 松浦 一平, 毛利 正玄, 西尾 謙吾
1999 年 48 巻 2 号 p.
627-630
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
Infection after arthroscopic surgery of the knee is rare. Despite the great frequency with which anterior cruciate ligament reconstruction is performed, currently little is known about the incidence of knee infections in patients who have gone arthroscopic ACL reconstruction.
We performed a retrospective study of knee joint infections after arthroscopic ACL reconstruction.
451 ACL reconstructions were performed between 1991 to 1997.
6 (1.3%) patients experienced postoperative infections of the knee. In all patients, abscess peripheral outlet of the tibial tunnel occurred.
All patients had positive cultures from the knee joint or tibial abscess aspirate staphylococcus aureus.
All patients underwent immediate irrigation and debridement and removed the tibial side fixation device.
The ACL graft was not removed from patients.
5 (83%) patients had minimal to no pain and improved stability in their operative knees, and they were satisfied with their function.
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東 努, 高下 光弘, 加来 信広, 松本 博文, 家坂 一穂, 鳥巣 岳彦
1999 年 48 巻 2 号 p.
631-633
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
This paper reports a case of delayed paraplegia associated to pyogenic spondylitis. 14 months ago, a 72-year-old man was diagnosed as pyogenic spondylitis and was given antibiotics. After 3 months, his erythrocyte sedimentation rate became normal. The pyogenic spondylitis was considered healed, and he was discharged. He had no fever since then. 8 months later, he presented with lumbago, hypesthesia and muscle weakness in the lower extremities with no history of any cause. Plain roentgenogram showed vertebral collapse of the L1 body. CT scan showed the L1 posteriorly displaced fragments occluding the spinal canal. Myelogram showed incomplate block at the level of L1. He underwent anterior decompression and spinal fusion 2 months from onset of symptoms. Anterior instrumentation was used and there was no persistent infectious signs. The result of the operation was satisfactory.
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山内 太郎, 中原 進之介, 末長 敢, 田中 雅人, 甲斐 信生
1999 年 48 巻 2 号 p.
634-637
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
We performed cervical decompressive surgery in 4 hemodialysis patients. The age range in these 4 cases was 48 to 58 years (average: 53) and the duration of hemodialysis ranged from 3.5 years t o 25 years (average: 16.1). The spinal cord was compressed by the deposition of amyloid in the hypertrophied posterior longitudinal ligament, ligamentum flavum, and epidural space. We believe that cervical myelopathy in longterm hemodialysis is caused by hypertrophy of the posterior longitudinal ligament and ligamentum flavum due to amyloid deposition and by developmental canal stenosis.
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毛利 正玄, 原 道也, 緒方 公介
1999 年 48 巻 2 号 p.
638-640
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
We report a case of the sleeve fracture of the upper pole of the patella. A sixteen-year-old boy presented with a history of falling down the stairs, landing on his knee, after which he could not walk with sudden pain in the right knee. Local examination showed a severe effusion and localised tenderness on the upper pole of the patella. He was unable to extend the knee actively. Aspiration produced 130ml of blood-stained fluid containing fat globules. Radiographs demonstrated avulsion of the upper pole of the patella. T1-weighted magnetic resonance images in the sagittal plane showed an avulsion fracture of the upper pole of the patella with an attached sleeve of cartilage. Thease findings were confirmed in the operation room. The avulsed patella fragment of the upper pole had included an sleeve of cartilage. The patella and its cartilage sleeve and the extensor retinaculum were repaired. After three days he started passive knee flexion. Now he has regained recovered his full range of movements and he is able to extend his knee completely. Such fracture may be misdiagnosed because of the painful swelling, the absence of a palpable gap in the extensor mechanism, and a fragment of avulsed bone that is too small to be detected radiographically. Early diagnosis, operative reduction, and fixation are thus important.
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毛利 正玄, 花村 達夫, 西野 一郎, 木田 浩隆, 後藤 俊介, 河田 典久, 馴松 義啓, 湯朝 友基, 村上 陽司
1999 年 48 巻 2 号 p.
641-646
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
In this paper, we report the results of using HUCKSTEP HIP prosthesis for the revision surgery of total hip arthroplasty or the salvage operation for failed hip surgery.
Between 1994 to 1997, 9 patients were operated on using this method and 6 patients were followed up. The follow-up periods ranged from 6 to 35 months. With the exception of 1 fracture, these patients were permitted early weight-bearing and all 6 patients had relief of pain with early ambulation. Although the period of postoperative follow-up was short, HUCKSTEP HIP proved useful for these cases.
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園田 広典, 平川 敬, 高下 光弘, 八塚 知二, 熊木 光包
1999 年 48 巻 2 号 p.
647-650
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
Tuberculosis of the cervical and cervicothoracic spine is uncommon. We report a case of the tuberculous spondylitis of the cervicothoracic lesion with paraplagia, without pain and other symptoms. Magnetic resonance imaging, particularly enhanced MR imaging, is useful for characterizing tuberculous spondylitis. The rim enhancemant around the abscesses is a finding that is diagnostic of infection. Posterior instrumentation and anterior debridement and spinal fusion were performed, and isoniazid, rifampicin, and ethambutol were administered.Posterior instrumentation is useful for providing immediate stability and protecting against the developmant of kyphotic deformity.
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松本 博文, 高下 光弘, 八塚 知二, 平 博文, 日隈 康雄, 鳥巣 岳彦
1999 年 48 巻 2 号 p.
651-655
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
Magnetic resonance imaging (MRI) has become an important diagnostic tool in diagnosing spinal cord tumors. But differential diagnosis is very difficult with only MRI.
Spinal meningiomas account for about 10% of primary spinal cord tumors in Asia. We studied three patients with spinal meningiomas in order to show special findings. T1-weighted images showed various intensities, but their signal intensities on T2-weighted images were similar to those of the spinal cord in all cases. We considered these to be special findings with MRI in spinal meningioma. The relationship between pathological type (e. g. psammomatous type, fibroblastic type, and transitional type) and MRI was not clear. Preoperative diagnosis of ossified spinal meningioma was made from MRI.
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熊谷 優, 吉田 健治, 遠藤 俊哉, 都築 克幸, 多田隈 元
1999 年 48 巻 2 号 p.
656-661
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
Tarsal coalition is a congenital fibrous, cartilaginous, or osseous union of the tarsal bones of the foot. Previous literatures have reported that the incidence of tarsal coalitions is between 0.03% and 0.4%. Talocalcaneal coalition, which is most common among tarsal coalitions, occasionally causes tarsal tunnel syndrome. In this paper, we report a female patient who had pain in her feet and slight limitation of subtalar motion. The findings only on plain roentgenogram were insufficient for diagnosing coalition. Computed tomography was the most useful for the diagnosis of early coalition and for determining the extent of resection. The patient was treated with resection of the coalition because conservative treatment failed to relieve pain. Symptoms improved after resection.
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徳丸 進一, 鳥巣 岳彦, 高木 一広, 平 博文
1999 年 48 巻 2 号 p.
662-665
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
Geometric Total Knee Arthroplasty (TKA) has been in general use since 1972. With this design the tibial compornent was composed of resin only, and patella resurfacing was not considered necessary. Consequently, many patients complained of pain around the patello-femoral joint or revisited for failed tibial component postoperatively. At this time however, we found a case who experienced no pain around the patello-femoral joint, no osteoarthrotic change and no evidence of loosening on plain roentgenogram. We concluded that good results in Geometric type TKA can be achieved with thorough preoperative planning and adequate operative technique.
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松尾 篤, 芝 啓一郎, 植田 尊善, 白澤 健蔵, 大田 秀樹, 森 英治, 力丸 俊一, 加治 浩三, 弓削 至, 柳田 晴久, 竹光 ...
1999 年 48 巻 2 号 p.
666-672
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
Between 1979 and 1996, 99 lumbar canal stenosis patients over 65-years were treated with posterior decompression surgery. The mean age at surgery was 71.6 years (range, 65 to 83) and the length of follow-up was an average of 23.7 months (range, 6 to 90). These patients were divided into two groups (with fusion or without fusion). The clinical scores were evaluated retrospectively with the Japanese Orthopedic Association low back pain rating score (JOA-score). The JOA-score was an average of 8.9 preoperatively and 15.9 postoperatively (improving rate: 49.6%). There was no significant difference between these two groups. However, low back pain improved in fusion groups more than in the no-fusion groups.
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加来 信広, 福永 拙, 高下 光弘, 高木 一広, 針 秀太, 東 努, 鳥巣 岳彦
1999 年 48 巻 2 号 p.
673-677
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
The present study was undertaken to determine whether a correlation exists between localized magnetic resonance imaging (MRI) signal behavior and specific histopathologic features of osteonecrosis of the femoral head. Continuous 5mm coronal MRI sections were compared with corresponding histological sections from 7 surgically excised femoral heads or core biopsy specimens. The band pattern low intensity area of the femoral head in MRI consisted of 3 repair layers historogically. The proximal layer showed considerable cellular invasion and new vascularization. The central layer had considerable fibrous tissue and local appositional new bone formation and there were considerable new vascularization and appositional new bone formation. In the more distal area than band pattern, vascularization was reduced gradually, but showed increased eosinophlic fluid in the intersitional space resembling the bone marrow edema syndrome. The distal area near the repair region showed partial appositional new bone formation. We considered the cause to be recurent necrosis.
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松本 佳之, 芝 啓一郎, 植田 尊善, 白澤 建蔵, 大田 秀樹, 森 英治, 力丸 俊一, 加治 浩三, 弓削 至, 竹光 義治
1999 年 48 巻 2 号 p.
678-683
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
We reviewed 7 cases of scoliosis combined with syringomyelia and or Arnold-Chiari malformation. Foramen magmun was decompressed in 5 cases, of which spinal deformities were followed conservatively in 3, and by surgical correction in 1. In the another case, scoliosis had been treated operatively before foramen magnum decompression. In 2 patients who were observed conservatively, the curve of scoliosis was progrssed.
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杉谷 勇二, 三原 圭司, 平野 徹, 進藤 裕幸, 橋口 隆, 麻生 英一郎
1999 年 48 巻 2 号 p.
684-688
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
We report the complications of 3 cases reconstructed with Huckstep intramedullary rod for invasive soft tissue sarcoma of the femur. Case 1, a 67 years old male, had malignant fibrous histiocytoma (MFH) invading the left femur. The femur was treated with intraoperarive radiotherapy and reconstructed using Huckstep rod. The rod failed at screw hole 1 year and 1 month after operation. Case 2, a 65-year-old female, has MFH contacting with the right femur. At sugery the partially resected femur was treated with alcool and osteosynthesized with the Huckstep rod. 2 years and 3 months after operation, she fell down and had condylar fracture of the left femur. Case 3, a 22 years old male, had clear cell sarcoma invading the left femur. The femur was treated with intraoperative radiotherapy and reconstructed using Huckstep rod. After operation, bone absotption advanced at the osteotomy area.
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高木 一広, 吉田 盛治, 池田 真一, 高下 光弘
1999 年 48 巻 2 号 p.
689-692
発行日: 1999/03/25
公開日: 2010/02/25
ジャーナル
フリー
It is well known that hydroxyapatite is a useful biomaterial with biocompatibility and nontoxicity in the reconstructive field of orthopedic surgery.
We report a case with suspected pes anserinus bursitis or enthesopathy caused by hydroxyapatite. A 56-year-old woman suffering from renal sarcoidosis with bone defect of the left medial tibial condyle underwent operation for hydroxyapatite 3 years ago. At this time, though the hydroxyapatite spilt and fell in the operation field, no symptoms were seen for 3 years.
Because of recurring sharp pain in the same area, we thought that this pain was caused by hydroxyapatite, and we removed the hydroxyapatite, after which the sharp pain disappeared.
Histologically, foreign body gaint cells around the hydroxyapatite particle were observed, but no inflammatory reaction and calcification were seen.
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吉兼 浩一, 西島 宗孝, 堤 義明, 大石 聡, 西尾 謙吾, 森久 喜八郎
1999 年 48 巻 2 号 p.
693-697
発行日: 1999/03/25
公開日: 2010/02/25
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A case of multiple neurilemmoma is reported. The patient was a 58-year-old male. His chief complain was slow progressive left buttock pain and a soft tumor of the left upper arm. He showed no symptoms of neurofibromatosis. He was operated on the spinal tumor of the cauda equina and soft tumor of the left ulnar nerve. The tumors were totally resected with good recovery. Histological examination of each specimen showed typical appearance of neurilemmoma. One year after his discharge he complains of no pain. Careful followup by computed tomography or magnetic resonance imaging is recommended.
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