巻号一覧
48 巻, 3 号
選択された号の論文の65件中51～65を表示しています
-
田口 学, 谷脇 功一, 木屋 博昭, 弓削 孝雄, 金井 一男, 仙波 圭, 川谷 洋右, 池尻 洋史1999 年 48 巻 3 号 p. 924-927
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーWe reviewed a series of seven patients in whom mid-clavicular fractures had been fixed percutraneously with Ender nails (2.0mm diameter). All patients achieved bone union. Serious complications did not develop, but one patient had motion pain slightly on the distal end of the nails. This was caused by the penetration of the nail posteriorly on the distal fragment. We therefore inserted the nail anteriorly recently. The circular proximal end of this nail prevents sliding and skin ulceration. We think this percutaneously intramedullary fixation with Ender nails is simple and effective for mid-clavicular fractures.抄録全体を表示PDF形式でダウンロード (2820K) -
生田 拓也, 湯朝 友基, 東 努1999 年 48 巻 3 号 p. 928-931
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーSix cases with fractures and five cases with pseudoarthrosis of the clavicle were treated using the reconstruction plate. All cases had bone union and good function of the shoulder joint.
The reconstruction plate is useful for treating clavicular pseudoarthrosis and comminuted fractures, providing stable fixation with early range of motion of the shoulder joint.抄録全体を表示PDF形式でダウンロード (3355K) -
金井 一男, 谷脇 功一, 木屋 博昭, 弓削 孝雄, 田口 学, 仙波 圭, 川谷 洋右, 池尻 洋史1999 年 48 巻 3 号 p. 932-934
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーWe treated 2-or 3-part proximal humeral unstable fractures with closed intramedullary fixation using Ender nails. Over 5 years (1994-1998), we treated 10 patients consisting of a man and 9 women whose age at operation ranged from 27 to 82 years (average; 61.6 years). 8 cases were 2-part fractures and 2 cases were 3-part. We perfomed fixation using 2 Ender nails from 2 entrance portals at the medial and lateral epicondyle of the distal humerus. Within 2 weeks after surgery, the patient was allowed to begin active and passive range of motion exercise.
There were no infections and non-unions. Clinical and radiographical results were acceptable in 8 cases, and poor in 2. One of the nails cut out in 3 patients, requiring reversion or extraction in 2.抄録全体を表示PDF形式でダウンロード (2509K) -
宮本 俊之, 野口 雅夫, 中西 秀二, 伊藤 茂, 鈴木 暢彦, 橋川 健1999 年 48 巻 3 号 p. 935-938
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーFracture-separation of the distal humeral epiphysis is rare and is often misdiagnosed as lateral condyle fracture or elbow dislocation. We reviewed four cases treated.
Four patients with fracture-separation of the distal humeral epiphysis were treated from 1989 to 1998, their ages ranging from two years to seven years (average 4.7 years). The cause of injury was fall in all cases. We treated one case conservatively with cast brace after overhead traction for week, and in three, we performed pin fixation of the distal humeral fragment (oan with close reduction and two with open reduction).
In two cases the initial diagnosis was wrong. The injury was thought to be lateral condyle fracture and elbow dislocation. Bone union was achieved in all cases. Two cases which we followed for more than three years, did not have any range of motion limitation nor cubitus varus deformity.抄録全体を表示PDF形式でダウンロード (4009K) -
加原 尚明, 藤原 紘郎, 井上 周, 綱島 敬, 前原 孝, 井上 淳1999 年 48 巻 3 号 p. 939-945
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーScince 1984, we have treated 60 children for displaced supracondylar and transcondylar fractures of humerus in children with reposition system and extemal fixation. The mean length of follw-up was 4.4 years (range, 3 months to 15 years). The mean age was 9.4 years (range, 2 to 16 years). The fracture were divided into three groups by Gartland classification. 22 patients (38%) of the fractures in this series were Type 2 and 34 cases (57%) were Thpe 3. There were no Type 1 fractures. In addition, we included 4 transcondylar fractures in this study. One of all patients was an open fracture. 16 patients (27%) had nerve injuries at the initial exam. We assessed the results of treatment using Flynn's criteria. Results of Range of Motion (ROM) were excellent in 51 (85%), good in 4 (7%), fair in 2 (3%) and poor in 3 (5%) patients. Results of Carring Angle (CA) were excellent in 53 (88%), good in 3 (5%) and fair in 4 (7%) patients. We had onle one patient (2%) with residual cubitus varus deformity. We conclude that extermal fixation is useful method for management of displaced supracondylar fractures in children.抄録全体を表示PDF形式でダウンロード (2859K) -
浦崎 賢演, 金谷 文則, 普天間 朝上, 喜山 克彦, 茨木 邦夫, 豊原 一作1999 年 48 巻 3 号 p. 946-949
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーWe report the surgical results of osteosynthesis for the non union of the lateral humeral condyle in three children, two girls and one boy aged 2 years and 3 months, 3 years and 5 months and 12 years 1 month respectively. All patients showed limitation of the range of motion and lateral instability. One girl showing ulnar nerve palsy had both varus and valgus instability. Two patients had localized tenderness at the nonunion site.
Osteosynthesis with a iliac bone graft was performed and bone union was achieved in all cases. Follow-up period after operation was 1 year, 3 years 9 months, and 5 years. The range of motion of the elbow decreased 10°, no change, and increased 10° in one patient each. Pain and instability disappeared in all cases. Ulnar nerve palsy seen in one patient improved after surgery.
Our short-term results of osteosynthrosis are satisfactory. However, post-operative roentgenogram revealed mild arthrosis and irregular epiphysis in each. Long-term follow-up is necessary after the osteosynthesis of the nonunion of the lateral humeral condyle in children.抄録全体を表示PDF形式でダウンロード (2726K) -
川畑 了大, 林 協司, 東 美智子1999 年 48 巻 3 号 p. 950-952
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーWe report a 51-year-old woman with neuropathic arthropathy in her elbow due to syringomyelia. She had been suffering swelling and mild pain in her right elbow for two years. Her right elbow swollen, and had local heat and abnormal instability. Her sense of heat and pain of right arm, but touch and vibration remained intact. diminished in her Roentgengrams of ther right elbow showed severe destructive change, deslocation and formation of ectopic ossification, and calcification. Cervical magnetic resonance imaging (MRI) showed syringomyelia due to Arnold-Chiari malformation. With 3 months of brace, pain and swelling of her elbow decreased and the destructive change reconstructed on roentgenogram.抄録全体を表示PDF形式でダウンロード (2738K) -
中西 秀二, 野口 雅夫, 伊藤 茂, 鈴木 暢彦, 橋川 健, 宮本 俊之1999 年 48 巻 3 号 p. 953-956
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーWe treated 10 children with diaphyseal forearm fractures by percutaneous intramedullary Kirschner wiring. Excellent results were achieved in all cases. We concluded that displaced fractures, middle one third and proximal one third fractures in children over 10 years old requred surgical treatment.抄録全体を表示PDF形式でダウンロード (2807K) -
宮本 力, 小無田 要, 川田 英人, 鳥越 雄喜, 高須賀 良一, 牧野 佳朗1999 年 48 巻 3 号 p. 957-961
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーTwo cases of deformity after epiphyseal plate injury of the distal forearm were treated by bone lengthening with Ilizarov apparatus (Ilizarov). Case 1 was a 15 year-old boy. He had injured the epiphysiolysis of the distal ulna and had been treated conservatively when he was 12 years old. After three years he experienced wrist pain. Preoperative radiograms showed ulnar shortening. Ulnar lengthening was performed using Iizarov. Four months after surgery, radiograms demonstrated an improvement in ulnar variance from -11mm to 0. There was no complication. Case 2 was a 13 year-old boy. He had injured the epiphysiolysis of the distal radius and had been treated conservatively when he was 10 years old. His hand gradually developed radial deviation of the hand and cubitus valgus. Preoperative radiograms showed radial shortening and deformity of the distal radius. Radial lengthening and correction of radial inclination was performed using Iazarv. Five months after surgery, rediograms demonstrated an improvement in ulnar variance from -13mm to 0 and radial inclination from -10° to 20°. Deformity of the distal forearm and cubitus valgus has been satisfactorily corrected. The Ilizarov method is effective for the correction of deformity after epihyseal plate injury of the distal forearm.抄録全体を表示PDF形式でダウンロード (2761K) -
山下 寿, 吉田 健治, 安部 淳, 坂井 健介, 星子 久, 村上 秀孝, 北川 敬二, 今井 達也, 後藤 琢哉1999 年 48 巻 3 号 p. 962-965
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーNineteen Monteggia fractures in adults were treated surgically from 1988 to 1997. The average age of injury was 34 years. There were 12 men and 7 women. Evaluation was done at an average of 1 year 8 months post operatively. Using the Bado classification, there were 11 Type I s, 3 Type II s, 2 Type ills, and 3 Type IVs. 11 cases (63.2%) had poor results, using Wheeler criteria for evaluating clinical result. To improve the cutcomes, we recommend rigid fixation of the ulna using 3.5mm DCP, and accurate menual reduction of the radial head within 24 hours after injury.抄録全体を表示PDF形式でダウンロード (2190K) -
越智 龍弥, 中野 哲雄, 阿部 靖之, 清水 泰宏, 清家 一郎, 岩本 克也1999 年 48 巻 3 号 p. 966-969
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーWe studied the clinical results of the external fixation for distal radius fractures. Between 1991 and 1998, we treated 24 fractures with Hoffmann external fixation and 22 fractures with Pennig external fixation. Postoperative results were evaluated using Saito's criteria. The results in the Hoffmann group were 3 excellent, 18 good and 3 fair. The results in the Penning group were 5 excellent, 15 good and 2 fair. There were no difference between the two groups. There were more unstable or more comminute fractures in cases using bone graft or internal fixation, but those results were better. It is important to use bone graft or internal fixation for unstable fractures.抄録全体を表示PDF形式でダウンロード (2166K) -
伊佐 智博, 金谷 文則, 喜山 克彦, 茨木 邦夫, 知念 弘1999 年 48 巻 3 号 p. 970-974
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーWe successfully treated two tibial osteomyelitis combined with a skin defect. We used antibiotic-impregnated cement beads in both patients together with a venoadipofascial (VAF) flap or a venoneuroadipofascial (V-NAF) flap. The VAF flap and the V-NAF flap, described by Nakajima, are fasciocutaneus flaps supplied by accompanying arteries of the cutaneous veins and cutaneous nerves. Both patients were male whose age at surgery were 45 years and 17 years. The skin defects after radical debridement of osteomyelitis were covered with a VAF flap (5cm×4cm) and a V-NAF flap (7cm×5cm). Skin grafs were required to cover the donor sites. At 4 months and 2 months after the flaps, cancellous bone grafs were performed. Follow-up periods were 2 years and 2 months, and 2 years and 4 months. Both flaps survived completely and there has been no recurrence of osteomyelitis. We consider the VAF flap and the V-NAF flap as the treatment of choice to cover skin defects at the proximal 2/3 of the anterior aspect of the tibia. The advantages of these flaps are reliable and easy to harvest without sacrificing the major arteries.抄録全体を表示PDF形式でダウンロード (3527K) -
重冨 充則, 金子 和生, 大藤 晃, 金子 昇, 池田 慶裕, 河合 伸也1999 年 48 巻 3 号 p. 975-977
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーThis experiment establishes the principles of using the compound muscle action potential (CMAP) as a possible post-operative monitor for fee muscle grafts. 20 rabbits were divided into 2 equal groups to investigate the effect of arterial and venous ischemia respectively on the CMAP of muscles. The rectus femoris muscle model was used, isolated only on its single vascular pedicle. The contralateral muscle was used as the control. In all muscles, total normothemic ischemia was induced for 90 minutes, by occluding both the artery and vein. This is to simulate the time needed for transference and insetting of the flap and the completion of the neurovascular anastomosis. Blood flow was then re-extablished for 3 hours. In the arterial ischemia group, (n=10) the artery was then occluded for 1 hour 10 simulate a thrombosis occurring in the artery. The clamp was then removed for 3 hours. Similarly in the venous ischemia group, (n=10) the vein was clamped and unclamped for the same duration, to simulate a venous thrombosis. CMAPs were recorded regularly from all muscles at each stage of the experiment, using theshold (T), twice threshold (2T), and three times threshold (3T) intensity. During each ischemic period, the amplitudes of all CMAPs decreased and latencies became prolonged. During the revascularization period, both the amplitude and latency improved, although not to the original valus at the start of the experiment. The results show that CMAP monitoring can provide easily detectable, objective indication of vascular compromise to a muscle graft within as early as 10 minutes of total, arterial and venous ischemia. Changes in latency are more constant and predictable compared to amplitude changes.抄録全体を表示PDF形式でダウンロード (280K) -
梶山 史郎, 酒井 和裕, 弓削 大四郎, 三村 寛, 中村 克巳, 貴船 雅夫, 大塚 和孝, 東 栄治1999 年 48 巻 3 号 p. 978-981
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーWe reviewed 10 cases of 9 elderly patients over 70 years of age who underwent microsurgical reconstruction. 4 free tissue transfers, 2 replantations, 2 vascular reconstruction and 2 neural sutures were performed. In 4 cases, in spite of the presence of sclerotic vessels, vascular anastomoses were successful. Veinous thrombosis, replantation failure, donor site wound necrosis, pressure sore of the heel, pneumonia and delirium were found as postoperative complications. The success rate was 87.5 percent.
The success rate of microsurgical reconstructions in the elderly did not differ from that in younger patients to a great extent. Complications due to arteriosclerosis, weakness of the skin and gineral complications should be taken into account preoperatively. Preoperative angiography and atraumtic vascular anastomosis to avoid ablation of the internal membrane are inevitable. Short term fixation of the joints and early rehabilitation are to be expected.抄録全体を表示PDF形式でダウンロード (2295K) -
砂川 秀之, 金谷 文則, 普天間 朝上, 喜山 克彦, 大城 亙, 茨木 邦夫1999 年 48 巻 3 号 p. 982-985
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーThe weight-bearing area of the foot is covered by thick, stable, and tough glabrous skin. In 6 patients, we covered the skin defect of the weight-bearing area with either pedicle or free medial plantar flaps. The patients' age ranged from 16 to 55 years old (mean 34 years old). Skin defects were located at the forefoot in 3 and at the heel in 3. The size of the flaps ranged from 6.5×5cm to 16×10cm. There were 5 free vascularized flaps and 1 pedicle flap. In 2 free flaps, nerve to medial plantar skin was not repaired. All flaps survived completely and 5 out of 6 flaps recovered some sensation. One patient who did not recover sensation in the free medial plantar flap produced ulcers at 2 years and 3 years-2months after surgery. These ulcers healed without sequele recurrence after debridement and closure.
We think that the medial plantar flap is the treatment of choice for the coverage of weight-bearing area, and sensory recovery is needed to prevent ulcer formation.抄録全体を表示PDF形式でダウンロード (2667K)