巻号一覧
48 巻, 4 号
選択された号の論文の70件中51～70を表示しています
-
三原 隆, 尾上 英俊, 木村 一雄, 武田 研1999 年 48 巻 4 号 p. 1198-1201
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーWe experienced 2 cases of femaral fractures at the other site after the operation for the femoral shaft fractures using Intramedullary devices. 2 cases were treated with intramedullary nail and Ender nails, and a new fracture occurred 5 months and 16 months after the operation, respectively. There were no refracture nor breakage of the implant in both cases.抄録全体を表示PDF形式でダウンロード (2275K) -
佐藤 善一郎, 鈴木 裕彦, 三原 潤二, 中川 広志, 一本杉 聡, 吉野 興一郎, 石村 啓司1999 年 48 巻 4 号 p. 1202-1206
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーWe report a case of bilateral tibial and femoral fracture; The bilateral “Floating Knee”.
A 19-year-old woman was admitted to the Otemachi Hospital on September 26, 1997 following an automobile accident. She had sustained fractures of bilateral tibias and femurs, left ankle and right 5th metatarsal bone. She had no other complications. Initial treatment consisted of skeletal traction with pins through the calcaneal bones. On October 3, 1997, open reductions of the femurs using intramedural nails and external fixations of the tibias were done. Casts were applied to other fractures because they were incomplete fractures. Her fractures healed without event and she was discharged on May 2, 1998.抄録全体を表示PDF形式でダウンロード (3931K) -
阿部 靖之, 中野 哲雄, 越智 龍弥, 清水 泰宏, 清家 一郎, 岩本 克也1999 年 48 巻 4 号 p. 1207-1209
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーWe retrospectively reviewed the records of patients with tibia fractures treated between May 1992 and May 1997. There were 83 tibial fractures; 49 closed and 34 open. The ratio of open fracture was 41% (34/83), 25% in the tibial plateau fractures, and 60% in the tibial shaft fractures. Most of the open fractures were the result of high-energy trauma (90%). Thirty percent of the closed fracture were the result of low-energy trauma. The average period to roentgenographic union was 5.4 months for closed fractures. The time to union in open fractures was 7.3 months. Infection occurred in 4 of the 34 open fractures. By Gustilo grade, deep infection occurred in none of the 17 Grade I, II fractures (0%); one of the 12 Grade III-A fractures (8.3%); and one of the 5 Grade III-B fractures (20%). In the statistical evaluation of the results, open fractures required longer time to union, and showed higher rate of high-energy trauma.抄録全体を表示PDF形式でダウンロード (329K) -
東 努, 田嶋 光, 生田 拓也, 湯朝 友基1999 年 48 巻 4 号 p. 1210-1213
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーWe present 15 cases of compartment syndromes. All cases were male and their age range was 7 to 72 years. Three cases were compartment syndrome of the forearm, one case was the hand, two cases were the thigh, 7 cases were the lower leg, and three cases were the foot. The diagnosis was determined by clinical symptoms, such as increasing pain, passive stretch test, tenseness, neurological symptoms, and circulation disturbance. Tissue pressure measurement was done inpatients with lumbar anesthesia. All 15 patients had fasciotomies, and showed good results.
In conscious and alert patients, acute compartment syndromes are usually easy to diagnosis clinically; however, in unconscious patients, a diagnostic aid such as the intracompartmental pressure monitor is useful.抄録全体を表示PDF形式でダウンロード (358K) -
森下 雄一郎, 井上 敏生, 緒方 公介1999 年 48 巻 4 号 p. 1214-1217
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーWe report a case of severe equinovarus deformity successfully treated only by soft tissue release in a 18-year-old male patient who was suspected of some type of neuromuscular disease such as spinal muscular atrophy. He began to walk at 1 year and 9 months of age, but showed Gower's sign and wadding gait at 2 year of age and could not walk independently at 8 years of age. Equinovarus deformities of both his feet appeared and increasingly worsened. At 18 years of age, he could stand only on his toes with pain but could hardly walk even with the aid of braces or crutches. We, therefore, performed posterior release of both ankles including Achilles tendon lengthening. The equinus contracture improved from 60 degrees to 20 degrees and when toe pain was found to almost diminish when standing, with improved stability.抄録全体を表示PDF形式でダウンロード (2043K) -
五味 徳之, 栗若 良臣, 岡田 祐司, 高原 茂之1999 年 48 巻 4 号 p. 1218-1221
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーA 30-year-old man was injured in a traffic accident on August 30, 1997, and he was brought to out hospital. His right ankle joint was dislocated postero-medial, and an open wound was recognized outside the ankle. But no bone fracture was seen in his ankle joint roentogenographically. We operated on his ankle joint on that day. At the operation, we recognized complete lateral collateral ligament rupture and partial medial collateral ligament rupture. But there was no damage to the extensor tendon, flexor tendon, and the neuro-vascular system. Ankle joint dislocation was reduced, and medial collateral ligament was sutured, but lateral collateral ligament was let alone. Below-knee cast fixation was done for six weeks postoperarively, after which he began rehabilitation. 11 months later, his ankle joint motion was slightly limited but there were no changes in osteoarthritis and varus instability on X-rays.
Cases of ankle joint dislocation without fracture are very rare because of its anatomical character. We believe that some power of traction is related to this trauma and primary suture for lateral collateral ligament rupture is necessary.抄録全体を表示PDF形式でダウンロード (2522K) -
矢野 勝巳, 中村 智, 江頭 昌幸, 村田 雅和1999 年 48 巻 4 号 p. 1222-1225
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーTwo cases of osteochondritis dissecans of the talus are reported. Case 1: A thirteen year old boy with left ankle pain in motion. After conservative treatment for two years, arthroscopic drilling of talus was performed. At eight month follow-up, he had no symptoms. Case 2: A twenty-five year old male with right ankle pain in motion. After six months of arthroscopic drilling, we performed re-arthroscopy. At eighth month follow-up, he has no symptoms.抄録全体を表示PDF形式でダウンロード (2510K) -
本村 悟朗, 野村 茂治, 福岡 真二, 山下 彰久1999 年 48 巻 4 号 p. 1226-1228
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーTarsal coalition is not a rare entity. We report a case of talocalcaneal coalition. A 12 year old boy had been suffering from pain in his right foot for 10 years before his initial appearance. At the age of 11, the pain of his affected leg became more severe, and he consulted a nearby hospital. He was referred to us because of continuous pain of the affected leg. Localized tenderness over the medial subtalar joint could be found in the initial examination. CT scan showed irregularity of the medial side of the subtalar joint and talocalcaneal coalition was diagnosed following the resection of the talocalcaneal coalition.抄録全体を表示PDF形式でダウンロード (1191K) -
八並 幹, 奥江 章, 岸川 陽一, 菊池 直士, 前 隆男, 中島 勝也, 喜多 正孝, 菅 隆史, 久枝 啓史, 篠田 侃1999 年 48 巻 4 号 p. 1229-1233
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーA rare case of peroneal spastic flat foot (P. S. F. F) associated with accessory scaphoid is reported. The patient is an 11 years old boy. His chief complaint was left foot pain and restriction of varus motion. On examination, his left foot had valgus deformity. No valus motion existed due to apparent spasm of the peroneal tendon. Roentgenographic revealed no significant findings except for accessory scaphoid. The symptoms were completely relieved by resection of the accessory scaphoid.抄録全体を表示PDF形式でダウンロード (3674K) -
本村 悟朗, 野村 茂治, 福岡 真二, 山下 彰久1999 年 48 巻 4 号 p. 1234-1236
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーSupranumerary bones and sesamoid bones can be found in the feet. We present two cases of the bone necroses of the supranumerary bone and sesamoid bone.
Case 1 was a 56 years old female. She suffered pain under the first metatarsal head of the right great toe two months before her initial appearance. The initial examination found a localized tenderness over the medial sesamoid, and roentgenographic examination slowed irregularity and fragmentation of the medial sesamoid. Removal of the sesamoid bone was performed and necrosis of the bone was diagnosed by the pathological finding.
Case 2 was a 49 years old male. He suffered from pain in his right foot 10 years ago. Though an arch support had been used for the treatment, however the pain became more severe 2 years back. Initial examination slowed a localized swelling over the right accessory navicular. Roentgenographic examination revealed irregularity and fragmentation of the accessory navicular. Removal of the accessory navicular was performed and bone necrosis was diagnosed by the pathological finding.抄録全体を表示PDF形式でダウンロード (2726K) -
金井 成行, 谷口 典正1999 年 48 巻 4 号 p. 1237-1241
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリー実験的骨減少症モデルと考えられている卵巣摘出 (OV) ラットと実験的関節症モデルであるアジュバント関節炎 (AA) ラットの脛骨の骨塩量をDEX法とCXD法にて測定した. OVラット, AAラットの骨塩量は, DEX法のみならずCXD法においても有意にコントロール群に比べて減少を示した. また, DEX法とCXD法による骨塩量には, 有意に相関が認められた. これらの結果からAAラットも実験的骨減少症モデルに充分なりうると考えられ, CXD法も骨減少の評価に有用であることが示唆された.抄録全体を表示PDF形式でダウンロード (344K) -
野村 裕, 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, 竹光 義治1999 年 48 巻 4 号 p. 1242-1249
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーSeven cases of vertebral body fractures adjacent to the instrumented vertebral were observed after posterior spinal instrumentation surgery. All patients were females and their ages ranged from 51 to 68 years (mean, 69 years). The interval between surgery and fracture recognized radiographically ranged from two months (mean, 3.5 years). This case report presents the possibility of biomechanical stress on the porotic spine adjacent to the instrumented rigid spinal segments.抄録全体を表示PDF形式でダウンロード (6110K) -
宮崎 清, 秋山 徹, 西田 民夫, 上野山 和秀, 泊 真二, 松本 光司, 中山 功一1999 年 48 巻 4 号 p. 1250-1254
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーLong-term hemodialysis patients develop various osteoarticular and soft tissue complications. Between 1989 and 1997, we operated on 19 long-term hemodialysis patients who had lumbar disorders. Of the 19 Patients, 5 had destructive spondylarthropathy (DSA), 1 had degenerative spondylolisthesis, 8 had canal stenosis, and 5 had disc herniation. Patients included 10 males and 9 females with an average age of 57 years (range 40-68 years). The mean duration of follow-up was 22 months (range 6-78 months) and the length of hemodialysis ranged from 2 to 22 years (mean 11 years). Clinical results were evaluated by the JOA score. The mean recovery rate was 61% (range 6.7-100%). The same treatment as lumbar disorders in hemodialysis patients can be used for lumbar degenerative disorders in nonhemodialysis patients.抄録全体を表示PDF形式でダウンロード (4109K) -
川口 謙一, 井原 和彦, 佐藤 陽昨1999 年 48 巻 4 号 p. 1255-1258
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーWe report a case of carpal tunnel syndrome and rupture of flexor pollicis longus (FPL) in dorsal intercalated segment instability deformity of the lunate. The patient was a 62-year-old man complaining of numbness of the right middle and ring finger. He also had limitation of range of motion in his right thumb IP joint. Roentgenogram showed the deformity of the scaphoid and dorsal deformity of the lunate. Computed Tomography (CT) showed the lunate protruding toward the palmar side. Magnetic Resonance Imaging (MRI) revealed that flexior tendons were compressed by the lunate.
Carpal tunnel decompression and tendon transfer were performed for this case. In operative findings, the median nerve existed on the lunate, while, FPL did not exist in the carpal tunnel and the space of FPL was narrow.
Finally, we concluded that carpal tunnel syndrome and rupture of FPL occurred by bony factor. After the operation, the symptoms improved.抄録全体を表示PDF形式でダウンロード (4035K) -
吉本 栄治, 王寺 享弘, 案浦 聖凡, 松田 和浩, 小林 晶1999 年 48 巻 4 号 p. 1259-1263
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーWe evaluated the reconstructed anterior cruciate ligament (ACL) using bone-patellar tendon-bone by Magnetic Resonance Imaging (MRI).
From 1992 to 1997, 182 patients were underwent ACL reconstructive surgery using bone-patellar tendon-bone, in which 67 underwent MRI from 3 to 45 months postoperatively. We classified these patients into 3 groups by the intensity of the reconstructed ACL; low intensity, low+high intensity, and high intensity groups. Low intensity group was 40%, low +high intensity group was 45%, and high intensity group was 15%. The operated Knee function by KT-2000, Cybex, and JOA score did not differ between the 3 groups.
We performed a second look operation on 22, and compared the inspection of the reconstructed ACL with the results of the MRI in low intensity group, reconstructed ACL was looked to be more excellent, but some was excellent even in high group. The high intensity in the reconstructed ACL by MRI is thought to appear by the impingement of the roof of the intercondylar notch on a reconstructed ACL. In our cases, we consider from the comparison to the inspection by the second look operation, all high intensity were not for impingement. So it is difficult to evaluate the quality of the reconstructed ACL by MRI, but at least, in low intensity group reconstructed ACL is thought to be in good quality.抄録全体を表示PDF形式でダウンロード (379K) -
園田 広典, 平川 敬, 高下 光弘, 松本 博文1999 年 48 巻 4 号 p. 1264-1268
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーThis report describes two hemodialysis patients with cervical myelopathy due to calcification of the ligamentum flavum. The patients were male aged 59 and 57 who had been hemodialysed for 2 years and 3 months, and 22 years respectively. Their chief complaint were gait and precise motion disturbance. Computed tomography after myelography clearly showed the calcified lesion of the yellow ligament, which markedly compressed the spinal cord. We performed spinous process-splitting laminoplasty, which decreased their symptoms.
Certain hypotheses were studied in the previous report on the causes of the calcification of the ligamentum flavum; for example mobile stress of the yellow ligament, estrogen decrease, and calcium metabolism disorder. Hemodialysis causes calcium metabolism disorder and calcium deposit to soft tissues like the periarticulation, vasculum and subcutis. There has however been no report on the observation of calcification at the yellow ligament.
We believe that hemodialysis which causes calcium metabolism disorder is related to the calcification of the ligamentum flavum.抄録全体を表示PDF形式でダウンロード (3982K) -
星子 久, 吉田 健治, 山下 寿, 安部 淳, 坂井 健介, 村上 秀孝, 北川 敬二, 今井 達也, 後藤 啄也1999 年 48 巻 4 号 p. 1269-1276
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーOf 119 patients (120 cases) with traumatic hip fracture treated at our hospital during a 16-year period from 1982 to 1997, 21 patients (21 cases, 17.6%) showed complications of femoral head fracture. 12 of these patients (12 cases; 9 males and 3 females) followed up for more than 1 year were included in the study. Fracture was suffered at a mean age of 33 years. Duration of follow-up was an average of 41 months. Fracture type of these cases were classified according to Pipkin's Classification into type I (5 cases), type II (4 cases), type III (1 case) and type IV (1 case), with the exception of one unclassifiable case of femoral head depressed fracture. One case each of type I and type II were treated by only open reduction. One case each of type I and type II and 2 cases of type II were treated by osteosynthesis. Three cases of type I, 1 case of type II and 1 case of depressed fracture were conservatively treated. One case of type IV was treated by a combination of bone fragment extirapation, and acetabular osteosynthesis. Duration of relief was an average of 13 weeks. During the follow-up period, femoral head necrosis was noted in 6 cases and osteoauthritis in 2.抄録全体を表示PDF形式でダウンロード (4366K) -
松本 博文, 高下 光弘, 吉田 盛治, 内納 正一, 徳丸 進一, 津村 弘1999 年 48 巻 4 号 p. 1277-1280
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーWe experienced a case of tuberculous sacroiliitis. The patient was a 70-year-old woman. She suffered from general fatigue and febrile, but complained of no pain of the sacroiliac (SI) joint. She had slight tenderness over the right SI joint. Gaenslen test was negative. Roentgenogram revealed diffuse destruction with calcificated masses on the right SI joint. Laboratory on admittance showed no leukocytosis, elevation of erythrocyte sedimentation rate (125mm/hr) and C-reactive protein (3.79mg/dl). Results of the Mantoux test were positive. Needle biopsy from the right SI joint was performed, but the culture of specimens was negative and the pathological findings were not the specific results. We performed curettage and irrigation, and got the specimen of the bone involved. Histologic examination revealed granulomatous inflammation with infiltration of epitheloid cells, tubercle formation, caseous necrosis, and Langhans' giant cells. She was treated with three combined antituberculosis drugs (isoniazid, ethambutol, and rifampicin). At present 6 months after surgery, she has no pain, no fever and feels no fatigue.
Sacroiliac joint involvement has been reported in 3-10 percent of patients with skeletal tuberculosis. Lack of awareness of this rare disease now often leads to diagnotic delay and increased morbidity. The direct sampling of the SI joint is necessary to establish the diagnosis. It is important to obtain the specimen involving oteoarticular fragments for the diagnosis.抄録全体を表示PDF形式でダウンロード (3130K) -
蔵重 芳文, 西野 一郎, 山口 哲, 佐々木 伸一1999 年 48 巻 4 号 p. 1281-1284
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーThe Gamma-nail is an effective device for the treatment of the trochanteric fracture of the femur. Through our experience with the Gamma-nail, we were able to determine the problems of its surgical technique.
From June 1998 to February 1999, we surgically treated 33 cases of the trochanteric fracture of the femur using the Gamma-nail. We examined the surgical results through X-rays. We also determined the problems concerning Gamma-nail both during and after surgery, indications, and the operative technique.
The advantage of the Gamma-nail is that it allows minimum blood loss during surgery by short operation time. It also allows early weight bearing by the patients. On the other hand, there is a risk of complications due to the wrong positioning of the nail, lag screws, and incorrect indications. To avoid complications and obtain satisfactory results, it is essential to study effective surgical techniques and careful operative procedures.抄録全体を表示PDF形式でダウンロード (3790K) -
1999 年 48 巻 4 号 p. 1285-1294
発行日: 1999/09/25
公開日: 2010/02/25
ジャーナル フリーPDF形式でダウンロード (1052K)