-
Hideki Yamashita, Hiroshi Hagino, Hiroshi Katagiri, Kei Kawaguchi, Koj ...
2008 Volume 57 Issue 3 Pages
377-380
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
Clinical pathways are proposed as means of providing high quality care in a timely and cost-effective manner. We apply clinical pathway for hip fracture at our institution. The length of in-hospital stay after surgery for osteosynthesis and femoral head prosthetic replacement are fixed at 10 weeks and eight weeks respectively. The length of acute phase hospital stay is fixed at within two weeks. We use the same clinical pathway in the West Tottori region. Clinical pathways should be applied in future, for establishing information technology networks among various institutions.
View full abstract
-
Atsunori Tokushige, Masamori Shigematsu, Motoki Sonohata, Masaaki Mawa ...
2008 Volume 57 Issue 3 Pages
381-384
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
The purpose of this study was to evaluate influence of adduction contructure after conversion of ankylosed hip to total hip arthroplasty. Between 1999 and 2007, we performed 47 total hip arthroplastys for ankylosed hips. Adduction contracture persisted in seven patients. In those patients, apparent leg length discrepancy persisted and five patients used insole. Neighboring joint pain did not improve in those patients.
Adduction contracture after conversion of ankylosed hip to total hip arthroplasty impedes patient satisfaction.
View full abstract
-
Masaru Higo, Shinji Yoshino, Masahiro Nakamura
2008 Volume 57 Issue 3 Pages
385-387
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
Open reduction for developmental dislocation of the hip was performed on seventeen hips in sixteen patients with long-term follow-up until skeletal maturity. The mean age at the open reduction was 1.4 years. The mean follow-up after the open reduction was 13.2 years. At the open reduction by anterior 5 cm skin incision over the inguinal skin crease, six hips were classified as group A in which the posterior joint capsule was not dissected and adhesion was not achieved, 11 hips were classified as group B in which the joint capsule was circumferentially dissected and adhesion was achieved. Eight hips with residual subluxation of the hip or acetabular dysplasia for 5-14 years after open reduction underwent additional bony procedure. At follow-up, none of the patients had hip pain and limp. Of 17 hips, 14 hips (82%) were classified as radiographically satisfactory (Severin's group I and II), and 3 hips (18%) were classified as unsatisfactory. The rate of open reduction without any secondary operation and satisfactory results in group B was higher than group A. The circumferential dissection of capusule and adhesion of the dislocated hip seems to be essential for obtaining concentric reduction of the femoral head and maintaining normal development of the hips in patients with developmental dislocation of the hip.
View full abstract
-
Naohiro Tanaka, Hiroshi Enomoto, Kunihiko Okano, Makoto Osaki, Hisatak ...
2008 Volume 57 Issue 3 Pages
388-391
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
We report a 70-year-old female patient with a history of pelvic irradiation for the treatment of vaginal cancer. The interval from irradiation to the onset of pain in the hip was 23 months (right hip) and 46 months (left hip). Radiogram and MRI showed rapid and wide changes in the femoral neck and hip joints after the onset of pain.
View full abstract
-
Naohide Takeuchi, Katsumi Harimaya, Nobuaki Tsukamoto, Yasutoshi Kai, ...
2008 Volume 57 Issue 3 Pages
392-396
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
We treated a case with unstable pelvic fractures and severe head injury by external fixation. A 77-year-old man, who was injured in a traffic accident, showed severe disturbance of consciousness (Glasgow coma scale score, GCS: 3). X-ray showed fracture-dislocation of the right sacroiliac joint (AO type C1-2), and brain CT showed traumatic subarachnoid hemorrhage, and multiple brain contusions. We performed intracranial pressure (ICP) monitoring to evaluate brain edema. Five days after injury, ICP was within normal range, the sacroiliac joint dislocation was fixed with a pelvic external fixator. Neither hypotension nor hypoxia caused by secondary brain injury occurred, and his consciousness improved (GCS: 10) at two months after the operation. ICP monitoring is important to evaluate head injury and to decide optimal timing of fracture fixation. Pelvic external fixation is a safe and minimal invasive surgery for unstable pelvic fractures with severe brain injury.
View full abstract
-
Masanobu Hirata, Masatoshi Satomura, Ichiro Katsuki, Kazushi Haraguchi ...
2008 Volume 57 Issue 3 Pages
397-400
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
We experienced a case of a 44-year-old woman who had left sacroiliac joint injuries. She was cought between a heavy machine and truck, and was taken to our hospital immediately.
Her left sacroiliac joint was found to have dislocated with left iliac bone fracture on CT and X-ray. Intrapelvic arterial hemorrhage was not observed on angiography. After direct traction on her left leg for 16 days, we performed arthrodesis with sacroiliac device.
After nine weeks, partial weight bearing was started. After 10 weeks, she walked with two crutches.
On the treatment of sacroiliac joint injuries, three methods are reported, (1) anterior plating, (2) posterior plating, (3) iliosacral screw fixation. Anterior plating has the advantage of providing precise and direct reduction and fixation. In this case, we performed anterior fixation with a sacroiliac plate.
View full abstract
-
Takuya Tokashiki, Hiroaki Tanaka, Yoshihisa Miyazaki, Masato Nagashima ...
2008 Volume 57 Issue 3 Pages
401-405
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
We report a rare case of traumatic posterior hip dislocation with bilateral trochanteric fractures.
A 74-year-old man was injured in a traffic accident. X-ray showed right posterior hip dislocation, right acetabular fracture, bilateral trochanteric fractures, and right patellar open fracture. On the day of injury, open reduction for right hip dislocation, and osteosynthesis for right acetabular fracture, bilateral trochanteric fractures, and right patellar fracture were performed. Seven weeks after the surgery, X-ray showed cutout of the lag screw from the femoral head. We performed right total hip arthroplasty three months after the first operation.
Only two cases of traumatic hip dislocations with ipsilateral trochanteric fracture have been reported and traumatic hip dislocation with bilateral trochanteric fractures never been previously reported. The mechanism of this case; after the first traumatic hip dislocation occured, the second trochanteric fractures occured due to secondary external force. After osteosynthesis, avascular necrosis of the femoral head occured for which total hip arthroplasty was performed to reconstruct the hip joint function.
View full abstract
-
Hidetoshi Onoue, Kazuo Kimura, Jun Nishio, Hikaru Saita, Fumihiko Yama ...
2008 Volume 57 Issue 3 Pages
406-410
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
We utilized the compression plate for five cases of femoral shaft fracture in children. All of the cases were male and the average age at the time of injury was 12 (8-15). AO classification of these cases was: Type A: One case, A2: One case, A3: Two cases, B2: One case. The fracture site of this series was: central 1/3 of the femur: One case, distal 1/3 of the femur: Four cases. The main rationale of utilizing the compression plate was as follows: Four cases demonstrated the distal 1/3 femoral fracture, and one case had extremely narrow femoral canal in the central 1/3 femoral fracture site. The average operation time was 72 minutes (60-90), and intraoperative bleeding was 158 g (50-250). All of the five cases had no complications and obtained previous walking ability. All the compression plates were removed nine months after initial surgery and there was no fracture present at the plate removal site. The advantage of the plate fixation is providing the rigid and anatomical fixation even in cases where the fracture site in distal 1/3 in the femoral shaft.
View full abstract
-
Natsuki Hara, Yukihiro Furue, Makoto Sasaki, Ikufumi Nagayoshi, Tatsuo ...
2008 Volume 57 Issue 3 Pages
411-414
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
We reviwed the clinical results of retrograde intramedullary nailing for femoral supracondylar fracture in elderly patients. We treated 12 patients (male: 1, female: 11) with supracondylar fracture of the femur by retrograde intramedullary nailing. All 12 fractures were classified as type A according to the AO classification. The average age was 84.8 years (72 to 96 years). Radiologically all cases united, six cases had residual valgus deformity, and three had varus one. Walking ability remained the same as the preoperative level in 10 cases. The average range of knee flexion was 96.3 degrees (70 to 130 degrees). The average shortness of the leg was 1.7 cm (0.9 to 3.3 cm). Each case was evaluated by modified Neer's clinical criteria. Excellent results were recorded in seven cases, satisfactory in three, unsatisfactory in two, and there was no failure case. There were no severe complications. We concluded that retrograde intramedullary nailing can be the first choice for type A supracondylar fracture of the femur in elderly patients. But, in patients with implant for previous femoral neck fracture, this method have some problems such as second fracture between the implants. In such cases, we may have to consider other methods.
View full abstract
-
Tetsuo Hayashi, Kenzo Shirasawa, Akihisa Yamashita, Hidehiko Kido, Tak ...
2008 Volume 57 Issue 3 Pages
415-418
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
Cervical myelopathy associated with athetoid cerebral palsy tend to occur in middle age, however, there have been few reports regarding occurrence in the twenties. We report three cases of men in the twenties with cervical myelopathy associated with athetoid cerebral palsy. Two of the three was acute onset. Degenerative change in X-ray and spinal canal stenosis in MRI or myelography was scarcely observed in two of three cases. Cervical myelopathy occurred at C3/4 and cervical posterior reconstruction led to good clinical results in all cases. As younger patients have more velocity and acceleration of involuntary movement, cervical laxity, and range of motion, spinal cord disorder is considered to occur because of excessive motion without cervical spondylosis.
View full abstract
-
Masanori Yamaguchi, Eiichiro Nakamura, Kenichiro Narusawa, Kenji Shimi ...
2008 Volume 57 Issue 3 Pages
419-423
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
It is difficult to treat thoracic myelopathy caused by ossification of the posterior longitudinal ligament (OPLL). We experienced two patients with thoracic OPLL who underwent surgical treatment by laminectomy and posterior instrumented fusion with dekyphosis stabilization, and who recovered well finally. In one case, postoperative palsy occured while the patient was sitting a week after the surgery. The palsy improved gradually by lying in bed again. Three weeks later, the patient could sit on the bed with NC (neck chest) brace and also walk. No deterioration was seen in this period although she had to wear a philadelphia collar at 12 weeks postoperatively. It is thought that in this patient, the spinal cord may have been compressed by beak-type OPLL at the upper thoracic level in the neck flexion position in an early period after surgery. Careful management and rehabilitation using NC brace after surgery is necessary for beak-type upper thoracic OPLL.
View full abstract
-
Fumito Tanabe, Eiji Taketomi, Nobuhiko Sunahara, Yasuhiro Tsuneyoshi, ...
2008 Volume 57 Issue 3 Pages
424-427
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
Simple posterior decompression for thoracic myelopathy sometimes causes postoperative aggravation of neurological symptoms. The main factor is because the thoracic spine is kyphosis anatomically. We therefore attempted transforaminal thoracic interbody fusion via posterior approach, following TLIF in lumbar spine.
Three patients with OPLL, herniation, and osteoporotic vertebral fracture were selected for this surgical technique. We examined the operation time, hemorrhage, clinical outcome, X-ray, and complications. Satisfactory results were obtained in a short time.
In comparison with other methods, it appears to be an effective method for the surgical treatment of thoracic myelopathy.
View full abstract
-
Yuichi Maeda, Ichiro Seike, Soichiro Yamabe
2008 Volume 57 Issue 3 Pages
428-430
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
We performed surgical treatment for lumbar extraforaminal stenosis on five patients. The operative method was posterior decompression only. After surgery, there was no or almost no pain
We have impressed that superficial fibular sensory nerve action potential and 3D-MRI for lumbar extraforaminal stenosis are not reliable beyond assisted diaghosis.
View full abstract
-
Kanehiro Matsuyama, Yasuhiro Ishido, Eiji Taketomi, Fumito Tanabe, Nob ...
2008 Volume 57 Issue 3 Pages
431-434
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
A lumber facet cyst in the spinal canal was surgically treated with microendoscopy. No complication was found during or after the operation. No postoperative instability was observed, but a new cyst appeared in the opposite side. The degeneration of facet is thought to be the primary reason for cyst formation.
View full abstract
-
Kei Yamada, Jin Soo Park, Kimiaki Sato, Kimiaki Yokosuka, Tatsuhiro Yo ...
2008 Volume 57 Issue 3 Pages
435-438
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
The degree of postoperative pain in 57 patients who underwent spinal surgery was evaluated according to Wang and Baker's face scale. Forty-three patients, 30 of whom were male and 13 female, were treated for postoperative pain using continuous subcutaneous morphine (SCM). Fourteen patients, seven of whom were male and the rest of female, were treated for postoperative pain using diclofenac sodium or pentazocine (DP). SCM may be better than DP in terms of postoperative analgesia six to 28 hours after surgery. However, there was no statistical difference between both groups at every two hours after operation. Seventeen patients in the SCM group sustained vomiting and nausea whereas hone experienced them in the DP group. Mild respiratory distress was recognized in one patient and low blood pressure in one patient in the SCM group. Both improved without having to stop the administration of the morphine. It was suggested that SCM is effective for postoperative pain for 24 hours after surgery, but vomiting and nausea might impede the use of SCM for postoperative pain.
View full abstract
-
Hiroshi Tanaka, Takatomo Mine, Yasuhiro Tani, Kazuki Chagawa, Toshihik ...
2008 Volume 57 Issue 3 Pages
439-442
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
The objective of this study was to analyze the efficacy of methotrexate and mizoribine combination therapy in adult rheumatoid arthritis (RA) patients. Fourteen adult patients with active RA (DAS 28=4.5 at baseline) were treated with a combination of methotrexate and mizoribine after failure of methotrexate monotherapy. 150 mg of mizoribine (once daily) was added to existing methotrexate. Side effects and efficacy (DAS 28) were evaluated at three, six, and 12 months. Patients experienced no side effects. Mean DAS 28 scores was 2.64 after 12 months administration of combination therapy. After 12 months, seven patients achieved EULAR criteria for good response, suggesting that 50% of the patients showed response. Combination therapy with methotrexate and mizoribine may provide clinical benefit in patients with methotrexate-resistant rheumatoid arthritis.
View full abstract
-
Takuya Akamine, Nobutaka Taguchi, Takao Tanaka, Dai Takada, Yasunari F ...
2008 Volume 57 Issue 3 Pages
443-446
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
We investigated the effects of therapeutic exercise in water in a temperature-adjusted pool on 21 female patients with rheumatoid arthritis (average 49.6 years, stage 2.2, and class 1.9).
Dorsal muscle power, power around a knee, grasping power, elasticity of the trunk and lower extremities, Lansbury index, and the Japanese Orthopaedic Association's judgment score for rheumatoid arthritic knees improved significantly (p<0.05) after an eight-week course of therapeutic exercise in water (two sessions a week). The results of psychological test showed that their mental conditions had significantly improved (p<0.01) by therapeutic exercise in water. Additionally, elasticity of M. biceps brachii and M. forearm extensors also increased significantly (p<0.05). No aggravation of inflammatory reactions was observed in serological examinations after the exercise.
We concluded that therapeutic exercise in water is an effective treatment for patients with rheumatoid arthritis.
View full abstract
-
Itaru Furuichi, Masakazu Murata, Takeshi Miyaji, Noriaki Miyata, Masar ...
2008 Volume 57 Issue 3 Pages
447-449
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
The Coonrad-Morrey total elbow arthroplasty was performed on three severely destructed rheumatoid arthritis elbows. Pre-operatively, all patients suffered from severe elbow pain and instability.
Two of the three patients had elbow joint fractures. Follow-up ranged from 8 to 13 months. The average pre-operative JOA score was 29 points. The average post-operative JOA score was 81 points. Post-operatively, pain relief was satisfactory, and limitation of flexion and instability significantly improved. No elbows sustained any complications including infection, aseptic loosening, nerve neuritis. The Coonrad-Morrey total elbow arthroplasty is therefore useful in severely destructed rheumatoid arthritis elbows.
View full abstract
-
Tomoaki Tanaka, Naoyuki Kuga, Masao Teramoto, Masuo Hanada, Noriyuki N ...
2008 Volume 57 Issue 3 Pages
450-455
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
We treated 11 tibial fractures using the locking compression plate (LCP). These consisted of six proximal-intra-articular fractures, one diaphyseal fracture, and four distal intra-articular fractures. Five fractures were fixed with minimally invasive plate osteosynthesis (MIPO). All fractures healed within 5.5 months without post-operative infections, delayed unions, or apparent malunions. We recommend LCP for almost all tibial fractures, especially metaphysial and diaphysial fractures with MIPO. LCP is also available with open reduction and internal fixation with bone grafting in comminuted intra-articular fractures.
View full abstract
-
Yoshiyuki Masuda, Kenichi Nakamura, Ryodai Kawabata, Yoshiya Arishima, ...
2008 Volume 57 Issue 3 Pages
456-458
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
We report a case of fracture-dislocation of the talus which did not cause avascular necrosis. It was Type IV fracture according to the Marti-Weber classification and was treated surgically using screws after 19 days. There was no evidence of avascular necrosis one year after follow-up. We conclude that appropriate anatomical reduction and non-weight-bearing are important for preventing avascular necrosis.
View full abstract
-
Hirofumi Osako, Masaaki Imabayashi, Ryoji Horikawa, Yuichiro Yazaki, K ...
2008 Volume 57 Issue 3 Pages
459-462
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
We treated calcaneal fractures by means of lateral approach using a calcaneal plate, and evaluated the clinical results. The mean age at the time of surgery was 60.1 (range: 36 to 78 ). The mean duration of follow-up was 3.4 years.
Eleven feet were treated with the ACE calcaneal plate, and two feet were treated with the Rabbit plate. The clinical result evaluation according to the Maxfield criteria was as follows: excellent in nine feet; very good in two feet; poor in one foot.
Pre-and postoperative changes in radiographic findings were studied. The improvement of the Bhler angle, width index, and intra-articular displacement was reflected in the clinical result. This method is considered to be an effective treatment for intra-articular calcaneal fractures.
View full abstract
-
Takuya Ikuta
2008 Volume 57 Issue 3 Pages
463-465
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
We report twelve cases with neglected rupture of the Achilles tendon. In all cases, tendon repair was done without tendon reconstruction. All patients could walk normally three months after operation. Nine patients could stand on tiptoe six months after operation. In the cases within four months after injury, we could achieve good results by tendon repair only for neglected rupture of the Achilles tendon.
View full abstract
-
Norimasa Kikuzato, Chotaku Futenma, Shin Yamada, Takeshi Uehara
2008 Volume 57 Issue 3 Pages
466-469
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
The aim of this study was to evaluate the results of nonoperative treatment of fractures of the clavicle in our hospital. Ninety-two patients were treated nonoperatively between 2004 and 2006. Sixty-eight fractures were middle third of the bone and 20 fractures were lateral third of the bone. Eighty-eight fractures were united. The prevalence of union was 95.7%. There were four nonunions. Two cases were middle third and two cases were lateral third. In displaced or comminuted fractures of middle third in patients over 20 years old and in Neer type II fractures of lateral third, the prevalence of nonunion or delayed union increased. We conclude that nonoperative treatment is effective for fractures of the clavicle and that operative treatment should be considered for displaced or comminuted fractures of middle third and Neer type II fractures of lateral third.
View full abstract
-
Hidehiko Yuge, Takahiro Hamada, Junichi Shida, Shigekazu Kaminomachi, ...
2008 Volume 57 Issue 3 Pages
470-473
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
We report a case with traumatic posterior dislocation of a right acromioclavicular joint and anterior dislocation of a right sternoclavicular joint. A 47-year-old woman hit her right back between a car bumper and the ground. First, she was carried to a hospital nearby, and was then transfered to our hospital two weeks later. X-ray examination showed posterior dislocation of right acromioclavicular joint, anterior dislocation of right sternoclavicular joint, and rib fractures. We reduced both end dislocations surgically three weeks after the injury. Postoperatively, her acromioclavicular joint and sternoclavicular joit have maintained good reduction. She is satisfied with the results. We think that open reduction is an effective therapy for dislocations of both ends of a clavicle.
View full abstract
-
Takuya Ikuta, Toshio Kitamura
2008 Volume 57 Issue 3 Pages
474-477
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
We report twelve cases with non-union of clavicle fracture. All cases were treated surgically using a plate. In eight cases, autogenous bone graft was used together. In all cases, bone union was achieved, and satisfactory results were obtained.
View full abstract
-
Masao Eto, Keizo Furukawa, Hideo Baba, Koichi Adachi, Shiro Kajiyama, ...
2008 Volume 57 Issue 3 Pages
478-480
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
«Purpose» Many women have loose shoulder with general joint laxity. We report the progress of hormonal treatment for such cases.
«Objective» The subjects were four females with loose shoulder and general joint laxity. Their ages were 38 (case 1), 53 (case 2), 28 (case 3), 25 (case 4) years old, respectively. The period of hormonal therapy was four months to five years. Currently, case 2 has discontinued treatment due to menopause, and case 3 due to side effects. Case 3 has not undergone operation, while the other three patients underwent thermal shrinkage or capsular shift of both shoulders.
«Results and Conclusion» Progesterone plays a role in the instability of joints. Considering that EP medical mixture (pill) or GnRHa restraining the action of progesterone way be effective for loose shoulders, all patients achieved stability of the shoulder joints, and subsequently the degree and the frequency of shoulder subluxation decreased.
Laxity of a shoulder joint does not completely disappear by hormonal therapy, and there is a side effects of the medication may also occur. However, hormonal therapy may be effective in patients with good adaptation.
Therefore, it should be tried before attempting operative treatment.
View full abstract
-
Koichi Kiyota, Yozo Shibata, Teruaki Izaki, Tsuyoshi Shinoda, Takeshi ...
2008 Volume 57 Issue 3 Pages
481-484
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
Clinical results of arthroscopic repair of Type II SLAP lesion in a professional baseball player are reported. He is a 20-year-old, right-handed minor league infielder. One day, he suddenly felt disability and pain in his right shoulder during throwing. He could not throw with maximum performance. In the first examination at our clinic, normal range of motion was revealed, but active compression test, Mimori's pain provocation test, Crank test and relocation test were positive. MR arthrography demonstrated type II SLAP lesion. Because he did not respoud to conservative treatment including stretch and cuff strengthening exercise for three months, we performed arthroscopic repair of type II SLAP lesion using the trans-rotator cuff approach based on cadveric. Throwing was gradually started five months after the surgery. Furthermore, he was promoted to major league 11 months after the surgery. JSS sports score improved from 38 points to 75 points. Clinical results of type II SLAP repair were excellent, when throwing ability was restored.
View full abstract
-
Ryota Iwamoto, Hidetoshi Onoue, Kazuo Kimura, Jun Nishio, Hikaru Saita ...
2008 Volume 57 Issue 3 Pages
485-488
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
We experienced a comparatively rare case of triceps brachii subcutis rupture. The case was a 17-year-old male who injured his right elbow in a judo match when his 120 kg partner rode onto him on his right shoulder back with his right elbow in the slightly bent position. He visited our hospital for checkup on the third day due to pain and swelling of his right elbow. The right elbow was enlarged generally, and the olecranal region showed tenderness. The automatic extension was impotent. Simple X-ray profile showed avulsion of the microsclere suspected to have from the olecranon near the olecranon proximal part. We diagnosed it as triceps brachii subcutis rupture with olecranon avulsion fracture from the above findings and we used two suture anchors from the sixteenth day. We started automatic range of motion exercise myodynamia training after a long arm cast consolidation of three weeks with the elbow joint in the slightly bent position post-operatively. He restarted judo training on his own decision from the post-operative fifth week. Early resumption of training is often allowed as in this case, but careful planning is required, and it was thought that the plans were important.
View full abstract
-
Yusuke Fujimoto, Yasuhisa Togo, Tadashi Ogura, Kaori Fukushima, Takash ...
2008 Volume 57 Issue 3 Pages
489-492
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
We treated four patients with the humeral capitellar fractures. The mean age was 46.5 years (range: 13 to 62), one male and three females. According to the Grantham classification, two cases were Type II-A, and two cases were Type II-C. The operative procedures performed were internal fixation, using PLLA screw on one case, and Herbert screw on three cases. Postoperatively, Grantham evaluation was excellent in two patients and good in two patients. The mean JOA score was 93 points (range: 85 to 100). In all cases, bone union was achieved and satisfactory results were obtained.
View full abstract
-
Yukihiro Furue, Makoto Sasaki, Ikufumi Nagayoshi, Tatsuo Motoyama, Mas ...
2008 Volume 57 Issue 3 Pages
493-496
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
We reviewed the clinical results and fracture profile of the diaphyseal refracture of the forearm (middle third of the shaft) in primary or junior high school students. From November 2003, 22 midshaft forearm fractures were treated at our hospital. Of these refractures had occured in six, and one had a second refracture. Excellent results were achieved by operative treatment in five patients. Refracture is thought to occur in ages older than 10, due to greenstick fracture which has not fully healed, residual angulation deformity, limitation of range of forearm supination and pronation, or return to sport activity too early. Care should be taken when treating greenstick fractures in higher grades.
View full abstract
-
Atsuhiko Nakamura, Hidetoshi Onoue
2008 Volume 57 Issue 3 Pages
497-499
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
We report a case of avulsion of the ring finger flexor digitorum profundus tendon. The patient was a 37-year-old woman whose chief complaint was pain and swelling on the volar side of the right ring finger. She could not flex the IP joint due to pain. Radiograph indicated a small avulsed bone fragment on the volar side of the proximal phalanx. We performed operation sixteen days after injury. The avulsed fragment was fixed with pull-out suture using nylon and button. At the final follow-up, she had limitation of ROM in the DIP joint. It is important to make early and accurate diagnosis of this injury.
View full abstract
-
Toshifumi Fujiwara, Tomotaro Yamaguchi, Hideya Kawamura, Goro Motomura
2008 Volume 57 Issue 3 Pages
500-502
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
The incidence of deep vein thrombosis (DVT) after total knee arthroplasty (TKA) is high, and as DVT cause pulmonary embolism, it needs to be prevented. We investigated the results of preventing venous thromboembolism (VTE) in our hospital by the original protocol of using a foot pump and unfractionated heparin. Between January 2006 and June 2007, 119 joints out of 112 cases underwent total knee arthrolasty (TKA). They consisted of 27 joints of 24 male and 92 joints of 88 females. Ultrasonography was performed when their lower limbs showed swelling postoperatively. Swollen lower limbs were found in 30 cases (25.2%). In these cases, 12 cases (10.1%) showed de-novo venous thrombi in the lower extremity in ultrasonography, and PE was found in two cases (1.7%). We examined the factors influencing the generation of DVT statistically by the logistic regression analysis. The administration of anticoagulant before operation influenced the generation of DVT significantly.
View full abstract
-
Natsuko Tomimura, Koji Sameshima, Yoshihisa Kawauchi, Setsuro Komiya
2008 Volume 57 Issue 3 Pages
503-505
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
We had performed extremity amputation on 104 patients between January 2003 and June 2007.
We investigated the prognosis after amputation and found gangrene in 76 patients, 111 extremities. At the time of investigation, 32 patients (42.1%) were alive, but 44 patients (57.9%) were dead because of pneumonia, cardiac failure, or septicemia. The average survival period was nine months. 62.5% of the survivors could not walk, 37.5% could (including seven patients with prosthesis who had undergone below-knee amputation). It is important to decide the extent of amputation in considertion of bad prognosis.
View full abstract
-
Issei Ishii, Tokushige Nishizato, Hidehiko Matsushita, Ryoichi Nakai, ...
2008 Volume 57 Issue 3 Pages
506-510
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
We report a case of nodular muscular sarcoidosis extending to right arm and leg muscles. A 52-year-old woman complained of palpable nodule in her right leg. On magnetic resonance imaging, nodular type muscular sarcoidosis lesions showing characteristic appearance, such as dark star and three stripes signs, were clearly detected. Ga-67 citrate scintigraphy showed intensely increased nodular activity in the right leg. Angiotensin-converting enzyme and γ-globulin levels rose to 23.2 IU/l and 22.8%, respectively, and tuberuculin skin test was negative. The diagnosis of muscular sarcoidosis was confirmed by block resection and histopathologic examination. Palpable nodules slowly increased in number and developed in her right forearm and right thigh. The nodules started to decrease in size by internal use of predonisolone.
View full abstract
-
Hideyuki Kawabata, Hironori Kakoi, Ryodai Kawabata, Yoshiya Arishima, ...
2008 Volume 57 Issue 3 Pages
511-514
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
We report two cases of synovial osteochondromatosis of the hip joint.
Case 1 was a 53-year-old woman who complained of severe pain in her left hip joint. MRI and arthrogram showed hypertrophic synovium and some small mass inside. We performed arthroscopic resection first. Two years after operation, recurrence of symptoms and osteochondromas was observed. Open resection of the remaining synoviums by anterior approach was performed, without dislocation of the hip joint. Relief of symptoms was obtained.
Case 2 was a 29-year-old man who complained of slight pain in his right hip joint. Roentgenograms and computed tomography showed osseous mass located in the medial lesion of the hip joint.
We tried to resect the lesion arthroscopically, but it could not be done completely. So additional open resection was needed, especially for the lesion in the inferior aspect of the femoral head and surrounding femoral neck.
However, no dislocation of the hip joint was needed, and relief of symptoms was obtained.
It is often discussed whether dislocation of the hip joint is needed for treating synovial osteochondromatosis. We found that arthroscopy by open resection was useful.
View full abstract
-
Takeshi Yamashita, Kenshi Kikukawa, Tateki Segata, Tomohiro Horikawa, ...
2008 Volume 57 Issue 3 Pages
515-518
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
We report a 51-year-old man with synovial osteochondromatosis in the subacromial bursa. Preoperative X-ray and MRI revealed two loose bodies. Arthroscopic debridement of the synovium and removal of the loose bodies were performed. He had no pain and impingement of the shoulder after the surgery. There was no recurrence at 12 months follow-up.
View full abstract
-
Kensaku Yamaga, Hideki Yamashita, Yasutsugu Yamashita, Koji Endo, Haru ...
2008 Volume 57 Issue 3 Pages
519-522
Published: September 25, 2008
Released on J-STAGE: November 20, 2008
JOURNAL
FREE ACCESS
We report a case of granulation tissue under the nail with bone scalloping in the distal phalanx after trauma. A 24-year-old female caught her left middle finger in the car door, and suffered hematoma under the nail. It was drained by opening a few holes through the nail. A mass however gradually formed and grew under the deformed nail. X-ray finding revealed a bone scalloping in the same site of the mass lesion of the distal phalanx dorsal side. Its size was 10 mm and margin was clear. MRI finding revealed that the mass was found under the nail, was 10×7 mm in size, margin was clear, TIWI was low signal change, T2WI was high signal change and periphery was enhanced by Gd. Suspecting a benign soft tissue tumor, osteomyelitis or hematoma, we performed excisional biopsy 10 weeks after trauma. Pathological diagnosis was granulation tissue hyperplasia. This mass was not a tumor but reactive lesion. We should keep in mind that soft tissue lesions except for tumors and infections way cause bone reactions in some cases.
View full abstract
