The purpose of this study is to study the mechanism of injury and to introduce a reduction method. 13 cases of triplane fracture in the distal tibial epiphysis treated in our hospital were reviewed clinically. There were 8 males and 5 females with an average age of 13.1 years old (range; 9 to 14 years). The average follow up period was 2 years 2 months (range; 6 months to 7.5 years). 8 cases were forced planter flexion-external rotation of the ankle at injury, only external rotation was seen in a case except for other unexplained cases. All cases were challenged closed reduction under spinal anesthesia, of which 7 cases required open reduction and internal fixation.
They recorded 98.2 points with the JOA score at follow-up. The length gap of the lower extremities was not explained clearly. The external rotation force of the ankle, in addition to the planter flexion force, is the most suspectable cause of the occurrence of triplane fracture. Manual reduction with K-wire inserted displaced fragments of the tibia is useful for cases which reject closed reduction.

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There are many types of malleolar fractures of the ankle. Among them a Salter-Harris type III fracture of the antero-lateral part of the distal tibial epiphysis, so-called Tillaux fracture, is rare.
We reported a case of a 15-year-old male who suffered a Tillaux fracture and whose ankle had a lateral instability and an abnormal mobility to anterior side.

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The purpose of our study is to establish the standard normal value of bone density in the average Ghanian. The measurement has followed the method described by Doyle. The subjects examined were 180 healthy Ghanian aged between 10 and 39 years and were divided into 6 groups. The subjects were selected with the cooperation of the staff of the Mamprobi Poly Clinic in Accra where the X-ray machine provided by Japan International Cooperation Agency (JICA) were installed. All were interviewed and completed the questionaires. The forearm was immersed into the water in a plastic bath, and two pictures, an antero-posterior view and a lateral view, of the left ulna were taken in every case. Then they were examined with a micro-densitometer and their mineral concentration of the bone was analyzed. The values were obtained on the basis of theory that the X-ray density of 1 mm Al is equivalent to that of 130 mg/cm2 of bone mineral. The data were statistically analyzed, and various factors, such as sex, age, height, weight, occupation, side of dexterity and physical activity were studied. The values obtained through our research can be regarded as normal ranges of bone density of Ghanian in 1977. They will serve as a standard value for the estimation of bone density of the morbid. And the evaluation of bone density would be a useful aid for the diagnosis and estimation of severity in some diseases, such as nutritional, hormonal and hematological disorders.

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脂肪腫は最も頻度の高い良性軟部腫瘍であるが，手部での発生はまれである．われわれは直径5 cmを超える巨大脂肪腫の症例を7例経験し，全例に外科的治療を行い，一塊として切除しえた．2例に医原性の神経損傷を予防するために手根管開放を併用した．術後，合併症は認めず，最終観察時に局所再発を認めた症例はなかった．手根管近傍まで腫瘍が伸展している際は，神経損傷を予防するために手根管開放の併用は有用と考えた．

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 Chronic expanding hematoma (CEH) is characterized by a hematoma that persists and gradually enlarges over more than one month, with hemorrhagic diathesis recognized as a contributing factor. To date, no cases of CEH associated with idiopathic thrombocytopenic purpura (ITP) have been reported. Although rare, CEH may rupture. Herein, we present a case of CEH that developed at a surgical site and ruptured in a patient with ITP. A 53-year-old woman, who underwent buttock surgery and was diagnosed with ITP at the ages of 16 and 33, respectively, noticed a mass in her left buttock 15 years prior. The mass progressively enlarged and ruptured. Following surgical removal, CEH diagnosis was established based on medical history taking, imaging, and pathology. The involvement of ITP in the development of CEH was suggested, emphasizing the importance of distinguishing CEH from soft tissue malignancies. When evaluating soft-tissue masses, CEH should be included in the differential diagnosis, with careful consideration of the patient's medical history.

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健常な成人18名（男性13名，女性5名）を対象にし，片脚立位で足部を内反強制，外反強制させた際の下肢アライメントの変化と下肢筋活動の動態について調査した。その結果，下肢アライメントの変化は前額面上膝関節・足関節部での変化はなく，脛骨傾斜角の変化と共に距骨下関節での変化が大きかった。また外反強制で下肢アライメントの変化が大きかった。下肢筋活動の動態は非強制と内反強制の筋活動に比して，外反強制の筋活動は増加していた。以上の結果から，足部を外反強制した際，下肢支持脚としてバランスをとるのが困難な状態にある事を示唆した。

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