著者

中村 好成 原 道也 張 敬範 花田 弘文 江本 玄 金宮 毅 内藤 正俊

出版者

West-Japanese Society of Orthopedics & Traumatology

雑誌

整形外科と災害外科 (ISSN:00371033)

巻号頁・発行日

vol.49, no.3, pp.758-761, 2000-09-25 (Released:2010-02-25)

参考文献数

5

被引用文献数

1 2

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We evaluated the use of manipulation under anesthesia in 5 knees as part of a retrospective study on 72 total knee arthroplasty cases (TKA) with osteoarthritis between September 1995 and May 1999. Manipulation was considered when intensive physiotherapy failed to increase flexion to more than 90° of ter 3 weekspostoperatiuly.The mean active flexion before manipulation was 67°. The mean final flexion achieved 104°. The mean gain was 37°.Between the manipulated patients and pativents requiring no manipwlatiow, the following parameters were assessed and compared; age, flexion, JOA, FTA, lateral release, and polyethylene?The manipulated patients in showed significant changes in FTA and used thick polyethylene.None of the patients showed supracondylar fracture, avulsion of the patellar tendon, myositis ossificans, and wound breakdown.

著者

古賀 敬 内藤 正俊 秋吉 祐一郎 白水 圭 浅山 勲 Tatsunobu Abe

出版者

West-Japanese Society of Orthopedics & Traumatology

雑誌

整形外科と災害外科 (ISSN:00371033)

巻号頁・発行日

vol.51, no.1, pp.148-152, 2002-03-25 (Released:2010-02-25)

参考文献数

12

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Sciatic nerve palsy is a proble troublesome complication of total hip arthroplasty. It may be caused by direct injury or over-traction at the time of operation. We investigated the effects of the hip and knee positions on the blood flow of the sciatic nerve of dogs. Tweyty hip joints of 10 adult mongrel dogs were examined.The blood flow in the sciatic nerve was measured using a Laser Doppler Flowmetry, at varying angles of flexion (90°, 120°, 150°) and internal rotation (0°, 30°) of the hip joint and angles of flexion of the knee (0°, 30°, 60°, 90°). This study showed that the blood flow in the sciatic nerve decreases with increasing flexion angle and increasing internal rotation angle of the hip joint, and that decreases in the flexion angle of the knee joint result in especially pronounced decreases in blood flow. We consider that the position of the hip and knee positions are considered a significant risk factor in total hip arthroplasty parformed with over-lengthening. Our results suggest that surgeons should pay attention to knee extension and the flexion and internal rotation positions of the hip tp prevent sciatic nerve palsy as a complication of total hip arthroplasty.

著者

真田 京一 吉村 一朗 金澤 和貴 萩尾 友宣 蓑川 創 内藤 正俊

出版者

西日本整形・災害外科学会

雑誌

整形外科と災害外科 (ISSN:00371033)

巻号頁・発行日

vol.65, no.3, pp.493-496, 2016-09-25 (Released:2016-12-06)

参考文献数

6

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【目的】今回Maisonneuve骨折に対し,吸収性螺子を用いて脛腓間固定を行った2症例を経験したので報告する.【症例1】63歳男性.階段を踏み外し転倒して受傷.単純X線でMaisonnueve骨折を認めた.内果骨折に対し骨接合術及び脛腓間を4.5mm吸収性螺子2本で固定した.術後1年で骨癒合良好であり内果の螺子の抜釘,吸収性螺子のヘッドの除去を行った.【症例2】53歳男性.ソフトボール中下腿外側へ他選手が乗り受傷.単純X線でMaisonnueve骨折を認めた.足関節鏡及び脛腓間を4.5mm吸収性螺子2本で固定した.【考察】従来遠位脛腓間固定には金属製螺子を使用されることが多かったが,抜釘の必要性や荷重の時期などが問題となる.吸収性螺子を使用することで,抜釘の必要性がなくなり早期の機能回復が期待できる.今回Maisonneuve骨折の2症例に対し吸収性螺子を用いた脛腓間固定を行い良好な成績を得ることができた.

著者

土井 庸直 石河 利之 戸田 慎 内藤 正俊

出版者

西日本整形・災害外科学会

雑誌

整形外科と災害外科 (ISSN:00371033)

巻号頁・発行日

vol.64, no.3, pp.562-566, 2015-09-25 (Released:2015-12-03)

参考文献数

9

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手指末節骨内に発生する類上皮嚢腫は稀である.外傷後に左環指末節骨内に発生し,長期経過により著明な増大・骨破壊をきたした類上皮嚢腫の1例を経験したので報告する.【症例】54歳の男性.20年前にモーターに左環指を挟み受傷し,末節骨粉砕骨折の診断にて某医にて手術施行.その後,指の変形・腫脹は続いていた.平成26年3月仕事中に左環指を打撲後に疼痛出現し,近医受診.軟部腫瘍の診断にて当科紹介となった.左示指の末節部~中節部にかけて腫瘤形成認め,皮膚表面は凹凸変形していた.X線にて示指末節骨の骨透亮像を認め,造影MRIでは嚢胞性病変を認め,明らかな造影効果は認めなかった.骨内類上皮嚢腫を疑い,手術施行した.病理診断は類上皮嚢腫であった.【考察】骨内類上皮嚢腫はしばしば骨破壊を伴う.本症例は長期経過により著明な骨破壊をきたしていた.悪性化する報告もあり,疑った際は比較的早期に手術を行うことが望ましいと思われた.

著者

金澤 和貴 吉村 一朗 井田 敬大 竹山 昭徳 内藤 正俊 井上 敏生

雑誌

整形外科と災害外科 (ISSN:00371033)

巻号頁・発行日

vol.56, no.1, pp.145-148, 2007-03-25

参考文献数

7

被引用文献数

1

著者

石河 利之 内藤 正俊 浅山 勲 山口 哲 秋吉 祐一郎 藤澤 基之 神戸 太一 安部 龍暢 白水 圭 舌間 崇士

出版者

West-Japanese Society of Orthopedics & Traumatology

雑誌

整形外科と災害外科 (ISSN:00371033)

巻号頁・発行日

vol.52, no.1, pp.5-9, 2003-03-25

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The purpose of the present study is to report the mid-term results of modified Sugioka transtrochanteric valgus ostetomy (TVO) for the treatment of secondary osteoarthritis. The lateral displacement of the greater trochanter was simultaneously performed. Fourteen TVOs were performed in 14 patients with unilateral osteoarthritis of the hip from 1993. We assessed 8 hips in 8 patients in this study. The mean age of the patients at the time of surgery was 46.4 years (41 to 55 years). The average follow-up was 3.9 years (2.4-7.2years). The patients were evaluated for radiographic changes of the joint space, roof osteophyte, weight bearing surface of acetabulum, AHI, abductor lever arm, capital drop, bone cyst in the acetabulum or femoral head as well as clinical results using JOA score. The mean JOA score improved from 57.4 to 76.3. The widening of joint space, lengthening of weight bearing surface of acetabulum were seen in seven hips. The length of the abductor lever arm after surgery was not proportional to the JOA score at the latest follow-up. In one patient, total hip arthroplasty was required after 2.2 years. This procedure is considered useful for the treatment of osteoarthritis in dysplastic hips.

著者

黒瀬 真之輔 佐々木 邦雄 角田 信昭 大屋 国益 小山 正信 池本 和人 東 良輝 内藤 正俊

出版者

西日本整形・災害外科学会

雑誌

整形外科と災害外科 (ISSN:00371033)

巻号頁・発行日

vol.28, no.4, pp.527-531, 1980-01-10 (Released:2010-02-25)

参考文献数

10

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Injuries to the thoracic and lumbar spine may result in severe instability with progressive neurologic defecit. Attention must be directed not only to restoring or improving neurologic function where possible, but also to promoting bony stability.We have carried out one stage decompression-stabilization procedure consisted of Harrington and anterior spinal fusion with anterior decompression in a total of 6 patients. All 6 of these with thoraco-lumbar spinal injuries had a neurogic defecit.The results have shown to be beneficial in restoring spinal alignment, allowing early mobilization of the patients, shortening rehabilitation, preventing the late complications of increasing deformity in all patients and recovering neurologic function in 4 cases with incomplete neurologic defecit.