著者

原 寛徳 伊藤 信之 衛藤 正雄 朝長 匡 ラッビ M. E. 安達 耕一

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.46, no.3, pp.894-897, 1997-09-25 (Released:2010-02-25)

参考文献数

5

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This study investigated the relation ship between the slope and shape of the acromion and the spur at the antero-inferior surface of the acromion no clarify the cause of subacromial impingement. This investigation was performed with 205 scapular dry bone specimens. The specimens of 107 males were used. Their ages ranged from 20 to 83 years with an average age of 56.5 years. The presence of acromial spurs was identified. All acromions were classified visually as type I (flat), type II (curved) or type II (hooked) as described by Bigliani et al. And the slope of the acromion was measured in all specimens.A spur at the antero-inferior surface was seen in 96 acromions (46.8%). And almost all spurs were located in the anterior one third of the acromion. In all specimens, fifty-six acromions (27.3%) were type I, one hundred and eight (52.7%) were type II and forty-one (20.0%) were type III. The type of acromion was not related to the presence or absence of a spur. The average slope of all acromions was 46±8°, that of acromions with spur was 44±7° and that of acromions without spur was 49±8°. There was a significant difference between the slope of the acromion with spur and acromions without spur. From this study it can be concluded that the type of acromion had no relation ship to subacromial impingement and the flattened slope of the acromion might be one cause of subacromial impingement.

著者

原田 真一 伊藤 信之 衛藤 正雄 朝長 匡 岩崎 勝郎

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.45, no.4, pp.1126-1130, 1996-09-25 (Released:2010-02-25)

参考文献数

5

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We report neuropathic arthropathy of the shoulder joint caused by syringomyelia and discuss the method of diagnosis and treatment.Three patients were treated and their ages were 41, 52 and 55 years respectively. In case No 1, there was swelling and the rapid destruction of the shoulder joint. Synovectomy was performed, however the ROM decreased markedly. Six months later, a shoulder joint replacement was carried out and a temporaly improvement of ROM was noticed. However it became worse gradually again and after ten years later she can abduct her arm only 40 degrees. In case No. 2, the synovectomy was performed, but the destruction of the joint progressed rapidly and the joint was dislocated anteriorly 6 months later. At present she has poor abduction of 60 degrees. In case No. 3, osteosynthesis was carried out for the humeral shaft fracture 5 years ago, however non-union and neuropathic arthropathy of the shoulder joint were diagnosed 3 years. later. Present ab-duction angle is 30 degrees.All these three cases had characteristics of massive swelling, rapid and progressive destruction of humeral head with slight pain.So far in Japan, 36 cases out of 42 cases of neuropathic arthropathy of the shoulder joint was caused by syringomyelia. However, the results of these cases were not satisfactory, even after performing synovectomy, prosthesis or arthrodesis because almost all the syringomyelia cases are slow and progressive and leads to the destruction of the joint.

著者

田浦 智之 朝長 匡 飯岡 隆 池田 倫太郎 入江 準二 木下 直江

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.63, no.4, pp.773-778, 2014-09-25 (Released:2014-11-11)

参考文献数

8

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骨代謝回転過剰抑制が要因と思われる大腿骨転子下骨折の1例を経験したので報告する.症例は48歳,女性.屋外で突如右大腿部痛出現.体動困難となったため,当院救急搬送.X線上,右大腿骨転子下骨折を認めた.既往歴として17年前より全身性エリテマトーデスに対してステロイド内服しており,ビスフォスフォネート製剤内服歴は3年間であった.2週間前より右大腿部痛を自覚していた.骨折に対しては髄内釘による固定術を行った.ところが,術後仮骨形成不良であったため,骨代謝回転過剰抑制による非定型骨折が疑われた.ビスフォスフォネート製剤内服中止し,テリパラチド開始.しかし,今度は健側である左大腿部痛出現.X線上,左大腿骨転子下不全骨折を認めた.治療法に関して患者とのインフォームド・コンセントの結果,健側に対しては保存的療法,手術側に対しては遠位横止めスクリュー挿入術を行った.その後,両側とも仮骨形成を認めていたが,再度,手術側である右大腿部痛出現.X線上,髄内釘近位部の折損及び骨折部の再転位を認めた.そのため髄内釘による再固定術を行い,腸骨から骨移植術も併用.再々手術後9ヵ月現在,保存的療法を行った左側に関しては比較的経過良好であるが,手術的療法を行った右側は骨癒合遅延傾向であり,今後も引き続き厳重な経過観察が必要である.

著者

楊井 知紀 衛藤 正雄 朝長 匡 末廣 昌嗣 岩永 斉 進藤 裕幸 相良 耕三 吉田 省二

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.2, pp.392-395, 2000-03-25 (Released:2010-02-25)

参考文献数

8

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We experienced a case of dysphasia and dysphonia due to Ankylosing spinal hyperostosis (ASH) of the cervical spine.The patient was a 78-year-old man who was admitted to the department of internal medicine in our hospital for the examination and treatment of dysphasia and Mendelson syndrome. Dysphonia appeared later. X-rays of the cervical spine showed ossification of the anterior longitudinal ligament (OALL) at the C2 to C7 regions. The patient received surgical treatment.After the removal of OALL, dysphasia and dysphonia improved. The causes of these ASH symptom are examined in this study.

著者

朝永 育 白石 和輝 前田 純一郎 朝長 匡 宮本 俊之

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.68, no.1, pp.99-102, 2019-03-25 (Released:2019-05-16)

参考文献数

7

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【はじめに】大腿骨転子部骨折におけるfemoral short nailでは,tip-to-apex distance(TAD)を20mm以下にすることでカットアウト率が減少すると言われている.本研究の目的はTADを術中測定できるcomputer-assisted navigation system(Navi)の有用性を検討することである.【対象と方法】大腿骨転子部骨折40例を対象とし,Navi群20例,非Navi群20例を比較した.評価項目はTAD,手術時間とした.【結果】TADはNavi群13.4mm,非Navi群15.2mm(p=0.18)であった.TADが10mmから20mmである症例はNavi群95%,非Navi群75%であった.手術時間はNavi群36.9分,非Navi群37.4分(p=0.90)であった.【考察】TADに2群間で有意差は認めなかったが,Navi群の方がより正確な位置に挿入することが可能であった.また手術時間に両群間で有意差はなかった.【結語】Femoral short nailにおけるNaviは有用である可能性が示唆された.

著者

穂積 晃 伊藤 信之 衛藤 正雄 朝長 匡 井上 博文 進藤 裕幸

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.48, no.2, pp.524-527, 1999-03-25 (Released:2010-02-25)

参考文献数

3

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We reported a case of radial head dislocation, the pathology of which we could determine by MRI images.A 12 year old boy, who had had no traumatic history of his right elbow, was introduced to our hospital due to the flexion disturbance of his right elbow. Pre-operative MRI images showed the soft tissue at radio-capittelar joint. So we estimated it annular ligament.In the annular ligament existing in the radio-capittelar joint which was seen on MRI images. We performed only reduction of the annular ligament and radial head without reconstruction of the ligament.MRI was useful in understanding the pathology of this case, and it may be a dislocation caused by “pulled elbow” during his childhood.

著者

宮本 俊之 伊藤 信之 衛藤 正雄 朝長 匡 原 寛徳 大渡 伸 M. E. Rabbi

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.46, no.3, pp.890-893, 1997-09-25 (Released:2010-02-25)

参考文献数

8

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There are rarely few reports on the clavicular motion during elevation of the extremity. This is may due to the complicated shape of the clavicle and its three-dimensional movement. The purpose of this study is to analyze the movements of clavicle by using X-ray fluoroscope.The study was performed on a 21 years old female who had clavicular fracture a year ago and had fixation with plate and screws. She had no difference on both shoulder ROM when examined. In front of X-ray fluoroscope, she was asked to abduct her arm to full in 10 seconds, and the movements were recorded on videotape. From the location of plate and screws we analyzed the clavicular motion.The clavicle rotated clockwise in its long axis when viewing from the left sagittal plane. This movement increased constantly during the elevation of arm and reached 50 degrees at maximum abduction. In Frontal view, 25 degrees of upward movement was observed, where the majority of the movement was seen within 90 degrees of elevation.