著者

花田 弘文 後藤 三晴 尾崎 勝博 宮本 浩幸

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.1, pp.165-168, 1999-03-25 (Released:2010-02-25)

参考文献数

8

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175 high school basketball players in Miyazaki were studied with regard to basketball injuries through questionnaires on the history of knee and ankle injuries and basuketball shoes. Many players were found to high-top shoes to decrease ankle sprains. They mentioned the need for basketball shoes that are soft and stable with better spring. Many prevention of ankle sprains.We emphasize the importance of checking shoes and footwork when examining players. In the future, we will conduct further studies on the relationship of injuries and shoes.

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

平川 善之 原 道也 藤原 明 花田 弘文 森岡 周

出版者

日本疼痛学会

雑誌

PAIN RESEARCH (ISSN:09158588)

巻号頁・発行日

vol.28, no.1, pp.23-32, 2013-03-10 (Released:2013-04-04)

参考文献数

29

被引用文献数

2

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Total knee arthroplasty (TKA) is a surgical treatment for conditions such as knee osteoarthritis; the treatment aims to relieve knee pain and improve quality of life. Treatment outcomes are stable; however, it has been reported that postoperative pain becomes chronic in 15 - 20% of cases. The aim of this study was to examine the factors involved in the chronicity of postoperative pain by investigating the effects of cognitive and psychological factors on postoperative pain at 3 weeks, 5 weeks, and 4 months post-operation. Subjects were 50 patients who underwent TKA (8 men and 42 women, mean age: 74.8 ± 6.5 years). Cognitive factors in this study comprised an assessment of neglect-like symptoms; such symptoms included decreased “cognitive function regarding the existence of one's own limbs" or “cognitive function regarding the motion perception of one's own limbs." The severity of these symptoms was assessed using the method described by Galar et al. Psychological factors comprised assessments of anxiety and catastrophic thinking about pain. Anxiety was assessed using the state-trait anxiety inventory, while catastrophic thinking about pain was assessed using the pain catastrophizing scale (comprises categories of helplessness, magnification, and rumination). Postoperative pain was assessed using a visual analog scale (VAS). Multiple regression analysis by using VAS as the dependent variable and all other factors as independent variables showed the following factors to be significantly correlated with VAS: neglect-like symptoms at 3 weeks, 5 weeks, and 4 months post-operation and rumination at 3 weeks and 4 months post-operation. Sensory integration becomes difficult because of decreased sensory function in neglect-like symptoms; this is thought to be caused by body image becoming inaccurate. On the basis of these findings, it is considered necessary to approach for the improvement of sensory function in postoperative rehabilitation. In addition, rumination is persistent in pain, which is believed to result in a prognosis of a psychological state of severe anxiety. Therefore, methods for dealing with postoperative pain and giving patients a prognosis that is as precise as possible are thought to be necessary. These measures are thought to be factors in relieving postoperative pain and preventing it from becoming chronic.

著者

小嶺 俊 松崎 昭夫 城戸 正喜 中村 宏 花田 弘文

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.830-833, 1997-09-25 (Released:2010-02-25)

参考文献数

10

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Two patients with compression neuropathy of the superficial radial nerve are presented.Case 1: A 71 year-old female visited our clinic in November, 1995 with a one month history of pain in the dorsum of both hands.Clinical examination revealed paresthsia on the radial half of the dorsum of her hand and tenderness on dorsal area of the distal forearm, where the superficial radial nerve pierced the deep fascia of the forearm. The patient was operated on after failure of conservative treatment for Cheiralgia Paresthetica.At exploration a membranous tissue traversing over the nerve was seen and incised, and a shallow indentation was seen on the nerve under the membrane.After the operation her pain disappeared and has not recurred.Case 2: A 38 year-old male presented in 1991 with dysesthesia on the dorsum of his right hand and a tumor on the dorsum of his right forearm.He also reported pain on the dorsal side of his right hand. Three years later he recognized a small tumor on the dorsal side of his right distal forearm and dysesthesia on the dorsum of his right hand. Examination revealed sensory loss limited to the area supplied by the superficial radial radial nerve and a tumor on the dorsal side of his right forearm.Partial resection of the tumor and neurolysis was carried out, under the diagnosis of a compression neuropathy of the superficial radial nerve due to a forearm tumor.The pathological diagnosis was a nalignant fibrous histiocytoma.The patient's pain disappeared after the operation but recurred one month later. The patient died four months later due to lung metastasis.

著者

平川 善之 野原 英樹 北條 琢也 蓮尾 幸太 山崎 登志也 原 道也 花田 弘文 渡辺 誠士

出版者

公益社団法人 日本理学療法士協会

雑誌

理学療法学Supplement Vol.32 Suppl. No.2 (第40回日本理学療法学術大会 抄録集)

巻号頁・発行日

pp.C0331, 2005 (Released:2005-04-27)

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【目的】反張膝はスポーツ障害・外傷に結びつくマルアライメントの一つである。臨床上、反張膝が原因と思われる半月板・靭帯損傷や、膝を徒手的に強制過伸展させることで再現できる膝蓋下や膝窩の疼痛を経験する。しかしこの疼痛を説明できる反張膝の過伸展域での運動動態を現したものはみられない。そこで今回健常者を対象に、膝過伸展角度を測定後、X線透視下にて膝伸展0°位(以下0°位)及び最大努力伸展位(以下HE位)の2条件の膝関節肢位で形態的特長を分析し、興味ある知見が得られたので報告する。【対象】下肢に疾患を有しない健常者19名(男性10名女性9名)36肢、平均年齢25.4±4.2歳である。【方法】a、膝過伸展角度の測定:被検者全員を立位にて、膝を最大過伸展させ、大転子・膝関節中央・外果を結んだ線を計測した。伸展角度15°以上を重度過伸展群(以下A群)、5°以上15°未満を中度過伸展群(以下B群)、5°以下を非過伸展群(以下C群)に分類した。b、X線透視:X線透視は全被験者に本研究の十分な説明を行い、同意を得た上で行った。東芝製透視装置(KXO-15C)を使用し、被験者は座位で矢状面より透視下にて大腿骨が真側面となるよう調節し、0°位とHE位の2肢位を3秒間静止させ録画した。録画した映像を画面上でトレースし以下の項目を測定した。脛骨関節面傾斜角(以下TJA):中点法により求めた大腿骨長軸と脛骨関節面のなす角とし、膝の前方で大腿骨側を計測した。脛骨前方変位量(以下TAD):大腿骨長軸と平行に大腿骨外・内顆と脛骨外・内顆に接する線を作図しその距離を測定し、大腿顆部最大前後径で除して標準化した。これらの形態的数値を基に0°位、HE位で、各群間を比較することにより、過伸展域での運動学的特性を分析した。統計処理は分散分析(有意水準5%未満)および多重比較(有意水準1%未満)を用いた。【結果】1:被検者の内訳はA群5名、B群6名、C群8名であり、平均膝過伸展角度は7.5°(±4.5°)であった。2:TJAは被験者の群間および膝関節肢位の両方の主効果が有意であった。HE位においてA群はC群よりも有意に大きかった。3:TADは群間の主効果に有意差はなかった。【考察】結果2、3より、0°位では膝過伸展角度の程度に関らず、各群間で形態的な特徴はみられないが、HE位ではA群はC群と比べ、脛骨前方変位に差はなく脛骨関節面の傾斜が大きくなることがわかった。このことはC群に比べてA群では、0°位から過伸展する際に、いわゆる「滑りと転がり運動」のうち、「滑り」に差はないが「転がり」が強いと考察された。これにより膝前方では脛骨関節前面と大腿骨関節面が衝突し、ここが支点となって後方では大腿・脛骨間距離が開大し、関節構成体の緊張の増大が起こることが推測される。このため強制過伸展により膝蓋下や膝後面に疼痛を生じさせる機序が考えられた。