著者
鬼木 泰成 藤原 怜 宮園 大地 大橋 浩太郎 山隈 維昭 髙木 克公 知花 尚徳 水野 秀夫 鬼木 泰博
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.66, no.2, pp.222-226, 2017-03-25 (Released:2017-05-01)
参考文献数
9

スポーツ外傷の中でも足底筋膜断裂は極めて稀である.今回我々は女子バスケットボール選手に発生した足底筋膜断裂の1例を経験したので報告する.34歳女性,主訴は右足底部痛と歩行困難である.学生時代より県内トップクラスの選手であり,現在も競技生活を継続している.平成27年11月,バスケットボールのストップ動作にて右足底部に激痛とポップ音を自覚し,当院スポーツ外来を受診した.右足底,踵骨足底筋膜付着部を中心に,腫脹,圧痛,皮下出血を認めた.MRIで足底筋周囲,付着部,heelpad内へ広がる高信号域が確認され,連続性の途絶を認めた.2週間のシーネ固定と足部トレーニング,体幹下肢機能改善訓練を実施した.受傷後4週で若干の圧痛は残存するものの,歩行可能となった.受傷後8週でジョギングが可能となり,12週でバスケットボールへ復帰した.本症例は保存療法が奏功し,比較的早期復帰が可能であった.
著者
山鹿 眞紀夫 高木 克公 森沢 佳三 井手 淳二 生田 拓也 北川 敏夫 鬼木 泰博 山隈 維昭
出版者
日本肩関節学会
雑誌
肩関節 (ISSN:09104461)
巻号頁・発行日
vol.12, no.2, pp.129-133, 1988-08-10 (Released:2012-11-20)
参考文献数
6

Neurovascular compression in the thoracic outlet produces great variation of signs and symptoms. The clinical picture is often complex, being made up of the derangement of blood vessels, somatic nerves and autonomic nervous networks in varying degrees. Thirty-eight of the 150 patients (25%) treated in our clinic because of possible thoracic outlet syndrome (TOS), complained of general malaise such as headache, dizziness, sleeplessness, nausea, anorexia or general fatigue, in addition to their peculiar signs and symptoms due to brachial plexus involvement.In order to find out whether or not autonomic nerve dysfunction can be demonstrated in patients with TOS, a non-invasive and quantitative technique was developed for assessing the mean (M) and coefficient of variations (CV) of R-R intervals in ECG at resting position. Thirty patients (13-39; mean 29.5 y/o) were put into two groups of 15 patient s each. In the first group patients with autonomic nerve disorder had complaints of general discomfort, M was 803.72 ± 106.9 msec and CV was 3.214±0.717%. In the second group, those without general discomfort, M was 972.21 ± 120.64 msec and CV was 5.926±0.720%. The first group had a significantly shorter M (P < 0.001) and smaller CV (P < 0.001) compared to the second group. Furthermore, in two cases in the first group diagnosed by psychologists as having schizophrenia and anxiety neurosis, it was found that their M and CV were the nearly same as those in the second group.Decompressive ope r a tions were performed on five patients in the first group. Their complaints decreased or vanished after the operation and the M and CV progressed to near the normal rate.From these results, we belive that this method in useful in differentiating between autonomic nervous disorders and psychological disorders; and that in patients with TOS, a decompressive operation can help eliminate complaints of general discomfort due to autonomic nervous disorders.