著者

足達 裕 松崎 昭夫 城戸 正喜 入江 豊 松永 和剛 広田 修

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.43, no.1, pp.344-349, 1994-03-25 (Released:2010-02-25)

参考文献数

11

---

We report three cases of femoral nerve paresis. Case 1 was a 25-year-old male, who was admitted to hospital complainning of left thigh pain. On examination he had tenderness in his left inguinal area. Neurological examination revealed a weakess of the quadriceps on the left, and diminished sensation on the anteromedial aspect of his left lower extremity. The mechanism of injury was not clear in this case. Case 2, a 56-year-old male had progressive muscle weakness and numbness in the right lower extremity. He had received cobalt radiation therapy 16 years previously. Clinical examination revealed a firm hypertrophic scar with tenderness in the right inguinal area, and neurological examination showed quadriceps weakness and sensory disturbance of the anteromedial surface of the right thigh nd leg. Case 3, an 18-year-old male complained of gait disturbance and sever pain around theleft inguinal area and numbness over the left thigh. “The patient was a hemophiliac who had been unde the care of a pediatrician”.Neurolysis was performed in two cases, and the other patient was treated with bed rest and replacement therapy. In all cases, symptoms improved after treatment.

著者

翁長 正道 仲宗根 哲 石原 昌人 平良 啓之 比嘉 浩太郎 上原 史成 当真 孝 東 千夏 西田 康太郎

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.70, no.1, pp.38-41, 2021

---

<p>【症例】54歳女性.ステロイド関連の両大腿骨頭壊死症に対し前方アプローチで左人工股関節全置換術(THA)を行った.自宅退院後2日目,自宅のトイレに座っている際に左股関節痛が出現し,歩行不能となり救急外来を受診した.単純X線像で前方脱臼を認め,全身麻酔下に整復した.整復後3日目に院内のトイレで再脱臼し,再整復を行った.座位の骨盤側面単純X線像で深く座ると骨盤は23°後傾,浅く座ると骨盤はさらに39°後傾していた.再整復後は股関節可動制限装具を装着し,脱臼なく経過している.【考察】THA後に座位姿勢で前方に脱臼することは稀である.しかし,立位から座位で骨盤の後傾が大きくなる症例では,座位でカップの前方開角が増大し,前方脱臼のリスクがある.本症例は座位姿勢で骨盤が後傾し,カップの前方開角増大のため前方脱臼したと考えられた.</p>

著者

水田 康平 比嘉 浩太郎 西田 康太郎 高江洲 美香 宮田 佳英 仲宗根 哲 石原 昌人 翁長 正道 平良 啓之 東 千夏 上原 史成

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.70, no.1, pp.54-57, 2021

---

<p>51歳男性.6年前に自己免疫性下垂体炎でステロイドパルス治療を受けた.その後,ステロイド補充療法をしていた.3年前に両股関節痛が出現し,MRIで両側大腿骨頭壊死症と診断し,人工股関節置換術を予定した.3週間前より間欠的に発熱を認め,両股関節痛が増悪し,近医より当院紹介され,精査目的に入院した.採血ではCRPは10.3mg/dlと炎症反応が高値であった.CTで股関節に液貯留を認め,化膿性股関節炎が疑われた.股関節穿刺で細菌培養が陰性であり,内科にてステロイド減量中であったため,副腎不全が疑われ,ステロイド内服増量を行った.その後,発熱や炎症反応は改善した.ステロイド内服を継続し,5か月後に人工股関節置換術を行った,術後半年,発熱や人工関節の緩みなく,独歩可能で仕事にも復帰し経過良好である,本症例では,発熱や炎症反応高値,股関節痛,関節液貯留を認め,化膿性股関節炎との鑑別に股関節穿刺が有用であった.</p>

著者

水田 康平 高江洲 美香 宮田 佳英 仲宗根 哲 西田 康太郎

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.70, no.1, pp.131-136, 2021

---

<p>83歳女性.5年前に左大腿骨転子部骨折に対してGamma Nail^Ⓡを用いた骨接合術を行った.今回,自宅で転倒し,ネイル遠位で大腿骨骨幹部骨折を受傷した.大腿骨は高度の弯曲を認め,ロングネイルの挿入が困難であった.手術は,既存ネイルを抜去し,骨折部の外側を楔状に切除し,矯正骨切りを併用した髄内釘による骨接合術を行い,骨折部に切除骨を移植した.術後はLIPUSとPTH製剤を併用し,術後3週後より部分荷重を行った.術後3か月で骨癒合が得られ,疼痛無く杖歩行が可能となった.高齢者の大腿骨骨幹部骨折において,高度な弯曲を有する症例があり,その場合ネイル先端での皮質骨穿破の危険があるためインプラント選択に難渋する.今回,高度弯曲を有する大腿骨骨幹部骨折に対して矯正骨切りを併用した髄内釘固定術を行い,経過は良好であり,有用な方法と思われた.</p>

著者

橋本 雄太 西田 康太郎 石原 昌人 仲宗根 哲 翁長 正道 平良 啓之 東 千夏 当真 孝 上原 史成 比嘉 浩太郎

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.70, no.1, pp.30-33, 2021

---

<p>31歳女性.コラーゲンタイプ2異常症による骨系統疾患あり.5年前より股関節痛認め,3年前に歩行困難となり,他院より紹介された.身長124cm,34kgと低身長で著明な可動域制限を認めた.単純レントゲンでは,両股関節とも関節裂隙は消失していた.CTでは,寛骨臼の低形成および大腿骨は短く,髄腔は扁平化していた.変形性股関節症の診断で右人工股関節置換術(THA)を行った.手術は側臥位後方アプローチで行った.Zimmer trabecular metal cup 38mmにオフセットライナーを用いて28mm骨頭を使用した.大腿骨はWagnar coneステムを用いた.術翌日よりリハビリテーションで歩行訓練を行った.術後1週目にステムの沈下を認めたが,進行はなかった.術後半年で左THAを行った.現在,術後2年経過し,カップやステムの緩みなく経過良好である.骨系統疾患に対するセメントレスTHAの際には,適切なインプラント選択には注意が必要であると思われた.</p>

著者

山城 正一郎 金城 政樹 金城 忠克 仲宗根 素子 大久保 宏貴 西田 康太郎

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.70, no.1, pp.111-114, 2021

---

<p>【はじめに】母指ボタンホール変形は,関節リウマチ(RA),外傷などに起因することが多い.両側長母指伸筋(EPL)腱,短母指伸筋(EPB)腱の脱臼から生じた特発例を報告する.【症例】59歳女性,主婦.誘因なく10年前より両母指変形を自覚し,徐々に進行した.1年前から両母指MP関節の自動伸展が困難となった.外傷歴なく,RA検査は陰性であった.両母指MP関節屈曲時にEPL腱とEPB腱が尺側へ脱臼し,左側はMP関節屈曲位からの自動伸展は不可で,左母指からwide awake surgeryで行った.関節包を縫縮して亜脱臼を整復.EPB腱を停止部で切離し,術中MP関節伸展0°屈曲45°が可能な緊張で再縫着,EPL腱と側々縫合し橈側伸筋腱帽を縫縮した.術後MP関節鋼線・ギプス固定後,術後5週で自動運動,8週から他動運動開始した.9か月後に右側の手術を行った.左側術後3年,右側術後2年3か月で両側MP関節自動伸展可能であり,変形の再発は認めていない.</p>

著者

北川 守 朝長 圀夫 江川 正 中村 泰 後藤 正治 三原 茂

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.38, no.2, pp.652-656, 1989-10-25 (Released:2010-02-25)

参考文献数

5

---

A comparative study was conducted on the 20 knees of 10 females with normal knee joints (age, 22-35 years) and on 7 knees of 7 patients with subluxation syndrome (age, 15-24 years), using axial radiography and CT. In axial radiography where the angle of knee flexion was 30° or 60°, no significant difference was recognized between the two groups with respect to tilting angle, patellofemoral angle, congruence angle and lateral shift. However, a significant difference was found using CT. Thus, CT was considered useful for diagnosis. Because of these results, all 7 cases underwent surgery for detachment of the lateral side and tightening of the medial side. Three cases underwent shifting of the tibial tuberosity to the anteromedial side, resulting in a favourable outcome. Here, we report the study.

著者

會田 勝広 森本 忠嗣 西田 圭介 前田 和政 佛淵 孝夫

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.53, no.4, pp.846-853, 2004 (Released:2005-06-10)

参考文献数

11

被引用文献数

1 1

---

In the present study, changing in pelvic inclination before total hip arthroplasty (THA) were investigated using 59 patients with osteoarthritis of the hip. The subjects were divided into following four groups by their age: Group A consisted of 21 patients between 45 and 54 years, Group B 10 patients between 55 and 64, Group C 18 patients between 65 and 74, and Group D 10 patients at 75 years or older. Pelvic inclination became retroverted with age, further retroverting at the standing position especially in elderly people. When performing THA on patients with severe pelvic retroversion, alignments of the lumber spine, pelvis, and hip should be carefully considered. Insertion of acetabular socket should be considered in some cases taking into account standing position or pelvic inclination in future. In elderly people with lumbar degenerative kyphosis and severe pelvic retroversion, it was important to insert the acetabular socket in prospect of future changes of the pelvis inclination since the pelvis retroverts according to posture and age.

著者

二見 俊郎 前之園 多幸 塚本 行男

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.40, no.3, pp.1229-1232, 1992-03-25 (Released:2010-02-25)

参考文献数

8

---

著者らは, 過去7年間に大腿外側皮神経障害 (meralgia paresthetica) の13例 (男性3例, 女性10例) を経験した. いずれの症例も Tinel 徴候や電気生理学的所見などから, 鼠径靱帯部での絞的性神経障害と考えられた. 我々の症例で特徴的なことは, 発症原因として下着の締め過ぎによると思われた症例を6例にみたことであった. 治療として, まず全例に保存的療法が試みられ, 6例に症状の改善が得られた. 改善が得られた症例は, 症例12を除きいずれも発症後8ヵ月以内に来院した症例であった. 保存的療法に抵抗した7例中4例に対して神経剥離術が施行され, いずれの症例も鼠径靱帯周囲部での種々の原因による神経の圧迫所見を確認し, 術後症状の改善を得た. 以上のことから, 下着の締めすぎを発症誘因の一つとして認識すべきであり, また罹病期間が短い症例には保存療法が有効であるが長期間の覆病期間を有する症例に対しては, 手術的療法を考慮すべきと思われた.

著者

清水 泰宏 中野 哲雄 阿部 靖之 越智 龍弥 中馬 東彦

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.587-590, 1997-09-25 (Released:2010-02-25)

参考文献数

6

被引用文献数

1

---

We describe the results of conservative treatment using a Kyuro knee brace in 12 cases (6 males and 6 females, ranging in age from 6 to 64 years) who had fresh tears of their cruciate ligament. The treatment consisted of eary continuous passive knee motion with protective bracing for three months. The mean follow-up period after injury was 5 months. M R imaging at follow-up revealed two different modes of conjoining. Seven cases with ACL tears had successful results at 6 months. However one case with on ACL tear and plateau fracture did not achieve such successful results. Two cases with avulsion fractures of the PCL had successful results at 3 months. We believe that conservative treatment is effective for treating fresh tears of the cruciate ligament.

著者

嘉悦 博 清水 正章 板倉 和資 山上 剛

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.27, no.3, pp.317-320, 1978 (Released:2010-02-25)

参考文献数

5

---

To know some problem after meniscectomy, we undertake long-term study. There were 13 male and 6 female, age range at operation was from 10 to 49 years. The range of post-operative follow-up was from 10 to 15 years and average was 12.7 years.1) Thirteen patients had excellent or good results. Five patients undergone discoid meniscectomy in their youth had all good results.2) Roentogenographic changes noted in all cases, but no related with clinical results.3) Severe OA changes was seen in 10 patients. (53%)4) Degree of ligamentous instability was related with OA changes.5) Two patients of poor result was seen retained posterior horn.

著者

花村 達夫 吉浦 光三 高岸 直人 松崎 昭夫

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.33, no.4, pp.1080-1084, 1985-03-25 (Released:2010-02-25)

参考文献数

8

---

We reviewed twenty-three cases of carpal navicular fracture visited our clinic in the past ten years. The length of follow up were one to seven years, with an average of fourty-five months. Prognosis of proximal part fractures were the worst (one fair and one poor) in comparison to that of middle and distal part. Eight cases, all of which were the symptomatic delayed union or non-union, were operated by the bone graft with or without the styloidectomy. The results of operated cases were four good, three fair and one poor. On the other hand, nontreated cases were all evaluated as good and excellent, but most of them had little symptoms when they visited our clinic. The characteristics of their roentogenograms were the absence of bone absorption at the fracture site and the stability in stress roentogenograms. Although many authors refered the carpal osteoarthritis following unstable non-union of the navicula, the result in this series may suggest that surgeons must be prudent in treatment of asymptomatic and stable non-union.

著者

加来 信広 中村 道利 高下 光弘 八塚 知二 松元 雅彦 真角 昭吾 宮原 正樹 中山 巌 駄阿 勉 横山 繁生

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.42, no.4, pp.1568-1572, 1993-09-25 (Released:2010-02-25)

参考文献数

6

---

Two cases of sacrococcygeal chordoma, were surgically treated in our hospital. One case was discovered after investigation of an episode of bruising on the hip, and the other case was diagnosed two years after the excision of rectal cancer that had no specific histological features.Both cases had partial destruction of sacral bone in the lateral plain X-ray film of the pelvis and a defined mass anterior to the lower sacrum was seen on MRI. We performed complete excision of tumor using the posterior approach and retained the unilateral S3 nerve. Postoperatively there was no neurological disturbance except the symptom of slight residual urine.

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

松本 英彦 井原 秀俊 川嶌 眞人 田村 裕昭

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.52, no.4, pp.925-932, 2003 (Released:2005-02-18)

参考文献数

12

---

Twelve cases of acute injury of the lateral collateral ligament of the ankle were treated conservatively by early mobilization. Weight bearing was allowed as soon as possible. Active exercise and dynamic joint control training were initiated at least by day 5. The mean talar tilt angle and anterior drawer distance showed significant improvement from 9.1° to 1.3° (p<0.001) and 3.5 mm to —0.3 mm (p<0.001) respectively. All cases completely returned to the competitive game level. This early mobilization prevented evils of using plaster. Early mobilization and weight bearing are considered as the method of first choice and provided recovery in range of motion of ankle mobility.

著者

今釜 哲男 服部 奨 小山 正信 河合 伸也 東 良輝 繁冨 頼雄 小田 裕胤 井之川 義典 多原 哲治

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.27, no.4, pp.559-563, 1978-12-25 (Released:2010-02-25)

参考文献数

16

被引用文献数

1

---

Vascular tests for thoracic outlet syndrome are considered to be one of the important diagnostic aid in order to determine the localization and the severity of neurovascular lesion at the thoracic outlet region. However, the mechanism and significance of vascular tests are still unclear.This is to report our clinical and autopsial study to try to clarify the exact meanings of each vascular test.Materials are 72 cases in 48 patients with thoracic outlet syndrome (46 cases in 39 patients recieved first rib resection) and 21 cases of exploration in autopsy.Positive Adson's test, although the incidence is quite low, may suggest severe lesion at the scalen triangle. Eden's test indicate lesions at the costo-clavicular space. In this positive the clavicle moves most to the posteromedial direction among the various positions. Abduction-external rotation test and Wright's test show neurovascular compression mainly at the costo-clavicular region and partly at the scalen triangle. These positions make the neurovascular bundle tracted foward the lateral. Compression at the subcoracoideal region is not the main cause in Wright's test.

著者

米満 弘之 平良 誠 中根 惟武 陣内 卓雄 林 茂

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.25, no.3, pp.338-341, 1976-11-25 (Released:2010-02-25)

参考文献数

15

---

Recently, we think thoracic outlet syndrome so noteworthy on it's diagnosis and treatment. In the past five years, there have been 30 cases of thoracic outlet syndrome in own clinic.We have some problems on the diagnosis of thoracic outlet syndrome, for example, the objective finding, the compression test of the brachial plexus and subclavian vessels and angiography.We report our cases and describe these problems.

著者

葉 山泉 諌山 照刀 吉武 研三 緒方 公介

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.42, no.3, pp.1313-1317, 1993-09-25 (Released:2010-02-25)

参考文献数

12

---

Most investigators believe that fibrous cortical defects and nonossifying fibromas are simply different radiographic manifestations of the same disease process. Fibrous cortical defects are small, asymptomatic, and intracortical lesions, while a nonossifying fibroma is a large, tumorous lesion involving spongy bone and the medullary cavity of bone, and leads to clinical symptoms.A fibrous cortical defect does not require either biopsy or curettage. Asymptomatic nonossifying fibromas require no treatment, but rare symptomatic forms of the disease, and those which are great enough in size to constitute a danger of fracture, should be submitted for curettage and bone grafting.

著者

松永 和剛 松崎 昭夫 宮内 亮輔

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.845-849, 2000-09-25 (Released:2010-07-01)

参考文献数

8

被引用文献数

1 2

---

The authors dissected 72 paired arm to study the anatomy of Gantzer's muscle. The dissection explored course of the median nerve from the elbow to the distal end of the forearm. The following anatomical structures and variations were noted;(1) The presence of a Gantzer's muscle, as well as its relationship to the median and anteriorinterosseous nerves.(2) The origin and insertion of Gantzer's muscle.Results: Gantzer's muscle arose from the medial epicondyle of the humerus in 45 arms (90%), from the coronoid process of the ulna in 3 arms (6%), from the intermuscular fascia in 1 arm (2%), and from a double origin- the medial epicondyle and the coronoid presess-in 1 arm (2%). Insertion was to the proximal part of the tendon of the flexor pollicis longus muscle in all arms.Gantzer's muscle always lies posterior to the median nerve. In 12 out of 50 arms, the muscle passed posterior to the anterior interosseous nerve, and in the remaining 38 arms, the anterior interosseous nerve ran proximal to the muscle along its proximal border and never cross Gantzer's muscle and its tendon.Based on these findings, the authors concluded that Gentzer's muscle rarely contributes to anterior interosseous nerve compression in the proximal forearm.

著者

橋川 健 伊藤 信之 衛藤 正雄 角 光宏 山本 尚幸 岩崎 勝郎

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.44, no.1, pp.314-317, 1995-03-25 (Released:2010-02-25)

参考文献数

8

---

We report on 57 cases of lateral condylar fractures of the humerus in children which were followed-up. Subjects comprised 40 boys and 17 girls with a mean age at injury of 6 years (range, 2-12 years). The follow-up period ranged from 9 months to 17 years with a mean of 7 years and 11 months. We studied the relationship between the carrying angle (C. A.), the range of motion (R. O. M.) of the elbows and the deformity of the lateral and medial condyles of the humerus after treatment. C. A. correlated with the length of the lateral and medial condyle. Limitation of flexion and extention of the elbow correlated with the length of the medial condyle. Varus or valgus deformities and limitation in the R. O. M. of the elbow after fracture of the lateral condyle of the humerus are relevant not only to the growth of the lateral condyle but also to that of the medial condyle.