著者

前田 和政 古市 格 村田 雅和 宮田 倫明 穂積 晃 久芳 昭一 松村 陽介

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.59, no.4, pp.869-871, 2010-09-25 (Released:2010-12-08)

参考文献数

5

被引用文献数

2 1 1

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Crowned dens syndrome(CDS)は急性に発症する重度の頚部痛と頚椎可動域制限を呈し,CT上歯突起周囲の石灰化が認められる症候群である.その病因は,歯突起周囲の結晶沈着といわれている.高齢女性に多いといわれているが,比較的若年者にも発症していた.CDSの2症例を経験したので,報告する.症例1.68歳女性.特に誘因なく,頚部の違和感が出現.後頭部部痛と頚部硬直が出現するも自宅で安静にしていた.数日後近医受診し,くも膜下出血疑いで当院脳神経外科に紹介されるも診断がつかず,当科紹介.CTで歯突起周囲の石灰化を認め,CDSと診断した.症例2.38歳女性.2,3日前からの頚部違和感あり.後頭部痛と頚椎可動域制限出現し当科受診.CT上歯突起周囲に石灰化を認め,CDSと診断した.両症例に対して内服治療を行い,1週間以内に疼痛は軽快した.

著者

有薗 剛 川村 秀哉 本田 勝定 本松 伸一 杉岡 洋一 緒方 公介

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.41, no.2, pp.774-778, 1992-11-25 (Released:2010-02-25)

参考文献数

10

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We studied 130 knees in 91 patients to determine the problems in fibula osteotomy sites following high tibial osteotomy. Fibula nonunion was seen radiologically in 20% of knees. The occurrence of nonunion was related to the length of the osteotomy site interval. Nonunion especially occurred with high frequency when the length was greater than 9mm. Nonunion could be divided into the hypertrophic and atrophic type. Gait pain around the fibula osteotomy site was frequently observed in patients who had hypertrophic nonunion.We have introduced a new fibula interlocking osteotomy which provides wide contact between the osteotomy sites to prevent occurrence of nonunion and fibula osteotomy site pain.

著者

舟橋 敦 伊地知 正光 粟国 順二 富田 祐司 猪飼 隆 後藤 正隆

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.42, no.1, pp.244-245, 1993-03-25 (Released:2010-02-25)

参考文献数

4

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A 48-year-old man presented with pain and a clicking noise in his right sternoclavicular joint for three years following a traffic accident. The ROM of his shoulder was limited by pain. We treated him surgically with resection of the lateral claviclular end and cut the coracoclavicular ligament. Fortunately, surgery was effective with improvement in the patients complaints.

著者

上原 敏則 平 宏章 粟国 敦男

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.44, no.4, pp.1420-1429, 1995-09-25 (Released:2010-02-25)

参考文献数

21

被引用文献数

1 1

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Osteopetrosis associated with renal tubular acidosis and cerebral calcification was established as an autosomal recessive inheritant syndrome, caused by a deficiency of carbonic anhydrase II (CA II) in 1983. Only 3 cases have been reported in Japan.We describe a family with this syndrome. Proband is a 31 year old female, who presented with pathological fracture of the femoral, tibial and fibullar shafts, renal tubular acidosis and cerebral calcification. She was treated with intramedullary nailing and long leg cast followed by PTB brace. Bone biopsy was done from the iliac wing. Pathology showed irregular thickening of trabecular bone and unresorbed persistent calcified cartilage. Only a few osteoclast and fibroblast cells were found, suggesting poor bone remodeling.Her two sisters are short and the elder one is affected with mild mental retardation. Both have osteopetrosis, renal tubular acidosis, cerebral calcification, and a history of long bone fracture. Her parents are not affected and not consanguineous. CA II activity was measured from erythrocyte hemolysates in all of the family. CA II activities from the mother, father, and three sisters were 57%, 40%, 13%, 15%, and 18% each, compared to the normal control. We consider these three sisters are homozygotes of CA II deficency and their parents heterozygotes.

著者

今釜 崇 田中 浩 徳重 厚典 伊達 亮 田口 敏彦

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.61, no.2, pp.204-207, 2012-03-25 (Released:2012-06-26)

参考文献数

11

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関節リウマチに対しインフリキシマブ(IFX)投与により臨床的寛解が得られ,投与を中止した症例の経過,特徴を検討した.IFX投与を行った93例中,DAS28の基準で寛解が6カ月以上維持され,患者の同意を得てIFX投与を中止し,1年以上経過観察を行った6例を対象とした.Bio free remissionを1年以上維持できた症例は3例で,3年以上の長期寛解例2例はいずれもSteinbrocker stage II,罹病期間も比較的短い症例で,IFX投与1回目から寛解を獲得していた.またIFX中止前に,Booleanの寛解基準を6カ月以上満たしていたものもこの2例のみであった.長期にBio free remisionを継続する要因として,発症早期で,骨破壊の進行がなく,DASよりも厳格なBooleanの寛解基準を満たすIFXの著効例であることが示唆された.

著者

浅尾 恒徳 上田 恵亮 村尾 哲 帖佐 博文

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.43, no.2, pp.712-715, 1994-03-25 (Released:2010-02-25)

参考文献数

4

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We heve treated 4 cases with pyogenic cervical spondylitis associated with paralysis over the last 5 years. Three males and 1 female were treated, ranging in age from 56 to 74 years. Anterior spinal fusion was carried out in 2 cases, and anterior and posterior spinal fusion were concomitantly used in 2 cases. Magnetic resonance imaging (MRI) was very useful in deciding on the surgical technique because it clearly showed the range of destruction of the vertebral body, degree of oppression of dural duct and range of extension of inflammation. Early favorable prognosis was obtained in 2 cases which had anterior spinal fusion of 3 intravertebral spaces plus the combined use of posterior spinal fusion. Kyphosis was not observed, and favorable osteorrhaphy was obtained.

著者

二宮 直俊 古庄 耕史 原 紘一

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.61, no.1, pp.36-40, 2012-03-25 (Released:2012-06-26)

参考文献数

6

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今回我々は,当科において加療した大腿骨転子下骨折の症例について報告する.【症例1】20歳,男性.高所より転落し受傷した.右大腿骨転子下骨折の診断で,髄内釘による骨接合術を施行した.術後29週で骨癒合を認めた.【症例2】53歳,男性.交通事故で受傷した.右大腿骨転子下骨折の診断で,髄内釘による骨接合術を施行した.術後,骨癒合が遷延し,2年経過後,骨癒合を認めた.【症例3】60歳,女性.交通事故で受傷した.寛骨臼骨折,左大腿骨転子下骨幹部骨折の診断で,ロッキングプレートによる骨接合術を施行した.術後27週で骨癒合を認めた.【考察】大腿骨転子下骨折の治療は,髄内釘固定法,プレート法に大別されるが,骨癒合を得るためには両者とも良好なアライメントの獲得が重要である.

著者

日野 瑛太 森口 昇 杉谷 勇二 井上 博文 山田 健治

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.62, no.4, pp.707-709, 2013-09-25 (Released:2013-11-26)

参考文献数

6

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Crowned Dens Syndromeとは,1985年にBouvetらによって報告された,急性の後頸部痛をきたす軸椎歯突起周囲の結晶誘発性関節炎である.今回,我々はCrowned Dens Syndromeの3症例を経験したので報告する.症例は男性1例,女性2例で,いずれも70代で急性発症の頸部回旋時痛で発症した.うち2例はCRPの上昇が見られ,3例とも軸椎歯突起周囲の石灰化像は単純X線像では見出せなかったが,単純CT像で確認することができた.いずれもNSAIDsで数日以内に症状は改善した.高齢者の,急性に発症する強い頸部痛の原因としてCrowned Dens Syndromeを念頭に置く必要がある.

著者

金井 成行 谷口 典正 川本 正純 遠藤 宏

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.50, no.1, pp.241-244, 2001-03-25 (Released:2010-02-25)

参考文献数

6

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A pathohysiological study of frozen shoulders was carried out by assessing thermography and deep body thermometry results together with the patients' subjective and objective symptoms. Active and dummy magnets were randomly assigned to patients (18 males and 20 females) in a double-blind study. All patients were magnets for three weeks, and subjective and objective symptoms were observed to be improved significantly 1 week after the application of the active magnets. The skin and deep body temperatures in the painful portion significantly increased with exposure to the active magnets at 2 weeks and 3 weeks after the application.These findings suggest that the static magnetic fields might gradually increase blood circulation.

著者

緒方 博司 林 泰夫 上村 光治 泉 清治 外園 不二夫 小糸 博文 伊達 徹 田中 宏明 高木 茂

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.39, no.3, pp.1197-1202, 1991-03-25 (Released:2010-02-25)

参考文献数

8

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Since 1984, we have performed osteosynthesis for intertrochanteric fracture of the femur using CHS method.79 Compression Hip Screws and 12 Captured Hip Screws were used for 46 stable and 45 unstable intertrochanteric fractures of the femur.The mean age was 77.9, ranging from 61 to 96 years.Among 91 patients, 8 patients could not walk even before the injury. 62 patients out of the remaining 83 patients (74.7%) were discharged with one cane gait.The major symptoms of 62 patients who could walk postoperatively were knee pain (25.8%) and thigh pain (9.7%).The major radiographic findings of those 62 patients were shortening of the neck more than 5mm (25.8%). But the shortening of the neck and the knee pain don't seem to correlate to each other.21 patients out of 83 patients (25.3%) were not able to walk on one cane. But systemic complications seemed to be the main causes in more than half of those 21 patients.

著者

坂田 浩章 水田 博志 白石 稔 北川 敏夫 大島 隆志

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.36, no.2, pp.347-349, 1987-10-25 (Released:2010-02-25)

参考文献数

7

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Traumatic myositis ossificans is well known to occur in the muscle hematoma as a result of a contusion or a strain.An 18-year-old male of traumatic myosits ossificans after contusion on his right anterior thigh while playing rugby football was reported. Five and seven days after the first injury he played rugby football and reinjured the same area. Three weeks after the reinjury he had increased anterior thigh pain and limited motion of the knee. When examined, the right quardriceps was tender and swollen in the antero-mid thigh. Flexion of the knee was about 80 degrees due to pain. Roentgenograms showed linear and cloudy calcification in the quardriceps muscle. His knee was immobilized, and he was given a non-steroid antiinflamatory agent for two weeks. After pain relief rehabilitation began with exercise to increase the range of motion. Four months after the first injury, the patient had no pain and limitation of knee flexion.Adolescents actively involved in contact sports are at risk for muscle trauma, which can results in myositis ossificans. The development of traumatic myositis ossificans is related to the severity of the quardriceps contusion.Recognition and appropriate therapy can reduce the associate disability.

著者

原 寛徳 田口 厚 伊藤 信之 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.43, no.2, pp.695-697, 1994-03-25 (Released:2010-02-25)

参考文献数

5

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We investigated the mechanism stabilising the glenohumeral joint that prevents anterior dislocation. We measured the strength of the glenoid labrum and capsule in fifteen shoulders of nine fresh cadavers. The glenoid labrum and capsule were cut in widths of 5mm then the glenoid fixed and the labrum and capsule strained. We measured the tension when the labrum detached from the glenoid or the capsule ruptured. Results showed that the anterior-inferior portion is weaker than the other portion.

著者

松元 光生 下野 哲朗 福田 稔朗 前原 東洋 酒匂 崇

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.39, no.2, pp.542-544, 1990-10-25 (Released:2010-02-25)

参考文献数

5

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Ultrasonography of the shoulder joint was investigated in 30 patients who had been suspected rotator cuff tear. In 26 patients, the sonographic fihdings were correlated with arthrography (sensitivity, 86%).The sonographic appearance of the rotator coff tear, be could be classified into three, categories as thinning (15 patients), invisualization (8 patients), and discontinuity (3 patients) of the rotator cuff. Based on these results, ultrasonography is comparable with arthrography for evaluation of the rotator cuff, so we think that ultrasonography can be used as the intial imaging test for the rotator cuff tear.

著者

藤川 勝正

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.27, no.3, pp.343-347, 1978 (Released:2010-02-25)

参考文献数

7

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Mechanism of arm pain syndrome at handwork is as follows.Overwork at handwork (ultimate cause) brings on overstrain of M. levator scapula. Overstrain of M. levator scapula (working cause) brings on subluxation of cervical spine.Subluxation of cervical spine (local cause) brings on overstrain of M. scalenus medius, M. scalenus anterior and etc.For example, overstrain of M. scalenus medius brings on pain and numbness of arm in radial nerve area.Overstrain of M. scalenus (local cause) brings on pain and numbness of arm (result).Analysis on disorder of neck, shoulder and arm was carried out in 103 cases.Enforcement of adjustment of cervical spine was carried out in 68%, including that relation subjunctive symptom and spinal column was obvious.These facts of subluxation of cervical spine were proved by computer tomography.Mechanism of arm pain syndrome in accidental disorder of neck is explained by external force without overstrain of M. levator scapula.

著者

礒部 憲二 服部 奨 早川 宏 森脇 宣允 新田 昭二 河内山 正 小田 裕胤

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.22, no.4, pp.446-449, 1973 (Released:2010-02-25)

参考文献数

11

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We experienced congenital anomalies of the cervical spine among 4961 patients in our clinic.These anomalies were analyzed 77 cases of congenital cervical vertebral fusion (C2-C3: 28, C5-C6: 13, C3-4: 12, Occ-C1: 9 and others), 14 cases of spina bifida occulta, 125 cases of posterior ponticle of atlas, and one case of os odontoideum.Among congenital cervical vertebral fusion 14 cases of myelopathy were observed, of which 4 cases were operated.Congenital fusion of lower cervical vertebrae affected commonly degeneration of adjacent vertebral disc.Congenital fusion of the occiput and the first vertebra is more frequently complicated with basilar impression and atlantoaxial subluxation.

著者

瀬戸嶋 政勝 小林 靖幸 田中 宏明 栗林 善昭 井上 尚美

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.37, no.1, pp.229-233, 1988-10-25 (Released:2010-02-25)

参考文献数

6

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Since ankylosing spondylitis (A. S.) tends to be milder and less progressive in women that in men, there are great difficulties in early diagnosing A. S. in female patients. We report a case of A. S. in a woman. A 22-year-old woman with a 6-year history of A. S. was admitted to our hospital in Mar., 1987. The initial sign was gait disturbance due to severe left hip joint pain. Laboratory findings included an almost normal complete blood count, blood chemistry and urinalysis. The ESR at that time was 51mm/h, CRP was 2 puls, rheumatoid factor was negative and HLA B-27 antigen was detected.The plain roentgenogram revealed a narrowing of the joint space and an ankylosing change in the bilateral hip and sacroiliac joints. Routine X-ray examination of the spine showed an almost normal view. An open biopsy of the hip joint showed histopathologically nonspecific chronic inflammatory findings. A Tc-99m scintigram on Feb. 9, 1982 showed an increased activity area in the bilateral hips and sternoclavicular joints, in the sacroiliac joints especially in the iliac sides, and in a part of the cervical spine. This activity began in the early stage of A. S. However, a plain roentgenogram of these joints at that time showed normal findings.If history, clinical and laboratory findings lead to a suspicion of A. S., and there is little significant change by roentgenographic studies, the whole body scintigraphy is useful for the early diagnosis of A. S. in female patients.

著者

生田 拓也 坂口 満

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.59, no.4, pp.681-683, 2010-09-25 (Released:2010-12-08)

参考文献数

3

被引用文献数

1

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脛骨の変形治癒骨折に対して一期的に矯正骨切り術を施行後,locking plateを用いて内固定を行い良好な結果を得たので報告した.症例は58歳,男性.18歳時に交通事故で右脛腓骨骨折を受傷し,保存的治療を受けた.X線所見にて右膝の内側型変形性関節症を認め,脛骨上中1/3の部位にて約21°の内反変形を認めた.手術はまず腓骨を切骨し脛骨変形中心部にて骨切り,open wedgeにて矯正を行いlocking plateにて内固定を行った.術後6ケ月の現在,骨癒合良好で右膝痛も軽快しておりADLに支障はなく,正座も可能である.変形治癒骨折の矯正骨切術の方法としては従来のプレートによる方法では矯正位の獲得は容易であるがプレートのbendingを細かく行わないとスクリューで骨皮質をプレートに引き寄せる際に矯正位を失う可能性がある.locking plateにて内固定は矯正位の保持が容易であり有用であった.