Explanipedia

Appropriate Use and Efficacy of LCP with MIPO in Distal Femur Fractures Open

Naoyuki Kuga · 2012

MIPOでの骨折整復は，髄内釘固定と同様にimplantに骨を沿わせることで整復を行う間接的整復が原則である．圧迫プレートによるrigid fixationと異なり，LCPによるbridge platingの固定力学はelastic fixationに基づくため，plateは充分長くなければならない．転位が大きな関節内粉砕骨折はMIPOの適応外であるが，離開が軽度であれば，関節内骨片を経皮的screwで一体化した上で遠位骨片にplateを正確に設置して，次にplateを骨幹…

Do Psychogenic Factors Influence the Outcomes of Lumbar Spine Surgery? A Statistical Study of JOABPEQ Assessments Open

Naoyuki Kuga, Hiroshi Hagihara · 2012

腰椎手術例における心理的障害と手術成績の関連を調べるために，JOABPEQでの術前心理的障害の程度と他項目，VASの改善度との相関性，および術後心理的障害改善度と他項目，VAS改善度との相関性を調べた．術後，疼痛関連障害や歩行機能障害は70％以上改善していたが，社会生活障害や心理的障害の改善は50％以下と低かった．術前心理的障害の程度と術後各項目の改善度とは正の相関性はみられなかった．術後心理的障害改善度と腰椎機能障害，歩行機能障害，社会生活障害，腰痛VAS，下肢痛VASそ…

Treatments for Osteoporotic Distal Humerus Fractures Open

Shojiro Ishibashi, Naoyuki Kuga, Hiroshi Hagihara · 2012

高齢者の上腕骨遠位端骨折は難治性であるが,近年,専用implantの開発により治療成績は向上してきた.治療上の問題点を調べるために,当科での治療成績を後ろ向きに調べた.症例は21例,平均年齢80.4才.関節外骨折が13例,関節内単純骨折が3例,関節内粉砕骨折が5例だった.ONI plateを10例,LCPを9例に使用し,関節内粉砕骨折の1例が偽関節となった.術後humeral angle,関節面gap,肘関節可動域の平均はそれぞれ95°,1.6mm,伸展-27°屈曲115°…

Huge Calcifying Tendinitis of Shoulder with Progressing Inferior Subluxation: A Case Report Open

Yasuhiro Mizuki, Mikihito Tamai, Yoshiteru Shida, Masuo Hanada, Naoyuki Kuga , et al. · 2012

肩石灰性腱炎において下方への亜脱臼を認めることがある．我々は巨大な肩石灰性腱炎の保存治療経過中に下方への亜脱臼が進行した一例を経験したので報告する．【症例】58歳女性，美容師．H21年9月より右肩痛が出現した．前医で石灰性腱炎の診断をうけ加療を受けたが，徐々に石灰が増大し亜脱臼をきたしたためH22年4月に紹介初診した．上肢の挙上及び回旋が著明に制限されており，単純X線では骨頭上方の巨大な石灰と骨頭の下方への亜脱臼を認めた．保存療法を行い疼痛や可動域は著しい改善が得られたが，…

Experience of Treatment for Lisfranc Joint Fracture-Dislocation Open

Yoshiteru Shida, Naoyuki Kuga, Yasuhiro Mizuki, Masuo Hanada, Hiroshi Hagihara · 2011

2003～2010年に当科で治療したLisfranc関節脱臼骨折患者11例11足（男性8例，女性3例）について後ろ向き調査を行った．平均年齢43.8歳（18―77歳），骨折型はHardcastle分類でA型0例，B型8例，C型3例，経過観察期間31ケ月（3―80ケ月）であった．受傷原因は直達外力7例・介達外力3例・不明1例で，全例腰椎麻酔下に手術を行った．B型2例は非観血的整復を，B型6例およびC型3例は観血的整復を行い，それぞれK-wireあるいはscrewで内固定した．…

Arthroscopic Surgery for Subacromial Impingement Syndrome with Minimally Displaced Greater Tuberosity Fracture: A Case Report Open

Yasuhiro Mizuki, Mikihito Tamai, Hidehiko Yuge, Yoshiteru Shida, Masuo Hanada , et al. · 2011

【はじめに】上腕骨大結節骨折は転位のわずかな場合には保存療法にて良好な成績が得られる．しかし骨癒合後も疼痛やインピンジメント徴候を呈す症例もある．今回我々は転位のわずかな大結節骨折後にインピンジメント徴候が残存した症例に対し，鏡視下手術を施行し良好な成績を得たので報告する．【症例】67歳女性．H21年7月に転倒し左手をついて受傷した．受傷5日後に当科紹介初診した．転位のわずかな大結節骨折を認めたため保存療法を行った．MRIでは明らかな腱板断裂の所見は認めなかったが，その後も…

The Device of the Operation that Used Wiring Together for Intertrochanteric Fractures and Subtrochanteric Femoral Fractures Open

Hidehiko Yuge, Naoyuki Kuga, Hiroshi Hagihara, Masao Teramoto, Masuo Hanada , et al. · 2010

【目的】大腿骨転子部及び転子下骨折に対する内固定法の発展によりその成績は飛躍的に向上したが，まれにカットアウト等の合併症が出現する．その原因は主に整復不良，ラグスクリュー挿入位置不良である．我々は閉鎖的整復不良な症例に対しては積極的に観血的整復を行っている．整復位を鋼線締結で保持しCHSあるいはγネイルで内固定することで術後内反変形やカットアウトを防ぐことができた症例を報告し，その適応について考察する．【対象と方法】鋼線締結を併用しCHSあるいはγネイルを行った大腿骨転子部…

Clinical Results of Volar Locking Plate Fixation for Distal Radius Fractures Open

Masao Teramoto, Hiroshi Hagihara, Naoyuki Kuga, Masuo Hanada, Tomoaki Tanaka , et al. · 2009

【目的】掌側遠位端骨折に対する手術療法で掌側ロッキングプレートが近年用いられるようになってきおり，今回当科における治療成績を検討した．【対象と方法】橈骨遠位端骨折に対して掌側ロッキングプレート（日本ユニテック Stellar locking plate）による手術療法を行い，6ヶ月以上経過観察し得た43例を対象とした．受傷時平均年齢58.8歳，平均経過観察期間10.9ヶ月，骨折型はAO分類でA型10例，B型5例，C型28例であった．これらの症例に対し，radial incl…

Bilateral Femoral Head Osteonecrosis with Bilateral Subcapital Fractures: A Case Report Open

Masuo Hanada, Hiroshi Hagihara, Naoyuki Kuga, Masao Teramoto, Tomoaki Tanaka , et al. · 2009

【目的】特に誘因無く両側骨頭下骨折を生じた両側大腿骨頭壊死症例を経験したので報告する．【症例】59歳男性．主訴は両大腿部痛．ステロイド使用歴なし．飲酒歴は，30歳から15年間，毎日日本酒3合程度．年間60日の潜水歴があった．1年前より特に誘因なく両股部痛が出現．半年後歩行不能となり近医受診し，両側大腿骨頭骨折と診断され，当科紹介となった．単純X線写真にて両側骨頭下骨折を認めた．右側には頚部に比較的大きな嚢胞像を認めた．CTでは右側は嚢胞との近位境界で骨頭骨折を生じていた．…

Indication and Limitation of Percutaneous Wiring for Patella Fractures Open

Mihoko Koga, Naoyuki Kuga, Hiroshi Hagihara, Masao Teramoto, Masuo Hanada , et al. · 2009

【はじめに】経皮的ワイヤリングは低侵襲手術としての利点が多いが，その適応は明らかでない．今回，自験例を検討し適応と限界を示す．【対象と方法】1999年以降，本法にて手術を行った36例の骨折型（AO分類），骨癒合，合併症を調査した．手術は経皮的に周囲および8字に二重締結を行い術後早期に膝可動域訓練開始した．【結果】AO分類のAが3例，Bが2例，C1が8例，C2が12例，C3が11例であった．3mm以上の転位例は18例だった．C2の1例が偽関節，C3の4例が骨癒合を期待できず再…

Experience of Shotgun Wound Open

Noriyuki Nakagawa, Hiroshi Hagihara, Naoyuki Kuga, Masao Teramoto, Tomoaki Tanaka , et al. · 2009

日本では，猟，クレー射撃などでの散弾銃の所持が許可されているため，事件，事故により散弾銃創を治療する可能性はある．今回我々は2007年12月に佐世保市のスポーツジムで発生した散弾銃乱射事件の被害者の治療を経験した．当院に搬送された被弾者は4例で，1例は死亡，3例は待機的に散弾摘出を行った．1例はすべて摘出できたが，2例は全摘困難であり一部残存した．散弾銃創における治療，合併症について報告する．

Pseudomembranous Enterocolitis after Surgery for Proximal Femoral Fracture Open

Yoshika Kawamura, Hiroshi Hagihara, Naoyuki Kuga, Masao Teramoto, Tomoaki Tanaka , et al. · 2008

整形外科領域において，抗生物質の使用により引き起こされる偽膜性大腸炎は高齢者にとって重要な合併症の一つである．当科にて2006年9月から2007年8月までに大腿骨近位部骨折に対し手術を行った95症例について調査した．年齢は65歳から98歳，平均80.8歳であった．このうち，偽膜性大腸炎と診断されたものは8症例であった．5例はバンコマイシンおよびメトロニダゾール内服により治癒したが，1例は再発し2例が重症化し死亡した．同時期に同一病棟内で多発した原因は，術後予防的抗菌薬として…

Reconstruction For Bone And Soft Tissue Tumor With Vascularised Composite Tissue Transfer Open

Tatuya Yoshida, Ryohei Yokoyama, Naoyuki Kuga, Koichi Chuma · 2004

From 1997 to 2002, 16 patients with bone and soft tissue tumor were treated by means of vascularised composite tissue transfer. Their average age was 40 years (range : 9 to 75 years). Of these patients, seven cases were treated by vascular…

Epithelioid Sarcoma of Trunk: A Case Report Open

Rin-ichiro Sato, Ryohei Yokoyama, Takahiro Hamada, Naoyuki Kuga, Yoichi Hachitanda · 2004

We present a rare case of epithelioid sarcoma of trunk. A 76-year-old man with a huge recurrent tumor of the right anterior chest wall underwent simple excision of the primary small tumor at a local hospital. He developed local recurrence …

The Effects of Chemotherapy in the Treatment of Myxoid Liposarcoma. Open

Toshiyuki Hatanaka, Noriko Urano, Mitsumasa Hayashida, Hirohito Tanaka, Naoyuki Kuga , et al. · 2003

Myxoid liposarcoma is thought to be insensitive to chemotherapy. This time, we applied a new chemotherapy to some cases of myxoid liposarcoma, and found that the treatment is very effective. The results were as follows: Case 1 was a 41-yea…

Multiple Osteochondromata after Total Body Irradiation: A Case Report. Open

Takahiro Hamada, Ryohei Yokoyama, Naoyuki Kuga, Rin-ichiroi Sato, Yoshihisa Nagatoshi , et al. · 2003

We present a rare case of multiple osteochondromata after total body irradiation in a bone marrow recipient. The patient was a 9-year-old boy. He had been given 13.2 Gy of total body irradiation (TBI) before allogeneic bone marrow transpla…

Clinical Evaluation of High Tibial Osteotomy and Unicompartmental Knee Arthroplasty for Spontaneous Osteonecrosis of the Femoral Medial Condyle of the Knee. Open

Hirofumi Taira, Toshihiro Odera, Takaaki Yoshimoto, Kiyochika Annoura, Naoyuki Kuga , et al. · 1998

We reviwed 24 cases treated by High Tibial Osteotomy (HTO) and Unicomparmental Knee Arthroplasty (UKA) for spontaneous osteonecrosis of the femoral medial condyle. The average age of patients at surgery was 62.4 years in the HTO group, and…

High Tibial Osteotomy using French's Technique. Open

Naoyuki Kuga, Wataru Hama · 1997

Thirty-four patients (forty-seven knees) who received a high tibial osteotomy using French's technique were examined for changes in the post-operative alignment of the knee until solid fusion and the occurence of non-union or delayed union…

Surgical Treatment of Anterior and Posterior Cruciate Ligament Injury of the Knee. Open

Kiyochika Annoura, Toshihiro Ohdera, Akira Kobayashi, Junichi Tokunaga, Takaaki Yoshimoto , et al. · 1997

From 1972 to 1996, 18 patients were treated surgically for acute complex ligamentous injuries (including ACL+PCL injury) of the knee.We investigated the clinical symptoms according to the JOA score and evaluation of the IKDC.In the ACL rec…

MRI Diagnosis of Meniscal Tears. Open

Naoyuki Kuga, Toshihiro Oh · 1996

We studied the accuracy of magnetic resonance imaging (MRI) of the knee in fifty-six patients who were also examined arthroscopically. The accuracy, sensitivity, and specificity were 96%, 100%, and 95% for medial meniscal tears, and 91%, 6…

Surgical treatment of the Anterior and Posterior Cruciate Ligaments of the Knee. Open

Kiyochika Annoura, Toshihiro Oh, Akira Kobayashi, Junichi Tokunaga, Takaaki Yoshimoto , et al. · 1995

Simultaneous rupture of the anterior and posterior cruciate ligaments is a rare but serious condition. From 1978 to 1992, 13 patients were treated surgically for this disorder at our hospital. They were followed up for a mean of 4.8 years,…

Classification and Treatment of Femoral and Tibial Shaft Fractures. Open

Naoyuki Kuga, Junichi Tokunaga, Toshihiro Oh, Takaaki Yoshimoto, Kiyochika Annoura , et al. · 1995

We classified the types and locations of 53 femoral shaft fractures and 109 tibial shaft fractures treated with either plates, intramedullary nails or interlocking nails. Interlocking nailing was used in all types and all segments, and all…

Treatment of Peritrochanteric Fractures Using Gamma Nail. Open

Kouji Kawai, Takaaki Yoshimoto, Junichi Tokunaga, Kiyochika Annoura, Takayasu Shintou , et al. · 1994

This paper evaluates clinical results of peritrochanteric fractures treated using the Gamma nail. The Gamma nail was introduced for treatment of peritrochanteric fractures with the theoretical advantage of a load-sharing femoral component …

Spinal Paraplegia in Tuberculous Spondylitis with Kyphotic Deformity. Open

Nobuo Kobara, Keiichiro Shiba, Takayoshi Ueta, Kenzo Shirasawa, Hideki Ohta , et al. · 1993

We reviewed ten cases of tuberculous spondylitis with kyphotic deformity with special reference to the cause of paraplegia. Paraplegia was due to abscess in six cases, metastatic tumor is two and intradural tuberculoma in one. In the remai…

Study for Union of Lumbar Posterolateral Fusion. With or without Transpedicular Fixation. Open

Naoyuki Kuga, Keiichirou Shiba, Takayoshi Ueta, Kenzo Shirasawa, Hideki Ohta , et al. · 1993

Posterolateral lumbar fusion is a useful method for stabilization of unstable lumbar spine segments. We reviewed 139 patients who were operated on with posterolateral lumbar fusion and 72 patients with transpedicular fixation. The success …

Magnetic Resonance Imaging of Ruptured Posterior Longitudinal Ligaments in Lumbar Disk Herniation. Open

Naoyuki Kuga, Keiichirou Shiba, Takayoshi Ueta, Kenzou Shirasawa, Hideki Ohta , et al. · 1992

The MRI findings in 61 subjects who were operated on for lumbar disc herniation were retrospectively studied, to diagnose rupture of the posterior longitudinal ligament(PLL). The accuracy rate of diagnosing rupture of the 66.7%. False nega…

Results of Dual Bearing Type Femoral Head Replacement for Coxarthroses. Experience of Omnifit Type Prosthesis. Open

Jyunji Konishi, Norio Uezaki, Tsukasa Yamaguchi, Hideya Sakurai, Hisashi Sakamoto , et al. · 1992

We reviewed 30 patients who had had a dual bearing type prosthesis between January 1987 and July 1990. The cases consisted of 4 males and 26 females.The age range from 55 to 77 years old with an average of 66 years old.They were evaluated …

Clinical Results and Radiological Investigation of Cervical Laminoplasty. Open

Toshiyuki Ando, Kenichiro Shibata, Tatsuoki Mashima, Akio Naturo, Masahiro Kina , et al. · 1991

Cervical laminoplasty by Miyazaki's method has been performed for twenty-nine patients with myelopathy due to spondylosis and ossification of posterior longitudunal ligament in cervical spine, we preserved nuchal ligament and deep muscles …

Results of the Treatment of Acromioclavicular Dislocation Using Leeds-Keio Synthetic Ligament. Open

Mutsuro Kuwahata, Kenichiro Shibata, Tatsuoki Mashima, Fusao Naruto, Masahiro Kina , et al. · 1991

Nine patients with complete acromioclavicular dislocation were treated with Leeds-Keio synthetic ligament, supplemented with a temporary fixation of the acromioclavicular joint. Seven patients were re-examined over an average of two years …

Results of Total K nee Replacement. Open

Masahiro Kina, Mamoru Tomishige, Kenichirou Shibata, Tatsuoki Mashima, Shinji Tomari , et al. · 1991

Since 1981, the Kodama-Yamamoto Knee Prostheses have been used in our hispital.We studied forty-nine knees in thirty-six patients whom we had been able to follow up for at least one year. Thirty knees in twenty-three patients were osteoart…

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