Hiroaki Yano

Clinical Results of Arthroscopic Surgery for Osteoarthritis of the Elbow

我々は疼痛や可動域制限を有する変形性肘関節症に対して関節鏡視下関節形成術を行なっている．今回，その短期成績を報告する．症例は変形性肘関節症に対し肘関節鏡を施行し術後4ヶ月以上経過観察可能であった5例5肘で男性5肘を対象とした．手術時平均年齢は54.0歳，平均経過観察期間は14.2ヶ月であった．評価方法として，術前後の日本整形外科学会肘機能評価法（JOAスコア）および可動域，合併症の有無で評価した．JOA肘スコアは平均69.0点から91.2点に，可動域は屈曲が平均106.4度から115.6度に，伸展が平均－12.4度から－3.6度と改善が見られたが，術前可動域制限が強い症例での改善度が低い傾向にあった．術後合併症は全例なかった．変形性肘関節症に対する鏡視下手術は組織への侵襲が少なく，有効な手術法であるが，術前可動域制限が強い症例では手術手技の更なる検討が必要である．

Forearm Lengthening by Callotasis

We report 4 cases of deformity and shortning of the forearm with bone tumor treated by callotasis.Four patients (3 women and 1 man) ranging in age from 7 to 13 years (average age: 10 years) underwent lengthening of the forearm bone. The original disease was osteochondroma (3 cases) and enchondroma (1 case). Lengthened forearm bones involved both the radius and ulna in 1 case and the ulna in 3 cases. Mono-tube lengthener was used for all cases.The lengthening obtained in the forearm bones ranged from 15 to 39mm (average: 27.8mm). The distraction rate was 8.1 to 27.1% (average: 19.1%). The healing index was 31.8 to 82.0day/cm (average: 56.3day/cm).Distraction callus fracture was recognized in 1 case, with posterior interosseous nerve temporary palsy as a complication.

Relationship between Prognosis of Aged Patients with Compression Spine Fractures and Gadolinium-enhanced Magnetic Resonance Imaging Characteristics

This study reviewed the relationship between the prognosis of 15 patients with compression spine fractures by osteoporosis and gadolinium-enhanced magnetic resonance imaging characteristics. All patients had undergone conventional and gadolinium-enhanced magnetic resonance imaging within 4 weeks of onset of the fractures except for 3 patients. Gadolinium-enhanced magnetic resonance imaging findings were classified into two types: fully vertebral body-enhanced type and partially vertebral body-enhanced type with the former, the degree of compression in the vertebral fracture did not become aggravated and back pain was easily relieved. With the latter the conditions of most of the patients become worse and back pain continued. These results suggested that patients who are partially vertebral body-enhanced continue to suffer back pain, and conditions become worse. The findings of the gad linium-enhanced magnetic resonance imaging were also found to be useful as a factor of prognosis for patients with compression spine fractures.

Clinical Study of Ender Nailing for Peritrochanteric Fractures of the Proxmal Femur

One complication of Ender nailing when used for peritrochanteric fractures of the proxmal femur is an outbreak of gonalgia. We analysed the cause of gonalgia, and considered ways of overcoming this problem.Subjects included twenty-three cases (five males, eighteen females) ranging in age from 58-95 years (mean 80 years), whom we treated from April 1992 to December 1993.Gonalgia was seen in twelve cases (52.2%). There was a correlation between gonalgia and projection of the pin on the medial epicondyle. Projection of the pin was due to operating technique, such as poor dispersion of the pin in the femoral head, the inserted position not fitting correctly and poor support on the medial epicondyle. To avoid these problems it is important that pin projection is avoided by studying the anatomical form of each case, by selecting a correctly fitting nail and by deciding on the bending position and angle of the pin.