Hiroshi Hieda

Factors affecting the variability of the torque curves at isokinetic trunk strength testing

OBJECTIVES To evaluate the relation between variability of the torque curves and factors such as age, gender, measurement speeds, and period from low back pain (LBP) onset at isokinetic trunk strength testing. DESIGN Observational. SETTING Hospital. PATIENTS One hundred forty-three consecutive LBP patients (acute, subacute, and chronic) who received physical therapy, and 200 healthy volunteer subjects. MAIN OUTCOME MEASURES The variability of the torque curves is an indicator of consistency of effort, and was measured as the coefficient of variance (CV) at different measurement speeds in isokinetic trunk flexion/extension strength testing. RESULTS The CV was lower in men than in women at the faster measurement speed. LBP patients had higher CV values than healthy subjects. The CV was different according to gender and measurement speed, but not different according to age and periods from LBP onset. CONCLUSION The CV was affected by measurement speed and gender, but not by age or period from LBP onset. Because the CV was higher in LBP patients than in healthy subjects, this value may be usable as an adjunctive index of LBP.

Ulnar deviation after volar subluxation of the proximal interphalangeal joint.

A rare case of irreducible and progressive ulnar deviation after volar subluxation of the proximal interphalangeal joint is presented. An immobilized proximal interphalangeal joint with remaining volar subluxation after improper reduction showed ulnar deviation at 3 weeks after injury. During surgery, the radial collateral ligament was found to be ruptured at its origin, with formation of concomitant scar tissues. There were no apparent lesions at the central slip, lateral band, and volar plate. Interposition of the ruptured ligament and infiltration of the surrounding scar tissues into the proximal interphalangeal joint were identified. Surgical incision of the capsule along the dorsal margin of the radial collateral ligament readily produced successful reduction. The irreducible and progressive ulnar deviation of the proximal interphalangeal joint seemed to result from gradual infiltration of the scar tissues, subsequent to remaining volar subluxation because of interposition of the ruptured collateral ligament.

Quantitive Computed Tomography of The Lumbar Spine

Quantitive Computed Tomography (QCT) is one of the most successful method in determining bone mineral content of the spine.Lumbar mineral contents of one hundred patients (thirty-one males and sixty-nine females) were determined by the QCT method.Following results were obtained.1) In the female patients, bone mineral content of the lumbar spine severely decreased to marginal value of abnormality, boundary of their anomeria.2) Bone mineral contents of the cases of trochanteric fractures were less than the cases of femoral neck fracture.3) The results of QCT method were related to the classification system on plain x-ray photographs.