Kazuhiko Ihara

Macrodactyly in Proteus syndrome.

A case of Proteus syndrome in a 13-year-old boy with macrodactyly, hemihypertrophy, exostosis of the skull, epidermal naevi, palmar and plantar masses, and scoliosis is reported. Macrodactyly involving the left thumb was treated surgically. The usual findings in macrodactyly, hypertrophy of the digital nerves and proliferation of subcutaneous fat, were not observed in this case. Macrodactyly associated with Proteus syndrome should be distinguished from other forms of macrodactyly because of its poor prognosis and high rate of recurrence.

Biomechanical Analysis of Three-Dimensional Osteotomy at the Distal End of the Radius for Kienböck’s Disease with Flexion Deformity of the Lunate

Failure of radial closing wedge osteotomy for advanced Kienbock’s disease frequently reveals a flexion deformity of the lunate and the collapse and fragmentation of its volar half. We performed biomechanical analyses including a rigid-body spring model and the finite-element method and demonstrated that the flexion deformity of the lunate increases contact pressure at the volar half of the radiolunate and capitolunate joints. The increased contact pressure could therefore lead to collapse and fragmentation of the volar half of the lunate. A new three-dimensional osteotomy, consisting of a radial closing wedge osteotomy and an extension osteotomy, was developed to achieve better alignment of the capitolunate joints. The three-dimensional osteotomy may therefore be an effective procedure for Kienbock’s disease having a flexion deformity of the lunate.

Lateral Discoid Meniscal Lesion as a Cause of lateral Osteoarthrosis of the Knee

Pathological findings of plain X-rays and arthrography were investigated to realize the causes of lateral asteoarthrosis of the knee.The number of lateral osteoarthrosis cases was 22 knees of 18 patients.14 cases were women. 12 cases were on the right side, 2 cases on the left and 4 cases on both sides.10 of 17 lateral menisci were found to be of the discoid type.In 9 knees which were classfied in the advanced stage (Stages III, and IV), 5 knees had seriously torn lateral discoid meniscus.Torn lateral discoid meniscus was supposed to be one of the important causes of lateral osteoarthrosis of the knee.