Kimitaka Fukuda

Tardy Ulnar Nerve Palsy Caused by Cubitus Varus Deformity

Clinical features and X-rays of thirty-four cases with cubitus varus deformity were analysed in order to explain the occurrence of tardy ulnar nerve palsy caused by cubitus varus deformity. Cubitus varus cases with tardy ulnar nerve palsy, compared to cases without it, were older at the first visit to the clinic for cubitus varus deformity. There were no other differences between the two groups in clinical features. Computed tomography showed that the olecranon moved to the ulnar side against the olecranon fossa. Operative findings showed that the medial head of triceps brachii shifted medially and covered the ulnar nerve. Both from computed tomography and operative findings we conjectured the possibility that tardy ulnar nerve palsy was caused because the ulnar nerve was compressed by the forward medial movement of the medial head of the triceps brachii caused by cubitus varus deformity.

Abductor Digiti Minimi Opponensplasty in Hypoplastic Thumb

Ten cases of hypoplastic thumbs were treated by abductor digiti minimi opponensplasty in order to restore opposition of the thumb and reform the wasted thenar eminence. In eight of these ten cases operations were combined with multiple Z-plasty or rotation flap to correct the narrowing of the first web space. Adductor plasty using extensor indicis proprius was performed in six cases to restore the stability of the metacarpophalangeal joint of the thumb and ligament reconstruction of the carpometacarpal joint in one hand. In all cases, the transferred abductor digiti minimi was strong enough to abduct the thumb and provide good functional and cosmetic results. We modified Littlers procedure by transferring the origins of abductor digiti minimi muscle from the flexor carpi ulnaris to the palmaris longus tendon. Our modified method gave a better cosmetic appearance than that provided by Littlers method.

Congenital Anomalies of the Upper Limb Among the Japanese in Sapporo

Nine hundred and forty three patients with nine hundred and fifty-five congenital upper limb anomalies are classified according to the Swansons classification. Relative incidence of each type of anomaly, sex incidence, affected side, associated abnormalities and familial history are analysed. The occurrence of congenital upper limb anomalies is also compared with Chinese and Western studies. The characteristic feature in this series is that the incidence of typical syndactyly is not as high as expected. Two problems of Swansons classification encountered in this analysis are discussed. One of the problems is the relation between polydactyly, syndactyly and typical cleft hand. The other is the relation between brachysyndactyly, atypical cleft hand and transverse deficiency.

Reconstruction of the Upper Limb by Arthrodesis in Cases of Tumors of the Proximal Humerus

We describe six cases of a limb salvage procedure for the treatment of malignant and clinically aggressive bone and soft tissue tumors in the shoulder girdle. In two of four cases treated by wide excision, shoulder arthrodesis was performed using a vascularized fibular graft.