Mamoru Tomishige

Treatment of Cervical Cord Compression, Caused by Hereditary Multiple Exostosis, With Laminoplasty : A Case Report

STUDY DESIGN Case report. OBJECTIVES Successful excision of the exostosis within the spinal canal. SUMMARY OF BACKGROUND DATA Myelopathy caused by exostosis within the spinal canal developed in a 13-year-old boy with hereditary multiple exostosis. METHODS Spinous process-splitting laminoplasty with an ultrasonic knife was performed to remove the mass and minimize the possibility of postlaminectomy kyphosis. RESULTS The spinal canal exostosis with cervical cord compression was excised successfully with laminoplasty. After surgery there has been no recurrence of tumor, and the stability of the cervical spine has been preserved. CONCLUSION This is the first report of laminoplasty as a useful surgical approach for intraspinal exostosis to prevent postoperative cervical instability.

A Study of the Open Fractures of the Tibia and Fibula

Twenty-nine cases of the open fractures in tibia and fibula were treated in our clinic for the past ten years.3 cases…emergency (not treated).4 cases…refered in 48hours after first-aid treatment.6 cases…refered with pseudoarthrosis.16 cases…refered with infected wound.For emergency csaes and refered in 48 hours after first-aid treatment cases, complete debridement were most important. Pseudoarthrosis cases were treated with bone graft and kuntscher-nail or A-O Plate. For infected cases, it was essential to differentiate suppurative germs and sensive antibiotics.Curettege and removal of previous plates and screws were done before skin coverage. After inflammation was arrested in most cases, osteosynthesis had been done secondly. Two cases infected with pseudomonas were difficult to acquire complete cure.

A Case Report of Suspected Histiocytosis X with Culture of Staphyloccus from Bone Lesions

A boy aged 12 was admitted to our clinic on January 1976, complaining of pain in both knees. The roentogenographic examination revealed lytic lession of the cortex in the distal metaphysis of both femurs with excessive periosteal reaction. The histological findings did not show typical pattern of Histiocytosis X.Culture of curettage material revealed Staphylococcus. The patient did not response to antibiotics, but responsed dramatically to vincristine, so we clinically suspects Histiocytosis X rather than osteomyelitis.

Osteochondromatosis of the Hip Joint

Osteochondromatosis of the hip joint is uncommon. A man aged twenty-nine years was complaining of pain in the right hip joint, especially at the flexion position. Radiographs showed large extraosseous mass of opacities in the joint cavity. A tentative diagnosis of osteochondromatosis was made by arthrography. At operation about ten loose bodies were removed.

Follow-up Studies of Congenital Dislocation of the Patella

The transplantation of the tibial tubercle were performed on the five children aged three to twelve. Operative treatments, principally used Hausers method, were done and the results were obtianed satisfactorily.And in another case, 22 year old man who had never been treated since he was diagnosed as having congenitalbilateral dislocation of the patella, has muscular atrophy and muscular weakness on both thighs, but he had neither limitation of movement nor complaints of his walking.The view that the operation on the tibial tubercle is unsuitable for children has been widly held currently because the premature closure of the epyphysis occurs and it often causes recurvatum deformity and genu valgus. But these experiences gave the contented results without any re-dislocation.They suggest that it may be done for children, while adequate bone attachment and transplantation adding soft-tissue operation are remarked.