Ritsu Tsujimoto

Epidemiology of Kienböck’s Disease in Middle-aged and Elderly Japanese Women

Little research has been done on the prevalence of Kienböcks disease, and there is no consensus on the relationship between Kienböcks disease and negative ulnar variance. The goal of this cross-sectional study was to determine the prevalence of Kienböcks disease in middle-aged and elderly Japanese women and to clarify the relationship between Kienböcks disease and negative ulnar variance. The authors analyzed plain radiographs of both hands in women 40 years and older residing in the community to investigate the prevalence of Kienböcks disease and the relationship between Kienböcks disease and negative ulnar variance. Kienböcks disease was seen in 7 of the 572 participants. In the group with Kienböcks disease, ulnar variance did not differ significantly between affected (0.3 mm; SD, 1.5) and unaffected (0.3 mm; SD, 1.0; P=.285) sides. No significant difference was seen in ulnar variance values between the affected side in the group with Kienböcks disease and the normal group (P=.118). The number or proportion of participants with negative ulnar variance did not differ significantly between the affected side in the group with Kienböcks disease (3 of 7) and the unaffected side in the group with Kienböcks disease (1 of 7; P=.237) and between the affected side in the group with Kienböcks disease and the normal group (111 of 504; P=.189) by chi-square test. The prevalence of Kienböcks disease was 1.2% in middle-aged and elderly Japanese women. Negative ulnar variance is not a contributing factor to Kienböcks disease.

Age-specific risk factors for incident disability in activities of daily living among middle-aged and elderly community-dwelling Japanese women during an 8–9-year follow up: The Hizen-Oshima study

The purposes of the present study were to investigate risk factors for incident disability in activities of daily living (ADL) among middle‐aged and older women, and to determine whether there are differences in risk factors according to age groups.

A case of excessive femoral anteversion which caused instability of the medial collateral ligament of the knee joint

Introduction The most cases of excessive femoral anteversion may be asymptomatic, because the he hip joint is a ball joint. However, when the hip, knee, or ankle joint is in a pathological state, excessive femoral anteversion may not be compensated for and induce symptoms. Case report A 16-year-old female with achondroplasia. Medullary compression by the odontoid process caused right hemiplegia at 10 months after birth and equinus foot concomitantly developed. At 14 years old, right knee pain developed during walking. For treatment, firstly, tenodesis of medial collateral ligament of the knee joint (MCL) was performed. Oblique osteotomy was applied to the proximal MCL attachment site over the distal tibial tuberosity, followed by simple limb lengthening, which improved knee instability. To prevent recurrence of knee instability, varus and derotationosteotomy of the femur and Vulpius procedure (triceps surae muscle lengthening) were additionally performed, and gait stabilized after surgery. Discussion Regarding the pathogenesis, her gait was originally in-toeing because of excessive femoral anteversion, but the lower leg did not internally rotate during walking because of equinus foot, and the foot grounded in an externally rotated position, loading burdens on the MCL. This condition may have gradually caused instability of the knee over the years. Conclusion We surgically treated the patient with knee joint valgus instability caused by excessive femoral anteversion and equinus foot and achieved a favorable outcome.