Shin Fukuyama

The effect of mechanical stress on hypertrophy of the lumbar ligamentum flavum.

To clarify the effect of mechanical stress on hypertrophy of the ligamentum flavum (LF), we compared the thicknesses, histological findings, and total collagen content of 161 lumbar LF in two groups defined by radiographic signs. LF with one or more signs of spondylolisthesis, disk degeneration, vacuum phenomenon, traction spur, or facet joint osteoarthrosis were considered degenerative; all others were considered nondegenerative. Thickness was measured by computed tomographic scan, and total collagen content by Woessners method. We found that the ligament was thicker in the degenerative group (4.0 +/- 1.1 mm vs. 3.0 +/- 0.7 mm, p < 0.01), the degeneration of fibers more severe, and the total collagen content higher (51.9 +/- 14.5% vs. 40.3 +/- 3.9%, p < 0.05). Thus, mechanical stress is considered a cause of ligament hypertrophy.

Treatment of Intertrochantric Fractures of the Femur

Eighty-eight patients (90 cases) aged over sixty-five with intertrochanteric fractures of the femur were surgically treated during 1983-1988. 44 cases were repaired with Ender nails and 46 cases with compression hip screws (C. H. S). The average operation time and bleeding volume were 43 minites and 57g in Ender nails, and 69 minites and 108g in C.H.S. Postoperative clinical evaluations and the recovery rates of walking ability were almost equal and general appearances affected them. The patients (33%) operated with Ender nails had complained of gonalgia at inserting point. Courses of rehabilitation of C. H. S. were more stable than those of Ender nails.