Shingo Naniwa

Intraosseous epidermal cyst of the sacrum. A case report.

An unusual case of intraosseous epidermal cyst is reported. The patient, a 45‐year‐old Japanese female, had suffered from lumbago and dysuria for about 15 years. X‐ray examinations and CT scan revealed an expanded osteolytic tumor without marginal sclerotic change within the sacrum, which anteriorly invaded the surrounding soft tissues at the S2/3 level. At this time, chordoma was suspected, but epidermal cyst with foreign body granuloma was finally diagnosed from biopsy and surgical specimens.

Comparative study on Sauvé-Kapandji and Darrach procedures in synovectomy for rheumatoid wrists

Our objectives were to evaluate synovectomy of the wrist in patients with rheumatoid arthritis (RA), and compare the Sauvé-Kapandji and Darrach procedures from clinical and radiographical aspects. Twenty-seven patients (34 joints) with RA after synovectomy of the wrist were enrolled. The average duration after surgery was 3.6 years. The patients were divided into two groups according to their surgical procedures: 20 patients (25 joints) underwent synovectomy with the Sauvé-Kapandji procedure (SK group) and seven patients (nine joints) underwent synovectomy with the Darrach procedure (D group). Palmar-flexion was reduced (P<0.005) and supination was improved (P<0.001) in the SK group. An increase of dorsiflexion and supination was observed in the D group (P<0.03). Radial rotation and ulnar drift showed no significant change between pre-surgery and last follow-up radiographs. The ulnar shift showed a significant increase (P<0.05) in the D group, while no change was observed in the SK group. Carpal height ratio also decreased significantly in the D group (P<0.02). Thus, symptoms such as joint pain and swelling, markedly improved in both groups, and both procedures seemed satisfactory; however, carpal shift is not rare when using the Darrach procedure, and therefore we conclude the Sauvé-Kapandji procedure is more preferable at synovectomy of the wrist in patients with RA.

Arthrodesis for the Severe Osteoarthritis of the Hip in the Middle Age

From 1976 to 1990, 17 hip arthrodeses have been performed for severe osteoarthritis at the National Misasa Onsen Hospital. The age of the patients ranged from 32 to 55 years at the time of the operation. Follow-up period was 4 months to 13 years (average, 3 years and 6 months).In the follow-up study, operated hips were evaluated using the JOA score. Results showed that preoperative total average score of 53.2 points (range, 32 to 68) was improved to 66.6 points (range, 50 to 76) postoperatively. Especially, pain score changed for the better from 15.3 points to 37.1. Nonunion rate was 17.6 per cent.We come to the conclusion that even recently, hip arthrodesis is one of the useful operation for severe osteoarthritis in the middle age.

A Clinical Report on Diseases of Central Nervous System with Cervical Spondylotic Changes

Between April 1976 and March 1985, 94 patients who have myelopathy and radiculopathy with cervical spondylosis were treated by anterior interbody fusion and laminectomy.Postoperatively, six of these patients were identified as another disorders of central nervous system.These disorders were motor neuron disease, multiple sclerosis, intramedullary tumor, metastatic brain tumor and cerebral vascular accident.