Souichi Uta

Hamatometacarpal fracture-dislocation: distinctive three dimensional computed tomographic appearance☆

We report here two fully documented cases of hamatometacarpal fracture-dislocation following trauma and treated in our hospital. In our cases, the patients suffered hamate fracture in association with metacarpal dislocation. In the first case, a dorsal oblique fracture of the hamate was associated with a dorsal dislocation of the base of the fourth metacarpal. In the second case, a dorsal oblique fracture of the hamate was not associated with a dorsal dislocation of the base of the fifth metacarpal. This diagnosis should be suspected on initial review of plain radiographs, which must include an oblique view because of diagnostic difficulty for this injury. We recommend three dimensional computed tomography (3D-CT) in any patient presenting with pain after blunt trauma to the hand to prevent in diagnosis. Open reduction and internal fixation of the fracture is indicated and relevant for displaced fracture.

The initial fixation of the press-fit acetabular shell – clinical observation and experimental study

Abstract The initial solid fixation of an uncemented acetabular component affects the amount of bone ingrowth. We had several problems with broken screws in cases of acetabular revision. In recent years, the development of uncemented components without screws has attempted to improve these problems. We started to use “press-fit”-type acetabular shells in November 1996. Our thirty cases undergoing 2 mm under-reaming show good initial stability. The aim of our biomechanical study was to assess the most suitable degree of under-reaming of the bony acetabulum for the implantation of an uncemented hemispherical porous coated component.

Lunatomalacia in association with congenital synostosis between the capitate and the hamate.

This report describes a case of lunatomalacia associated with congenital synostosis between the capitate and the hamate, an association not previously reported. The case was examined in detail, and compared to the findings in the literature including observation regarding prognosis of lunatomalacia.

Vertical dislocation of the talus without malleolar fractures

We report an unusual case of open vertical dislocation of the talus without malleolar fracture following motor vehicle accident.Most previously reported cases are medial, lateral, posteromedial and posterior dislocations. The anterolateral, posterolateral, and purely superior dislocations of the talus make up smaller a percentage. The mechanism of this injury appears to be forced eversion of the foot when it is maximally plantar flexed and axially loaded.Our case has treated by open reduction of the talus and anatomical repair of the disrupted deltoid ligament at the time of initial incision and open reduction with internal fixation of the calcaneus also achieved good long-term functional and radiographic results.