Y. Nishiyama

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.