Yoshiaki Makino

Treatment for Chronic and Broad Osteomyelitis of Femor with Papineau's Method

今回我々は，長期間放置されていた大腿骨の慢性化膿性骨髄炎の3例に対し，Papineau法による治療を行い良好な治療成果が得られたので報告する．症例は男性2例，女性1例で，年齢は60歳～70歳（平均64.7歳）．骨髄炎罹患期間は23年～52年（平均38.0年）であった．第1相～第2相までの日数は平均47.3日，第2相～第3相までは平均28.0日で，入院期間は平均110.0日であった．病巣掻爬の範囲が約20cmに及ぶものが1例あったが，両側前後の腸骨からの骨移植でなんとか骨充填可能であった．第3相は3例とも創の縫縮のみで閉創可能で，再燃は認めていない．〈考察〉慢性化膿性骨髄炎に対してはPapineau法以外にもさまざまな治療法が施行されている．当院ではイリザロフによる仮骨延長法等も症例によっては施行しているが，患者の性格，年齢，罹患部位等を考慮すると，今回のようにPapineau法の有用性が改めて確認できた．

A Case with Trigger Wrist Complicated to the Fragmentation of Flexor Digitorum Profundus Tendon of the Little Finger

The trigger wrist is a rare disease revealing trigger phenomenon being caused by tumorous-shaped lesion which was formed in the carpal tunnel. This time, we experienced a trigger wrist complicated to the fragmentation of flexor digitorum profundus tendon of the little finger, and report its results as follows.This case is a 31-year-old male carpenter. The tenosynovectomy was carried out because trigger phenomena were noted in the left ring finger and little finger, while trigger phenomenon of the ring finger was not disappeared. The trigger wrist was considered to be complicated because removal of tumorous-shaped matter in the carpal tunnel was palpable at the trigger phenmenon of the ring finger. The fragmentation of the flexor digitorum profundus tendon of the little finger, and adhesion of its proximal region and flexor digitorum profundus tendon of the ring finger were noted by operative findings. It was considered that trigger phenomena occur at the passing of the carpal tunnel becuse its partial amputation stumps roll back. After resection of the carpal tunnel interendinous adhesion was exfoliated, adn flexor digitoum profundus tendon of the little finger was resected. The trigger phenomenon of the ring finger has disappeared and the patient is under observation of its progress at the present time.

Long-Term Results of Operation for Lumbar Canal Stenosis

Forty-seven patients with lumbar canal stenosis operated were examined by questionaire. Their follow-up period ranged from 5 to 12 years with an average of 8.8 years. The excellent and good results were obtained in 77% of the cases. The results appeared to be correlated with their age, evaluation points, activities of daily living, sensory disturbance, muscle power loss, preoperative ambulatory distance and their follow-up period.