Yoshiyuki Nagata

Peripheral Nerve Injuries in the Hand

Although the repairments of the peripheral nerve have been developed in cases recently, there are some controversies over the timing of the secondary repairment. We have experienced 14 cases (18 nerves) of secondary repairment of divided peripheral nerve injuries. There are 5 nerves of the ulnar nerve, 3 of the median nerve, 2 of the radial nerve and 8 of the digital nerve. All cases were sutured with epineural suture microscopically, and these postoperative results were evaluated by using Heighets criterion and the static two-point discrimination method. No significant differences were observed between the timing before and after 3 month from the initial injuries. However, neuromas and relative big scars at the nerve stumps were observed in the cases which repair was performed after 3 months. We suggest that the large gap should be avoided, so the timing of secondary repairment is better within 3 months after injuries.

Aging on X-ray Film of Bone and Joint

When one sees some aging changes of bone or joint on a piece of roentgenogramme, it is not infrequently difficult to determine whether it is physiological or pathological.The authors have been attempting to gain a more complete knowledge concerning “physiological” aging of bone or joint in the general population by examining roentgenogrammes sampled randomly from non-orthopedic clinics in our university hospital.Each bone or joint was evaluated on four items, that is, osteoporosis, narrowing of joint or disc space, subchondral bone sclerosis and osteophyte formation, and rated as follows: 0: no changes; 1: some changes; 2: prominant changes.We have examined the roentgenogrammes of 1, 508 patients, including those of 631 new patients.In five regions (cervical and lumbar spine, acromioclavicular joint, sacroiliac joint and hip joint) the frequency of each mark was calculated and demonstrated in histogram.We tentatively defined that changes up to 90 percentile are normal or physiological and that those over 90 percentile are pathological.Some aging changes are considered normal or physiological, for example, osteophyte formation in L 4/5 and sacroiliac joint, osteoporosis in elderly women, and so forth.In order to investigate physiological aging of bone or joint in the appendicular skeleton, we are now looking for another method and hope to report on it in the near future.

The utilization of Computed Tomography in Orthopedic Surgery

We examined 56 cases by CT scanner during past three years. The cases are constituted of OPLL 10, Bone tumor 11, Soft tissue tumor 9, Spinal tumor 3, tuberculous spondilitis 1, Cryptoccosis 1, and the others. We can get many informations from CT Scan. For example, the relation between the lesion and normal tissue, about the size of the lesion, the nature of the lesion.If CT Scan reveal anatomical abnormality remakably, operative indication will become more definite one. CT Scan is useful especially at emergency diagnosis in spinal canal lesion.We can follow up these cases effectively after operation or chemo-therapy.Still more we made the lymphangiography or enhancement at the same time with CT scan.

Aging on X-ray film of bone

The authors have been tried to study aging changes on X-ray films which were collected randomly from some clinics except for the orthopaedic clinic in our university hospital. Four items, that is, spur formation, narrowing, subchondral sclerosis and osteoporosis, in each bone were checked always by two doctors of the authors and numerical expression, which was classified as follows, no changes; O, some changes; 1, and prominent changes; 2, of each item was summed up in each bone. In each decade, these summed-up numbers were divided by numbers of patients in each bone.Of these data, correlations between these numerical data and ages in lumbar spines were reported and discussed in this paper.Of total 1274 films on the acromio-clavicular joints, the sacro-iliac joints, the lumbar spines and the hip joints, 226 films of lumber spines were studied and analyzed. Prominent aging changes were detected in lower lumbar spines of both sexes after the fifth decade. On the other hand, osteoporotic changes were remarkable after the sixth decade of female.These methods studying for aging are concluded as useful maneuvers.