The case of the anterior dislocation of the radio-ulnar joint with no fracture is presented. On first examination right forearm was found locked in supination and the wrist showed a deep depression posteriorly at the site of the ulnar head. Manipulation under general anesthesia was not successful and open reduction was followed. The reason not successful to reduce was suggested the soft tissue swelling and the severity of dislocation.Arthrography after reduction showed the rupture of the articular disk.
Etiology of ossification or calcification of spinal ligaments is not clear. This is to report scanning electron microscopic observation of the ossification of the spinal ligaments, especially on the ligamenta flava.On the surface of the non-ossification there are large collagen fibers, measured 1.8-5μ in diameter and little fibrillar connection is seen between them.In the peripheral part of the ossification there was found an irregular network composed of the fine microfibrils which are 400Å-900Å in diameter. Between or on the surface of the microfibrils, a number of granular particles measured 1μ-5μ in diameter were seen.Crystal deposition in the ligamenta flava was observed at the accumulation of the layer where a clear line of demarcation was seen between the clllagen framework and crystals. The crystals were rod and granular with a length of 0.6μ-4.0μ in diameter.The crystals deposited in the tissue were examined by X-ray microdiffractmeter. The X-ray diffraction pattern of the crystal coincided well to that of CPPD (Ca2P2O7·2H2O).
A clinical study of computed tomographic myelography with metrizamide was performed in 41 patients operated for cervical spondylotic myelopathy. Anteroposterior (AP) diameter and area of the spinal cord were measured at intervertebral levels. The correlation between these factors and clinical symptoms and surgical results were examined. Results were as follows: 1) AP diameter and area of the spinal cord at the most severely affected level were less than 5mm and 55mm2 deformity and the severity of symptoms; and 3) There was no good correlation between the degree of cord deformity and recovery of symptoms after surgery.
This paper presents an analysis of the results of the treatment of fracture dislocation of the ankle.The final clinical results were studied in 44 patients with 46 fractures at the ankle treated at the Yamaguchi Rosai Hospital between 1977 and 1982. The anatomical results of the reduction affected significantly the final clinical results.
Many cases of senile round back have chronic backache. The lesion of backache is obscure yet. We have done facet block on 39 cases of senile round back (9 males, 30 females, age range from 60 to 80 years). The block was effective in 30 cases. The level of block was mainly L2-3 and L3-4. It was slightly lower than the level of the endvertebra of round back, and many cases had local scoliosis in those levels.
Twenty-four children between one and thirteen years of age were treated for fracture of the femoral shaft during the years 1976 to 1982 at Yamaguchi Rosai Hospital.Fifteen cases of these were reviewed and checked roentogenologically with regard to difference in limb length and angular deformity. Conservative treatment or external skeletal fixation was done for all cases except two elderly cases.Correction of angular deformity and overgrowth of bone were measured and the results discussed.
Thirty patients with surgically proved lumbar disc herniation and 25 with surgically proved LCS (lateral stenosis type) were studied retrospectively. Lumbar lateral recess morphometry (depth of the lateral recess, interfacetal diameter and interpedicular diameter) for CT-Myelography (CTM) was performed at the levels of L3/4, L4/5 and L5/S. In the patients with LCS, depth of the lateral recess is narrow, which may tend to result in an entrapment of the nerve root at the peripheral portion of the canal and lateral recess. Also degeneration and hypertrophy of a superior articular facet may tend to progress with aging.
Senile round backs are mostly due to osteoporosis, wedge vertebrae and narrowing of the disc, and often associated with back pain. The accurate causes of the back pain are still obscure. 101 cases of senile round back were investigated to clarify the mechanism of the back pain. They were classified into 2 groups according to the types of round back, namely 1) the upper group in which the apex of kyphosis is located in the middle thoracic spine, and 2) the lower group in which the apex is the thoracolumbar junction.Most of the cases in two groups demonstrated similar clinical symptoms. The pain was located at bilateral paravertebral regions including the area close to lumbar spinal process and at the gluteal region.Facet block with xylocain at the lumbar spine produced relief of the pain in 76% of 34 cases, which suggests that one of the main causes of chronic back pain of senile round back originates from the lumbar facet joints.
