Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association
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To investigate recent trends in the incidence of fractures in children and adolescents, we conducted a survey of distal radius fractures in 1992 and 1995 in Tottori Prefecture, Japan. Seven-hundred and forty-five patients under age 20 years were registered (562 males and 183 females). The age and sex-specific incidences of fractures in patients under 20 years of age were higher in males than in females, showing peaks at age 12-13 years for males and at age 10-11 years for females. ⋯ The age and sex-specific incidences were compared with those in the period 1986-1988, which we reported previously. The incidence in each year showed a significant increase with time for males but not for females. We conclude that the incidence of distal radius fractures in children and adolescents has a prominent peak matched by the age of the growth spurt, and the incidence of the fracture has increased in males during the past decade in Tottori Prefecture.
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Comparative Study
Relief from pain after Bombelli's valgus-extension osteotomy, and effectiveness of the combined shelf operation.
Between 1979 and 1993, we treated 67 hips in 58 patients with severe osteoarthritis caused by congenital dislocation of the hip, employing Bombelli's valgus-extension osteotomy. The mean age of the patients was 43.6 years (range, 23-59 years). The mean follow-up period was 9.7 years (range, 5-16 years). ⋯ The mean pain score in the combined group was significantly higher than that in the single group 6 to 9 years after the operation. The results of our assessments led us to conclude that Bombelli's valgus-extention osteotomy is satisfactory as far as clinical and radiological evaluations are concerned, as relief from the pain has continued for more than 10 years after the operation. The combined shelf operation is effective for relieving pain in severe osteoarthritis caused by congenital dislocation of the hip.
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Abiomechanical study of the functions of the iliolumbar ligament in L5 spondylolysis was performed. Five fresh cadaveric specimens were used. The bilateral ilia and sacrum were fixed. ⋯ The three-dimensional position of the L5 vertebra was measured after serial transections in: (1) the intact condition; (2) bilateral pars interarticulares of L5 transected; (3) anterior bands of the iliolumbar ligaments transected; and (4) posterior bands of the iliolumbar ligaments transected. In L5 spondylolysis, flexion and axial rotation of L5 on S1 are significantly regulated by the anterior and posterior bands of the iliolumbar ligaments (especially by the posterior bands of the ligaments). The integrity of the ligament may determine the stability of the lumbosacral junction and the amount of forward slipping of the L5 vertebra.