Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association
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The epidemiology of orthopedic surgery cases in Japan has not been determined adequately. This study analyzed statistics in orthopedic surgery for 2006 and 2007 using the Japanese Diagnosis Procedure Combination database. ⋯ This study presents an overview of the clinical features of orthopedic surgery in Japan, which may be of value for determining therapeutic strategies in the management of orthopedic surgery patients.
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Instrumentation and fusion to the sacrum/pelvis has been a mainstay in the surgical treatment of scoliosis in patients with Duchenne muscular dystrophy since the development of the intrailiac post. It is recommended for correcting pelvic obliquity. However, caudal extent of instrumentation and fusion has remained a matter of considerable debate. This study was performed to determine the efficacy and safety of stopping segmental pedicle screw constructs at L5 during surgical treatment of scoliosis associated with Duchenne muscular dystrophy (DMD). ⋯ Segmental pedicle screw instrumentation and fusion only to L5 is safe and effective in patients with DMD scoliosis of <85 degrees and pelvic obliquity of <15 degrees . Good sagittal plane alignment was achieved and maintained. All patients benefited from surgery in terms of improved quality of life. There was no major complication.
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The present study evaluated the importance of visualizing both sides of the triangular fibrocartilage complex (TFCC) when diagnosing ulnar wrist pain. ⋯ Adding DRUJ arthroscopy to RCJ arthroscopy enables more accurate diagnosis of TFCC pathology because the proximal aspect of the articular disk and the foveal insertion of the distal radioulnar ligament can be visualized.
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Hip fractures following falls by the elderly, which increase with age, are increasing in number annually. The incidence of refracture (second hip fractures) has been reported to be 5%-10% in Japan and is expected to increase with the aging of the population in the future. Therefore, through a retrospective cohort study, we attempted to clarify the risk factors associated with second hip fractures. ⋯ In this study, 85.7% of refractures occurred within 3 years of the first fracture, with dementia and respiratory disease being the complicating factors that influenced refracture.
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From 1979 to 2005, a total of 279 hips in 249 patients with advanced and/or terminal-stage osteoarthritis of the hip underwent valgus osteotomy. Among them, we reviewed 256 hips in 229 patients (91.8%) with a minimum follow-up of 1 year. We reviewed the clinical and radiological results and analyzed prognostic factors that may have affected the postoperative outcome. ⋯ Valgus osteotomy is effective joint-preserving surgery for advanced or terminal-stage osteoarthritis of the hip in middle-aged patients, and it is acceptable for clinical and radiological evaluation. If the AHI is <60%, valgus osteotomy should be combined with Chiari's pelvic osteotomy.