Faculty Profiles - SAIGA Kenta

Papers - SAIGA Kenta

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A Characteristic Magnetic Resonance Imaging Finding to Identify Morton Neuroma: The Slug Sign Reviewed

Masahiro Horita, Kenta Saiga, Tomohiro Fujiwara, Eiji Nakata, Toshifumi Ozaki

Foot & Ankle Orthopaedics 9 ( 3 ) 2024.7

Authorship：Corresponding author Publishing type：Research paper (scientific journal) Publisher：SAGE Publications

Background:

Morton neuroma is a common cause of forefoot pain and sensory disturbances, but it is difficult to identify on magnetic resonance imaging (MRI). The aim of this study was to verify the usefulness of a characteristic MRI finding (slug sign) for identifying Morton neuroma and to clarify the relationship between excised neuroma characteristics and preoperative MRI findings.

Methods:

Twenty-two web spaces were retrospectively assessed from the second and third intermetatarsal spaces of 11 feet of 10 patients (7 women and 3 men, aged average 59.5 years) who underwent surgical excision of Morton neuroma between 2017 and 2022. Asymptomatic web spaces were used as control. Neuromas with 2 branches of the plantar digital nerves on axial T1-weighted MRI (MRI-T1WI) were considered the slug sign. We investigated the preoperative presence of the slug sign in Morton neuroma and asymptomatic control web spaces. We also investigated the relationship between the maximum transverse diameter of the excised specimen and that estimated on coronal MRI-T1WI.

Results:

A total of 15 Morton neuromas were excised and assessed. The slug signs were present in 10 intermetatarsal spaces in 15 web spaces with Morton neuroma whereas the sign was found in 1 intermetatarsal space in 7 asymptomatic web spaces. The sensitivity and specificity for the slug sign to diagnose Morton neuroma was 66.7% and 85.7%, respectively. The positive and negative predictive values were 90.9% and 54.5%, respectively. The mean maximum transverse diameter of excised neuromas was 4.7 mm. The mean maximum transverse diameter of neuromas on coronal MRI-T1WI was 3.4 mm. A significant positive correlation was found between the maximum transverse diameters of excised specimens and diameters estimated on coronal MRI-T1WI ( r = 0.799, P < .001).

Conclusion:

The slug sign may be a useful indicator of Morton neuroma on MRI to confirm nerve involvement after bifurcation.

Level of Evidence:

Level IV, retrospective series.

DOI： 10.1177/24730114241268285

Other Link： https://journals.sagepub.com/doi/full-xml/10.1177/24730114241268285

Prosthetic joint infection after total talar replacement: An implant-retained case treated with combined continuous local antibiotic perfusion (CLAP)

Kohei Iwamoto, Norio Yamamoto, Kenta Saiga, Akihiro Maruo, Tomoyuki Noda, Keisuke Kawasaki, Toshifumi Ozaki

Journal of Orthopaedic Science 29 ( 1 ) 349 - 353 2024.1

Comparison of screw versus locking plate fixation via sinus tarsi approach for displaced intra-articular calcaneal fractures. International journal

Kohei Sato, Masanori Yorimitsu, Takenori Uehara, Shiro Fukuoka, Toshiaki Hata, Kenta Saiga, Tomoyuki Noda, Toshifumi Ozaki

Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons 29 ( 1 ) 97 - 102 2023.1

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: The optimal treatment of displaced intra-articular calcaneal fractures (DIACF) is controversial. This study compared the fixation stability of screws and locking plates in DIACF treated via the sinus tarsi approach (STA). METHODS: We retrospectively evaluated 118 DIACF cases treated via STA and extracted data that could affect treatment outcomes. Loss of Böhler's angle after surgery was measured to compare fixation stability. RESULTS: The loss of Böhler's angles was significantly smaller in the locking plate group than in the screw group (2.6 ± 2.7º vs. 5.6 ± 5.3º, P < 0.01). There was no difference in the clinical outcomes between the groups. On multivariate logistic regression analysis, screw fixation was significantly associated with loss of Böhler's angle by> 10º (odds ratio, 8.63; 95% confidence interval, 1.16-64.4; P < 0.05). CONCLUSIONS: Locking plate fixation is more reliable than screw fixation for preventing correction loss in DIACF treated via STA. LEVEL OF EVIDENCE: III.

DOI： 10.1016/j.fas.2022.11.002

Elevated Expression of CCN3 in Articular Cartilage Induces Osteoarthritis in Hip Joints Irrespective of Age and Weight Bearing. International journal

Kazuki Hirose, Miho Kuwahara, Eiji Nakata, Tomonori Tetsunaga, Kazuki Yamada, Kenta Saiga, Masaharu Takigawa, Toshifumi Ozaki, Satoshi Kubota, Takako Hattori

International journal of molecular sciences 23 ( 23 ) 2022.12

Language：English Publishing type：Research paper (scientific journal)

Osteoarthritis (OA) occurs not only in the knee but also in peripheral joints throughout the whole body. Previously, we have shown that the expression of cellular communication network factor 3 (CCN3), a matricellular protein, increases with age in knee articular cartilage, and the misexpression of CCN3 in cartilage induces senescence-associated secretory phenotype (SASP) factors, indicating that CCN3 promotes cartilage senescence. Here, we investigated the correlation between CCN3 expression and OA degenerative changes, principally in human femoral head cartilage. Human femoral heads obtained from patients who received total hip arthroplasty were categorized into OA and femoral neck fracture (normal) groups without significant age differences. Gene expression analysis of RNA obtained from femoral head cartilage revealed that CCN3 and MMP-13 expression in the non-weight-bearing part was significantly higher in the OA group than in the normal group, whereas the weight-bearing OA parts and normal cartilage showed no significant differences in the expression of these genes. The expression of COL10A1, however, was significantly higher in weight-bearing OA parts compared with normal weight-bearing parts, and was also higher in weight-bearing parts compared with non-weight-bearing parts in the OA group. In contrast, OA primary chondrocytes from weight-bearing parts showed higher expression of CCN3, p16, ADAMTS4, and IL-1β than chondrocytes from the corresponding normal group, and higher ADAMTS4 and IL-1β in the non-weight-bearing part compared with the corresponding normal group. Acan expression was significantly lower in the non-weight-bearing group in OA primary chondrocytes than in the corresponding normal chondrocytes. The expression level of CCN3 did not show significant differences between the weight-bearing part and non-weight-bearing part in both OA and normal primary chondrocytes. Immunohistochemical analysis showed accumulated CCN3 and aggrecan neoepitope staining in both the weight-bearing part and non-weight-bearing part in the OA group compared with the normal group. The CCN3 expression level in cartilage had a positive correlation with the Mankin score. X-ray analysis of cartilage-specific CCN3 overexpression mice (Tg) revealed deformation of the femoral and humeral head in the early stage, and immunohistochemical analysis showed accumulated aggrecan neoepitope staining as well as CCN3 staining and the roughening of the joint surface in Tg femoral and humeral heads. Primary chondrocytes from the Tg femoral head showed enhanced expression of Ccn3, Adamts5, p16, Il-6, and Tnfα, and decreased expression of Col2a1 and -an. These findings indicate a correlation between OA degenerative changes and the expression of CCN3, irrespective of age and mechanical loading. Furthermore, the Mankin score indicates that the expression level of Ccn3 correlates with the progression of OA.

DOI： 10.3390/ijms232315311

Larger sagittal inter-screw distance/tibial width ratio reduces delayed union or non-union after arthroscopic ankle arthrodesis. Reviewed International journal

Suguru Yokoo, Kenta Saiga, Koji Demiya, Hideki Ohashi, Masahiro Horita, Toshifumi Ozaki

European journal of orthopaedic surgery & traumatology : orthopedie traumatologie 2022.6

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Arthroscopic ankle arthrodesis (AAA) has risks of complications, such as delayed union and non-union. The number and direction of the inserted screws have been reported as important factors affecting the time to union of AAA. However, the ratio of inter-screw distance (ISD) to tibial width (TW) in different planes has not been investigated. Therefore, we aimed to explore the effect of this ratio on bone union following AAA. METHODS: We retrospectively enrolled 63 patients (64 ankles) undergoing AAA from 2013 to 2019. Then, their age, body mass index (BMI), sex, diabetes mellitus (DM) status, Takakura-Tanaka classification, number of screws and radiographic parameters were analysed. RESULTS: The patients had a mean age of 70.3 (range, 45-91) years. Bone fusion was achieved in 57 ankles (89%) in a mean period of 3.3 (range, 2-6) postoperative months. There were four cases of delayed union and three of non-union. No significant differences in age, BMI, sex, DM, Takakura-Tanaka classification, and number of screws could be detected between the groups. However, the sagittal ISD/TW ratio was significantly larger in the union group than in the delayed/non-union group with a cut-off value of 57.0%. CONCLUSION: Larger sagittal ISD/TW ratios result in reduced post-AAA delayed union or non-union. The surgeon should be aware that the anterior and posterior screw widths should be approximately 60% or more of the anteroposterior width of the tibia.

DOI： 10.1007/s00590-022-03307-x

寛骨臼骨折における術後臨床成績評価方法の比較 Matta scoreとJHEQの比較検討

近藤宏也, 上原健敬, 福岡史朗, 佐藤浩平, 畑利彰, 齋藤太一, 雑賀建多, 島村安則, 依光正則, 野田知之, 尾崎敏文

日本整形外科学会雑誌 96 ( 3 ) S874 - S874 2022.3

Outcome after resection arthroplasty or shortening oblique osteotomy of the lesser metatarsals combined with arthrodesis of the first metatarsophalangeal joint for severe rheumatoid forefoot deformities

Masahiro Horita, Keiichiro Nishida, Yoshihisa Nasu, Ryuichi Nakahara, Kenta Saiga, Masanori Hamada, Toshifumi Ozaki

Journal of Orthopaedic Surgery 30 ( 2 ) 102255362211179 - 102255362211179 2022.1

Publishing type：Research paper (scientific journal) Publisher：SAGE Publications

Purpose

We investigated objective and patient-reported outcomes after resection arthroplasty or shortening oblique osteotomy (SOO) of the lesser metatarsals combined with arthrodesis of the first metatarsophalangeal (MTP) joint for severe rheumatoid forefoot deformities.

Methods

17 feet from 14 women (mean age, 67.8 years) underwent resection arthroplasty of the lesser metatarsal heads (MTH resection group), while 13 feet from nine women and two men (mean age, 68.7 years) underwent SOO of the lesser metatarsals (MTH preservation group). Arthrodesis of the first MTP joint was performed in all cases. Mean follow-up in the MTH resection and preservation groups was 25.0 and 21.3 months, respectively. Preoperative and postoperative clinical evaluation included Japanese Society for Surgery of the Foot (JSSF) scale and self-administered foot evaluation questionnaire (SAFE-Q) scores.

Results

Mean total JSSF scale significantly improved from 53.4 to 76.4 in the MTH resection group ( p < .001) and from 50.1 to 74.2 in the MTH preservation group ( p = .002). Pain and pain-related and shoe-related SAFE-Q subscale scores significantly improved after surgery in both groups. In the MTH resection group, recurrence of painful callosities and claw toe deformity was observed in four and three feet, respectively. In the MTH preservation group, one patient experienced recurrence of painful callosities and one underwent revision surgery for IP joint dislocation.

Conclusion

Resection arthroplasty or SOO of the lesser metatarsals combined with arthrodesis of the first MTP joint achieved significant improvement with respect to pain relief, deformity correction, and footwear comfort.

DOI： 10.1177/10225536221117903

Other Link： http://journals.sagepub.com/doi/full-xml/10.1177/10225536221117903

A Novel Radiographic Measurement Method for the Evaluation of Metatarsophalangeal Joint Dislocation of the Lesser Toe in Patients with Rheumatoid Arthritis Reviewed International journal

Hideki Ohashi, Keiichiro Nishida, Yoshihisa Nasu, Kenta Saiga, Ryuichi Nakahara, Masahiro Horita, Shunji Okita, Toshifumi Ozaki

International Journal of Environmental Research and Public Health 18 ( 14 ) 7520 - 7520 2021.7

Language：English Publishing type：Research paper (scientific journal) Publisher：MDPI AG

Dorsal dislocation of metatarsophalangeal (MTP) joints of the lesser toe frequently occurs in patients with rheumatoid arthritis (RA), and may cause painful and uncomfortable plantar callosities and ulceration. The current study examined the reliability and clinical relevance of a novel radiographic parameter (the MTP overlap distance [MOD]) in evaluating the severity of MTP joint dislocation. The subjects of the current study were 147 RA patients (276 feet; 1104 toes). MOD, defined as the overlap distance of the metatarsal head and the proximal end of the phalanx, was measured on plain radiographs. The relationship between the MOD and clinical complaints (forefoot pain and/or callosity formation) was analyzed to create a severity grading system. As a result, toes with callosities had a significantly larger MOD. ROC analysis revealed that the MOD had a high AUC for predicting an asymptomatic foot (−0.70) and callosities (0.89). MOD grades were defined as follows: grade 1, 0 ≤ MOD < 5 mm; grade 2, 5 ≤ MOD < 10 mm; and grade 3, MOD ≥ 10 mm. The intra- and inter-observer reliability of the MOD grade had high reproducibility. Furthermore, the MOD and MOD grade improved significantly after joint-preserving surgeries for lesser toe deformities. Our results suggest that MOD and MOD grade might be useful tools for the evaluation of deformities of the lesser toe and the effect of surgical intervention for MTP joints in patients with RA.

DOI： 10.3390/ijerph18147520

多発外傷患者における筋断面積の推移の比較

近藤宏也, 上原健敬, 福岡史朗, 佐藤浩平, 畑利彰, 斎藤太一, 雑賀建多, 島村安則, 野田知之, 尾崎敏文

骨折 43 ( Suppl. ) S371 - S371 2021.7

踵骨骨折における3DCTを用いた後距踵関節面の評価

上原健敬, 野田知之, 福岡史朗, 佐藤浩平, 畑利彰, 近藤宏也, 齋藤太一, 雑賀建多, 島村安則, 尾崎敏文

骨折 43 ( Suppl. ) S248 - S248 2021.7

寛骨臼骨折に対する術後臨床成績評価方法の比較 Matta scoreとJHEQの比較検討

近藤宏也, 上原健敬, 福岡史朗, 佐藤浩平, 畑利彰, 斎藤太一, 雑賀建多, 島村安則, 野田知之, 尾崎敏文

骨折 43 ( Suppl. ) S283 - S283 2021.7

関節面の整復に術中3D撮影およびナビゲーションが有用であった寛骨臼骨折の2例

畑利彰, 野田知之, 島村安則, 上原健敬, 福岡史朗, 佐藤浩平, 近藤宏也, 齋藤太一, 雑賀建多, 尾崎敏文

骨折 43 ( Suppl. ) S367 - S367 2021.7

Subjective and Objective Outcomes of Surgery for Rheumatoid Forefoot Deformities Under the Current Treatment Paradigm. International journal

Masahiro Horita, Keiichiro Nishida, Daisuke Kaneda, Kenzo Hashizume, Yoshihisa Nasu, Ryuichi Nakahara, Kenta Saiga, Hideki Ohashi, Masahito Watanabe, Toshifumi Ozaki

The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons 61 ( 1 ) 53 - 59 2021.6

Language：English Publishing type：Research paper (scientific journal)

We investigated the clinical outcomes of surgical procedures for the treatment of forefoot deformities in patients with rheumatoid arthritis. Twenty feet in 16 women (mean age 62.1 years) underwent corrective osteotomy of the first metatarsal bone with shortening oblique osteotomy of the lesser metatarsophalangeal joints (joint-preservation group), while 13 feet in 12 women (mean age 67.4 years) underwent arthrodesis of the first metatarsophalangeal joint with resection arthroplasty of the lesser metatarsophalangeal joints (joint-sacrifice group); mean follow-up for each group was 25.8 and 23.8 months, respectively. The mean total Japanese Society for Surgery of the Foot (JSSF) scale improved significantly from 64.2 to 89.2 in the joint-preservation group (p < .001), and from 54.2 to 74.2 in the joint-sacrifice group (p = .003). In the joint-preservation group, the postoperative range of motion (ROM) of the joint, walking ability, and activities of daily living scores of the JSSF scale were significantly higher than those in the joint-sacrifice group (p = .001, p = .001, and p = .019, respectively). There were no differences in the subscale scores of the self-administered foot evaluation questionnaire between 2 groups either pre- or postoperatively. No differences in the postoperative complications were found between 2 groups. Although the joint-sacrificing procedure resulted in lower objective outcomes than the joint-preserving procedure regarding the ROM of the joint, the walking ability, and the level of activities of daily living, both procedures resulted in similar treatment outcomes when evaluated by the subjective measures.

DOI： 10.1053/j.jfas.2021.06.008

Ilizarov創外固定とMasquelet法が有効であった下腿遠位部開放骨折の1例

近藤宏也, 上原健敬, 根津智史, 松橋美波, 出宮光二, 横尾賢, 斎藤太一, 雑賀建多, 島村安則, 野田知之, 尾崎敏文

日本創外固定・骨延長学会雑誌 32 226 - 226 2021.4

大腿骨頸部前捻角に左右差はあるか 3D計測による検討

佐藤浩平, 野田知之, 近藤宏也, 畑利彰, 上原健敬, 齋藤太一, 雑賀建多, 島村安則, 尾崎敏文

日本整形外科学会雑誌 95 ( 3 ) S1125 - S1125 2021.3

大腿骨頸部前捻角に左右差はあるか 3D計測による検討

佐藤浩平, 野田知之, 近藤宏也, 畑利彰, 上原健敬, 齋藤太一, 雑賀建多, 島村安則, 尾崎敏文

日本整形外科学会雑誌 95 ( 3 ) S1125 - S1125 2021.3

Steep posterior slope and shallow concave shape of the medial tibial plateau are risk factors for medial meniscus posterior root tears Reviewed International journal

Yuki Okazaki, Takayuki Furumatsu, Yuya Kodama, Yusuke Kamatsuki, Yoshiki Okazaki, Takaaki Hiranaka, Shota Takihira, Tomonori Tetsunaga, Kenta Saiga, Toshifumi Ozaki

Knee Surgery, Sports Traumatology, Arthroscopy 29 ( 1 ) 44 - 50 2021.1

Language：English Publishing type：Research paper (scientific journal) Publisher：Springer Science and Business Media LLC

PURPOSE: Bone morphological factors are important for menisci. Their association with medial meniscus posterior root tears, however, has not yet been studied. This study aimed to compare sagittal medial tibial slope and medial tibial plateau depth between knees with and without medial meniscus posterior root tears. METHODS: Nine healthy volunteers, 24 patients who underwent anterior cruciate ligament reconstruction, and 36 patients who underwent medial meniscus posterior root pullout repair were included. Magnetic resonance imaging examinations were performed in the 10°-knee-flexed position. The medial tibial slope and medial tibial plateau depth were compared among the groups. RESULTS: In healthy volunteers, the anterior cruciate ligament reconstruction group, and the medial meniscus posterior root tear group, the medial tibial slopes were 3.5° ± 1.4°, 4.0° ± 1.9°, and 7.2° ± 1.9°, respectively, and the medial tibial plateau depths were 2.1 ± 0.7 mm, 2.2 ± 0.6 mm, and 1.2 ± 0.5 mm, respectively. Patients with medial meniscus posterior root tears had a significantly steep medial tibial slope and shallow medial tibial plateau concavity compared to those of healthy volunteers (P < 0.01) and the anterior cruciate ligament group (P < 0.01). In the multivariate logistic regression analysis, body mass index, medial tibial slope, and medial tibial plateau depth were significantly associated with medial meniscus posterior root tears. CONCLUSIONS: A steep posterior slope and a shallow concave shape of the medial tibial plateau are risk factors for medial meniscus posterior root tear. LEVEL OF EVIDENCE: Level III: Case-control study.

DOI： 10.1007/s00167-019-05590-4

Other Link： http://link.springer.com/content/pdf/10.1007/s00167-019-05590-4.pdf

整形外科医の家事・育児の役割分担，現状と課題夫婦へのアンケート調査および主婦業体験を踏まえて Reviewed

雑賀建多

中・四整会誌 32 ( 2 ) 223 - 230 2020.9

Effect of Lateral Gutter Osteophyte Resection on Correction of Varus Deformity in Arthroscopic Ankle Arthrodesis. Reviewed International journal

Kenta Saiga, Suguru Yokoo, Hideki Ohashi, Masahiro Horita, Takayuki Furumatsu, Toshifumi Ozaki

Foot & ankle international 41 ( 6 ) 683 - 688 2020.6

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Recently, arthroscopic ankle arthrodesis has been performed for moderate-to-severe varus-deformed ankle osteoarthritis. However, the effect of osteophyte resection in the lateral gutter in arthroscopic ankle arthrodesis has not been clarified. We hypothesized that a varus-deviated ankle with lateral gutter osteophytes can be corrected by osteophyte resection. METHODS: Thirty-nine ankles of 38 patients were included. The mean age of patients was 70.0 (45-83) years. The patients were divided into the following groups: group with an osteophyte in the lateral gutter (osteophyte) and group with no osteophytes (nonosteophyte). Preoperative and postoperative tibiotalar angle, tibial plafond angle, and tibiotalar angle under valgus stress, as well as the Japanese Society for Surgery of the Foot (JSSF) ankle/hindfoot scale, were recorded. Twelve ankles underwent lateral gutter osteophyte resection, whereas the other 27 ankles did not require osteophyte resection. RESULTS: Preoperative tibiotalar angle was higher in the osteophyte group than in the nonosteophyte group (21.8 vs 11.2 degrees, P = .01). The tibiotalar angle in the preoperative valgus stress imaging was higher in the osteophyte group (12.9 vs 5.7, P < .01). However, the postoperative tibiotalar angle was similar between the 2 groups (7.1 vs 5.4, P = .183). JSSF ankle/hindfoot scale improved in both groups. CONCLUSION: Lateral gutter osteophyte resection enabled correction of the varus malalignment in arthroscopic ankle arthrodesis. LEVEL OF EVIDENCE: Level III, retrospective comparative series.

DOI： 10.1177/1071100720910388

人工関節周囲骨折に対するプレート骨接合術 Locking plate を中心に. Reviewed

野田知之, 山川泰明, 横尾賢, 出宮光二, 清野正普, 望月雄介, 雑賀建多, 齋藤太一, 遠藤裕介, 島村安則, 尾崎敏文

日本創外固定・骨延長学会雑誌 31 196 - 196 2020.3

第4中足骨短縮症に対して創外固定器を用いて仮骨延長法を行った2例. Reviewed

大橋秀基, 雑賀建多, 野田知之, 清野正普, 望月雄介, 出宮光二, 尾崎敏文

日本創外固定・骨延長学会雑誌 31 354 - 354 2020.3

変形性足関節症 stage IIIb に対して Distal Tibial Oblique Osteotomy（DTOO）を行い術後良好な社会復帰を果たした一例. Reviewed

近藤宏也, 雑賀建多, 大橋秀基, 野田知之, 尾崎敏文

日本創外固定・骨延長学会雑誌 31 312 - 312 2020.3

耕運機外傷による下腿感染性偽関節、骨欠損に対してイリザロフ型創外固定を用いて治療した1例. Reviewed

清野正普, 野田知之, 山川泰明, 雑賀建多, 出宮光二, 望月雄介, 大橋秀基, 島村安則, 尾崎敏文

日本創外固定・骨延長学会雑誌 31 334 - 334 2020.3

腸骨稜の CT 計測による high route 創外固定ピン至適位置検討. Reviewed

横尾賢, 島村安則, 雑賀建多, 齋藤太一, 清野正普, 望月雄介, 出宮光二, 尾崎敏文, 野田知之

日本創外固定・骨延長学会雑誌 31 51 - 55 2020.3

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：日本創外固定・骨延長学会

創外固定法は骨盤輪骨折に汎用されているが、創外固定ピンが骨外に逸脱する症例も散見され、固定力低下や神経血管損傷の原因となり得る。High route創外固定ピンの至適挿入経路について検討した。AZE社製VirtualPlaceを用いて、骨盤CT撮影を行った患者のDICOM画像データを解析した。対象症例は10例18ヶ所、平均年齢は46.6歳であった。3D-CT上で上前腸骨棘から2、4、6cm後方の腸骨稜に対する接線をひき、それぞれに垂直な断面を作成した。腸骨稜の幅、最狭部の髄腔内距離、腸骨稜から最狭部までの距離等を計測した。腸骨稜の最大幅の平均は後方に向かうにつれて広くなる傾向が、最狭部の髄腔内距離の平均値は後方に向かうにつれて狭くなる傾向がみられた。各断面において、腸骨稜上面から深さ2cmと4cmの中点を結ぶ直線は腸骨稜のやや内側を通過したのに対し、腸骨稜上面から深さ3cmと5cmの中点を結んだ直線は、腸骨稜のやや外側を通過した。ピンの刺入点を腸骨稜の中央よりもやや外側に置くことで、腸骨内へのピンをより長くかつ確実に捉えることができ、ピン逸脱を減少させる可能性が示唆された。(著者抄録)

遊離組織移植と創外固定にて患肢温存し10年後に変形矯正を行った重度下腿開放骨折の1例. Reviewed

望月雄介, 横尾賢, 出宮光二, 大橋秀基, 清野正普, 齋藤太一, 雑賀建多, 尾崎敏文, 野田知之

日本創外固定・骨延長学会雑誌 31 133 - 137 2020.3

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：日本創外固定・骨延長学会

創外固定と遊離組織移植などマイクロサージャリー技術の発達により、重度下腿開放骨折に対して切断を回避し患肢温存が可能な症例が増えてきている。重度軟部組織損傷を合併した下腿骨幹部開放骨折に対し患肢温存するも変形癒合となり、その後10年で変形矯正骨切り、さらには偽関節手術に対してリング型創外固定器を用い骨癒合を得た、難渋症例を経験した。症例は24歳男性、2階から転落受傷した。両下腿骨幹部開放骨折を認め、緊急で洗浄デブリドマンと創外固定を施行した。左下腿骨髄炎も発症し最終的に血管柄付き肩甲骨移植とhybrid創外固定器を用いて骨癒合を得るも変形治癒となった。10年後、左下腿の内反変形に対してTaylor Spatial Frameを用いて変形矯正術を施行した。しかし骨癒合が得られず、Ilizarov創外固定器に変更し骨移植を施行した。術後10ヵ月で骨癒合し創外固定器を抜去した。術後15ヵ月で仕事復帰した。Taylor Spatial Frameによる変形矯正後の偽関節発生などの課題が残ったが、重度軟部組織損傷を合併した下腿骨幹部開放骨折に対するマイクロサージャリー再建、偽関節に対するリング型創外固定を用いた治療は有用であった。(著者抄録)

Clinical outcomes of treatment with locking compression plates for distal femoral fractures in a retrospective cohort. Reviewed International journal

Masahiro Kiyono, Tomoyuki Noda, Hiroshi Nagano, Takashi Maehara, Yasuaki Yamakawa, Yusuke Mochizuki, Takahiko Uchino, Suguru Yokoo, Koji Demiya, Kenta Saiga, Yasunori Shimamura, Toshifumi Ozaki

Journal of orthopaedic surgery and research 14 ( 1 ) 384 - 384 2019.11

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: Plate fixation is one of the standard surgical treatments for distal femoral fractures. There are few reports on the relationship between the screw position and bone union when fixing by the bridging plate (relative stability) method. METHODS: This retrospective study included 71 distal femoral fractures of 70 patients who were treated with the locking compression plate for distal femur (DePuy Synthes Co., Ltd, New Brunswick, CA, USA). The following measurements were evaluated and analyzed: (1) bone union rate, (2) bridge span length (distance between screws across the fracture), (3) plate span ratio (plate length/bone fracture length), (4) number of empty holes (number of screw holes not inserted around the fracture), and (5) medial fracture distance (bone fracture distance on the medial side of the distal femur). Patient demographics (age), comorbidities (smoking, diabetes, chronic steroid use, dialysis), and injury characteristics (AO type, open fracture, infection) were obtained for all participants. Univariate analysis was performed on them. RESULTS: Of 71 fractures, 26 fractures were simple fractures, 45 fractures were comminuted fractures, and 7 fractures resulted in non-union. Non-union rate was significantly higher in comminuted fractures with bone medial fracture distance exceeding 5 mm. Non-union was founded in simple fractures with bone medial fracture distance exceeding 2 mm, but not significant (p = 0.06). In cases with simple fractures, one non-union case had one empty hole and one non-union case had four empty holes, whereas in cases with comminuted fractures, five non-union cases had two more empty holes. CONCLUSIONS: We concluded that bone fragment distance between fracture fragments is more important than bridge span length of the fracture site and the number of empty holes. Smoking and medial fracture distance are prognostic risk factors of nonunion in distal femoral fractures treated with LCP as bridging plate.

DOI： 10.1186/s13018-019-1401-9

工夫! 遊離前外側大腿皮弁を用いたアキレス腱再建強度確保とトラブル回避のための工夫 Reviewed

木下雅人, 渡邊敏之, 櫻井透, 小野田聡, 木股敬裕, 雑賀建多

形成外科 62 ( 8 ) 916 - 921 2019.8

Time-Dependent Increase in Medial Meniscus Extrusion after Medial Meniscus Posterior Root Tear Analyzed by Using Magnetic Resonance Imaging. Reviewed International journal

Yoshiki Okazaki, Takayuki Furumatsu, Yasunori Shimamura, Kenta Saiga, Hideki Ohashi, Takahiko Uchino, Yusuke Kamatsuki, Yuki Okazaki, Toshifumi Ozaki

Knee surgery & related research 31 ( 2 ) 120 - 125 2019.6

Language：English Publishing type：Research paper (scientific journal)

Purpose: Medial meniscus posterior root tear (MMPRT) causes progression of medial meniscus extrusion (MME). This study aims to calculate the progression rate of MME based on findings in two preoperative magnetic resonance imaging (MRI) scans and determine the associated factors. Materials and Methods: We retrospectively reviewed 33 patients (27 females and 6 males; mean age, 60 years) who underwent MRI twice, at a mean interval of 48 days. We measured the medial meniscus body width, medial joint space width (MJSW), and MME. The MME progression rate was derived from regression analysis of the increase in MME (ΔMME) between the two MRI scans. In addition, the correlations of the MME increase rate with age, body mass index, femorotibial angle, and MJSW were evaluated. Results: The mean MME increased from 3.4 mm to 4.5 mm (p<0.001). A good correlation was observed between ΔMME and the interval of MRI scans (R2=0.621), and the MME progression rate was 0.020 mm per day. A moderate correlation was observed between the MME increase rate and the MJSW (R2=0.432). Conclusions: The MME progression rate was rapid in MMPRT and narrowing of the MJSW was associated with the progression of MME. Level of Evidence: V, Cross-sectional study.

DOI： 10.5792/ksrr.18.059

Nonunion fragility fracture of the pelvis with complication from bladder rupture: A case report. Reviewed International journal

Yasuaki Yamakawa, Tomoyuki Noda, Taichi Saito, Kenta Saiga, Ryuichi Nakahara, Yasunori Shimamura, Toshifumi Ozaki

Trauma case reports 20 100169 - 100169 2019.4

Language：English Publishing type：Research paper (scientific journal)

The incidence rate of bladder rupture associated with pelvic ring fractures is reported to be about 5-10%, mostly occurring at the time of injury. Fragility pelvic ring fractures are reported to increase fracture displacement or become nonunion if they are treated inadequately. Few case reports on bladder rupture associated with fragility pelvic ring fracture have been published. We report a rare case of delayed bladder rupture associated with a fragility fracture of the pelvis. A 65-year-old female felt right hip pain without sustaining any trauma. She was diagnosed with a right pubic rami fracture. However, her pain deteriorated, and a sacral fracture was identified one month later. She was prescribed teriparatide, but her pain worsened and she was referred to our hospital. She was diagnosed with fragility fracture of the pelvis (Rommens classification type IVb) and was treated operatively. During the surgery, her thin bladder wall, which was compressed by a displaced pubic fragment, was torn and repaired. This is the first report describing a fragility fracture of the pelvis associated with a bladder rupture. Our treatment led to a successful result.

DOI： 10.1016/j.tcr.2019.100169

Histological alterations to the hamstring tendon caused by cleaning during autograft preparation Reviewed International journal

Okazaki Y, Furumatsu T, Maehara A, Saiga K, Miyazawa S, Kamatsuki Y, Hino T, Ozaki T

Muscles Ligaments Tendons Journal 9 ( 2 ) 217 - 224 2019.4

左下腿遠位部骨折術後6年で再燃を認めた難治性骨髄炎の1例 Reviewed

出宮光二, 雑賀建多, 大橋秀基, 清野正普, 野田知之, 尾崎敏文

骨折 41 ( 2 ) 658 - 662 2019.4

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：(一社)日本骨折治療学会

症例は46歳、男性。祭りで左下腿遠位部骨折を受傷した。前医での内固定術後、深部感染症を発症し、抜釘+抗菌薬含有セメントビーズ留置+遊離筋皮弁術が行われ感染の沈静化を得た。しかし、約6年後骨髄炎の再燃を認め、前医処置で感染沈静化せず、当院紹介受診となった。下腿遠位部切除+イリザロフ創外固定を行い、術後1ヵ月で足関節固定+脛骨近位骨切り、その後約5cm骨延長を行い、術後4ヵ月で最終固定とした。術後8ヵ月でイリザロフ創外固定器を除去し、術後24ヵ月現在、骨髄炎の再燃はなく独歩可能となった。左下腿遠位部骨折術後6年で再燃を認めた難治性骨髄炎に対し、十分な病巣掻爬と近位健常部での骨延長により感染を沈静化し、機能再建し得た。骨髄炎の治療においては十分なデブリドマン、病巣切除による感染巣の摘出が重要である。慢性骨髄炎治療においては長期間の沈静化後の再発も起こりうるため、今後も注意深い経過観察が重要である。(著者抄録)

指節骨用創外固定器を用いて治療した化膿性DIP関節炎・骨髄炎の2例 Reviewed

齋藤太一, 島村安則, 出宮光二, 望月雄介, 清野正普, 雑賀建多, 野田知之, 尾崎敏文

日本創外固定・骨延長学会雑誌 30 212 - 212 2019.3

血管柄付き腸骨移植とイリザロフ創外固定を併用し足関節固定術を行った足関節骨折後真菌感染の1例 Reviewed

清野正普, 雑賀建多, 野田知之, 山川泰明, 出宮光二, 横尾賢, 望月雄介, 大橋秀基, 島村安則, 尾崎敏文

日本創外固定・骨延長学会雑誌 30 213 - 213 2019.3

左下腿遠位部骨折術後6年で再燃を認めた難治性骨髄炎の1例 Reviewed

出宮光二, 雑賀建多, 横尾賢, 望月雄介, 清野正普, 齋藤太一, 野田知之, 尾崎敏文

日本創外固定・骨延長学会雑誌 30 249 - 249 2019.3

下腿遠位部開放骨折に対し MATILDA 法（Multidirectional Ankle Traction using Ilizarov external fixator with Long rod and Distraction Arthroplasty）を用いて治療した1例 Reviewed

望月雄介, 雑賀建多, 出宮光二, 大橋秀基, 清野正普, 齋藤太一, 尾崎敏文, 野田知之

日本創外固定・骨延長学会雑誌 30 79 - 83 2019.3

Language：Japanese Publishing type：Research paper (scientific journal) Publisher：日本創外固定・骨延長学会

Ilizarov創外固定に代表されるリング型創外固定器は、脆弱性骨折でも強固な固定を行うことができ、軟部組織に対する侵襲を最小限にできる利点がある。Ilizarov創外固定にdistraction arthroplastyを併用するMATILDA法は、早期荷重を可能とする強固な固定と関節温存を目的とする治療法である。症例は70歳男性、1.5mの高さから転落し受傷した。右下腿遠位部開放骨折を認めたが、軟部組織損傷が強くMATILDA法を選択した。術後は荷重を許可したがフットリングの前足部ワイヤー刺入部の痛みのために十分な荷重はできなかった。術後6ヵ月で骨癒合し、7ヵ月で創外固定器を抜去、術後9ヵ月でゆっくりと独歩可能となった。MATILDA法は軟部組織侵襲が最小限であり、今回の軟部組織損傷を合併した下腿遠位部骨折に対して有用であった。今後、前足部ワイヤー刺入部痛を和らげ、創外固定装着中の全荷重歩行を可能にする補装具を工夫する必要がある。(著者抄録)

Nonunion fragility fracture of the pelvis with complication from bladder rupture: A case report Reviewed International journal

Yamakawa Y, Noda T, Saito T, Saiga K, Nakahara R, Shimamura Y, Ozaki T

Trauma Case Reports 20 100169 - 100169 2019.2

関節リウマチ外側趾MTP関節背屈変形の重症度分類

大橋秀基, 西田圭一郎, 那須義久, 中原龍一, 雑賀建多, 堀田昌宏

日本足の外科学会雑誌 39 ( Suppl. ) S370 - S370 2018.10

踵骨開放骨折術後創部感染症によるアキレス腱欠損に対し ALT flap を用いたアキレス腱再建術を行った1例. Reviewed

出宮光二, 雑賀建多, 清野正普, 大橋秀基, 吉村将秀, 野田知之, 尾﨑敏文

日足外会誌 39 ( 1 ) 330 - 333 2018.8

当院における外脛骨障害の治療成績. Reviewed

大橋秀基, 雑賀建多, 吉村将秀, 清野正普, 木曽洋平, 横尾賢, 出宮光二, 野田知之, 尾﨑敏文

日足外会誌 39 ( 1 ) 176 - 179 2018.8

スポーツに起因する外脛骨障害の治療 Reviewed

大橋秀基, 雑賀建多, 尾﨑敏文

別冊整形外科 No.73 スポーツ傷害の予防・診断・治療 ( 73 ) 231 - 234 2018.4

足関節脱臼骨折後遺残変形に対し腓骨延長を行った2例

雑賀建多, 大橋秀基, 堀田昌宏, 出宮光二, 横尾賢, 内野崇彦, 清野正普, 望月雄介, 小松原将, 吉村将秀, 中道亮, 山川泰明, 齋藤太一, 野田知之, 尾崎敏文

中国・四国整形外科学会雑誌 30 ( 1 ) 163 - 163 2018.4

Outcomes of Resection and Joint-Preserving Arthroplasty for Forefoot Deformities for Rheumatoid Arthritis. Reviewed International journal

Masahiro Horita, Keiichiro Nishida, Kenzo Hashizume, Yoshihisa Nasu, Kenta Saiga, Ryuichi Nakahara, Takahiro Machida, Hideki Ohashi, Toshifumi Ozaki

Foot & ankle international 39 ( 3 ) 292 - 299 2018.3

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND: We investigated the clinical outcomes of resection and joint-preserving arthroplasty for forefoot deformities in patients with rheumatoid arthritis. METHODS: Sixteen feet of 14 women (average age, 67.1 years; range, 53-82) underwent resection arthroplasty of the metatarsal head (resection group), and 18 feet of 15 women (average age, 61.3 years; range, 40-73) underwent a metatarsophalangeal joint-preserving procedure with shortening oblique metatarsal osteotomies of the lesser toes (joint preservation group). The mean disease duration in the resection and joint preservation groups was 23.6 and 19.1 years, and the average follow-up period was 37.3 and 33.5 months, respectively. The classification of Larsen was used to assess the severity of destruction of the metatarsophalangeal (MTP) joint. Preoperative and postoperative clinical evaluation included Japanese Society for Surgery of the Foot (JSSF) score and postoperative complications. RESULTS: The number of preoperative radiographic destruction of the MTP joints (Larsen grade II, III, IV, and V) was 0, 29, 39, and 12 joints in the resection group and 13, 67, 9, and 1 joints in the joint preservation group. The mean JSSF score improved significantly from 61.3 to 83.9 points in the resection group ( P < .001) and from 62.2 to 90.8 points in the joint preservation group ( P < .001). In the resection group, recurrence of callosities and claw toe deformity was observed in 6 and 3 feet, respectively. In the joint-preserving group, recurrence of callosities and hammer toe deformity was observed in 1 foot each. CONCLUSION: The resection arthroplasty and joint-preserving procedure showed satisfactory clinical outcomes. However, whether both procedures can maintain the good clinical results without the recurrence of forefoot deformity will require longer follow-up. LEVEL OF EVIDENCE: Level III, retrospective comparative series.

DOI： 10.1177/1071100717743996

リトルリーグショルダーに対する新しい診断法抵抗下外旋テストおよび抵抗下内旋テストの有用性

内野崇彦, 島村安則, 志渡澤央和, 中道亮, 齋藤太一, 雑賀建多, 島村好信, 古松毅之, 名越充, 野田知之, 尾崎敏文

日本整形外科学会雑誌 92 ( 3 ) S1175 - S1175 2018.3

母趾 MTP 関節固定術用プレートの各社比較. Reviewed

雑賀建多, 大橋秀基, 尾﨑敏文

関節外科 37 ( 1 ) 35 - 42 2018.1

重度外反母趾に対する母趾 MTP 関節固定術の手術成績 Reviewed

雑賀建多, 大橋秀基, 清野正普, 吉村将秀, 堀田昌宏, 尾﨑敏文

日足外会誌 38 ( 1 ) 180 - 184 2017.9

青年期の肘関節弛緩性に対して年齢が与える影響についての検討

内野崇彦, 島村安則, 島村好信, 名越充, 中道亮, 井上博登, 雑賀建多, 古松毅之, 野田知之, 尾崎敏文

日本整形外科スポーツ医学会雑誌 37 ( 4 ) 561 - 561 2017.8

距骨下関節開放脱臼骨折に対し観血的内固定および靭帯修復を行った1例 Reviewed

伊達宏和, 小西池泰三, 雑賀建多

JOSKAS 42 ( 2 ) 400 - 401 2017.4

関節リウマチ患者の前足部変形に対する切除関節形成術と関節温存手術の治療成績の比較

堀田昌宏, 雑賀建多, 竹下歩, 兼田大輔, 大橋秀基, 尾崎敏文, 西田圭一郎, 橋詰謙三, 那須義久, 中原龍一

中国・四国整形外科学会雑誌 29 ( 1 ) 157 - 157 2017.4

Treatment experience of postoperative calcaneal osteomyelitis Reviewed

KIYONO Masahiro

The Central Japan Journal of Orthopaedic Surgery & Traumatology 60 ( 2 ) 315 - 316 2017.3

関節リウマチ患者の前足部変形に対する切除関節形成術と関節温存手術の治療成績

堀田昌宏, 西田圭一郎, 橋詰謙三, 那須義久, 中原龍一, 雑賀建多, 竹下歩, 兼田大輔, 大橋秀基, 尾崎敏文

日本整形外科学会雑誌 91 ( 3 ) S860 - S860 2017.3

SAFE-Qを用いた関節リウマチ足部手術成績の評価

兼田大輔, 西田圭一郎, 那須義久, 中原龍一, 雑賀建多, 堀田昌宏, 竹下歩, 大橋秀基, 尾崎敏文

日本整形外科学会雑誌 91 ( 3 ) S863 - S863 2017.3

関節リウマチ患者における足部障害の評価

吉村将秀, 雑賀建多, 大橋秀基, 兼田大輔, 竹下歩, 堀田昌宏, 中原龍一, 那須義久, 西田圭一郎, 尾崎敏文

日本整形外科学会雑誌 91 ( 3 ) S845 - S845 2017.3

肘関節内側側副靱帯損傷に対する関節造影ストレス撮影の有用性

島村安則, 内野崇彦, 島村好信, 中道亮, 名越充, 雑賀建多, 古松毅之, 野田知之, 尾崎敏文

日本整形外科学会雑誌 91 ( 3 ) S1109 - S1109 2017.3

上腕骨小頭離断性骨軟骨炎の発生部位は内側支持機構のゆるみに影響される

内野崇彦, 島村安則, 島村好信, 中道亮, 名越充, 雑賀建多, 古松毅之, 野田知之, 尾崎敏文

日本整形外科学会雑誌 91 ( 3 ) S1106 - S1106 2017.3

肘関節投球障害に対する関節造影ストレス撮影の有用性

島村安則, 内野崇彦, 島村好信, 中道亮, 井上博登, 名越充, 雑賀建多, 古松毅之, 野田知之, 尾崎敏文

日本肘関節学会雑誌 24 ( 1 ) S106 - S106 2017.1

上腕骨小頭離断性骨軟骨炎に対する内側支持機構のゆるみの影響

内野崇彦, 島村安則, 島村好信, 中道亮, 井上博登, 名越充, 雑賀建多, 古松毅之, 野田知之, 尾崎敏文

日本肘関節学会雑誌 24 ( 1 ) S18 - S18 2017.1

小児上腕骨顆上骨折後にVolkmann拘縮を来した1例

柏原尚子, 島村安則, 原田遼三, 中原龍一, 雑賀建多, 野田知之, 西田圭一郎, 尾崎敏文

日本小児整形外科学会雑誌 25 ( 2 ) 183 - 187 2016.12

Language：Japanese Publisher：(一社)日本小児整形外科学会

小児上腕骨顆上骨折は、小児肘関節周囲骨折の中で最も高頻度に発生し、合併症が多い疾患である。上腕骨顆上骨折後にVolkmann拘縮を来した1例を経験したので報告する。7歳男児、ジャングルジムより墜落して受傷。前医で上腕骨顆上骨折と診断され、当日創外固定術を施行された。術後徐々に手指の屈曲傾向が進行し、当科紹介となった。Volkmann拘縮と診断し、装具加療や徹底したリハビリの後、屈筋腱解離術を施行した。手術所見としては、屈筋群深層筋線維に変性像を認め、正中・尺骨神経剥離術、屈筋群剥離・前進術を施行した。術後6ヵ月時、DIP関節の屈曲拘縮が残存するも全指伸展位保持可能となり、術後7年時生活に支障のない状態まで回復した。小児上腕骨顆上骨折の合併症であるVolkmann拘縮は、重篤な後遺症を残す。本骨折に対していかなる治療方法を選択しても、阻血性障害への注意が重要である。(著者抄録)

Shortening Oblique Osteotomy with Screw Fixation for Correction of the Lesser Metatarsophalangeal Joints of Rheumatoid Forefoot.

Keiichiro Nishida, Takahiro Machida, Masahiro Horita, Kenzo Hashizume, Ryuichi Nakahara, Yoshihisa Nasu, Hideki Ohashi, Kenta Saiga, Toshifumi Ozaki

Acta medica Okayama 70 ( 6 ) 477 - 483 2016.12

Language：English Publishing type：Research paper (scientific journal)

The metatarsophalangeal (MTP) joints are often and predominantly affected in rheumatoid arthritis. The aim of the current study was to describe surgical techniques of shortening oblique osteotomy for lesser metatarsal bone with screw fixation at the osteotomy site, and to investigate the short-term clinical outcomes of our procedure. Twenty-seven feet (78 toes) of 24 RA patients underwent the shortening oblique osteotomy for the correction of deformity at the lesser MTP joints. The average Japanese Society of Surgery of the Foot (JSSF) standard rating system for the RA foot and ankle scale improved significantly from 59.6 points preoperatively to 88.3 points postoperatively (p＜0.001). Twenty-four feet (89% ) were free from metatarsalgia and symptomatic callosities at the lesser MTP joint after surgery. Our present findings showed satisfactory early clinical outcomes of the shortening oblique osteotomy of the metatarsal bone with screw fixation for RA forefoot.

足関節OAの治療選択脛骨骨切り術 VS 足関節固定術脛骨骨切り術の立場から Reviewed

雑賀建多

Loco Cure 2 ( 2 ) 160 - 163 2016.5

プロサッカー選手に発生した肉離れの検討-過去6年間の調査- Reviewed

大森敏規, 雑賀建多, 武田健, 宮澤慎一, 島村安則, 千田益生, 尾﨑敏文, 阿部信寛

JOSKAS 41 ( 2 ) 558 - 559 2016.4

患肢を温存し得た踵骨骨折術後骨髄炎の1例 Reviewed

吉村将秀, 雑賀建多, 野田知之, 大橋秀基, 堀田昌宏, 尾﨑敏文

日足外会誌 37 ( 1 ) 352 - 355 2016.4

Shortening Oblique Osteotomy with Screw Fixation for Correction of the Lesser Metatarsophalangeal Joints of Rheumatoid Forefoot Reviewed International journal

Nishida K, Machida T, Horita M, Hashizume K, Nakahara R, Nasu Y, Ohashi H, Saiga K, Ozaki T

Acta Med Okayama 70 ( 6 ) 477 - 483 2016.4

外傷後の著明な尖足に対して Taylor Spatial Frame を用いて変形矯正を施行した1例 Reviewed

望月雄介, 雑賀建多, 大橋秀基, 兼田大輔, 吉村将秀, 堀田昌宏, 尾﨑敏文

中・四整学誌 28 ( 2 ) 313 - 316 2016.4

claw toe に対して後足部鏡視下長母趾屈筋腱切離術を施行した2例 Reviewed

大橋秀基, 雑賀建多, 吉村将秀, 堀田昌宏, 尾﨑敏文

日足外会誌 37 ( 1 ) 288 - 291 2016.4

整形外科外傷治療における3Dモデル・3Dプリンターの応用 Reviewed

杉生和久, 中原龍一, 吉村将秀, 山川泰明, 雑賀建多, 島村安則, 野田知之, 尾﨑敏文

関節外科 35 ( 2 ) 76 - 85 2016.2

【3Dモデル・3Dプリンターを利用した整形外科手術】整形外科分野への応用整形外科外傷治療における3Dモデル・3Dプリンターの応用

杉生和久, 中原龍一, 吉村将秀, 山川泰明, 雑賀建多, 島村安則, 野田知之, 尾崎敏文

関節外科 35 ( 2 ) 180 - 189 2016.2

外反母趾に対する遠位骨切り術 Reviewed

雑賀建多

関節外科 35 ( 1 ) 68 - 73 2016.1

Postoperative change in the length and extrusion of the medial meniscus after anterior cruciate ligament reconstruction Reviewed

Shinji Narazaki, Takayuki Furumatsu, Takaaki Tanaka, Masataka Fujii, Shinichi Miyazawa, Hiroto Inoue, Yasunori Shimamura, Kenta Saiga, Toshifumi Ozaki

INTERNATIONAL ORTHOPAEDICS 39 ( 12 ) 2481 - 2487 2015.12

Language：English Publishing type：Research paper (scientific journal) Publisher：SPRINGER

Purpose The medial meniscus is a secondary stabilizer of anterior tibial translation in anterior cruciate ligament (ACL)-deficient knees. ACL reconstruction effectively restores an increased anterior tibial translation in the ACL-deficient knee. However, knee osteoarthritis sometimes develops in ACL-reconstructed patients during a long-term follow-up period. We hypothesized that the medial meniscal position would be different between the ACL-deficient and reconstructed knees. The aim of this study was to investigate pre-operative and postoperative location of the medial meniscus in patients who underwent ACL reconstruction.
Methods ACL-reconstructed knees (28 knees) and normal knees (27 knees) were investigated. Medial tibial plateau length (MTPL) and medial tibial plateau width (MTPW) were determined using radiographic images. Magnetic resonance imaging (MRI)-based medial meniscal length (MML), medial meniscal width (MMW), and medial meniscal extrusion (MME) were measured. Postoperative change in the MML, MMW, and MME were evaluated and compared with those in normal knees.
Results No significant differences between the ACL-deficient (pre-operative) and normal groups were noted. The ACL-reconstructed (postoperative) group showed an increase in the MML, in the percentage of the MML (%MML = 100 MML/MTPL), and in the MME. Significant differences between postoperative and normal groups were observed in the MML, %MML, and MME. MMW and MMW percentage (100 MMW/MTPW) were similar in all groups.
Conclusions The anteroposterior length and radial extrusion of the medial meniscus increased after ACL reconstruction. Transposition of the medial meniscus may be a possible cause of developing further degenerative knee joint disorders after ACL reconstruction.

DOI： 10.1007/s00264-015-2704-z

寛骨臼骨折におけるposterior column screwの安全域 3DCTによる検討

吉村将秀, 上原健敬, 野田知之, 小松原将, 杉生和久, 山川泰明, 雑賀建多, 中原龍一, 島村安則, 尾崎敏文

日本整形外科学会雑誌 89 ( 8 ) S1424 - S1424 2015.9

キーンベック病に対する手術治療長期経過の1例

原田遼三, 島村安則, 井上円加, 小澤正嗣, 山川泰明, 柏原尚子, 雑賀建多, 魚谷弘二, 中原龍一, 野田知之, 西田圭一郎, 尾崎敏文

中国・四国整形外科学会雑誌 27 ( 2 ) 379 - 379 2015.9

足関節開放脱臼骨折に対してVAF flapを用いて治療した2例

堀田昌宏, 雑賀建多, 野田知之, 尾崎敏文, 木浪陽, 斎藤太一

骨折 37 ( 3 ) 829 - 832 2015.6

Language：Japanese Publisher：(一社)日本骨折治療学会

足関節開放脱臼骨折2例に対してvenoaccompanying artery fasciocutaneous(以下、VAF)flapを用いて治療した。症例1は49歳男性で、右足関節開放脱臼骨折(Gustilo type IIIB、AO44-B3)に対して、受傷から4時間半後に緊急で洗浄デブリドマンおよび創外固定施行、受傷後11日目に内固定し、受傷後17日目にVAF flapを施行。症例2は60歳男性で、右足関節開放脱臼骨折(Gustilo type IIIB、AO44-B3)に対して、受傷から6時間半後に緊急で洗浄デブリドマンおよび創外固定施行。受傷後11日目に内固定とVAF flapを施行。2例とも元の生活活動に復帰し経過良好であった。足関節開放骨折に対して当科では、まず洗浄・デブリドマン・創外固定を施行し、次に二期的に徹底したデブリドマンを行い、可能な限り同時に骨軟部組織再建を施行するという治療方針を立てている。今回2例とも骨接合に併用してVAF flapを用いて治療し、良好な足関節の機能を獲得することができた。足関節開放骨折Gustilo type IIIBに対し、皮弁挙上部の軟部組織損傷を認めなければVAF flapは有用であった。(著者抄録)

大腿骨ステム周囲骨折に対するロッキングプレートの治療経験

児玉有弥, 野田知之, 島村安則, 木浪陽, 中原龍一, 雑賀建多, 山川泰明, 上原健敬, 杉生和久, 尾崎敏文

骨折 37 ( Suppl. ) S191 - S191 2015.6

寛骨臼骨折におけるPosterior Column ScrewおよびInfra Acetabular Screwの安全域 3DCTによる検討

上原健敬, 野田知之, 吉村将秀, 杉生和久, 山川泰明, 雑賀建多, 中原龍一, 島村安則, 木浪陽, 尾崎敏文

骨折 37 ( Suppl. ) S188 - S188 2015.6

Iliosacral screw挿入における仙骨安全域の検討

上原健敬, 野田知之, 山川泰明, 雑賀建多, 中原龍一, 木浪陽, 島村安則, 尾崎敏文

日本整形外科学会雑誌 89 ( 3 ) S805 - S805 2015.3

足関節開放脱臼骨折に対してVAF flapを用いて治療した2例

堀田昌宏, 雑賀建多, 野田知之, 井上円加, 中原龍一, 島村安則, 尾崎敏文, 木浪陽, 斎藤太一

骨折 36 ( Suppl. ) S432 - S432 2014.6

Can we use a 4.0-mm arthroscope for arthroscopic ankle arthrodesis?:—Evaluation by a pre-operative stress X-ray—

SAIGA Kenta

The Central Japan Journal of Orthopaedic Surgery & Traumatology 57 ( 2 ) 419 - 420 2014

下肢長管骨関節近傍骨折に対する一時的創外固定の有用性

野田知之, 島村安則, 西山武, 中原龍一, 雑賀建多, 斉藤太一, 金澤智子, 長谷井嬢, 尾崎敏文

日本創外固定・骨延長学会雑誌 23 207 - 207 2012.1

Roof impactionを伴う寛骨臼骨折の治療経験

藤原智洋, 野田知之, 中原龍一, 雑賀建多, 島村安則, 尾崎敏文

骨折 33 ( 3 ) 637 - 642 2011.9

Language：Japanese Publisher：(一社)日本骨折治療学会

Roof impactionを伴う寛骨臼骨折3例の手術治療について検討した。本所見に伴う骨折型は前壁骨折1例、前柱骨折2例であった。前壁骨折に伴う1例に対してはilioinguinal approachの2nd windowから前壁骨片を翻転し陥没骨片を直視下に整復した。前柱骨折に伴う2例に対してはmodified Stoppa approachにlateral windowを併用し、1例は陥没骨片直上の骨折部から整復を、1例は骨片直上を開窓し整復した。いずれも内固定および人工骨充填によるsubchondral supportを行った。全例整復位・臨床評価ともに概ね良好な成績を得たが、うち1例はアプローチ選択に課題が残った。Roof impactionの存在は成績不良因子とされるが、個々の症例における術前の詳細な評価、アプローチ選択および整復固定法の工夫により治療成績の改善が期待できる。(著者抄録)

三次元実体石膏模型を用いて、術前プレートベンディングを行った寛骨臼骨折の2例

西山武, 野田知之, 島村安則, 雑賀建多, 中原龍一, 尾崎敏文

骨折 33 ( 3 ) 643 - 647 2011.9

Language：Japanese Publisher：(一社)日本骨折治療学会

CT画像を基に作成した三次元実体石膏模型を用いて、寛骨臼骨折の術前計画を行った。使用するプレートの設定位置を決定し、術前にベンディングした。2例の寛骨臼骨折(37歳男性、左寛骨臼骨折AO分類:62-A3。53歳男性、左骨盤輪骨折および右寛骨臼骨折AO分類:61-C1+62-B2)に対し、術前にベンディングしたプレートを使用し、良好な結果を得た。三次元実体石膏模型は、術前計画において画像からの把握(視覚的情報)のみならず、立体像の把握(触覚的情報)を得ることができる。手術に有用な情報が得られ術者を助けるばかりでなく、術前にチーム間で骨盤立体構造をディスカッションすることで、立体解剖の認識が高まり、教育の面でも有用である。(著者抄録)

3D-CADシステムを用いた鎖骨の三次元形状比較

中原龍一, 野田知之, 金澤智子, 斉藤太一, 雑賀建多, 島村安則, 尾崎敏文

骨折 33 ( Suppl. ) S286 - S286 2011.7

A Case of Surgery for Kyphosis of the Thoracolumbar Spine in an Elderly Patient with Dysphagia Reviewed

Kazuo Nakanishi, Kentarou Yamane, Masato Tanaka, Haruo Misawa, Kenta Saiga, Toshifumi Ozaki

ACTA MEDICA OKAYAMA 65 ( 3 ) 211 - 214 2011.6

Language：English Publishing type：Research paper (scientific journal) Publisher：OKAYAMA UNIV MED SCHOOL

Here we report a case of surgery for kyphosis of the thoracolumbar spine in an elderly patient, in whom surgery was performed because the patient had developed intractable digestive symptoms. The case was that of a 76-year-old female with complaints of back pain and dysphagia. When videofluoroscopic examination (VF) of swallowing was performed in the cardia of the stomach, images that indicated stagnation and the reflux of food were observed. It was easier for the patient to swallow food in the extension position. We performed corrective fusion of the posterior spine. After the surgery, the kyphosis angle was improved to 27 degrees, the patient's back pain was alleviated, and it became easier for the patient to swallow food. VF also showed that the patient's difficulties with the passage of food had improved. We believe that surgery is a good treatment option for cases of kyphosis with digestive symptoms and deteriorating activities of daily living (ADL), even in the absence of pain and paralysis. VF is also useful for performing evaluations before and after surgery.

掌側プレート固定を行った橈骨遠位端骨折における抜釘術の重要性

島村安則, 井上円加, 小澤正嗣, 斎藤太一, 金澤智子, 中原龍一, 雑賀建多, 野田知之, 西田圭一郎, 尾崎敏文

中国・四国整形外科学会雑誌 23 ( 1 ) 258 - 258 2011.4

ハンドル外傷による舟状骨骨折の1例

金澤智子, 島村安則, 西田圭一郎, 斎藤太一, 中原龍一, 雑賀建多, 野田知之, 尾崎敏文

中国・四国整形外科学会雑誌 23 ( 1 ) 253 - 253 2011.4

原発性肺癌患者における周術期管理について

岩井賢司, 築山尚司, 太田晴之, 大塚貴久, 堅山佳美, 雑賀建多, 福田智美, 萩山明和, 石岡裕也, 千田益生

理学療法学 38 ( Suppl.2 ) PI2 - 359 2011.4

骨髄炎に対する抗菌薬含有セメント髄内釘による治療成績の検討

金澤智子, 野田知之, 島村安則, 西山武, 雑賀建多, 中原龍一, 尾崎敏文

日本骨・関節感染症学会雑誌 24 43 - 46 2011.2

Language：Japanese Publisher：(一社)日本骨・関節感染症学会

骨折治療後に生じた長管骨骨髄炎に対して抗菌薬含有セメント髄内釘または抗菌薬含有セメントロッドによる治療を行った7例の成績を報告した。男性6例、女性1例、年齢16〜81歳、罹患部位は大腿骨5例、脛骨2例、起因菌はMRSAが6例、不明1例であった。治療成績は6例(86%)で感染の沈静化が得られ、治療開始時に骨癒合していなかった5例中3例(60%)で骨癒合が得られた。代表例1例を提示した。

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2011&ichushi_jid=J04867&link_issn=&doc_id=20110214090009&doc_link_id=%2Fey4kotsu%2F2010%2F002400%2F009%2F0043-0046%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fey4kotsu%2F2010%2F002400%2F009%2F0043-0046%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Comparison between Fondaparinux and Enoxaparin in Early Administration after Total Knee Arthroplasty

Okada Yukimasa, Furumatsu Takayuki, Itani Satoru, Saiga Kenta, Takata Naoki, Yokoyama Yusuke, Ozaki Toshifumi, Abe Nobuhiro

The Journal of the Chugoku-Shikoku Orthopaedic Association 23 ( 2 ) 399 - 403 2011

Language：Japanese Publisher：The Chugoku-Shikoku Orthopaedic Association

Background: The validity of fondaparinux and enoxaparin has been reported in the prevention of deep vein thronbosis and pulmonary embolism (DVT/PE) after total knee arthroplasty (TKA). We compared the effectiveness of early administration of these two drugs after TKA.<br>Methods: We studied 32 patients who underwent TKA in the period between May 2009 and May 2010. The operations were performed under general anesthesia and femoral nerve block, using an air tourniquet, and using cements for implant fixation. The patients were divided in two groups, use of 2.5mg fondaparinux once daily (Fa group), and use of 2000IU of enoxaparin twice daily (Ex group). The initial dose was administered between 12 and 21 hours after surgery and continued for 14 days. We compared the incidence of DVT/PE, bleeding complications, D dimer level, and hemoglobin (Hb) loss.<br>Results: DVT/PE occurred in 6 patients (38%) in the Fa group, and 3 (19%) in the Ex group. Bleeding complications occurred in none of the Fa group and 4 (25%) in the Ex group. There were no significant differences in D dimer level and Hb loss.<br>Conclusion: Our results indicate that enoxaparin decreases the incidence of DVT/PE compared with fondaparinux, but increases the bleeding complications.

DOI： 10.11360/jcsoa.23.399

Combined use of bFGF and GDF-5 enhances the healing of medial collateral ligament injury Reviewed

Kenta Saiga, Takayuki Furumatsu, Aki Yoshida, Shin Masuda, Shota Takihira, Nobuhiro Abe, Toshifumi Ozaki

BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS 402 ( 2 ) 329 - 334 2010.11

Language：English Publishing type：Research paper (scientific journal) Publisher：ACADEMIC PRESS INC ELSEVIER SCIENCE

Basic fibroblast growth factor (bFGF) and growth and differentiation factor (GDF)-5 stimulate the healing of medial collateral ligament (MCL) injury. However, the effect of isolated and combined use of bFGF/GDF-5 remains still unclear. We investigated cellular proliferation and migration responding to bFGF/GDF-5 using rabbit MCL fibroblasts. Rabbit MCL injury was treated by bFGF and/or GDF-5 with peptide hydrogels. Gene expression and deposition of collagens in healing tissues were evaluated. bFGF/GDF-5 treatment additively enhanced cell proliferation and migration. bFGF/GDF-5 hydrogels stimulated Col1a1 expression without increasing Col3a1 expression. Combined use of bFGF/GDF-5 stimulated type I collagen deposition and the reorganization of fiber alignment, and induced better morphology of fibroblasts in healing MCLs. Our study indicates that combined use of bFGF/GDF-5 might enhance MCL healing by increasing proliferation and migration of MCL fibroblasts, and by regulating collagen synthesis and connective fiber alignment. (C) 2010 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.bbrc.2010.10.026

【肩関節・肩甲帯部疾患病態・診断・治療の現状】治療保存的治療と手術的治療の現状骨折と脱臼鎖骨骨折鎖骨骨幹部骨折に対するプレート固定法前下方プレート法、minimally invasive plate osteosynthesis法

島村安則, 野田知之, 中原龍一, 雑賀建多, 西山武, 尾崎敏文

別冊整形外科 ( 58 ) 71 - 75 2010.10

Language：Japanese Publisher：(株)南江堂

2007年より鎖骨骨幹部骨折に対してプレート固定による手術的治療を行った症例は42例であった。そのうち、初期の32例に対してはanteroinferior plating法(AP法)を、2009年からの10例は、AP法を応用したminimally invasive plate osteosynthesis法(MIPO法)を施行した。AP法、MIPO法ともに全例において骨癒合が得られ、JOAスコア、DASHスコアともに良好な改善が得られた。MIPO法はAP法に比較して、早期に疼痛の軽減が得られている印象であった。AP法は従来の手術法に比べて早期に社会復帰が可能となる有用な方法であるが、さらにMIPO法はAP法のメリットに加えて整容面や骨折部の血流温存といった面でも有利であり、手術・保存的治療双方のメリットを併せ持つ優れた治療法であると考えられた。

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2010&ichushi_jid=J04037&link_issn=&doc_id=20101104480015&doc_link_id=10.15106%2FJ04037.2011097692&url=https%3A%2F%2Fdoi.org%2F10.15106%2FJ04037.2011097692&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

肩鎖関節脱臼に合併した外傷性肩関節前方不安定症の1例

島村安則, 阿部信寛, 野田知之, 雑賀建多, 斎藤太一, 金澤智子, 井上円加, 小澤正嗣, 中原龍一, 尾崎敏文

肩関節 35 ( 1 ) 189 - 189 2010.9

ロッキングプレートによる下肢長管骨非感染性偽関節の治療成績

藤原智洋, 野田知之, 西山武, 中原龍一, 雑賀建多, 島村安則, 尾崎敏文, 加原尚明, 宮澤慎一, 高城康師

中国・四国整形外科学会雑誌 22 ( 2 ) 355 - 361 2010.9

Language：Japanese Publisher：中国・四国整形外科学会

2005〜2008年に当科と関連施設で下肢長管骨非感染性偽関節に対してロッキングプレートによる治療を行った15例の成績を報告した。男性7例、女性8例、手術時年齢21〜82歳、手術部位は大腿骨骨幹部2例、大腿骨遠位部3例、脛骨近位部7例、脛骨骨幹部2例、脛骨遠位部1例であった。偽関節の種類はhypertrophic non-unionが9例、atrophic non-unionが6例であった。手術では14例に自家骨移植を併施した。治療成績は全例で骨癒合が得られた。術直後から最終観察時までのアライメント変化の度合いは、単純X線正面像で平均1.13°(0〜10°)、側面像で平均0.35°(0〜5°)であり、ほとんどの症例で良好なアライメントが維持されていた。術後合併症として遷延治癒を5例(33%)、矯正損失を1例(7%)に認め、感染や皮膚壊死などの軟部組織合併症は認めなかった。合併症を認めた6例中4例がatrophic non-unionであった。

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2010&ichushi_jid=J02438&link_issn=&doc_id=20101006220017&doc_link_id=10.11360%2Fjcsoa.22.355&url=https%3A%2F%2Fdoi.org%2F10.11360%2Fjcsoa.22.355&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

鎖骨骨幹部粉砕骨折に対するMIPOによる治療経験

島村安則, 野田知之, 西山武, 中原龍一, 雑賀建多, 斉藤太一, 門田康孝, 尾崎敏文

中国・四国整形外科学会雑誌 22 ( 2 ) 494 - 495 2010.9

鎖骨骨幹部骨折に対する前下方プレート法による治療成績

島村安則, 野田知之, 中原龍一, 金澤智子, 井上円加, 斎藤太一, 小澤正嗣, 雑賀建多, 西田圭一郎, 尾崎敏文

肩関節 35 ( 1 ) 75 - 75 2010.9

鎖骨骨幹部骨折に対するMIPOによる治療経験

島村安則, 野田知之, 中原龍一, 斎藤太一, 金澤智子, 長谷井嬢, 雑賀建多, 井上円加, 尾崎敏文

骨折 32 ( Suppl. ) S82 - S82 2010.7

"Gull Sign"を示す寛骨臼骨折の治療経験

藤原智洋, 野田知之, 中原龍一, 雑賀建多, 西山武, 島村安則, 尾崎敏文

骨折 32 ( Suppl. ) S87 - S87 2010.7

掌側ロッキングプレートを用いて加療した橈骨遠位部骨折における抜釘術の検討

島村安則, 斎藤太一, 金澤智子, 中原龍一, 雑賀建多, 野田知之, 西田圭一郎, 尾崎敏文

中国・四国整形外科学会雑誌 22 ( 1 ) 199 - 199 2010.4

Anterior cruciate ligament-derived cells have high chondrogenic potential Reviewed

Takayuki Furumatsu, Motomi Hachioji, Kenta Saiga, Naoki Takata, Yusuke Yokoyama, Toshifumi Ozaki

BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS 391 ( 1 ) 1142 - 1147 2010.1

Language：English Publishing type：Research paper (scientific journal) Publisher：ACADEMIC PRESS INC ELSEVIER SCIENCE

Anterior cruciate ligament (ACL)-derived cells have a character different from medial collateral ligament (MCL)-derived cells. However, the critical difference between ACL and MCL is still unclear in their healing Potential and cellular response. The objective of this study was to investigate the mesenchymal differentiation property of each ligament-derived cell. Both ligament-derived cells differentiated into adipogenic, osteogenic, and chondrogenic lineages. In chondrogenesis, ACL-derived cells had the higher chondrogenic property than MCL-derived cells. The chondrogenic marker genes, Sox9 and alpha 1(II) collagen (Col2a1), were induced faster in ACL-derived pellets than in MCL-derived pellets. Sox9 expression preceded the increase of Col2a1 in both pellet-cultured cells. However, the expression level of Sox9 and a ligament/tendon transcription factor Scleraxis did not parallel the increase of Col2a1 expression along with chondrogenic induction. The present Study demonstrates that the balance between Sox9 and Scleraxis have an important role in the chondrogenic differentiation of ligament-derived cells. (C) 2009 Elsevier Inc. All rights reserved.

DOI： 10.1016/j.bbrc.2009.12.044

【関節周辺骨折最近の診断・治療】膝関節ダブルプレートによる脛骨近位部骨折の治療戦略

野田知之, 島村安則, 中原龍一, 雑賀建多, 門田康孝, 尾崎敏文

別冊整形外科 ( 56 ) 179 - 183 2009.10

Language：Japanese Publisher：(株)南江堂

ダブルプレートで治療した脛骨近位部骨折19例(平均61歳)の成績を報告した。骨折型はAO分類41-A3が1例、C2が3例、C3が15例で、開放骨折は2例であった。初期治療として10例に膝関節架橋創外固定を施行し、ダブルプレート時の皮切は前外側と後内側に分離して作成した。術後観察期間3〜30ヵ月で、骨癒合期間は平均14.2週であった。平均膝関節可動域は伸展-2.4°、屈曲133.9°で、Holh & Luckの解剖学的評価はexcellent 12例、good 6例、fair 1例、機能的評価はexcellent 15例、good 4例であった。X線学的評価でtibial angleは術直後平均91.9°から最終時92.1°に、tibial plateau angleは7.4°から7.2°となり、5°以上のアライメント変化を起こした症例はなかった。術直後の整復位不良は2例、関節面step off残存は4例、関節面再陥没は2例に認めたが、感染・創離開・創壊死などはなかった。追加手術は1例でスクリュー入れ替えを行った。

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2009&ichushi_jid=J04037&link_issn=&doc_id=20091015480030&doc_link_id=10.15106%2FJ04037.2010044658&url=https%3A%2F%2Fdoi.org%2F10.15106%2FJ04037.2010044658&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

ロッキングプレートによる下肢長幹骨非感染性偽関節の治療成績

藤原智洋, 野田知之, 島村安則, 中原龍一, 雑賀建多, 門田康孝, 尾崎敏文

中国・四国整形外科学会雑誌 21 ( 3 ) 479 - 479 2009.10

THA術前に発症した成人化膿性股関節炎の一例

雑賀建多, 遠藤裕介, 鉄永智紀, 皆川寛, 三谷茂, 尾崎敏文, 藤原一夫

中国・四国整形外科学会雑誌 20 ( 2 ) 285 - 290 2008.9

Language：Japanese Publisher：中国・四国整形外科学会

74歳女。関節リウマチによる右股関節変形に対しTHAを予定していたが、手術予定日の5日前に誘因なく右股関節痛が増悪し、発熱とCRPの上昇を認め入院となった。右股関節の可動域は制限され、単純X線で右股関節の関節裂間の消失と骨破壊を認めた。また、CTおよびMRIで右腸骨筋の腫脹と右股関節液の貯留を認めた。関節穿刺を行い、培養でα-Streptococcusを検出した。化膿性股関節炎と診断し、手術を施行した。後側方アプローチで関節包を切開すると、大量の関節液を認めた。関節内には中等度の滑膜増生を認め、デブリドマンを行った。骨頭軟骨は変性が高度であり、感染の波及も疑われたため、頸部で骨切りしGirdlestoneとした。入院後、抗菌薬は関節穿刺後にイミペネムを開始し、術後はクリンダマイシンを併用した。術後5ヵ月の画像所見および血液所見で異常を認めなかったためTHAを施行し、術後半年の現在、杖なしで歩行可能である。

Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2008&ichushi_jid=J02438&link_issn=&doc_id=20081001070020&doc_link_id=%2Fcm4ortho%2F2008%2F002002%2F020%2F0285-0290%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcm4ortho%2F2008%2F002002%2F020%2F0285-0290%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

ScleraxisとSox9による軟骨細胞分化調節

古松毅之, 迫間巧将, 吉田晶, 伊達宏和, 鉄永智紀, 雑賀建多, 阿部信寛, 宿南知佐, 雨宮三千代, 島野仁, 尾崎敏文

日本整形外科学会雑誌 82 ( 8 ) S1098 - S1098 2008.8

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