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Biomedical subjects

Akifusa Wada

Publications and source records attributed to Akifusa Wada.

6 recordsLinked to original sources
PubMed2004

Metatarsal lengthening by callus distraction for brachymetatarsia.

Twelve metatarsal lengthening procedures by callus distraction were performed in seven patients with brachymetatarsia. The mean age at the time of the surgery was 12.0 years (range, 11.1-14.5 years). The mean duration of follow-up was 5.2 years (range, 1.2-13.5 years). The bones were lengthened at a rate of 0.7 mm/day by a mean of 20 mm (range, 15-30 mm), which was 45% of their original length (range, 37-61%). The mean healing index was 73 days/cm (range, 41-98 days/cm). Corrective shortening osteotomy was performed in one case in which the metatarsophalangeal joint was dislocated due to excessive lengthening. In 10 of the remaining 11 cases, joint stiffness, narrowing of the joint space and some degree of plantar subluxation of the metatarsophalangeal joint were observed during distraction, but these were gradually resolved without either elongation of the tendon or metatarsophalangeal joint fixation with Kirschner wire.

Adolescent↗
PubMed2002

Primary lymphocutaneous nocardiosis caused by Nocardia otitidiscaviarum.

A case of primary lymphocutaneous nocardiosis caused by Nocardia otitidiscaviarum in a 69-year-old previously healthy woman is described. The organism was identified in cultures of pus specimens. The patient was treated with a six-month course of oral trimethoprim-sulfamethoxazole chemotherapy following incision and drainage, and the infection completely resolved.

Aged↗
PubMedDate not supplied

Limb salvage treatment for congenital deficiency of the tibia.

Nine limb salvage treatments were performed in 7 patients with congenital deficiency of the tibia. All feet showed equinovarus deformity and were centralized in a slightly equinus position by placing the distal end of the fibula into the posterior facet of the calcaneus. Tibiofibular fusion was performed in 4 patients with partial deficiency, and fibular transfer (fibular centralization; Brown procedure) in 5 with complete deficiency of the tibia. Callus distraction lengthening was performed repeatedly for leg-length discrepancy on either the femur or the centralized fibula. Satisfactory functional and cosmetic results were obtained in all limbs with partial deficiency, whereas in limbs with completely deficiency, none of the 5 knees treated by fibular transfer achieved a satisfactory functional result because of insufficient quadriceps strength, progressive knee flexion contracture, and persistent ligamentous instability. Nevertheless, in these 5 cases, all patients were ultimately able to withstand weight-bearing.

Adolescent↗
PubMedDate not supplied

Sternal segment dislocation in children.

Three cases of sternal segment dislocation in children are described. The primary mechanisms were direct blow in a 4-year-old boy, indirect forces in a 3-year-old boy, and osteomyelitis in a 10-year-old boy. The two former cases were dislocated at the junction of the manubrium with the sternal body, and the latter case was at the junction of the first and second sternal segments. The dislocated segments were gradually rotated for approximately 2 weeks and were finally stabilized after rotation. While in the dislocated state, the patients were observed conservatively, although all the dislocated segments were remodeled. Surgical treatment of sternal segment dislocation is not inevitable.

Bone Remodeling↗
PubMedDate not supplied

Pemberton osteotomy for developmental dysplasia of the hip in older children.

The authors reviewed the results of the Pemberton osteotomy as treatment of developmental dysplasia of the hip in 17 hips treated after 7 years of age. Twelve hips required one or more concomitant surgical procedures. The average age at the time of the osteotomy was 9.3 years, and the average follow-up was 9.4 years. Using modified McKay's clinical criteria, 14 hips were classified as excellent or good. Using Severin's radiographic classification, 13 hips met class I-II criteria. Two patients who preoperatively showed Kalamchi and MacEwen's group IV severe avascular necrosis, plus two patients whose necessary acetabular coverage was not achieved by the Pemberton osteotomy without femoral varus osteotomy, were found to meet Severin's class III-IV criteria. Pemberton osteotomy can be an effective procedure for older children in whom progressive acetabular development is not expected, although this osteotomy may have to be combined with other operative procedures.

Child↗