Biomedical subjects

E Horii

Publications and source records attributed to E Horii.

At least 19 recordsLinked to original sources

PubMed2005

The primary Sauve-Kapandji procedure--for treatment of comminuted distal radius and ulnar fractures.

We have performed primary Sauve-Kapandji procedures on four patients with severe open comminuted fractures of both the distal radius and ulna. The fragmented distal ulna was fixed to the sigmoid notch in order to stabilize the ulnar side of the carpus, and a proximal pseudoarthrosis was maintained for forearm rotation. All the distal radial fractures united without major complications. The mean wrist flexion/extension arc was 76 degrees , the mean pronation/supination arc was 135 degrees, and grip strength was 64% of the contralateral side. All patients returned to their work or daily activities within short time period without any additional surgical treatment, except for removal of implants in three patients. The primary Sauve-Kapandji procedure is effective for the reconstruction of severely combined distal radius and ulnar fractures.

Aged↗

PubMed2005

Results of ulnar shortening osteotomy for ulnocarpal impaction syndrome in wrists with neutral or negative ulnar variance.

Ulnocarpal impaction syndrome was diagnosed in six wrists of five patients with neutral or negative ulnar variance. All underwent ulnar shortening with satisfactory results. The average grip strength increased from 53% to 78% and the range of flexion-extension increased from 82% to 93%, the mean Cooney's score improved from 25 to 83. These cases show that ulnocarpal impaction syndrome can occur in wrists with zero or negative ulnar variance, and that ulnar shortening is an effective treatment for such wrists.

Adult↗

PubMed2004

Differences in radiographic findings between scaphoid fracture patterns.

Scaphoid fracture patterns can be divided into volar and dorsal type using three-dimensional computed tomography. Ninety-nine patients underwent this examination plus radiography to determine how often fracture pattern was identifiable by radiography including proximal fragment ratio (PFR) measurement. Oblique radiographs obtained at 45 degrees of pronation demonstrated a volar displacement in 28 of 37 volar type fractures in three-dimensional computed tomography (76%), while as oblique view with 45 degrees of supination could identify the dorsal type in ten of 18 (56%). PFR showed a significant difference, with means of 0.59 for volar type and 0.43 for dorsal type. Using oblique views in the two rotational directions together with the PFR, the two fracture patterns could be differentiated in 35 of 43 fractures (81%). No differences were evident between the two fracture patterns with respect to prevalence of dorsal intercalated segment instability deformity.

Adolescent↗

PubMed2001

Triphalangeal thumb without associated abnormalities: clinical characteristics and surgical outcomes.

Thirty-four triphalangeal thumbs of 23 patients, who had no associated anomaly in their ipsilateral hand, were reviewed to clarify the characteristics of an isolated triphalangeal thumb and its surgical outcome. There were 13 type 1 thumbs, 21 type 2 thumbs, and no type 3 thumbs. The existence of an accessory phalanx caused ulnar bending at the interphalangeal joint. Thirteen type 1 thumbs were operated on by excising an accessory phalanx. Corrective osteotomy at the epiphysis was performed on four type 2 thumbs, and partial excision of the epiphysis was performed on 11 type 2 thumbs. At follow-up examination, the average interphalangeal joint motion was 54 degrees in type 1 thumbs and 53 degrees in type 2 thumbs. More than 10 degrees of lateral bending remained in one type 1 thumb and six type 2 thumbs. Good results were observed when an early excision of the accessory phalanx with a securing collateral ligament was performed on type 1 thumbs. For type 2 thumbs, partial excision of the epiphysis provided relatively better correction than osteotomy. For good adaptation of interphalangeal joints, surgery should be performed when the patient is between the ages of 1 and 2, when the epiphysis is visible on x-rays.

Child, Preschool↗

PubMed2000

Distraction lengthening of the forearm for congenital and developmental problems.

Thirty-five callus distractions of the forearm were carried out in 23 patients, who were divided into two groups according to the cause of the shortening. Eleven cases in group A had congenital dysplasia, and the 12 cases in group B had growth disturbances from tumours or infection. The mean amount of lengthening was 27 mm in group A and 25 mm in group B. The mean percentage increase in length was 35% and 17%, respectively. The mean duration of fixation was 159 days and 127 days, respectively. The Healing Index had a positive correlation with the age at surgery in group A, but not in group B. The main complication was callus deformity after the removal of a fixator, which was especially frequent in group A. To avoid complications, the aetiology of shortening and the age of the patient should be considered when deciding the surgical protocol.

Adolescent↗

PubMed2000

Theoretical stress analysis in wrist joint--neutral position and functional position.

A three-dimensional rigid body spring model (3D-RBSM) was used to analyse force distribution through the wrist joint. In the neutral position, 48% of the force was transmitted through the radioscaphoid fossa, 40% through the radiolunate fossa, and 12% through the triangular fibrocartilage complex. In the functional position, the wrist joint was slightly extended, resulting in significantly increased force through the lunate (53%). The lunate appears to bear more load than has been reported previously.

Adult↗

PubMed2000

Diagnostic imaging for fracture of the hook of the hamate.

We experienced 16 patients with a fracture of the hook of the hamate. The routine posteroanterior view raised the suspicion of fracture in four of 13 patients (31%), the carpal tunnel view showed the actual fractures in six of 14 patients (43%), and the supine oblique radiographic view of the wrist showed fractures in eight of ten patients (80%). Computed tomography corroborated the fracture in all eight patients (100%). Computerized tomography proved most useful for accurate diagnosis of fracture of the hook of the hamate.

Adult↗

PubMed1998

A syndrome of digital fibromas, facial pigmentary dysplasia, and metacarpal and metatarsal disorganization.

We report on a girl with fibrous tumors involving hands and feet associated with unusual brachydactyly and facial abnormalities with pigmentary skin lesions. The multiple, infiltrative fibrous tumors clinically resembled recurring digital fibromata (RDF) of infancy, but eosinophilic cytoplasmic inclusion bodies pathognomonic for RDF were not demonstrated in her tumor cells. Skeletal alterations of the hands and feet comprised brachymesophalangy with cone-shaped epiphyses and variable shortening and deformity of the metacarpals and metatarsals. Facial abnormalities included upward slant of palpebral fissures, primary telecanthus with epicanthal folds, and a depressed nasal tip, along with a small fibrous tumor on the left eyelid. The patient also had patchy, brownish discolorations of the face. The clinical, radiological, and histological constellation in the patient may represent a hitherto undescribed hamartomatous syndrome.

Abnormalities, Multiple↗

PubMed1998

Surgical treatment of congenital metacarpal synostosis of the ring and little fingers.

Fifteen hands with congenital metacarpal fusions were treated operatively by osteotomy combined either with the use of a silicone block or a distraction device. The aim of the silicone block was to separate the fused metacarpals, but it was buried in the metacarpals at follow-up, with recurrence of fusion. By the distraction technique, 13 mm of lengthening was obtained. The average length of the little metacarpal was 88% of that of the long finger metacarpal. Both methods were effective in correcting the abduction deformity of the little finger by a mean of 34 degrees, and increasing the range of motion of the metacarpophalangeal joint to 28 degrees of active flexion. Although the distraction method took longer than the silicone block method, the final appearance of the hand was better.

Child↗

PubMed1998

Proximal row carpectomy versus limited wrist arthrodesis for advanced Kienböck's disease.

The outcomes in 20 patients with advanced Kienböck's disease treated by proximal row carpectomy (seven patients) or limited wrist arthrodesis (13 patients) were reviewed retrospectively. Postoperatively, the results were more satisfactory in terms of wrist pain, the range of wrist flexion-extension, and grip strength following limited wrist arthrodesis than after proximal row carpectomy, although the differences were not statistically significant. We recommend scaphotrapeziotrapezoid arthrodesis in selected patients with advanced Kienböck's disease who have a fragmented lunate.

Adolescent↗

PubMed1998

Ulnar styloid malunion with dislocation of the distal radioulnar joint.

Four patients with dorsal dislocation of the distal radioulnar joint and ulnar styloid malunion had corrective osteotomy of the ulnar styloid. Dislocation of the distal radioulnar joint was reduced in three of four patients. Subluxation persisted in the remaining patient. Wrist function improved in all patients. These results support the contention that a displaced ulnar styloid fracture with distal radioulnar joint dislocation should be reduced and internally fixed. Corrective osteotomy is recommended for malunion of the ulnar styloid associated with dislocation of the distal radioulnar joint.

Adolescent↗

PubMed1997

Avulsion fracture of the metacarpophalangeal joint of the finger.

Six patients with avulsion fractures of the metacarpophalangeal joints of the fingers are reported. Operation was performed in all cases. Judging from the operative findings, the radiological assessment of fragment shape is helpful in treatment. Surgery is recommended when the fragment is triangular or rectangular in shape because the fracture involves the articular surface. Conservative treatment is effective if the fragment is round because the articular surface of the joint is not involved in this type of fracture. The avulsed fragment often overlaps the metacarpal head and a collateral ligament injury is likely to be misdiagnosed. It is important to suspect this injury and assess the shape of the whole fragment for a good functional result.

Adolescent↗

PubMed1997

The ulnocarpal stress test in the diagnosis of ulnar-sided wrist pain.

Forty-five patients with persistent ulnar-sided wrist pain and a positive ulnocarpal stress test were investigated by X-ray, arthrography, 99mTechnetium bone scanning, magnetic resonance imaging and wrist arthroscopy. Ulnar wrist pathology was positively identified in nine of 45 patients by X-ray, 18 of 37 by arthrography, 19 of 27 by bone scan, four of 33 by MRI, and in all 45 patients by arthroscopy. The final diagnosis was ulnocarpal abutment syndrome in 28 patients, traumatic triangular fibrocartilage (TFC) tear in six, lunotriquetral (LT) ligament tear in five, TFC and LT ligament tear in one, wrist arthritis in four and cartilaginous free body in one. The ulnocarpal stress test is a useful provocative test, and a positive test suggests the presence of ulnar-sided wrist pathology. The test is sufficiently sensitive to warrant further investigation by arthroscopy.

Adolescent↗

PubMed1997

Duplicated thumb bifurcation at the metacarpophalangeal joint level: factors affecting surgical outcome.

In order that the factors causing poor surgical outcome might be clarified, 175 duplicated thumbs bifurcating at the metacarpophalangeal joint level were analyzed. Cases were further divided into types A-D, based upon the details of the bifurcation form; that is, based on the connection of the radial digit to the ulnar components by either cartilage, joint, or fibrous tissue. The incidence of each type was 16% for type A (wide cartilaginous connection between phalanges), 68% for type B (2 separate phalanges), 6% for type C (cartilaginous connection to metacarpal), and 10% for type D (fibrous connection to joint capsule). Triphalangeal types and the relative size of the excised digit were determined by the preoperative radiograph. One hundred six cases were available for evaluation with a minimum of 3 years' follow-up. Good results were obtained in 50% of types A and C and in 80% of types B and D. Three phalanges in the preserve digits were observed in 10 cases and surgery on all but 1 resulted in a fair outcome. In cases where the size of the excised digit was more than 75% of the preserved digit, the results were fair or pool in 93%. The presence of subdivisions of types A and C, of 3 phalanges in the preserved digit, and of a relatively bigger excised digit were factors causing poor results, despite intensive reconstructive surgery.

Child, Preschool↗

PubMed1996

Criteria for diagnosing distal radioulnar joint subluxation by computed tomography.

Bilateral wrist computed tomography (CT) was performed in 30 patients with suspected unilateral distal radioulnar joint (DRUJ) subluxation to evaluate dynamic DRUJ CT scanning with a straight elbow. Five CT criteria for diagnosing dorsovolar subluxation were examined. Maximum active supination and pronation on a conventional scanning table yielded satisfactory rotation (mean +/- SD, 119 degrees +/- 29 degrees) at the DRUJ, thus permitting a dynamic diagnosis of DRUJ subluxation. The radioulnar line method and the congruity method frequently yielded false positive results compared with bilateral diagnosis and were unreliable. Modifications of these two methods achieved sensitivity and specificity comparable to the epicenter method. We recommended the modified radioulnar line method for diagnosing dorsovolar subluxation using unilateral CT because of its excellent sensitivity and specificity combined with ease of technique.

Adolescent↗

PubMed1995

Distal radioulnar joint subluxation and dislocation diagnosed by standard roentgenography.

The use of standard lateral roentgenography for diagnosing distal radioulnar joint (DRUJ) subluxation and dislocation was investigated. Using a wrist support, bilateral standard lateral roentgenograms of the wrist were obtained in 42 patients with normal wrists and in 56 patients with a unilateral wrist injury. In normal wrists the difference between the radioulnar distance in the right and the left wrist did not exceed 4 mm when the difference in the pisoscaphoid distance was less than 3 mm. Of the 36 patients with wrist injury whose difference in pisoscaphoid distance was less than 3 mm, 15 had a radioulnar distance of 5 mm or more, and computed tomography (CT) confirmed DRUJ dislocation in 14. Concordance between lateral roentgenograms and CT was present in 33 of 36 patients (92%). These results demonstrate the value of a standardized technique for bilateral lateral roentgenography in diagnosing DRUJ subluxation and dislocation.

Adolescent↗

PubMed1994

The position of symbrachydactyly in the classification of congenital hand anomalies.

The clinical features of 53 cases of intercalated hypoplasia and 113 cases of distal aplasia are reviewed and compared with each other and with 129 cases of syndactyly. Tri-, di- and mono-phalangeal symbrachydactyly, and adactyly with nubbin digits are consecutive anomalies. Transverse deficiency may result if the mesenchyme is damaged severely, and if damage is mild and formation has continued, intercalated transverse deficiency may occur. Webbing in symbrachydactyly may result from failure of the apical ectodermal ridge under the influence of damaged mesenchyme.

Female↗

PubMed1994

Ulnar ray deficiency. A report of a family.

We report three cases of ulnar ray deficiency in one family. The father had a left ring finger deficit, and a hypoplastic little finger was amputated at childhood. His first baby had a deep cleft between the ring and little finger in the right hand, and his second baby had complete absence of the left ulna, only one metacarpal, and two digits were present on the hand. All three cases were unilaterally involved and they had no other skeletal abnormalities.

Adult↗