The tendon grafting in finger and our method

In the foregoing our methods of the grafting of tendon in finger used recently are presented. Namely, the proximal ends of tendon to be grafted are at first sutured by the embedding method of BUNNELL, and then the distal ends are fixed with our method we get the benefits of giving just appropriate tension to the tendon and also of reliable fixation. Finally the findings before and after operation on the two cases treated by our method are pictorially presented in Figs. 12 and 13.</p

Tendon transfers for claw hand

We have recently operated on 56 cases of claw hand and described the method of tendon transfer in Hansen's disease which occupied the majority of the cases, and several problems have been discussed from our experiences.</p

裂手症に関する最近の知見 : 特に病態と抱括範囲について

Cleft hand is an anomaly in which the primary feature is oligodactyly, and it is considered an important congenital malformation. The authors have analyzed the cases they have handled and developed an independent classification based on the number of defective digits. It has been ascertained that the clinical symptoms correlate with the number of defective digits, and a regular pattern was observed. Study of cases considered to be in the main stream led us to feel that polydactyly of the middle finger is the developmental mechanism for this entity. That is, we feel that the polydactylous partner on the radial side is transpositioned to the index finger while the same on the ulnar side is transfered to the ring finger, which is followed by fusion of the respective rays resulting in the loss of the middle finger. Generally when refferring to the central fingers, it often the case that reference is being made to the index, middle and ring fingers. The kind of morphological anomalies that develop when cleft hand changes similar to the those of the middle finger occur in the index or ring finger are shown by schematic diagrams. As a result, in the case of index finger involvment, in addition to cleft hand of the index finger, there is development of Wassel VII type polydactyly of the thumb and single type triphalangeal thumb can be considered, while in the case of the ring finger, the occurence of polydactyly of the little finger in addition to cleft hand of the ring finger can be considered. Pursuit of such changes in the clinical cases from the standpoint of morphology or symptoms, indicates that many cases which had been difficult to diagnose in the past had findings which agreed with the above, which surved to confirm the presence of such a developmental course. That is, cleft hand is not a diagnosis to be assigned to a fixed morphological condition, but indicates a set scope, and from the standpoint of site it involves not only the middle finger, but it is obvious it can develop in any of the other central fingers as well. However, attention should be paid to the fact that the cleft hand changes which develop in the index and ring fingers present an entirely different morphology from that of the concept entertained in the past. The above developmental mechanism is an anomaly in the distribution of digital rays which occurs to the formation of polydactyly within the hand plate, considered to be based upon this anomaly. It is presumed to be a typical congenital anomaly which occurs during the hand plate formation stage

小指個有伸筋腱の腱鞘炎に起因した弾発指の症例

Snapping finger is frequently encountered in orthopeidic diagnosis and treatment, and frequently experienced as cases of minor surgical operation of the hand. Cases of snapping finger generally are broadly classified into infantile cases and adult cases by their operative findings. The former is caused by formation of tumor by the flexor pollicis longus tendon itself at the entrance of the tendon sheath at the MP joint and the latter is caused when tendovaginitis of flexor tendon developing in the thumb, middle finger or ring finger disturbs the gliding at the tendon sheath entrance. These are very regular conditions, and it would be no exaggeration to say it is not the custom to look for another cause when snapping of finger is observed clinically. However, very rare as it is, it is a fact also that snapping fingers exist which are not attributable to the above-described general causes. Their cause can be attributed to the structure of the PIP joint or to the extensor tendon and not to the flexor tendon. The authors recently experienced three cases of snapping of the little finger originating in tendovaginitis of the extensor digiti quinti proprius tendon, which they will report

コンピューターを利用した末梢神経再生の新しい形態学的評価法 : 軸索空間パターンの統計的解析

Free grafts of the common peroneal nerve of rats were performed, and the state of regeneration was observed at four week intervals the 24th post-operative week. The specimens used consisted of whole transverse sections of the nerve. These sections were magnified 2, 100X by electron microscope, and radom photogrphs were taken of 10 sites. The negatives were enlarged threefold to produce 6, 300X prints. Using the photos, the axon coordinates, diameters and peripheral lengths of the specimens were entered into a minicomputer (NOVA-01) that has an effective tablet area of 350 x 350 mm. with a Graf/Pen Model GP3 (Scientific Accessories Corporation). The computer programs were developed by the authors exclusively for this study. The axon spatial patterns were classified into three groups, those with regular, random and clustered distributions, respectively. Each of the 10 photographs of each section was tested to determine the category into which they fell. Two methods for analysis of the spatial patterns are available, The 'distance' method and the 'quadrat' method. We used both, but the results obtained by the former are presented in this report. It was noted that the sequence of spatial pattern changes in myelinated fibers during the regenerating process was clustered random, regular, thus gradually approaching the normal pattern.Parts of this report were presented by Dr. Y. Miyamoto as an invited speaker at the WHO sponsored International Symposium on Posttraumatic Peripheral Nerve Regeneration held in Italy on October 16-18, 1980. A considerable amount of additional data has been used in the completion of this manuscript.Part of the research funds for this work was made available by a Project Research Grant (#55-405, #55-001) from Kawasaki Medical School

神経切断後の筋肉と神経筋接合部の変化

A histochemical study was conducted on the anterior tibial muscle of rats after transection of the right sciatic nerve at the proximal third of the thigh. Fibrillation was most prominent at the 4th week after denervation and even at the 7th month tiny fibrillations were infrequently recognized. The denervated muscle reduced its wet weight rapidly for the first one nonth and thereafter the decrease was gradual. From the 3rd month onwards muscle weight loss reached the plateau where the denervated muscle weighed about 15 to 20% against the control. The decrease of S. D. H. activity in the red muscle fibers resulted in histochemical undifferentiation of muscle fiber types, particularly from the 2nd month onwards after denervation. Motor end-plates stained by Wachstein, Meisel and Falcon's method became less visible in the course of time up to the 2nd month after denervation, but thereafter their staining intensity increased gradually with the abnormal internal structure of the synaptic folds