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博士論文
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DOI[info:doi/10.1177/2325967119876247]のデータに遷移します
Closed-Wedge Osteotomy of the Distal Humerus for Treating Osteochondritis Dissecans of the Capitellum in Young Patients
- 国立国会図書館永続的識別子
- info:ndljp/pid/11538645
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一般注記:
- Background: Even in patients with an open capitellar physis, nonsurgical treatment for advanced-stage osteochondritis dissecans (OCD) of the capitellu...
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デジタル
- 資料種別
- 博士論文
- 著者・編者
- Ueki, Masato
- 出版年月日等
- 2020-03-13
- 出版年(W3CDTF)
- 2020-03-13
- 並列タイトル等
- 若年者の上腕骨小頭離断性骨軟骨炎に対して施行した上腕骨外側上顆楔状骨切り術
- 授与機関名
- 新潟大学
- 授与年月日
- 2020-03-13
- 授与年月日(W3CDTF)
- 2020-03-13
- 報告番号
- 乙第2240号
- 学位
- 博士(医学)
- 博論授与番号
- 乙第2240号
- 本文の言語コード
- eng
- 一般注記
- Background: Even in patients with an open capitellar physis, nonsurgical treatment for advanced-stage osteochondritis dissecans (OCD) of the capitellum often yields poor outcomes. However, surgical methods for such patients are controversial. At our institution, we have consistently performed closed-wedge osteotomy of the distal humerus to treat advanced-stage OCD of the capitellum, regardless of the OCD grade or condition of the capitellar physis. Purpose: To clarify the clinical and radiological results and determine the influence of the capitellar physis on closed-wedge osteotomy for advanced-stage OCD of the capitellum in young patients. Study Design: Case series; Level of evidence, 4. Methods: A total of 32 patients with OCD of the humeral capitellum were treated surgically with closed-wedge osteotomy. Of these, 17 patients with more than 2-year follow-up were available for an evaluation. The mean patient age was 11.8 years (range,11-12 years), and the mean follow-up period was 70.1 months (range, 25-184 months). The clinical assessment included range of motion, elbow pain, and the Japanese Orthopaedic Association (JOA) and Timmerman-Andrews scores. The radiological assessment at the final examination included cross-bridging of the physis, size and fishtail deformity of the distal part of the humerus, size of the radial head, healing of the OCD lesion, and osteoarthritis. Results: The mean range of motion and JOA and Timmerman-Andrews scores improved significantly after surgery; 13 patients were completely pain free. In 11 patients with an open capitellar physis, metaphyseal-epiphyseal, cross-bridging was observed in 1 patient. A fishtail deformity of the distal part of the humerus was not observed. Healing of the OCD lesion was defined as excellent in 9 patients, good in 3, fair in 3, and poor in 2. In 3 of the 5 patients in whom healing was described as fair or poor, there was a lesion of the lateral widespread type with osteoarthritis before surgery. Moderate osteoarthritic changes were evident in 2 patients. Conclusion: Closed-wedge osteotomy for the treatment of advanced-stage OCD of the capitellum in young patients can provide satisfactory clinical and radiological results. However, fair and poor outcomes were found in lateral widespread–type cases with osteoarthritis before surgery. We believe that patients in whom osteoarthritic changes have not yet appeared are eligible for closed-wedge osteotomy.The Orthopaedic Journal of Sports Medicine. 2019, 7(10), 2325967119876247.新大博(医)乙第1811号
- DOI
- info:doi/10.1177/2325967119876247
- 国立国会図書館永続的識別子
- info:ndljp/pid/11538645
- コレクション(共通)
- コレクション(障害者向け資料:レベル1)
- コレクション(個別)
- 国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文
- 収集根拠
- 博士論文(自動収集)
- 受理日(W3CDTF)
- 2020-09-07T06:04:08+09:00
- 作成日(W3CDTF)
- 2020-08-31
- 記録形式(IMT)
- application/pdf
- オンライン閲覧公開範囲
- 国立国会図書館内限定公開
- デジタル化資料送信
- 図書館・個人送信対象外
- 遠隔複写可否(NDL)
- 可
- 連携機関・データベース
- 国立国会図書館 : 国立国会図書館デジタルコレクション