Biomedical subjects
Publications and source records attributed to C Hamanishi.
Three cases of asymmetric physeal closure with angular deformities of the ankle, knee, and wrist, respectively, were corrected by rotatory physeal distraction. Osteotomy of the bony bridges was unnecessary.
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Three sibs born to normal but consanguinous parents had flexion deformities of the thumb and fingers on one hand and sensory deficit in the other hand. Extensor muscles were absent or vestigial in all of them. Polyneuropathic electrophysiological findings were detected in 4 limbs. This is an apparently autosomal recessive trait previously unreported.
Diplopodia with the duplicated foot tucked up posteriorly, was reconstructed successfully in an 8-year-old boy. The knee joint, fibula and tibia were uninvolved; he had been walking on the dorsum of the foot wearing an ordinary shoe with the heel forward. The foot had ten toes, nine metatarsals and nine tarsal bones including one talus and one large calcaneus on which two Achilles tendons were inserted into two tuberosities. The lateral supernumerary foot was excised and the medial foot was dorsiflexed by almost 180 degrees by massive release and elongation of tendons. He could walk on his bare reconstructed foot without a brace 10 months after the operation.
Sixty-nine cases of congenital vertical talus (CVT) were classified into five groups in association with (1) neural tube defects or spinal anomalies, (2) neuromuscular disorders, (3) malformation syndromes, (4) chromosomal aberrations, and (5) idiopathic CVT unassociated with any of the systemic conditions described above. Forty-four cases of idiopathic CVT were subclassified into four groups: (5A) intrauterine molded or deformed cases, (5B) cases of digitotalar dysmorphism associated with contractile finger abnormalities and genetic inheritance, (5C) patients whose close relatives had CVT or oblique talus (OT) deformity, and (5D) cases unassociated with any skeletal deformity or genetic inheritance. The talar and Calcaneal axis--first metatarsal base angles (TAMBA and CAMBA) are introduced, which enable us to describe not only the obliquity of the talus and calcaneus but also the severity of the dislocation of the talonavicular joint and the contracture of the tendo Achilli. The changing point from flexible OT to rigid CVT is TAMBA of about 60 degrees and CAMBA of 20 degrees, and there are many borderline cases of CVT that could be treated conservatively. For the typical CVT, open reduction should be carried out as promptly as possible if 3 months of corrective casting in extreme equinovarus fails to reduce the TAMBA to 50 degrees.
Seventy patients with 91 congenital short femora are classified. Deformities resulting maternal Thalidomide treatment are compared with those where Thalidomide was not involved and genetic and epidemiological factors investigated in 50 patients. No essential anatomical difference was found between the two groups of femora but the whole complex of abnormalities differed: the Thalidomide group showed femur-tibia-radius anomalies while the non-Thalidomide garoup had femur-fibula-ulna anomalies, indicating either different aetiological factors or different timing of the insult to the foetus. Some differences between congenital coxa vara and congenital short femur associated with coxa vara are mentioned. Simple hypoplasia of the femur may possibly have a multifactorial genetic background since it is associated with other minor abnormalities of the limbs in these families, whereas environmental factors only are associated with the more severe femoral defects.
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