Locomotive syndrome affects the acquisition of long-term care insurance system certification.

BACKGROUND: Locomotive syndrome is closely related to the state of long-term care. This study aimed to longitudinally evaluate long-term care certification occurrence in locomotive syndrome using data from the Miyagawa study. METHODS: The study included 470 individuals (168 males, 302 females; mean age, 70.7 years) with no long-term care certification at the time of participation in the study. Locomotive syndrome was classified into three stages (stages 1-3) according to the 25-question Geriatric Locomotive Function Scale. Analysis was performed with long-term care certification occurrence as the endpoint and locomotive syndrome stage as the explanatory variable. RESULTS: The median observation period was 6.3 years, and long-term care certification occurred in 69 (34.2%) and 30 (11.2%) of the participants in the locomotive syndrome and no-locomotive syndrome groups, respectively. Independent risk factors of long-term care certification occurrence were locomotive syndrome stage-3 (hazard ratio: 2.27) in the total number of studies, and locomotive syndrome stages 2 (hazard ratio: 2.49) and 3 (hazard ratio: 2.79) in females. Locomotive syndrome stage-3 was an independent risk factor in long-term care certification occurrence due to musculoskeletal disorders (hazard ratio: 3.89). CONCLUSIONS: The higher the locomotive syndrome stage, especially in females, the higher the risk of long-term care certification occurrence.

Prevalence of and risk factors for hallux rigidus: a cross-sectional study in Japan.

BACKGROUND: Hallux rigidus (HR) is a common osteoarthritis of the first metatarsophalangeal joint. However, the epidemiology and risk factors of this pathology have yet to be clarified. METHODS: We have been conducting cohort studies among individuals over 50 years old every 2 years since 1997. This study analyzed data from the 7th to 10th checkups in 2009, 2011, 2013, and 2015. We investigated the prevalence of HR and its risk factors in a total of 604 individuals (mean age, 67.1 ± 6.4 years; 208 men, 396 women). Radiographic HR was defined as Hattrup and Johnson classification grade 1 or higher. Knee osteoarthritis (KOA) was scored according to the Kellgren-Lawrence grading system. Radiographic KOA was defined as grade 2 or higher. Cases with a hallux valgus (HV) angle of 20° or higher were defined as showing HV. Statistical analyses were performed using the Kruskal-Wallis test, Fisher's exact test, logistic regression modeling, and the Cochran-Armitage trend test. All p-values presented are two-sided and values of p < .05 were considered statistically significant. RESULTS: The prevalence of HR was 26.7% (161/604). Rates of grade 0, 1, 2, and 3 HR according to the Hattrup and Johnson classification were 73.3% (443/604), 16.4% (99/604), 8.0% (48/604), and 2.3% (14/604), respectively. Overall ratio of symptomatic HR was 8.1%. Univariate analysis revealed KOA, gout attack (GA), and HV as significantly associated with HR. The same factors were confirmed as independent risk factors for HR in multivariate analysis. All parameters were significantly associated with HR. Odds ratios of KOA, HV, and GA for HR were 1.73, 3.98, and 3.86, respectively. The presence or absence of KOA was significantly associated with severity of HR. CONCLUSIONS: This study revealed that the prevalence of HR in the elderly (≥50 years) was 26.7%. KOA, HV, and GA were independent risk factors for HR. KOA was associated with severity of HR.

Arthroscopic Internal Brace Augmentation With Arthroscopic Modified Broström Operation for Chronic Ankle Instability.

Lateral ankle sprains are very common injuries that sometimes lead to chronic lateral ankle instability. The modified Broström operation is the gold standard procedure for treatment of chronic lateral ankle instability. Currently, this operation is performed arthroscopically. Broström repair depends on the quality of the remnant ligament. In cases with an insufficient remnant ligament, Gould augmentation or reconstruction using the gracilis tendon is generally performed. Recently, tape augmentation (internal brace) also has been used to support an insufficient ligament. This article introduces arthroscopic tape augmentation with arthroscopic modified Broström operation. This technique consists of creation of a talar anchor hole and fibular anchor hole, reattachment of the remnant ligament to the fibula with tape, and tape fixation to the talus. This technique uses only one knotless anchor screwed to the fibula for both the modified Broström operation and fixation of the tape. This technique is relatively simple and produces similar results as an open procedure.

Surgical Treatment for Delayed Ulnar Carpometacarpal Fracture-Dislocations.

Background Fracture and dislocations of the carpometacarpal (CMC) joints except the thumb are relatively rare. Herein, we report the case of a delayed fracture-dislocation of fourth and fifth carpometacarpal joints. Case Description The patient is a 41-year-old, right-handed male. To improve the complaints, such as decreased motion, reduced grip strength, and cosmetic appearance, surgical treatment surgically performed with resection of scar tissues and fixation using suture button at 11 weeks after injury. Movement began at 2 weeks after the surgery, which resulted in satisfactory appearance and good function of 92 and 101% of the motion of the unaffected side of the fifth CMC joint and grip strength, respectively. Literature Review Missed diagnosis can cause impairment of function including grip strength and range of motion. Nevertheless, a few previous studies reported that patients with delayed diagnosis did not need further treatment because of less functional loss and less improvement. Clinical Relevance The surgical treatment using the implant allowed early motion from 2 weeks after surgery which resulted in good motion of the ulnar CMC joints as well as increased hand grip.

Spontaneous Osteonecrosis of the Tarsal Navicular: A Report of Two Cases.

Spontaneous osteonecrosis of the tarsal navicular, called the Mueller-Weiss syndrome, is an uncommon disease. Patients who are resistant to conservative treatment require operative treatment. However, there is no established operative treatment. Two cases of spontaneous osteonecrosis of the tarsal navicular with double (talonavicular and naviculocuneiform joints) arthrodeses with different locking plates are presented. Removal of necrotic areas from the tarsal navicular and replacement with autologous bone graft procured from the iliac crest followed by arthrodesis using a locking plate were performed. Case 1 was fixed with an LCP Distal Radius Plate (SYNTHES) and 6 2.4 mm locking screws. Case 2 was fixed with a Cervical Spine Locking Plate Variable Angle (SYNTHES) and 4 4.0 mm locking screws. Case 2 achieved solid fusion of the talonavicular-cuneiform joints, but case 1 resulted in nonunion of the talonavicular joint. This difference in internal fixation strength might have caused the difference in the results. Performance of double arthrodeses from the medial aspect using a locking plate is a reasonable operative procedure to treat spontaneous osteonecrosis of the tarsal navicular. Strong primary fixation using a thick plate with large-thread screws was important to obtain joint fusions.