Publications by authors named "Ichiro Tonogai"

Gelatinous transformation of bone marrow (GTBM) is a complication of various diseases, one of which is anorexia nervosa (AN). We describe a rare case of a 20-year-old man who presented to our clinic with a 3-month history of heel pain without trauma. At presentation, he was noted to have a low body mass index (BMI) of 16.

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A 77-year-old woman presented with a mucous cyst on the lateral aspect of the interphalangeal joint of the first toe caused by contact pressure with the second toe from hallux valgus. She complained of discomfort and discharge from the left first toe for approximately 4 months. Physical examination showed the second toe pressing strongly against the first toe due to hallux valgus and discharge from the skin on the lateral aspect of the interphalangeal joint of the first toe.

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Article Synopsis
  • This study evaluates how the position of the baseplate in reverse shoulder arthroplasty (RSA) impacts the placement and length of superior screws, aiming to reduce the risk of suprascapular nerve injury.
  • Researchers used 3D computer simulations based on CT scans of cadaver shoulders to analyze various baseplate positions and their effects on screw measurements.
  • Results suggested that using a 1-7 o'clock rotation with a 0-degree inferior tilt for the baseplate helps increase the distance from the superior screw to the suprascapular notch, minimizing nerve injury risks despite a shorter inferior screw length.
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Background: The dorsalis pedis artery (DPA) usually branches into the arcuate artery (AA) from its lateral side which in turn crosses the bases of the lateral four metatarsals. The DPA then passes into the first interosseous space, where it divides into the first metatarsal artery and the deep plantar artery. In this study, we aimed to determine the extent of variation in the DPA and the distance between the AA and the tarsometatarsal (TMT) joint with the aim of reducing the risk of vascular complications arising from dorsal midfoot surgery.

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Introduction: There is a risk of mallet toe following proximal interphalangeal (PIP) joint fusion for hammertoe. Here we describe a rare case of penetration of the dorsal aspect of the middle phalanx head by the distal portion of a dual-component intramedullary implant during progression of mallet toe that was treated with flexor tenotomy.

Presentation Of Case: A 59-year-old man underwent uneventful arthrodesis of the third PIP using a dual-component intramedullary implant and presented 6 months later with progressive mallet toe and swelling, pain, and ulceration over the distal interphalangeal joint of the third toe.

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Introduction: There are no reports on one-stage corrective tibial opening wedge osteotomy and arthrodesis for osteoarthritis of the ankle and tibial malalignment after distal tibial osteotomy.

Presentation Of Case: The patient was a 70-year-old woman who presented with complaints of ankle pain and lower limb deformity after tibial osteotomy performed for ankle arthritis 17-18 years earlier. Clinical examination revealed marked swelling around the ankle joint and pain and tenderness at the joint line.

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Background: Biological adjuvants are used after a musculoskeletal injury to improve healing, decrease inflammation, and restore joint homeostasis. Work on 1 such adjuvant, platelet-rich plasma (PRP), has suggested a positive effect when introduced during cartilage repair. However, it remains unknown whether healing osteochondral injuries benefit from serial PRP injections.

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Introduction: Numerous operative procedures have been described for correction of hallux valgus, including distal step-cut osteotomy such as the Mitchell osteotomy. However, overcorrection can occur due to technical problems with the initial metatarsal osteotomy. Here, we describe a modified Mitchell osteotomy with a novel method, the temporary Kirschner wire fixation of the first metatarsophalangeal joint (TeKFiM) method (Tonogai method), that can be used before osteotomy for hallux valgus to avoid incongruency and overcorrection.

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Introduction: Legs are sometimes infected and swollen by cat bite or scratch. However, there is no report of synovitis with an enlarged talar posterior process in the posterior ankle caused by a cat bite or scratch which was treated by removal of the enlarged process and synovectomy with release of the flexor hallucis longus tendon via posterior ankle arthroscopy.

Presentation Of Case: The patient was a 58-year-old woman who had started keeping a cat 7 months earlier.

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Introduction: Lateral premalleolar bursitis develops on the dorsolateral aspect of the foot anterior to the lateral malleolus, distinct from lateral malleolar bursitis located just around the lateral malleolus.

Presentation Of Case: A 71-year-old woman visited an orthopedic clinic about 40 years after an episode of ankle sprain and was diagnosed with lateral premalleolar bursitis and osteoarthritis of the left ankle. Stress radiography revealed left ankle anterolateral malleolar bursitis with varus and anterior instability.

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Background: Tibiotalocalcaneal (TTC) arthrodesis with retrograde intramedullary nailing has become established. Iatrogenic injury to the vasculature (eg, lateral plantar artery [LPA] pseudoaneurysm) during insertion of the nail has been reported. The aim of this study was to identify the safe zone that avoids injury to the LPA during TTC arthrodesis.

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Introduction: Adult acquired flatfoot deformity (AAFD) caused by posterior tibial tendon dysfunction (PTTD) can lead to the development of peritalar subluxation (PTS) and much more rarely to lateral subtalar dislocation.

Presentation Of Case: A 75-year-old woman was referred to our hospital with an approximately 15-year history of pain in her right foot without obvious trauma. The lateral shifting foot deformity had worsened in the previous 5 years.

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Introduction: There are some reports of tarsal tunnel syndrome (TTS) entrapment/impingement from bony factors, including exostosis and fragment, but there are no reports on TTS with traumatic osteoarthritis of the ankle that were treated with osteophyte excision for TTS and arthroscopic arthrodesis for osteoarthritis of the ankle.

Presentation Of Case: A 61-year-old woman with left trimalleolar fracture had undergone surgery 3 years earlier and was referred to our hospital for further investigation of persistent left ankle pain and numbness around the left medial malleolus and plantar aspect of the foot. Clinical examination demonstrated plantar hypesthesia and a positive Tinel's sign at the tarsal tunnel.

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Background: Calcaneal osteotomy are used to treat various pathologies in the correction of hindfoot deformities. But lateral plantar artery (LPA) pseudoaneurysms have been reported following calcaneal osteotomy, and LPA pseudoaneurysms may be at risk for rupture. Although the vascular structures in close proximity to calcaneal osteotomies have variable courses and branching patterns, there is little information on safe zone for LPA during calcaneal osteotomy.

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Introduction: Hemophilic arthropathy can affect multiple joints including ankle. However, only one report has been published regarding both arthroscopic ankle arthrodesis with hemophilic arthropathy.

Presentation Of Case: The patient was a 23-year-old man with hemophilia A and a 3-year history of recurrent hemarthrosis in both ankles.

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We report a rare case of osteochondromatosis of the posterior ankle extra-articular space with a longitudinal tear of flexor hallucis longus (FHL). A 77-year-old woman was referred to our hospital with an approximately 4-year history of pain and swelling in the right posterior ankle joint without obvious trauma. The pain had worsened in the previous 2 years.

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We report a rare case of massive accumulation of fluid in the flexor hallucis longus tendon sheath with stenosing tenosynovitis and os trigonum. A 34-year-old woman presented to our hospital with pain and swelling in the posteromedial aspect of the left ankle joint after an ankle sprain approximately 8 months earlier. There was tenderness at the posteromedial aspect of the ankle, and the pain worsened on dorsiflexion of the left great toe.

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Purpose: The aim of this study was to evaluate the relationship between soft tissue laxity and kinematics of the normal knee using a navigation system.

Methods: Fifteen cadaveric knees from 11 fresh frozen whole-body specimens were included in this study. The navigation system automatically recorded the rotation angle of the tibia as the internal-external (IE) kinematics and the coronal alignment of the lower limb as the varus-valgus (VV) kinematics.

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Purpose: The purpose of this study was to test the hypotheses that the joint distraction force changes the three-dimensional articulation between the femur and the tibia and that the presence of posterior cruciate ligament (PCL) affects the three-dimensional articulation during joint gap evaluation in total knee arthroplasty (TKA).

Methods: Cruciate-retaining TKA procedures were performed on 6 cadaveric knees using a navigation system. The joint center gap and varus ligament balance were measured using Offset Repo-Tensor with the knee at 90° of flexion before and after PCL resection for joint distraction forces of 89, 178, and 266 N.

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Introduction: There have been reports of true aneurysm of the posterior tibial artery, but only three reports have described true aneurysm of the posterior tibial artery at the ankle, and there has been only one report of tarsal tunnel syndrome caused by true aneurysm of this artery. In this case report, we describe a rare case of true septic aneurysm of the posterior tibial artery presenting as tarsal tunnel syndrome which was found after anterior arthroscopic debridement of a septic ankle in a 55-year-old man.

Case Report: 13 years earlier, this patient had undergone aortic valve replacement for severe aortic regurgitation caused by infective endocarditis with aortic valve vegetations.

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The anterior lateral malleolar artery (ALMA), which usually originates from the anterior tibial artery (ATA), courses transversely and laterally, passing under the extensor digitorum longus and peroneus tertius tendons. Variations in the origin of the ALMA from the ATA can occur. Branches of the ATA, such as the ALMA, are prone to pseudoaneurysm.

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The use of standard anterolateral and anteromedial portals in ankle arthroscopy results in reduced risk of vascular complications. Anatomical variations of the arterial network of the foot and ankle might render the vessels more susceptible to injury during procedures involving the anterior ankle joint. The literature, to our knowledge, reports only one case of a pseudoaneurysm involving the peroneal artery after ankle arthroscopy.

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Purpose: The aim of this study was to test the hypothesis that the medial constrained insert would reproduce the native knee kinematics after bicruciate-retaining (BCR) total knee arthroplasty (TKA).

Methods: Using an image-free navigation system in six fresh-frozen whole-body cadavers, the rotation angle of the tibia at minimum flexion, at 10° intervals from 0° to 130° flexion, and at maximum flexion during manual passive knee flexion was assessed. The data was collected in native knees, in BCR TKA using a normal flat insert (BCR-XP), and in BCR TKA using a more constrained insert in the medial side (BCR-AS).

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Background: The deep plantar arch is formed by anastomosis of the lateral and deep plantar arteries. Osteotomy of the lesser metatarsals is often used to treat metatarsalgia and forefoot deformity. Although it is known that some blood vessels supplying the lesser metatarsals are prone to damage during osteotomy, there is little information on the distances between the deep plantar arch and the three lesser metatarsals.

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Reconstruction is challenging in a patient with loss of a segment of Achilles tendon and infection in the overlying soft tissue. Here the authors describe one-stage tendon reconstruction, using an anterolateral thigh free flap incorporating a vascularized muscle flap and a strip of iliotibial tract in a patient with re-rupture of an Achilles tendon and soft tissue infection. Postoperative immobilization of the affected ankle using an external fixator enabled us to observe the flap directly and reduce pressure on the flap.

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