The prevalence and pattern of joint involvement in radiographic hand osteoarthritis (OA) have been reported in Western populations, but similar data are lacking for Japanese. We examined this issue in 551 Japanese women aged > or = 40 years. Radiographs were obtained of both hands and graded according to the Kellgren-Lawrence (K-L) criteria. OA was defined as K-L grade 2 or higher. The prevalence of radiographic OA in the IP, MCP, and CMC joints was distributed similarly in both hands. The most frequent locations of radiographic OA were the distal IP joints of the index finger, the IP joint of the thumb, and the distal IP joints of the middle finger, in this order. The prevalence of radiographic OA in each joint group increased significantly with age, and that in Japanese women was lower in the thumb CMC joint and higher in the thumb IP joint compared to those in Caucasian women reported previously. The strongest predictor for the presence of radiographic OA in a particular joint was the disease status in the same joint of the opposite hand (OR = 18.5; 95% CI; 15.2-22.7), followed by the joints in the same row of the same hand (OR = 15.5; 95% CI, 11.9-20.1), and then by the joints in the same ray of the same hand (OR = 1.3; 95% CI, 1.0-1.6). Although the prevalence of hand OA is likely to show site-specific differences between Japanese and Caucasian women, our results indicate that both groups show similar involvement pattern symmetrically and in the same row of the same hand.

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We report a case of ulnar nerve palsy following forearm fracture in a 13-year-old girl. Significant anterior angulation and displacement of the ulna were noted. Operation was performed 3 months after the injury, when no recovery of numbness and claw hand deformity were demonstrated. Intra-operatively the ulnar nerve was found to be embedded between fragments of the fractured ulna, which showed lack of callus formation on the preoperative radiograph. The patient achieved complete recovery of sensory and motor functions 4 months after the surgery.

We hypothesised that using a palmaris longus tendon ball (PLTB) with bone core (w bc) after excisional arthroplasty for Kienböck disease would maintain post-operative carpal height compared to a PLTB without bone core (w/o bc). Seventeen hands of 16 consecutive patients with Kienböck disease at Lichtman stage IIIA or IIIB were treated by replacement of the lunate with a PLTB w bc or w/o bc. We evaluated the clinical and radiological outcomes at one, three and 12 months after surgery. According to Dornan and Lichtman criteria respectively, there were no significant differences between the two groups. In the w bc group, the post-operative values of the carpal height ratio (CHR) were maintained at the same level as pre-operative values for one year, while the post-operative CHR values in the w/o bc group were significantly lower than those in the w bc group. Our results indicate that in Kienböck disease, arthroplasty using a PLTB w bc can maintain CHR at one year after surgery compared to arthroplasty using a PLTB w/o bc.

BMD and physical performance of the lower extremities decrease with older age. Unipedal standing time, timed up and go test, and age are associated with BMD in community-dwelling Japanese women. In women aged 70 years and over, unipedal standing time is significantly associated with BMD.