Motoo Hosokawa

Kyoto Prefectural University of Medicine, Kyoto, Kyoto-fu, Japan

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Publications (4)3.02 Total impact

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    ABSTRACT: Prior to 1992, our postoperative management for congenital muscular torticollis consisted of either plaster cast immobilization or no immobilization, depending on the patient's age and the degree of contracture. However, some patients required further surgery and developed complications. In 1992, we produced rugby helmet braces for postoperative management. The purpose of this study was to compare the clinical results of the previous postoperative management with the results achieved using rugby helmet braces. Twenty-five children aged younger than 6 years underwent caudal partial resection of the sternocleidomastoid muscle. Twelve children aged 6 years and older underwent cranial tenotomy. These 37 patients were divided into 2 groups: no immobilization or plaster immobilization (group A; n=19) and rugby helmet braces (group B; n=18). Canale's method was used for evaluation of clinical results. In group A, the results were good in 12 patients, fair in 4, and poor in 3, whereas all 18 patients in group B had good results. Two patients in group A required further surgery, and complications were observed in 5 patients. In group B, alopecia areata was observed in 1 patient.The rugby helmet brace is easy to put on and remove, providing good retention and allowing for physiotherapy. It provides a useful method of postoperative management for congenital muscular torticollis.
    Orthopedics 01/2011; 34(10):e659-63. · 1.05 Impact Factor
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    ABSTRACT: In 1992, the authors developed a non-weightbearing unilateral ambulatory hip abduction brace, which was named the new pogo-stick brace for unilateral Legg-Calve -Perthes' disease. The hip abduction angle of the new pogo-stick brace was adjustable 45 degrees . The advantage of this brace was that even in the sitting position, the hip abduction angle was maintained. Twenty patients were treated with unilateral LCPD using the new pogo-stick brace. In the Catterall classification, one patient was classified as group 2, 17 as group 3, two as group 4. In Herring classification, one patient was classified as group A, 17 as group B, two as group C. Ultrasonography was performed to determine containment of the hip joints, and the abduction angle of the new pogo-stick brace was adjusted to get better containment, every 2 months. Mose's and acetabular head index methods were used for radiographic evaluation, and classified into good, fair and poor groups both at the primary healing and at the final follow-up. Total evaluation was defined as worse group between Mose's method and acetabular head index method. The average time from onset of disease to the primary healing was 25 months. The average bracing period was 21 months. The average follow-up period was 94 months. At the final follow-up appointment, patients who were classified into good and fair groups were 85% in Mose's method, 95% in acetabular head index method, 85% in total evaluation. In Stulberg classification, the total number of patients who were classified into classes I and II was 85%. The outcome of the new pogo-stick brace was not worse than that of any other treatment method, and was better than that of other unilateral ambulatory braces.
    Journal of Pediatric Orthopaedics B 04/2006; 15(2):98-103. · 0.66 Impact Factor
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    ABSTRACT: To investigate the usefulness of epiphyseal quotient (EQ) measurement for outcome prediction in patients with Legg-Calve-Perthes disease (LCPD), magnetic resonance (MR) imaging was performed in 26 patients with unilateral LCPD within 6 months of the disease onset and subsequently once every 3 months. All the patients were treated conservatively in our institute between 1990 and 1999. The mean follow-up period was 80 months. Clinical outcome was evaluated based on the plain radiograms of the femoral head at the final examination according to Stulberg's classification: the patients whose outcome was class I were regarded as 'excellent' (excellent group), class II as 'good' (good group), and classes III, IV and V as 'poor' (poor group). The excellent group consisted of 10 patients, the good group of 12, and the poor group of four. The EQ measured on MR images (MR-EQ) decreased remarkably in the poor group chronologically, whereas there was no decrease in the excellent group and a slow decrease in the good group. The mean MR-EQ at or before the sixth month (range, 2-6 months; mean, 4.9 months) was 86.2 (range, 76.8-94.8) in the excellent group, 78.3 (57.0-93.4) in the good group, and 67.4 (57.8-74.5) in the poor group (P<0.05 among the three groups). According to our results, because all patients having an MR-EQ at or before the sixth month of 75 or higher were classified in the excellent or good groups, it is thought that the ongoing method of treatment can be continued. On the other hand, since half of the patients having an MR-EQ at or before the sixth month of lower than 75 were classified in the poor group and had a high potential for a poor outcome, it is thought that these patients require strict containment therapy, and altering the surgical procedure could be considered depending on the particular patient. It was thought that the MR-EQ is a useful predictive factor of LCPD prognosis.
    Journal of Pediatric Orthopaedics B 02/2005; 14(1):16-23. · 0.66 Impact Factor
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    ABSTRACT: The usefulness of magnetic resonance imaging (MRI) for predicting prognosis was evaluated in 11 patients with unilateral early-stage Legg-Calvé-Perthes disease who were treated with a non-weight-bearing abduction brace. Six to 10 months after disease onset, severity of cartilage hypertrophy and physeal curvature of the femoral head were scored on MRI. Femoral head deformity was radiographically evaluated. Among five patients whose MRI score was 8 or greater, radiographic evaluation after the treatment was "poor" or "fair," whereas evaluation for the other six patients whose MRI score was 7 or less was "good." The MRI scores indicated possible occurrence of femoral head deformation. Treatment method should be considered carefully when the MRI score is high.
    Journal of Pediatric Orthopaedics B 08/1999; 8(3):161-4. · 0.66 Impact Factor