We conducted an interview survery on the social self-sustenance of two groups of people with cervical spinal cord injuries, most difficult to cure, in a rural environment where aging, family nuclearization and depopulation are in progress. One group was composed of those staying at home (10 males) and the other, of those accommodated in a care facility (nine males, one femal). In the survery, we compared social lives of patients who associate with healthy people in their community and those who see only fellow patients in the care facility. When it comes to the basis for their livelihood, both groups were significantly reliant on pensions.
Even those patients with so severe disorders as to need help in most part of their everyday lives could be expected to display ability of a kind which is not readily conceivable in light of the conventional criteria for the assessment of physical functions thanks to the use of office-automation equipment. Whether home care for patients with severe disorders could be provided effectively or not depends much on whether they could find their place in their homes as a respectable member of the family, aside from the degree of severity. This factor is more decisive for patients with desorders in the facilities than those at home.

During 1962-83, we had a total of 104 ankle fracture cases, of which a half were treated by surgical operation. Since 1981, Zuggurtungsosteosyntheses have been employed in most of the cases for fixing fractures instead of screws.
In this method, special devices are not necessary except for Kirschner steel wires and clamping wires. Moreover, after surgery, external support by the plaster of paris is not necessary, because compression is continuously applied on the surface of the fracture. Exercises to strengthen the injured ankle can be begnu early.
In these cases treated with the Zuggurtungsosteosynthese method, postoperative prognosis has been very good. This paper demonstrates the effectiveness of this modality in the treatment of ankle fractures.
We also discuss the use of tapes which we have recently adopted to immobilize simple and minor ankle fractures not requiring a surgical operation.