8 results on '"Ikeguchi R"'
Search Results
2. Treatment of Complete Brachial Plexus Injuries Using Double Free Muscle Transfer.
- Author
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Kakinoki R, Ohtani K, Ohta S, Ikeguchi R, Akagi M, and Goto K
- Abstract
Purpose: The purpose of this study was to examine the surgical outcomes of double free muscle transfer (DFMT) performed in patients with complete brachial plexus injury (BPI)., Methods: We retrospectively analyzed the outcomes of DFMT for 12 patients with complete BPI who were followed up for more than 2 years after the final muscle transplantation. Their mean age was 29 years (range, 18-41). Three patients underwent contralateral C7 nerve root transfer before the DFMT. The range of motion (ROM) of the shoulder, elbow, and fingers was measured. Patient-reported outcome measures, including Disability of the Shoulder, Arm, and Hand (DASH) scores and visual analog scale (VAS) scores for pain, were also examined., Results: The mean shoulder ROM against gravity was 22° ± 8° in abduction and 33° ± 5° in flexion. Seven patients underwent phrenic nerve (PhN) transfer to the suprascapular nerves, and five exhibited asymptomatic lung impairment on spirography more than 2 years after PhN transfer. The mean elbow ROM against gravity was 111° ± 9° in flexion and -32° ± 7° in extension. All patients obtained elbow flexion >90° against a 0.5-kg weight. All patients obtained touch sensation and two recognized warm and cold sensations in the affected palm. The mean total active motion of the affected fingers was 44° ± 11°. All patients exhibited hook function of the hands. The mean preoperative and postoperative DASH scores were 70.3 ± 13.4 and 51.8 ± 15.9, respectively. The mean pain VAS score was 28 ± 31 at the final follow-up., Conclusions: Double free muscle transfer provided patients with complete brachial plexus palsy with good elbow flexion and hand hook functions., Type of Study/level of Evidence: Therapeutic IV., (Copyright © 2023 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.)
- Published
- 2023
- Full Text
- View/download PDF
3. Intractable Fractures of the Bilateral Proximal Ulnae After 8 Years of Zoledronate Treatment for Breast Cancer Bone Metastasis.
- Author
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Ohta S, Ikeguchi R, Noguchi T, Kaizawa Y, and Matsuda S
- Subjects
- Bone Plates, Female, Fracture Fixation, Internal methods, Humans, Ulna surgery, Zoledronic Acid, Bone Neoplasms drug therapy, Bone Neoplasms surgery, Breast Neoplasms drug therapy, Breast Neoplasms surgery, Ulna Fractures diagnostic imaging, Ulna Fractures drug therapy, Ulna Fractures surgery
- Abstract
Long-term administration of bisphosphonates strongly suppresses osteoclastic bone resorption and rarely causes atypical fractures. This report presents a case of bilateral atypical ulnar fractures, following an 8-year course of zoledronate to treat breast cancer bone metastasis. Nonsurgical treatment for the left ulnar fracture failed, in spite of minimal displacement with callus formation at initial presentation. After failure of plate fixation with a pedicled vascularized bone graft, removal of osteosclerotic lesions and plate fixation with corticocancellous iliac bone graft resulted in bone healing, although the healing process took 1.5 years. Plate fixation for the contralateral fractured ulna was unsuccessful., (Copyright © 2022 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.)
- Published
- 2022
- Full Text
- View/download PDF
4. Vascularized Bone Graft to the Lunate Combined With Temporary Scaphocapitate Fixation for Treatment of Stage III Kienböck Disease: A Report of the Results, a Minimum of 2 Years After Surgery.
- Author
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Matsumoto T, Kakinoki R, Ikeguchi R, Ohta S, Akagi M, and Matsuda S
- Subjects
- Adult, Cancellous Bone blood supply, Cancellous Bone transplantation, Capitate Bone diagnostic imaging, Female, Follow-Up Studies, Hand Strength physiology, Humans, Lunate Bone diagnostic imaging, Male, Osteonecrosis classification, Osteonecrosis physiopathology, Range of Motion, Articular physiology, Retrospective Studies, Scaphoid Bone diagnostic imaging, Visual Analog Scale, Arthrodesis, Capitate Bone surgery, Lunate Bone surgery, Osteonecrosis surgery, Radius blood supply, Radius transplantation, Scaphoid Bone surgery
- Abstract
Purpose: To report the outcomes of patients with stage III Kienböck disease treated by vascularized bone graft (VBG) followed by temporary scaphocapitate (SC) fixation, a minimum of 2 years after surgery., Methods: Twenty-six patients (mean age, 35 years) with stage III Kienböck disease (16 with stage IIIA and 10 with stage IIIB), treated with VBG followed by SC fixation for 4 months, were retrospectively followed for at least 2 years (range, 24-121 months; mean, 61.8 months). The preoperative and postoperative assessments included range of motion (ROM) of the wrist, grip strength (GS), wrist pain, the modified Mayo wrist score (MMWS), carpal height ratio (CHR), Ståhl index (STI), and radioscaphoid angle (RSA). The outcomes of each assessment of the stages IIIA and IIIB groups at the final examination were compared with those before surgery., Results: In both stages IIIA and IIIB groups, GS increased after surgery. Decrease of CHR and STI was associated with the increase of RSA in the stage IIIA group after surgery, while RSA decreased, although neither CHR nor STI significantly increased in the stage IIIB patients. No patient demonstrated deterioration of the wrist pain after surgery. Twenty-one of 26 patients had an improved MMWS grade at the final follow-up., Conclusions: Vascularized bone graft combined with SC fixation for 4 months provided greater GS, pain relief, and functional improvement compared with before surgery in both stages IIIA and IIIB groups., Type of Study/level of Evidence: Therapeutic IV., (Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.)
- Published
- 2018
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5. Treatment of a type 3B hypoplastic thumb using extra phalanges from the contralateral duplicated thumb: case report.
- Author
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Kakinoki R, Ikeguchi R, Ohta S, Duncan SF, Fujita S, and Noguchi T
- Subjects
- Anastomosis, Surgical, Child, Fingers blood supply, Fingers innervation, Hand Strength, Humans, Male, Radiography, Sensation, Thumb diagnostic imaging, Finger Phalanges transplantation, Fingers transplantation, Thumb abnormalities, Thumb surgery
- Abstract
A boy was born with a right duplicated thumb (Wassel type 6) and a left radial club hand (type 3) associated with a hypoplastic thumb (type 3B). He underwent surgical centralization of the left wrist when he was 13 months old. At age 38 months, he underwent reconstruction of the carpometacarpal joint of the hypoplastic left thumb. This procedure involved transplantation of the radial ray of the right duplicated thumb to the base of the left thumb. When he was 6 years old, the patient underwent an abductor digiti minimi muscle transfer to create opposition for the left thumb and deepening of the first web. At the final follow-up, he could grasp items in the first web space and pick up small items between the thumb and other digits of the left hand. The treatment represents a method of using otherwise discarded tissues for effective reconstruction., (Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.)
- Published
- 2011
- Full Text
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6. Treatment of posttraumatic painful neuromas at the digit tip using neurovascular island flaps.
- Author
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Kakinoki R, Ikeguchi R, Atiyya AN, and Nakamura T
- Subjects
- Adult, Aged, Female, Finger Injuries complications, Fingers innervation, Humans, Hypesthesia classification, Hypesthesia etiology, Hypesthesia surgery, Male, Middle Aged, Neuralgia classification, Neuralgia etiology, Neuralgia surgery, Recovery of Function, Severity of Illness Index, Fingers surgery, Neoplasms, Post-Traumatic surgery, Neuroma surgery, Peripheral Nervous System Neoplasms surgery, Surgical Flaps
- Abstract
Purpose: We report the treatment of 9 patients with 9 painful neuromas at the tips of the digits using reverse pedicled island flaps containing subcutaneous nerves that were connected to the digital nerve stumps after removal of the neuromas., Methods: There were 9 patients (7 men and 2 women) with painful cutaneous neuromas at the tips of the digits. The ages of the patients at time of surgery were 21 to 66 years (mean, 46 y). All neuromas were formed in the palmar digital nerves in the hand. Preoperative and postoperative status of the patients with neuromas were assessed and graded using a system modified from previously described grading systems for patients with neuromas. Recovery of sensation in the transplanted skin islands was assessed using the Semmes-Weinstein monofilament test., Results: In the preoperative assessment of patients using the grading system for neuromas, 3 patients were assessed as grade 4 (severe), 5 patients as grade 3 (moderate), and the remaining patient as grade 2 (mild). After surgery, Tinel sign disappeared completely in 6 of 9 patients. According to the grading system for neuromas, 6 patients were assessed as grade 1 (normal), and the other 3 patients were assessed as grade 2 (mild) postoperatively. Using the Semmes-Weinstein monofilament test for assessing recovery of sensation of the skin islands, 3 patients recognized the 2.83 monofilament (normal), 2 patients recognized the 3.22 monofilament (loss of tactile sense), and the remaining 4 patients recognized the 3.66 monofilament applied (loss of tactile sense)., Conclusions: This skin island approach provided us with good pain control and recovery of hand function after painful neuromas., Type of Study/level of Evidence: Therapeutic IV.
- Published
- 2008
- Full Text
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7. Mycobacterium monacense: a mycobacterial pathogen that causes infection of the hand.
- Author
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Taieb A, Ikeguchi R, Yu VL, Rihs JD, Sharma M, Wolfe J, and Wollstein R
- Subjects
- Hand, Humans, Male, Middle Aged, Mycobacterium Infections, Nontuberculous therapy, Skin Diseases, Bacterial therapy, Mycobacterium Infections, Nontuberculous diagnosis, Mycobacterium Infections, Nontuberculous microbiology, Nontuberculous Mycobacteria, Skin Diseases, Bacterial diagnosis, Skin Diseases, Bacterial microbiology
- Abstract
We present a report of a diabetic patient with an infection of his left thumb and thenar eminence. Standard cultures of drainage and tissue biopsy were unrevealing. The infection progressed despite empiric antibacterial agent therapy and multiple debridements. Two intraoperative tissue biopsies revealed a yellow-pigmented, rapidly growing Mycobacterial nontuberculous species. The organism was identified as Mycobacterium monacense, a newly described species. The patient was cured with a 6-week course of clarithromycin and levofloxacin.
- Published
- 2008
- Full Text
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8. Second dorsal metacarpal artery muscle flap: an adjunct in the treatment of chronic phalangeal osteomyelitis.
- Author
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Kakinoki R, Ikeguchi R, and Nakamura T
- Subjects
- Adult, Bone Marrow surgery, Chronic Disease, Female, Fingers pathology, Humans, Fingers surgery, Metacarpus blood supply, Muscle, Skeletal transplantation, Osteomyelitis surgery, Surgical Flaps blood supply
- Abstract
We describe a surgical approach for treating chronic osteomyelitis of the proximal phalanx in the hand. The procedure consisted of inserting the second dorsal metacarpal reverse adipofascial flap, including a small amount of interosseous muscle, into the bone marrow space of the phalanx after complete removal of the focus of infection. Two years after the procedure, the patient had full range of motion of the finger with no signs of infection or drainage. This operation resulted in minimal morbidity and a full range of motion of the finger.
- Published
- 2004
- Full Text
- View/download PDF
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