Goichi Okahara
University of the Ryukyus
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Orthopaedics and Traumatology | 2009
Goichi Okahara; Chojo Futenma; Kenji Horikiri; Yoshiyuki Akamine; Tomohiro Isa; Fuminori Kanaya
陳旧性小指屈筋腱皮下断裂に対して,橋渡し腱移植後に減張位早期自動運動を行い,良好な成績を得た1例を経験したので報告する.症例は66歳,男性.ゴルフ練習中に練習場のマットを強打した後から左手掌に疼痛があり,近医を受診したが骨折の診断は得られなかった.受傷から1カ月後,左小指の屈曲が困難となり,握力低下と徐々にゴルフのドライバー飛距離も落ちてきた.受傷から3カ月後,手術加療目的に当科に紹介され,有鉤骨鉤偽関節に伴う小指深指屈筋(FDP)腱皮下断裂と診断された.手術は偽関節となった有鉤骨鉤を切除し,断裂したFDP腱に対し長掌筋腱を用いた橋渡し腱移植術を行った.術後2日目より環指の掌側に小指を重ねた減張位バディテーピングにて早期自動運動療法を3週間行った.術後3年の現在,可動域は % total active motion 84%と日本手の外科学会評価法でGoodであり,握力とドライバー飛距離の改善も得られた.
Journal of Reconstructive Microsurgery | 2006
Fuminori Kanaya; Tomohiro Isa; Tomohiro Shiroma; Wataru Oshiro; Goichi Okahara; Chojo Futenma
The veno-accompanying artery fasciocutaneous (VAF) flap and veno-neuro-accompanying artery fasciocutaneous (V-NAF) flap are fasciocutaneous flaps receiving arterial blood supply from accompanying arteries of the cutaneous vein and nerve (Nakajima, 1999). These skin flaps can cover skin defects of the extremities as pedicle flaps. These authors reported the results of these flaps used to cover skin defect of the leg. Since 1996, 17 flaps were used in 17 patients. The mean age of 14 men and 3 women was 42 years (range: 3 to 71 years). Cases involved skin defects in 6 patients, traumatic bone and skin defects in 5, and skin defects after tumor resection and after contracture release in 3 patients each. Four patients had combined osteomyelitis and were treated simultaneously with antibiotic-impregnated bone cement. The size of the skin defect ranged from 4 cm × 3.5 cm to 15 cm × 8 cm. The sural or saphenous nerve was used in V-NAF flaps. Currently, the authors spare these nerves, especially the saphenous nerve, in the proximal leg because it runs under the fascia and makes less of a contribution to the blood supply to the leg. There were 13 flaps containing the small saphenous vein and 4 flaps containing the great saphenous vein. Five proximally-based flaps were used to cover proximal skin defects, as proximal as the popliteal fossa and the prepatellar region. Twelve distally-based flaps were used to cover distal skin defects, as distal as the stump of Chopart amputation. Follow-up ranged from 1 year to 6 years (mean: 2 years). All flaps survived completely. The donor sites of these flaps were closed primarily in 6 and with a skin graft in 11 cases. All osteomyelitis cases healed without any problems. Skin defects exposing bone in the leg and ankle are difficult to treat. Free vascularized flaps used to be required in many cases. However, free flap transfer may be difficult in elderly patients or in patients having disease or damage to major arteries of the leg. The VAF and V-NAF flaps are pedicle flaps, relatively easy to dissect and with no need to sacrifice the major arteries of the leg. They are useful for covering skin defects of the leg and ankle.
Genomics | 2004
Goichi Okahara; Shinobu Matsubara; Takaya Oda; Jun Sugimoto; Yoshihiro Jinno; Fuminori Kanaya
Orthopaedics and Traumatology | 2010
Hirotaka Okubo; Yoshiyuki Akamine; Kenji Horikiri; Goichi Okahara; Chojo Futenma; Fuminori Kanaya
Orthopaedics and Traumatology | 2010
Takayuki Yamauchi; Tsugukazu Toma; Satoshi Kinjo; Goichi Okahara; Fuminori Kanaya; Jun Asato
Orthopaedics and Traumatology | 2010
Motoko Nakasone; Goichi Okahara; Chojo Futenma; Fuminori Kanaya; Hiroshi Chinen
Orthopaedics and Traumatology | 2009
Kenji Horikiri; Chojo Futenma; Goichi Okahara; Tomohiro Isa; Yoshiyuki Akamine; Hirotaka Okubo; Fuminori Kanaya
Orthopaedics and Traumatology | 2009
Masamichi Onaga; Goichi Okahara; Tomohiro Isa; Wataru Oshiro; Chojo Futenma; Fuminori Kanaya
Orthopaedics and Traumatology | 2009
Shoichiro Higa; Goichi Okahara; Chojo Futenma; Fuminori Kanaya; Satoshi Kinjo
Orthopaedics and Traumatology | 2003
Yusei Funakoshi; Fuminori Kanaya; Ichiro Owan; Chojo Futenma; Goichi Okahara