著者

時吉 聡介 井手 淳二 廣瀬 隼 水田 博志

出版者

西日本整形・災害外科学会

雑誌

整形外科と災害外科 (ISSN:00371033)

巻号頁・発行日

vol.58, no.2, pp.228-230, 2009-03-25 (Released:2009-06-02)

参考文献数

7

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【目的】超音波検査は侵襲が少なく,外来で検査が可能であり,非常に簡便な検査法である.当施設で行った超音波検査の正診率について検討した.【対象と方法】平成19年3月から11月までに熊本大学医学部附属病院にて肩関節鏡視下手術を行った28人(男性16人,女性12人,平均年齢52.3歳)を対象とした.超音波検査を術前に行い,腱板断裂の有無を肩甲下筋腱,棘上筋腱,棘下筋腱おのおのについて診断した.最終的な診断は手術時の所見とし感度,特異度,正診率を算出した.【結果と考察】肩甲下筋腱;感度は100%,特異度92.0%,正診率92.9%であった.棘上筋腱;感度は93.3%,特異度84.6%,正診率89.3%であった.棘下筋腱;感度は36.4%,特異度100%,正診率75.0%であった.我々の結果は諸家の報告と比べてやや低い傾向にあった.正診率を挙げるためには今後もトレーニングが必要と考えられた.

著者

山鹿 眞紀夫 高木 克公 森沢 佳三 井手 淳二 生田 拓也 北川 敏夫 鬼木 泰博 山隈 維昭

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.12, no.2, pp.129-133, 1988-08-10 (Released:2012-11-20)

参考文献数

6

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Neurovascular compression in the thoracic outlet produces great variation of signs and symptoms. The clinical picture is often complex, being made up of the derangement of blood vessels, somatic nerves and autonomic nervous networks in varying degrees. Thirty-eight of the 150 patients (25%) treated in our clinic because of possible thoracic outlet syndrome (TOS), complained of general malaise such as headache, dizziness, sleeplessness, nausea, anorexia or general fatigue, in addition to their peculiar signs and symptoms due to brachial plexus involvement.In order to find out whether or not autonomic nerve dysfunction can be demonstrated in patients with TOS, a non-invasive and quantitative technique was developed for assessing the mean (M) and coefficient of variations (CV) of R-R intervals in ECG at resting position. Thirty patients (13-39; mean 29.5 y/o) were put into two groups of 15 patient s each. In the first group patients with autonomic nerve disorder had complaints of general discomfort, M was 803.72 ± 106.9 msec and CV was 3.214±0.717%. In the second group, those without general discomfort, M was 972.21 ± 120.64 msec and CV was 5.926±0.720%. The first group had a significantly shorter M (P < 0.001) and smaller CV (P < 0.001) compared to the second group. Furthermore, in two cases in the first group diagnosed by psychologists as having schizophrenia and anxiety neurosis, it was found that their M and CV were the nearly same as those in the second group.Decompressive ope r a tions were performed on five patients in the first group. Their complaints decreased or vanished after the operation and the M and CV progressed to near the normal rate.From these results, we belive that this method in useful in differentiating between autonomic nervous disorders and psychological disorders; and that in patients with TOS, a decompressive operation can help eliminate complaints of general discomfort due to autonomic nervous disorders.

著者

北村 歳男 高木 克公 山鹿 眞紀夫 森澤 佳三 井手 淳二 荒木 崇一 田上 学

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.18, no.1, pp.1-4, 1994-09-01 (Released:2012-11-20)

参考文献数

8

被引用文献数

1

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The purpose of this research was to clarify the causes of numbness and pain by traction of the upper limbs. We stretched the nerves in the upper limbs of rats by utilizing the flail of the shoulder girdle, and measured the blood flow of the brachial plexus and the median nerve. The model animals,32 wistar rats, were inserted with steel lines to the radius and ulna. These steel lines were drawn in the direction of a shoulder abduction of 80 degrees. A decrease and recovery of the blood flow were measured using the hydrogen gas clearance method.The blood flow of the subepineural space in the brachial plexus decreases sharply in conditions with looseness of the plexus.The blood flow of the intrafuniculuse in the brachial plexus decreases like a straight line in those states without looseness of the plexus. The blood flow of the subepineural space in the median nerve decrease like a straight line, too. The decrease rate of the subepineural space was sharper than that of the intrafuniculuse. As for the recovery rate, there was no significant difference in either site.One of the factor that causes nervous and functional imbalance with a slight traction is a sharp reduction of the blood flow in the subepineural space of the brachial plexus.

著者

井手 淳二 森沢 佳三 山鹿 真紀夫 北川 敏夫

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.12, no.1, pp.91-94, 1988-08-10 (Released:2012-11-20)

参考文献数

5

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We have determined the effectiveness of muscular strengthening exercises of the rotator muscles for shoulder instability. These exercises are one of the conservative treatments for shoulder instability.As of y et, there have only been a few reports about the effectiveness of this procedure due to lack of data. So we have attemped to clarify this treatment and its effect. In this study, we will report on 11 cases-19 shoulders with inferior and/or multidirectional instability and 3 cases-3 shoulders with recurrent anterior dislocation.All the patients began isometric rehabilitation exercises and followed up using a Cybex machine and a grading system. As a result, we found muscular strengthening exercises to be effective and useful in 75% of the patients with inferior and/or multidirectional instability. Patients with recurrent anterior dislocation also had a good rate of response. However the success and effectiveness of this technique has certain limitations.We should first try muscular strengthening exercises of the rotator muscles in the treatment of shoulder instability.

著者

井手 淳二 山鹿 眞紀夫 北村 歳男 田上 学 前田 智 高木 克公 森澤 佳三

出版者

日本肩関節学会

雑誌

肩関節 (ISSN:09104461)

巻号頁・発行日

vol.21, no.2, pp.311-314, 1997-06-25 (Released:2012-11-20)

参考文献数

7

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(Purpose)We Studied the diagnosis and surgical management of suprascapular nerve entrapment neuropathy in athletes.(Materials and methods)Eighteen patients with infraspinatus muscle atrophy were studied. Fourteen were men and 4 women. Their mean age was 27 (range 14 to 40) years. The diagnosis was confirmed by physical and electromyographic examinations. As an ancillary test, MRIs of the shoulder joint were obtained. Those patients with rotator cuff tear were excluded from this study.(Results)Electromyographic examinations showed an abnormality in 8 patients. Two of them had isolated paralysis of the infraspinatus muscle. We operated on 4 patients with suprascapular nerve entrapment. We performed a release of the superior scapular transverse ligament on 2 patients with paralysis of the supraspinatus and infraspinatus muscles, a shaving of the spinoglenoid notch on a patient with isolated paralysis of the infraspinatus muscle and removed the ganglion cyst in 1. All the patients had good results, however, they needed 1 or 2 years to recover from paralysis.(Conclusion)Early diagnosis and treatment are important for the management of suprascapular nerve entrapment neuropathy in athletes.

著者

坂本 憲史 平良 誠 中島 伸一 井手 淳二 寒野 龍弘 本多 一宏 師井 位栄

出版者

西日本整形・災害外科学会

雑誌

整形外科と災害外科 (ISSN:00371033)

巻号頁・発行日

vol.40, no.2, pp.836-841, 1991-11-25 (Released:2010-02-25)

参考文献数

12

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We Reported two cases of pyogenic arthritis of the knee which were obliged to undergo arthrodesis. Both cases had past histories of repeated steroid injection into the knee joints. Initially they were treated with closed irrigation-suction therapy, but did not improve at all, and finally underwent arthrodesis.Second case was a deep sepsis after total knee arthroplasty. In both cases bacterial isolation from specimens revealed pseudomonas pseudomonas aeruginosa, but bone union was obtained favorably by external fixation.