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Biomedical subjects

I Hamanaka

Publications and source records attributed to I Hamanaka.

27 records · Page 2Linked to original sources
PubMed1996

Complete endoscopic carpal tunnel release in long-term haemodialysis patients.

The roof of the carpal tunnel (or canal) consists of the distal portion of the flexor retinaculum, the flexor retinaculum (or the transverse carpal ligament) and the proximal portion of the flexor retinaculum. We tried to determine which anatomical structures were relevant to complete endoscopic carpal tunnel decompression in long-term haemodialysis patients with carpal tunnel syndrome. Carpal tunnel pressure was measured using the continuous infusion technique before and after endoscopic release of the flexor retinaculum, distal portion of the flexor retinaculum and the proximal portion of the flexor retinaculum respectively in 257 hands. We concluded that release of the distal portion of the flexor retinaculum, in addition to the flexor retinaculum, is essential for complete carpal tunnel decompression in long-term haemodialysis patients.

Adult↗
PubMed1996

Complete endoscopic carpal canal decompression.

We made a model of the endoscopic decompression of the carpal canal in clinical cases. The model entailed the release of the transverse carpal ligament, ie, the flexor retinaculum, first; then the transverse fibers: deep layer of the midpalmar fascia or distal portion of the flexor retinaculum; and, finally, release of the forearm fascia. Carpal canal pressure was measured using the continuous infusion technique, and the carpal canal was observed endoscopically at each step. Carpal canal pressure data were analyzed by using the Wilcoxon matched pairs signed-rank test. When the transverse carpal ligament and the transverse fibers were divided, carpal canal pressure was significantly statistically lower than that with release of the transverse carpal ligament alone. We conclude that release of both the transverse carpal ligament and the transverse fibers are essential for complete decompression of the carpal canal in endoscopic surgery.

Adult↗
PubMed1995

Evaluation of carpal canal pressure in carpal tunnel syndrome.

Preoperative electrophysiologic testing and intraoperative carpal canal pressure measurements were performed on 957 hands in 647 patients with clinical signs of carpal tunnel syndrome. Fifty-five symptomatic hands in 48 patients were normal in both distal sensory latency and distal motor latency preoperatively. Carpal canal pressure was, however, significantly elevated compared to control data in all 55 hands. After complete subcutaneous release of the carpal canal using the Universal Subcutaneous Endoscope system, carpal canal pressure was reduced to within the normal control range. Clinical symptoms of carpal tunnel syndrome improved in all 55 hands. Postoperative electrophysiologic data remained within normal range in patients who agreed to receive electrophysiologic examinations.

Adult↗
PubMed1993

Results of endoscopic management of carpal-tunnel syndrome in long-term haemodialysis versus idiopathic patients.

The purpose of this paper is to compare the results of our endoscopic management of carpal-tunnel syndrome caused by long-term haemodialysis to that with no apparent cause (idiopathic). We have operated on 551 hands in 370 patients using the Universal Subcutaneous Endoscope system under local anaesthesia without a pneumatic tourniquet on an out-patient basis since 1986. Ninety-six hands in 64 patients who suffered from carpal-tunnel syndrome from long-term haemodialysis and 85 hands in 52 patients who suffered from carpal-tunnel syndrome for no apparent cause were statistically analysed using complete pre- and postoperative electrophysiological and clinical studies for periods of time ranging from over 6 months to 4.8 years (mean 16.9 months). Electrophysiological and clinical results showed that our endoscopic management in long-term haemodialysis patients is effective, safe and yields the same results as in patients who suffered from carpal-tunnel syndrome for no apparent cause.

Adult↗
PubMed1993

Results of endoscopic management of carpal tunnel syndrome.

This paper is a retrospective study of 27 women with carpal tunnel syndrome (39 hands) who underwent a new endoscopic operative procedure utilizing the Universal Subcutaneous Endoscope system developed by the lead author. Operations on 199 hands were performed under local anesthesia on an outpatient basis. The etiology was considered idiopathic in all cases. Complete preoperative and postoperative clinical and electrophysiologic data were analyzed in 39 hands. The follow-up period ranged from 12 to 45.8 months (mean, 18.3 months). Symptoms of sensory disturbances disappeared in an average of 20 weeks in all patients. Electrophysiologic studies showed definite improvement when compared with preoperative studies. No complications were recorded. Clinical and electrophysiologic results showed that the less-invasive management of carpal tunnel syndrome by endoscopy is safe and effective.

Ambulatory Surgical Procedures↗
PubMed1992

Coracoacromial ligament release for shoulder impingement syndrome using the Universal Subcutaneous Endoscope system.

We developed a new operative procedure of coracoacromial ligament release for shoulder impingement syndrome. The operative procedure was confirmed by cadaveric studies and applied to clinical cases in 40 shoulders of 37 patients who suffered from shoulder impingement without bony abnormalities. The subacromial space was observed under local anesthesia using the Universal Subcutaneous Endoscope (USE) system on an outpatient basis. A popping phenomenon was observed between the coracoacromial ligament and the greater tuberosity of the humerus, which was covered by the rotator cuff, and the coracoacromial ligament was resected with a rongeur under endoscopic visualization in all shoulders. Resection of the coracoacromial ligament relieved the impingement and clinical signs, as in open or arthroscopic resection of the coracoacromial ligament. Resection of the coracoacromial ligament using the USE system is a safe and less-stressful surgical invasion than open or standard arthroscopic resection of the coracoacromial ligament.

Anesthesia, Local↗
PubMed1991

Endoscopic management of shoulder pain in long-term haemodialysis patients.

In 48 shoulders of 29 patients receiving long-term haemodialysis and complaining of intolerable shoulder pain, endoscopic resection of the coracoacromial ligament was performed under local anaesthesia on an outpatient basis, using the Universal Subcutaneous Endoscope system. Predominant endoscopic findings were proliferation of the subacromial bursae and popping between the coracoacromial ligament and the rotator cuff. Amyloid originating from beta 2 microglobulin (beta 2-M) was demonstrated in 87% of the resected coracoacromial ligaments and 86% of the subacromial bursae. Resection of the coracoacromial ligament relieved the shoulder pain in all patients.

Adult↗
PubMed1989

Measurement of pressure in the carpal canal before and after endoscopic management of carpal tunnel syndrome.

In forty-six patients who had carpal tunnel syndrome, a technique of continuous infusion, given under local anesthesia and without a pneumatic tourniquet, was used to measure pressures in the carpal canal before and after endoscopic release of the transverse carpal ligament (retinaculum flexorum manus). Pressures were similarly measured in sixteen subjects in a control group. The mean preoperative pressures were significantly higher in the patients who had carpal tunnel syndrome than in the patients in the control group when the pressures were measured under four conditions: with the wrist in the resting position, with active grip, and with maximum passive extension and flexion of the wrist. The mean pressures improved significantly postoperatively and were in the range of values that were found under each condition for the control group. Measurement of pressure in the carpal canal before and after operation may be useful in diagnosing carpal tunnel syndrome and in determining the effectiveness of endoscopic management.

Adult↗