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手外科・外傷再建グループ
臨床研究
これまで当グループではマイクロサージャリーおよび骨延長等を用いて、外傷から小児の先天異常、再建まで様々な手術を行ってきました。個々の症例に応じて手術を工夫し、術後成績を含めて報告しています。また小児の先天異常や手の変性疾患などに対しては、関節可動域や筋力評価といった客観的評価だけでなく患者立脚型機能評価質問表などを用いて評価し、保存治療を含めた治療法の検討に役立てています。
疫学調査・岩木健康増進プロジェクト
当科では2005年に弘前市岩木地区住民の生活習慣病予防と健康の維持・増進、寿命の延長を目指して開始された「岩木健康増進プロジェクト」に参加しています。当グループでは変形性手指関節症やDupuytren拘縮などを中心に、有病率や他疾患との関連、原因の解明などを目的に、横断的、縦断的な研究を行っています。調査結果を被検者へ還元するとともに、他科と合同で包括的に調査しながら多角的視点から病態解明に迫っています。業績:手外科グループ
- Wood-Splitter-Related Upper-Limb Injuries: A Single-Centered Case-Series Study. Int J Environ Res Public Health.
- Aoyagi A, Nomura O, Sasaki N, Fujita Y, Ichikawa N, Ishizawa Y, Ishibashi Y, Hanada H.
- 2022 Sep 13;19(18):11507. doi: 10.3390/ijerph191811507. PMID: 36141775; PMCID: PMC9517299.
- Menstrual Status and Pregnancy in Former Elite Long-Distance Runners With Menstrual Disorders.
- Fujita Y, Sasaki E, Yoneda K, Kinugasa S, Oishi M, Tsuda E, Ishibashi Y, Umeda T.
- Clin J Sport Med. 2022 Nov 4. doi: 10.1097/JSM.0000000000001083. Epub ahead of print. PMID: 36633593.
- Role of MDA5 in regulating CXCL10 expression induced by TLR3 signaling in human rheumatoid fibroblast-like synoviocytes.
- Saruga T, Imaizumi T, Kawaguchi S, Seya K, Matsumiya T, Sasaki E, Sasaki N, Uesato R, Ishibashi Y.
- Mol Biol Rep. 2021 Jan;48(1):425-433. doi: 10.1007/s11033-020-06069-z. Epub 2021 Jan 2. PMID: 33387195; PMCID: PMC7884359.
- Epidemiology of Dupuytren's Disease in Japanese General Population.
- Sasaki N, Uesato R, Yamauchi T, Ishibashi Y, Nakaji S.
- J Hand Surg Asian Pac Vol. 2021 Jun;26(2):229-234. doi: 10.1142/S2424835521500235. PMID: 33928865.
- Non-vascularized bone grafting in scaphoid nonunion: principles and type of fixation.
- Uesato R, Toh S, Hayashi Y, Maniwa K, Ishibashi Y.
- Eur J Orthop Surg Traumatol. 2017 Jan;27(1):11-21. doi: 10.1007/s00590-016-1868-6. Epub 2016 Oct 19. PMID: 27761662.
- Surgical outcomes of foramen magnum decompression for syringomyelia associated with Chiari I malformation: relation between the location of the syrinx and body pain.
- Ono A, Numasawa T, Wada K, Yokoyama T, Takeuchi K, Suetsuna F, Ueyama K, Toh S.
- J Orthop Sci. 2010 May;15(3):299-304. doi: 10.1007/s00776-010-1462-4. Epub 2010 Jun 18. PMID: 20559796.
- Pulsation Sensor Integrated with Microvascular Holding Actuator for thrombosis Monitoring.
- Mineta T, Kida N, Nomura S, Makino E, Sugawara T, Toh S, Shibata T.
- Sensors and Acuators A, 2008;143(1);14-19.
- Thermal Type Blood Flow Sensor on Titanium Micro Needle.
- Mineta T, Tanahashi Y, Makino E, Toh S, Kawashima T, Shibata T.
- Sensors and material, 2008:20(7);341-349.
- Evaluation of lengthened callus by callotasis with analysis of mathematical morphology.
- Yamasaki Y, Narita S, Toh S, Kashima I.
- J Orthop Sci. 2008 May;13(3):211-7. doi: 10.1007/s00776-008-1224-8. Epub 2008 Jun 6. PMID: 18528654.
- Validation of the Japanese Society for Surgery of the Hand version of the Carpal Tunnel Syndrome Instrument.
- Imaeda T, Uchiyama S, Toh S, Wada T, Okinaga S, Sawaizumi T, Nishida J, Kusunose K, Omokawa S; Clinical Outcomes Committee of the Japanese Orthopaedic Association and the Impairment Evaluation Committee of the Japanese Society for Surgery of the Hand.
- J Orthop Sci. 2007 Jan;12(1):14-21. doi: 10.1007/s00776-006-1087-9. Epub 2007 Jan 31. PMID: 17260112; PMCID: PMC2778629.
- Locally administered low-dose alendronate increases bone mineral density during distraction osteogenesis in a rabbit model.
- Omi H, Kusumi T, Kijima H, Toh S.
- J Bone Joint Surg Br. 2007 Jul;89(7):984-8. doi: 10.1302/0301-620X.89B7.18980. PMID: 17673599.
- Arthroscopic evaluation and treatment by tendon interpositional arthroplasty of first carpometacarpal joint arthritis.
- Pegoli L, Parolo C, Ogawa T, Toh S, Pajardi G.
- Hand Surg. 2007;12(1):35-9. doi: 10.1142/S0218810407003389. PMID: 17613182.
- A quarter century of advancement in vascularized bone grafts in the Orthopaedic field.
- Toh S, Nakamura Y, Jin H, Yukawa M, Arai K.
- Medical Investigations, 2007;4l:28-33, 39549
- Comparison of responsiveness of the Japanese Society for Surgery of the Hand version of the carpal tunnel syndrome instrument to surgical treatment with DASH, SF-36, and physical findings.
- Uchiyama S, Imaeda T, Toh S, Kusunose K, Sawaizumi T, Wada T, Okinaga S, Nishida J, Omokawa S; Clinical Outcomes Committee of the Japanese Orthopaedic Association; Impairment Evaluation Committee of the Japanese Society for Surgery of the Hand.
- J Orthop Sci. 2007 May;12(3):249-53. doi: 10.1007/s00776-007-1128-z. Epub 2007 May 31. PMID: 17530376; PMCID: PMC2778722.
- Validation of the Japanese Society for Surgery of the Hand Version of the Quick Disability of the Arm, Shoulder, and Hand (QuickDASH-JSSH) questionnaire.
- Imaeda T, Toh S, Wada T, Uchiyama S, Okinaga S, Kusunose K, Sawaizumi T; Impairment Evaluation Committee, Japanese Society for Surgery of the Hand.
- J Orthop Sci. 2006 May;11(3):248-53. doi: 10.1007/s00776-006-1013-1. PMID: 16721524; PMCID: PMC2778693.
- Vastus medialis muscle flap and hemi V-Y skin flap for knee extensor and soft tissue reconstruction.
- Kubota Y, Tsubo K, Toh S, Ogawa T.
- Ann Plast Surg. 2006 Feb;56(2):196-9. doi: 10.1097/01.sap.0000192031.46986.9b. PMID: 16432332.
- Biocompatibility and Osteoconductivity of Hydroxyapatite/Polysaccharide Nanocomposite Microparticles.
- Omi H, Itoh S, Ikoma T, Asou Y, Nishikawa S, Tanaka J, Shinomiya K, Toh S.
- Key Engineering Materials, 2006;309-311:561-564.
- Shape memory thin film actuator for holding a fine blood vessel.
- Sugawara T, Hirota K, Watanabe M, Mineta T, Makino E, Toh S, Shibata T.
- Sensors and Actuators. Physical, 2006;14:561-467.
- Fracture of the Scaphoid.
- Toh S, eds. by David C. Ring & Mark S. Cohen.
- Informa Helth Care Co., New York, London, Fracture of the Hand and Wrist, 2007:115-136.
- What’s New in Hand and Reconstructive Surgery? Hirosaki University Press,2005;82.
- Raimondi PL, Toh S, Ceruso Massimo, Nakamura R.
- Hirosaki University Press,2005;82.
- Arthroscopic treatment of a ganglion of the first metatarsophalangeal joint.
- Nishikawa S, Toh S.
- Arthroscopy. 2004 Jan;20(1):69-72. doi: 10.1016/j.arthro.2003.11.011. PMID: 14716282.
- Arthroscopically assisted treatment of ankle fractures: arthroscopic findings and surgical outcomes.
- Ono A, Nishikawa S, Nagao A, Irie T, Sasaki M, Kouno T.
- Arthroscopy. 2004 Jul;20(6):627-31. doi: 10.1016/j.arthro.2004.04.070. PMID: 15241315.
- Endoscopic treatment of delayed unions and nonunions with calcium phosphate paste.
- Nishikawa S, Toh S, Tsukahara S, Takahashi I.
- Arthroscopy. 2003 Apr;19(4):436-9. doi: 10.1053/jars.2003.50135. PMID: 12671628.
- Ganglion of the triangular fibrocartilage complex. A report of three cases.
- Nishikawa S, Toh S.
- J Bone Joint Surg Am. 2003 Aug;85(8):1560-3. doi: 10.2106/00004623-200308000-00020. PMID: 12925639.
- The Ishiguro extension block technique for the treatment of mallet finger fracture: indications and clinical results.
- Pegoli L, Toh S, Arai K, Fukuda A, Nishikawa S, Vallejo IG.
- J Hand Surg Br. 2003 Feb;28(1):15-7. doi: 10.1054/jhsb.2001.0733. PMID: 12531661.
- 2.3.1. Fibula, Experimental and Clinical Reconstructive microsurgery.
- Toh S, Arai K, Yasumura M.
- E. CLINICAL RECONSTRUCTIVE MICROSURGERY , 349-54, 2003
- Scaphoid fractures in children: problems and treatment.
- Toh S, Miura H, Arai K, Yasumura M, Wada M, Tsubo K.
- J Pediatr Orthop. 2003 Mar-Apr;23(2):216-21. PMID: 12604954.
- 1.2. Forearm Replantation, Experimental and Clinical Reconstructive microsurgery.
- Toh S, Nishikawa S, Inoue S.
- E. CLINICAL RECONSTRUCTIVE MICROSURGERY, 193-96, 2003
- 3.5. Congenital Pseudoarthrosis, Experimental and Clinical Reconstructive microsurgery.
- Toh S, Tsubo K, Narita S.
- E. CLINICAL RECONSTRUCTIVE MICROSURGERY, 437-41, 2003
- 1.Preoperative Planning and Evaluation of Vascular System in the Donor and Recipient, Experimental and Clinical Reconstructive microsurgery.
- Toh S.
- Preoperative and Postoperative Management, E. CLINICAL RECONSTRUCTIVE MICROSURGERY 2003:157-161/
- Treatment of soft tissue injuries to the dorsum of the metacarpophalangeal joint (Boxer's knuckle).
- Arai K, Toh S, Nakahara K, Nishikawa S, Harata S.
- J Hand Surg Br. 2002 Feb;27(1):90-5. doi: 10.1054/jhsb.2001.0656. PMID: 11895354.
- Complications of vascularized fibula graft for reconstruction of long bones.
- Arai K, Toh S, Tsubo K, Nishikawa S, Narita S, Miura H.
- Plast Reconstr Surg. 2002 Jun;109(7):2301-6. doi: 10.1097/00006534-200206000-00021. PMID: 12045554.
- An occult fracture of the trapezoid bone. A case report.
- Nagumo A, Toh S, Tsubo K, Ishibashi Y, Sasaki T.
- J Bone Joint Surg Am. 2002 Jun;84(6):1025-7. doi: 10.2106/00004623-200206000-00020. PMID: 12063340.
- The carpal detachment injury of the triangular fibrocartilage complex.
- Nishikawa S, Toh S, Miura H, Arai K.
- J Hand Surg Br. 2002 Feb;27(1):86-9. doi: 10.1054/jhsb.2001.0680. PMID: 11895353.
- Anatomical study of the carpal attachment of the triangular fibrocartilage complex.
- Nishikawa S, Toh S.
- J Bone Joint Surg Br. 2002 Sep;84(7):1062-5. doi: 10.1302/0301-620x.84b7.12979. PMID: 12358373.
- Distraction lengthening by callotasis in the hand.
- Toh S, Narita S, Arai K, Nakashima K, Tsubo K.
- J Bone Joint Surg Br. 2002 Mar;84(2):205-10. doi: 10.1302/0301-620x.84b2.12131. PMID: 11922361.
- Long-standing nonunion of fractures of the lateral humeral condyle.
- Toh S, Tsubo K, Nishikawa S, Inoue S, Nakamura R, Harata S.
- J Bone Joint Surg Am. 2002 Apr;84(4):593-8. doi: 10.2106/00004623-200204000-00013. PMID: 11940620.
- Osteosynthesis for nonunion of the lateral humeral condyle.
- Toh S, Tsubo K, Nishikawa S, Inoue S, Nakamura R, Narita S.
- Clin Orthop Relat Res. 2002 Dec;(405):230-41. doi: 10.1097/00003086-200212000-00030. PMID: 12461379.
- Results of the latissimus dorsi and teres major tendon transfer on to the rotator cuff for brachial plexus palsy at birth.
- Vallejo GI, Toh S, Arai H, Arai K, Harata S.
- Scand J Plast Reconstr Surg Hand Surg. 2002;36(4):207-11. doi: 10.1080/02844310260259860. PMID: 12426994.
- Flexion osteotomy of the metacarpal neck: a treatment method for avascular necrosis of the head of the third metacarpal: a case report.
- Wada M, Toh S, Iwaya D, Harata S.
- J Bone Joint Surg Am. 2002 Feb;84(2):274-6. doi: 10.2106/00004623-200202000-00016. PMID: 11861735.
- One-bone forearm formation using vascularized fibula graft for massive bone defect of the forearm with infection: case report.
- Arai K, Toh S, Yasumura M, Okamoto Y, Harata S.
- J Reconstr Microsurg. 2001 Apr;17(3):151-5. doi: 10.1055/s-2001-14345. PMID: 11336145.
- Reconstruction of the elbow joint by metatarsophalangeal joint transfer from second and third toes. Reconstructive Microsurgery: Proceeding of the Inaugural Congress of the World Societies for Reconstructive Microsurgery.
- Miura H, Toh S, Tsubo K, Kudoh S, Vallejo GI.
- Monduzzi Editore, Edited by Wei FC, Chuang DCC, Chen HC, Bologna, Italy, 2001, pp 227-229.
- Arthroscopic diagnosis and treatment of dorsal wrist ganglion.
- Nishikawa S, Toh S, Miura H, Arai K, Irie T.
- J Hand Surg Br. 2001 Dec;26(6):547-9. doi: 10.1054/jhsb.2001.0620. PMID: 11884110.
- Tardy posterolateral rotatory instability of the elbow due to cubitus varus.
- O'Driscoll SW, Spinner RJ, McKee MD, Kibler WB, Hastings H 2nd, Morrey BF, Kato H, Takayama S, Imatani J, Toh S, Graham HK.
- J Bone Joint Surg Am. 2001 Sep;83(9):1358-69. doi: 10.2106/00004623-200109000-00011. PMID: 11568199.
- Combining free vascularized fibula graft and the Ilizarov external fixator: recent approaches to congenital pseudarthrosis of the tibia.
- Toh S, Harata S, Tsubo K, Inoue S, Narita S.
- J Reconstr Microsurg. 2001 Oct;17(7):497-508; discussion 509. doi: 10.1055/s-2001-17752. PMID: 11598824.
- Ipsilateral pedicle vascularized fibula grafts for reconstruction of tibial defects and non-unions.
- Toh S, Tsubo K, Nishikawa S, Narita S, Kanno H, Harata S.
- J Reconstr Microsurg. 2001 Oct;17(7):487-96. doi: 10.1055/s-2001-17751. PMID: 11598823.
- The Ishiguro extension block technique for the treatment of mallet finger fracture. Proceeding of the 8th Congress of the International federation of Societies for Surgery of the Hand.
- Pegoli L, Toh S, Arai K, Fukuda A, Nishikawa S.
- THK co. Edited by Ege R, Ankara 2001, pp 92-95.
- Traumatic boutonniere deformity of the thumb.
- Cardon LJ, Toh S, Tsubo K.
- J Hand Surg Br. 2000 Oct;25(5):505-8. doi: 10.1054/jhsb.1999.0303. PMID: 10991824.
- Severely displaced scaphoid fracture treated by arthroscopic assisted reduction and osteosynthesis.
- Toh S, Nagao A, Harata S.
- J Orthop Trauma. 2000 May;14(4):299-302. doi: 10.1097/00005131-200005000-00014. PMID: 10898205.
- Vascularized free flaps for reconstruction after resection of congenital arteriovenous malformations of the hand.
- Toh S, Tsubo K, Arai H, Harata S.
- J Reconstr Microsurg. 2000 Oct;16(7):511-7. doi: 10.1055/s-2000-8388. PMID: 11083389.
- Yokoyama T, Harata S, Toh S, Kumazawa Y, Akimoto H, and Fujii K: Vascularized pedicle bone-grafting for experimental necrosis of the femoral head.New Directions for Cellular and Organ Transplantation, Sasaki M, Yokoyama M, Suzuki T and Y. editors I eds., Elsevier Science, Amsterdam 2000, pp 211-216
【四肢外傷】
当院は3次救急病院のため、四肢の切断や開放骨折などの重度四肢外傷症例が搬送されてきます。これらの重症例に対しては、超急性期から整形外科が介入し、適切な治療を開始するようにしております。軟部組織の損傷が高度な症例に対しては、皮弁や筋弁を組織欠損部に移植し、マイクロサージャリーによる神経・血管吻合などを行い、組織再建術を行っております。
- 重度四肢外傷に対する骨接合術
- 軟部組織欠損に対する広背筋皮弁
【脊椎外傷】
上位頚椎から骨盤骨折までの全脊椎を低侵襲で手術治療を行っております。多発外傷に伴う脊椎骨折おいては、Damage Control Orthopedicsの概念で、経皮的椎弓根スクリュー(PPS)を用いたMISt (Minimally Invasive spine Stabilization)を積極的に取り入れ、早期離床を目指しております。また、待機手術における難治症例には術中CT (O-arm® Medtronic社)を用いて、除圧固定術を行っております。
- PPSによるMISt
- O-armを用いた脊椎手術
業績:外傷・再建グループ
- Posterior hip fracture-dislocation associated with posterior wall fracture of the acetabulum and ipsilateral comminuted trochanteric fracture of the femur: A case report.
- Nohmi S, Oishi H, Sakamoto Y.
- Int J Surg Case Rep. 2022 May;94:107075. doi: 10.1016/j.ijscr.2022.107075. Epub 2022 Apr 12. PMID: 35427888; PMCID: PMC9026913.
- Helical plating for a re-nonunion and a peri-implant fracture after humeral intramedullary nailing: A report of two cases.
- Nohmi S, Suzuki M, Sakamoto Y.
- Ann Med Surg (Lond). 2022 Aug 18;81:104442. doi: 10.1016/j.amsu.2022.104442. PMID: 36147059; PMCID: PMC9486657.
研究・実績
- 研究内容
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