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A pediatric robotic thumb exoskeleton for at-home rehabilitation The isolated orthosis for thumb actuation(IOTA)

International Journal of Intelligent Computing and Cybernetics 2014年第3期7卷 233-252页

作者： Patrick Aubin Kelsey Petersen Hani Sallum Conor Walsh Annette Correia Leia Stirling Rehabilitation and Development Center of Excellence for Limb Loss Prevention and Prosthetic Engineering VA Puget Sound Health Care SystemSeattleWashingtonUSA Wyss Institute for Biologically Inspired Engineering Harvard UniversityBostonMassachusettsUSA Boston Children’s Hospital BostonMassachusettsUSA Wyss Institute for Biologically Inspired Engineering Harvard UniversityBostonMassachusettsUSA and Massachusetts Institute of TechnologyCambridgeMassachusettsUSA

Purpose–Pediatric disorders,such as cerebral palsy and stroke,can result in thumb-in-palm deformity greatly limiting hand *** not only limits children’s ability to perform activities of daily living but also limits important motor skill ***,the isolated orthosis for thumb actuation(IOTA)is 2 degrees of freedom(DOF)thumb exoskeleton that can actuate the carpometacarpal(CMC)and metacarpophalangeal(MCP)joints through ranges of motion required for activities of daily *** paper aims to discuss these ***/methodology/approach–IOTA consists of a lightweight hand-mounted mechanism that can be secured and aligned to individual *** mechanism is actuated via flexible cables that connect to a portable control *** encoders and bend sensors monitor the 2 DOF of the thumb and flexion/extension of the wrist.A linear force characterization was performed to test the mechanical efficiency of the cable-drive transmission and the output torque at the exoskeletal CMC and MCP joints was ***–Using this platform,a number of control modes can be implemented that will enable the device to be controlled by a patient to assist with opposition grasp and fine motor *** force and torque studies showed a maximum efficiency of 44 percent,resulting in a torque of 2.3971.06 in.-lbf and 0.6970.31 in.-lbf at the CMC and MCP joints,*** implications–The authors envision this at-home device augmenting the current in-clinic and at-home therapy,enabling telerehabilitation ***/value–This paper presents the design and characterization of a novel device specifically designed for pediatric grasp telerehabilitation to facilitate improved functionality and somatosensory learning。

关键词： Pediatric Exoskeleton At-home hand rehabilitation Rehabilitation robotics thumb

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Management of soft tissue defects of the thumb

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Plastic and Aesthetic Research 2023年第1期10卷 529-542页

作者： Bram Van Hove Francisco Del Piñal Hand and Reconstructive Surgery Private Practice MadridMadrid 28001Spain Orthopaedic Surgery Department RZ Heilig HartLeuven 3000Belgium

Hand surgery has undergone substantial changes in recent years,especially for reconstructive surgery *** discuss the management of soft tissue defects of the thumb,discussing indications,and operative pearls and *** cover non-operative treatment and local advancement flaps for small distal soft tissue defects and pedicled flaps for more significant *** also discuss composite vascularized free flaps such as second-toe neurocutaneous flaps and partial hallux transfer for compound defects or total *** article aims to provide hand surgeons with an update on reconstructing an injured thumb.

关键词： Hand surgery reconstructive surgery soft tissue defects thumb trauma free flap partial hallux transfer

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Sports Injury-Related Fingers and thumb Deformity Due to Tendon or Ligament Rupture

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Chinese Medical Journal 2018年第9期131卷 1051-1058页

作者： Rong-Jie Bai Hui-Bo Zhang Hui-Li Zhan Zhan-Hua Qian Nai-Li Wang Yue Liu Wen-Ting Li Yu-Ming Yin Department of Radiology Beijing Jishuitan Hospital Beijing Institute of Traumatology and Orthopedics Beijing 100035 China Department of Radiology Beijing Chaoyang Hospital of Capital Medical University Beijing 100020 China Institute of Basic Medical Sciences Chinese Academy of Medical Sciences School of Basic Medicine Peking Union Medical College Beijing 100005 China Radiology Associates LLP 1814 South Alameda Street Corpus Christi TX 78404 USA

Background：Hand injuries are very common in sports,such as skiing and ball *** of the major reasons causing hand and finger deformity is due to ligament and tendon *** aim of this study was to investigate if the high-resolution 3T magnetic resonance imaging （MRI） can demonstrate the complex anatomy of the fingers and thumb,especially the tendons and ligaments,and provide the accurate diagnosis of clinically important fingers and thumbs deformity due to ligamentous and tendinous injuries during sport ***：Sixteen fresh un-embalmed cadaveric hands were harvested from eight cadavers.A total of 20 healthy volunteers＇ hands and 44 patients with fingers or thumb deformity due to sports-related injuries were included in this *** subjects had MR examination with T1-weighted images and proton density-weighted imaging with fat suppression （PD FS） in axial,coronal,and sagittal plane,***,all 16 cadaveric hands were sliced into 2-mm thick slab with a band saw （six in coronal plane,six in sagittal plane,and four in axial plane）.The correlation of anatomic sections and the MRI characteristics of tendons of fingers and the ulnar collateral ligament （UCL） at the metacarpal phalangeal joint （MCPJ） of thumb between 20 healthy volunteers and 44 patients （confirmed by surgery） were ***：The normal ligaments and tendons in 16 cadaveric hands and 20 volunteers＇ hands showed uniform low-signal intensity on all the sequences of the *** 44 patients with tendinous and ligamentous injuries in the fingers or thumb,12 cases with UCL injury at MCPJ of the thumb （Stener lesion =8 and non-Stener lesion=4）,6 cases with the central slip injury,12 cases with terminal tendon injury,and 14 cases with flexor digitorum profundus *** ligaments and tendons disruption manifested as increased signal intensity and poor definition,discontinuity,and heterogeneous signal intensity of the involved ligaments and ***：Spo

关键词： Boutonniere Deformity Fingers Jersey Finger Magnetic Resonance Imaging Mallet Finger Stener Lesion thumb

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Reversed vascularized second metatarsal flap for reconstruction of Manske type ⅢB and Ⅳ thumb hypoplasia with reduced donor site morbidity

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Chinese Medical Journal 2019年第21期132卷 2565-2571页

作者： De-Di Tong Le-Hao Wu Peng-Cheng Li Yan-Bo Rong Bo Liu WPAndrew Lee Qi-Pei Wei Lu Liu He-Jia Miao Shan-Lin Chen Department of Hand Surgery Beijing Jishuitan HospitalBeijing 100035China Department of Plastic Surgery Plastic Surgery HospitalChinese Academy of Medical SciencesBeijing 100144China Department of Plastic Surgery Johns Hopkins HospitalBaltimoreMD 21287USA

Background:The predominant method for Manske type ⅢB and Ⅳ thumb hypoplasia is ***,for those who are not willing to sacrifice the index finger,a method that could reconstruct a functionally capable and aesthetically acceptable thumb remains *** study aimed to investigate and assess the functional and radiographic outcomes of utilizing a reversed vascularized second metatarsal composite flap for thumb reconstruction as a new ***:From May 2014 to January 2017,15 patients with Manske type ⅢB or Ⅳ thumb hypoplasia who were admitted to the Department of Hand Surgery,Beijing Jishuitan Hospital were included in this *** osteocutaneous flap containing a section of second metatarsal and its distal head was transferred in reversed position to reconstruct carpometacarpal *** donor site was reconstructed by a split half of the third *** functional reconstructions were commenced at second *** reconstructed thumbs were evaluated using the Kapandji score,pinch force,and the capacities of performing daily activities through a detailed ***:Among these 15 patients(seven type ⅢB and eight type Ⅳ),there were ten boys and five girls with median age of 4.2 years(range:2.0–7.0 years).There were seven right,three left,and five bilateral thumbs for whom only the right thumb received *** were 14 metatarsal flaps survived(14/15).With an average follow-up of 19.2 months,the reconstructed thumbs had acceptable functional and aesthetic outcomes and the donor foot presented in decent appearance without signs of impaired *** 15 children have improved the Kapandji score(from 0 to an average of 6.7),pinch force(from 0 to an average of 1.5 kg),with ability of grip and pen holding.X-ray indicated continuous bone *** and parents had good acceptance of the new ***:Reconstruction of an unstable hypoplastic thumb(Manske type ⅢB and Ⅳ)with use of a vascularized metatar

关键词： thumb hypoplasia Second metatarsal flap Donor site morbidity Microsurgery

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Restoration of thumb opposition by transposing the flexsor pollicis brevis muscle:thirteen-year clinical application

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Chinese Medical Journal 2006年第3期119卷 207-210页

作者： ZHU Wei WANG Shu-huan ZHANG You-le WEI Jia-ning TIAN Guang-lei Department of Hand Surgery Jishuitan Hospital Beijing 100035China

Background To repair late median nerve injury, many methods have been used in the past years. The aim of this study was to review a thirteen-year experience in restoration of thumb opposition by transposing flexor pollicis brevis muscle. Methods From July 1992 to August 2005, 63 patients without thumb opposition because of late median never injury were treated by transposing the flexor pollicis brevis muscle. All the patients had received primary nerve repair after the jnjury. The interval between the injury and the second operation was （1.87±9.31） years （6 months to 4.2 years）. The patients were followed up for 3 to 48 [months mean （22.93±9.31） months]. A functional evaluation system designed in 1992 were used to estimate the outcomes of the patients. Results All the patients gained excellent functional results without complications and disabilities during follow-up. Conclusions Restoration of thumb opposition by transposing flexsor pollicis brevis muscle has the following advantages： 1. Operative trauma is minimal; 2. It is not necessary to transpose other tendons; 3. Except for the thumb in opposition, movements of other fingers and the wrist are not restricted postoperatively.

关键词： thumb median nerve wounds and injuries

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Donor site reconstruction by adjacent half-width metatarsal after full-width metatarsal transfer for metacarpal reconstruction in severe thumb hypoplasia

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Chinese Medical Journal 2023年第17期136卷 2104-2106页

作者： Fan Bai Lu Liu Qipei Wei Qiuya Li Yunhao Xue Chen Yang Shanlin Chen Department of Hand Surgery Beijing Jishuitan HospitalBeijing 100035China

The treatment of Manske type IIIB and IV thumb hypoplasia remains controversial,and parents increasingly expect to maintain the hypoplastic thumb in preference to a five-digit hand.[1,2]There has been a recent increased number of reports regarding the reconstruction of severe thumb hypoplasia with the use of free metatarsal transfers(MTs).Tsujino et al[3]reconstructed a thumb with a nonvascularized 4th metatarsal,and filled the bone defect with an iliac *** et al[4]reported on thumb reconstruction with hemi-width MT,which reduced not only the sacrifice of the donor foot but also the strength of the reconstructed metacarpal.

关键词： thumb metatarsal width

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Rare double fracture-dislocation of the thumb： a case report and review of the literature

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Chinese Journal of Traumatology 2013年第4期16卷 240-242页

作者： Davinder Singh Loveneesh G Krishna Sunil Dhaka Surender Kumar Sumit Arora Central Institute of Orthopaedics Vardhman MahavirMedical College & Safdarjung Hospital New Delhi 110029India

Simultaneous fracture/dislocation of the thumb carpometacarpal （CMC）joint and dislocation of the metacarpophalangeal （MCP） joint is considered as a rare injury pattern. We report an unusual case of dorsal disloca- tion of MCP joint of the thumb associated with extraarticular fracture of the base of the first metacarpal in a 28-year-old man. The dislocation of MCP joint had been missed during initial presentation at a peripheral centre. The patient made an uneventful recovery following open reduction and fixa- tion with 1.25 mm Kirschner wire of the MCP joint along with repair of the ulnar collateral ligament. This injury pat- tern has not been previously reported to the best of our knowledge in the English-language based medical literature.

关键词： Carpometacarpaljoints Metacarpopha- langeal joint thumb

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Surgical Repair of Dorsal Capsulo-Ligamentous Complex for Dislocation of the thumb Carpometacarpal Joint

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Open Journal of Orthopedics 2019年第8期9卷 145-151页

作者： Haruhiko Shimura Tetsuya Sato Akimoto Nimura Yoshiaki Wakabayashi Koji Fujita Department of Orthopedic Surgery Tokyo Bay Urayasu Ichikawa Medical Center Chiba Japan Department of Orthopedic Surgery Doai Memorial Hospital Tokyo Japan Department of Functional Joint Anatomy Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan Department of Orthopedic Surgery Graduate School of Medical and Dental Sciences Tokyo Medical and Dental University Tokyo Japan

Background: Acute dislocation of the thumb carpometacarpal (CMC) joint is a rare and challenging injury, and its treatment remains controversial. The purpose of the study was to evaluate the clinical outcome after surgical repair of the dorsal capsulo-ligamentous complex. Materials and methods: Eight patients with a mean age of 39.8 years (range, 23 - 56 years) treated for the thumb CMC joint were treated in our hospital between 2008 and 2018. The ruptured dorsal capsulo-ligamentous complex was repaired using suture anchors in all patients, and the joint was immobilized with a Kirschner wire pinning and splint for 3 weeks. The clinical outcome was assessed by measuring the range of motion of the thumb CMC joint and the Japanese Society for Surgery of the Hand version of the Quick Disability of the Arm, Shoulder, and Hand (Q-DASH-JSSH) score. Results: The mean radial abduction of the thumb CMC joint was 66°, and the volar abduction was 63°. The mean Q-DASH-JSSH score was 4.8 (range, 0 - 15.6). There were no cases of infection, nerve disturbance, or osteoarthritis. Anatomical reduction was observed in seven patients at the final follow-up and in a rugby football player at 6 months of follow-up;however, subluxation of the thumb CMC joint at 12 months of follow-up due to reinjury was observed. Conclusion: Surgical repair of the dorsal capsulo-ligamentous complex with suture anchors is a reliable and simple treatment for acute unstable dislocation of the thumb CMC joint.

关键词： thumb Carpometacarpal Joint Dislocation Dorsal Capsulo-Ligamentous Complex Surgical Repair Suture Anchors

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Combined index finger pollicization with an anterolateral thiqh flap for thumb reconstruction

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Chinese Journal of Traumatology 2014年第6期17卷 354-357页

作者： Yu Guang Xu Hongyan Lei Hongyu Guo Shuang Huang Jianhua Li Dibin Department of Hand and Foot Surgery Kangyi Hospital of Dongguan Dongguan 523047 Guangdong Province China

A severe crush injury to the hand is devastating to patients. Under conditions in which the crush force is too great, the digits are not viable candidates for replantation. We present two cases in which the patients suffered from loss of the thumb ray at the first carpometacarpal joint and skin defect at the radial side. The tendons, radial nerve and metacarpal bone of the index finger were injured, and the second metacarpal head was retained. There was a comminuted fracture of the trapezium in both patients. The treatment protocols consisted of the index finger pollicization and the free anterolateral thigh flap transfer. The procedure was performed in a single operation. The new thumb is able to provide a stable post for pinch and grip after six months follow-up. Both patients were satisfied with the function and appearance of the reconstructed thumb.

关键词： thumb Reconstructive surgical procedures Surgical flaps Hand

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Study on Underground Stem Tissue Structure and Agronomic Traits of Different Populations of Wild Houttuynia cordata thumb

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Medicinal Plant 2017年第6期8卷 51-55页

作者： Can CHEN Huang HUANG Huabin ZHENG Guangxiang DENG Tianxi WANG College of Agriculture Hunan Agricultural University

[Objectives] To study the underground stem tissue structure and agronomic traits of different populations of wild Houttuynia cordata thumb. [Methods] 8 different populations of wild Houttuynia cordata thumb. in southern China were selected,the preliminary study was carried out about underground stem tissue structure( stem wall thickness,underground stem cross section diameter,medullary cavity,large vascular bundle area,small vascular bundle area,and number of vascular bundles),and main agronomic traits of aboveground and underground parts. [Results]There were significant differences in the underground stem tissue structure and agronomic traits of some populations of wild Houttuynia cordata thumb. [Conclusions] From comparison,it reached the conclusion that the populations of wild Houttuynia cordata thumb. in Kunming of Yunnan,Hechuan of Chongqing,and Nanning of Guangxi showed better underground stem tissue structure and agronomic traits. The results are expected to provide certain guidance for cultivation,reasonable development,and utilization of wild populations of Houttuynia cordata thumb.

关键词： Different populations Wild Houttuynia cordata thumb Underground stem Tissue structure Agronomic traits Comparison

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