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upper limb Fractures in Kinshasa: Therapeutic Approach in a Sub-Saharan African Country

Open Journal of Orthopedics 2023年第10期13卷 405-420页

作者： Johnny Cizemba Luc Mokassa Bakumobatane Ezeckiel Kalunda Mutombo Maurice Kanunyangi Mukendi Roger Muamba Kabengele Daniel Mukadi Bamuleka Christian Dumontier Department of Surgery University clinics of Kinshasa Kinshasa Democratic Republic of the Congo upper limb Surgery Department Water Clinics Guadeloupe France

Background: The upper limb fractures management is the subject of considerable controversy in the literature. Data on the treatment of these fractures in Africa are scarce. Most publications come from so-called northern countries (especially Europe and the USA) and their conclusions cannot be applied in Africa, where other factors must be taken into account. Objective: The aim of this study was to determine trends in the management of upper limb fractures in Kinshasa. Methods: The descriptive, cross-sectional, multicenter study reviewed the records of adult patients managed for upper limb fractures between January 2009 and December 2018 in 6 hospitals in the 4 districts that make up the city of Kinshasa. The results will be presented in the form of frequency, percentage, median and extremes. The data were processed anonymously in accordance with the Helsinki declarations. Results: We listed 852 upper limb fractures out of 844 patients. upper limb fractures showed a very high rate of humerus fractures n = 350 (41.0%) followed by radius fractures n = 22.9% (n = 193). The four seats most important were the humeral diaphysis n = 292 (34.3%);the distal radius n = 115 (13.5%);the radial and ulnar shafts n = 79 (9.3%) and n = 74 (8.7%) respectively. The management of the latter was mainly surgical n = 538 (63.1%) against n = 314 (36.8%) for no-operative treatment. Surgical treatment showed a slight predominance in women aged ≤ 55 years n = 168 (51.8%) and it remained dominant on the almost all foci except the distal radius. Surgical practice has shown surprisingly a very high rate of plate use n = 232 (43.1%) overall broken bones. The external fixator was the most used material on the humeral diaphysis n = 140 (66.1%). Conclusion: upper limb fractures care is certainly controversial, but today several recommendations based on clinical and imaging data must be taken into account in the choice of therapy if a satisfactory functional result is to be hoped for. Knowledge of ou

关键词： Fracture upper limb Treatment Controversy

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upper limb Musculo-Skeletal Model for Biomechanical Investigation of Elbow Flexion Movement

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Journal of Shanghai Jiaotong university(Science) 2011年第1期16卷 61-64页

作者：张琳琳周健张希安王成焘 Shanghai Medical Instrumentation College School of Mechanical Engineering Shanghai Jiaotong University Department of Orthopedics Renji HospitalShanghai Jiaotong University School of Medicine

A biomechanical musculo-skeletal model of upper limb is presented in this paper,which can provide accurate representations of muscles and joints,and capture important interactions between *** upper limb model is made up of seven segments:ribs,sternum,clavicle,scapular,humerus,radius and ulna,considered as a single rigid body respectively and includes 22 *** individual muscle forces can be calculated by using an electromyography (EMG) assisted method,which is verified by comparing the simulation results with other researches of an elbow flexion *** comparisons show that the muscle forces and the estimated joint moment match well with previous literatures.

关键词： upper limb muscle force computer simulation

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High prevalence of vitamin D insufficiency in Chinese children with upper limb fractures

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Genes & Diseases 2020年第3期7卷 408-413页

作者： Tianjing Liu Enbo Wang Qiwei Li Lianyong Li Department of Pediatric Orthopedics Shengjing Hospital of China Medical UniversityChina

This study aimed at investigating the vitamin D status of pediatric patients with upper limb fractures and finding out the influences of age,gender,season and fracture sites.695 patients were admitted for upper limb fractures between November 1st 2014 and October 31st 2015.224 healthy children were included during the same *** 25(OH)D was measured at the time of visit and their demographic data were *** fracture patients had significant lower vitamin D level than the healthy *** average serum 25(OH)D of the patients was 24.5 ng/ml,compared to 28.1 ng/ml in healthy *** D status worsened with the increase of age and adolescents had a deficiency rate of as high as 68.6%.Gender and fracture sites had no influence on vitamin D *** study revealed high prevalence of vitamin D deficiency and insufficiency in pediatric patients with upper limb *** had such high rate of vitamin D deficiency that called for vast attention.

关键词： Adolescent Fracture Pediatric upper limb Vitamin D

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Design and Analysis of Joint-Assisted Exoskeleton Control System of upper limb in Active Spacesuit

Design and Analysis of Joint-Assisted Exoskeleton Control Sy...

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第三十九届中国控制会议

作者： Zhaoyang Li Yuehong Dai Jiejun Hu Junyao Wang Peng Tang University of Electronic Science and Technology of China Research Center of Intelligent Aircraft System Technology and Application of UESTC Aircraft Swarm Intelligent Sensing and Cooperative Control Key Laboratory of Sichuan Province

Based on joint-assisted exoskeleton technology, a concept of active spacesuit for future extraterrestrial exploration activities is presented. Firstly, we design the mechanical structure of joint-assisted exoskeleton of upper limb, and perform kinematic analysis on the upper limb to obtain the joint motion information when lifting load. We obtain the resistance torque of the spacesuit joint by the measuring equipment, and the total torque of the upper limb by the simplified two-links dynamic ***, we present the combination of adaptive impedance control and sliding mode control that based on CTC method. Finally, the prototype of joint-assisted exoskeleton robot of upper limb is fabricated and tested, and the experimental results indict that the control system can improve the trajectory tracking effect and eliminate the influences of environmental change. The research can not only help the astronauts more easily complete the task of collecting samples of the future manned space missions, but also provide a theoretical foundation for the subsequent research of active spacesuit.

关键词： Active Spacesuit Exoskeleton Adaptive Impedance Control upper limb Extraterrestrial Exploration

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Leap Motion-based virtual reality training for improving motor functional recovery of upper limbs and neural reorganization in subacute stroke patients

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Neural Regeneration Research 2017年第11期12卷 1823-1831页

作者： Zun-rong Wang Ping Wang Liang Xing Li-ping Mei Jun Zhao Tong Zhang Capital Medical University School of Rehabilitation Medicine China Rehabilitation Research Center Beijing Boai Hospital Beijing Rehabilitation Hospital Capital Medical University

Virtual reality is nowadays used to facilitate motor recovery in stroke patients. Most virtual reality studies have involved chronic stroke patients; however, brain plasticity remains good in acute and subacute patients. Most virtual reality systems are only applicable to the proximal upper limbs （arms） because of the limitations of their capture systems. Nevertheless, the functional recovery of an affected hand is most difficult in the case of hemiparesis rehabilitation after a stroke. The recently developed Leap Motion controller can track the fine movements of both hands and fingers. Therefore, the present study explored the effects of a Leap Motion-based virtual reality system on subacute stroke. Twenty-six subacute stroke patients were assigned to an experimental group that received virtual reality training along with conventional occupational rehabilitation, and a control group that only received conventional rehabilitation. The Wolf motor func- tion test （WMFT） was used to assess the motor function of the affected upper limb; functional magnetic resonance imaging was used to measure the cortical activation. After four weeks of treatment, the motor functions of the affected upper limbs were significantly improved in all the patients, with the improvement in the experimental group being significantly better than in the control group. The action perfor- mance time in the WMFT significantly decreased in the experimental group. Furthermore, the activation intensity and the laterality index of the contralateral primary sensorimotor cortex increased in both the experimental and control groups. These results confirmed that Leap Motion-based virtual reality training was a promising and feasible supplementary rehabilitation intervention, could facilitate the recovery of motor functions in subacute stroke patients. The study has been registered in the Chinese Clinical Trial Registry （registration number： ChiCTR-OCH- 12002238）.

关键词： nerve regeneration virtual reality Wolf motor function test functional magnetic resonance imaging stroke Leap Motion rehabilitation upper limb neural reorganization neural regeneration

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Mechanism of Kinect-based virtual reality training for motor functional recovery of upper limbs after subacute stroke

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Neural Regeneration Research 2013年第31期8卷 2904-2913页

作者： Xiao Bao Yurong Mao Qiang Lin Yunhai Qiu Shaozhen Chen Le Li Ryan S.Cates Shufeng Zhou Dongfeng Huang Department of Rehabilitation Medicine the First Affiliated Hospital Sun Yat-sen University Key Laboratory of Health Informatics of Chinese Academy of Sciences Shenzhen Institutes of Advanced Technology Department of Pharmaceutical Sciences College of Pharmacy University of South Florida

The Kinect-based virtual reality system for the Xbox 360 enables users to control and interact with the game console without the need to touch a game controller, and provides rehabilitation training for stroke patients with lower limb dysfunctions. However, the underlying mechanism remains un- clear. In this study, 18 healthy subjects and five patients after subacute stroke were included. The five patients were scanned using functional MRI prior to training, 3 weeks after training and at a 12-week follow-up, and then compared with healthy subjects. The FugI-Meyer Assessment and Wolf Motor Function Test scores of the hemiplegic upper limbs of stroke patients were significantly increased 3 weeks after training and at the 12-week follow-up. Functional MRI results showed that contralateral primary sensorimotor cortex was activated after Kinect-based virtual reality training in the stroke patients compared with the healthy subjects. Contralateral primary sensorimotor cortex, the bilateral supplementary motor area and the ipsilateral cerebellum were also activated during hand-clenching in all 18 healthy subjects. Our findings indicate that Kinect-based virtual reality training could promote the recovery of upper limb motor function in subacute stroke patients, and brain reorganization by Kinect-based virtual reality training may be linked to the contralateral sen- sorimotor cortex.

关键词： neural regeneration neurological rehabilitation rehabilitation training neural plasticity virtual reality functional MRI stroke Kinect-based virtual reality training upper limb cerebral cortex brain activation region of interest grants-supported paper neuroregeneration

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Clinical applications of paraumbilical perforator flaps in multiple angiosomes for the reconstruction of the upper limbs

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Chinese Journal Of Plastic and Reconstructive Surgery 2022年第1期4卷 1-5页

作者： Xiaojun Liu Rui Zhao Xinyuan Jin Lei Liu Guoliang Shen Department of Burn and Plastic Surgery The First Affiliated Hospital of Soochow UniversitySuzhou 215006JiangsuChina Department of Burn and Plastic Surgery North District of Suzhou Municipal HospitalSuzhou 215008JiangsuChina

Background:Repair of extensive deep wounds in the forelimb remains challenging for *** objective of this study was to evaluate the surgical technique and clinical significance of multiple-territory paraumbilical perforator(PUP)flaps in patients with massive soft tissue defects in the upper ***:Between January 2017 and September 2021,16 patients(6 women and 10 men)aged 24–54 years(average,41.4 years)who were hospitalized at the First Affiliated Hospital of Soochow University and the North District of the Suzhou Municipal Hospital were *** injuries included damage to the fingers,dorsal skin of the hands,wrist,or *** tendons or bones were exposed after *** some patients,multiple-territory PUP flaps that encompassed adjacent angiosomes were transplanted to cover the soft tissue ***:All flaps survived and healed *** a follow-up of 2–54 months,all patients recovered satisfactorily in terms of characteristic and functional ***:The application of PUP flaps,especially those encompassing multiple angiosomes(multiple-territory PUP flaps),can be an optimal reconstruction method for repairing massive soft tissue defects in the forelimb.

关键词： Angiosome Perforator flap upper limb Reconstruction

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Human-Exoskeleton Joint Coordination Assessment:A Case Study on the Shoulder and Elbow Joints

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Journal of Bionic Engineering 2022年第6期19卷 1712-1721页

作者： Pablo Delgado Clarissa Rincon Yimesker Yihun Mechanical Engineering Wichita State University1845 FairmountWichitaKS67260USA Biomedical Engineering Wichita State University1845 FairmountWichitaKS67260USA

This study is aimed at developing a methodology to assess and quantify the human limb motions and interactions with the exoskeleton in relation to *** different basic and common upper arm joint movements and their interaction with a joint-based exoskeleton are considered:shoulder vertical and horizontal abduction-adduction,and elbow *** exoskeleton and the human model are aligned to the respective joints inside a Musculoskeletal Modeling *** the range of motion,the linear and angular displacement errors were analyzed,and the effect of those errors on the length of the associated tendons was *** have shown a noticeable variation of the muscle-tendon lengths up to 65.7 mm and a change in the pattern on different muscle groups of the ***,about 4 mm muscle-tendon length changes observed particularly at the elbow anconeus *** changes of length could cause unwanted stresses at the joints,specially for people with disabilities due to stroke that might not have the flexibility to accommodate those extra pose variations imposed by the exoskeleton.

关键词： Exoskeleton upper limb Rehabilitation Misalignment OpenSim Computational modeling Bioinspiration

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"Proximal to distal" sequence of the release of the upper extremity post-burn contracture:Rule or case-based approach?

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Chinese Journal of Traumatology 2023年第1期26卷 60-62页

作者： A.Priyadharshini Geley Ete Paul M.Kingsly Shwetha Agarwal Department of Plastic Surgery Christian Medical CollegeVelloreTamil NaduIndia

Post-burn contractures are common entities seen in developing *** are multiple reasons for the development of contractures,most are *** extensive contractures,a strategic plan is necessary to release all contractures and yet not antagonize post-operative *** is also necessary to be cost-effective and minimize the number of surgeries *** the release sequence in extensive burn contractures is proximal to *** this case report,we discuss an unusual sequence where we released distal contractures before the proximal to achieve optimum results.A 3-year-old child with post-burn contracture of hand,wrist,elbow,and axilla was treated in 2 stages,with the release of wrist contracture and cover with pedicled abdominal flap in the first stage and division of pedicled flap with the release of axilla and elbow contracture in the second ***,the release of all contractures was achieved without antagonizing post-operative positions and minimized the number of surgeries.A case-based approach may be crucial in making a strategic surgical plan to minimize the rehabilitation phase,rather than following known dictums.

关键词： Burns Post-burn contractures upper limb Release sequence

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Congenital Gangrene in a Premature Newborn: A Case Report

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Open Journal of Pediatrics 2021年第3期11卷 393-397页

作者： Assetou Cissouma Mamadou B. Coulibaly Djibril Kassogué Hachimi A. Poma Moussa Diassana Bathio Traoré Aly Diallo Layes Touré Ternan Traoré Moussa Kanté Abdoulaye Kissima-Traoré Pediatric Service Sikasso Hospital Sikasso Mali Pediatric Surgery Service Sikasso Hospital Sikasso Mali Pediatric Service Timbuktu Hospital Timbuktu Mali Surgery General Service Sikasso Hospital Sikasso Mali Orthopedic and Trauma Surgery Service Sikasso Hospital Sikasso Mali Anesthesia and Intensive Care Service Sikasso Hospital Sikasso Mali Cardiology Service Sikasso Hospital Sikasso Mali

Introduction: Congenital limb gangrene is a rare pathology. In the majority of cases, no cause is identified and its treatment is not codified. Observation: 29-week premature newborn, female from poorly followed twin pregnancy. Clinical examination at admission found an unstable neonate, the presence of necrosis of the left hand and forearm well limited, with absent humeral pulse and absence of hand movement. Surgical treatment was scheduled for amputation of the limb after the agreement of the parents whose postoperative follow-ups were simple. Conclusion: Congenital gangrene remains a rare entity in neonatology.

关键词： Gangrene upper limb Newborn Prematurity

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