• 제목/요약/키워드: Partial Hand Amputation

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부분 손 절단자를 위한 프로토 타입의 손목 회전 모듈 디자인 제안과 상지 움직임의 영향 분석 (Design and Analysis of a Wrist Rotation Module Prototype for Partial Hand Amputees: Effects on Upper Limb Movement)

  • 최서영;조원우;김기훈
    • 로봇학회논문지
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    • 제18권4호
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    • pp.367-375
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    • 2023
  • Most partial hand amputees experience limited wrist movement, which hinders the efficient functioning of upper limb, affecting hand-to-use coordination and the usability of the prosthetic hand. This limitation can lead to secondary musculoskeletal issues due to repetitive compensatory movement patterns. However, current partial hand prosthetic lack rotational wrist movement due to challenges in accommodating various hand shapes and limited space. In our study, we proposed a prosthetic hand with a wrist rotation module for partial hand amputees, aiming to reduce compensatory movement. To validate the proposed wrist rotation module, we conducted motion analysis during reach-to-grasp task. Furthermore, during the Jebsen-Taylor hand function test, we evaluated both the effect on upper limb movement and the usability of the prosthetic hand, comparing configurations with and without the wrist rotation module. The results showed that the prosthetic hand equipped with rotational wrist movements reduces compensatory movements and promotes efficient upper limb movement patterns. This finding highlights the value of incorporating a wrist rotation module in prosthetic hands to improve upper limb movement for partial hand amputees.

무학습 근전도 패턴 인식 알고리즘: 부분 수부 절단 환자 사례 연구 (Training-Free sEMG Pattern Recognition Algorithm: A Case Study of A Patient with Partial-Hand Amputation)

  • 박성식;이현주;정완균;김기훈
    • 로봇학회논문지
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    • 제14권3호
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    • pp.211-220
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    • 2019
  • Surface electromyogram (sEMG), which is a bio-electrical signal originated from action potentials of nerves and muscle fibers activated by motor neurons, has been widely used for recognizing motion intention of robotic prosthesis for amputees because it enables a device to be operated intuitively by users without any artificial and additional work. In this paper, we propose a training-free unsupervised sEMG pattern recognition algorithm. It is useful for the gesture recognition for the amputees from whom we cannot achieve motion labels for the previous supervised pattern recognition algorithms. Using the proposed algorithm, we can classify the sEMG signals for gesture recognition and the calculated threshold probability value can be used as a sensitivity parameter for pattern registration. The proposed algorithm was verified by a case study of a patient with partial-hand amputation.

당뇨발 절단 치료에서 Fillet Flap의 사용 (Fillet Flap Coverage for Closure of Diabetic Foot Amputation)

  • 이정우;유환;박재용
    • 대한족부족관절학회지
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    • 제24권4호
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    • pp.148-155
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    • 2020
  • Purpose: Minor foot amputations are performed for recurrent or infected ulcers or osteomyelitis of the diabetic feet. Patients may require a large amount of bone resection for wound closure. On the other hand, this results in more foot dysfunction and a longer time to heal. The authors describe fillet flap coverage to avoid more massive resection in selected cases. This study shows the results of fillet flap coverage for the closure of diabetic foot minor amputation. Materials and Methods: This was a retrospective case series of patients who underwent forefoot and midfoot amputation and fillet flap for osteomyelitis or nonhealing ulcers between March 2013 to November 2017. In addition, the patient comorbidities, hospital days, complications, and duration to complete healing were evaluated. Results: Fourteen fillet flap procedures were performed on 12 patients. Of those, two had toe necrosis, nine had forefoot necrosis, and three had midfoot necrosis. Eleven forefoot amputations and three midfoot amputations were performed. Among forefoot necrosis after a fillet flap, three patients had revision surgery for partial necrosis of the flap, and two patients had an additional amputation. Two patients had additional amputations among those with midfoot necrosis. By the fillet flap, the amputation size was reduced as much as possible. The mean initial healing days, complete healing days, and hospital stay was 70.6 days, 129.0 days, and 60.0 days, respectively. Conclusion: The fillet flap facilitates restoration of the normal foot contour and allows salvage of the metatarsal or toe.

다중절단수지의 재접합술 (Replantation of Multi-level Amputated Digit)

  • 권순범;박지웅;조상헌;서형교;황종익
    • Archives of Plastic Surgery
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    • 제38권5호
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    • pp.642-648
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    • 2011
  • Purpose: The recent advances in microsurgical techniques and their refinement over the past decade have greatly expanded the indications for digital replantations and have enabled us to salvage severed fingers more often. Many studies have reported greater than 80% viability rates in replantation surgery with functional results. However, replantation of multi-level amputations still remain a challenging problem and the decision of whether or not to replant an amputated part is difficult even for an experienced reconstructive surgeon because the ultimate functional result is unpredictable. Methods: Between January of 2002 and May of 2008, we treated 10 multi-level amputated digits of 7 patients. After brachial plexus block, meticulous replantation procedure was performed under microscopic magnification. Postoperatively, hand elevation, heat lamp, drug therapy and hyperbaric oxygen therapy were applied with careful observation of digital circulation. Early rehabilitation protocol was performed for functional improvement. Results: Among the 19 amputated segments of 10 digits, 16 segments survived completely without any complications. Overall survival rate was 84%. Complete necrosis of one finger tip segment and partial necrosis of two distal amputated segments developed and subsequent surgical interventions such as groin flap, local advancement flap and skin graft were performed. The overall result was functionally and aesthetically satisfactory. Conclusion: We experienced successful replantations of multi-level amputated digits. When we encounter a multi-level amputation, the key question is whether or not it is a contraindication to replantation. Despite the demand for skillful microsurgical technique and longer operative time, the authors' results prove it is worth attempting replantations in multi-level amputation because of the superiority in aesthetic and functional results.

수부 손상에서 정맥이식의 유용성 (Usefulness of Venous Graft in Hand Injury)

  • 이학승;김연환;김창연;김정태;안희창
    • Archives of Plastic Surgery
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    • 제37권4호
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    • pp.396-399
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    • 2010
  • Purpose: In hand injury, pedicle is usually damaged by avulsion injury or crushing injury. Because of postoperative pedicle obliteration, it is often hard to save the injured hand and fingers, even after successful replantation. The author introduces three cases of extensive hand injury, and successful results after applicatoin of multiple venous grafts to these patients. Methods: In all cases there was no circulation in any finger. In the first case, some vessels were extracted, so venous graft was applied to two sites of severely damaged venous sites. In the second case, venous grafts were applied to all four digital arteries of all fingers except thumb which got severely crushed, and two sites of dorsal veins. In the third case, venous graft was applied to all four digital arteries of all five fingers, and two sites of dorsal veins and palmar veins each. Results: In all cases, survival of hands and fingers was successful. In the second case, however, amputation in thumb and little finger at DIP joint level was inevitable, because of its severe damage, and the large dorsal defect on index finger was filled with DIEP free flap. Thumb was reconstructed with toe-to-thumb free flap, and additional debulking procedures and contracture release is furtherly needed. In the first case, additional surgery was done, as FDP tendon got re-ruptured, but in long term follow-up, satisfactory range of motion was attained. In the third case, FTSG on dorsal skin region was planned. as flap on dorsal area got partial necrosis. Conclusion: In hand injury, there are many structures to be repaired, but sometimes venous graft is avoided for its long operating time. Even though the length of damaged vessel is enough for anastomosis, the endothelium is often damaged (zone of injury). In extensive hand injury, successful reconstruction would be possible with active venous graft to all vessels suspicious for damage.

상지에 발생한 악성 및 침윤성 종양의 분절절제 및 재접합술 (Segmental Resection and Replantation for Primary Malignant or Aggressive Tumors of the Upper Limb)

  • 한수봉;이우석;신규호
    • 대한골관절종양학회지
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    • 제6권1호
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    • pp.10-16
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    • 2000
  • 목적 : 상지에 발생한 악성 및 침윤성 종양에서 분절절제 및 재접합술을 시행후 그 결과를 보고하고자 한다. 대상 및 방법 : 1986년부터 1994년까지 상지에 발생한 악성 및 침윤성 종양으로 분절절제 및 재접합술을 시행한 10례를 대상으로 평균 7년 7개월(3년 4개월~10년 2개월)간 추적하였다. 수술의 적응증은 절단 외에는 적절한 절제방법이 없는 stage II B의 종양을 대상으로 하였다. 종양의 종류는 연골육종이 3례, 골육종이 2례, 병적 골절을 동반한 거대세포종이 2례 동맥류성 골낭종을 동반한 광범위한 연골아세포종, 병적 골절을 동반한 광범위 유잉육종, 연부조직 및 골을 침범한 평활근육종이 각각 1례씩이었다. 종양의 발생부위는 근위 상완골이 6례로 가장 많았고 견갑골 3례, 전완부의 연부조직 1례였다. 10례중 7례에서 광범위 절제술을 시행하였고 3례에서는 변연절제술을 시행하였다. 결과 : 다발성 전이로 수술후 40개월에 사망한 1례를 제외하고 9례에서 종양의 국소재발이나 전이는 없었다. 최종추시시 상지의 평균기능점수는 65%(43~90%)였고, 수부의 파악력은 정상측에 비하여 평균 75%(28~95%), 집는 힘은 평균 82 %(63~100%)였다. 수술후 합병증으로는 3례에서 상처의 이개가 있었으나 치유되었고, 1례에서 수술후 요골신경의 마비소견이 보였으나 수술후 3개월에 신경기능은 회복되었다. 결론 : 상지에 발생한 악성 및 침윤성 종양의 치료로서 분절절제 및 재접합술은 선택적인 환자에서 절단술 대신에 부분 상지 구제술로서 추천할 수 있는 방법으로 사료된다.

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