• Archives of Reconstructive Microsurgery
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• v.10 no.2
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• pp.143-148
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• 2001

The hand with amputation of all fingers is useless for activities of daily living and traumatic amputation of some of the fingers can result in the diminished ability to perform power grip and precision grip which is vital to maintain normal function of the hand. Precision grip is used to hold an object between the opposable thumb and flexed fingers. In power grip the object is held between the flexed fingers and the palm while the thumb applies the necessary counterpressure to maintain the grip on the object. A 35 year old male lost his right all fingers including thumb at the level of proximal phalanx from the pressure machinary accident. Thumb was reconstructed using wrap around flap and the second and third fingers were reconstructed using the second and third toe transplantation. Seven years after reconstruction, he uses the reconstructed thumb and the second and the third fingers for eating meals, writing down a paper with a pencil and putting on socks.

• Archives of Plastic Surgery
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• v.38 no.6
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• pp.821-828
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• 2011

Purpose: The authors applied Bilhaut-Cloquet procedure to Wassel type III and IV duplicated thumb, which was limited to patients with Wassel type I, II. This procedure was applied in order to improve the growth potential, range of joint motion, joint stability and cosmetic outcome. Methods: Sixteen patients received Bilhaut-Cloquet procedures to correct duplicated thumbs from May, 2005 to December, 2010. Seven patients were Wassel type III, nine patients were type IV. This procedure was applied not only to balanced type, but also unbalanced type or convergent type. Five patients were balanced type and eleven patients were unbalanced type. Convergent type of Wassel type IV was three. Sex ratio was the same, mean age at the operation was 20.1 months old (8~52 months old). Angular deformity, joint stability and range of joint motion and cosmetic outcome were considered together and estimated in Tada score. Also, postoperative subjective satisfaction score of the parents was evaluated by a 100-points scale. Results: Mean subjective satisfaction scored 75 points at 28 months after the operation. Radiologic study showed bony union of proximal phalangeal bone and stable joint in all patients. Range of motion was mean 20 degrees in interphalangeal joint and mean 73 degrees in metacarpophalangeal joint. Tada score showed 'good' in eleven patients (68.8%), 'fair' in three patients (18.7%) and 'poor' in two patients (12.5%). In seven patients those who were able to follow up for a long term showed no significant difference in length of proximal and distal phalangeal bones compared to the opposite thumb. Conclusion: Bilhaut-Cloquet procedure can be applied not only to balanced type of Wassel type III, IV duplicated thumb, but also to unbalanced type or convergent type that focused on functional reconstruction and cosmetic improvement.

• Archives of Plastic Surgery
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• v.35 no.5
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• pp.527-532
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• 2008

Purpose: Transverse type or volar oblique type of defect of thumb tip can be covered by Moberg flap or second toe pulp free flap. We compared these two methods in functional result, patients' satisfaction, and sensation, etc. to find a better way to cover the defect of the thumb tip. Methods: From 2003 to 2006, we chose the patients randomly with preoperative pictures. The patients had the defect of the thumb tip which is either transverse or volar oblique type. The 6 patients were treated with Moberg flap and other 6 patients were treated with second toe pulp free flap. We have analyzed the results by 2 point discrimination, side pinching power test, pulp to pulp pinching power test, pain scales (visual analogue scale), satisfaction scales of the patients (functional and aesthetic), the degree of the range of motion, etc. Results: All flaps survived without any complications. In the cases of Moberg flaps, the value of static 2 point discrimination test was 5.6 mm, and the value of moving 2 point discrimination test was 4.8 mm. In the cases of second toe pulp free flaps, the values were 9.6 mm and 9.3 mm. In the cases of Moberg flaps, the value of the Side pinch power test was 6.6 kg, 4.4 kg. In the case of second toe pulp free flaps, the values were 4.8 kg and 2.5 kg. The value of aesthetic satisfaction scale of the patients in Moberg flaps was 5.6, the value of functional satisfaction scale of the patients was 3.6. In cases of second toe pulp free flaps, the values were 5.6 and 3.6. The active range of motion of Interphalangeal joint in the cases of Moberg flaps was 46.6 degree, and the active range of motion of metacarpophalangeal joint was 55 degree, in the cases of second toe pulp free flaps, the values were 36.6 degree and 59 degree. Conclusion: As a result, when the defect of the thumb tip is transverse or volar oblique type, we suggest that the operators choose Moberg flap to cover the defect of the thumb tip.

• Archives of Reconstructive Microsurgery
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• v.10 no.2
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• pp.86-92
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• 2001

Failure of replantation is inevitable in finger replantation surgery, around 10% of failure rate are reported in many authors. Management of the failed finger replantation is one of big dilemma to microsurgeons. We report 5 cases of thumb reconstruction after failure of replantation. The reconstructive surgery composed with early debridement of soft tissue that are under gangrenous processing, extract the phalangeal bone without any soft tissues. Osteosynthesis of the extracted phalangeal bone with host phalangeal bone. The exposed bony portion covered with vascularized flaps such as revered radial forearm pedicled flap, free radial forearm flap and neurovascular island finger flap. This procedure underwent within a week after vascular insufficiency developed. All of the flaps are survived, bone union achieved within 3 months. The function and external appearance of the reconstructed thumb were encouraging; Pinch Power was average 1.2 Pounds. Early removal of necrotizing soft tissue followed by covering none vascular phalangeal bone which extracted from the dead phalanx with vascularized flap is one of the useful alterative solutions in failed replantation surgery in hand.

• Archives of Reconstructive Microsurgery
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• v.15 no.1
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• pp.33-37
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• 2006

Purpose: The aim of this study was to evaluate the efficacy of lateral middle phalangeal finger flap for pulp and palmar defect of the finger. Materials and methods: We performed the lateral middle phalangeal finger flap in thumb pulp defect 4 cases and the palmar defect of other finger 3 cases. Mean age was 38(25-53) years old and there were male 6 cases and female 1 case. Sensate flap was performed in 4 cases of thumb pulp defects. Mean follow-up period was 14(7-22) months. Results: All flaps were survived. Mean static two-pint discrimination of sensate flap 4 cases was 8(6-10) mm. The sensation of donor finger tip was normal in all cases. Limitation of range of motion of the donor fingers was absent. Patients complained of transient cold intolerance 1 month after surgery but didn't complain of that in all cases at last follow-up. Conclusions: The advantages of the lateral middle phalangeal finger flap are the preservation of the ipsilateral palmar digital nerve, good sensory reconstruction of the fingertip, well maintained donor finger mobility with minimal exposure of the extensor tendon, cosmetically good appearances of donor finger, and easy raising as a large flap. So we suggest that this flap is versatile for reconstructing of relatively large pulp defect of the thumb and the palmar defects involving the joint of finger.

• Korean Journal of Applied Biomechanics
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• v.24 no.3
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• pp.301-308
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• 2014

The purpose of this study was to determine whether there are significant differences in kinematic variables and muscle activities of the thumb between two smartphone holding techniques. Twelve right handed university students(age $25.4{\pm}3.9yrs$, height $176.2{\pm}5.1cm$, weight $75.8{\pm}11.4kg$, hand length $19.2{\pm}1.1cm$) who have no musculoskeletal disorder were recruited as the subjects and had experience in using a smartphone for more than one year. Maximum joint angle, angular velocity, muscular activities were determined for each trial. For each dependent variable, paired t-test was used to determine whether there were significant differences between one hand (OH) and two hands ([TH], ${\rho}$ <.05). The results of this study showed that there were no significant differences between OH and TH in the maximum joint angle of the thumb. The angular velocity of each joint was not statistically significant between OH and TH. The statistical analysis revealed that the main effect of the smartphone holding conditions was significant in the peak normalized muscular activities of FDI and APL. Although smartphone holding technique doesn't affect on mobility and movement of the thumb joint, it may affect on active degree of the thumb and the upper extremity in directly and indirectly.

• Herbal Formula Science
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• v.29 no.2
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• pp.93-103
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• 2021

Objectives : This study was conducted to evaluate the Intraocular pressure (IOP) and retina neuroprotective effect of Acer palmatum thumb. extract in glaucoma of DBA2/J mice vivo model. Methods : The amount of change in intraocular pressure(IOP) was measured every two weeks for 30 weeks in the DBA2/J glaucoma animal model. The increased IOP were regrouping into drug treatment groups. EW and EE (1, 2 mg/㎖)extract was eye drop administered twice per day for 8 weeks. After administration of the extract, IOP was measured every 1 week at a fixed time for 8 weeks, and protein expression levels and serological changes related to retinal function were investigated. Results : The DBA2/J mice were IOP increased as time dependent, resulting in damage to the retinal function protein related in glaucoma animal model. However, administration of extracts from Leaves of Acer palmatum thumb. prevented an increase IOP, increased for Brn3α, PKCα, and OPN1SW. Additionally, the experssion of Aterocyte maker, GFAP was decreased in DBA2/J mice. Conclusions : These results demonstrate that both IOP and age can be considered in studies using DBA2/J mice and suggest that the extracts from Leaves of Acer palmatum thumb. regulating of IOP and expression of proteins related to retinal function.

• The Journal of Korean Physical Therapy
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• v.14 no.1
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• pp.125-130
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• 2002

This study was applied using vojta therapy in the patient with hydrocephalus occurred by on traumatic brain injury. Vojta treatment was a recently developed of the brain damage patient treatment which can be applied eariler than the other traditional methods. The results were as follows. 1. Hip joint flexion contracture from $100^{\circ}$ to $15^{\circ}$ was improved on prone position. 2. Left convexity curve on thracolumbar region due to functional scoliosis the normal aligment. 3. The thumb finger was changed from thumb-in to thumb-out. 4. Right tilted pelvis on prone position became the normal symmetry

• The Journal of the Acoustical Society of Korea
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• v.20 no.7
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• pp.63-68
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• 2001

This paper describes the details of ITU-T SGIS G.729A speech coder implementation using ARM9 Thumb/sup R/ processor core and various techniques used in the optimization process. ITU-T G.729 speech coder is the standard of the toll quality 8 kbit/s speech coding. The input to the speech encoder is assumed to be a 16 bits PCM signal at a sampling rate of 8000 samples per second. G.729A is reduced complexity version of the G.729 coder. This version is bit stream interoperable with the full version. The implemented coder requires 34.8 MIPS for the encoder and 8.1 MIPS for the decoder, 36.5 kBytes of program ROM and 6.3 kBytes of data RAM, respectively. The implemented coder is tested against the set of 9 test vectors provided by ITU-T for bit exact implementation.

• Archives of Reconstructive Microsurgery
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• v.24 no.2
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• pp.62-67
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• 2015

Purpose: Pollicization typically involves surgical migration of the index finger to the position of the thumb. This procedure facilitates the conversion of a useless hand into a well-functioning one in patients who are not amenable to the toe-to-hand transfer. However, middle finger pollicization has been rarely reported. Materials and Methods: We reconstructed a thumb by immediate pollicization of the remnants of the middle finger in two patients who sustained a tumor and a trauma, respectively. The former, after cancer ablation was performed, has not been reported literally, and the latter involved free devitalized pollicization of the middle finger using a microsurgical anastomosis. The distal third extensor communis tendon was sutured to the proximal extensor pollicis longus tendon and the distal flexor digitorum superficialis and profundus were sutured to the proximal flexor pollicis longus. The abductor pollicis brevis tendon was sutured to the distal end of the first palmar interosseous muscle. Coaptation of the third digital nerve and the superficial radial nerve branch was performed. Results: Patients showed uneventful postoperative courses without complication such as infection or finger necrosis. Based on the principles of pollicization, a wide range of pinch and grasp movements was successfully restored. They were pleased with the functional and cosmetic results. Conclusion: Although the index finger has been the digit of choice for pollicization, we could also use the middle finger on specific occasions. This procedure provides an excellent option for the reconstruction of a mutilated thumb and could be performed advantageously in a single step.