• Title/Summary/Keyword: Metacarpophalangeal Joint Flexion

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Underactuated Finger Mechanism for Body-Powered Partial Prosthesis (신체 힘에 의해 동작되는 부분 의수를 위한 부족구동 손가락 메커니즘)

  • Yoon, Dukchan;Lee, Geon;Choi, Youngjin
    • The Journal of Korea Robotics Society
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    • v.11 no.4
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    • pp.193-204
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    • 2016
  • This paper presents an anthropomorphic finger prosthesis for amputees whose proximal phalanx is mutilated. The finger prosthesis to be proposed is able to make the amputees to perform the natural motion such as flexion/extension as well as self-adaptive grasping motion as if normal human finger does. The mechanism of finger prosthesis with three degrees-of-freedom (DOFs) consists of two five-bar and one four-bar linkages. Two passive components composed of torsional spring and mechanical stopper and only one active joint are employed in order to realize an underactuation. Each passive component is installed into the five-bar linkage. In order to activate the finger prosthesis, it is required for the user to flex and extend the remaining proximal phalanx on the metacarpophalangeal (MCP) joint, not an electric motor. Thus the finger prosthesis conducts not only the natural motion according to his/her intention but also the grasping motion through the deformation of springs by the object for human finger-like behavior. In order to reveal the operation principle of the proposed mechanism, kinematic analysis is performed for the linkage design. Finally both simulations and experiments are conducted in order to reveal the design feasibility of the proposed finger mechanism.

Reliability Analysis of Finger Joint Range of Motion Measurements in Wearable Soft Sensor Gloves (웨어러블 소프트 센서 장갑의 손가락 관절 관절가동범위 측정에 대한 신뢰도 분석)

  • Eun-Kyung Kim;Jin-Hong Kim;Yu-Ri Kim;Ye-Ji Hong;Gang-Pyo Lee;Eun-Hye Jeon;Joon-bum Bae;Su-in Kim;Sang-Yi Lee
    • PNF and Movement
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    • v.21 no.2
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    • pp.171-183
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    • 2023
  • Purpose: The purpose of this study was to compare universal goniometry (UG), which is commonly used in clinical practice to measure the range of motion (ROM) of finger joints with a wearable soft sensor glove, and to analyze the reliability to determine its usefulness. Methods: Ten healthy adults (6 males, 4 females) participated in this study. The metacarpophalangeal joint (MCP), interphalangeal joint (IP), and proximal interphalangeal joint (PIP) of both hands were measured using UG and Mollisen HAND soft sensor gloves during active flexion, according to the American Society for Hand Therapists' measurement criteria. Measurements were taken in triplicate and averaged. The mean and standard deviation of the two methods were calculated, and the 95% limits of agreement (LOA) of the measurements were calculated using the intraclass correlation coefficient (ICC) and Bland-Altman plot to examine the reliability and discrepancies between the measurements. Results: The results of the mean values of the flexion angles for the active range of motion (AROM) of the finger joints showed large angular differences in the finger joints, except for the MCP of the thumb. In the inter-rater reliability analysis according to the measurement method, the ICC (2, 1) value showed a low level close to 0, and the mean difference by the Bland-Altman plot showed a value greater than 0, showing a pattern of discrepancy. The 95% LOA had a wide range of differences. Conclusion: This study is a preliminary study investigating the usefulness of the soft sensor glove, and the reliability analysis showed a low level of reliability and inconsistency. However, if future studies can overcome the limitations of this study and the technical problems of the soft sensor glove in the development stage, it is suggested that the measurement instrument can show more accurate measurement and higher reliability when measuring ROM with UG.

An Intramuscular Neurofibroma Presenting as a Thenar Mass (엄지 두덩 덩이로 발생한 근육내 신경섬유종)

  • Kang, Moon-Seok;Choi, Hwan-Jun;Nam, Seoung-Min;Lee, Hyung-Gyo
    • Archives of Plastic Surgery
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    • v.38 no.1
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    • pp.109-112
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    • 2011
  • Purpose: Neurofibromas may present as multiple or solitary lesions. Although there is no predilection site for solitary lesions, they are rare on the hand. In addition, solitary intramuscular neurofibromas are a very rare pathological type. Here, we report a rare solitary intramuscular neurofibroma in the hand. This paper examines the clinical characteristics of intramuscular neurofibroma arising from the lumbricalis in order to enable a correct diagnosis and treatment. Methods: A 32-year-old male presented with a painless mass on the palm. The physical examination revealed a $3{\times}2$ cm protruding mass that was non-tender to palpation. The vascular and sensory examinations were unremarkable, while the motor examination showed mild difficulty with flexion and extension. Magnetic resonance imaging demonstrated an enhancing solid mass between the thenar eminence and second metacarpophalangeal joint. The diagnosis of an intramuscular neurofibroma was confirmed following surgical excision and histological evaluation. Results: The pathological examination was consistent with a neurofibroma, with delicate fascicles and loose fusiform cells in a fibrous stroma, with oval or spindle-shaped nuclei and scant cytoplasm. The background matrix was pale staining and had focal myxoid stroma. There was no significant nuclear pleomorphism and no mitoses. Immunohistochemistry with S-100 was slightly positive. At the 6-month follow-up, motor and sensory function were intact and the range of motion was full. Conclusion: A neurofibroma is a rare tumor of the hand, especially the intramuscular type. Hand surgeons should consider the diagnosis of this tumor based on the examination and imaging.

Clinical Results of Subtotal Fasciectomy for Treatment of Dupuytren Contracture (아전 근막절제술을 이용한 듀피트렌 구축의 치료 결과)

  • Lee, Yoon-Min;Song, Seok-Whan;Kim, Yong-Woo;Choi, Jae-Hoon
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.4
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    • pp.353-360
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    • 2019
  • Purpose: In the treatment of Dupuytren's contracture, the aim of optical treatment is to lower the recurrence rate and reduce complications. This paper reports the results of subtotal fasciectomy in Dupuytren's contracture, extending the excision of palmar fascial structures from the diseased to normal appearing adjacent fascial structure. Materials and Methods: From 2007 to 2017, 45 patients with Dupuytren's contracture treated by subtotal fasciectomy were reviewed retrospectively. The mean follow-up period was 45.9 months. Ninety-two digits were involved (index: 2, middle: 10, ring: 44, little: 36). The predisposing factors and affected joint were reviewed and the preoperative and postoperative contracture was measured. For clinical results, quick disabilities of the arm, shoulder, and hand (quick DASH) were used. Complications, including wound or skin problems, nerve injuries, hematoma, and complex regional pain syndrome, were assessed. Results: Preoperative flexion contracture was 43.2° in the proximal interphalangeal joint and 32.9° in the metacarpophalangeal joint. In nine cases, patients had residual contracture of 9.7° (range, 5°-20°) on average and if the total number of cases were included, the mean residual contracture was 2.3° on average. The quick DASH score at the 12 months follow-up was 12.4. The overall complication rate was 26.6%. Conclusion: Subtotal fasciectomy can be a good surgical treatment option for Dupuytren's contracture with a low recurrence and low complication rate compared to other open procedures.