In daily life, another major role of human hand is a communicative function using hand gestures besides grasp function. Therefore, if amputees can express their intention by the prosthetic hand, they can much actively participate in social activities. Thus, this paper propose myoelectric multi-function prosthetic hand which can express 6 useful hand gestures such as Rock, Scissors, Paper, Indexing, Ok and Thumb-up. It was designed as under-actuated structure to minimize volume and weight of the prosthetic hand. Moreover, in order to effectively control various hand gestures by only two EMG sensors, we propose a control strategy that the signal type are expanded as "Strong" and "Light", and hand gestures are hierarchically classified for the intuitive control. Finally, we prove the validity of the developed prosthetic hand with the experiment.
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.
The Status of oral health and dental prosthetic treatment in Daegu and Gyoung Buk area was examined. To investigate the correlation between factors such as demographic and socioeconomic characteristics and status of oral health and knowledge about oral preventive measures, a survey was performed. After analyzing the effects of knowledge levels about dental prosthetic treatment on the oral health status and preventive measures, following results were obtained. A Total of 625 people participated in the survey for three months from October 2007 to January 2008. The responses from the survey were then analyzed to assess whether those with less knowledge of preventive measures tended to have more dental prosthetic work. Of those that took part in the survey: ${\cdot}$ 30.2% were in their twenties ${\cdot}$ 56.2% were married ${\cdot}$ 51.4% of respondents had at least a college degree ${\cdot}$ 42.4% had monthly incomes below one million Won ${\cdot}$ 24.3% were students ${\cdot}$ 55.8% were from urban areas After studying the relationship between oral health and various demographics, researchers concluded that respondents' sex, income, job and place of residence had no effect on the overall status of their oral health. However, those that were divorcees or widows (1.95${_+}/{_-}$ 0.32), over the age of 70 (1.67${_+}/{_-}$0.31), or had little education (0.82${_+}/{_-}$0.28), all demonstrated a statistically significant effect on their oral health with a significance level of 0.05.Cross analysis revealed a p-value of 0.000. The correlation between knowledge of oral preventive measures and other factors was examined. No difference was found between men and women but people who were divorced or lost their spouse, people over the age of 60, and people with no education, the results of knowledge of oral preventive measure was poor as 1.74$\pm$0.44, 1.85$\pm$0.40, 1.85$\pm$0.44,and 1.60$\pm$0.47 separately. Cross analysis showed that p-value was 0.000 and correlation between knowledge of oral preventive measures and those factors were statistically significant at significance level of 0.05. The status of dental prosthetic treatment was investigated. Women, people with higher income, and married people had more dental prosthetic treatment and it was related to education, income, residential area, and the status of dental prosthetic treatment. The returns of those factors was 32.7%. Respondents$^{\circ}{\emptyset}$ oral hygiene status and knowledge of oral preventive measures was related to demographic or socioeconomic factors. Therefore, a preventive program for oral health care needs to be developed in advanced countries. Knowledge of oral health is below the international average and more research and effort needs to be put in to develop public knowledge of dental prosthetic treatment. Government intervention such as enacting an oral health initiative or dental insurance that covers prosthetic treatments is urgently needed.
Kim, Mi Jung;Ahn, Sung Jae;Fan, Kenneth L.;Song, Seung Yong;Lew, Dae Hyun;Lee, Dong Won
Archives of Plastic Surgery
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제46권6호
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pp.544-549
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2019
Background As the indications for postmastectomy radiotherapy expand, innovative solutions are required to reduce operative complications and reconstructive failure after prosthetic breast reconstruction. In this study, we investigated the effectiveness of acellular dermal matrix (ADM) inlay grafts in preventing postoperative wound dehiscence of irradiated breasts in the context of prosthetic breast reconstruction. Methods A retrospective analysis was conducted of 45 patients who received two-stage prosthetic reconstruction and radiotherapy following mastectomy. An ADM graft was placed beneath the incisional site during the second-stage operation in 19 patients using marionette sutures, whereas the control group did not receive the ADM reinforcement. Patient demographics and complications such as wound dehiscence, capsular contracture, peri-prosthetic infection, cellulitis, and seroma were compared between the two groups. Results During an average follow-up period of 37.1 months, wound dehiscence occurred significantly less often in the ADM-reinforced closure group (0%) than in the non-ADM group (23.1%) (P=0.032). There was no significant difference between the two groups in relation to other complications, such as capsular contracture, postoperative infection, or seroma. Conclusions The ADM inlay graft is a simple and easily reproducible technique for preventing incisional dehiscence in the setting of radiotherapy after prosthetic breast reconstruction. The ADM graft serves as a buttress to offload tension during healing and provides a mechanical barrier against pathogens. Application of this technique may serve to reduce complications in prosthetic breast reconstruction after radiotherapy.
The optimized prosthetic mass distribution was a controversial problem in the previous studies because they are not supported by empirical evidence. The purpose of the present study was to evaluate the effect of prosthetic mass properties by modeling musculoskeletal system, based on the gait analysis data from two above-knee amputees. The joint torque at hip joint was calculated using inverse dynamic analysis as the mass was changed in knee and foot prosthetic components with the same joint kinematics. The results showed that the peak flexion and abduction torque at the hip joint were 5 Nm and 15 Nm when the mass of the knee component was increased, greater than the peak flexion and abduction torque of the control group at the hip joint, respectively. On the other hand, when the mass of the foot component was increased, the peak flexion and abduction torque at the hip joint were 20 Nm and 15 Nm, greater than the peak flexion and abduction torque of the control, respectively. The hip flexion torque was 4.71-fold greater and 7.92-fold greater than the hip abduction torque for the knee mass increase and the foot mass increase on the average, respectively. Therefore, we could conclude that the effect of foot mass increase was more sensitive than that of knee mass increase for the hip flexion torque. On the contrary, the mass properties of the knee and foot components were not sensitive for the hip abduction torque. In addition, optimized prosthetic mass and appropriate mass distributions were needed to promote efficiency of rehabilitation therapy with consideration of musculoskeletal systems of amputees.
Purpose. The purpose of this study was to compare the type and frequency of prosthetic complications associated with attachment types for implant overdenture. Material and methods. In this retrospective study, 38 patients (mean age, 63.5 years) have been treated with implant overdentures from 2007 to 2014. Ten patients received a bar-clip attachment. Eleven patients had received a milled bar with Locator attachment. Seventeen patients had received a Locator attachment. The mean follow-up period was 36.9 months (range, 15-83 months). The type and frequency of prosthetic complications was recorded. The frequency was analyzed to determine the statistical difference among the 3 different attachments by using one-way ANOVA (${\alpha}=.05$) and Bonferroni post hoc method at a 5% level of significance. Results. The total number of prosthetic complications was higher in the bar-clip attachment (55 events) than in the milled bar with Locator attachment (39 events) and the Locator attachment (34 events). There were no statistically significant differences, and the most common prosthetic complication was the loss of retention. In the bar-clip attachment group, the average frequency of prosthetic complications was 3.0 events per prosthesis during the first year. In the milled bar with Locator attachment and Locator attachment groups, the average frequencies were 1.45 events and 2.35 events, respectively. Statistically significant differences were observed in the frequency of the complication. (p = .043) Conclusions. Compared to the bar-clip attachment, implant overdentures that use milled bars with the Locator attachment have a significantly lower incidence of prosthetic complications in the first year of follow-up after placement.
Kim, Duk-Sil;Kim, Sung-Wan;Kim, Jun-Chul;Cho, Ji-Hyung;Kong, Joon-Hyuk;Park, Chang-Ryul
Journal of Chest Surgery
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제44권1호
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pp.25-31
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2011
Background: Mature autogenous arteriovenous fistulas have better long term patency and require fewer secondary interventions compared to arteriovenous prosthetic graft. Our Study evaluated vascular patency rates and incidence of interventions in autogenous arteriovenous fistulas and grafts. Material and Methods: A total of 166 vascular access operations were performed in 153 patients between December 2002 and November 2009. Thirty seven caeses were excluded due to primary access failure and loss of follow-up. One group of 92 autogenous arterioveous fistulas and the other group of 37 arteriovenous prosthetic grafts were evaluated retrospectively. Primary and secondary patency rates were estimated using the Kaplan-Meier method. Results: The primary patency rate (84%, 67%, 51% vs. 51%, 22%, 9% at 1, 3, 5 year; p=0.0000) and secondary patency rate (96%, 88%, 68% vs. 88%, 65%, 16% at 1, 3, 5 year; p=0.0009) were better in autogenous fistula group than prosthetic graft group. Interventions to maintain secondary patency were required in 23% of the autogenous fistula group (average 0.06 procedures/patient/year) and 65% of prosthetic graft group (average 0.21 procedures/patient/year). So the autogenous fistula group had fewer intervention rate than prosthetic graft group (p=0.01) The risk factor of primary patency was diabetus combined with ischemic heart disease and the secondary patency's risk factor was age. Conclusion: Autogenous arteriovenous fistulas showed better performance compared to prosthetic grafts in terms of primary & secondary patency and incidence of interventions.
Purpose: A novel attachment system for implant-retained overdentures (IRODs) with novel material combinations for improved mechanical resilience and prosthodontic success (Novaloc) has been recently introduced as an alternative to an existing system (Locator). This study investigated whether differences between the Novaloc and Locator attachment systems translate into differences in implant survival, implant success, and patient-centered outcomes when applied in a real-world in-practice comparative setting in patients restored with mandibular IRODs supported by 2 interforaminal implants (2-IRODs). Methods: This prospective, intra-subject crossover comparison compared 20 patients who received 2 intra-foraminal bone level tapered implants restored with full acrylic overdentures using either the Locator or Novaloc attachment system. After 6 months of function, the attachment in the corresponding dentures was switched, and the definitive attachment system type was delivered based on the patient's preference after 12 months. For the definitive attachment system, implant survival was evaluated after 24 months. The primary outcomes of this study were oral health-related quality of life and patient preferences related to prosthetic and implant survival. Secondary outcomes included implant survival rate and success, prosthetic survival, perceived general health, and patient satisfaction. Results: Patient-centered outcomes and patient preferences between attachment systems were comparable, with relatively high overall patient satisfaction levels for both attachment systems. No difference in the prosthetic survival rate between study groups was detected. The implant survival rate over the follow-up period after 24 months in both groups was 100%. Conclusions: The results of this in-practice comparison indicate that both attachment systems represent comparable candidates for the prosthodontic retention of 2-IRODs. Both systems showed high rates of patient satisfaction and implant survival. The influence of material combinations of the retentive system on treatment outcomes between the tested systems remains inconclusive and requires further investigations.
The purpose of this study was to introduce rotation-plasty procedure and prosthetic ambulation training. The recent development of chemotherapy and diagnostic facility have permitted the orthopaedic surgeons to try limb saving procedures rather than amputations for the treatment of the malignant bone tumors. If the tumors around the knee joint were treated by mid-thigh amputation or hip disarticulation, it would impose the client with a great handicap for rehabilitation. Rotation-plasty procedure was first done by Borggreve, in 1930 for the congenital short femur. Recently this procedure was used a malignant bone tumor at the distal femur by Kotz and Salzer in 1982. In spite of its cosmetic problem of the distal stump, this procedure has the great functional advantage of converting the above-knee amputation to the below-knee amputation. The inverted foot was also good to control the prosthesis as a below-knee stump and heel functioned as a patella to support the body weight. This 15 years old girl case was had rotation-plasty due to osteosarcoma of the distal femur with 3rd postoperative chemotherapy, and admitted to Yonsei rehabilitation hospital for prosthetic ambulation training. Then, the case had excellent functional results of prosthetic ambulation training with rotaion-plasty after 3 months.
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