• Archives of Reconstructive Microsurgery
• /
• v.9 no.1
• /
• pp.56-61
• /
• 2000

Recommendable reconstructive surgery in the patient with thumb amputation through base of the first metacarpal bone is pollicization. Some patients who do not agree with harvest sound finger as a new thumb, we can consider other options as toe transplantation or osteoplastic thumb reconstruction for creating thumb. Toe transplantation to the thumb is effective procedure in the amputation of distal to metacarpal shaft, it is rarely indicated in the cases of proximal to base of the first metacarpal bone. We performed three cases of modified osteoplastic thumb reconstruction with free vascularized rib that combined with scapular free flap or radial forearm flap. The length of transplanted rib ranged from 7~11cm, the donor vessels are posterior intercostal artery and vein which anastomosed to radial artery. The grafted rib wrapped with additional free flap for creating new thumb. Result of that procedure was not much encouraging, aesthetic appearance and mobility of thumb were not so satisfactory but reconstructed thumb gave improvement of the hand function without sacrificing toe or other digit. That gave reasonable stability for powerful side pinch and three pod pinch and opposable thumb with normal carpo-metacarpal joint motion that can give much function to the thumb absent hand. In spite of those disadvantages, thumb reconstruction with rib transfer can be useful for patients who do not want to lose another part of the body for creating thumb in basal amputation of the thumb metacarpal.

• Archives of Reconstructive Microsurgery
• /
• v.15 no.2
• /
• pp.117-122
• /
• 2006

The function of the thumb is critical to overall hand function. The thumb enables motions such as pinch, grip, fine manipulation and allows to circumduction and opposition. It's loss is a serious problem not only from cosmetic point of view but also functional. Therefore, we should make every effort on thumb reconstruction. Many methods of thumb reconstruction from simple osteoplasty to complex microsurgical reconstruction have been reported. We should understand merits and demerits of each method and choose proper method on case by case. When both hands are injured and there is no option but to amputate one hand and the thumb of another hand is lost, spare part flap from the thumb of the amputated hand to another hand can solve cosmetic problem, functional problem and donor morbidity. We report a case of amputated thumb which has been reconstructed with amputated ring finger of the contralateral hand using spare part flap concept.

• Physical Therapy Korea
• /
• v.5 no.2
• /
• pp.39-46
• /
• 1998

Thumb adduction is an abnormal pattern typically noted in children with spastic cerebral palsy. This abnormal pattern can limit hand function, specifically in the type and quality of prehension pattern used and in the coordination of release. This ABAB single-subject research was designed to examine the effects of short thumb opponens splint on hand function in cerebral palsy. The subject was a 4 years and 8 months old boy with right upper extremity spasticity. The child was fitted with a short thumb opponens splint, which was worn for 8 hours per day during the daytime. Two different measures were used: (a) prehension component scores; (b) Bruininks-Oseretsky test of motor proficiency. Data was collected three times a week for 10 weeks. Visual analysis of data indicate that after the application of a short thumb opponens splint, improvements were noted in the prehension pattern and fine motor functional task. The results of this study suggest that short thumb opponens splint may prove efficaciousness in the treatment of the child with cerebral palsy.

• Journal of KIISE:Software and Applications
• /
• v.32 no.3
• /
• pp.227-235
• /
• 2005

In the embedded system domain, both memory requirement and energy consumption are great concerns. To save memory and energy, the 32 bit ARM processor supports the 16 bit Thumb instruction set. For a given program, the Thumb code is typically smaller than the ARM code. However, the limitations of the Thumb instruction set can often lead to generation of poorer quality code. To generate codes with smaller size but a little slower execution speed, Krishnaswarmy suggests a profiling guided selection algorithm at module level for generating mixed ARM and Thumb codes for application programs. The resulting codes of the algorithm give significant code size reductions with a little loss in performance. When the instruction set is selected at module level, some functions, which should be compiled in Thumb mode to reduce code size, are compiled to ARM code. It means we have additional code size reduction chance. In this paper, we propose a profile guided selection algorithm at function level for generating mixed ARM and Thumb codes for application programs so that the resulting codes give additional code size reductions without loss in performance compared to the module level algorithm. We can reduce 2.7％ code size additionally with no performance penalty

• Journal of Digital Convergence
• /
• v.16 no.7
• /
• pp.511-516
• /
• 2018

This study examined the effectiveness of a short thumb splint and a glove type splint which combined features of a fitness glove in order to improve hand function and performance of functional task after traumatic brain injury. One subject with traumatic brain injury participated in this study and wore a short thumb splint and customized glove type splint. His hand function was significantly improved when comparing to that of not using those splints. In addition, using the glove type splint was more significant to perform functional tasks than using the short thumb splint. The findings of this study identified that hand function of people with traumatic brain injury was improved by using those splints as an occupational therapy service and it is necessary to adapt the customized splints according to the personal characteristics.

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

• Archives of Reconstructive Microsurgery
• /
• v.3 no.1
• /
• pp.81-89
• /
• 1994

Firstly the wrap-around free flap from the great toe was transferred successfully by Morrison and O'Brien in 1980 for reconstruction in chronic case of amputated thumb distal to the MP joint. Since then, significant bone peg resorption and grafted bone fracture have been reported in most of cases after operation. We have performed thumb reconstructions within 2 weeks after injury in 11 cases which included acute crushing injuries or failed replantation of thumb at Guro Hospital from September, 1983 to October, 1993. The results obtained from this study are as follows: 1. There were 8 males and 3 females and the mean age was 28.8 years old ranged from 3 years old to 50 years old. 2. The most common injury mechanism was machinary injury in 10 of 11 cases. 3. We have performed thumb reconstructions by using wrap-around free flap from the great toe without bone graft in 6 cases and with bone graft in 5 cases within 2 weeks after injury. 4. During 6 years and 1 month mean follow-up period, there were bone resorptions in 3, grafted bone fracture in 1, infections in 2 and soft tissue necrosis in 3 cases. 5. We obtained satisfactable results in respect of function and cosmesis and urged to use this flap for reconstruction in acute thumb injury.

• Archives of Reconstructive Microsurgery
• /
• v.21 no.1
• /
• pp.56-60
• /
• 2012

Purpose: Thumb reconstruction plays most important role in hand injuries because total loss of a thumb constitutes about 40% disability in the hand. The reconstruction can be accomplished by pollicization, free toe-to-thumb transfer, wrap around procedure and lengthening extraction. However, we sometimes need consecutive or double free flaps in the reconstruction of mutilating hand injuries. Methods: We reconstructed a mutilating hand injury in a 54-years old man. Because of severe crushing injury of right thumb and index fingers, we reconstructed a thumb with pollicization using nearly amputated middle finger. Although it survived completely, the adjacent soft tissues which had been covered by fillet flap from the space past was necrosed on 1 month. We debrided the necrotic tissues and covered it with anteromedial thigh perforator free flap consecutively because he had an anatomical variation in branches of lateral femoral circumflex artery. Results: He had an uneventful postoperative course without any complication such as infection, dehiscence and flap necrosis. Three months later, he had undergone tenolysis and defatting procedure of flap site. He recovered the some amount of grip function and was happy with the result. Conclusion: In severe hand trauma including thumb amputation, thumb reconstruction using pollicization and perforator free flap could be an alternative option. It provides minimal donor site morbidity and an acceptable functional result.

• Journal of Korean Neurosurgical Society
• /
• v.54 no.3
• /
• pp.232-235
• /
• 2013

Objective : Major complaints of carpal tunnel syndrome (CTS) are sensory components. However, motor deficit also impedes functional status of hand. Contrary to evaluation of sensory function, the objective, quantitative evaluation of median nerve motor function is not easy. The motor function of median was evaluated quantitatively using load cell and its correlation with findings of electrodiagnostic study (EDS) was evaluated. Methods : Objective motor function of median nerve was evaluated by load cell and personal computer-based measurement system. All of the measurement was done in patients diagnosed as having idiopathic CTS by clinical features and EDS findings. The strength of thumb abduction and index finger flexion was measured in each hand three times, and the average value was used to calculate thumb index ratio (TIR). The correlation of TIR with clinical, EDS, and ultrasonographic findings were evaluated. Results : The TIR was evaluated in 67 patients (119 hands). There were 14 males and 53 females, mean age were 57.6 years (range 28 to 81). The higher preoperative nerve conductive studies grade of the patients, the lower TIR was observed [p<0.001, analysis of variance (ANOVA)]. TIR of cases with thenar atrophy were significantly lower than those without (p<0.001, t-test). TIR were significantly lower in patients with severe median nerve swelling in ultrasonography (p=0.042, ANOVA). Conclusion : Measurements of median nerve motor function using load cell is a valuable evaluation tool in CTS. It might be helpful in detecting subclinical motor dysfunction before muscle atrophy develops.

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