• Archives of Reconstructive Microsurgery
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• v.20 no.2
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• pp.126-131
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• 2011

Purpose: The subcutaneous pocket graft of the thumb tip amputation across or proximal to the lunula is chosen in case of impossible microvascular anastomosis and in patient who strongly desired to preserve the thumb tip after failed replantation. Materials and Methods: Two patients who underwent a subcutaneous pocket graft for a thumb tip reconstruction between August 2008 and November 2009 were reviewed retrospectively. They were all males with a mean age at the time of surgery of 48 years and had sustained complete thumb tip amputations across or proximal to the lunula. In one case, the microsurgical replantation was not feasible and the other one revealed arterial insufficiency at the 7th day after microsurgical replantation. Results: Authors had experienced 2 cases of flaps which survived completely. The results of sensibility was good, the range of motion at interphalangeal joint and tip to tip pinch was acceptable and color mismatch and loss of thumb finger nail was unacceptable after more than 1 year follow up with conventional successful thumb tip replantation. Conclusion: The subcutaneous pocket graft could be chosen in thumb tip amputation in case of impossible microvascular anastomosis as well as who strongly desires to preserve thumb tip after failed replantation.

• Journal of KIISE:Software and Applications
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• v.32 no.3
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• pp.227-235
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• 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 the Korean Society for Precision Engineering
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• v.30 no.7
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• pp.709-716
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• 2013

Rehabilitation of finger patients requires that the patients exercise their hands and fingers for proper functioning to return. A thumb rehabilitation robot, equipped with a two-axis force sensor, can prevent injury to the thumb by monitoring the applied pulling force. In this paper, we describe a link-type thumb rehabilitation robot designed for patients' thumb rehabilitation exercise. Tests of the manufactured link-type thumb rehabilitation robot were performed on normal male patients. Our results show that the robot can be used for flexibility and muscle-strength rehabilitation exercises for a patient's thumb.

• Archives of Reconstructive Microsurgery
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• v.14 no.2
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• pp.152-156
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• 2005

Purpose: We reconstructed the thumb with groin flap combined with secondary heterodigital neurovascular island flap and report our 6 cases. Materials and Methods: Between March 2003 and August 2004, 6 degloving thumbs or amputation of thumbs were reconstructed with groin flap combined with secondary heterodigital neurovascular island flap. There ware 4 men and 2 women, and mean age was 42.2 years. The following parameters were evaluated. Results: Recipient thumb was no limitation of apposition. but flexion contracture of interphalangeal joint was about 10 degree in two cases. Average grip power were 80% and average pinch power were 70% that of the normal thumb. The two point discrimination was average 10.5 mm and double sensibility in 2 cases. 2 patients have cold intolerance. Neuroma formation was not made. Cosmetic results as judged by patients were that 4 cases are good and 2 cases are fair. Conclusion: If massive skin defect after degloving thumb or amputation of thumb are present, we consider the numerous methods for reconstruction of thumb. This surgical procedure is good methods because of it's pliability, sensation, satisfactory functional results but major disadvantage are the staged operation and cosmetic effect of the absence of thumb nail.

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

• Archives of Reconstructive Microsurgery
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• v.17 no.2
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• pp.101-107
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• 2008

Purpose: Free flaps from the great toe are an established method for reconstruction of absent or partially amputated thumbs. However, options differ as to which technique represents the ideal solution for each level of amputation. Various methods of distal thumb reconstruction have been proposed. We prefer to transplant the entire great toe nail complex with the almost all of the pulp rather than a portion of the nail. This paper reflects our experience in using the great toe mini wrap-around flap for distal thumb reconstruction. Materials and Methods: In the period from October of 2005 to July of 2007, 9 patients were treated for traumatic thumb defects localized at the distal phalanx of the thumb. The patients included seven men and two women. The mean age was 44 years (range, 21~60) and the dominant right hand was involved in seven of nine patients. Results: The transferred flaps have survived completely in all cases. The mean range of motion in the interphalangeal joints was 51o, with 73% of the normal uninjured opposite hands. The two-point discrimination was 10.5 mm (range, 5~13 mm). In Semmes-Weinstein monofilament test, the sensibility was 4.31 in 4 cases, 3.61 in 3 cases and 2.83 in 2 cases. The pinch power was 64% (range, 55~95%) of the opposite hand. All patients were satisfied with the appearance of the reconstructed thumb and felt comfortable at final follow-up. Conclusion: We have successfully reconstructed 9 cases of traumatic distal thumb defects using the mini wrap-around free flap. The mini wrap-around free flap in great toe is an excellent alternative method for distal thumb reconstruction in selected patients.

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

• Archives of Reconstructive Microsurgery
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• v.10 no.2
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• pp.169-174
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• 2001

Purpose : The problems of late deterioration of sensation and a double sensibility phenomenon are a known deficiency of the original neurovascular island flap. To eliminate this problems, the authors was performed to assess the results of Thumb-pulp loss reconstruction with a heterodigital neurovascular island Flap Using a Nerve Disconnecting-Reconnecting Technique Material and Methods : Between July. 1987 and November. 2000, we have used a disconnecting-reconnecting technique for heterodigital island flaps in which divided nerve of the transferred island flap is sutured to original nerve of the thumb in 9 patients. 9 patients with a mean follow-up period of 3.6 years were examined, while 7 patients were follow-up for 2years or more. Evaluation of results was based on flap quality, donor site quality, classic two-point sensory discrimination(2PD), and location of sensation(double sensibility), donor site cold intolerance, neuroma formation, scar contractures, total active movement(TAM) of the thumb and donor digit and subjective results and objective results. Results : The two-point discrimination was average 6.7 mm. Donor site paresthesia was observed more frequently in a short postoperative period. Sensation was referred to the thumb in all cases and the recovery occurred over a period of a two months. There were no flap complication or failures and the length of the thumb tip was preserved in all cases. Conclusion : This technique was found to provide well-vascularized pulp of the thumb with proper cortical representation in one operative stage.

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

• Journal of the Korea Society of Computer and Information
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• v.18 no.7
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• pp.1-10
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• 2013

In this paper, the parallel branch instruction is proposed which executes a branch instruction and the frequently used instruction simultaneously to improve the performance of Thumb-2 instruction set architecture. In the proposed approach, new 32-bit parallel branch instructions are introduced which combine 16-bit branch instruction with each of the frequently used 16-bit LOAD, ADD, MOV, STORE, and SUB instructions, respectively. To provide the encoding space of the new instructions, the register field in less frequently executed instructions is reduced, and the new instructions are encoded by using the saved bits. Experiments show that the proposed approach improves performance by an average of 8.0% when compared to the conventional approach.