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https://www.readbyqxmd.com/read/28799990/state-of-the-art-amputation-and-prosthetics
#1
David E Westberry
Amputation is not a defeat or failure of treatment, but an effective management strategy for certain conditions in the pediatric population. The principles of management, especially in the pediatric population, have not changed. Current surgical strategies focus on providing an optimal residual limb for prosthetic fitting. New technology provides improvement in the design and fabrication of prosthetic devices.
September 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28769755/broadband-prosthetic-interfaces-combining-nerve-transfers-and-implantable-multichannel-emg-technology-to-decode-spinal-motor-neuron-activity
#2
Konstantin D Bergmeister, Ivan Vujaklija, Silvia Muceli, Agnes Sturma, Laura A Hruby, Cosima Prahm, Otto Riedl, Stefan Salminger, Krisztina Manzano-Szalai, Martin Aman, Michael-Friedrich Russold, Christian Hofer, Jose Principe, Dario Farina, Oskar C Aszmann
Modern robotic hands/upper limbs may replace multiple degrees of freedom of extremity function. However, their intuitive use requires a high number of control signals, which current man-machine interfaces do not provide. Here, we discuss a broadband control interface that combines targeted muscle reinnervation, implantable multichannel electromyographic sensors, and advanced decoding to address the increasing capabilities of modern robotic limbs. With targeted muscle reinnervation, nerves that have lost their targets due to an amputation are surgically transferred to residual stump muscles to increase the number of intuitive prosthetic control signals...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28753228/use-of-arterialized-saphenous-vein-venous-flow-through-flaps-as-a-temporizing-measure-for-hand-salvage-in-contaminated-wounds-presenting-with-limb-ischemia-a-case-series
#3
Julian Diaz-Abele, Bauback Safa, Rudolf F Buntic, Avinash Islur
BACKGROUND: Vascular injuries resulting in limb ischemia are traditionally treated acutely with autologous or prosthetic bypass grafts. Traumatic contaminated injuries with soft tissue and vascular segmental loss are challenging as prosthetic bypasses are at risk of erosion, infection, and occlusion; and autologous bypasses are at risk of desiccation, blow-out, infection, and clotting. We propose a novel approach to these injuries by using arterialized saphenous vein venous flow-through free flaps (S-VFTF) as an autologous bypass, and present the results of its application in a series of cases...
July 28, 2017: Microsurgery
https://www.readbyqxmd.com/read/28747047/novel-approach-in-using-ultrasound-in-treating-acute-limb-ischemia
#4
Michael H Wholey, Raul G Palacios, Alejandro Mendez-Castillo, Lori C Pounds
BACKGROUND: It is imperative to gain safe access into the occluded targeted vessel and begin treating acute extremity limb ischemia. Often the origin of the targeted native artery or bypass graft will have a flush occlusion making it difficult to cannulate. This paper looks at the novel use of portable ultrasound to evaluate the origin of the artery or bypass graft to help facilitate the start of thrombolysis. METHODS: We reviewed our last 2 years of acute limb ischemia in our patients with high risk factors and co-morbidities...
July 26, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28744189/self-recalibrating-surface-emg-pattern-recognition-for-neuroprosthesis-control-based-on-convolutional-neural-network
#5
Xiaolong Zhai, Beth Jelfs, Rosa H M Chan, Chung Tin
Hand movement classification based on surface electromyography (sEMG) pattern recognition is a promising approach for upper limb neuroprosthetic control. However, maintaining day-to-day performance is challenged by the non-stationary nature of sEMG in real-life operation. In this study, we propose a self-recalibrating classifier that can be automatically updated to maintain a stable performance over time without the need for user retraining. Our classifier is based on convolutional neural network (CNN) using short latency dimension-reduced sEMG spectrograms as inputs...
2017: Frontiers in Neuroscience
https://www.readbyqxmd.com/read/28742043/mixed-modality-stimulation-to-evoke-two-modalities-simultaneously-in-one-channel-for-electrocutaneous-sensory-feedback
#6
Kyunghwan Choi, Pyungkang Kim, Kyung-Soo Kim, Soohyun Kim
One of the long-standing challenges in upper limb prosthetics is restoring the sensory feedback that is missing due to amputation. Two approaches have previously been presented to provide various types of sensory information to users, namely, multi-modality sensory feedback and using an array of singlemodality stimulators. However, the feedback systems used in these approaches were too bulky to be embedded in prosthesis sockets. In this paper, we propose an electrocutaneous sensory feedback method that is capable of conveying two modalities simultaneously with only one electrode...
July 24, 2017: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/28736684/multimodality-imaging-approaches-for-evaluating-traumatic-extremity-injuries-implications-for-military-medicine
#7
REVIEW
Mitchel R Stacy, Christopher L Dearth
Significance: Military service members are susceptible to traumatic extremity injuries that often result in limb loss. Tremendous efforts have been made to improve medical treatment that supports residual limb function and health. Despite recent improvements in treatment and novel prosthetic devices, many patients experience a wide range of clinical problems within residual limbs that can negatively impact the progress of rehabilitation programs while also impairing functional capacity and overall quality of life...
July 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28736683/progress-toward-optimizing-prosthetic-socket-fit-and-suspension-using-elevated-vacuum-to-promote-residual-limb-health
#8
Matthew M Wernke, Ryan M Schroeder, Michael L Haynes, Lonnie L Nolt, Alexander W Albury, James M Colvin
Objective: Prosthetic sockets are custom made for each amputee, yet there are no quantitative tools to determine the appropriateness of socket fit. Ensuring a proper socket fit can have significant effects on the health of residual limb soft tissues and overall function and acceptance of the prosthetic limb. Previous work found that elevated vacuum pressure data can detect movement between the residual limb and the prosthetic socket; however, the correlation between the two was specific to each user. The overall objective of this work is to determine the relationship between elevated vacuum pressure deviations and prosthetic socket fit...
July 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28712733/long-term-outcomes-after-autogenous-versus-synthetic-lower-extremity-bypass-in-patients-on-hemodialysis
#9
Isibor Arhuidese, Caitlin W Hicks, Satinderjit Locham, Tammam Obeid, Besma Nejim, Mahmoud B Malas
BACKGROUND: Hemodialysis dependence confers unique physiologic conditions. Prior reports of outcomes after infrainguinal open bypass operations in patients on hemodialysis have been based on relatively small sample institutional series. In this study, we evaluate long-term outcomes after open bypass operations in a large contemporary population-based cohort of hemodialysis patients. We studied all hemodialysis patients who underwent infrainguinal open operation using autogenous versus prosthetic conduits in the United States Renal Data System between January 2007 and December 2011...
July 13, 2017: Surgery
https://www.readbyqxmd.com/read/28705487/amputee-locomotion-frequency-content-of-prosthetic-vs-intact-limb-vertical-ground-reaction-forces-during-running-and-the-effects-of-filter-cut-off-frequency
#10
Dovin Kiernan, Ross H Miller, Brian S Baum, Hyun Joon Kwon, Jae Kun Shim
Compared to intact limbs, running-specific prostheses have high resonance non-biologic materials and lack active tissues to damp high frequencies. These differences may lead to ground reaction forces (GRFs) with high frequency content. If so, ubiquitously applying low-pass filters to prosthetic and intact limb GRFs may attenuate veridical high frequency content and mask important and ecologically valid data from prostheses. To explore differences in frequency content between prosthetic and intact limbs we divided signal power from transtibial unilateral amputees and controls running at 2...
June 21, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28704685/dynamic-balance-changes-within-three-weeks-of-fitting-a-new-prosthetic-foot-component
#11
Jenny A Kent, Nicholas Stergiou, Shane R Wurdeman
Balance during walking is of high importance to prosthesis users and may affect walking during baseline observation and evaluation. The aim of this study was to determine whether changes in walking balance occurred during an adaptation period following the fitting of a new prosthetic component. Margin of stability in the medial-lateral direction (MOSML) and an anterior instability margin (AIM) were used to quantify the dynamic balance of 21 unilateral transtibial amputees during overground walking. Participants trialled two prosthetic feet presenting contrasting movement/balance constraints; a Higher Activity foot similar to that of their own prosthesis, and a Lower Activity foot...
July 5, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28704467/locomotor-adaptability-in-persons-with-unilateral-transtibial-amputation
#12
Benjamin J Darter, Amy J Bastian, Erik J Wolf, Elizabeth M Husson, Bethany A Labrecque, Brad D Hendershot
BACKGROUND: Locomotor adaptation enables walkers to modify strategies when faced with challenging walking conditions. While a variety of neurological injuries can impair locomotor adaptability, the effect of a lower extremity amputation on adaptability is poorly understood. OBJECTIVE: Determine if locomotor adaptability is impaired in persons with unilateral transtibial amputation (TTA). METHODS: The locomotor adaptability of 10 persons with a TTA and 8 persons without an amputation was tested while walking on a split-belt treadmill with the parallel belts running at the same (tied) or different (split) speeds...
2017: PloS One
https://www.readbyqxmd.com/read/28700180/-superior-cava-vein-stenosis-in-a-hemodialysis-patient-with-long-term-central-venous-catheter-and-vascular-graft-a-case-report
#13
Carlo Jovane, Piera Farfaglia, Anna Maria Ierardi, Laura Rimoldi, Elisabetta Sogni, Carmela Figliola, Daniela Pogliani, Matteo Tozzi, Elena Caramella, Pasquale Esposito, Alessandro Castiglioni
Recently, the use of central venous catheters (CVC) as a vascular access in patients undergoing hemodialysis is significantly increased, mainly because of the aging of this population and the presence of several comorbidities. However, the implantation and the long stay of CVC are associated with many complications. Among them, central venous stenosis represents one of the most common problems that, if not properly diagnosed, could lead to vascular thrombosis and consequent vascular access malfunction. Here, we report a case of a 38-year-old patient, who underwent hemodialysis firstly by a CVC long-term into right jugular vein and then by a prosthetic fistula in the ipsilateral limb...
June 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28697795/improved-prosthetic-hand-control-with-concurrent-use-of-myoelectric-and-inertial-measurements
#14
Agamemnon Krasoulis, Iris Kyranou, Mustapha Suphi Erden, Kianoush Nazarpour, Sethu Vijayakumar
BACKGROUND: Myoelectric pattern recognition systems can decode movement intention to drive upper-limb prostheses. Despite recent advances in academic research, the commercial adoption of such systems remains low. This limitation is mainly due to the lack of classification robustness and a simultaneous requirement for a large number of electromyogram (EMG) electrodes. We propose to address these two issues by using a multi-modal approach which combines surface electromyography (sEMG) with inertial measurements (IMs) and an appropriate training data collection paradigm...
July 11, 2017: Journal of Neuroengineering and Rehabilitation
https://www.readbyqxmd.com/read/28693533/classification-complexity-in-myoelectric-pattern-recognition
#15
Niclas Nilsson, Bo Håkansson, Max Ortiz-Catalan
BACKGROUND: Limb prosthetics, exoskeletons, and neurorehabilitation devices can be intuitively controlled using myoelectric pattern recognition (MPR) to decode the subject's intended movement. In conventional MPR, descriptive electromyography (EMG) features representing the intended movement are fed into a classification algorithm. The separability of the different movements in the feature space significantly affects the classification complexity. Classification complexity estimating algorithms (CCEAs) were studied in this work in order to improve feature selection, predict MPR performance, and inform on faulty data acquisition...
July 10, 2017: Journal of Neuroengineering and Rehabilitation
https://www.readbyqxmd.com/read/28692486/standard-and-amputation-adjusted-body-mass-index-measures-comparison-and-relevance-to-functional-measures-weight-related-comorbidities-and-dieting
#16
Christopher Kevin Wong, Ryan J Wong
People with limb loss may misjudge weight-related health when not adjusting body mass index (BMI) for amputation level. This cross-sectional, community-based study compared BMI and amputation-adjusted BMI (A-BMI) and evaluated relationships among BMI categories, function, and dieting. Subjects provided self-reported demographic, functional, and medical/prosthetic data including height and weight and completed performance-based balance and gait measures. A Web-based A-BMI calculator adjusted for amputation levels...
July 7, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28676749/preliminary-evidence-for-training-induced-changes-of-morphology-and-phantom-limb-pain
#17
Sandra Preißler, Désirée Thielemann, Caroline Dietrich, Gunther O Hofmann, Wolfgang H R Miltner, Thomas Weiss
The aim of this study was to investigate whether a special prosthetic training in phantom limb pain patients aimed at increasing the functional use of the prosthesis leads to neural morphological plasticity of brain structures and a reduction in phantom limb pain. For chronic pain disorders, it was shown that morphological alterations due to pain might become at least partially reversed by pain therapies. Phantom limb pain is a chronic pain disorder that is frequently followed by neural plasticity of anatomical brain structures...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/28675376/model-based-bayesian-signal-extraction-algorithm-for-peripheral-nerves
#18
Thomas Eggers, Yazan M Dweiri, Grant McCallum, Dominique M Durand
Multi-channel cuff electrodes have recently been investigated for extracting fascicular-level motor commands from mixed neural recordings. Such signals could provide volitional, intuitive control over a robotic prosthesis for amputee patients. Recent work has demonstrated success in extracting these signals in acute and chronic preparations using spatial filtering techniques. These extracted signals, however, had low signal-to-noise ratios and thus limited their utility to binary classification. In this work a new algorithm is proposed which combines previous source localization approaches to create a model based method which operates in real time...
July 4, 2017: Journal of Neural Engineering
https://www.readbyqxmd.com/read/28657565/robotic-arm-assisted-partial-knee-arthroplasty-a-single-centre-experience
#19
Andrea Marcovigi, Francesco Zambianchi, Dario Sandoni, Elisa Rivi, Fabio Catani
BACKGROUND AND AIM OF THE WORK: UKA has proven to be an effective surgical procedure, but its survivorship is still negatively affected by inaccuracy in component component positioning, implant and limb alignment. Robotic surgery has been introduced in order to minimize such technical errors. The aim of the present paper was to evaluate clinical and surgical outcomes after a 3 years' experience of robotic assisted UKA with the Mako Robotic Arm. METHODS: Seventy-three patients undergoing  UKA with robotic instrumentation (65 medial UKAs, 8 lateral UKAs) and with a clinical follow-up of 3 -37 months were included in the present study...
June 7, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28657562/patient-specific-instrumentation-in-total-knee-arthroplasty
#20
Andrea Colombelli, Alberto Belluati, Yousef Rizqallah, Giovanni Guerra, Carlo Busatto
BACKGROUND AND AIM OF THE WORK: The international literature and analysis of the prosthetic registers highlight a significant relationship between the alignment of the components and the survival of prosthetic implants of the knee. The patient specific instrumentation (PSI) technology exploits the data obtained with the MRN for the production of cutting blocks (CB) useful to a TKA. Revisiting the recent international literature, comparing the results of the conventional method and PSI, numerous studies confirm a statistically significant difference of inliers (± 3 degrees) for HKA...
June 7, 2017: Acta Bio-medica: Atenei Parmensis
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