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Upper extremity prosthetics

Cesar Colasante, Kyle Silva, Yuxi Chen, Matthew N Bartels
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Peirong Yu
The introduction of the transverse rectus abdominis myocutaneous flap in the 1970s marks the beginning of modern breast reconstruction although implants were available even earlier mainly for breast augmentation. Mastectomy techniques have evolved from the early Halsted radical mastectomy to the modern skin sparing mastectomy. The latter made possible using implants for breast reconstruction. Although prosthetic reconstruction provides a simpler procedure with quick recovery, autologous reconstruction offers more natural and long-lasting results especially in the setting of radiotherapy...
August 2016: Gland Surgery
S Salminger, J A Mayer, A Sturma, O Riedl, K D Bergmeister, O C Aszmann
During the last years, the prosthetic replacement in upper limb amputees has undergone different developments. The use of new nerve surgical concepts improved the control strategies tremendously, especially for high-level amputees. Technological innovation in the field of pattern recognition enables the control of multifunctional myoelectric hand prostheses in a natural and intuitive manner. However, the different levels of amputation pose different challenges for the therapeutic team which concern not only the prosthetic attachment; also the expected functional outcome of prosthetic limb replacement differs greatly between the individual levels of amputation...
August 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Stefan Salminger, Aidan D Roche, Agnes Sturma, Laura A Hruby, Oskar C Aszmann
OBJECTIVE: In patients with severe bilateral congenital arm deficiencies, even simple activities of daily living, such as feeding, may be major challenges. We report here a case of a patient with arthrogryposis multiplex congenita affecting all 4 extremities, who underwent prosthetic replacement after elective transhumeral amputation of his right functionless arm. CASE REPORT: A 22-year-old man with arthrogryposis multiplex congenita had severe deficits of his upper limbs...
October 5, 2016: Journal of Rehabilitation Medicine
Blessen C Eapen, Douglas P Murphy, David X Cifu
The goals of rehabilitation medicine programs are to promote health, restore functional impairments and improve quality of life. The field of neuroprosthetics has evolved over the last decade given an improved understanding of neuroscience and the incorporation of advanced biotechnology and neuroengineering in the rehabilitation setting to develop adaptable applications to help facilitate recovery for individuals with amputations and brain injury. These applications may include a simple cognitive prosthetics aid for impaired memory in brain-injured individuals to myoelectric prosthetics arms with artificial proprioceptive feedback for those with upper extremity amputations...
August 9, 2016: Experimental Neurology
Evan R Brownie, Clark D Kensinger, Irene D Feurer, Derek E Moore, David Shaffer
OBJECTIVE: With improvements in medical management and survival of patients with end-stage renal disease, maintaining durable vascular access is increasingly challenging. This study compared primary, assisted primary, and secondary patency, and procedure-specific complications, and evaluated whether the number of interventions to maintain or restore patency differed between prosthetic femoral-femoral looped inguinal access (thigh) grafts and Hemodialysis Reliable Outflow (HeRO; Hemosphere Inc, Minneapolis, Minn) grafts...
July 18, 2016: Journal of Vascular Surgery
Masaya Nakashima, Hideaki Kobayashi, Masayoshi Kobayashi
The treatment tactics for subclavian artery occlusion include the more commonly used endovascular therapy rather than surgical intervention. We present a case of a 61-year-old woman with dialysis-dependent chronic renal failure who experienced left finger necrosis in the left upper extremity. To salvage the limb, we performed femoro-axillary (fem-ax) artery bypass using an autologous saphenous vein graft. However, 10 months later, she experienced coldness in the left forearm. Angiography revealed chronic total occlusion of the venous bypass...
June 2016: Vascular Specialist International
Laura Hughey, Lewis A Wheaton
Loss of an upper extremity and the resulting rehabilitation often requires individuals to learn how to use a prosthetic device for activities of daily living. It remains unclear how prostheses affect motor learning outcomes. The authors' aim was to evaluate whether incidental motor learning and explicit recall is affected in intact persons either using prostheses (n = 10) or the sound limb (n = 10), and a chronic amputee on a modified serial reaction time task. Latency and accuracy of task completion were recorded over six blocks, with a distractor task between blocks 5 and 6...
June 24, 2016: Journal of Motor Behavior
Delisa T Lawson, William F Cusack, Regan Lawson, Ashley Hardy, Robert Kistenberg, Lewis A Wheaton
Prior work in amputees and partial limb immobilization have shown improved neural and behavioral outcomes in using their residual limb with prosthesis when undergoing observation-based training with a prosthesis-using actor compared to an intact limb. It was posited that these improvements are due to an alignment of user with the actor. It may be affected by visual angles that allow emphasis of critical joint actions which may promote behavioral changes. The purpose of this study was to examine how viewing perspective of observation-based training effects prosthesis adaptation in naïve device users...
September 2016: Journal of Motor Behavior
Rodolphe J Gentili, Hyuk Oh, Alissa V Kregling, James A Reggia
The human hand's versatility allows for robust and flexible grasping. To obtain such efficiency, many robotic hands include human biomechanical features such as fingers having their two last joints mechanically coupled. Although such coupling enables human-like grasping, controlling the inverse kinematics of such mechanical systems is challenging. Here we propose a cortical model for fine motor control of a humanoid finger, having its two last joints coupled, that learns the inverse kinematics of the effector...
June 2016: Bioinspiration & Biomimetics
S Salminger, J A Mayer, A Sturma, O Riedl, K D Bergmeister, O C Aszmann
BACKGROUND: Prosthetic replacement after amputation or loss of function of the upper extremity has gained therapeutic value over the last years. The control of upper arm prostheses has been refined by the use of selective nerve transfers, and the indication for prosthetic replacement has been expanded. OBJECTIVES: Overview regarding surgical, therapeutic and prosthetic options in upper extremity amputations or their loss of function. METHODS: Selective literature research including the authors' own experience in everyday clinical practice, as well as a review of medical records...
May 2016: Der Unfallchirurg
T S Davis, H A C Wark, D T Hutchinson, D J Warren, K O'Neill, T Scheinblum, G A Clark, R A Normann, B Greger
OBJECTIVE: An important goal of neuroprosthetic research is to establish bidirectional communication between the user and new prosthetic limbs that are capable of controlling >20 different movements. One strategy for achieving this goal is to interface the prosthetic limb directly with efferent and afferent fibres in the peripheral nervous system using an array of intrafascicular microelectrodes. This approach would provide access to a large number of independent neural pathways for controlling high degree-of-freedom prosthetic limbs, as well as evoking multiple-complex sensory percepts...
June 2016: Journal of Neural Engineering
Kilian Wegmann, Wei Zhang, Volker Strauss, Christian Ries, Lars P Müller, Klaus J Burkhart
BACKGROUND: Overlengthening by radial head prosthetic replacement leads to insufficient functionality and increased capitellar wear. It has been shown that in monopolar prostheses, the radial overlengthening by an overstuffed prosthesis leads to significant differences in the distal radioulnar variance at the wrist. This study evaluated ipsilateral ulnar variance as a predictor for overlengthening after implantation of a multipolar prosthesis. METHODS: The radial heads of seven fresh frozen upper extremities were resected and a multipolar radial head prosthesis was implanted...
2016: European Journal of Medical Research
Michaela V Walsh, Trey W Armstrong, Julia Poritz, Timothy R Elliott, Warren T Jackson, Tiffany Ryan
OBJECTIVE: To test mediating effects of positive emotion and activity restriction on the associations of resilience and pain interference with distress reported by individuals with traumatic upper limb loss evaluated for prosthetics. DESIGN: Cross-sectional correlational study of several demographic and self-report measures of resilience, pain interference, activity restriction, positive emotions, and symptoms of depression and posttraumatic stress. SETTING: Six regional centers throughout the United States...
May 2016: Archives of Physical Medicine and Rehabilitation
Masatsugu Takami, Makoto Ieguchi, Masanari Aono, Manabu Hoshi, Jun Takada, Naoto Oebisu, Tadashi Iwai
Reconstruction following periacetabular tumor resection of the pelvis is one of the most challenging issues in limb salvage surgery. An ideal procedure has still not been established. There are several reconstruction methods available, including arthrodesis, pseudoarthrosis, resection arthroplasty, prosthetic arthroplasty, saddle prosthesis, allograft and hip transposition. In our hospital, we have been using a flail hip joint procedure without reconstruction. Herein, we report good extremity function following a flail hip joint procedure which used the upper surface of the femoral neck as a saddle facing the remaining ilium...
December 2015: Oncology Letters
Morad Askari, Kevin N Christensen, Shaun Heath, Steven L Moran, Nirusha Lachman
PURPOSE: Mirror hand or ulnar dimelia is a rare and poorly studied congenital anomaly of the upper extremity. Understanding of its anatomy is limited by the rarity of the deformity and the variability in presentation. We present the case of an 80-year-old female donor with an incidental finding of mirror hand. METHODS: Medical history indicated no record of any surgical procedures or interventions to the right upper extremity suggesting that the donor had lived an independent life without the need for prosthetic aids...
September 2016: Surgical and Radiologic Anatomy: SRA
Mahdi Rasouli, Rohan Ghosh, Wang Wei Lee, Nitish V Thakor, Sunil Kukreja
Force myography has been proposed as an appealing alternative to electromyography for control of upper limb prosthesis. A limitation of this technique is the non-stationary nature of the recorded force data. Force patterns vary under influence of various factors such as change in orientation and position of the prosthesis. We hereby propose an incremental learning method to overcome this limitation. We use an online sequential extreme learning machine where occasional updates allow continual adaptation to signal changes...
August 2015: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Adam J Bauermeister, Alexander Zuriarrain, Martin I Newman
BACKGROUND: Increasingly affordable three-dimensional (3D) printing technologies now make it possible for surgeons to create highly customizable patient-tailored products. This process provides the potential to produce individualized artificial and biologic implants, regenerative scaffolds, and cell-specific replacement tissue and organs. The combination of accurate volumetric analysis and production of 3D printed biologic materials are evolving techniques that demonstrate great promise in achieving an accurate and naturally appearing anthropomorphic reconstruction...
December 15, 2015: Annals of Plastic Surgery
Mark K Solarz, Joseph J Thoder, Saqib Rehman
Traumatic upper extremity amputation is a life-altering event, and recovery of function depends on proper surgical management and postoperative rehabilitation. Many injuries require revision amputation and postoperative prosthesis fitting. Care should be taken to preserve maximal length of the limb and motion of the remaining joints. Skin grafting or free tissue transfer may be necessary for coverage to allow preservation of length. Early prosthetic fitting within 30 days of surgery should be performed so the amputee can start rehabilitation while the wound is healing and the stump is maturing...
January 2016: Orthopedic Clinics of North America
Celalettin Karatepe, Mustafa Aldemir, Bayer Çınar, Akif Önalan, Halim Işsever, Onur S Goksel
Patent vascular access is critical for patients on regular hemodialysis. Prosthetic grafts are good alternatives when the superficial venous system is of poor quality. However, thrombosis is one of the main drawbacks of synthetic grafts, with reports of 59% to 90% patency rates for 1 year. In cases of thrombotic occlusion of prosthetic arteriovenous fistula grafts, percutaneous mechanical thrombectomy has recently gained clinical popularity as a potential alternative to surgical thrombectomy or pharmacologic thrombolysis...
July 2015: International Surgery
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