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Upper extremity amputations AND driving

M Iglesias, M Ramírez-Berumen, P Butrón, J Alberú-Gómez, F Salazar-Hernández, J Macias-Gallardo, R P Leal-Villalpando, J Zamudio-Bautista, V Acosta, L Jauregui, A Hernández-Campos, V Espinosa-Cruz, J Vázquez-Lamadrid, J González-Sánchez, J Cuellar-Rodriguez, J G Sierra-Madero, R Gaytan-Cervantes, S Contreras-Barbosa, A Navarro-Lara, J Guzman-Gonzalez, J Domínguez-Cherit, M Vilatoba, S Toussaint-Caire, F Vega-Boada, F J Gómez-Pérez, M Mayorquin-Ruiz
BACKGROUND: The function reported after arm transplantation is deemed beneficial relative to the marked disability that upper arm amputation causes. OBJECTIVE: We report a 51-year-old man with a Disabilities of the Arm, Shoulder and Hand (DASH) score of 75.83 who underwent bilateral arm transplantation in October 2015. PROCEDURE: The right arm was transplanted at the glenohumeral joint level, including transplantation of the humeral head, joint capsule, and rotator cuff ligaments and tendons...
April 2018: Transplantation Proceedings
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
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
M Malherbe, D Cheval, B Lejacques, L Vaiss, N Kerfant, D Le Nen
In front of a major upper limb trauma, do we need to make everything possible to keep the limb with the risk of facing poor functional outcomes? This study was performed to evaluate and compare long-term functional, psychological and social outcomes following major upper extremity trauma between patients treated with amputation and those who underwent limb salvage. This was a retrospective monocenter cohort study of 22 patients who sustained an upper limb injury requiring either amputation or limb salvage. The characteristics of the patient, trauma and initial take-care were studied...
September 2013: Chirurgie de la Main
Helena Burger, Crt Marincek
BACKGROUND: In the existing literature, there is scarce information about subjects with upper limb amputation and driving. OBJECTIVES: The aim of this study was to find out how frequently subjects following upper limb amputation have problems when driving; most frequently proposed adaptations and, when possible, factors that influence driving ability. STUDY DESIGN: Retrospective clinical study. METHODS: Medical records were reviewed of all subjects following upper limb amputation who had been amputated in the last 5 years and those with congenital upper limb deficiency who in the last 5 years turned 17...
October 2013: Prosthetics and Orthotics International
Peter S Kim, Jason H Ko, Kristina K O'Shaughnessy, Todd A Kuiken, Eric A Pohlmeyer, Gregory A Dumanian
PURPOSE: A targeted muscle reinnervation (TMR) model was created using a pedicled rabbit rectus abdominis (RA) flap to receive the input from previously amputated forelimb neuromas. We hypothesize that a segmental muscle flap can undergo TMR and that it is possible to differentiate the signal from 3 independent nerves. In addition, by virtue of the nerve coaptation, the morphology of the previous amputation neuroma would become more like that of an in-continuity neuroma. METHODS: Five New Zealand white rabbits had a forelimb amputation...
August 2012: Journal of Hand Surgery
Chul Ho Jang, Hee Seung Yang, Hea Eun Yang, Seon Yeong Lee, Ji Won Kwon, Bong Duck Yun, Jae Yung Choi, Seon Nyeo Kim, Hae Won Jeong
OBJECTIVE: To assess prosthetic use by upper extremity amputees, and their difficulties with prostheses in activities of daily living and occupations. METHOD: This study is based on a survey of 307 subjects, who were using prostheses manufactured in the Center of Prosthetics and Orthotics. The survey questionnaire included items about general demographic characteristics, side and level of amputation, type of prosthesis and its use, and difficulties in the activities of daily living, employment and driving...
December 2011: Annals of Rehabilitation Medicine
B Grüttner, G Frohnauer, R Burgkart
Whereas passive prostheses are fitted onto the patient after the amputation of an arm, hand or finger and are mostly cosmetic in function, active prostheses have much more potential. They can transform the movements of other body regions to movement in the artificial limb. Belts or harnesses, for example, effect the direct transfer of the power from the muscle to the prosthesis. The range of movement possible depends upon the level of the amputation, the length of the residual limb, the age of the patient, his body build and fitness...
June 24, 2004: MMW Fortschritte der Medizin
J H Davidson, L E Jones, J Cornet, T Cittarelli
ISSUE: Multiple limb amputations involving at least one upper extremity are very uncommon. The amputation of both an upper and lower limb is even more uncommon. Due to the rarity of these amputations therapists are uncertain regarding the most appropriate treatment methods. While the majority of the protocols used for single limb amputations are appropriate for these multiple limb amputees, there are differences. Loss of multiple limbs creates a problem of overheating for the individual...
September 10, 2002: Disability and Rehabilitation
T Verrall, J R Kulkarni
The advice given to upper limb amputees in the United Kingdom with regard to the use of driving appliances has often been somewhat variable. At best a full rehabilitation package has been provided, including the fitting of the appliances to the person's vehicle and contact with the driver's instructor, to the other extreme of issuing driving appliances to patients with no instruction at all. Though upper limb amputations are not a relevant or prospective disability, all drivers with a "limb disability" are legally required, in the UK, to declare changes in their physical state to the Driver and Vehicle Licensing Agency...
August 1995: Prosthetics and Orthotics International
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