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https://www.readbyqxmd.com/read/27824734/targeted-muscle-reinnervation-for-transradial-amputation-description-of-operative-technique
#1
Emily N Morgan, Benjamin Kyle Potter, Jason M Souza, Scott M Tintle, George P Nanos
Targeted muscle reinnervation (TMR) is a revolutionary surgical technique that, together with advances in upper extremity prostheses and advanced neuromuscular pattern recognition, allows intuitive and coordinated control in multiple planes of motion for shoulder disarticulation and transhumeral amputees. TMR also may provide improvement in neuroma-related pain and may represent an opportunity for sensory reinnervation as advances in prostheses and haptic feedback progress. Although most commonly utilized following shoulder disarticulation and transhumeral amputations, TMR techniques also represent an exciting opportunity for improvement in integrated prosthesis control and neuroma-related pain improvement in patients with transradial amputations...
December 2016: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/27638013/attachment-of-upper-arm-prostheses-with-a-subcutaneous-osseointegrated-implant-in-transhumeral-amputees
#2
Stefan Salminger, Andreas Gradischar, Richard Skiera, Aidan D Roche, Agnes Sturma, Christian Hofer, Oskar C Aszmann
BACKGROUND: The stump-socket interface is of utmost importance for prosthetic function in transhumeral amputees. Stability of this connection may be improved using a newly designed subcutaneous implant. OBJECTIVES: The purpose was to determine the effect of the implant together with customized socket designs on the range of motion of the shoulder and the prosthetic function compared to conventional fitting. STUDY DESIGN: Case series. METHODS: The range of motion was measured with scaled metrics and the prosthetic function evaluated with the Southampton Hand Assessment Procedure and the Box and Block Test...
September 16, 2016: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/27534547/improving-arm-function-by-prosthetic-limb-replacement-in-a-patient-with-severe-arthrogryposis-multiplex-congenita
#3
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
https://www.readbyqxmd.com/read/27166714/an-anthropomorphic-transhumeral-prosthesis-socket-developed-based-on-an-oscillometric-pump-and-controlled-by-force-sensitive-resistor-pressure-signals
#4
N A Abd Razak, H Gholizadeh, N Hasnan, N A Abu Osman, S S Mohd Fadzil, N A Hashim
While considering the importance of the interface between amputees and prosthesis sockets, we study an anthropomorphic prosthesis socket whose size can be dynamically changed according to the requirements of the residual limb. First, we introduce the structure and function of the anthropomorphic prosthesis socket. Second, we study the dynamic model of the prosthesis system and analyze the dynamic characteristics of the prosthesis socket system, the inputs of an oscillometric pump, and the control mechanism of force-sensitive resistor (FSR) pressure signals...
May 11, 2016: Biomedizinische Technik. Biomedical Engineering
https://www.readbyqxmd.com/read/27164596/classification-of-phantom-finger-hand-wrist-and-elbow-voluntary-gestures-in-transhumeral-amputees-with-semg
#5
Nathanael Jarrasse, Caroline Nicol, Amelie Touillet, Florian Richer, Noel Martinet, Jean Paysant, Jozina Bernardina De Graaf
Decoding finger and hand movements from sEMG electrodes placed on the forearm of transradial amputees has been commonly studied by many research groups. A few recent studies have shown an interesting phenomenon: simple correlations between distal phantom finger, hand and wrist voluntary movements and muscle activity in the residual upper arm in transhumeral amputees, i.e., of muscle groups that, prior to amputation, had no physical effect on the concerned hand and wrist joints. In this study, we are going further into the exploration of this phenomenon by setting up an evaluation study of phantom finger, hand, wrist and elbow (if present) movement classification based on the analysis of surface electromyographic (sEMG) signals measured by multiple electrodes placed on the residual upper arm of 5 transhumeral amputees with a controllable phantom limb who did not undergo any reinnervation surgery...
May 4, 2016: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/26992713/-periprosthetic-humeral-fractures-strategies-and-techniques-of-revision-arthroplasty
#6
C Kirchhoff, M Beirer, U Brunner
The primary aims when performing revision arthroplasty of periprosthetic humeral fractures (PHF) are preservation of bone stock, achieving fracture healing and preserving a stable prosthesis with the focus on regaining the preoperative shoulder-arm function. The indications for revision arthroplasty are given in PHF in combination with loosening of the stem. In addition, further factors must be independently clarified in the case of an anatomical arthroplasty. In this context secondary glenoid erosion as well as rotator cuff insufficiency are potential factors for an extended revision procedure...
April 2016: Der Unfallchirurg
https://www.readbyqxmd.com/read/26932982/cutaneous-sensory-outcomes-from-three-transhumeral-targeted-reinnervation-cases
#7
Jacqueline S Hebert, K Ming Chan, Michael R Dawson
BACKGROUND: Although targeted muscle reinnervation has been shown to be effective in enhancing prosthetic control for upper limb amputees, restored hand sensations have been variable. An understanding of possible sensory feedback channels is crucial in working toward more effective closed-loop prosthetic control. OBJECTIVES: To compare sensory outcomes of different targeted sensory reinnervation approaches. STUDY DESIGN: Case series, cross-sectional, and retrospective...
June 2016: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/26780786/control-of-a-robotic-hand-using-a-tongue-control-system-a-prosthesis-application
#8
Daniel Johansen, Christian Cipriani, Dejan B Popovic, Lotte N S A Struijk
OBJECTIVE: The aim of this study was to investigate the feasibility of using an inductive tongue control system (ITCS) for controlling robotic/prosthetic hands and arms. METHODS: This study presents a novel dual modal control scheme for multigrasp robotic hands combining standard electromyogram (EMG) with the ITCS. The performance of the ITCS control scheme was evaluated in a comparative study. Ten healthy subjects used both the ITCS control scheme and a conventional EMG control scheme to complete grasping exercises with the IH1 Azzurra robotic hand implementing five grasps...
July 2016: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/26737044/phantom-movements-from-physiologically-inappropriate-muscles-a-case-study-with-a-high-transhumeral-amputee
#9
Julie Gade, Rosa Hugosdottir, Ernest N Kamavuako
Individuals with high-level amputation have a great need for functional prostheses because of their vast functional deficits. Conventional techniques are considered inappropriate for high-level amputees due to the lack of physiologically appropriate muscles. This study investigates how accurate phantom movements (PMs) can be classified from physiologically inappropriate muscles. The study involves a case study of a 42-year-old transhumeral amputee. Suitable PMs and best electrode configuration were identified using the sequential forward selection method and brute-force technique...
August 2015: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/26314220/targeted-muscle-reinnervation-in-the-upper-extremity-amputee-a-technical-roadmap
#10
REVIEW
Michael S Gart, Jason M Souza, Gregory A Dumanian
Targeted muscle reinnervation (TMR) offers the potential for improved prosthetic function by reclaiming the neural control information that is lost as a result of upper extremity amputation. In addition to the prosthetic control benefits, TMR is a potential treatment for postamputation neuroma pain. Here, we present our surgical technique for TMR nerve transfers in transhumeral and shoulder disarticulation patients.
September 2015: Journal of Hand Surgery
https://www.readbyqxmd.com/read/26190031/feasibility-of-using-combined-emg-and-kinematic-signals-for-prosthesis-control-a-simulation-study-using-a-virtual-reality-environment
#11
Dimitra Blana, Theocharis Kyriacou, Joris M Lambrecht, Edward K Chadwick
Transhumeral amputation has a significant effect on a person's independence and quality of life. Myoelectric prostheses have the potential to restore upper limb function, however their use is currently limited due to lack of intuitive and natural control of multiple degrees of freedom. The goal of this study was to evaluate a novel transhumeral prosthesis controller that uses a combination of kinematic and electromyographic (EMG) signals recorded from the person's proximal humerus. Specifically, we trained a time-delayed artificial neural network to predict elbow flexion/extension and forearm pronation/supination from six proximal EMG signals, and humeral angular velocity and linear acceleration...
August 2016: Journal of Electromyography and Kinesiology
https://www.readbyqxmd.com/read/26188784/transhumeral-portal-for-arthroscopic-glenohumeral-resurfacing-procedures-a-cadaveric-study-of-the-safety-and-accuracy
#12
Kimberly A Bartosiak, Joseph A Gil, Brittany Kaim Degreef, Gregory J Barton, Steven C Chudik
PURPOSE: To evaluate the safety and accuracy of a transhumeral portal to arthroscopically access and prepare the glenohumeral articular surface without subscapularis transection or glenohumeral dislocation. METHODS: In 10 fresh-frozen cadaveric shoulders, we used a transhumeral portal and an anterior mini-open rotator interval exposure to arthroscopically prepare the humeral and glenoid articular surfaces. To evaluate our technique, we measured the distance from the portal to the branches of the axillary nerve and the biceps groove on the humeral extra-articular surface, the angle of trajectory of the portal through the humerus, and the accuracy of targeting the center-center of the humeral and glenoid surfaces...
November 2015: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/26185472/designing-and-testing-lightweight-shoulder-prostheses-with-hybrid-actuators-for-movements-involved-in-typical-activities-of-daily-living-and-impact-absorption
#13
Masashi Sekine, Kahori Kita, Wenwei Yu
Unlike forearm amputees, transhumeral amputees have residual stumps that are too small to provide a sufficient range of operation for their prosthetic parts to perform usual activities of daily living. Furthermore, it is difficult for small residual stumps to provide sufficient impact absorption for safe manipulation in daily living, as intact arms do. Therefore, substitution of upper limb function in transhumeral amputees requires a sufficient range of motion and sufficient viscoelasticity for shoulder prostheses under critical weight and dimension constraints...
2015: Medical Devices: Evidence and Research
https://www.readbyqxmd.com/read/25917956/life-without-limbs-technology-to-the-rescue
#14
Deirdre M Cooke, Matthew Ames, Saul Geffen
BACKGROUND: This article reports a rare and inspirational case of a four-limb amputee, the range of integrated technology solutions that enable him to be a productive member of his family and the process and pitfalls of seeking technology solutions. CASE DESCRIPTION AND METHODS: A complex case of bilateral transhumeral amputation and bilateral transfemoral amputation with residual upper limbs too short to oppose is presented. The multiple 'high-tech' and 'low-tech' devices used on a daily basis to move around his house and community, control his environment, communicate and feed himself without the use of limbs, prostheses or a second person are outlined...
August 2016: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/25685105/targeted-muscle-reinnervation-and-advanced-prosthetic-arms
#15
Jennifer E Cheesborough, Lauren H Smith, Todd A Kuiken, Gregory A Dumanian
Targeted muscle reinnervation (TMR) is a surgical procedure used to improve the control of upper limb prostheses. Residual nerves from the amputated limb are transferred to reinnervate new muscle targets that have otherwise lost their function. These reinnervated muscles then serve as biological amplifiers of the amputated nerve motor signals, allowing for more intuitive control of advanced prosthetic arms. Here the authors provide a review of surgical techniques for TMR in patients with either transhumeral or shoulder disarticulation amputations...
February 2015: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/25498535/-cross-hand-replantation-in-bilateral-upper-limb-amputation-an-anatomical-emergency
#16
A Andre, M Rongieres, J-M Laffosse, R Pailhe, F Lauwers, J-L Grolleau
Bilateral amputations of upper limbs are excessively rare clinical situations. We report an exceptional clinical case of bilateral amputation of upper limbs at different levels: destruction of the right hand and left transhumeral amputation in a patient after an attempted suicide on train lines. This special situation led us to perform a cross-hand replantation of the left hand to the right forearm. Only 4 other similar cases have been published in the literature. Once the surgical indication had been formulated collectively, and taking into account all the ethical issues surrounding such a decision, we had to solve the issue of inverting anatomical structures in emergency...
August 2015: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/25440851/reconstruction-of-transhumeral-amputation-stumps-with-ipsilateral-pedicled-latissimus-dorsi-myocutaneous-flap-in-high-voltage-electrical-burns
#17
Erol Kesiktas, Cengiz Eser, Eyuphan Gencel, Emrah Efe Aslaner, Metin Yavuz
Injury due to high-voltage (>1000V) electricity is one of the most challenging problems in emergency medicine and plastic surgery. Extremity amputation because of electrical injury yields a stump that leaves vital structures, such as bone, muscle, blood vessels, and nerves, exposed; these structures should be covered with appropriate tissue. We designed a retrospective study that included twelve patients with a high-voltage electrical injury followed by trans-humeral amputation who were evaluated between 2004 and 2013...
March 2015: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/25425411/comparison-of-transhumeral-socket-designs-utilizing-patient-assessment-and-in-vivo-skeletal-and-socket-motion-tracking-a-case-study
#18
Linda Resnik, Tarpit Patel, Shane G Cooney, Joseph J Crisco, Christopher Fantini
PURPOSE: This case study compares the impact of two prosthetic socket designs, a "traditional" transhumeral (TH) socket design and a Compression Released Stabilized (CRS) socket. METHODS: A CRS socket was compared to the existing socket of two persons with transhumeral amputation. Comparisons included assessments of patient comfort and satisfaction with fit, as well as dynamic kinematic assessment using a novel high-speed, high-resolution, bi-plane video radiography system (XROMM, for X-ray Reconstruction of Moving Morphology)...
2016: Disability and Rehabilitation. Assistive Technology
https://www.readbyqxmd.com/read/25357185/design-and-evaluation-of-prosthetic-shoulder-controller
#19
Joseph E Barton, John D Sorkin
We developed a 2-degree-of-freedom (DOF) shoulder position transducer (sensing shoulder protraction-retraction and elevation-depression) that can be used to control two of a powered prosthetic humerus' DOFs. We also developed an evaluation protocol based on Fitts' law to assess the performance of our device. The primary motivation for this work was to support development of powered prosthetic shoulder joints of a new generation of prosthetic arms for people with shoulder disarticulation and very high-level transhumeral amputation...
2014: Journal of Rehabilitation Research and Development
https://www.readbyqxmd.com/read/25300990/comparison-of-transposition-techniques-to-reduce-gap-associated-with-high-ulnar-nerve-lesions
#20
COMPARATIVE STUDY
Imran K Choudhry, Daniel N Bracey, Ian D Hutchinson, Zhongyu Li
PURPOSE: To determine in a cadaveric model which of 3 anterior transposition techniques allows for maximum gap reduction for high ulnar nerve lesions. METHODS: Six fresh-frozen human adult upper extremity cadaveric transhumeral specimens were used. We anchored the ulnar nerve to bone 10 cm proximal and distal to the medial epicondyle along its exact course while keeping the elbow in 30° flexion as the baseline measurement. We then used a thick suture to mimic and measure the exact course of the nerve between the pins in varying elbow positions...
December 2014: Journal of Hand Surgery
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