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find Keyword "手功能" 5 results
  • SURGICAL TREATMENT OF CONGENITAL TYPE V THUMB SYNDACTYLY

    ObjectiveTo study the effectiveness of surgical treatment of congenital type V thumb syndactyly. MethodsBetween March 2010 and May 2015, 12 cases of congenital type V thumb syndactyly were treated. There were 7 males and 5 females, aged from 1 to 25 years (mean, 8 years). The right thumb was involved in 8 cases, and the left thumb in 4 cases. There were 2 cases of radial type, and 10 cases of ulnar type. The basement of polydactylism was far away from the carpometacarpal joint in 7 cases, and was close to the carpometacarpal joint in 5 cases (slight ulnar deviation in 1 case). X-ray films showed that the main first thumb metacarpal bone and trapezium fitted well, and 2 cases had the first metacarpal bone deformity. Preoperative individualized treatment plan was made, and polydactylism was excised by the "S" or "Z" incision and simultaneous reconstruction of thenar muscle insertions or adductor muscle insertions was performed; if necessary, wedge osteotomy was used for correction. ResultsAll incisions healed by first intention with no complication. All cases were followed up 6 to 24 months (mean, 12 months). The thumb appearance, flexion and extension, the function of opposition, abduction function were improved significantly in 11 cases with no scar contracture deformity, small first web space, and deviation deformity. One case had slightly narrow first web space. According to hand function criterion, the results were excellent in 10 cases, good in 1 case, poor in 1 case; excellent and good rate was 91.7%. ConclusionBased on the condition of the type V thumb syndactyly, the individualized treatment plan is made, which can better restore the shape and function of the thumb.

    Release date:2016-10-02 04:55 Export PDF Favorites Scan
  • Hand function reconstruction by tendon transfers in patients with cervical spinal cord injury

    ObjectiveTo explore the effectiveness of functional reconstruction of hand grasp and pinch by tendon transfers in patients with cervical spinal cord injury.MethodsBetween July 2013 and January 2016, tendon transfer surgery were performed in 21 patients (41 hands) with cervical spinal injury that motion level was located at C6 to reconstruct hand grasp and pinch function. There were 18 males and 3 females with a mean age of 42.3 years (range, 17-65 years). Nineteen patients were with complete spinal cord injury [American Spinal Injury Association (ASIA) grading A], 1 patient was with central cord syndrome whose bilateral hands were completely paralyzed and lower limbs were normal (ASIA grading D), and 1 patient was with cervical spondylotic myelopathy (AISA grading D). The time from injury to hospitalization was 12-22 months (mean, 16.8 months). According to the International classification of surgery of the hand in tetraplegia (ICSHT), there were 6 cases of grade O3, 10 of grade O4, 3 of grade OCu5, and 2 of grade O5. The surgery was divided into two stages with an interval of 6-11 months. At the first stage, grip function was reconstructed in all patients by transfering the extensor carpi radialis longus from radialis side to palmar side through subcutaneous tunnel, and braided and sutured with the flexor pollicis longus and flexor digitorum profundus. At the second stage, the lateral pinch function of the thumb and index finger was reconstructed by braiding and suturing the radial half of the extensor carpi ulnaris (the patients graded as ICSHT O3) or pronator tere (the patients graded above ICSHT O3) with extensor pollicis longus and abductor pollicis longus. The grasp force, the thumb and index finger lateral pinch force, and the maximum fingertips distance between the thumb and index finger were measured at preoperation and at different time points after operation. The modified Lamb and Chan questionnaire, based upon the activities of daily living, was used to evaluate the hand function of all patients at 6 months after sencond stage surgery.ResultsThere was 1 patient with elbow skin lesion, 1 patient with wrist stiffness; both of them recovered after corresponding treatment. All the 21 patients were followed up 15-32 months (mean, 19.6 months) without wound infection, tendon adhesion, tendon rupture, and other complications. The grasp forces of all patients were significantly improved at 4 weeks, 3 months, 6 months, and 1 year after the first stage surgery when compared with preoperative value (P<0.05); and no significant difference was found between different time points after operation (P>0.05). The thumb and index finger lateral pinch force and the maximum fingertips distance between the thumb and index finger of all patients were also significantly improved at 4 weeks, 3 months, 6 months, and 1 year after the second stage surgery when compared with preoperative values (P<0.05); and no significant difference was found between different time points after operation (P>0.05). And there was no significant difference of above indexes between the patients graded as ICSHT O3 and above ICSHT O3 (P>0.05). The functional outcome was good in 19 cases, fair in 1 case, and poor in 1 case according to modified Lamb and Chan questionnaire at 6 months after second stage surgery.ConclusionTendon transfer can significantly improve the hand function and the quality of life of the patients with complete cervical spinal cord injury.

    Release date:2018-05-02 02:41 Export PDF Favorites Scan
  • Review of comprehensive intervention by hand rehabilitation robot after stroke

    Using intelligent rehabilitation robot to intervene hand function after stroke is an important physical treatment. With the development of biomedical engineering and the improvement of clinical demand, the comprehensive intervention of hand-function rehabilitation robot combined with new technologies is gradually emerging. This article summarizes the hand rehabilitation robots based on electromyogram (EMG), the brain-computer interface (BCI) hand rehabilitation robots, the somatosensory hand rehabilitation robots and the hand rehabilitation robots with functional electrostimulation. The advantages and disadvantages of various intervention methods are discussed, and the research trend about comprehensive intervention of hand rehabilitation robot is analyzed.

    Release date:2019-02-18 03:16 Export PDF Favorites Scan
  • 完全清醒无止血带局部麻醉技术在手外科手术中的应用

    目的总结完全清醒无止血带局部麻醉技术(wide awake local anesthesia no tourniquet,WALANT)在手外科手术中的应用效果。方法 2021年4月—10月,采用WALANT为28例手外伤患者实施麻醉并手术。男18例,女10例,年龄15~55岁,平均35岁。急诊手术22例,择期手术6例。骨折切开复位内固定术5例,骨折内固定物取出术l例,肌腱探查断裂修复术18例,肌腱粘连松解术4例。采用疼痛视觉模拟评分(VAS)评估疼痛情况,术中观察出血情况,术后观察麻醉维持时间、手指血供变化及有无并发症发生,采用主动运动总和法(TAM)评定手部功能。结果 术中麻醉与止血效果满意,患者未诉疼痛。第1针刺入皮肤时VAS评分为2~4分;术中操作未引起明显疼痛,VAS评分为0~1分;麻醉效果可持续6~8 h,VAS评分为2~6分。术后手术区域麻醉效果逐渐消失后,所有患者口服或静脉滴注非甾体止痛药能有效缓解疼痛。术后24 h内患者无头痛、头晕、恶心、呕吐、乏力、皮疹等药物不良反应,术后8 h手指皮温及毛细血管反应同正常手指。术后未出现血运障碍等麻醉不良反应。28例患者均获随访,随访时间6~12个月,平均8个月。末次随访时TAM评定获优20例、良8例。结论手外科手术中应用WALANT止痛和止血效果良好、操作简单、安全有效,术中能即刻观察手术效果。

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  • Virtual reality-brain computer interface hand function enhancement rehabilitation system incorporating multi-sensory stimulation

    Stroke is an acute cerebrovascular disease in which sudden interruption of blood supply to the brain or rupture of cerebral blood vessels cause damage to brain cells and consequently impair the patient's motor and cognitive abilities. A novel rehabilitation training model integrating brain-computer interface (BCI) and virtual reality (VR) not only promotes the functional activation of brain networks, but also provides immersive and interesting contextual feedback for patients. In this paper, we designed a hand rehabilitation training system integrating multi-sensory stimulation feedback, BCI and VR, which guides patients' motor imaginations through the tasks of the virtual scene, acquires patients' motor intentions, and then carries out human-computer interactions under the virtual scene. At the same time, haptic feedback is incorporated to further increase the patients' proprioceptive sensations, so as to realize the hand function rehabilitation training based on the multi-sensory stimulation feedback of vision, hearing, and haptic senses. In this study, we compared and analyzed the differences in power spectral density of different frequency bands within the EEG signal data before and after the incorporation of haptic feedback, and found that the motor brain area was significantly activated after the incorporation of haptic feedback, and the power spectral density of the motor brain area was significantly increased in the high gamma frequency band. The results of this study indicate that the rehabilitation training of patients with the VR-BCI hand function enhancement rehabilitation system incorporating multi-sensory stimulation can accelerate the two-way facilitation of sensory and motor conduction pathways, thus accelerating the rehabilitation process.

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