Relevant bibliographies by topics / Joints; Thumb

Academic literature on the topic 'Joints; Thumb'

Author: Grafiati
Published: 10 December 2022
Last updated: 28 January 2023

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Journal articles on the topic "Joints; Thumb"

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Tonogai, Ichiro, Yoshitaka Hamada, and Naohito Hibino. "EVALUATION OF THE FIRST METACARPAL PROXIMAL FACET INCLINATION AS A PROGNOSTIC PREDICTOR FOLLOWING ARTHROPLASTY FOR OSTEOARTHRITIS OF THE THUMB CARPOMETACARPAL JOINT." Hand Surgery 18, no. 01 (January 2013): 69–72. http://dx.doi.org/10.1142/s0218810413500135.

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We have retrospectively reviewed 17 thumbs in 16 patients with osteoarthritis of the thumb carpometacarpal joints, for which arthroplasty was performed using Kaarela's method. Postoperatively, three thumbs in two patients had poor outcomes; both patients had a sharp slope of the base of the first metacarpal. Serial radiographic measurements suggested that this sharp slope affected the adducted position of the first metacarpal, and led to the appearance of a metacarpophalangeal joint hyperextension deformity of the thumb. This radiological finding could be a prognostic predictor after surgery for osteoarthritis of the thumb carpometacarpal joint.
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Wang, Kun, Fangxin Ai, Pan Zhou, Zhiwei Liu, Zhenbing Chen, and Jianghai Chen. "Opening wedge phalangeal osteotomy for correction of Wassel type IV-D thumb duplication." Handchirurgie · Mikrochirurgie · Plastische Chirurgie 52, no. 02 (October 9, 2019): 147–50. http://dx.doi.org/10.1055/a-0893-6659.

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Abstract Background Thumb duplication is one of common anomalies of the hand. Among of Wassel type IV subtypes, type IV-D duplication with a zigzag deformity is most challenging for reconstructing. Several factors may affect the surgical outcomes. This study aimed to present an opening wedge osteotomy at proximal phalangeal neck for treating type IV-D duplication. Methods Data from 14 patients are presented in this study. Eight patients had duplication of the right thumb, and six left thumb. After removal of radial supernumerary thumb, a snug collateral ligament was repaired to correct angular deformity of metacarpophalangeal joint (MCP). Angular deformity of the interphalangeal (IP) joint was corrected by an opening wedge osteotomy at the proximal phalangeal neck. A wedge bone from ablated thumb was grafted to correct the malalignment. IP joint was further stabilized by plication of the ulnar capsule. The relocation of radial part of FPL to the center of distal phalangeal base by use of pull-out suture technique Results After surgery, the angulations of the IP joints and the MCP joints were improved. Bone union was observed in all patients. According to the Japanese Society for Surgery of the Hand evaluation form, twelve cases were rated good, 2 cases fair. Stability of IP and MCP joints was good in all cases. The active ROM of IP was less in residual thumb than in normal thumb. Small nails were observed in some patients. Conclusions Although the reconstructed thumbs were smaller than normal counterparts, they were aligned and with stable joints. The opening wedge osteotomy at proximal phalangeal neck could improve realignment of IP joint and prevent reoccurrence of deformity over time.
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JENKINS, M., H. B. BAMBERGER, L. BLACK, and R. NOWINSKI. "Thumb Joint Flexion." Journal of Hand Surgery 23, no. 6 (December 1998): 796–97. http://dx.doi.org/10.1016/s0266-7681(98)80100-9.

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The purpose of this study was to measure the amount of active flexion from a neutral position in normal thumb metacarpophalangeal and interphalangeal joints and compare the results with previously published reports. One hundred and nineteen subjects (238 thumbs) volunteered to have active flexion of the metacarpophalangeal (MP) and interphalangeal (IP) joints of the thumb measured with a computerized Greenleaf goniometer by a certified hand therapist. The mean MP flexion was 59° and IP flexion was 67°. The results of this study suggest that the accepted normal values of thumb flexion should be reconsidered, particularly as a guide for determining impairment.
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Minami, Akio, Norimasa Iwasaki, Keiji Kutsumi, Naoki Suenaga, and Kazunori Yasuda. "A LONG-TERM FOLLOW-UP OF SILICONE-RUBBER INTERPOSITION ARTHROPLASTY FOR OSTEOARTHRITIS OF THE THUMB CARPOMETACARPAL JOINT." Hand Surgery 10, no. 01 (July 2005): 77–82. http://dx.doi.org/10.1142/s0218810405002607.

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There are several surgical options for osteoarthritis (OA) of the thumb carpometacarpal (CMC) joint. This paper presents our long-term clinical and radiographic review of 12 thumbs in ten patients treated by partial trapezial excision and silicone-rubber interposition arthroplasty. The follow-up period averaged 15; three years with a ten-year minimum. Although the procedure provided early pain relief in most thumbs, all but two had mild to severe pain at follow-up. The average range of post-operative palmar abduction was 23°. The average post-operative grip strength was 9.5 kg. Both tip and key pinch between thumb and index finger averaged about 50% that of normal subjects. Dislocation of the implant occurred in two joints and breakages in five. Bony erosions around the implant, which we attributed silicone synovitis, were found in four thumbs. The indications for silicone-rubber interposition arthroplasty for OA of the thumb CMC joint should be severely restricted as these produced unsatisfactory long-term results.
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Sasaki, Shuichi. "The development of the Kitasato thumb splint as a conservative therapy treatment for patients with thumb carpometacarpal (CMC) arthropathy." Impact 2021, no. 8 (October 28, 2021): 64–66. http://dx.doi.org/10.21820/23987073.2021.8.64.

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Orthoses are devices that are applied externally to help in the rehabilitation of specific bones or joints. Dr Shuichi Sasaki, Department of Rehabilitation, Kitasato University Hospital, Japan, and his team is working to develop a new orthosis for repatriating thumb arthropathies called the Kitasato thumb splint. It is designed to improve usability of the thumb joint, especially in cases of thumb carpometacarpal (CMC) arthropathy, by taking into consideration the thumb CMC joint structure. It exerts force at the base of the CMC joint to move the thumb into the correct joint alignment, improving symptoms for patients. With the Kitasato thumb splint, Sasaki and the team are also eager to provide patients with an alternative to surgery as they believe that the use of more conservative measures with orthoses can prove effective and also prevent costly surgery. The Kitasato thumb splint is made of a low-temperature thermoplastic knit material and can be assembled in as little as 10 minutes, quickly and conveniently providing patients with additional support during painful daily tasks. In his work, Sasaki and the team are looking at orthoses used to treat thumb CMC osteoarthritis and analysing the pressure on CMC joints using quantitative analysis. So far, the Kitasato thumb splint has been found to help in pain reduction and improvements in the activities of daily living in patients with mild cases (Eaton Classifications I to II) of thumb CMC joints and to also provide some improvement in severe cases (Eaton Classifications III-IV).
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Kodama, Akira, Hiroshi Kurumadani, Teruyasu Tanaka, Rikuo Shinomiya, Toru Sunagawa, and Nobuo Adachi. "Three-dimensional analysis of thumb motion recovery after carpal tunnel release." Journal of Hand Surgery (European Volume) 46, no. 7 (May 9, 2021): 743–48. http://dx.doi.org/10.1177/17531934211014700.

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This study quantified recovery of thumb motion in patients with carpal tunnel syndrome after carpal tunnel release using three-dimensional motion analysis with a retroreflective surface-based marker method. Eighteen hands from 14 patients who underwent carpal tunnel release for idiopathic carpal tunnel syndrome were included. The angular movements of the three joints of the thumb, the path length of the thumb tip and the area enclosed by the perimeter path of the thumb tip were measured during circumduction. The range of joint movement, including abduction/adduction of the trapeziometacarpal joint, and flexion/extension of the interphalangeal and metacarpophalangeal joints and the path length of the thumb tips, improved significantly 1 year after surgery. The quantification of thumb kinematics helps to better understand motor dysfunction in carpal tunnel syndrome, assess the severity of the condition and decide on treatment. Level of evidence: IV
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Jarque-Bou, Néstor J., Margarita Vergara, and Joaquín L. Sancho-Bru. "Estimation of the Abduction/Adduction Movement of the Metacarpophalangeal Joint of the Thumb." Applied Sciences 11, no. 7 (April 1, 2021): 3158. http://dx.doi.org/10.3390/app11073158.

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Thumb opposition is essential for grasping, and involves the flexion and abduction of the carpometacarpal and metacarpophalangeal joints of the thumb. The high number of degrees of freedom of the thumb in a fairly small space makes the in vivo recording of its kinematics a challenging task. For this reason, along with the very limited independence of the abduction movement of the metacarpophalangeal joint, many devices do not implement sensors to measure such movement, which may lead to important implications in terms of the accuracy of thumb models. The aims of this work are to examine the correlation between thumb joints and to obtain an equation that allows thumb metacarpophalangeal abduction/adduction movement to be estimated from the other joint motions of the thumb, during the commonest grasps used during activities of daily living and in free movement. The correlation analysis shows that metacarpophalangeal abduction/adduction movement can be expressed mainly from carpometacarpal joint movements. The model thus obtained presents a low estimation error (6.29°), with no significant differences between grasps. The results could benefit most fields that do not typically include this joint movement, such as virtual reality, teleoperation, 3D modeling, prostheses, and exoskeletons.
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Yonekura, Satoru, Hiroyoshi Hagiwara, Takahiro Nishimura, Hiroshi Amagai, Mayu Yamamura, Osamu Miyamoto, and Sueo Nakama. "Synovial Osteochondromatosis at the Carpometacarpal Joint of the Thumb." Case Reports in Orthopedics 2017 (2017): 1–3. http://dx.doi.org/10.1155/2017/3974342.

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Synovial osteochondromatosis (SOC) is a benign tumor characterized by synovial connective tissue metaplasia. SOC commonly affects major joints including the knee followed by the hip, elbow, and wrist. SOC cases in the hand are not reported as often as SOC of major joints. Particularly SOC of the carpometacarpal joint of the thumb is rare. We report on a 57-year-old female with primary SOC of the carpometacarpal joint of her left thumb. Surgical excision was performed and the patient had no symptoms with full range of motion of her left thumb. At 3 years of follow-up, there was no recurrence.
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Kurumadani, Hiroshi, Kazuya Kurauchi, Shota Date, Yosuke Ishii, and Toru Sunagawa. "Effect of the position of the interphalangeal joint on movements of the trapeziometacarpal joint during thumb opposition." Journal of Hand Surgery (European Volume) 47, no. 5 (January 8, 2022): 495–500. http://dx.doi.org/10.1177/17531934211065879.

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The Kapandji test is a simple method to score thumb opposition; however, the position of the interphalangeal joint of the thumb during this test has not been described. We aimed to quantitatively examine the effect of the thumb interphalangeal joint position on movements of the trapeziometacarpal joint during thumb opposition using the Kapandji test. The Kapandji test was carried out in 20 healthy participants during thumb interphalangeal joint extension and flexion. Movements of the joints and the activity of thenar muscles were recorded using motion capture and electromyography, respectively. We found that interphalangeal joint extension increased the trapeziometacarpal joint movement and thenar muscle activity compared with interphalangeal joint flexion, which contributed to thumb opposition at Kapandji Positions 0–6. These findings suggest the position of the thumb interphalangeal joint affects the trapeziometacarpal joint during thumb opposition, and assessment of thumb opposition using the Kapandji test is best done with the thumb interphalangeal joint in extension.
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Grinyagin, I. V., E. V. Biryukova, and M. A. Maier. "Kinematic and Dynamic Synergies of Human Precision-Grip Movements." Journal of Neurophysiology 94, no. 4 (October 2005): 2284–94. http://dx.doi.org/10.1152/jn.01310.2004.

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We analyzed the adaptability of human thumb and index finger movement kinematics and dynamics to variations of precision grip aperture and movement velocity. Six subjects performed precision grip opening and closing movements under different conditions of movement velocity and movement aperture (thumb and index finger tip-to-tip distance). Angular motion of the thumb and index finger joints was recorded with a CyberGlove and a three-dimensional biomechanical model was used for solving the inverse dynamics problem during precision grip movements, i.e., for calculating joint torques from experimentally obtained angular variations. The time-varying joint angles and joint torques were analyzed by principal-component analysis to quantify the contributions of individual joints in kinematic and dynamic synergies. At the level of movement kinematics, we found subject-specific angular contributions. However, the adaptation to large aperture, achieved by an increase of the relative contribution of the proximal joints, was subject-invariant. At the level of movement dynamics, the adaptation of thumb-index finger movements to task constraints was similar among all subjects and required the linear scaling of joint torques, the synchronization of joint torques under high velocity conditions, and a flexible redistribution of joint torques between the proximal joint of the thumb and that of the index finger. This work represents one of the first attempts at calculating the joint torques during human precision-grip movements and indicates that the dynamic synergies seem to be remarkably simple compared with the synergies found for movement kinematics.
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Dissertations / Theses on the topic "Joints; Thumb"

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Mak, Suk-han Anna. "Thumb base joints : comparison between standard and special radiographic projections /." Hong Kong : University of Hong Kong, 1999. http://sunzi.lib.hku.hk/hkuto/record.jsp?B22079142.

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麥淑嫻 and Suk-han Anna Mak. "Thumb base joints: comparison between standard and special radiographic projections." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1999. http://hub.hku.hk/bib/B31223187.

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Wajon, Anne. "Prevention And Management Of Trapeziometacarpal Joint Pain." University of Sydney, 2005. http://hdl.handle.net/2123/918.

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Doctor of Philosophy
The aim of the studies reported in this project was to examine factors associated with the prevention and management of trapeziometacarpal osteoarthritis, both in musculoskeletal physiotherapists and the general patient population. Two studies were undertaken to investigate factors associated with the aggravation of thumb pain in musculoskeletal physiotherapists. Study 1 was a survey of the prevalence of thumb pain, and allowed determination of the most aggravating spinal manipulative therapy technique. It identified that 83% of respondents complained of an aggravation of thumb pain due to the performance of spinal manipulative therapy techniques, with 85-87% of the painful respondents complaining of thumb pain aggravated by unilateral and central PA glides. Study 2 was conducted to determine whether the alignment of the joints of the thumb during performance of these glides was associated with thumb pain. This observational study of 129 musculoskeletal physiotherapists performing a PA glide identified that aligning the metacarpophalangeal and interphalangeal joints in extension was associated with a lower prevalence of work-related thumb pain. Therefore, it is suggested that musculoskeletal physiotherapists be taught to perform these techniques with the joints of their thumb in extension in an effort to reduce the development of work-related thumb pain. Furthermore, it is suggested that those who are unable to maintain this alignment voluntarily be provided with a thermoplastic thumb splint to maintain the extended alignment. Two studies were undertaken to investigate the conservative and surgical management of patients with trapeziometacarpal osteoarthritis. Study 3 was a randomised controlled trial conducted to compare the efficacy of a new thumb strap splint and an abduction exercise regimen against the standard approach to conservative management of trapeziometacarpal osteoarthritis, namely a short opponens splint and pinch exercise regimen. While there was no additional benefit of one approach over the other, all participants improved in the outcomes of pain, strength and hand function over the six-week period of intervention. Nevertheless, some people find that symptom relief from conservative intervention is inadequate and short-lived, requesting surgery for the treatment of disabling and persistent pain from trapeziometacarpal osteoarthritis. Study 4 was a systematic review, conducted to determine evidence of efficacy of one surgical procedure over another. This review identified six randomised controlled trials of surgery for trapeziometacarpal osteoarthritis. While there was evidence of no difference in the reduction in weakness between the procedures, there was insufficient evidence to confirm that there was no difference in the outcomes of pain, contracture, hand function, or patient global assessment. Furthermore, there was sufficient evidence to conclude that trapeziectomy had significantly fewer adverse effects, and trapeziectomy with ligament reconstruction and tendon interposition (LRTI) had significantly more, when compared with the other procedures analysed in this review. It is suggested that the decision as to which intervention is most appropriate for a given patient be based upon the individual patient’s requirements, the extent of disease, and the demands placed upon the joint by domestic duties, work, leisure and recreational activities. The studies presented in this project assist in formulating preventative and management strategies for people with trapeziometacarpal osteoarthritis.
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Sverrisdóttir, Kristín. "Improvements and Validation of THUMS Upper Extremity : Refinements of the Elbow Joint for Improved Biofidelity." Thesis, KTH, Skolan för kemi, bioteknologi och hälsa (CBH), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-261099.

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Introduction One out of five reported motor vehicle collision injuries occur to the upper extremities. Certain parts of The Total HUman Model for Safety (THUMS) lack validation against experimental data, including the elbow. The aim of this project is to refine and validate the elbow joint of THUMS, with focus on anatomical response of the elbow during axial impact applied to the wrist. Methods Internal contacts in the elbow were modified and new contacts assigned between bones and ligaments of the elbow. The posterior part of the radial- and ulnar collateral ligaments, and joint capsule was implemented to the model. Elasticmodulus of the cortical bones of the elbow was increased as well as the shell thickness of the humeral cortical bone. The updated model was validated against an experiment where an axial load was applied to the wrist of a female cadaver. The experimental resultant force in the wrist was then compared with the wrist force obtained from the simulations. Results The correlation between the experimental and simulation resultant wrist force for the updated model resulted in a CORA score of 0.882. This gave a 6.7% higher CORA score compared with the original model. Hourglass energy was reduced from 63.52% of internal energy to 0.78%. Energy ratio and contact energies indicated that the simulation was stable. Discussion Movement of elbow bones was assessed to be more anatomically correct, by accounting for the posterior ligament and elbow capsule support. The contact peak force in the humerus was lower and occurred earlier in the simulation in the updated model compared to the original. This is believed to be due to the reduced gap between the elbow bones after increasing the shell thickness of the humeral cortical bone. The model setup resembled the experiment in a good manner. Conclusion The upper extremity of THUMS was refined for improved biofidelity, with focus on the anatomical response of the elbow joint under an axial impact. However, further model improvements are suggested as well as extended validated against other experimental impact results.
Introduktion En av fem rapporterade krockskador med motorfordon förekommer i de övre extremiteterna. Vissa strukturer hos Total HUman Model for Safety (THUMS) saknar validering gentemot experimentell data, där armbågen är ett av dem. Syftet med detta projekt är att förfina och validera armbågsleden hos THUMS, med fokus på dess anatomiska respons under axiellt islag applicerad på handleden. Metod Interna kontakter i armbågen modifierades och nya kontakter tilldelades mellan ben och ligament. De posteriora delarna av kollateral ligament hos radius och ulna implementerades i modellen, så även armbågens ledkapseln. Elasticitetsmodulen hos de kortikala benen i armbågen höjdes och skalets tjocklek idet humerala kortikala benet utökades. Den uppdaterade modellen validerades mot ett experiment där en axiell belastning hade applicerats mot en kvinnlig kadavers handled. Den resulterande kraften i handleden från experimentet jämfördes sedan med erhållen kraft i handleden från simuleringarna. Resultat Korrelationen mellan den experimentella kraften och simulerade kraften hos den uppdaterade modellen resulterade i ett CORA-poäng på 0,882. Detta är en ökning med 6,7% jämfört med den ursprungliga modellen. Hourglassenergin reducerades från 63,52% av inre energi till 0,78%. Energiförhållandet och kontaktenergier indikerade stabil simulering. Diskussion Rörelsen av armbågens ben bedömdes vara mer anatomiskt korrekt, med hänsyn till stödet från de posteriora ligamentet och armbågens ledkapsel. Den maximala islagskraften i humerus minskade och uppträdde tidigare i simuleringen hos den uppdaterade modellen jämfört med originalet. Detta tros bero på reducerat avstånd mellan armbågens ben genom ökandet av skaltjockleken hos det humeralakortikala benet. Modelluppställningen motsvarade experimentets uppställning. Konklusion De övre extremiteterna av THUMS förfinades i syfte att förbättra biofideliteten. Fokus låg på armbågens anatomiska respons under ett axielltislag. Både ytterligare förbättringar av modellen och utökad validering mot andra experimentella islag rekommenderas.
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Podsedník, Karel. "Biomechanická studie karpometakarpálního (CMC) kloubu palce ruky." Master's thesis, Vysoké učení technické v Brně. Fakulta strojního inženýrství, 2013. http://www.nusl.cz/ntk/nusl-230512.

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This master thesis deals with stress-strain analysis of carpometacarpal (CMC) thumb joint. It is a preliminary study, which was not analysed on BUT Mechanical and biomechanical institute yet. There is a comparative stress-strain analysis of CMC with applied total endoprosthesis and physiological condition. The model of geometry was created based on CT images and processed with using software Catia and Solidworks. The problem was solved in numerical FEM (finite element method) in software Ansys 13.0
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Durand, Sébastien. "Modélisation de l'articulation trapézo-métacarpienne : application à l'étude de la rhizarthrose." Thesis, Compiègne, 2013. http://www.theses.fr/2013COMP2063/document.

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Ce travail de thèse concerne l'articulation trapézométacarpienne. La première partie du travail a concerné l'étude de la morphogénèse de l'arche palmaire par modélisation géométrique 3D. Cinq embryons ont été utilisés. Les résultats de cette étude montre le caractère asymétrique et l'opposition précoce du pouce chez l'embryon humain. La deuxième partie a consisté à partir d'un protocole IRM spécifique sur 5 sujets sains à déterminer la cinématique 3D de l'articulation trapézo-métacarpienne en utilisant les axes hélicoïdaux. La troisième partie, suivant le même protocole sur sujets pathologiques à partir d'image scanner a permis d'évaluer l'effet des différents types de traitement en cas de rhizarthrose. Les résultats trouvent leur application dans l'évaluation quantitative des pathologies de l'articulation trapézo-métacarpienne ainsi que dans le développement des prothèses
This work concerned the first carpo-metacarpal joint. The first part of this work was the study of the morphogenesis of the palmar arch using three-dimensional geometrie modeling. Five embryos were used for this study. The results of this study support the hypothesis that opposition and asymmetry of the thumb appears early in embryological development. In the second part, with specifie MRI protocol on 5 normal subjects, the objective was to quantify the 3D motion of the trapezo-metacarpal joint using helical axes theory. In the last part, using the same protocol on pathological subjects (CT scan images), the objective was to evaluate the effect of different type of treatment of the first carpo­ metacarpal arthritis.The results of the work are of interest for the quantitative evaluation of pathological trapezo-metacarpal joint and in the development of prosthesis
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Nusia, Jiota. "Evaluation of Knee Ligament Injuries in Occupants of Heavy Goods Vehicles by Simulating Frontal Impacts using THUMS HBM." Thesis, KTH, Skolan för kemi, bioteknologi och hälsa (CBH), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-262667.

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INTRODUCTION. Frontal collisions have been observed to cause the severe injuries on heavy goods vehicle occupants, and the lower extremities have been frequently injured. Injuries of knee joints are rarely life threatening, however they tend to give long-term consequences. AIM. Evaluate non-lethal frontal impacts towards the knee joint of Total Human Model for Safety (THUMS) v4.0 using a cylindrical barrier. The main objectives are to 1) create local injury risk functions of the knee ligaments restraining frontal impacts, 2) simulate frontal impacts towards the knee joints of THUMS and3) prepare the Hybrid III (HIII)-model for corresponding frontal impacts conducted on THUMS. The intention is for future HIII-simulations to be cross-correlated with the responses from THUMS for the ability to estimate knee ligament strains by investigating impacts on HIII. METHODS. 1) Ligament risk curves of PCL, MCL and LCL were formulated by assembling mean strain threshold values and standard deviations from literature. Virtual values were generated from these pooled strain thresholds, creating the risk curves. 2) THUMS lower body was impacted by a cylindrical steel barrier at four different locations - middle of patella, middle of knee joint, upper tibia and below tibia tuberositas. Four impact velocities ranging from 8-14 km/h were used at each location, giving a total of 16 impacts. 3) The HIII-model was prepared by removing the upper body and inserting the cylindrical steel barrier into the model file. RESULTS. The strain threshold at 50% rupture risk for PCL resulted in 23.6±4.4%, 34.2±6.0% for MCL and 26.6±6.5% for LCL. The simulated THUMS PCL strains reached between 36%-58% for the highest velocity at the impact locations where tibia was involved. Both MCL and LCL gave an approximate 5% strain outcome. The resultant knee displacement for these impacts ranged between 22 mm - 32 mm. The knee displacements at the PCL strain threshold ranged between 14 mm - 16 mm. DISCUSSION and CONCLUSION. Most of the maximal PCL strains exceeded the PCL threshold with large margins. However, the knee displacement at the PCL strain threshold resulted in outcomes comparable to the thresholds used for HIIImodel. These results supported the obtained PCL threshold to be within a reasonable range.
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Mei-LingChou and 周美綾. "Contact Mechanics of the Thumb Carpometacarpal Joint." Thesis, 2011. http://ndltd.ncl.edu.tw/handle/16429594747228851616.

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Yueh-FengLee and 李岳峯. "In Vitro Contact Mechanics of Thumb Carpometacarpal Joint in Using Smartphone." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/59601053423322193151.

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碩士
國立成功大學
生物醫學工程學系
100
The osteoarthritis (OA) of thumb carpometacarpal (CMC) joint is one of the most common diseases in human upper extremity. Although there are some researches about thumb movement and biomechanical analysis of CMC joint, but it is still insufficient. Moreover, various treatments for CMC OA were unsatisfactory which is caused by the insufficient knowledge of biomechanics for thumb CMC joint. Developing treatments or rehabilitation procedural would be helpful if we can know more biomechanics property of carpometacarpal (CMC) joint in different situations. Therefore, the purpose of this study is to investigate basic contact modes of thumb CMC joint. This study used cadaveric experiments to investigate contact mechanics of thumb CMC joint by simulated the grasp or pinch posture which press on palmar side by thumb. The muscles were given different loading to simulate thumb posture in different positions and different press forces, and then investigated the contact pattern in different situation. This study used a plate to simulate the grasp objects, and extended press position to radial side of ring finger to simulate the range of motion when grasp something. Three-dimensional biomechanical model was developed to calculate the motion pattern. I calculated the translation and rotation of CMC joint under various loadings. This study also measured the cartilage thickness of cadaver specimen and used the equation of hyperbolic paraboloid to describe the curvature of articular surface. From our result, when thumb pressed at press position four, the contact pattern on CMC joint might extend to voiar-ulnar side of trapezium. This region had higher prevalence of CMC OA disease. I also found the metacarpal bone had higher internal rotation angle at this posture which might lead to joint incongruity with localized stress peaks of the joint. This posture had unstable joint contact situation. That is, if the press position near ulnar side, it might have higher possibility to cause joint damage. From data of cartilage thickness, I found the thinner cartilages are usually presented on volar and ulnar side on metacarpal and trapezium cartilage surface. I also found when thumb pressed at position one, the specimen who had small curvature on dorsal-volar direction might contact at more closed to dorsal side of trapezium. This result indicated that the geometric of bone had ability to against joint gliding.
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Neklanová, Anna. "Preventivní a kurativní využití kineziotapu při zatížení palce ruky v ambulantní terapeutické péči." Master's thesis, 2015. http://www.nusl.cz/ntk/nusl-348633.

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Title : Kinesio taping in treatment and prevention of thumb overload in outpatient physiotherapy Purposes : The main purpose of this thesis was to evaluate a degree of pain decrease in thumb joint after kinesio tape application. The differences in grip strength were concurrently evaluated to objectify previous results. Hand dynamometer was used to support this claim. Methods : Data for the experiment were obtained by use of hand dynamometer measurement and record of a pain degree according to chosen pain scale. Each person was measured right before defined strain and immediately after it (daily work in outpatient therapy according to therapist's working shift). Each therapist was asked to record a degree of actual pain following the instructions during strain. All the results were processed and statistically analyzed. Results : The results show that kinesio tape is successful in decreasing of thumb joint pain. This was confirmed both during and after the strain. At the same time kinesio tape prevents decreasing of the grip strength. Keywords : Thumb, thumb joint, kinesio taping of a thumb, dynamometry, pain decrease of a thumb, overloading of a thumb
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Books on the topic "Joints; Thumb"

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Thumb arthritis. Philadelphia: Saunders, 2008.

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Warwick, David, Roderick Dunn, Erman Melikyan, and Jane Vadher. Osteoarthritis of the hand. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199227235.003.0009.

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Introduction 254Digital joint replacement 256Scaphoid–trapezium–trapezioid joint 258Thumb CMCJ arthritis 260Non-operative treatment for thumb CMC OA 262Operative treatment for thumb CMCJ OA 264Finger carpometacarpal joint 269Metacarpophalangeal joint 270Proximal interphalangeal joint 272Distal interphalangeal joint 274Common disease of diarthrodial joints. Primary aetiology is characterized by progressive degeneration of articular cartilage: a manifestation of an abnormal state of chondrocyte metabolism, loss of certain tissue components, alterations in microstructure and changes in biomechanical properties....
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Rust, Philippa, Meg Birks, and David Warwick. Osteoarthritis of the hand. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198757689.003.0009.

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The small joints of the hand are vulnerable to osteoarthritis, usually spontaneous but sometimes following trauma or infection. Nodular arthritis and arthritis in the thumb CMC has a benign natural history and most might get a little stiff but pain usually settles and function is good. Precipitous surgical intervention is inappropriate; time, reassurance, occupational therapy, splints, analgesics, and occasionally steroids should always be tried. The choice of surgical treatment depends on the functional needs of the joint—the little and ring fingers need flexibility for grip whereas the index and thumb require stability for pinch. Options include fusion (e.g. thumb metacarpophalangeal joint), excision arthroplasty (e.g. thumb base) and joint replacement (e.g. finger metacarpophalangeal joint)
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Stothard, J. Rheumatoid arthritis of the hand and wrist. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199550647.003.006005.

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♦ RA is common♦ Medical treatment is the mainstay and newer anti-TNF drugs are reducing morbidity and thus referral for surgery♦ Assessment is primarily clinical♦ Investigations – Primarily radiographs♦ Treatment• Non-operative• Steroid injections are often very useful• Operative• Site and condition specific♦ In general• DRUJ – excision ulna head• Wrist – partial fusion, arthrodesis, arthroplasty• MP joints – synvestomy, arthroplasty• PIP joints – soft tissue rebalancing, arthrodesis• DIP joints – arthrodesis• Thumb MP and IP joints – arthrodesis
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Warwick, David, Roderick Dunn, Erman Melikyan, and Jane Vadher. Rheumatology. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199227235.003.0012.

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General principles 362Rheumatoid arthritis 364Rheumatoid wrist 368Surgical treatment of the rheumatoid wrist 370Metacarpophalangeal joints 374Rheumatoid fingers 378Rheumatoid thumb 381Scleroderma 382Psoriasis 383Dactylitis 383Systemic lupus erythematosus 384Juvenile rheumatoid arthritis 385Generalized ligamentous laxity 386Diabetes and the hand ...
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Bodor, Marko, Sean Colio, and Christopher Bonzon. Hand and Wrist Injections: Ultrasound. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199908004.003.0045.

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Two basic ultrasound-guided approaches are used for procedures to diagnose and treat chronic pain in the upper extremity. The short-axis approach is best for injections of superficial, vertically oriented joints, whereas the long-axis approach is best for relatively deep injections and more open joints or whenever it is necessary for the needle to be seen at all times. Ultrasound can guide injections for nerve compressions. Carpal tunnel syndrome is the most common peripheral nerve entrapment syndrome. Ulnar tunnel syndrome occurs in the setting of space-occupying lesions. Ultrasonography can identify a space-occupying lesion, while electrodiagnostic studies can help differentiate ulnar neuropathy at the wrist from ulnar neuropathy at the elbow. Ultrasound can also guide injections at joints such as the basilar join of the thumb, phalangeal joints, and wrist joints. Ultrasound-guided injections are also useful for tendon dysfunctions including de Quervain’s Tenosynovitis, trigger finger, intersection syndrome, and tendon impingement.
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Hems, T. E. J. Reconstruction after nerve injury. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199550647.003.006009.

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♦ Late reconstructive procedures may improve function if there is persisting paralysis after nerve injury♦ Transfer of a functioning musculotendinous unit to the tendon of the paralysed muscle is the most common type of procedure♦ Passive mobility must be maintained in affected joints before tendon transfer can be performed♦ The transferred muscle should be expendable, have normal power, and have properties appropriate to the function it is required to restore♦ Tendon transfers can provide reliable improvement in function after isolated radial nerve palsy♦ A number of procedures have been described for reconstruction of thumb opposition but impaired sensation after median nerve injury may limit gain in function♦ Tendon transfers are possible to improve clawing of fingers and lateral pinch of the thumb after ulnar nerve palsy or other cases of intrinsic paralysis.
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Mason, Will, and David Warwick. Bone and joint injuries of the hand. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198757689.003.0005.

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The small bones and joints of the hand are vulnerable to fracture and dislocation. These same structures need to be pain-free, stable, and mobile for proper function. Careful diagnosis and meticulous management is required. This may entail early mobilization (e.g. a metacarpal neck fracture) or temporary splinting (e.g. mallet fracture), early repair (e.g. unstable thumb ulnar collateral avulsion), complex sequential and dynamic splinting (e.g. central slip rupture); percutaneous wires (e.g. Bennett’s fracture) or plate fixation (e.g. displaced index metacarpal shaft). There is often a trade-off between the mobilization required to avoid stiffness and the immobilization required to allow anatomical healing. Rigid surgical fixation with meticulous hand therapy may both contribute in certain patients.
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Warwick, David, Roderick Dunn, Erman Melikyan, and Jane Vadher. Bone and joint injuries of the hand. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199227235.003.0005.

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Thumb dislocations and ligament injuries 136Finger dislocations and ligament injuries 139Metacarpal fractures 145Finger fractures 147Associated with sports and motorcycle injuries. The mechanism of this injury is controversial, however likely to be axial loading of semiflexed thumb. Base of thumb metacarpal dislocates dorsally, rupturing the palmar oblique ligament (‘beak’ ligament). May reduce spontaneously....
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Burge, Peter. Dislocations and joint injuries in the hand. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199550647.003.012021.

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♦ Dislocation – X-ray first if possible, then early reduction♦ Many injuries can be treated with splintage♦ Many unstable injuries can be treated with percutaneous wire fixation♦ Chronic instability most commonly affects the thumb♦ CMC joint injuries often need wiring if unstable.
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Book chapters on the topic "Joints; Thumb"

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Miyata, Natsuki, Yuya Yoneoka, and Yusuke Maeda. "Modeling the Range of Motion and the Degree of Posture Discomfort of the Thumb Joints." In Advances in Intelligent Systems and Computing, 324–29. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-96077-7_34.

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Lee, Jae Hoon. "Arthritis of the Interphalangeal Joint and Metacarpophalangeal Joint." In The Thumb, 137–41. Singapore: Springer Singapore, 2019. http://dx.doi.org/10.1007/978-981-10-4400-7_8.

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Hara, Akira, Yasuo Yamauchi, and Koichi Kusunose. "Analysis of Thumb and Index Finger Joints During Pinching Motion and Writing a Cross, as Measured by Electrogoniometers." In Clinical Biomechanics and Related Research, 282–93. Tokyo: Springer Japan, 1994. http://dx.doi.org/10.1007/978-4-431-66859-6_25.

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Harwood, Paul, and Peter V. Giannoudis. "Basal Thumb Joint (Carpometacarpal Joint)." In Practical Procedures in Orthopedic Surgery, 21–24. London: Springer London, 2011. http://dx.doi.org/10.1007/978-0-85729-817-1_8.

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Song, Seok-Whan, and Joo-Yup Lee. "Arthritis of the Carpometacarpal Joint." In The Thumb, 143–55. Singapore: Springer Singapore, 2019. http://dx.doi.org/10.1007/978-981-10-4400-7_9.

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Freeland, Alan E., Michael E. Jabaley, and James L. Hughes. "Thumb Trapeziometacarpal Joint Arthrodesis." In Stable Fixation of the Hand and Wrist, 198–200. New York, NY: Springer New York, 1986. http://dx.doi.org/10.1007/978-1-4613-8640-7_45.

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Freeland, Alan E., Michael E. Jabaley, and James L. Hughes. "Thumb Metacarpophalangeal Joint Arthrodesis." In Stable Fixation of the Hand and Wrist, 208–12. New York, NY: Springer New York, 1986. http://dx.doi.org/10.1007/978-1-4613-8640-7_48.

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Freeland, Alan E., Michael E. Jabaley, and James L. Hughes. "Thumb Interphalangeal Joint Arthrodesis." In Stable Fixation of the Hand and Wrist, 221. New York, NY: Springer New York, 1986. http://dx.doi.org/10.1007/978-1-4613-8640-7_51.

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Qin, Mia M., Chirag M. Shah, Thomas A. Wiedrich, Joseph T. Labrum, and Douglas R. Weikert. "Thumb Basilar Joint Injuries." In Hand and Wrist Injuries in Baseball, 87–97. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-81659-9_7.

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Urruela, Adriana M., and Michelle G. Carlson. "Thumb Metacarpophalangeal Joint Collateral Ligament Injury." In Hand and Wrist Injuries in Baseball, 115–27. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-81659-9_10.

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Conference papers on the topic "Joints; Thumb"

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Koff, Matthew F., Niket Shrivastava, Amy E. Abbot, Benton E. Heyworth, Thomas R. Gardner, Robert J. Strauch, and Van C. Mow. "Effect of Extension Osteotomy of the 1st Metacarpal on Laxity of the Thumb Carpometacarpal Joint." In ASME 2002 International Mechanical Engineering Congress and Exposition. ASMEDC, 2002. http://dx.doi.org/10.1115/imece2002-33029.

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Osteoarthritis (OA) of the human thumb carpometacarpal (CMC) joint is a debilitating disease. It has been proposed in the clinical literature that joint ligamentous laxity, or joint looseness, is a major etiological factor in OA of the CMC joint (Figure1) [1–4]. Previous investigations of laxity and stability of the human thumb CMC joint have been performed visually, with no quantitative measures of joint laxity recorded [5–7]. Surgical treatment has been a common solution to reduce the pain associated with CMC OA. One treatment, extension osteotomy of the 1st metacarpal, has been suggested not only to reduce the pain of OA, but also improve hand function [8], however, little is known about its biomechanical effects. A complete description of joint laxity requires that all physiological directions of motion be fully tested. A custom-designed, 4 degree of freedom tester was constructed and instrumented for displacement and load in the distraction-compression, dorsal-volar, pronation-supination, and radial-ulnar directions. The purpose of this study was to use this device to: 1) Measure the joint laxity and compliance of non-OA human thumb CMC joints and 2) Determine the effect that a simulated extension osteotomy has on joint laxity and joint stiffness. This study provides an accurate baseline for future comparisons with osteoarthritic, surgically corrected, and otherwise non-healthy CMC joints.
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Wu, Lianjun, and Yonas Tadesse. "Humanoid Robot Hand With SMA Actuators and Servo Motors." In ASME 2014 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2014. http://dx.doi.org/10.1115/imece2014-39326.

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This paper describes the design of a child humanoid robot hand with SMA actuators and servo motors. Human hands can grasp and manipulate complicated objects relying on its flexible structure and real-time control. However, it is difficult to replicate an exact human hand using rigid structures because of intricate biomechanical structure. In human hand, one metacarpal and three phalanges make up each finger, except for the thumb which only has two phalanges. Each finger except the thumb is composed of 3 joints: the metacarpophalangeal (MCP), the proximal interphalangeal (PIP) and distal interphalangeal joints (DIP). The DIP and PIP joints are always moving simultaneously, while the MCP joint can move independently. The child-sized robot hand is developed which replicates a seven year-old child’s hand in its fundamental structure. The robot hand has five fingers and all the fingers consist of 3 links. Servo motors and shape memory alloy actuators were used as a drive mechanism for the fingers and mathematical model of the SMA actuators are described to study the finger dynamics. A prototype humanoid robot hand was fabricated using 3D printing techniques and experimental results are presented.
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Takahashi, Reiko, Natsuki Miyata, Yusuke Maeda, and Koji Fujita. "Grasp Synthesis for Digital Hands with Limited Range of Motion in Their Thumb Joints." In 2019 IEEE International Conference on Systems, Man and Cybernetics (SMC). IEEE, 2019. http://dx.doi.org/10.1109/smc.2019.8914453.

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Buffi, James, James Hoover, Joseph J. Crisco, and Wendy M. Murray. "Quantification of the Ranges of Motion of the CMC Joints of the 4th and 5th Digits of the Human Hand In Vivo Using Computed Tomography." In ASME 2012 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2012. http://dx.doi.org/10.1115/sbc2012-80642.

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Over 80% of activities of daily living involve grasping or seizing objects with the hand [1]. The carpometacarpal (CMC) joints of the hand and wrist, the five joints that articulate the distal row of carpal bones and the proximal bases of the five metacarpal bones, are particularly important for prehensile tasks involving the opposition of the ring and little fingers with the thumb, such as during precision grasping. In addition, impairment of the CMC joints can weaken grip strength [2].
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Refour, Eric, Bijo Sebastain, and Pinhas Ben-Tzvi. "Design and Integration of a Two-Digit Exoskeleton Glove." In ASME 2017 International Design Engineering Technical Conferences and Computers and Information in Engineering Conference. American Society of Mechanical Engineers, 2017. http://dx.doi.org/10.1115/detc2017-67373.

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This paper presents the design and integration of a two-digit exoskeleton glove. The proposed glove is designed to assist the user with grasping motions, such as the pincer grasp, while maintaining a natural coupling relationship among the finger and thumb joints, resembling that of a normal human hand. The design employs single degree of freedom linkage mechanisms to achieve active flexion and extension of the index finger and thumb. This greatly reduces the overall weight and size of the system making it ideal for prolonged usage. The paper describes the design, mathematical modeling of the proposed system, detailed electromechanical design, and software architecture of the integrated prototype. The prototype is capable of recording information about the index finger and thumb movements, interaction forces exerted by the finger/thumb on the exoskeleton, and can provide feedback through vibration. In addition, the glove can serve as a standalone device for rehabilitation purposes, such as assisting in achieving tip or pulp pinch. The paper concludes with an experimental validation of the proposed design by comparing the motion produced using the exoskeleton glove on a wooden mannequin with that of a natural human hand.
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Yang, Jingzhou, Karim Abdel-Malek, and Esteban Pen˜a Pitarch. "Design and Analysis of a Cable Actuated Hand Prosthesis." In ASME 2004 International Design Engineering Technical Conferences and Computers and Information in Engineering Conference. ASMEDC, 2004. http://dx.doi.org/10.1115/detc2004-57108.

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Design and analysis of a cable actuated hand prosthesis is presented. The hand has multi-actuated fingers, four with two joints, and the thumb with three joints. Each joint is designed using a novel flexible mechanism based on the loading of a compression spring in both transverse and axial directions and using cable-conduit systems. The rotational motion is transformed to tendon-like behavior, which enables the location of the actuators to be far from the arm (e.g., on a belt around the waist). It is shown that the solution of the transverse deflection of each finger segment is obtained in a general form through a Haringx model followed by an element stiffness model. Also, we use a FEM model (ANSYS) to visualize the deflection of one finger. A prototypic finger is experimentally tested, results are verified, and the hand prosthesis is built.
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Makino, Shogo, Kento Kawaharazuka, Ayaka Fujii, Masaya Kawamura, Tasuku Makabe, Moritaka Onitsuka, Yuki Asano, Kei Okada, Koji Kawasaki, and Masayuki Inaba. "Five-Fingered Hand with Wide Range of Thumb Using Combination of Machined Springs and Variable Stiffness Joints." In 2018 IEEE/RSJ International Conference on Intelligent Robots and Systems (IROS). IEEE, 2018. http://dx.doi.org/10.1109/iros.2018.8594316.

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Teixeira, Igor de Lima e., Vanessa Pereira de Alencar Souza, Caroline Zorzenon, Beatriz Azevedo dos Anjos Godke Veiga, Vanderci Borges, and Henrique Ballalai Ferraz. "“Striatal Hand Signs” and early diagnosis of Parkinson’s Disease: The “Monkey-Wrench Sign”." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.228.

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Background: Striatal hand signs, first described by Charcot, are reported in 10% of advanced Parkinson’s Disease patients as flexion of the metacarpophalangeal joints, extension of proximal interphalangeal joints, flexion of distal interphalangeal joints and ulnar deviation. Another deformation is the metacarpophalangeal joints flexion and thumb medialization (U shaped - “Monkey-Wrench sign”). We believe that mild hand deformities are present in earlier phases of the disease and may help the diagnosis of PD. Objectives: To identify hand deformities in PD patient. Methods: We evaluated 36 PD patients, according to UKPDS Brain Bank Diagnostic Criteria, side of onset, disease duration, severity by UPDRS part III - left/ right side, hand deformities and the “monkey-wrench sign”. Results: We had 14 patients 10 years. 2/3 had left side onset. 33 patients (91.67%) presented the “Monkey- Wrench sign”, unilaterally or asymmetrically, and it was present in all PD patients > 4 years of disease onset, but it was present only in 78.6% less than 4 years. The “MW” sign was easily detected in the more affected side, with a mean UPDRS score of 31.1 on the side of striatal hand signs compared to the mean score of 24.7 on the less affected side. Conclusions: Striatal hand deformities and the “Monkey-Wrench” sign may be useful to diagnosis PD, if unilateral or asymmetrical signs, as well as, it could be used to differentiate between tremors of PD and other etiologies, in a more visual way.
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Blake, Jonathan, and Hakan Gurocak. "Magnetorheological Fluid Brake for a Force Feedback Glove for Virtual Environments." In ASME 2005 International Design Engineering Technical Conferences and Computers and Information in Engineering Conference. ASMEDC, 2005. http://dx.doi.org/10.1115/detc2005-85073.

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The research and development of a Magnetorheological (MR) fluid brake for use in a force feedback glove is presented. The glove is a haptic interface for a virtual reality (VR) environment. The glove implements the MR fluid brakes to restrict motion of the VR user’s fingers. It is controlled by an input current and produces a corresponding output torque. The torque of the MR fluid brake is equivalent to the continuous torque exerted by a typical human index finger. Two sizes of brakes were developed to control the joints of the thumb, index, and middle fingers. The paper presents background and design details of implementing the MR fluid. The prototype designs of the MR fluid brakes are then introduced. Test procedures and results of the braking torque and response time are presented. Lastly, the implementation of the brakes into a force feedback glove is briefly discussed. Test results show that the MR fluid brake is capable of restricting the motion of a human finger.
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Soltz, Michael A., Mathew F. Koff, Eric J. Balaguer, Robert J. Pawluk, Robert J. Strauch, Melvin P. Rosenwasser, Gerard A. Ateshian, and Van C. Mow. "A Device for Evaluating Laxity of the Thumb Carpometacarpal Joint." In ASME 2000 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2000. http://dx.doi.org/10.1115/imece2000-2556.

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Abstract It has been proposed that ligamentous laxity promotes osteoarthritis of the thumb carpometacarpal joint. However, quantitative measurements of laxity for this joint have not been correlated with its incidence of osteoarthritis nor with other measures of degenerative changes such as joint congruence, surface remodeling, cartilage mechanical properties or biochemical composition. The goal of this study was to design and build a device for testing the laxity of the carpometacarpal joint, with the long-term aim of advancing our understanding of the etiology of osteoarthritis in this joint. This laxity tester has the ability to accurately measure the force-displacement response along the joint’s dorsal-volar, radial-ulnar, and distraction-reduction directions, as well as the torque-rotation response in pronation-supination. The compliance of the tester was evaluated and laxity curves were generated for a sample thumb carpometacarpal joint.
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Reports on the topic "Joints; Thumb"

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Neumeister, Michael W., Shaun D. Mendenhall, and Michael R. Ruebhausen. Thumb CMC Joint Arthroplasty. Touch Surgery Simulations, 2017. http://dx.doi.org/10.18556/touchsurgery/2017.s0116.

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Neumeister, Michael W. Thumb CMC Joint Arthroplasty. Touch Surgery Simulations, 2018. http://dx.doi.org/10.18556/touchsurgery/2018.s0116.

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Gómez Hernández, Damián. Prosthetic Arthroplasty of the Thumb CMC Joint in a 69-year old female. Touch Surgery Publications, November 2018. http://dx.doi.org/10.18556/touchsurgery/2018.s0142.

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