Difference in the epidemiologic and clinical characteristics by age groups of the children who visited a hand center emergency department with a hand injury requiring surgery

Purpose We aimed to describe the difference in the epidemiologic and clinical characteristics by age groups of the children with hand injuries requiring surgery who visited the emergency department (ED) of a community hospital that runs a hand center. Methods We reviewed 388 consecutive children with hand injuries requiring surgery, aged < 16 years, who visited the ED from January 2011 through September 2016. Information was obtained regarding age and gender of the children, seasonal and daily distribution of the visits, location, cause, site, and level of the injury, the diagnosis, and presence of serious injury. The children were classified into 3 age groups; toddlers (0 to 3 years), preschoolers (4 to 6 years), and schoolers (7 to 15 years). Severe injury was defined as amputation or crush injury. Results Mean age of the children was 7.4 ± 5.0 years and boys accounted for 65.7%. The most frequent visits occurred during the weekend (53.1%) and in spring (30.7%), and most children visited the ED with injuries that occurred at home and indoors (55.2% and 79.9%, respectively). The most common cause, site, and level of the injury were sharp object (34.8%), fingers other than the thumb and index finger (64.7%), and the distal phalanx (46.7%), respectively. In the toddler group, domestic, indoor, door-related, and distal phalanx injuries were more common than in the schooler group (P < 0.001). Physical contact or sharp object-related injuries increased with increasing age (P < 0.001). Severe injuries were more common among the toddlers than the schoolers (P < 0.001). Conclusion In the toddler group, domestic, indoor, door-related, distal phalanx, and severe injuries were more common than in the schooler group. These characteristics by age groups would aid in preventing hand injury in children, especially toddlers

Wearable Inertial Sensor-Based Hand-Guiding Gestures Recognition Method Robust to Significant Changes in the Body-Alignment of Subject

The accuracy of the wearable inertia-measurement-unit (IMU)-sensor-based gesture recognition may be significantly affected by undesired changes in the body-fixed frame and the sensor-fixed frame according to the change in the subject and the sensor attachment. In this study, we proposed a novel wearable IMU-sensor-based hand-guiding gesture recognition method robust to significant changes in the subject&rsquo;s body alignment based on the floating body-fixed frame method and the bi-directional long short-term memory (bi-LSTM). Through comparative experimental studies with the other two methods, it was confirmed that aligning the sensor-fixed frame with the reference frame of the human body and updating the reference frame according to the change in the subject&rsquo;s body-heading direction helped improve the generalization performance of the gesture recognition model. As a result, the proposed floating body-fixed frame method showed a 91.7% test accuracy, confirming that it was appropriate for gesture recognition under significant changes in the subject&rsquo;s body alignment during gestures

BALLU2: A Safe and Affordable Buoyancy Assisted Biped.

This work presents the first full disclosure of BALLU, Buoyancy Assisted Lightweight Legged Unit, and describes the advantages and challenges of its concept, the hardware design of a new implementation (BALLU2), a motion analysis, and a data-driven walking controller. BALLU is a robot that never falls down due to the buoyancy provided by a set of helium balloons attached to the lightweight body, which solves many issues that hinder current robots from operating close to humans. The advantages gained also lead to the platforms distinct difficulties caused by severe nonlinearities and external forces such as buoyancy and drag. The paper describes the nonconventional characteristics of BALLU as a legged robot and then gives an analysis of its unique behavior. Based on the analysis, a data-driven approach is proposed to achieve non-teleoperated walking: a statistical process using Spearman Correlation Coefficient is proposed to form low-dimensional state vectors from the simulation data, and an artificial neural network-based controller is trained on the same data. The controller is tested both on simulation and on real-world hardware. Its performance is assessed by observing the robots limit cycles and trajectories in the Cartesian coordinate. The controller generates periodic walking sequences in simulation as well as on the real-world robot even without additional transfer learning. It is also shown that the controller can deal with unseen conditions during the training phase. The resulting behavior not only shows the robustness of the controller but also implies that the proposed statistical process effectively extracts a state vector that is low-dimensional yet contains the essential information of the high-dimensional dynamics of BALLUs walking

Hand-Guiding Gesture-Based Telemanipulation with the Gesture Mode Classification and State Estimation Using Wearable IMU Sensors

This study proposes a telemanipulation framework with two wearable IMU sensors without human skeletal kinematics. First, the states (intensity and direction) of spatial hand-guiding gestures are separately estimated through the proposed state estimator, and the states are also combined with the gesture’s mode (linear, angular, and via) obtained with the bi-directional LSTM-based mode classifier. The spatial pose of the 6-DOF manipulator’s end-effector (EEF) can be controlled by combining the spatial linear and angular motions based on integrating the gesture’s mode and state. To validate the significance of the proposed method, the teleoperation of the EEF to the designated target poses was conducted in the motion-capture space. As a result, it was confirmed that the mode could be classified with 84.5% accuracy in real time, even during the operator’s dynamic movement; the direction could be estimated with an error of less than 1 degree; and the intensity could be successfully estimated with the gesture speed estimator and finely tuned with the scaling factor. Finally, it was confirmed that a subject could place the EEF within the average range of 83 mm and 2.56 degrees in the target pose with only less than ten consecutive hand-guiding gestures and visual inspection in the first trial

Wearable Inertial Sensor-Based Hand-Guiding Gestures Recognition Method Robust to Significant Changes in the Body-Alignment of Subject

The accuracy of the wearable inertia-measurement-unit (IMU)-sensor-based gesture recognition may be significantly affected by undesired changes in the body-fixed frame and the sensor-fixed frame according to the change in the subject and the sensor attachment. In this study, we proposed a novel wearable IMU-sensor-based hand-guiding gesture recognition method robust to significant changes in the subject’s body alignment based on the floating body-fixed frame method and the bi-directional long short-term memory (bi-LSTM). Through comparative experimental studies with the other two methods, it was confirmed that aligning the sensor-fixed frame with the reference frame of the human body and updating the reference frame according to the change in the subject’s body-heading direction helped improve the generalization performance of the gesture recognition model. As a result, the proposed floating body-fixed frame method showed a 91.7% test accuracy, confirming that it was appropriate for gesture recognition under significant changes in the subject’s body alignment during gestures

Extended Distal Chevron Osteotomy

Category: Bunion, Midfoot/Forefoot Introduction/Purpose: Numerous corrective osteotomies have been performed for surgical treatment of hallux valgus(HV). One of these procedures is distal chevron osteotomy, traditionally indicated for correction of mild to moderate HV. We proposed a new modification of the chevron osteotomy, extended distal chevron osteotomy, to provide even greater stability by extend the contact surface, as well as more effective and accurate correction of the angulation and rotational profile than conventional osteotomy. Methods: Between July 2013 and June 2014, the extended distal chevron osteotomy (DCO) was performed for the treatment of mild-to-moderate hallux valgus deformity in 63 feet (Group A) by the same surgeon. For the extended chevron, the first osteotomy was performed to cut 5-10 mm from the head of metatarsal to the proximal upper 1/3 of the neck. The second osteotomy was performed to cut 2.5~3.0 cm from the upper 1/3 of the neck toward horizontal plane of the plantar surface with an angle of 45~50 degree. Standard foot radiographic measurements, hallux valgus angle(HVA) and intermetatarsal angle(IMA), were recorded to compare with the values of 37 patients (Group B) who were treated by the traditional DCO technique. Results: Mean patient age was 45.3 (range 15–78) years, and 54 patients were available for follow-up at both one and two years postoperatively. Mean follow-up duration was 13.7 (range 4–26) months. In group A, mean HVA decreased from 32.3° preoperatively to 8.4° at final follow-up, while the angle of group B decreased from 32.4° to 11.4°. Mean IMA decreased from 15.1° preoperatively to 7.3° at final follow-up in group A, while the IMA decreased from 15.1° to 8.9° in group B. That way we could verify that the extended chevron osteotomy is more effective for stability and correcting of the angulation and rotational profile than traditional DCO. Conclusion: The extended chevron osteotomy achieved even greater stability and accurate correction of the deformity. Furthermore, it was more effective than traditional chevron osteotomy in terms of correction of the angulation and rotational profile

Figure 8 (Heel open) short leg cast

Category: Ankle, Trauma Introduction/Purpose: To report the results of applying heel open (figure 8) short leg cast on foot & ankle trauma or disease patients requiring short leg casts. Methods: 380 patients who were confirmed and treated by diagnosed of foot & ankle trauma or diseases were included between November 2014 and July 2016. Comprised of 222 males and 158 females, their mean age was 46 years old. The bottom of the figure 8 cast covered the metatarsal head to half portion of the medial longitudinal arch, while leg portion covering consisted from the prominence of the both malleolus to halfway of the lower leg, resulting in complete exposure of the heel and distal portion of the achilles tendon. After application of the figure 8 cast, changes in the ROM in active ankle dorsiflexion & plantarflexion, passive foot inversion & eversion, and foot internal & external rotation were measured. Results: In all cases, measurements of active ankle dorsiflexion & plantarflexion was less than 5 degrees, measurements of passive foot inversion & eversion was less than 5 degrees, foot internal & external rotation was less than 0 degrees, and were stably held without skin or soft tissue injury until cast removal. Notable were 22 cases of foot & ankle fractures treated with conservative therapy with figure 8 short leg cast resulting in bone union and stabilization without surgery. VAS discomfort score was an average of 2.6 (0~5) and figure 8 short leg cast was selected in all cases requiring a short leg cast. Conclusion: The use of figure 8 short leg cast in patients of foot & ankle trauma and diseases requiring short leg cast provides safety and prevention of skin necrosis and pressure sores from open heels while providing high patient satisfaction in daily life, such as heel touch. We believe that figure 8 short leg cast could replace the traditional short leg cast, if the safety of the figure 8 cast could be proven through long-term follow up study with various patient and cases

Comparison between Absorbable and Nonabsorbable Suture Material in Modified Broström Operation

Category: Ankle, Trauma Introduction/Purpose: The current clinical standard for the surgical treatment of lateral ankle instability remains the modified Broström procedure. Almost surgeons are using non-absorbable suture material because of their strength & permanent. But this has several complications such as irritation, surface tenderness, etc. So we compare the clinical result between nonabsorbable and absorbable suture material. Methods: All patients who underwent the modified Broström operation of the anterior talofibular ligament and/or the calcaneofibular ligament by a single surgeon between July 2011 and May 2015 were included in this study. A total of 96 patients were included in this study: 63 men and 33 women (mean age, 33.16 years; range, 14-72 years). Non-absorbable suture(2-0 Fiberwire®, Arthrex, Naples, FL) patient were 50 (33 men, 17 women) and absorbable suture(0-Vicryl®, Ethicon, Sommerville, NJ) patient were 46(30 men, 16 women). Mean follow-up duration was 2.5 years (range, 1.0-4.7 years). Patients completed a subjective questionnaire. Outcomes measures included the Foot and Ankle Disability Index (FADI), American Orthopaedic Foot and Ankle Society (AOFAS) and Reoperation cases by the recurred lateral ankle instability. All data were collected prospectively and reviewed retrospectively. Results: In non-absorbable suture group, The mean talar tilt angle in preoperative talar tilt test was 14.4 and in absorbable suture group, 13.7, respectively. The mean talar tilt angle in postoperative talar tilt test was 5.3 and in absorbable suture group, 6.1, respectively. There were no significant differences between non-absorbable suture method and absorbable suture method with talar tilt angle in varus stress x-ray (P > .05). There was no significant difference in FADI (87 vs 91; P = .553), AOFAS (83 vs 87; P = .372) score between non-absorable suture method group and the absorbable suture method group. During follow up, Except of 2 patients, they were no clinical symptom. Each one patient in non-absorbable and absorbable suture group underwent revision lateral ligament surgery. Conclusion: As compared with non-absorbable suture in open modified Broström procedure, absorbable suture method produced similarly favorable outcomes