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Designing for Hand and Wrist Anatomy
Published in Karen L. LaBat, Karen S. Ryan, Human Body, 2019
Baseball and softball gloves are designed to protect the athlete’s fingers and hands from impact of the ball. Gloves are designed for the player’s position: catcher’s mitts, first baseman’s mitts, infielder’s gloves, pitcher’s gloves, outfielder’s gloves, and switch-thrower’s gloves. The glove structure is suited to the performance requirements. For example, the catcher’s mitt is much like a mitten, with no individual fingers and extra padding at the mitt’s center pocket, which also makes a good target for the pitcher and extra protection for the carpal bones. In contrast, the infielder’s glove is smaller with a shallow pocket so that the player can easily remove the ball to throw it quickly to a baseman (Rosciam, 2010). Hicks (2015) found that even with glove wear, catchers “commonly develop abnormal blood flow in the ulnar artery, digital ischemia in the index finger, and index finger hypertrophy (p. ii)” from continual trauma to the hand. She recommends glove designs be modified to further minimize risk of hand injury. For a thorough overview of the mechanisms of impact and impact protection methods for wearable products, read Watkins’ and Dunne’s (2015) chapter on impact protection.
General Thermography
Published in James Stewart Campbell, M. Nathaniel Mead, Human Medical Thermography, 2023
James Stewart Campbell, M. Nathaniel Mead
Thermography of the arms is generally quite uniform when normal. The antecubital fossa is usually the warmest location in a normal arm, due to the venous and arterial vessels located close to the skin surface there. The skin over the volar radial head may also appear warm due to the radial artery coursing under the dermis in that location. The ulnar artery is sometimes visible at the wrist, but this is less common. Diffuse warmth is often seen over the hand extensor and flexor muscles located in the forearm. In the upper arm region, the main warm areas are seen over the deltoid muscles; the cephalic vein is sometimes visible coursing up the anterior upper arm. See the images of the arms in Chapter 13 for more details.
Multicenter randomized trial of carpal tunnel release with ultrasound guidance versus mini-open technique
Published in Expert Review of Medical Devices, 2023
Kyle R. Eberlin, Benjamin P. Amis, Thomas P. Berkbigler, Christopher J. Dy, Mark D. Fischer, James L. Gluck, F. Thomas D. Kaplan, Thomas J. McDonald, Larry E. Miller, Alexander Palmer, Paul E. Perry, Marc E. Walker, James F. Watt
Investigators completed a cadaver-based training program and at least 10 CTR-US procedures before trial participation. The CTR-US technique used an FDA-cleared, single-use, hand-held device (UltraGuideCTR, Sonex Health, Inc., Eagan, MN) inserted into the carpal tunnel through a small incision at the proximal wrist using real-time ultrasound guidance (Figure 1). Detailed procedural steps with CTR-US have been previously reported [12,13]. Briefly, an ultrasound probe was applied to the volar aspect of the wrist and hand to visualize the relevant anatomy (e.g. TCL, median nerve, ulnar artery), and ultrasound guidance was utilized throughout the procedure. An incision was made proximal to the wrist crease and the device was inserted into the carpal tunnel until the device tip was distal and deep to the TCL as visualized under ultrasound. A pair of balloons in the distal end of the device were inflated to create and maintain space between the cutting portion of the device and the median nerve. A recessed retrograde cutting blade in the device was then activated to transect the TCL distal to proximal. After the blade was recessed and the balloons deflated, TCL transection was verified by probing the ligament under ultrasound visualization. The incisions were closed with Steri-strips, skin glue, and/or sutures according to the surgeon’s preference.
Endovascular arteriovenous fistulas— are they the answer we haven’t been looking for?
Published in Expert Review of Medical Devices, 2021
Bynvant Sandhu, Charlie Hill, Mohammad Ayaz Hossain
Over manipulation of the blood vessel during open surgery has been hypothesized to generate intimal hyperplasia which, if focal, results in vessel stenosis. Endovascular AVF presents a minimally invasive alternative to surgical AVF creation. Ultrasound or fluoroscopic guidance are utilized to create an arteriovenous anastomosis using a combination of heat, pressure or radiofrequency energy. Endovascular AVF creation reduces the degree of manipulation required, thereby potentially conferring an advantage compared to open surgery. An AVF is created between the proximal radial or ulnar artery and an adjacent deep vein. Embolization of the proximal deep vein may then be required to divert flow into the superficial venous system to allow successful cannulation.
The modified Allen test and a novel objective screening algorithm for hand collateral circulation using differential photoplethysmography for preoperative assessment: a pilot study
Published in Journal of Medical Engineering & Technology, 2020
Measuring the time delay between the PPG signals recorded from the thumb and little fingers helped in highlighting the anatomy of blood flow in hand. From the results, the normal case of the hand showed that the little finger PPG signal came first before the thumb finger PPG signal. Negative values mean that the little finger signal was leading the thumb signal. This finding is congruent with the blood circulation anatomy, as the diameter of the ulnar artery is smaller than the radial artery, and the blood flow is reversely proportional to the artery diameter; therefore, the blood flow in the ulnar artery is faster than in the radial artery; thus, the little signal should lead to the thumb signal.