Epidemiology of Fingertip Injuries at South Central Hospital Petróleos Mexicanos “Pemex” with a Review of the Literature

Background: The hand is an essential component for performing our daily tasks;as a result, injuries to the fingertip are frequently seen. Accurate evaluation and treatment of fingertip injuries are essential to avoiding long-term disability, job loss and psychological issues. No matter the injury classification system, maintaining finger length, regaining sensation, and improving appearance are the three main objectives of treatment. The objective of this research was to outline the epidemiology of fingertip injuries treated between 2021 and 2022 at a highly specialized referral hospital in Mexico City. Methodology: This investigation is cross-sectional, retrospective, and observational. From January 2021 to December 2022, 60 patients with a diagnosis of fingertip injury from the South Central Hospital “Pemex” were included. The descriptive statistical analysis was performed using SPSS29. Results: 60 patients were included, 27 (45%) were women and 33 (55%) were men. Allen’s classification was able to classify only 19 patients, of which 18 (94.7%) had a type 1 classification and one (5.26%) had a type 2 classification. 10% of patients experienced complications, which included 2 patients with surgical site infections (3.3%), 3 patients with persistent pain (5%), and 1 patient (1.6%) with graft rejection. Conclusions: There are currently insufficient epidemiological data on hand and wrist injuries and its effects on labor in Mexico. Fingertip injuries require particular care in order to prevent complications and long-term damage. The creation of national registries could help with the creation of reference manuals for the care of hand and wrist injuries in our nation.

Supermicrosurgery in fingertip defects-split tibial flap of the second toe to reconstruct multiple fingertip defects: A case report

BACKGROUND Injuries to multiple fingertips pose a significant treatment dilemma.Numerous reconstructive options exist,all with the ultimate goal of restoring function and sensibility to the injured fingertips.CASE SUMMARY A 24-year-old male suffered injury to multiple fingertips of the right hand,resulting in exposed distal phalanges of the middle,ring,and small fingers.The amputated distal stumps were not possible for replantation.Free flap coverage was selected in order to achieve better functional outcome.The fingertip defects were covered by performing a right second toe split tibial flap using local anesthesia at the harvest site and brachial plexus nerve block for the right upper extremity.At 6-month follow-up,all three of the reconstructed fingertips had some preserved nail growth,Semmes-Weinstein Monofilaments testing was equal to the contralateral side and the Static Two-Point Discrimination were comparable to the contralateral side.CONCLUSION This report provides a novel reconstructive option for the management of multiple fingertip injuries and demonstrates the utility of supermicrosurgery in management of these injuries.

Evaluation of sensory function and recovery after replantation of fingertips at ZoneⅠin children

Sensory function is the most significant criterion when evaluating the prognosis of replanted fingers. Current clinical research has focused on surgical techniques and indications for finger replantation; however, few studies have focused on recovery of finger sensory function af- ter replantation. This study retrospectively assessed data of eight patients who had undergone nine Zone I replantations of the fingertips in the First Affiliated Hospital of Sun Yat-sen University of China from July 2014 to January 2016. Variations in the extent of damage, with the residual vessels or nerves in some fingers being too short or even missing, prevented tension-free suture repair in some patients. Thus, re- pair of four of the nine fingertips included arteriovenous anastomosis, the remaining five undergoing arterial anastomosis during replanta- tion of the amputated fingers. Three patients underwent nerve repair, whereas the remaining six cases did not. Fingertip replantations were successful in all eight patients. Compared with the patients without vascular anastomosis, no obvious atrophy was visible in the fingertips of patients who did undergo vascular anastomosis during replantation and their sensory function did recover. Fingertip replantation pro- vides good sensory function and cosmetic outcomes when good artery and vein anastomoses have been created, even when digital nerves have not been repaired.

A Vision-Based Fingertip-Writing Character Recognition System

This paper presents a vision-based fingertip-writing character recognition system. The overall system is implemented through a CMOS image camera on a FPGA chip. A blue cover is mounted on the top of a finger to simplify fingertip detection and to enhance recognition accuracy. For each character stroke, 8 sample points (including start and end points) are recorded. 7 tangent angles between consecutive sampled points are also recorded as features. In addition, 3 features angles are extracted: angles of the triangle consisting of the start point, end point and average point of all (8 total) sampled points. According to these key feature angles, a simple template matching K-nearest-neighbor classifier is applied to distinguish each character stroke. Experimental result showed that the system can successfully recognize fingertip-writing character strokes of digits and small lower case letter alphabets with an accuracy of almost 100%. Overall, the proposed finger-tip-writing recognition system provides an easy-to-use and accurate visual character input method.

Fingertip skin models for analysis of the haptic perception of textiles

This paper presents finite element models of the fingertip skin which have been created to simulate the contact of textile objects with the skin to gain a better understanding of the perception of textiles through the skin, the so-called hand of textiles. Many objective and subjective techniques have already been developed for analysing the hand of textiles;however, none of them provide exact overall information concerning the sensation of textiles through the skin. As the human skin is a complex heterogeneous hyperelastic body composed of many particles, some simplifications had to be made at the early stage of building the models;however, their utilitarian value was maintained. The models relate only to mechanical loading of the skin. They predict a low deformation of the fingertip skin under the pressure of virtual heterogeneous material: acrylic, coarse wool, and steel.

RESEARCH ON BEHAVIORS OF ELECTRORHEOLOGICAL FLUID-BASED SEMIACTIVE ROBOT FINGERTIPS

A new design of robot gripper with electrorheological fluid (ERF) semiactive tips is described. There are two remarkable properties using this fingertip. One is the higher lifting capability at little grasp force, which can realize stable grasp. Another is the damping controllable which can be used for controlling contact forces. A viscoelastic plastic model for normal direction of the fingertip is proposed to explore the contact behavior. The electric field strength is induced into the dynamic model of contact transition for simulations. The simulation results and conclusions are given.

Acute Fingertip Injuries in Sudanese Patients: Patterns and Clinical Presentation

Background: Acute fingertip injuries are common and may lead to functional and aesthetic complications if not treated properly. Different types of trauma result in injuries with variable severity and affect certain risk groups. Objectives: To study the high-risk groups affected by fingertip injuries, their etiological factors, clinical features, and wound patterns, and the influence of hand dominance. Study Design: A descriptive study of 103 consecutive patients with 144 acutely injured fingertips. Data Collection/Analysis: We obtained demographic data, occupation, hand dominance, time and cause of trauma, and the presenting symptoms. Further, clinical examination, radiological, and laboratory studies were performed. Wound characteristics were classified according to the pulp, nailbed and bone (PNB) classification. The data were analyzed with the Fisher’s exact test and Chi-square test. Results: A total of 103 patients (88 males, 15 females) presented with 144 injured fingertips. The male to female ratio was 5.8:1, and the mean age was 27.5 years. The age group affected most commonly was 16 - 20 years. There was a strong association between hand dominance and fingertip injuries, as in 65% of the cases, the dominant hand was injured more frequently than the non-dominant (p = 0.01). The sharp and blunt injuries observed involved the left hand more than the right and were often the result of machinery-related trauma (p = 0.04). Approximately 68% of the injuries were related to work, while 26% were attributable to domestic accidents. In 22% of the cases, seasonal workers were the category affected most often, followed by factory workers. Nearly half of the injuries were related to working with machines, while door-trapping was the most frequent cause of injury in children under 5. The index finger was injured most frequently (31.9%), followed by the middle finger (27.9%), while the thumb and little fingers were involved least (11% for each). Pulp injuries were seen in 97% of cases, commonly with lacerations (39.6%, n = 139) while complete pulp loss was seen in 12.6% of cases. 87% of the cases were nail bed injuries, often with nail bed lacerations (28.6%, n = 126), while complete nail bed loss was observed in 9.5% of cases. Tuft fractures were the commonest bone injuries (26%), while complete bone loss was seen in 7.7% of the injured bones (n = 104). Conservative management was carried out on 9% of fingers, while the others required various methods of surgical repair. Nail bed repair was performed in 48.8% of cases (n = 126), while bone fixation was required in 20.2% (n = 104). Conclusions: Fingertip injuries are highly common in practice. In our study, the age, gender, mechanism of trauma and hand dominance had their influence on the pattern of injury. Finally, wound characteristics determine the type of management required.

Fascinating Rhythms Played on Fingertips

Zhao Cong, a young pipa (four-stringedChinese lute) performer with the China CentralTraditional Music Ensemble, was born into a familyof musicians. She developed an extraordinaryinterest in this ancient Chinese instrument in herchildhood. When her parents asked

Affine transformation of virtual 3D object using 2D localization of fingertips

Background Interactions with virtual 3D objects in the virtual reality(VR)environment using the gesture of fingers captured in a wearable 2D camera have emerging applications in real-life.Method This paper presents an approach of a two-stage convolutional neural network,one for the detection of hand and another for the fingertips.One purpose of VR environments is to transform a virtual 3D object with affine parameters by using the gesture of thumb and index fingers.Results To evaluate the performance of the proposed system,one existing,and another developed egocentric fingertip databases are employed so that learning involves large variations that are common in real-life.Experimental results show that the proposed fingertip detection system outperforms the existing systems in terms of the precision of detection.Conclusion The interaction performance of the proposed system in the VR environment is higher than that of the existing systems in terms of estimation error and correlation between the ground truth and estimated affine parameters.

Perception of Static and Dynamic Forces with a Bio-inspired Tactile Fingertip

With the aid of different types of mechanoreceptors,human is capable of perceiving stimuli from surrounding environments and manipulating various objects dexterously.In this paper,a bio-inspired tactile fingertip is designed mimicking human fingertip in both structures and functionalities.Two pairs of strain gages and(Polyvinylidene Fluoride)PVDF films are perpendicularly arranged to simulate the Fast-Adapting(FA)and Slowly Adapting(SA)type mechanoreceptors in human hands,while silicones,Polymethyl Methacrylate(PMMA),and electronic wires are applied to mimic the skin,bone and nerve fibers.Both static and dynamic forces can be perceived sensitively.A preprocessing electric circuit is further designed to transform the resistor changes into voltages,and then filter and amplify the four-channel signals.In addition to strong robustness due to the embedded structure,the developed fingertip is found sensitive to deformations via a force test experiment.Finally,two robotic experiments explore its recognition ability of contact status and object surface.Excellent performance is found with high accuracy of 99.72%achieved in discriminating six surfaces that are ubiquitous in daily life,which demonstrates the effectiveness of our designed tactile sensor.

基于FBG的机器手指尖触觉感知研究

为了提高机器手指尖触觉感知灵敏度和精度,基于机器手指尖触觉感知机理分析,设计了特征分离式双层“十字”型FBG触觉感知单元,并进行了有限元仿真分析,针对感知单元开展了标定实验和抓握感知实验。基于接触温度和抓握力复合感知进行了耦合分析,提出了基于鲸鱼优化算法优化BP神经网络(WOA-BPNN)的解耦方法。实验结果表明:FBG感知单元的接触温度灵敏度为11.255 pm/℃,抓握力灵敏度为17.342 nm/MPa;WOA-BP解耦模型的接触温度平均绝对误差减小了72.53%,抓握力平均绝对误差减小了68.55%。

指固有动脉背侧支血管链蒂逆行岛状皮瓣修复指端缺损的近期疗效分析及治疗体会

目的分析指固有动脉背侧支血管链蒂逆行岛状皮瓣修复指端缺损的近期疗效,并总结治疗体会。方法回顾性分析21例(21指)指端缺损患者的临床资料,患者均行指固有动脉背侧支血管链蒂逆行岛状皮瓣修复。随访评估患者的主观满意度、皮瓣感觉恢复情况、患指活动功能。结果术后19例患者皮瓣完全成活并顺利拆线,1例因术后私自吸烟致皮瓣严重发绀延迟愈合,1例因术后私自开空调温度过低致皮瓣部分坏死。21例患者中共19例获得随访,随访时间3~18个月,平均(8.9±4.6)个月。获得随访患者中,患者的主观满意度:很满意16例(84.2%)、比较满意3例(15.8%),无不满意病例。皮瓣感觉恢复情况:S415例(78.9%),S3+3例(15.8%),S31例(5.3%)。患指活动功能:优16例(84.2%),良3例(15.8%)。结论指固有动脉背侧支血管链蒂逆行岛状皮瓣修复指端缺损外形功能满意,优势明显,术后积极处理和密切护理对于术后良好疗效亦至关重要。

指尖自锁欠驱动机械手设计与研究

欠驱动机械手结构简单、成本低、易于控制、自适应能力强,但欠驱动机械手是通过机械限位与弹簧约束来完成抓取,抓取稳定性差,无法输出较大的指尖抓取力.本文提出一种新型的指尖可自锁的欠驱动三指机械手,在抓取时远指节与中指节可实现自锁,增加了抓取的稳定性.同时建立了单指的D-H运动学模型,利用MATLAB分析了机械手的工作空间,对手指进行了静力学分析,利用ADAMS软件对机械手进行仿真分析,最后进行抓取测试,结果表明指尖自锁机械手能输出更大抓取力,从而验证了指尖自锁机械手结构的合理性与可行性.

基于近红外光谱法的血液酒精浓度检测仪

针对解决呼气式酒精检测仪存在飞沫传播风险的问题,提出了一种基于近红外光谱法的便携式无污染血液酒精浓度检测方案。使用硬件完成信号采集、放大、滤波再放大,利用软件完成卡尔曼滤波、三样条插值法去基等算法获取标准的脉搏波信号在上位机中通过呼气式的测量结果与脉搏波信号的幅值建立数学模型,将数学模型写入单片机实现离线测量。通过实验测试验证数学模型精度。结果表明,其满足相对误差小于10%的精度要求,符合实际使用需求。

仅吻合双侧指掌侧固有动脉甲根离断断指再植10例

目的探讨末节甲根部平面以远的离断指应用无需吻合静脉回流的再植方法及疗效。方法2019-2022年对10例于末节甲根部平面离断的手指,仅作双侧指掌侧固有动脉吻合而不需吻合静脉的再植修复。结果10例甲根部平面离断手指再植后,全部成活,再植成活率为100%。出院后10例均得到随访,随访时间3~6个月,再植后成活指体的功能与外观恢复良好,患者对手术结果满意。结论手指甲根部及以远的指体离断,基本无静脉可吻合。在再植时只吻合双侧指掌侧固有动脉而不吻合静脉的情况下,早期血流及供血通过双侧指掌侧固有动脉达到供血压力平衡、不会导致供血过多,而后重建动静脉网达到正常静脉血液回流,使其成活,术后断指成活情况较好,此方法可于临床推广应用。

Aesthetic fingertip reconstruction with partial second toe transfer

Background Fingertip defect significantly affects the appearance of the hand. The aim of this research was to evaluate the clinical effect of aesthetic fingertip reconstruction with partial second toe transfer.Methods Between July 2005 and December 2008, 17 patients underwent aesthetic fingertip reconstruction with partial second toe transfer. The mean size of fingertip defects was 0.7 cm （ranging from 0.5-1.1 cm）. Anastomosis was performed between one dominant plantar digital artery and one proper digital artery, between two dorsal digital veins of the toe and two dorsal digital veins of the finger, respectively, for the reconstruction of blood supply to the reconstructed finger. Two plantar digital nerves of the toe were then sutured to two proper digital nerves of the finger for the restoration of fingertip sensation.Results All reconstructed fingers survived completely. The follow-up period ranged from 6 to 24 months, and the appearance of the reconstructed fingertip was similar to that of the normal fingertip. Two-point discrimination of the reconstructed fingertip was （7.8±1.3） mm. The recovered pinch strength of the reconstructed finger was about （89.0±5.1）% of that of the normal finger. Donor site healed well without complications.Conclusions Partial second toe transfer is an ideal aesthetic reconstruction method for fingertip defects; it can not only achieve a satisfactory appearance of the fingertip, but can also obtain excellent sensory and motor functions.

人工真皮覆盖修复指端缺损的疗效

目的探讨人工真皮覆盖修复指端缺损的疗效。方法采用人工真皮覆盖修复25例指端缺损患者(30指)。记录创面愈合情况、瘢痕形成情况、指端感觉功能恢复情况。根据中华医学会手外科学会上肢部分功能评定试用标准评定手功能恢复情况,采用Michigan手概况调查表评定患者对术后手指的主观满意度。结果患者均获得随访,时间3~20个月。创面全部愈合,时间4~6(4.7±0.5)周。术后3个月,温哥华瘢痕量表(VSS)评分0~4(1.2±1.0)分,无明显瘢痕形成;两点辨别觉4~12(7.5±3.5)mm;指端感觉功能恢复情况:S4级10指,S3+级13指,S3级4指,S2级3指。术后3个月,手功能恢复情况:优24指,良4指,差2指;患者对术后手指的主观满意度:非常满意19指,满意9指,一般2指。结论采用人工真皮覆盖修复指端缺损操作简单,临床效果良好,尤其适合基层医院开展。

不同修复术处理指端缺损效果及对炎症-氧化应激的影响

目的探讨不同修复术处理指端缺损的效果。方法选取2020年2月至2022年8月南阳市中心医院指端缺损者80例,依据治疗方案分为研究组、对照组,各40例。对照组行桡背侧皮瓣修复术,研究组行拇指桡侧穿支螺旋桨皮瓣修复术。比较两组围手术期指标、并发症以及手指功能[密歇根手功能量表(MHQ)评分、关节活动度(TAM)]、炎症指标[白介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)]、氧化应激指标[促肾上腺皮质激素(ACTH)、皮质醇(Cor)]。结果与对照组相比,研究组两点辨别觉缩短,创面完全愈合时间减少(P<0.05);术后6个月研究组MHQ评分、TAM均高于对照组(P<0.05)。术后3 d,两组血清TNF-α、IL-10水平高于术前(P<0.05);ACTH、Cor水平均高于术前(P<0.05);研究组皮瓣瘀紫发生率低于对照组(P<0.05)。结论拇指桡侧穿支螺旋桨与桡背侧皮瓣修复术治疗指端缺损患者引起炎症-氧化应激接近,但拇指桡侧穿支螺旋桨皮瓣修复术可促进康复,改善手功能,保障安全性。