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.

Reconstruction of Allen's type IV fingertip amputation via bilateral unequal-sized hallux osteo-onychocutaneous free flaps:A retrospective study with 5-year follow-up

Purpose:The reconstruction of Allen''s type IV fingertip amputation is a clinical challenge.Our team designed bilateral unequal-sized hallux osteo-onychocutaneous free flaps for the long-term reconstruction of Allen''s type IV fingertip amputation and conducted a retrospective study with a 5-year follow-up aims to evaluate the effects of this technique.Methods:A retrospective analysis with a 5-year follow-up including 13 patients with Allen''s type IV fingertip amputation who were admitted to our hospital from January 2010 to January 2017 was conducted.The patients were treated with bilateral unequal-sized hallux osteo-onychocutaneous free flaps.The operation time,intraoperative blood loss,and complications were recorded,and the survival rate of the transplanted flaps was calculated.During the 5-year follow-up after operation,the nail growth time was recorded and the finger appearance was observed.At the last follow-up appointment,the length,width,and girth of the reconstructed fingertip and contralateral normal fingertip,range of motion of the reconstructed fingertip and contralateral normal fingertip,Semmes-Weinstein test(for the evaluation of tactile sensation),and two-point discrimination testing results were recorded.SPSS 22.0 software was used for the statistical analysis and the data are presented as mean±SD.Results:The mean operation time was(5.62±0.51)h,the mean intraoperative blood loss was(34.15±3.13)mL,and the survival rate of the transplanted flaps was 100%.During the 5-year follow-up,the average nail growth time was(10.14±1.98)months and the average bone union time was(3.78±0.91)months.The length,width,and girth of the reconstructed fingertip were(31.52±3.73)mm,(17.82±1.74)mm,and(59.75±3.04)mm,respectively,which did not differ from those of the contralateral normal fingertip.The range of motion of the reconstructed fingertip was(12.15±2.79)degrees which is different from that of the contralateral normal fingertip.The average tactile sensation evaluated via the Semmes-Weinstein test and the average two-point discrimination test of the reconstructed fingertip were(0.39±0.17)g and(7.46±1.14)mm,respectively,which were not different from those of the contralateral normal fingertip.The average Maryland score of feet in the donor area was 87.66±7.39,which was satisfactory.Conclusion:Bilateral unequal-sized hallux osteo-onychocutaneous free flaps are an effective method to reconstruct Allen''s type IV fingertip amputations with a satisfactory appearance and good sensory function.

游离趾腓侧瓣与指背岛状皮瓣在手指末节指腹缺损修复中的应用对比

目的对比游离趾腓侧瓣与指背岛状皮瓣在手指末节指腹缺损修复中的应用效果。方法选取2022年1月至2024年1月在安阳市人民医院进行游离趾腓侧瓣与指背岛状皮瓣在手指末节指腹缺损修复的80例患者作为研究对象,其中40例患者采用游离趾腓侧瓣进行修复的患者纳入观察组;另选取40例采用指背岛状皮瓣进行修复的患者纳入对照组。比较两组术后患指较健侧短缩水平、皮瓣两点辨别觉、手功能恢复优良率、皮瓣外观感觉评分、皮瓣成活率。结果观察组患者患指较健侧短缩水平小于对照组,差异有统计学意义(P<0.05)。观察组患者在术后1个月、2个月、3个月后皮瓣两点辨别觉大于对照组,差异有统计学意义(P<0.05)。观察组术后6个月的手功能恢复优良率为85.00%,对照组术后6个月的手功能恢复优良率为82.50%,对比差异无统计学意义(P>0.05)。观察组患者的皮瓣外观感觉评分高于对照组,差异有统计学意义(P<0.05)。观察组术后皮瓣成活率为90.00%,对照组术后皮瓣成活率为72.50%,观察组高于对照组,差异有统计学意义(P<0.05)。结论在手指末节指腹缺损修复中,采用游离趾腓侧瓣具有患指较健侧短缩水平小、皮瓣外观感觉好、皮瓣成活率高的优点,但采用背岛状皮瓣在皮瓣两点辨别觉优于游离趾腓侧瓣,两种方式均有良好的手功能恢复优良率。

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.

桃红四物汤联合拇指背侧筋膜皮瓣修复对指端软组织缺损皮瓣存活率的影响

目的:观察桃红四物汤联合拇指背侧筋膜皮瓣修复对指端软组织缺损患者皮瓣存活率的影响。方法:选取2022年12月—2023年4月于海宁市第二人民医院进行治疗的80例指端软组织缺损患者为研究对象,按照随机数字表法分为对照组和治疗组各40例。对照组术后给予常规治疗,治疗组在对照组基础上联合桃红四物汤治疗,2组均治疗7 d。比较2组临床疗效、皮瓣存活率及凝血功能。结果:治疗组总有效率为95.00%(38/40),高于对照组77.50%(31/40)(P<0.05)。治疗组皮瓣存活率为95.00%(38/40),高于对照组77.50%(31/40)(P<0.05)。术后第7天,2组活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)长于术前,纤维蛋白原(Fib)水平低于术前(P<0.05);治疗组PT、APTT长于对照组,Fib水平低于对照组(P<0.05)。结论:桃红四物汤联合拇指背侧筋膜皮瓣修复对指端软组织缺损患者具有较好的疗效,能够提高皮瓣存活率,改善凝血功能。

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.

At Your Fingertips

Biometric technology is helping to streng then China’s banking security you are at the ATM machine.You have your credit card ready,but can’t remember the password.You have several credit cards,and it is

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.