Search Results (123)

Introduction: The scapholunate interosseus ligament (SLIL) is critical for wrist stability, with injuries causing carpal instability and potential scapholunate advanced collapse (SLAC). This technical note presents a novel ligament-sparing surgical technique for treating SLIL tears ranging from grade 2 to 4 of the Garcia-Elias classification. Materials and Methods: A retrospective study was performed on ten patients treated with this novel technique. The technique involves a dorsal approach to the wrist through a 5–7 cm incision ulnar to Lister’s tubercle. After exposing the scapholunate joint, reduction is performed using Kirschner wires (K-wires) as joysticks, followed by stabilisation with three K-wires through the scapholunate, scapho-capitate, and radio-lunate joints. Two 2.3 mm suture anchors with double sutures are placed where the reduction K-wires were removed. One pair of sutures connects the anchors and any remaining SLIL tissue, while the second pair create a shoelace-like capsulodesis. Post-operative care includes staged K-wire removal at one and two months, with progressive rehabilitation before returning to weight-bearing activities at six months. Results: All patients improved in pain and function. The technique addresses SLIL injuries by restoring both coronal alignment through ligament repair and sagittal alignment via dorsal capsulodesis. The use of suture anchors and direct repair preserves the native tissue while reinforcing the dorsal capsule–scapholunate septum complex, avoiding the need for tendon grafts or extensive bone tunnelling. Conclusions: This ligament-sparing technique offers several advantages, including absence of donor site morbidity, minimal damage to carpal cartilage and vascularity, and preservation of surgical options should revision be necessary. The procedure effectively addresses both components of scapholunate instability while maintaining a relatively straightforward surgical approach. Full article

This study presents a self-powered smart wrist brace integrated with a piezoelectric sensor for real-time biomechanical monitoring during weightlifting activities. The system was designed to quantify wrist flexion across multiple loading conditions (0 kg, 0.5 kg, and 1.0 kg), leveraging mechanical strain-induced voltage generation to capture angular displacement. A flexible PVDF film was embedded within a custom-fitted wrist brace and tested on male and female participants performing controlled wrist flexion. The resulting voltage signals were analyzed to extract root-mean-square (RMS) outputs, calibration curves, and sensitivity metrics. To interpret the experimental results analytically, a lumped-parameter cantilever beam model was developed, linking wrist flexion angles to piezoelectric voltage output based on mechanical deformation theory. The model assumed a linear relationship between wrist angle and induced strain, enabling theoretical voltage prediction through simplified material and geometric parameters. Model-predicted voltage responses were compared with experimental measurements, demonstrating a good agreement and validating the mechanical-electrical coupling approach. Experimental results revealed consistent voltage increases with both wrist angle and applied load, and regression analysis demonstrated strong linear or mildly nonlinear fits with high $R^2$ values (up to 0.994) across all conditions. Furthermore, surface plots and strain sensitivity analyses highlighted the system’s responsiveness to simultaneous angular and loading changes. These findings validate the smart wrist brace as a reliable, low-power biomechanical monitoring tool, with promising applications in injury prevention, rehabilitation, and real-time athletic performance feedback. Full article

Background: Arterial variations in the upper limb, although infrequent, carry critical clinical implications. The presence of superficial ulnar and radial arteries, especially when originating from high levels, increases the risk of iatrogenic injury, misdiagnosis, and surgical complications. To confirm and describe, through ultrasound and anatomical dissection, the presence of a high-origin superficial ulnar artery and a superficial radial artery in a cadaver, highlighting their anatomical trajectory and clinical relevance. Methods: A cross-sectional ultrasound and anatomical study was conducted on 150 upper limbs from fresh-frozen cadavers. High-frequency ultrasound was used to scan the vasculature from the axilla to the wrist. Subsequently, dissection was performed to confirm sonographic findings. Results: One case (0.66%) of concurrent superficial ulnar artery and superficial radial artery was identified in the left arm of a 79-year-old male cadaver. The superficial ulnar artery originated from the axillary artery and coursed superficially along the forearm, anterior to the flexor muscles. The superficial radial artery emerged from the brachial artery and ran subcutaneously in the distal forearm. These arteries remained in close relation to key neural and venous structures, increasing their vulnerability to clinical error. Conclusions: The identification of high-origin superficial arteries is essential for clinical practice. Ultrasound serves as a reliable, non-invasive method for detecting such variations preoperatively. Awareness of these anomalies can prevent inadvertent vascular injuries, improve diagnostic accuracy, and inform safer surgical and anesthetic approaches in upper limb interventions. Full article

The complex structure of the wrist joint supports the hand to complete a variety of dexterous and accurate operations in daily living, which in turn makes it vulnerable to motor injury due to stroke, sports, occupational, or traffic accidents. As a supplement to traditional medical treatment, timely and effective rehabilitation training can accelerate the recovery process of wrist motor function. The wearable rehabilitation device in this work exhibits excellent application prospects in the field of human rehabilitation training due to its inherent flexibility and safety. Inspired by the motion principle of tendons and muscles, a modular vacuum-actuated artificial muscle (VAM) is proposed, with the advantages of being lightweight and having a high contraction ratio. The VAMs are applied to the development of a wearable wrist rehabilitation device (WWRD) prototype, which can realize wrist rehabilitation training in the motion directions of extension, flexion, radial deviation, and ulnar deviation. The design concept, structural model, and motion analysis of a WWRD are introduced to provide a reference for the design and analysis of the WWRD prototype. To evaluate the performance of the WWRD, we establish the force and motion parameter models of the WWRD and carry out performance experiments. The process of wrist rehabilitation training is tested and evaluated, which indicates that the WWRD with VAMs will enhance flexibility, comfort, and safety in wrist rehabilitation training. This work is expected to promote the development of high-performance wearable wrist rehabilitation devices based on an understanding of the bionic vacuum-actuated artificial muscles. Full article

Low-energy bone fractures refer to injuries that occur from minimal trauma or impact. These fractures are often a result of activities, such as falls from standing height or minor accidents, where the force exerted on the bone is insufficient to cause a break under normal conditions. To design an effective orthotic splint, it is critical to select the appropriate material that mimics the mechanical properties of traditional materials like plaster, which has long been used for immobilization purposes. In this case, Ansys CES Edupack 2025 software was utilized to evaluate and identify materials with mechanical characteristics similar to those of plaster. The software provided a list of six materials that met these criteria, but selecting the most suitable material involved more than just mechanical properties. Three different multicriteria decision-making methods were employed to ensure the best choice: TOPSIS, VIKOR, and COPRAS. These methods were applied to consider various factors, such as strength, flexibility, weight, cost, and ease of manufacturing. The results of the analyses revealed a strong consensus across all three methods. Each approach identified PLA (Polylactic Acid) as the most appropriate material for the orthotic design. Following the material selection process, simulations were conducted to assess the structural performance of the orthotic splint. The results determined that the minimum thickness required for the PLA orthosis was 4 mm, ensuring that it met all necessary criteria for acceptable stresses and deformations during the four primary movements exerted by the wrist. This thickness was sufficient to maintain the orthosis’s functionality without compromising comfort or effectiveness. Moreover, a significant improvement in the design was achieved through topological optimization, where the mass of the preliminary design was reduced by 9.58%, demonstrating an efficient use of material while maintaining structural integrity. Full article

Distal radius fractures (DRFs) constitute one of the most prevalent injuries in adults. This study compares the clinical and radiological outcomes of intra- and extra-articular DRFs treated with percutaneous Kirschner wires (PKW) or volar locking plates (VLP). Materials and Methods: A retrospective analysis was conducted on 42 patients (aged 18 to 85) treated between 2017 and 2019 with a minimum follow-up of five years. Outcomes were assessed using radiographic parameters and validated clinical scoring systems such as Disabilities of the Arm, Shoulder, and Hand (DASH), Patient-Rated Wrist Evaluation (PRWE), and Mayo Wrist Score (MAYO). Results: Clinical outcomes were better in the VLP group but not statistically significant (p > 0.05). For extra-articular fractures, DASH were 1.5 (VLP) vs. 6.4 (PKW) (p = 0.5007), PRWE were 1.3 (VLP) vs. 2.9 (PKW) (p = 0.4049), and MAYO were 95 (VLP) vs. 86.1 (PKW) (p = 0.2406). For intra-articular fractures, DASH were 6.6 (VLP) vs. 19.7 (PKW) (p = 0.0981), PRWE 12.9 (VLP) vs. 21.1 (PKW) (p = 0.3661), and MAYO 78.9 (VLP) vs. 72.2 (PKW) (p = 0.4503). Conclusions: PKW and VLP showed satisfactory long-term outcomes. VLP fixation allowed better short-term recovery and anatomical restoration, but long-term functional outcomes were comparable. Full article

Background: In volleyball, upper limb dimensions, handgrip strength (HGS), and baropodometric parameters are critical for executing offensive and defensive actions during the match. These movements demand not only physical precision but also carry a significant risk of injury, varying by playing position. Objectives: This study aimed to determine the differences in specific upper limb anthropometric characteristics, HGS, and selected baropodometric variables among U-23 male volleyball players concerning playing position. Methods: The sample consisted of 92 U-23 male players who prepared for the U-23 Men’s Volleyball National Championship 2022 (20.39 (1.74) years, 184 (8.46) cm, 75.52 (10.20) kg). Playing positions analyzed were setters (n = 12), outside (n = 18), opposites (n = 19), middle blockers (n = 16), and liberos (n = 12). Results: player position differences in HGS and several anthropometric upper limb variables were observed. Middle blockers, outsides, and opposites exhibited superior anthropometric traits in most of the measurements compared to liberos and setters (p < 0.05). Differences in baropodometric parameters were only found between feet and their zones when the entire sample was evaluated. Finally, regression analysis identified dominant hand breadth (β = 3.42, 95%CI [0.43, 6.40], upper arm muscle area (β = 0.157, 95%CI [0.02, 0.29]), and wrist diameter (β = 3.59, IC 95% [0.49, 6.68]) as associated variables of HGS. Conclusions: The study underscores the importance of positional profiling in volleyball, revealing key physical traits linked to performance. The observed differences are likely attributable to the specific role and physical demands inherent to each playing position. These findings can guide targeted training and injury prevention strategies to enhance performance. Full article

Background/Objectives: This study aimed to investigate the results of surgical intervention in cases of scaphoid nonunion and delayed healing among individuals aged 18 or younger, focusing on both clinical and radiological aspects, as well as identifying possible factors that may impact the effectiveness or failure of the treatment. Methods: A total of 20 boys with impaired scaphoid bone healing underwent surgical treatment, with the average duration between the suspected injury and the procedure being approximately 10.8 months. At the time of surgery, the patients had a mean age of 15 years, and the average follow-up period was 20 months. We assessed the type of surgery performed, along with range of motion and pain intensity, comparing preoperative findings with those recorded at the final evaluation. Based on lateral X-ray examination, CLA (capitolunate angle), SCA (scaphocapitate angle), and SLA (scapholunate angle) angles were measured before and after surgery and at the last follow-up. Results: The treatment results showed bone union in 18 out of 20 patients (90%), complete pain relief in 17 patients (85%), and a significant improvement in ROM. There was a statistically significant improvement in the SLA angle and an increase in wrist dorsal flexion. We also identified three factors that significantly influence better ROM after surgery, namely the values of the CLA and SLA angles, as well as the time from injury to surgery. Conclusions: Our findings suggest that surgical intervention contributes to improved joint mobility, pain reduction, and restoration of anatomical alignment in the wrist. While we identified factors associated with more favorable functional results, we did not find any that were linked to a higher likelihood of treatment failure. Full article

Wrist fractures, especially those involving the elbow and distal radius, are the most common injuries in children, teenagers, and young adults, with the highest occurrence rates during adolescence. However, the demand for medical imaging and the shortage of radiologists make it challenging to ensure accurate diagnosis and treatment. This study explores how AI-driven approaches are used to enhance fracture detection and improve diagnostic accuracy. In this paper, we propose the latest version of YOLO (i.e., YOLO11) with an attention module, designed to refine detection correctness. We integrated attention mechanisms, such as Global Attention Mechanism (GAM), channel attention, and spatial attention with Residual Network (ResNet), to enhance feature extraction. Moreover, we developed the ResNet_GAM model, which combines ResNet with GAM to improve feature learning and model performance. In this paper, we apply a data augmentation process to the publicly available GRAZPEDWRI-DX dataset, which is widely used for detecting radial bone fractures in X-ray images of children. Experimental findings indicate that integrating Squeeze-and-Excitation (SE_BLOCK) into YOLO11 significantly increases model efficiency. Our experimental results attain state-of-the-art performance, measured by the mean average precision (mAP50). Through extensive experiments, we found that our model achieved the highest mAP50 of 0.651. Meanwhile, YOLO11 with GAM and ResNet_GAM attained a maximum precision of 0.799 and a recall of 0.639 across all classes on the given dataset. The potential of these models to improve pediatric wrist imaging is significant, as they offer better detection accuracy while still being computationally efficient. Additionally, to help surgeons identify and diagnose fractures in patient wrist X-ray images, we provide a Fracture Detection Web-based Interface based on the result of the proposed method. This interface reduces the risk of misinterpretation and provides valuable information to assist in making surgical decisions. Full article

Background: Wrist immobilization is a common clinical intervention for wrist injuries; however, its repercussions on gait parameters and plantar support have not been extensively investigated. Objectives: The purpose of the study was to determine whether wrist immobilization causes alterations in foot pressure and center of gravity, considering hand dominance and visual conditions (eyes open or closed). Methods: The research experiment was conducted using the PodoPrint S4 platform. Basic descriptive statistics were calculated to summarize the variables. Additionally, in the mixed linear model (t-tests use Satterthwaite’s method) an analysis of variance for repeated measures (ANOVA-RM) was conducted for the determination of the objectives of the study. Results: This study included a total of 44 participants (29 females and 15 males), with an average age of 36.5 years (SD = 17.5). Immobilization, independent of eye condition, resulted in significant alterations in antero-posterior oscillation and in a larger plantar support area. In addition, the results suggest that the eye state significantly influences plantar support, independent of limb immobilization or dominance. Conclusions: Our findings reveal significant alterations in antero-posterior oscillation and plantar support due to immobilization, suggesting a dynamic interplay between wrist function and lower limb biomechanics. Full article

Background and Objectives: Although virtual reality (VR) has been shown to be effective in rehabilitation through motor learning principles, its impact on upper extremity function, particularly in the context of console use, remains unclear. Materials and Methods: This study aimed to investigate the effects of VR-based task-oriented movement on the upper extremity of healthy individuals. A total of 26 healthy individuals performed task-oriented movements in both real and virtual environments in a randomized order. All participants completed a single session of task-oriented movements using a VR Goggle system in a virtual setting. Physiotherapists designed immersive VR-based experiences and 3D screen-based exergames for this study. Upper extremity function was assessed using several measures: joint position sense (JPS) of the wrist and shoulder was evaluated using a universal goniometer, reaction time was measured via a mobile application, and gross manual dexterity was assessed using the box-and-block test (BBT). Evaluations were conducted before and after the interventions. Results: The results showed that JPS remained similar between conditions, while BBT performance improved in both groups. However, the reaction time increased significantly only after VR intervention (p < 0.05). No significant period or carryover effects were observed across the parameters. These findings suggest that VR-based task-oriented training positively influences reaction time and supports hand function. Moreover, VR systems that simulate joint position sense similar to real-world conditions may be beneficial for individuals with musculoskeletal motor deficits. Conclusions: These results highlight the potential for integrating VR technology into rehabilitation programs for patients with neurological or orthopedic impairments, providing a novel tool for enhancing upper extremity function and injury prevention strategies. Full article

The aging of society is a global concern nowadays. Falls and fall-related injuries can influence the elderly’s daily living, including physical damage, psychological effects, and financial problems. A reliable fall detection system can trigger an alert immediately when a fall event happens to reduce the adverse effects of falls. Notably, the wrist-based fall detection system provides the most acceptable placement for the elderly; however, the performance is the worst due to the complicated hand movement modeling. Many works recently implemented deep learning technology on wrist-based fall detection systems to address the worst, but class imbalance and data scarcity issues occur. In this study, we analyze different data augmentation methodologies to enhance the performance of wrist-based fall detection systems using deep learning technology. Based on the results, the conditional diffusion model is an ideal data augmentation approach, which improves the F1 score by 6.58% when trained with only 25% of the actual data, and the synthetic data maintains a high quality. Full article

Wrist kinematics can provide insight into the development of repetitive strain injuries, which is important particularly in workplace environments. The emergence of markerless motion capture is beginning to revolutionize kinematic assessment such that it can be conducted outside of the laboratory. The purpose of this work was to apply open-source software (OSS) and machine learning (ML) by using DeepLabCut (OSS) to determine anatomical landmark locations and a variety of regression algorithms and neural networks to predict wrist angles. Sixteen participants completed a series of flexion–extension (FE) and radial–ulnar (RUD) range-of-motion (ROM) trials that were captured using a 13-camera VICON optical motion capture system (i.e., the gold standard), as well as 4 GoPro video cameras. DeepLabCut (version 2.3.3) was used to generate a 2D dataset of anatomical landmark coordinates from video obtained from one obliquely oriented GoPro video camera. Anipose (version 1.0.1) was used to generate a 3D dataset from video obtained from four GoPro cameras. Anipose and various ML algorithms were used to determine RUD and FE wrist angles. The algorithms were trained and tested using a 75%:25% data split with four folds for the 2D and 3D datasets. Of the seven ML techniques applied, deep neural networks resulted in the highest prediction accuracy (5.5) for both the 2D and 3D datasets. This was substantially higher than the wrist angle prediction accuracy provided by Anipose ($FE-99$; $RUD-25.2$). We found that, excluding cubic regression, all other studied algorithms exhibited reasonable performance that was similar to that reported by previous authors, showing that it is indeed possible to predict wrist kinematics using a low-cost motion capture system. In agreement with past research, the increased MAE for FE is thought to be due to a larger ROM. Full article

Guyon’s canal, or the ulnar tunnel, is a critical anatomical structure at the wrist that houses the ulnar nerve and artery, making it susceptible to various pathological conditions. Pathologies affecting this canal include traumatic injuries, compressive neuropathies like ulnar tunnel syndrome, and space-occupying lesions such as ganglion cysts. Ulnar tunnel syndrome, characterised by numbness, tingling, and weakness in the ulnar nerve distribution, is a prevalent condition that can severely impair hand function. The canal’s intricate anatomy is defined by surrounding ligaments and bones, divided into three zones, each containing distinct neural structures. Variations, including aberrant muscles and vascular anomalies, can complicate diagnosis and treatment. Imaging techniques are essential for evaluating these conditions; ultrasound provides real-time, dynamic assessments, while magnetic resonance imaging (MRI) offers detailed visualisation of soft tissues and bony structures, aiding in pre-surgical documentation and pathology evaluation. This review article explores the anatomy, pathologies, and imaging modalities associated with Guyon’s canal and underscores the necessity of understanding Guyon’s canal’s anatomy and associated pathologies to improve diagnostic accuracy and management strategies. By integrating anatomical insights with advanced imaging techniques, clinicians can enhance patient outcomes and preserve hand function, emphasising the need for increased awareness and research in this often-neglected area of hand anatomy. Full article

Introduction: Occupational injuries among healthcare workers adversely affect the quality of healthcare services by undermining their physical and mental well-being. This study evaluates the frequency, characteristics, and influencing factors of occupational injuries among non-physician healthcare workers in a university hospital. Methods: This cross-sectional study examines occupational injuries reported between 2020 and 2023 at a university hospital in Turkey. Variables included sociodemographic characteristics, occupation, department, working hours, cause and type of injury, time of injury, affected body part, use of personal protective equipment (PPE), medical intervention, and incapacity for work. Results: A total of 694 occupational injuries were reported at Gazi University Hospital between 2020 and 2023, with the fewest cases occurring in 2021. Among the injured workers, 58.8% were female, 89.2% were aged between 20 and 49 years, 30.1% did not use PPE, 76.4% received medical intervention, and 11.1% experienced incapacity for work. Cleaning workers (33.6%) and nurses (32.1%) accounted for the highest proportion of injuries. Sharps injuries were the most common type (48.8%), while injuries to the hands, fingers, and wrists comprised 53.3% of cases. The highest frequency of injuries occurred between 11:00 and 11:59 am. Sharps injuries were significantly associated with gender, age, educational background, occupation, working hours, and injury time. In contrast, cases of workplace violence were significantly associated with gender, occupation, and working hours. Conclusions: Sharps injuries and violence represent critical occupational hazards. Preventive strategies should be tailored to healthcare workers’ occupational roles and educational levels. Effective surveillance systems and reporting mechanisms should be implemented to promote workplace safety and reduce the risk of injuries. Full article