Establishing morphological database of lower limbs for providing appropriate clinical postoperative prosthesis socket / 中国组织工程研究

BACKGROUND: At present, the prosthesis is made by three steps: Taking, trimming and shaping. Because the process of trimming is manual, it is closely related to the experience and technology of clinical technicians. If the prosthesis is not beautiful, it is difficult to make full contact between the receiving cavity and the residual limb. OBJECTIVE: To collect MRI data of thigh in healthy volunteers, evaluate the anatomical symmetry of thigh amputation range (10-25 cm above knee joint space), and establish MRI data as a database so as to provide reference data for patients with lower limb amputation to match the appropriate prosthesis after operation. METHODS: Totally 40 healthy volunteers were recruited and basic information was collected, including age, height, weight, the circumference of the knee, the circumference of the knee at 5 cm, the circumference of the knee at 10 cm, and the circumference of the knee at 15 cm. All volunteers signed the informed consent. This study was approved by the Hospital Ethics Committee. Three-dimensional reconstruction was carried out in thigh amputation range. Taking the surface area and volume of the model as parameters, the thighs of each volunteer were anatomically measured. Three-dimensional reverse engineering software was used to analyze the three-dimensional deviation of the measurement results so as to conduct quantification and visualization of the thigh symmetry. RESULTS AND CONCLUSION: (1) Self symmetric analysis: Regarding the surface area, the maximal percent difference between the left and right thigh amputation was no more than 0.56% (P=0.109). Regarding the volume, the maximal percent difference between the left and right thigh amputation was no more than 1.19% (P=0.182). Results of the three-dimensional deviation analyses showed that the maximal mean negative deviation was -1.47 mm, while the maximal mean positive deviation was 1.14 mm. Moreover, the three-dimensional deviation distribution of 40 subjects was within 2 mm (78.02%), between 2.1 and 3.0 mm (20.97%), and more than 3 mm (1.01%). (2) Allogeneic symmetric analysis: Results of the three-dimensional deviation analyses showed that the maximal mean negative deviation was -1.97 mm, while the maximal mean positive deviation was 1.89 mm. (3) The results confirmed that adult bilateral thigh amputation range has a high degree of anatomical symmetry. When differences between two adults' right thighs are no more than 2 cm in the circumference of the knee, the circumference of the knee at 5 cm, the circumference of the knee at 10 cm, and the circumference of the knee at 15 cm, their surface profiles of thigh amputation ranges are considered to be highly similar, but are not associated with gender, height and weight.

Disinfection for Prosthetic Sockets in 19 Wearers / 中国康复理论与实践

Objective To explore the possibities of routine disinfection for prosthetic sockets. Methods From June to August, 2016, 19 lower limbs prosthesis wearers wiped their prosthetic socket surfaces and sprayed the stump socks with a compound of quaternary ammoni-um salt every night for three weeks. Meanwhile, field investigation and sampling were carried out weekly. Staphylococcus aureus, Pseudo-monas aeruginosa, Escherichia Coli and Candida albicans were isolated and identified, and colony counting was carried out. Results After disinfection, the number of bacteria on the prosthetic socket reduced 1.8-3.0 log, and the number of fungi reduced 1.6-1.9 log. One strain of Staphylococcus aureus and one strain of Escherichia Coli were isolated before disinfection and one strain of Pseudomonas aeruginosa was isolated after disinfection. Eczema and itching symptoms relieved or disappeared and deodorant effect was distinguished after continuous disinfection. Conclusion Disinfection on prosthetic sockets with compound of quaternary ammonium salt may control the microbial contam-ination and odor, reduce the incidence of eczema and other skin diseases.

Diseño personalizado de una interfaz mioeléctrica para una prótesis de miembro superior / Custom design of a myoelectric interface for upper limb prostheses

Desde los años sesenta se utilizan las señales electromoigráficas (EMG) como señales de control para prótesis actuadas por servomotores, así como en la estimulación de músculos que sufren de parálisis o de atrofia parcial. Mediante el avance tecnológico se ha logrado mejorar el diseño, así como la fabricación de sistemas protésicos, que funcionan como extensiones de algún miembro del cuerpo humano, agregando además con los nuevos diseños, características básicas como: flexibilidad, estética morfológica, incremento de la relación resistencia/peso así como multifuncionalidad. Una prótesis mioeléctrica es una estructura desarrollada con el fin de reemplazar una parte o la totalidad de un miembro del cuerpo humano, lo mismo que suplir las funciones perdidas de este, sin dejar de lado la imagen corporal del paciente. Estas prótesis son accionadas por actuadores que se controlan a través de señales EMG, las cuales se obtiene mediante agujas intramusculares superficiales o por medio de electrodos colocados en el muñón del paciente. Este tipo de prótesis es cada vez más aceptado por personas con amputación de mano, ya que proporciona un mejor desempeño y permite el incremento de funcionalidad para el paciente que la utiliza, debido a que su control es más sencillo.

Since 60’s electromiographical signals (EMG’s) are used like a control signals for prostheses acted by servomotors, as well as stimulation of muscles that are affected due to partial or total paralysis. By means of technological advance, it has been possible to improve the design as well as the production of prosthetic systems that work as extensions of some member of human body, adding with the new designs also basic characteristics as: flexibility, aesthetic morphology, and superior strength/weight relationship, as well as multi-functionality. Mioelectric prosthesis is a structure developed with the purpose of replacing a part or the entirety member of human body, same as to replace the lost functions of this, without leaving aside patient's corporal image. These prostheses are acted by actuators that are controlled through EMG signals, which are obtained by means of intramuscular or superficial needles, or by means of electrodes placed in patient's stump. This class of prostheses is more and more accepted by people with hand amputation since it provides a better acting, that which allows a superior functionality for patient that uses it, because its control is simpler.

Geometric Modeling of Prosthetic Socket / 中国康复理论与实践

@#Objective To investigate the geometric modeling method for trans-femoral prosthetic socket. Methods The socket reference shapes (i.e. shape templates) were constructed based on the statistic analysis and integrated into the CASD program. The initial socket shape was obtained by transformation from the corresponding reference shape based on the data from the patient's stump and the final socket shape was determined by a kind of three-dimensional interaction method under the OpenGL environment. The fabrication experiment is conducted on the specialized numerical control machine. Results The interactive modification method was easy to use. The machined socket mold is consistent with the designed model in the shape and the precision. Conclusion This method can meet the clinical requirements in the main, but need to optimize the surface shaping characters and rules during the interactive modification stage.

Development of ultrasound measurement system for residual lower limbs / 医疗卫生装备

It is an important approach for CAD/CAM of prosthetic sockets to establish digital model of residual lower limbs from amputees. In this thesis, ultrasonic imaging technology is utilized to extract the internal and external contours of residual lower limbs for their 3D modeling , and an ultrasound measurement system is developed.