Single Hand Research Articles

Light in the Larynx: a Miniaturized Robotic Optical Fiber for In-office Laser Surgery of the Vocal Folds.

This paper reports the design, construction, and experimental validation of a novel hand-held robot for in-office laser surgery of the vocal folds. In-office endoscopic laser surgery is an emerging trend in Laryngology: It promises to deliver the same patient outcomes of traditional surgical treatment (i.e., in the operating room), at a fraction of the cost. Unfortunately, office procedures can be challenging to perform; the optical fibers used for laser delivery can only emit light forward in a line-of-sight fashion, which severely limits anatomical access. The robot we present in this paper aims to overcome these challenges. The end effector of the robot is a steerable laser fiber, created through the combination of a thin optical fiber (ϕ 0.225 mm) with a tendon-actuated Nickel-Titanium notched sheath that provides bending. This device can be seamlessly used with most commercially available endoscopes, as it is sufficiently small (ϕ 1.1 mm) to pass through a working channel. To control the fiber, we propose a compact actuation unit that can be mounted on top of the endoscope handle, so that, during a procedure, the operating physician can operate both the endoscope and the steerable fiber with a single hand. We report simulation and phantom experiments demonstrating that the proposed device substantially enhances surgical access compared to current clinical fibers.

Single-Step 3D Printing of Bio-Inspired Printable Joints Applied to a Prosthetic Hand.

Single-step 3D printing, which can manufacture complicated designs without assembly, has the potential to completely change our design perspective, and how 3D printing products, rather than printing static components, ready-to-use movable mechanisms become a reality. Existing 3D printing solutions are challenged by precision limitations, and cannot directly produce tightly mated moving surfaces. Therefore, joints must be designed with a sufficient gap between the components, resulting in joints and other mechanisms with imprecise motion. In this study, we propose a bio-inspired printable joint and apply it to a Single sTep 3D-printed Prosthetic hand (ST3P hand). We simulate the anatomical structure of the human finger joint and implement a cam effect that changed the distance between the contact surfaces through the elastic bending of the ligaments as the joint flexed. This bio-inspired design allows the joint to be single-step 3D printed and provides precise motion. The bio-inspired printable joint makes it possible for the ST3P hand to be designed as a lightweight (∼255 g), low-cost (∼$500) monolithic structure with nine finger joints and manufactured via single-step 3D printing. The ST3P hand takes ∼6 min to assemble, which is approximately one-tenth the assembly time of open-source 3D printed prostheses. The hand can perform basic hand tasks of activities of daily living by providing a pulling force of 48 N and grasp strength of 20 N. The simple manufacturing of the ST3P hand could help us take one step closer to realizing fully customized robotic prosthetic hands at low cost and effort.

Grasp compliance achieved with a planar hand composed of multiple 3-joint fingers

AbstractIn this paper, the realization of any specified planar Cartesian compliance for an object grasped by a compliant hand is addressed. The hands considered have 2 or more fingers for which each has 3 modulated elastic joints and predetermined link lengths. Geometric construction-based compliance synthesis procedures are developed. Using these procedures, a large set of compliant behaviors can be realized by a single hand simply by adjusting the configuration of each finger and by adjusting the joint stiffness (using variable stiffness actuation) of each finger joint.

Discrepancies in Work Relative Value Unit Assignment Based on Operative Time in Hand Surgery.

Work relative value units (wRVUs) are an intricate component of physician reimbursement determination in the United States. This paper assesses whether wRVUs appropriately consider operative time in hand surgery. The 50 most common single Current Procedural Terminology code hand surgery cases were queried from the 2013 to 2018 National Surgical Quality Improvement Program database. The average assigned wRVUs and median operative times were calculated for each CPT. Linear regressions were calculated between operative time, wRVUs, and wRVUs per hour. Cases deviating the most from the expected wRVUs based on operative time were identified. In all, 46 800 cases comprising the top 50 most common hand surgery procedures were identified. Among these cases, the median (range) assigned operative time was 62 minutes (18-110), wRVUs were 7.5 (3.5-18.0), and wRVUs per hour was 8.3 (4.9-14.2). There was a positive linear correlation between operative time and wRVUs (R2 = 0.60). Each additional operative hour was associated with an additional 6.3 wRVUs (P < .001). Based on this relationship, the assigned wRVUs for included cases ranged from 59.7% to 172.6% of expected. There was a weak negative relationship between wRVUs per hour and operative time (R2 = 0.25). Cases shorter than 1 hour had more wRVUs per hour than those longer than 1 hour (10.0 vs. 8.1, P = .003). However, this relationship disappeared when considering case turnover. This study suggests a moderately strong positive correlation between wRVUs and operative time in hand surgery. Yet, numerous outliers from this trend exist, suggesting some discrepancies in reimbursement.

Changes in Cross-sectional Area of the Median Nerve and Boston Carpal Tunnel Questionnaire Scores After Carpal Tunnel Release.

We hypothesized that postoperative Boston Carpal Tunnel Questionnaire (BCTQ) scores and ultrasound (US) measurements of the median nerve cross-sectional area (CSA) at the distal wrist crease are significantly decreased at 2-week, 6-week, and ≥ 6 months follow-up appointments, compared with baseline values. This study was a retrospective chart review of patients who presented to a single hand clinic with evidence of carpal tunnel syndrome over a 6-year period (2014-2020). Patients received baseline US measurements of the median nerve CSA as well as completion of the BCTQ, and for the patients who underwent carpal tunnel release (CTR), postoperative US measurements and questionnaire scores were obtained at 2 weeks, 6 weeks, or ≥ 6 months postoperatively. This study included 224 separate wrists. Median Nerve CSA measurements were 13.2 ± 4.5 mm2 at baseline, 11.9 ± 3.6 mm2 at 2 weeks postoperatively, 11.6 ± 4.5 mm2 at 6 weeks postoperatively, and 11.7 ± 4.3 mm2 at 6 months or more (P = .002). The BCTQ Symptom Severity Scale scores were 3.14 ± 0.76 at baseline, 1.76 ± 0.63 at 2 weeks, 1.68 ± 0.70 at 6 weeks, and 1.41 ± 0.64 at 6 months or longer (P < .001). The BCTQ Functional Status Scale scores were 2.56 ± 0.89 at baseline, 2.03 ± .1.0 at 2 weeks, 1.65 ± 0.77 at 6 weeks, and 1.36 ± 0.61 at 6 months or longer (P < .001). These findings demonstrated a sustained decrease in median nerve CSA and patient-reported outcomes following CTR at 2 weeks, 6 weeks, and between 6 and 12 months.

Effect of icon size, icon position and sex on clicking motion when operating smartphones with single hand

Nowadays, increasingly more situations exist where smartphones are operated with one hand, requiring an in-depth understanding of human–computer interaction in single-hand scenarios. 104 volunteers (57 men, 47 women) participated in this study. We aimed to explore thumb movements with the right and left hand on smartphone touchscreens at different icon sizes (50, 80, 110 and 140 rpx) in different operation areas (a 4*7 icon matrix). The results partially conformed to Fitts’ Law. The movement time (MT) significantly increased as the icon size decreased, but this effect was not found over 110 rpx. The MT increased with distance in the vertical direction, but icons with the same horizontal distance had different MTs, indicating that one-handed operation restricted the click on the same side. Additionally, subjects rated 140 rpx better than other sizes, and men clicked faster than women. Suggestions regarding one-handed interface design for different hands of different sexes are provided. Practitioner summary: This study investigated how icon size, position and sex influenced one-thumb click usability on touch-screen mobile phones with different hands of different sexes. The results indicate single-hand operation partially conformed to Fitts’ Law. We suggested the most economical and comfortable size and the fast operation area in one-handed interface design. Abbreviations: MT: movement time; ID: index of difficulty; RPX: responsive pixel; NASA-TLX: task load index of National Aeronautics and Space Administration; ANOVA: analysis of variance.

Complex Hand Interaction Authoring Tool for User Selective Media

Nowadays, with the advancement of the Internet and personal mobile devices, many interactive media are prevailing, where viewers make their own decisions on the story of the media based on their interactions. The interaction that the user can make is usually pre-programmed by a programmer. Therefore, interactions that users can make are limited to programmable areas. In comparison, in this paper, we propose an Interactive media authoring tool which can compose diverse two-hand interactions from several one-hand interactive components. The aim is to provide content creators with a tool to produce multiple hand motions so that they can design a variety of user interactions to stimulate the interest of content viewers and increase their sense of immersion. Using the proposed system, the content creator can gain greater freedom to create more diverse and complex interactions than programmable ones. The system is composed of a complex motion editor that edits one-hand motions into complex two-hand motions, a touchless sensor that senses the hand motion and a metadata manager that handles the metadata, which specify the settings for the interactive functions. To our knowledge, the proposed system is the first web-based authoring tool that can authorize complex two-hand motions from single hand motions, and which can also control a touchless motion control device.

Similarity of hand muscle synergies elicited by transcranial magnetic stimulation and those found during voluntary movement.

Converging evidence in human and animal models suggests that exogenous stimulation of the motor cortex (M1) elicits responses in the hand with similar modular structure to that found during voluntary grasping movements. The aim of this study was to establish the extent to which modularity in muscle responses to transcranial magnetic stimulation (TMS) to M1 resembles modularity in muscle activation during voluntary hand movements involving finger fractionation. Electromyography (EMG) was recorded from eight hand-forearm muscles in eight healthy individuals. Modularity was defined using non-negative matrix factorization to identify low-rank approximations (spatial muscle synergies) of the complex activation patterns of EMG data recorded during high-density TMS mapping of M1 and voluntary formation of gestures in the American Sign Language alphabet. Analysis of synergies revealed greater than chance similarity between those derived from TMS and those derived from voluntary movement. Both data sets included synergies dominated by single intrinsic hand muscles presumably to meet the demand for highly fractionated finger movement. These results suggest that corticospinal connectivity to individual intrinsic hand muscles may be combined with modular multimuscle activation via synergies in the formation of hand postures.NEW & NOTEWORTHY This is the first work to examine the similarity of modularity in hand muscle responses to transcranial magnetic stimulation (TMS) of the motor cortex and that derived from voluntary hand movement. We show that TMS-elicited muscle synergies of the hand, measured at rest, reflect those found in voluntary behavior involving finger fractionation. This work provides a basis for future work using TMS to investigate muscle activation modularity in the human motor system.

Radiographic Outcomes of Casting Versus Splinting for Conservatively Treated Metacarpal Fractures

IntroductionWhile many have studied alternate forms of casting for conservative treatment of metacarpal fracture, few have compared casting and splinting. This study aims to compare radiographic alignment in metacarpal shaft and neck fractures immobilized with splints to those treated with casts.MethodsA retrospective review was conducted to identify all metacarpal fractures treated by a single orthopedic hand surgeon from 2016-2020. Patients with metacarpal shaft or neck fractures treated nonoperatively, immobilized with either a cast or a splint, and with a minimum of one follow-up visit were included. Degrees of radial/ulnar angulation, dorsal/volar angulation, and changes in angulation were measured. Mean angulation measurements and changes in angulation were compared across groups using Mann-Whitney U tests.ResultsA total of 61 patients, 45 treated with casts and 16 with splints, met our inclusion criteria. The average immobilization time was 28 days for both groups (p=0.958). Change in radial/ulnar angulation was similar between the two groups (splint = -3⁰, cast = -3⁰, p=0.79). No significant differences were found when comparing changes in dorsal/volar angulation across groups (splint = -0.3⁰, cast = -0.1⁰, p=0.57). No complications were reported in either group.ConclusionsOur results suggest that metacarpal shaft and neck fractures treated with splints can maintain fracture reduction and angulation comparable to casting. Splints offer additional benefits of reduced costs with improved patient hygiene and satisfaction. Further studies on the utility and cost-effectiveness of splints for treating metacarpal fractures are warranted.

The Yale MyoAdapt Hand: A Highly Functional and Adaptive Single Actuator Prosthesis

The drawbacks of many commercially available multi-actuator prosthetic hands have led to high rejection rates in both adults and children. For an active lifestyle, there is a need for a device that is both lightweight and easy to control. Underactuation has quickly become an attractive solution in prosthetics by reducing the control burden and the weight of multi-actuator hands while still providing a compliant anthropomorphic grasp. In this paper we present the design and evaluation of a novel single actuator prosthetic hand. The hand uses adaptive mechanisms to allow for three unique grasp types with varying grasp rates, force output and thumb positions. The hand kinematics and geometry are optimized to prevent against common grasp failure modes of underactuated grippers. The hand was evaluated through benchtop and human subject testing to evaluate its effectiveness on activities of daily living. Additionally, we compared the performance of the hand to previously published results from a powered hook, a single actuator anthropomorphic robotic hand, and several commercial multi-actuator anthropomorphic robotic hands. The results show that the hand is comparable even to multiactuator commercial devices with users who have trained on these devices for several months to years.

Unveiling the sign value of early potter’s wheels based on a 3-D morphometric analysis of Late Chalcolithic vessels from the southern Levant

The sign value of the first potter's wheels used in the southern Levant (second half of the 5th mill. BC) is explored through the production modalities of V-shaped bowls, the main category of vessels shaped on the wheel at that time. To this end, a morphometric approach is applied to V-shaped bowls from four sites through numerical methods available in a Pottery 3-D software used to extract shape parameters. The results obtained highlight a high variability in absolute dimensions and a low variability in profiles. This apparent contradiction is discussed in light of the variability of bowls made under three experimental conditions. The baseline data obtained suggests that the roughouts of the archaeological bowls were made by several hands, while the shaping of the bowls on the wheel was done by a single hand. This disjunction in the production process supports the hypothesis that the earliest rotary instruments found in the southern Levant were loaded with symbolic meaning that was then transferred to the vessels when they were shaped on the wheel.

The Double Role of Architecture: The Critical and Therapeutic Potency of Unbuilt Utopias

ABSTRACT Born in periods of crises, utopias adopt a threefold structure: a critique of society, a spatial arrangement, and a new society sustained by this spatial arrangement. Accordingly, space and architecture are recognized as spatial levers to address crises and change societies. However, three problematic characteristics emerge from an analysis of past and contemporary utopias. First, utopias do not always advocate for new societal orders, as some tend to consolidate the existing ones. Second, they have evolved to be increasingly tangible. Third, while appearing as collective narratives, they are written by a single hand, allowing little variations. To address these issues and revitalize their critical potency, utopias could act as beacons rather than concrete projects, work on processes rather than goals, and build collective narratives rather than monologues. Eventually, the article illustrates architecture’s twofold rationale: a means to physically build space and a critical tool to reflect on society.

Fair Copy: Relational Poetics and Antebellum American Women’s Poetry. Jennifer Putzi. Philadelphia: University of Pennsylvania Press, 2021. Pp. xii+272.

<i>Fair Copy: Relational Poetics and Antebellum American Women’s Poetry</i>. Jennifer Putzi. Philadelphia: University of Pennsylvania Press, 2021. Pp. xii+272.

Yozgat High School from First Constitutional Era to Today

Çalışmamızın konusu Osmanlı İmparatorluğu’nda eğitim modernizasyonu neticesinde inşa edilen Yozgat Lisesi binasıdır. II. Mahmud (1808-1839) döneminden itibaren başlatılan eğitimde yenileşme hareketleri kapsamında, 1869 Maarif-i Umumiye Nizamnamesi yürürlüğe sokulur. Nizamname eğitim alanında uygulanacak değişimin teorik ayağını oluşturmaktadır. Modernizasyonun uygulama aşamasında yeni binalar inşa edilir. Binaların yapımı için sancak yönetimleri tarafından komisyonlar oluşturulur. Bu komisyonlar tarafından arsa alımı ve binanın planı ile ilgili keşif defterleri merkeze gönderilir. Keşif defterinde gereken harcamalar kalemler halinde belirtilir. Yozgat’ta bahsi geçen modernizasyon çalışmaları kapsamında Yozgat Lisesi binası için benzer prosedürler uygulanır. Binanın inşasına orta öğretimin bir kademesi olarak îdâdi adı altında 1895 yılında başlanır. Ancak inşaat maddi imkânsızlıklar nedeni ile II. Abdülhamid döneminde (1876-1909) tamamlanamaz. İnşa sürecinin uzun sürmesi nedeni ile tek bir elden inşa edilemeyen binanın, II. Abdülhamid döneminde tasarlanan cephe ve plan anlayışından farklı bir şekilde inşa edildiği görülmektedir. Kullanımı açısından binanın ilk etapta 1924 Tevhid-i Tedrisat Kanunu ile ortaokul, 1933-1934 eğitim-öğretim yılından itibaren lise olarak hizmet verdiği bilinmektedir. Çalışmamızda binanın ilk tasarlandığı şeklinin ne olduğu, sonradan hangi değişikliklerle inşasının tamamlandığı, zaman içerisinde binada görülen eskime ve tadilatların ne olduğu, kendi çağdaşları ile mukayesesi, sanatsal ve üslup özellikleri üzerinde durulmaktadır. Yozgat Lisesi mimari açıdan bütün ayrıntıları ile ele alınarak bilim literatürüne konu edilmektedir.

Design and Development of Efficient Model to Predict Neurodegenerative Disorders Using Advanced LSTM: A Review of Literature

Purpose: A continuous Nervous system illness that influences development is known as neurodegenerative sickness. Side effects show up continuously, and may start with a scarcely distinguishable quake in just a single hand. Quakes are normal, but they are frequently joined by firmness or eased back versatility. The emphasis is on Parkinson's infection specifically (PD). The signs and results of Parkinson's contamination shift starting with one individual then onto the next. Early reprimand markers could be subtle and go unnoticed. Regardless, when aftereffects start to influence the different sides of your body, secondary effects normally jump on single side of your body and decay on that side. Parkinson's illness is brought about by the demise of nerve cells in the substantia nigra, a portion of the cerebrum. The exactness of a few fake brain network approaches, for example, Convolutional Neural Network, Recurrent Neural Network, Long-Short term Memory network have been concentrated on to analyze Parkinson's illnesses. This record inspects a synopsis of a portion of the examination and concentrates on that have been directed in the field of clinical diagnostics. In light of the audit, research holes are featured, as well as examination needs for future review. Approach: A thorough study on the algorithms used in analysis of handwritten and vocal to distinguish and anticipate Parkinson's illness. Findings: The review showed that the majority of the AI and deep learning strategy can order neurodegenerative illness in view of vocal, transcribed and walk investigation in light of the clinical datasets. The new crossover philosophy proposed will be more exact as the model will actually want to foresee and distinguish neurodegenerative sickness in view of eye development. Originality: The sort of information expected for forecast and discovery framework are considered and the design and portrayal outline of a proposed model are incorporated. Paper Type: Literature Review.

A feasibility and pilot study of the clinical efficacy of a custom designed handgrip device to improve patient immobilisation for the external beam radiotherapy of oesophageal cancers

The primary aim of radiotherapy is to eradicate tumour cells within the clinical target volume (CTV), at the same time while sparing surrounding organs at risk (OAR) which is often accomplished by conforming to the treatment fields, i.e. target volume and by using appropriate margins for accounting the treatment uncertainties. Furthermore, for accurate radiation dose delivery, perfect immobilisation is required to keep the patient within the same position at each treatment fraction. There has always been a need for perfect immobilisation which should provide minimal patient movement, patient comfort, reproducible patient positioning during radiotherapy and be less expensive. The main objective of the present study was to design, fabricate and evaluate a handgrip board immobilisation device for the thorax region to boost the efficiency of the external beam radiotherapy in oesophageal cancer patients and evaluate the set-up error. Our indigenously fabricated handgrip baseboard device is made of poly-methyl methacrylate (PMMA), which consists of the main baseboard with an adjustable central T-bar and separate right and left single hand poles. In the present study, fifteen patients with oesophageal tumours were included. Patients were positioned using the indigenously fabricated handgrip immobilisation device; portal images were performed prior to the treatment and matched with the digitally reconstructed radiographs (DRR). The population systematic (Σ) and random (σ) patient set-up errors were calculated along the direc­tions of Anterior-Posterior (AP), Medial-Lateral (ML) and Superior-Inferior (SI). The values for the planning target volume (PTV) margins were calculated using ICRU 62, Van Herk’s and Stroom’s formulae. The population systematic (Σ) errors of AP, ML and SI were 0.12, 0.20 and 0.20 cm, respectively while the population random (σ) errors of AP, ML, SI were 0.17, 0.31 and 0.17 cm, respectively. The PTV margins were calculated according to ICRU 62, Van Herk’s, and Stroom’s and it was observed in the range of 0.2–0.7 cm in the three acquisition directions. The use of a handgrip immobilisation device allowed for relatively small set-up errors and ensured the patient’s comfort. Also, the technique showed satisfactory accuracy and reproducibility.

Virtual management of clinically suspected scaphoid fractures.

The aim of this study was to describe the introduction of a virtual pathway for the management of patients with a suspected fracture of the scaphoid, and to report patient-reported outcome measures (PROMs) and satisfaction following treatment using this service. All adult patients who presented with a clinically suspected scaphoid fracture that was not visible on radiographs at the time of presentation during a one-year period were eligible for inclusion in the pathway. Demographic details, findings on examination, and routine four-view radiographs at the time of presentation were collected. All radiographs were reviewed virtually by a single consultant hand surgeon, with patient-initiated follow-up on request. PROMs were assessed at a minimum of one year after presentation and included the abbreviated version of the Disabilities of the Arm, Shoulder and Hand Score (QuickDASH), the EuroQol five-dimension five-level health questionnaire (EQ-5D-5L), the Net Promoter Score (NPS), and return to work. A total of 221 patients were referred to the virtual pathway. Their mean age was 41 years (range 16 to 87) and there were 99 male patients (45%). A total of 189 patients (86%) were discharged with advice and 19 (9%) were recalled for clinical review: seven with an undisplaced scaphoid fracture, six with another fracture of the hand or wrist, two with a scapholunate ligament injury, and four in whom no abnormality was detected. A total of 13 patients (6%) initiated follow-up with the hand service: no fracture or ligament injury was identified in this group. PROMs were available for 179 patients (81%) at a mean follow-up of 19 months (range 13 to 33). The median QuickDASH score was 2.3 (interquartile range (IQR) 0 to 15.9), the median EQ-5D-5L was 0.85 (IQR 0.73 to 1.00), the NPS was 76, and 173 patients (97%) were satisfied with their treatment. There were no documented cases of symptomatic nonunion one year following injury. We describe the introduction of a virtual pathway for the management of patients with a suspected scaphoid fracture. We found high levels of patient satisfaction, excellent PROMs, and no detrimental effects in the vast majority of cases. Cite this article: Bone Joint J2022;104-B(6):709-714.

Large zircon age spans record multi-stage history of batholith assembly: Insights from the Late Triassic Dongcuo batholith in the eastern Tibetan Plateau

Large and homogeneous plutons can assemble incrementally over millions of years, yielding large age spans. Determination of the age span is crucial to constrain the timing and nature of the batholith assembly. This paper reports comprehensive whole-rock geochemical data, LA-ICP-MS zircon U-Pb age, and zircon Hf isotopic data to constrain the timing and assembly process of the Late Triassic Dongcuo batholith, the largest batholith in the Yidun Terrane, eastern Tibetan Plateau. Samples from the batholith consist of metaluminous to weakly peraluminous granitoids (SiO2 = 69.91–79.85 wt%). These granitoids show large variation of zircon Hf isotopic compositions with εHf(t) of -17.15 to +0.13. The multiple zircon populations in single hand specimens revealed by kernel density estimation spread over 20 Myr (ca. 225–204 Ma), which is also confirmed by core-rim ages of single zircon grains, suggesting prolonged magmatism of the Dongcuo batholith. Our data indicate that the assembly of the batholith resulted from emplacement of discrete magma batches which derived from spatially varied sources and underwent variable differentiation. The assembly mainly involved three stages, including an early episode of magmatism (ca. 228 Ma), a high-flux magmatism between ca. 220 Ma and ca. 216 Ma, and a late-stage thermal event (ca. 211–204 Ma) possibly related to high temperature and localized remelting of the batholith. This study highlights the complexity of zircon populations in composite granitic batholith, showing that the search for single crystallization ages for a sample is fraught with difficulties and may mask rather than elucidate the crystallization history of the magmatic body.

Fingertips Detection With Nearest-Neighbor Pose Particles From a Single RGB Image

Vision-based detection of fingertips is useful for freehand Human-Computer Interaction (HCI)&#x2014;especially in virtual, augmented, and mixed reality&#x2014;to have a seamless experience. The estimation of fingertips position in an RGB image involves overcoming various challenges like occlusion, appearance ambiguities, etc. The general approach relies on a two-stage pipeline involving hand location and detection of fingertips for a single hand. This paper presents an effective single-stage Convolutional Neural Network (CNN) for the detection of fingertips of both hands. We use a set of reference points, referred to as pose particles, and train a CNN model end-to-end to find the N-nearest particles in the proximity of each fingertip. Moreover, the same CNN model is used to compute the position vector&#x2019;s components with reference to these N-nearest neighbors. Finally, a fingertip position is estimated by computing the centroid of all the points given by these position vectors. With the proposed approach, it is possible to estimate the fingertips position for single or double hands. Moreover, there is no requirement for prior hand localization. We demonstrated the feasibility and effectiveness of the proposed methodology by performing experiments on three different datasets.

PAPER 14: Excision of Hook of Hamate Fractures in Elite Baseball Players: Surgical Technique and Return to Play

Objectives:Hook of hamate fractures are relatively common in baseball players, but diagnosis and surgical technique can be challenging. Outcomes following surgical excision, as well as optimal surgical technique, in elite baseball players have not been clearly established. Our hypothesis was that excision of hook of hamate fractures in elite professional and collegiate baseball players with a tailored technique would lead to high rates of return to play within a short time.Methods:eview of a single academic hand surgery practice from 2006-2020 found 42 elite athletes competing at professional (20) or varsity collegiate (22) baseball levels who underwent surgical excision of 42 hook of hamate fractures with a standardized technique. The clinical history, timing of surgery, complications, and time to return to play were recorded for each patient.Results:All patients underwent an excision of their hook of hamate fracture at an average of 7.2 weeks (range 0.5 – 52 weeks) from the onset of symptoms. All patients but one were able to return to full pre-injury level of baseball participation within 6 weeks from the date of surgery, with a mean return to sport of 5.4 weeks (range 3-8 weeks). Two patients returned to the operating room – one for scar tissue formation causing ulnar nerve compression and one for residual bone fragment causing pain and ulnar nerve compression.Conclusions:Surgical excision of hook of hamate fractures in elite baseball players showed a very high rate of return to play within six weeks. Meticulous adherence to the described surgical technique tailored to athletes optimizes clinical outcomes and avoids complications.