Treatment of Advanced Carpometacarpal Joint Disease: Trapeziectomy and Hematoma Arthroplasty
ABSTRACT Some surgical treatment options of painful basal joint arthritis do not require complex arthroplasty or suspensionplasty techniques. Simple trapeziectomy with temporary pinning of a slightly overdistracted thumb metacarpal can provide reliable pain relief, good motion, and functional stability. Recent literature supports alternative options when compared with formal ligament reconstruction or suspensionplasty procedures. Simple trapeziectomy is associated with less morbidity due to shorter operative times and the lack of need for graft harvest and ligament reconstruction.
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ABSTRACT: Background The safety and the effects of different trajectories on thumb motion of suture-button suspensionplasty post-trapeziectomy are not known. Methods In a cadaveric model, thumb range of motion, trapeziectomy space height, and distance between the device and nerve to the first dorsal interosseous muscle (first DI) were measured for proximal and distal trajectory groups. Proximal trajectory was defined as a suture button angle directed from the thumb metacarpal to the second metacarpal at a trajectory less than 60° from the horizontal; distal trajectory was defined as a suture button angle directed from the thumb metacarpal to the second metacarpal at a trajectory of greater than 60° from the horizontal (Fig. 1). Results There were no significant differences in range of motion and trapeziectomy space height between both groups. The device was significantly further away from the nerve to the first DI in the proximal trajectory group compared to the distal trajectory group, but was still safely away from the nerve in both groups (greater than 1 cm). Conclusions These results suggest that the device placement in either a proximal or distal location on the second metacarpal will yield similar results regarding safety and thumb range of motion.Hand 06/2013; 8(2). DOI:10.1007/s11552-012-9473-6
Conference Paper: Multiple Output Minimization[Show abstract] [Hide abstract]
ABSTRACT: This paper describes two logic minimization algorithms. CAMP (Computer Aided Minimization Procedure) minimizes single functions. The minterms are covered either by essential prime implicants or by selective prime implicants. The two types of prime implicants are determined one at a time thus completely avoiding the computationally expensive covering problem. The adjacency of a minterm, that depends upon the proximity of this minterm with respect to other minterms on the Karnaugh map, guides the determination of prime implicants. This procedure is nonheuristic and has proved to be very efficient for large number of input variables. The multiple output minimization (MOM) algorithm generates the product terms with maximum sharing between the output functions. In addition to using adjacency, this procedure is also guided by the frequency with which a minterm is used by the functions. Examples show the performance of this algorithm to be equal or better than many other minimization procedures.Design Automation, 1985. 22nd Conference on; 07/1985
Conference Paper: Fleet management with automatic vehicle location[Show abstract] [Hide abstract]
ABSTRACT: A dispatcher can improve a fleet's productivity by knowing where each vehicle in the fleet is located. This productivity gain is independent of whether reduced fleet costs, increased tonnage capacity, safe delivery of secure cargo or less down time due to distracted drivers is management's goal. This paper describes the portion of an automatic vehicle location system which has been designed to enhance fleet management depending on a variety of efficiency concerns. This subsystem, referred to as the Fixed End, is where the dispatcher manipulates the collected location information to make the decisions required to improve the fleet's performance. The Fixed End subsystem has three fundamental tasks it must perform: it must accept commands from the dispatcher then display and update the requested information, it must allow the dispatcher to control the communication rate between the Fixed End and the mobiles and it must allow the dispatcher to customize certain internal data structures to the desired use.Vehicular Technology Conference, 1986. 36th IEEE; 06/1986