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Combined radial and ulnar artery injuries are associated with a >35% amputation rate when not revascularized promptly. We describe a patient who suffered a penetrating injury to both the radial and ulnar arteries. Despite the ulnar artery being ligated and the radial artery primary repair becoming occluded after the index operation, his hand remained salvageable, likely because of collateral arterial pathways. The patient obtained a delayed radial-radial artery bypass and afterward achieved meaningful neuromotor function. This case emphasizes the importance of forearm vascular anatomy variability and the need for prompt management of arterial injuries to reduce limb loss and disability.

Dissatisfaction among upper limb prosthetic users is high, reaching over 70%, and 52% of upper limb amputees abandon their prosthetic devices due to limitations such as limited functionality, poor design/aesthetic, and improper fit. The conventional procedure of making prosthetics is time-consuming and expensive. This study was conducted to provide an alternative solution for the several issues of current prosthetic devices. 3D printing technology offers a promising alternative, providing greater accuracy, reduced labor time, and improved fit and comfort. This research explores the application of 3D printing for creating custom silicone prosthetic fingers, using Fused Deposition Modelling (FDM) for the mold. A high-resolution 3D scanner was employed to capture the precise anatomy of the patient's hand, and CAD software was used to design molds that satisfied the patient preference and were reusable. The resulting prosthetics demonstrated good fit and patient satisfaction, though exact color matching remains a challenge, but still, it did demonstrate that it is possible to fabricate colored prosthetics. Performance tests, such as the Jebsen–Taylor Hand Function Test, indicated that while initial performance with the prosthetic was slightly lower, patient satisfaction and potential for improved functionality over time were high. This study underscores the potential of 3D printing to enhance the customization, cost-effectiveness, and overall quality of prosthetic devices, contributing to Sustainable Development Goals related to health and industry innovation. [ABSTRACT FROM AUTHOR]

Combined radial and ulnar artery injuries are associated with a >35% amputation rate when not revascularized promptly. We describe a patient who suffered a penetrating injury to both the radial and ulnar arteries. Despite the ulnar artery being ligated and the radial artery primary repair becoming occluded after the index operation, his hand remained salvageable, likely because of collateral arterial pathways. The patient obtained a delayed radial-radial artery bypass and afterward achieved meaningful neuromotor function. This case emphasizes the importance of forearm vascular anatomy variability and the need for prompt management of arterial injuries to reduce limb loss and disability.

Introduction: More than half of the patients with moderate and severe osteoarthritis (OA) report unsatisfactory pain relief, requiring consideration of intra‐articular (IA) injections as the second‐line management. Ultrasound‐guided IA injection has proven evidence of higher accuracy in administering IA injectates into the joints than landmark‐guided or blind IA injections. However, questions remain about translating higher accuracy rates of ultrasound‐guided injection into better clinical improvements. Therefore, we examined the symptomatic benefits (pain, function and patient satisfaction) of ultrasound‐guided injection in knee, hip and hand OA compared with blind injections by synthesising a systematic review and meta‐analysis of randomised controlled trials (RCT). Methods: PubMed, Medline and Embase databases were searched for eligible studies from their inception to August 28, 2023. Results: Out of 295 records, our meta‐analysis included four RCTs (338 patients with knee OA), demonstrating significant improvement in procedural pain [−0.89 (95% CI −1.25, −0.53)], pain at follow‐up [−0.51 (95% CI −0.98, −0.04)] and function [1.30 (95% CI 0.86, 1.73)], favouring ultrasound guidance. One single study showed higher patient satisfaction with ultrasound guidance. Conclusion: Ultrasound‐guided IA injection provided superior clinical outcomes compared with landmark‐guided IA injection. [ABSTRACT FROM AUTHOR]

Objective: There are various factors that affect bone mineral density (BMD) in postmenopausal women. The aim of this study was to evaluate the relationships between anthropometric characteristics and BMD in women with postmenopausal osteoporosis (PMO). Materials and Methods: Demographic features of the participants including age, menopause age, smoking habits, comorbidities, educational and marital status were recorded. Anthropometric characteristics such as height, weight, body mass index (BMI), waist-to-hip ratio (WHR), digit ratio of dominant hand (2D:4D), skeletal muscle mass index (SMI), hand and thigh circumferences were measured. In addition to L1-L4, femur neck (FN), femur total (FT) T-scores, serum calcium and 25(OH) vitamin D levels were noted. Results: This study included a total of 181 women with PMO (mean age 62.78±7.81 years, menopause age 45.69±5.58 years and BMI 27.24±4.87 kg/m²). 64.6% of the participants had at least one systemic disease and 71.8% were non-smokers. The mean values of serum calcium and 25(OH) vitamin D were 9.71±0.73 mg/dL and 26.22±15.34 ng/mL, respectively. Weight and BMI showed significant positive correlations with T-scores at L1-L4 total, FN and FT. While thigh circumference and SMI significantly correlated with T-scores at FN and FT, hand circumference only correlated with T-score at FN. On the other hand, no correlations were found between T-scores and other anthropometric measurements (height, WHR, 2D:4D). Conclusion: These findings have shown that the patients with lower weight and BMI have lower T-scores at lumbar spine and femur. Additionally, thigh circumference and SMI correlated positively with femur T-scores. Further studies are warranted to reveal the role of these anthropometric measurements in determining the risk of osteoporosis in postmenopausal women. [ABSTRACT FROM AUTHOR]

Forensic science plays a crucial role in the pursuit of justice, particularly through the identification of physical evidence found at crime scenes, such as human fingerprints and handprints. This study aimed to develop formulae for determining living stature using the handprint anthropometry of Tagalog people, an indigenous ethnic group in the Philippines. A total of 360 Tagalog volunteers, comprising 180 men and 180 women, were recruited. This study excluded subjects who had finger and hand-related diseases, injuries, or were under the age of 18. The materials used were a stadiometer for height measurement, a digital vernier caliper for handprint measurements, and a handprint kit to collect handprints. Five length measurements were collected for each handprint. The length measurement spanned the distance from the middle wrist crease to the tips of each of the five fingers. The data were analyzed statistically using regression analysis (p<0.05) in IBM SPSS Statistics for Windows, version 26.0 (IBM Corp., Armonk, N.Y., USA). The analysis results produced equations for determining stature using all the length measurements of the handprints. The study involved the calculation of correlation coefficients (r values) and standard deviations using the stature and handprint lengths of individuals of both genders. The results are presented in the form of tables and figures. The study concluded with the development of regression equations that may be utilized for determining stature based on various handprint length measurements of the Tagalog people. This study represents the first-ever anthropological study conducted on the Philippine Tagalog population within the scope of this research subject matter. The formulae can be applied to actual crime scenes for the purpose of personal identification. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate hand muscle thickness in patients with rheumatoid arthritis (RA) and to investigate the relationship between muscle thickness and clinical factors and physical performance indicators. Materials and Methods: This cross-sectional study was conducted with 73 female participants between May 2022 and September 2022 (mean age: 60.83±9.73 years, range: 18-85). Among them, there were 37 RA patients (mean age: 60.8±9.9 years) diagnosed according to the 2010 American College of Rheumatology/European League Against Rheumatism RA classification criteria. The remaining 36 females were age- and sex-matched healthy subjects (mean age: 60.9±9.8 years). Thickness measurements of the thenar, hypothenar, and thigh muscles were obtained with ultrasound for all participants. In both groups, hand grip strength was measured using a hand dynamometer, and lower extremity performance assessments were made using 6-meter timed walk test (6MTWT) and a 5-time sit-to-stand test (5XSST). Disease activity score-28 (DAS-28), RA articular damage score (RA-ADS), and Duruöz Hand scale scores of RA patients were calculated. Results: Compared with the control group, thenar (p=0.004), hypothenar (p=0.000), and thigh (p=0.006) muscle thickness values were lower in RA patients. The RA group showed lower mean hand grip strength, longer time to complete 5XSST, and slower gait speed on 6MTWT (all p<0.01). Hand muscle thickness was negatively correlated with disease duration, RA-ADS, Duruöz Hand scale, and positively correlated with hand grip strength. Thigh muscle thickness was negatively correlated with age and 5XSST and positively correlated with hand grip strength and gait speed. Thickness measurements from all three muscles were not correlated with DAS-28. Conclusion: Hand muscle thickness of RA patients is affected by the disease regardless of age. Disease duration, articular damage, and decreased hand functions are closely related to muscle thickness. Low muscle thickness indicates reduced physical performance. [ABSTRACT FROM AUTHOR]

Body weight is a significant risk factor for the disease burden of noncommunicable diseases (NCDs). Anthropometric measurements are the first step in determining NCDs risk, and clinicians must have access to valid cutoffs. This study aims to review the literature of Saudi national guidelines and studies previously conducted in Saudi Arabia (SA) and to provide insights and recommendations to establish national guidelines in anthropometric measurements for Saudi adults/elderly in line with the Saudi 2030 Vision. In total, 163 studies were included, and 12 of them contributed to the development of specific anthropometric cutoffs. Cutoffs for metabolic syndrome, waist circumference, and body mass index were established in Saudi adults. However, limited studies were conducted in the elderly. This review warrants establishing standard cutoffs of Saudi adult anthropometrics to avoid over/underreporting of malnutrition and adiposity. This review will help policymakers and the Ministry of Health to establish national guidelines and standard cutoffs to be used in SA for anthropometric measurements that may assist in detecting malnutrition and NCDs. [ABSTRACT FROM AUTHOR]

ABSTRACT: Background: Venous anatomy of the digits and the hand is poorly reported in the literature compared to arterial anatomy. While knowledge of the venous anatomy is crucial to ensure safe skin incisions, skin flap design, or blood return restoration for digital replantations, data in anatomical and clinical textbooks are rather limited. The purpose of this anatomical study was to describe the venous anatomy of the digits and the hand. Method: Our series reports descriptive results from 10 non-embalmed hand dissections from 5 different corpses. Hands were previously co-injected by arteries followed by veins with a different colored latex before being dissected under optical magnification (x4). Each anatomical specimen was photographed before being analyzed. Results: Each injection revealed both arterial and venous vascular systems. Latex injections were a useful technique to show the dorsal, volar superficial, and deep venous system. There was a constant and reliable topographic vascular anatomy of the superficial venous system of the digits and hand. However, we could not observe a high density of dorsal superficial venous valves as previously reported. Conclusion: The knowledge of the arrangement of the venous system of the digits and the hand should help the surgeon when performing surgical procedures in the hand. The surgeon should take into consideration this venous anatomy when performing skin incisions, skin flaps, or replantation procedures which would preserve the normal venous physiology as much as possible.

Augmented reality (AR) and virtual reality (VR) hand hygiene training has been developed for healthcare workers, but has not yet been applied to care homes. This qualitative realist study seeks to capture care home workers' theories concerning how and in what contexts AR or VR training delivered via smartphone apps might work in promoting their hand hygiene practice. Semistructured interviews were conducted with 25 care home workers across three residential and three nursing care homes in Northern England. The interviews explored hand hygiene practices and training in care homes. Participants also provided feedback on an existing programme theory that explains how, for whom, and in which contexts AR/VR might be used to upskill health and care workers. Data were analysed on NVivo using a combined deductive and inductive approach. Participants had varying experiences with hand hygiene training, highlighting an opportunity to refresh skills. Repeated practice, interactive learning, feedback, reminding, and perceived task realism were considered important for hand hygiene and could be trigged by AR/VR. There was less support for other mechanisms including deep immersion, practice in a safe environment, visualisation of personal anatomy (hands) and mistakes, and perceived realism of the imagery and environment. Expected outcomes were effective learning, learner satisfaction, enhanced hand hygiene skills, and infection control. Three themes explained how context matters when implementing AR/VR training: learners (e.g., comfort and preference), care homes (e.g., policies, staffing, and infrastructure), and technology (e.g., cost and using a VR headset). Overall, participants theorised that AR/VR could refresh hand hygiene and trigger repeated practice, interactive learning, feedback and reminding, and task realism. Future work should test the mechanisms and technology in care homes. Hand hygiene training in care homes should consider implementation factors by offering alternative technologies, providing technical support, and working with managers to determine the most appropriate choice of technology. [ABSTRACT FROM AUTHOR]

Many anatomical details and variants occur in the finger tendons and soft tissue structures. These may lead to misdiagnosis if the radiologist is not well aware of them. We discuss the midhand extensor tendons, dorsal hood, junctura tendinea, conjoint tendons, transverse retinacular ligament, triangular ligament as well as central and distal slip anatomy and ultrasound correlation. The dorsal hood is an important structure to center the tendons at the midportion of the MCP heads, and the sagittal bands are its main components. Two tendons are present at the second digit, and two or more at the fifth digit. The extensor mechanism is anatomically interrelated with the palmar lumbricals and interosseous tendons. At the palmar side, the flexor superficialis and profundus tendons show varying relationships along the finger. The flexor profundus passes through an opening in the flexor superficialis. We also discuss the chiasma crurale, ridges at the flexor superficialis insertions and bifid flexor profundus tendon. Although a typical distribution of annular pulleys can be observed, many variants may be present of which we address some. The volar plate is a midline fibro-cartilaginous meniscus attached proximally to the well-identifiable checkrein ligaments and distally to the base of the phalanges. Knowledge of these details and variations allows for better understanding of the finger and hand ultrasound.

Microscopic anatomical study of the hand requires difficult or destructive dissection techniques for each anatomical structure. Synchrotron phase‐contrast imaging (sPCI) allows us to study precisely, at a microscopic resolution and in a nondestructive approach, the soft tissues and bone structures within a single 3D image. Therefore, we aimed to assess the capacity of sPCI to study the arterial anatomy of the hand and digits in human cadavers for anatomical purposes. A non‐injected hand from an embalmed body was imaged using sPCI at 21‐µm pixel size. The vascularization and innervation of the hands were virtually reconstructed at 84‐µm resolution, and the medial neurovascular bundle of the third digit at 21 µm. The thinner‐most distal structures were observed and reported. The diameter and thickness of the vascular and neural structures were defined on 2D computed tomographic axial projections, and using a granulometry method coupled to the 3D reconstructions. The vascularization of the hand was visible from the radial and ulnar arteries to the distal digital transverse anastomoses. The thinnest structure observed was the anastomotic arterial network around the proper palmar digital nerve. The latter emerged from the proper palmar digital artery and vascularized the nerve around its whole length and circumference. The perineural arterioles individualizable at this resolution had a diameter of 66–309 µm. In conclusion, sPCI allows both the arterial and neural anatomy of the hand to be studied at the same time, as well as the anatomical interactions between both networks. It facilitates the study of structures that have different sizes, diameters, thickness, and histological origin with great precision, in a noninvasive way, and using a single technique. [ABSTRACT FROM AUTHOR]

Theoretical development of the inter-relationship between sex determination and hand dimensions is important in the identification of mutilated and skeletal remains found in several mass disasters and fatal assault cases. The primary aim of the study was to determine sex from hand dimensions (HL: hand length and HB: hand breadth) of adult Rajbanshi individuals. Data for the present study were obtained from 400 (200 males; 200 females) unrelated adult (aged 20-60 years) Rajbanshi individuals. The data was statistically analyzed using statistical tests such as descriptive statistics, one-way analysis of variance (ANOVA) and two-way ANOVA. Binary Logistic Regression was employed to develop predictive sex models. We found that the mean values of HL and HB of both hands were higher in males compared to females. Statistically significant sex differences were found in hand lengths only. Bilateral differences in HL and HB were found to be statistically significant in both sexes. Predictive sex models were found to be significant (p<0.05) and bear reliable accuracies for both sexes separately as well as combinedly. It could be inferred that hand dimensions can identify sex with reasonable accuracy. However, hand length appeared to be the most reliable sex discriminator. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 77-year-old woman with left knee pain and swelling. Gray mode sonography revealed a large suprapatellar effusion containing rice bodies, along with large osteophytes and meniscal calcification. The patient was successfully treated with colchicine and an intraarticular injection of Depo-Medrol, leading to symptom resolution.

Objective Hand swelling may result from injury or trauma. Various physical assessment tools and measurement methods can be used to quantify the volume or size of the hand or fingers; however, the reliability and validity of each tool and measurement method have not been evaluated. The purpose of this study was to evaluate the reliability and validity of physical assessment tools and methods used to quantify hand and finger volume or size. Methods MEDLINE, CINAHL, EMBASE, Web of Science, and Scopus were searched using key terms related to swelling, edema, volume, size, hand, measures, reliability, and validity. Cross-sectional or longitudinal studies that assessed reliability and/or validity of physical assessment tools or measurement methods to quantify hand swelling were included. Two examiners independently extracted data from the included articles and appraised the articles' quality using the Consensus-Based Standards for the Selection of Health Measurement Instruments methodology. Data extracted from studies analyzing reliability and validity were grouped by type of assessment tool and measurement method. Results Five physical assessment tools used for quantification of hand swelling were evaluated, including tape measure, water volumeter, bioimpedance spectroscopy, ring gauge, 3-dimensional techniques. All assessment tools had good to excellent reliability (ICC = 0.74 − 0.99), and moderate to high validity (Pearson coefficient = 0.58 − 0.99), for quantification of the volume or size of the hand or fingers. Conclusion All measurement methods with these tools had good to excellent reliability and moderate to high validity. The evidence underpinning the figure-of-eight technique, which uses a tape measure, was the highest. Because these physical assessment tools and measurement methods assess different aspects and regions of the hand, which one is selected depends on the region of interest for assessment and the availability of tools. Impact Reliable tools and measurement methods are available to measure the size or volume of the hand and fingers, either together or separately. The best tool will depend on the aim of assessment and tool availability. Lay Summary Hand swelling can occur with injuries, burns, or lymphedema. This review shows that tools are available to accurately measure swelling in any part of the hand. [ABSTRACT FROM AUTHOR]

Duplication of the flexor digitorum profundus (FDP) tendon is an extremely uncommon anatomical anomaly found within the flexor digitorum superficialis (FDS) muscle, with minimal documentation in the current literature. We present the case of a 45-year-old female manual laborer who exhibited symptoms suggestive of trigger finger in her right middle finger. Surgical exploration uncovered a duplicated FDP tendon, a previously unreported anatomical anomaly in this context. Despite attempting conservative treatment initially, surgical intervention involving release of the A1 pulley, excision of the A1 pulley, and identification of the duplicated tendon was performed. The unusual nature of this anatomical variation highlights the need for additional research into its clinical significance and treatment options. This case highlights the significance of conducting comprehensive anatomical assessments to diagnose and treat uncommon variations within the FDS muscle. It underscores the continued need for collaborative research to enhance treatment approaches, especially in instances where trigger finger symptoms are present., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Lyrtzis et al.)

Amaç: Bu çalışma, Resim-İş Eğitimi özel yetenek sınavına giren adayların el anatomisinin (parmak uzunlukları, el bileği çap, çevre ve hareket genişliği ölçümleri) desen sınavında aldıkları puan ile ilişkisi olup olmadığını ortaya koymayı amaçlamaktadır.Gereç ve Yöntem: Türkiye’deki bir üniversitenin Eğitim Fakültesi Güzel Sanatlar Eğitimi Bölümü Resim-İş Eğitimi Anabilim Dalı Özel Yetenek Sınavı’na giren adaylar çalışmaya dahil edilmiştir. Öğrencilerin dijital kaliper, esnek olmayan mezura ve dijital inklinometre kullanılarak parmak uzunlukları, el bileği çapı, çevresi ve hareket genişlikleri ölçülmüştür. Bulgular: Çalışmamıza 18-25 yaş arası 161 öğrenci (60 erkek, 101 kız öğrenci) dahil edilmiştir. Desen sınavında elli ve üzerinde puan alan 49 kız, 35 erkek öğrenci, kırk dokuz ve altında puan alan 52 kız, 25 erkek öğrenci bulunmaktadır. Çizim başarısı puanı elli ve üzerinde olan ile kırk dokuz ve altında olanların antropometrik özellikleri karşılaştırıldığında anlamlı fark elde edilememiştir. Sonuç: Bu çalışma, çizim becerisine etki eden pek çok unsurun olduğu ve tek başına antropometrik standartlarla çizim başarısı arasındaki ilişkinin ifade edilmesinin zor olduğunu göstermiştir.

Background. Musculoskeletal disorders (MSDs) are commonly observed among workers around the world. These diseases not only affect the health of workers, their quality of life, and their performance, but the effects of such diseases also represent a great burden for the health and social systems. These issues are even more prevalent in developing countries, and nurses are no exception. Many studies worldwide have shown a high prevalence of work-related MSDs in each body position among nurses. However, there are very few studies that have mentioned multisite musculoskeletal symptoms (MMS). Objectives. To describe the prevalence and characteristics of MMS among district hospital nurses in Haiphong, Vietnam. Material and Methods. A cross-sectional study was carried out on 1179 nurses working in all 15 district hospitals using the Modified Nordic Questionnaire at 9 anatomical sites on the body (neck, shoulder/upper arm, elbow/forearm, wrist/hand, upper back, lower back, hip/thigh, knee/lower leg, and ankle/foot). The following main indicators were calculated: the prevalence of musculoskeletal symptoms (MS) (at least 1 of 9 sites), MMS (two or more sites), and widespread musculoskeletal symptoms (WMS) (MS of the upper limb, the lower limb, and the back or the neck). Results. The prevalence of MS during the past 12 months and symptoms lasting for at least 30 days was 60.6% and 17.2% in men and 77.6% and 21.5% in women, respectively. The lower back, neck, upper back, and shoulder/upper arm were the most common sites affected. In terms of MMS, the prevalence was 37.6% in men and 57.1% in women during the past 12 months while 8.6% of men and 11.3% of women reported that symptoms lasted for at least 30 days. The prevalence of MMS tended to increase with age, seniority, having a history of musculoskeletal diseases, and in nurses working in district hospitals located in urban areas. Nearly 90% of MMS concerned two or three anatomical regions during the past 12 months, and almost 80% of MMS lasting at least 30 days involved two or three anatomical regions. The prevalence of WMS was 10.4% in men and 18.6% in women during the past 12 months and 0.9% in men and 2.1% in women lasting at least 30 days. Conclusions. This study showed the high prevalence of MMS and WMS among nursing staff. Further and more extensive research is needed to improve our understanding of multisite musculoskeletal symptoms and act as the foundation for developing preventive measures for nurses. [ABSTRACT FROM AUTHOR]

Trigger digit, Dupuytren's disease, and ganglion cysts are 3 common disorders treated by hand surgeons. Despite the varying nature of their pathology, these 3 entities can all present as a mass at the flexor crease in the distal palm. The regional similarity of these presentations can make diagnosis more difficult. In this paper, we describe a simple clinical exam method that can assist in distinguishing between trigger digit, Dupuytren's disease, and flexor sheath ganglion cysts. [ABSTRACT FROM AUTHOR]

Left distal transradial approach is a novel technique for coronary intervention. This technique is convenient for specialists to operate and welcomed for right-handed patients. The anatomical snuffbox and the first intermetacarpal are two available puncture sites on the basis of hand anatomy. In technical aspects, main differences between left distal transradial approach and conventional transradial approach are patient's special position, puncture procedure, sheath choice, and hemostasis methods. According to the preliminary data, this technique is feasible and safe and it has low rate of complications including radial artery occlusion in forearm. Left distal transradial approach is a quite promising strategy of coronary intervention and deserves further exploration. In this review article, we describe the main technical characteristics and the results obtained from early clinical experiences. We also discuss the main challenges and future perspectives on this novel technique. [ABSTRACT FROM AUTHOR]

Introduction: Accomplishment of adequate retention in prosthesis is vital to patient comfort. The purpose of this article is to present a technique of fabrication of a nonimplant, nonadhesive retained silicone finger prosthesis for a short, flabby residual digit. Materials and Methods: To achieve adequate retention in this compromised clinical scenario, two rings were used: one on the residual finger and the other on the adjacent finger, which were soldered at accurate orientation using a custom-made putty index. Results: Retention of the prosthesis was found to be satisfactory and alleviated the apprehension of the patient regarding surgical placement of implants. Conclusions: The technique described in this report provides an effective, reversible, and straightforward method of managing the compromised situation. The double-ring technique offers a nonsurgical alternative to rehabilitation of patients with compromised residual digits. [ABSTRACT FROM AUTHOR]

Background: Repair of the flexor pollicis longus (FPL) tendon by tendon retriever can be challenging because of uncertainty of the optimal direction. This study aims to describe the FPL tendon path in the thenar eminence. Methods: In 18 hands of 9 cadavers, the angle of the FPL tendon was, after dissection, measured in relation to the axis formed between the metacarpophalangeal (MCP) joint of the thumb and the dorsal carpometacarpal joint (MC1-axis) and the axis formed between the second MCP joint and the distal edge of the trapezium (MC2-axis). Results: The FPL does not follow the angle of the thumb metacarpal. The FPL runs ulnarly from the MC1-axis at a median of 32.5° in abduction and 30.6° in adduction. In relation to the MC2-axis, it runs at a median of 47.5° in abduction and 25° in adduction. Conclusions: The FPL tendon path can be preoperatively marked using: (1) the MC1-axis from which it runs ulnarly approximately at an angle of 30° in both abduction and adduction; or (2) the MC2-axis from which it runs radially at an angle of 47.5° in abduction and at an angle of 25° in adduction. We conclude that the FPL tendon path can be preoperatively marked using these axes and does not parallel the metacarpal axes of the thumb. [ABSTRACT FROM AUTHOR]

Purpose: The research aims to determine whether there is a statistically significant relation between the drawing exam scores got by candidates entering the special aptitude exams in the Fine Arts Education and their hand anatomy (phalange lengths, carpus diameter, circumference and width of motion measurements) or not. Materials and Methods: This study includes the candidates who entered Special Aptitude Exams organized by Department of Fine Arts Education, Faculty of Education of a university in Turkey. Phalanges length, wrist diameter, circumference and motion width were measured using digital caliper, inflexible scales and digital inclinometer. Results: In our study, 161 students (60 boys, 101 girls) aged 18-25 years were included. There are 49 female and 35 male students who score fifty or more in the drawing examination and 52 female and 25 male students with scores of forty-nine and under in this study. A significant difference was not obtained when the anthropometric features of those who were fifty or more and those who were below forty-nine were below the drawing achievement score. Conclusion: This study has revealed that there are many factors that influence the drawing skill. Also reached the conclusion that it is difficult to say that the effect of drawing on the success of the single anthropometric standards. [ABSTRACT FROM AUTHOR]

Anatomy is considered one of the foundation studies for all of the health science students especially medical and nursing students. Anatomy of the hand is complicated. It composes of bones, nerves, blood veins, muscles, and tendon. Memorising all the details about all those parts is tedious work and need much imagination. With the advances in computer graphics and humancomputer interaction techniques, understanding how those body parts move is easy to understand in a visual presentation. Augmented Reality (AR) is the technique that allowed the computer-generated objects to overlay on top of the real world. In this study, we concentrate on studying the bones only. We have selected the Leap Motion, which is the device that can detect the hands and fingers, like a tracking device, and marker-based AR technique for displaying the computer generated bones on top of the real hand. Since the Leap Motion detects the hands and shows the bone in real time, so when a user moves the hands such as waving, all the 3D virtual bones move to the new position just like the real hand. Besides using this tool as the educational tool to help the students have better learning about anatomy, it can also be used as an assessment tool for anatomy class as well. Results from testing this tool with volunteer students indicate that it helps them to understand the hand anatomy better and faster than traditional ways. [ABSTRACT FROM AUTHOR]

This study aimed to compare thumb kinematics and upper limb muscle activity, and the influence of hand size, when texting on a keypad smartphone and a touchscreen smartphone. Furthermore, the study compared exertion, discomfort, and performance when texting on the two phones. The thumb kinematics were tracked using a 3D motion analysis system and muscle activity was registered in six upper limb muscles using surface electromyography in 19 participants. When texting on the touchscreen phone compared to the keypad phone thumb flexion (p = 0.008) and flexion/extension range of motion were smaller (p = 0.02), the thumb was on average less internally rotated (p = 0.02), and activity (50th and 90th percentile) of the thumb and forearm muscles was lower (p ≤ 0.05). The differences in thumb flexion were found only in the group with shorter hands and the differences in muscle activity was found only in the group with longer hands. These findings suggest there are differences in risks for developing musculoskeletal disorders during smartphone use with different key activation mechanisms and different hand sizes. [ABSTRACT FROM AUTHOR]

Identification of the deceased is important at the time of medicolegal autopsy in case of mutilated dead bodies. stature is one of the parameter which could help in identification of the deceased especially in cases of mass disasters wherein mutilated or amputated body fragments are brought to the mortuary for the purpose of examination. The aim of the present study was to estimate supine length from percutaneous measurement of hand length in 200 dead bodies (100 male and 100 female) brought to the mortuary of University college of Medical sciences and Guru Teg Bahadur Hospital, Delhi. The results showed significant positive correlation between hand length and supine length (right hand length r = 0.898 and left hand length r = 0.866). [ABSTRACT FROM AUTHOR]

Background: stature being an important factor in identity, needs to be researched in depth. Height is a factor that is very reliable since it does not change over few days or weeks in adults like weight. To predict height in decomposed remains of a dead body where a Hand is recovered we need to see correlation of height to Hand length and derive a regression equation. Material & Method: so, current study was undertaken at GMERs Medical college, Junagadh. Total 244 students were enrolled in study as per inclusion criteria. Their Height, Weight and other parameters were measured as per standard guidelines. The data so collected was digitized and analysed. statastical Analysis: systat 13 software license version was used to derive correlation coefficient between Height to hand length, hand breadth and arm span. And Regression coefficient was used to derive formula of height from hand length, hand breadth & arm span Results: Our study showed Male students have higher mean height than female students. correlation between Height and arm span length was highest, followed by hand length and hand breadth. Conclusion: There is strong positive correlation between height and hand length, hand breadth and arm span. so, Height can be predicted with some confidence if armspan, hand length or hand breadth is available. [ABSTRACT FROM AUTHOR]

It is widely agreed that biomechanical stresses imposed by stone tool behaviors influenced the evolution of the human hand. Though archaeological evidence suggests that early hominins participated in a variety of tool behaviors, it is unlikely that all behaviors equally influenced modern human hand anatomy. It is more probable that a behavior's likelihood of exerting a selective pressure was a weighted function of the magnitude of stresses associated with that behavior, the benefits received from it, and the amount of time spent performing it. Based on this premise, we focused on the first part of that equation and evaluated magnitudes of stresses associated with stone tool behaviors thought to have been commonly practiced by early hominins, to determine which placed the greatest loads on the digits. Manual pressure data were gathered from 39 human subjects using a Novel Pliance ® manual pressure system while they participated in multiple Plio-Pleistocene tool behaviors: nut-cracking, marrow acquisition with a hammerstone, flake production with a hammerstone, and handaxe and flake use. Manual pressure distributions varied significantly according to behavior, though there was a tendency for regions of the hand subject to the lowest pressures (e.g., proximal phalanges) to be affected less by behavior type. Hammerstone use during marrow acquisition and flake production consistently placed the greatest loads on the digits collectively, on each digit and on each phalanx. Our results suggest that, based solely on the magnitudes of stresses, hammerstone use during marrow acquisition and flake production are the most likely of the assessed behaviors to have influenced the anatomical and functional evolution of the human hand. [ABSTRACT FROM AUTHOR]

Background: Many clinicians require a solid understanding of the anatomical areas supplied by specific peripheral nerves. Virtually all pertinent medical textbooks claim that the entire (palmar and dorsal) surface of the hand is supplied by three (median, radial, and ulnar) nerves and that each of these covers a well-defined area. This study was designed to evaluate the sensory-distribution pattern of peripheral nerves in the hand.Methods: Twelve volunteers were enrolled and randomly allocated to have median, ulnar, or radial nerve blocks to each hand on three successive days. All blocks were performed using ultrasound guidance. A neurologist carried out pinprick testing to define the sensory-distribution area of each procedure. The hand surface was then scanned, and the sensory-distribution area of the blocked nerve was traced, measured, and quantified in relation to the entire hand surface for descriptive and comparative statistical analyses.Results: The sensory-distribution areas of the three nerves revealed a high degree of inter-individual and intra-individual variabilities. Sizeable areas were not covered by any of the three nerves, again involving great variability. Conversely, 15 of the 24 hands showed areas of overlapping supply from more than one nerve.Conclusions: Our findings suggest that the anatomical areas supplied by peripheral nerves are characterised by much greater variability than is routinely claimed.Clinical Trial Registration: DRKS00010707. [ABSTRACT FROM AUTHOR]

Background: Hand function is an overall indicator of health and is often measured using grip strength. Hand-held dynamometry is the most common method of measuring grip strength. The purpose of this study was to determine the inter-rater and test-retest reliability, the reliability of one trial versus three trials, and the preliminary norms for a young adult population using the Baseline® Pneumatic Squeeze Bulb Dynamometer (30 psi). Methods: This study used a one-group methodological design. One hundred and three healthy adults (30 males and 73 females) were recruited. Six measurements were collected for each hand per participant. The data was analyzed using Intraclass Correlation Coefficients (ICC) two-way effects model (2,2) and paired-samples t-tests. Results: The ICC for inter-rater reliability ranged from 0.955 to 0.977. Conclusion: The results of this study suggest that the bulb dynamometer is a reliable tool to measure grip strength and should be further explored for reliable and valid use in diverse populations and as an alternative to the Jamar dynamometer. [ABSTRACT FROM AUTHOR]

This paper proposes a static hand gesture recognition method with low computation and memory consumption for wearable applications. The hand contour is chosen as the hand gesture feature and support vector machine is used to classify the feature. A multiscale weighted histogram of contour direction-based direction normalization is proposed to ensure good recognition performance. In order to improve efficiency, the proposed histogram only counts the direction of the contour point to focus on the most significant hand feature in the first-person view of wearable devices. Based on the hand’s anatomy, the proposed histogram is weighted by considering each contour point’s position and direction jointly using the direction-angle map, to ensure robustness. Experimental results show that the proposed method can give a recognition accuracy of 97.1% with a frame rate of 30 fps on a PC. [ABSTRACT FROM PUBLISHER]

Key points The cortical mechanisms of grasping have been extensively studied in macaques and humans; here, we investigated whether common marmosets could rely on similar mechanisms despite strong differences in hand morphology and grip diversity., We recorded electrocorticographic activity over the sensorimotor cortex of two common marmosets during the execution of different grip types, which allowed us to study cortical activity (power spectrum) and physiologically inferred connectivity (phase-slope index)., Analyses were performed in beta (16-35 Hz) and gamma (75-100 Hz) frequency bands and our results showed that beta power varied depending on grip type, whereas gamma power displayed clear epoch-related modulation., Strength and direction of inter-area connectivity varied depending on grip type and epoch., These findings suggest that fundamental control mechanisms are conserved across primates and, in future research, marmosets could represent an adequate model to investigate primate brain mechanisms., Abstract The cortical mechanisms of grasping have been extensively studied in macaques and humans. Here, we investigated whether common marmosets could rely on similar mechanisms despite striking differences in manual dexterity. Two common marmosets were trained to grasp-and-pull three objects eliciting different hand configurations: whole-hand, finger and scissor grips. The animals were then chronically implanted with 64-channel electrocorticogram arrays positioned over the left premotor, primary motor and somatosensory cortex. Power spectra, reflecting predominantly cortical activity, and phase-slope index, reflecting the direction of information flux, were studied in beta (16-35 Hz) and gamma (75-100 Hz) bands. Differences related to grip type, epoch (reach, grasp) and cortical area were statistically assessed. Results showed that whole-hand and scissor grips triggered stronger beta desynchronization than finger grip. Task epochs clearly modulated gamma power, especially for finger and scissor grips. Considering effective connectivity, finger and scissor grips evoked stronger outflow from primary motor to premotor cortex, whereas whole-hand grip displayed the opposite pattern. These findings suggest that fundamental control mechanisms, relying on adjustments of cortical activity and connectivity, are conserved across primates. Consistently, marmosets could represent a good model to investigate primate brain mechanisms. [ABSTRACT FROM AUTHOR]

The palmaris brevis ( PB) is a small cutaneous hand muscle that has been described as the most mysterious muscle from a functional and developmental perspective [Kaplan () Kaplan's Functional and Surgical Anatomy of the Hand]. Functionally, the PB is considered to deepen the hollow of the palm and to protect the neurovasculature of the ulnar canal. Although the function of the PB has been inferred from cadaveric observations, the electromyographic ( EMG) activity of this muscle has not been explored systematically during specific movements of the hand. The purpose of this study was to record PB intramuscular EMG activity during dynamic grasping tasks, and to quantify the change in PB muscle length ( ML) and thickness ( MT) incurred during maximal contraction using ultrasound imaging. Intramuscular EMG was recorded from the PB in the dominant hands of 12 healthy participants (11 males, one female; age: 27 ± 4 years) during maximal abduction, flexion and opposition of the 5th digit, and two grasping tasks. Abduction of the 5th digit yielded the greatest EMG activity in most individuals (seven out of 11), and produced significantly less PB EMG activity when compared with grasping a cylindrical-shaped object ( P = 0.003) but not a spherical-shaped object ( P = 0.130). During maximal abduction of the 5th digit, PB ML decreased in both the left (28 ± 11%; P = 0.002) and right (32 ± 5%; P = 0.002) hands. Similarly, a concomitant increase in PB MT was observed in the left (68 ± 30%; P = 0.002) and right (85 ± 44%; P = 0.002) hands during the same contraction. These EMG results indicate that the PB is voluntarily activated during prehensile and non-prehensile movements of the hand with significant changes in muscle architecture. The study supports the preservation of the PB in surgical procedures based on its proposed protective role as a muscular barrier to the neurovasculature within the ulnar canal. [ABSTRACT FROM AUTHOR]

This research was undertaken to develop a cardiovascular simulator for use in the study of pulse diagnosis. The physical (i.e., pulse wave transmission and reflection) and physiological (i.e., systolic and diastolic pressure, pulse pressure, and mean pressure) characteristics of the radial pulse wave were reproduced by our simulator. The simulator consisted of an arterial component and a pulse-generating component. Computer simulation was used to simplify the arterial component while maintaining the elastic modulus and artery size. To improve the reflected wave characteristics, a palmar arch was incorporated within the simulator. The simulated radial pulse showed good agreement with clinical data. [ABSTRACT FROM AUTHOR]

In the rehabilitation field, the use of additive manufacturing techniques to realize customized orthoses is increasingly widespread. Obtaining a 3D model for the 3D printing phase can be done following different methodologies. We consider the creation of personalized upper limb orthoses, also including fingers, starting from the acquisition of the hand geometry through accurate 3D scanning. However, hand scanning procedure presents differences between healthy subjects and patients affected by pathologies that compromise upper limb functionality. In this work, we present the concept and design of a 3D printed support to assist hand scanning of such patients. The device, realized with FDM additive manufacturing techniques in ABS material, allows palmar acquisitions, and its design and test are motivated by the following needs: (1) immobilizing the hand of patients during the palmar scanning to reduce involuntary movements affecting the scanning quality and (2) keeping hands open and in a correct position, especially to contrast the high degree of hypertonicity of spastic subjects. The resulting device can be used indifferently for the right and the left hand; it is provided in four-dimensional sizes and may be also suitable as a palmar support for the acquisition of the dorsal side of the hand. [ABSTRACT FROM AUTHOR]

Background. The well-known rubber hand paradigm induces an illusion by having participants feel the touch applied to a fake hand. In parallel, the kinesthetic mirror illusion elicits illusions of movement by moving the reflection of a participant’s arm. Experimental manipulation of sensory inputs leads to emergence of these multisensory illusions. There are strong conceptual similarities between these two illusions, suggesting that they rely on the same neurophysiological mechanisms, but this relationship has never been investigated. Studies indicate that participants differ in their sensitivity to these illusions, which provides a possibility for studying the relationship between these two illusions. Method. We tested 36 healthy participants to confirm that there exist reliable individual differences in sensitivity to the two illusions and that participants sensitive to one illusion are also sensitive to the other. Results. The results revealed that illusion sensitivity was very stable across trials and that individual differences in sensitivity to the kinesthetic mirror illusion were highly related to individual differences in sensitivity to the rubber hand illusion. Conclusions. Overall, these results support the idea that these two illusions may be both linked to a transitory modification of body schema, wherein the most sensitive people have the most malleable body schema. [ABSTRACT FROM AUTHOR]

Emotional signals, like threatening sounds, automatically ready the perceiver to prepare an appropriate defense behavior. Conjecturing that this would manifest itself in extending the safety zone around the body we used the rubber hand illusion (RHI) to test this prediction. The RHI is a perceptual illusion in which body ownership is manipulated by synchronously stroking a rubber hand and real hand occluded from view. Many factors, both internal and external, have been shown to influence the strength of the illusion, yet the effect of emotion perception on body ownership remains unexplored. We predicted that listening to affective vocalizations would influence how strongly participants experience the RHI. In the first experiment four groups were tested that listened either to affective sounds (angry or happy vocalizations), non-vocal sounds or no sound while undergoing synchronous or asynchronous stroking of the real and rubber hand. In a second experiment three groups were tested comparing angry or neutral vocalizations and no sound condition. There was a significantly larger drift towards the rubber hand in the emotion versus the no emotion conditions. We interpret these results in the framework that the spatial increase in the RHI indicates that under threat the body has the capacity to extend its safety zone. [ABSTRACT FROM AUTHOR]

Introduction: The hand grip strength test provides useful and reliable information about overall health. Different studies have investigated the optimal grip span for determining maximal hand grip strength in different populations such as adults, adolescents and children without disabilities.Objective: To ascertain whether there is an optimal grip span for determining maximal hand grip strength in adolescents with Down syndrome (DS).Methods: Twenty-seven right-handed youths with DS (seven females) aged 15.5 ± 3.6 years were evaluated in this methodological study. Each hand was randomly tested on ten times using five different grip spans, allowing one-minute rest between attempts. The hand span was measured from the tip of the thumb to the tip of the small finger with the hand widely opened. To confirm the usefulness of the optimal grip span, a new group of 15 adolescents with DS were recruited.Results: An optimal grip span was identified for the dominant hand in adolescents with DS. The equation relating grip span as a function of dominant hand span in this group is formulated as follows: y = 0.342x - 1.161 cm (r = 0.63, p < 0.05). In the case of non-dominant hand, a tendency towards a linear association (p = 0.058) was found; the equation is formulated as follows: y = 0,210x + 1.324 cm.Conclusion: It is important to standardize the procedure and increase reliability when measuring hand grip strength in DS population. The values stated in this study are recommended to assess hand grip strength in adolescents with Down syndrome. [ABSTRACT FROM AUTHOR]

The rubber hand illusion (RHI) is a perceptual illusion whereby a model hand is perceived as part of one's own body. This illusion has been extensively studied, but little is known about the temporal evolution of this perceptual phenomenon, i.e., how long it takes until participants start to experience ownership over the model hand. In the present study, we investigated a version of the rubber hand experiment based on finger movements and measured the average onset time in active and passive movement conditions. This comparison enabled us to further explore the possible role of intentions and motor control processes that are only present in the active movement condition. The results from a large group of healthy participants (n = 117) showed that the illusion of ownership took approximately 23 s to emerge (active: 22.8; passive: 23.2). The 90th percentile occurs in both conditions within approximately 50 s (active: 50; passive: 50.6); therefore, most participants experience the illusion within the first minute. We found indirect evidence of a facilitatory effect of active movements compared to passive movements, and we discuss these results in the context of our current understanding of the processes underlying the moving RHI. [ABSTRACT FROM AUTHOR]

Grasping is one of a few adaptive mechanisms that, in conjunction with clinging, hooking, arm swinging, adhering, and flying, allowed for incursion into the arboreal eco-space. Little research has been done that addresses grasping as an enhanced manual ability in non-mammalian tetrapods, with the exception of studies comparing the anatomy of muscle and tendon structure. Previous studies showed that grasping abilities allow exploitation for narrow branch habitats and that this adaptation has clear osteological consequences. The objective of this work is to ascertain the existence of morphometric descriptors in the hand skeleton of lizards related to grasping functionality. A morphological matrix was constructed using 51 morphometric variables in 278 specimens, from 24 genera and 13 families of Squamata. To reduce the dimensions of the dataset and to organize the original variables into a simpler system, three PCAs (Principal Component Analyses) were performed using the subsets of (1) carpal variables, (2) metacarpal variables, and (3) phalanges variables. The variables that demonstrated the most significant contributions to the construction of the PCA synthetic variables were then used in subsequent analyses. To explore which morphological variables better explain the variations in the functional setting, we ran Generalized Linear Models for the three different sets. This method allows us to model the morphology that enables a particular functional trait. Grasping was considered the only response variable, taking the value of 0 or 1, while the original variables retained by the PCAs were considered predictor variables. Our analyses yielded six variables associated with grasping abilities: two belong to the carpal bones, two belong to the metacarpals and two belong to the phalanges. Grasping in lizards can be performed with hands exhibiting at least two different independently originated combinations of bones. The first is a combination of a highly elongated centrale bone, reduced palmar sesamoid, divergence angles above 90°, and slender metacarpal V and phalanges, such as exhibited by Anolis sp. and Tropidurus sp. The second includes an elongated centrale bone, lack of a palmar sesamoid, divergence angles above 90°, and narrow metacarpal V and phalanges, as exhibited by geckos. Our data suggest that the morphological distinction between graspers and non-graspers is demonstrating the existence of ranges along the morphological continuum within which a new ability is generated. Our results support the hypothesis of the nested origin of grasping abilities within arboreality. Thus, the manifestation of grasping abilities as a response to locomotive selective pressure in the context of narrow-branch eco-spaces could also enable other grasping-dependent biological roles, such as prey handling.

The effective use of point-of-care ultrasound for the diagnosis and treatment of hand conditions is dependent upon a thorough understanding of its anatomic bases. To facilitate this understanding, in-situ cadaveric hand dissections were correlated with handheld ultrasound images in the palm focusing on key areas of clinical relevance. The palms of an embalmed cadaver were dissected, minimizing the reflection of structures whenever possible to emphasize normal relationships and tissue planes. Point-of-care ultrasound images were obtained from a living hand and correlated with related anatomy in the cadaver. Juxtaposing cadaver structures, spaces, and relationships with the associated ultrasound images, surface hand orientation, and ultrasound probe positioning, a series of images were developed as a guide to correlating in-situ anatomy with point-of-care ultrasound in the hand., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Loomis et al.)