Biomedical subjects
Publications and source records attributed to Haw-Yen Chiu.
This case report illustrates the role of high-resolution sonography in the preoperative assessment of a neurilemmoma of the median nerve in the forearm. Sonography identified the 3-dimensional localization of the nerve tumor its origin from a nerve fascicle, and its relationship with noninvolved nerve fascicles, facilitating the surgeon's approach to preserve noninvolved fascicles.
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The distally based anterolateral thigh flap has been used for coverage of soft-tissue defects of the knee and upper third of the leg. This flap is based on the septocutaneous or musculocutaneous perforators derived from the lateral circumflex femoral system. The purpose of this study was to examine the results of anatomical variations of the descending branch of the lateral circumflex femoral artery and the retrograde blood pressure of the descending branch of the lateral circumflex femoral artery so that the surgical technique for raising and transferring a distally based anterolateral thigh flap to the knee region could be improved. The authors have actually used this flap in three cases. In 11 thighs of six cadavers, the descending branch of the lateral circumflex femoral artery had a rather consistent connection with the lateral superior genicular artery or profunda femoral artery in the knee region. The pivot point, located at the distal portion of the vastus lateralis muscle, ranges from 3 to 10 cm above the knee. In their three cases, the maximal flap size was 7.0 x 16.0 cm and was harvested safely, without marginal necrosis. The mean pedicle length was 15.2 +/- 0.7 cm (range, 14.5 to 16 cm). The average proximal and distal retrograde blood pressure of the descending branch of the lateral circumflex femoral artery was also studied in another 11 patients, and the anterolateral thigh flap being used for reconstruction of head and neck defects showed 58.3 and 77.7 percent of proximal antegrade blood pressure, respectively. The advantages of this flap include a long pedicle length, a sufficient tissue supply, possible combination with fascia lata for tendon reconstruction, and favorable donor-site selection, without sacrifice of major vessels or muscles.
This study develops the basis for video-computer quantitative evaluation method for measuring degree of thumb impairment. The system evaluates the three-dimensional space (workspace) within which the thumb-tip moves and computes its surface area. This study is intended to be the basis of a subsequent study which will compute the percentage of actual use compared to the "ideal" value for the given thumb length. Based on this quantitative measurement, the movement function of the impaired thumb can be identified objectively. Repeatability testing confirms that the video motion analysis system is a reliable tool for measuring the workspace of thumb-tip motion. It is also shown experimentally that there is a linear correlation between the surface area of thumb-tip motion workspace and the square of the thumb length. Accordingly, this method may be used to evaluate the functional abnormalities and deformities of the thumb.
While several different methods have been used to measure hand kinematics, fluoroscopy is generally considered to be the most accurate. Recently, video-based motion analysis has been developed for the measurement of joint kinematics. This method is versatile, easy to use, and can measure motions dynamically. Surface markers are most commonly used in the video-based motion systems. However, whether the surface markers placed on the thumb accurately represent the true kinematics of the underlying bony segment is questionable. In this study, the feasibility of surface markers to represent thumb kinematics was investigated by fluoroscopy. Both the positions of surface markers and bony landmarks were simultaneous recorded and then digitized. The Ra(2) values comparing the angular changes of the thumb interphalangeal, metacarpal and carpometacarpal joints derived using the surface markers or bony landmarks were 0.9986, 0.9730 and 0.9186 in the flexion/extension plane respectively, 0.8837, 0.9697 and 0.8775 in the abduction/adduction plane; and 0.9884, 0.9643 and 0.9431 in the opposition plane. The ranges, mean and standard deviation of the absolute differences between calculated angles of different marker sets were also compared. These data revealed that the similarities of the two different marker techniques throughout the motion cycle were high. The differences between the two methods were also within clinically allowable range of +/-5 degrees. It is concluded that the application of the video-based motion analysis system with surface markers to thumb kinematics is warranted.