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Taniguchi S, Matsuura Y, Takehara T, Yamada A, Shiko Y, Nakagawa K, Ohtori S. Thumb Pronation Angle in Thumb Opposition Evaluated by the Nail Tip Angle of Thumb-Ring Finger Opposition. Hand (N Y) 2024:15589447241236249. [PMID: 38491921 DOI: 10.1177/15589447241236249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2024]
Abstract
BACKGROUND This study aimed to devise the method for the evaluation of the thumb pronation angle and calculate its reference value. METHODS The study was conducted from October 2021 to March 2022, and 600 hands of 300 healthy volunteers were included in this study. The participants were divided into 6 age groups with 50 participants each. In study 1, 12 participants from group 1 were randomly selected, which included 6 male and 6 female participants. We measured the thumb pronation angle using FASTRAK system and the nail tip angle of thumb-ring finger opposition (T-R angle) and also evaluated the relation between them. In study 2, we measured the T-R angle of 600 hands of 300 healthy volunteers. The T-R angle mean (SD) and 95% confidence interval (CI) of each age group were calculated as reference values. RESULTS The thumb pronation angle was correlated with the T-R angle. The T-R angle mean (SD) and 95% CI of the 6 groups were as follows: group 1, 142.5° (12.4) and 117.7 to 167.3; group 2, 139.9° (10.1) and 119.7 to 160.1; group 3, 142.3° (9.7) and 122.9 to 160.5; group 4, 140.2° (12.6) and 115.0 to 165.4; group 5, 138.3° (11.9) and 114.5 to 162.1; and group 6, 135.4° (13.0) and 109.4 to 161.4. The 95% CI tended to decrease with an increasing age. CONCLUSIONS The T-R angle was a suitable evaluation method for the thumb pronation angle, and it should be evaluated by age groups.
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Affiliation(s)
- Shinji Taniguchi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Japan
- Department of Orthopaedic Surgery, Toho University School of Medicine, Sakura, Japan
| | - Yusuke Matsuura
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Japan
| | | | - Ayae Yamada
- Department of Rehabilitation, Chiba University Hospital, Japan
| | - Yuki Shiko
- Clinical Research Center, Graduate School of Medicine, Chiba University, Japan
| | - Koichi Nakagawa
- Department of Orthopaedic Surgery, Toho University School of Medicine, Sakura, Japan
| | - Seiji Ohtori
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Japan
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Shrestha N, Batajoo S, Jaiswal S, Shrestha OP. Acute Thumb Reconstruction with Iliac Crest Bone Graft and Groin Flap: A Case Report. JNMA J Nepal Med Assoc 2023; 61:731-734. [PMID: 38289797 PMCID: PMC10579738 DOI: 10.31729/jnma.8264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Indexed: 02/01/2024] Open
Abstract
Crush injury with bone loss results in shortening the length of the thumb. Most of the immediate intervention is amputation and stump closure. Revision amputation with stump closure gives loss of functional length and the patient is unable to do daily activities as before. In most of all hand functions, the opposition of the thumb plays an important role. Reconstruction of the thumb with iliac crest bone graft with its functional length is one of the major achievements for the patient. As in our case, the patient is right-hand dominant he is more concerned about the functional length of the thumb, whatever the aesthetic appearance. Here we present a case of a 24-year-old male with thumb reconstruction in a severely injured thumb with loss of bone and soft tissue just distal to the base of the proximal phalanx. Nine months postoperatively, the patient showed a great outcome with restored thumb length, function, grip strength, and a good range of motion. Keywords case reports; injury; thumb.
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Affiliation(s)
- Niresh Shrestha
- Department of Orthopedics, B&B Hospital Pvt. Ltd., Gwarko, Lalitpur, Nepal
| | - Santosh Batajoo
- Department of Orthopedics, B&B Hospital Pvt. Ltd., Gwarko, Lalitpur, Nepal
| | - Sweta Jaiswal
- Department of Orthopedics, B&B Hospital Pvt. Ltd., Gwarko, Lalitpur, Nepal
| | - Om Prasad Shrestha
- Department of Orthopedics, B&B Hospital Pvt. Ltd., Gwarko, Lalitpur, Nepal
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3
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Effect of the Thumb Orientation and Actuation on the Functionality and Performance of Affordable Prosthetic Hands: Obtaining Design Criteria. Biomimetics (Basel) 2022; 7:biomimetics7040233. [PMID: 36546933 PMCID: PMC9775784 DOI: 10.3390/biomimetics7040233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 11/22/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022] Open
Abstract
The advent of 3D printing technologies has enabled the development of low-cost prosthetic underactuated hands, with cables working as tendons for flexion. Despite the particular relevance to human grasp, its conception in prosthetics is based on vague intuitions of the designers due to the lack of studies on its relevance to the functionality and performance of the device. In this work, some criteria for designers are provided regarding the carpometacarpal joint of the thumb in these devices. To this end, we studied four prosthetic hands of similar characteristics with the motion of abduction/adduction of the thumb resolved in three different ways: fixed at a certain abduction, coupled with the motion of flexion/extension, and actuated independently of the flexion/extension. The functionality and performance of the hands were assessed for the basic grasps using the Anthropomorphic Hand Assessment Protocol (AHAP) and a reduced version of the Southampton Hand Assessment Procedure (SHAP). As a general rule, it seems desirable that thumb adduction/abduction is performed independently of flexion/extension, although this adds one degree of control. If having this additional degree of control is beyond debate, coupled flexion/extension and adduction/abduction should be avoided in favour of the thumb having a fixed slight palmar abduction.
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Kurumadani H, Kurauchi K, Date S, Ishii Y, Sunagawa T. Effect of the position of the interphalangeal joint on movements of the trapeziometacarpal joint during thumb opposition. J Hand Surg Eur Vol 2022; 47:495-500. [PMID: 35001677 DOI: 10.1177/17531934211065879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The Kapandji test is a simple method to score thumb opposition; however, the position of the interphalangeal joint of the thumb during this test has not been described. We aimed to quantitatively examine the effect of the thumb interphalangeal joint position on movements of the trapeziometacarpal joint during thumb opposition using the Kapandji test. The Kapandji test was carried out in 20 healthy participants during thumb interphalangeal joint extension and flexion. Movements of the joints and the activity of thenar muscles were recorded using motion capture and electromyography, respectively. We found that interphalangeal joint extension increased the trapeziometacarpal joint movement and thenar muscle activity compared with interphalangeal joint flexion, which contributed to thumb opposition at Kapandji Positions 0-6. These findings suggest the position of the thumb interphalangeal joint affects the trapeziometacarpal joint during thumb opposition, and assessment of thumb opposition using the Kapandji test is best done with the thumb interphalangeal joint in extension.
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Affiliation(s)
- Hiroshi Kurumadani
- Analysis and Control of Upper Extremity Function, Hiroshima University, Hiroshima, Japan
| | - Kazuya Kurauchi
- Analysis and Control of Upper Extremity Function, Hiroshima University, Hiroshima, Japan
| | - Shota Date
- Analysis and Control of Upper Extremity Function, Hiroshima University, Hiroshima, Japan
| | - Yosuke Ishii
- Department of Biomechanics, Hiroshima University, Hiroshima, Japan
| | - Toru Sunagawa
- Analysis and Control of Upper Extremity Function, Hiroshima University, Hiroshima, Japan
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5
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Sasaki T, Koyama T, Kuroiwa T, Nimura A, Okawa A, Wakabayashi Y, Fujita K. Evaluation of the Existing Electrophysiological Severity Classifications in Carpal Tunnel Syndrome. J Clin Med 2022; 11:jcm11061685. [PMID: 35330012 PMCID: PMC8950957 DOI: 10.3390/jcm11061685] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/13/2022] [Accepted: 03/16/2022] [Indexed: 12/13/2022] Open
Abstract
Electrophysiological examination is important for the diagnosis and evaluation of nerve function in carpal tunnel syndrome (CTS). Electrophysiological severity classifications of CTS using a nerve conduction study (NCS) have been reported, and there are many reports on the relationship between severity classifications and clinical symptoms. The existing electrophysiological severity classifications have several problems, such as cases that do not fit into a classification and unclear reasons for the boundary value. The purpose of this study was to clarify the relationship between sensory nerve conduction velocity (SCV) and distal motor latency (DML) and to evaluate whether the existing severity classification method is appropriate. We created a scatter diagram between SCV and DML for our NCSs and found a negative correlation between SCV and DML (correlation coefficient, −0.786). When we applied our NCSs to the existing classifications (Padua and Bland classifications), there were many unclassifiable cases (15.2%; Padua classification), and the number of Grade 3 cases was significantly higher than that of Grade 2 or 4 cases (Bland classification). Our large dataset revealed a strong negative correlation between SCV and DML, indicating that the existing severity classifications do not always accurately reflect the severity of the disease.
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Affiliation(s)
- Toru Sasaki
- Department of Orthopaedic and Spinal Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan; (T.S.); (T.K.); (T.K.); (A.O.)
- Department of Orthopaedic Surgery, Tsuchiura Kyodo General Hospital, 4-1-1, Tsuchiura 300-0028, Ibaraki, Japan
| | - Takafumi Koyama
- Department of Orthopaedic and Spinal Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan; (T.S.); (T.K.); (T.K.); (A.O.)
| | - Tomoyuki Kuroiwa
- Department of Orthopaedic and Spinal Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan; (T.S.); (T.K.); (T.K.); (A.O.)
| | - Akimoto Nimura
- Department of Functional Joint Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan;
| | - Atsushi Okawa
- Department of Orthopaedic and Spinal Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan; (T.S.); (T.K.); (T.K.); (A.O.)
| | - Yoshiaki Wakabayashi
- Department of Orthopaedic Surgery, Yokohama City Minato Red Cross Hospital, 3-12-1, Shinyamashita, Naka-ku, Yokohama City 231-8682, Kanagawa, Japan;
| | - Koji Fujita
- Department of Functional Joint Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo 113-8519, Japan;
- Correspondence: ; Tel.: +81-3-5803-5279
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6
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Bachy M, Victoria C, Martinot-Lagarde C, Romana C, Vialle R, Fitoussi F. Global assessment of pollicization outcomes: an analysis in 27 patients. J Hand Surg Eur Vol 2021; 46:754-761. [PMID: 33789509 DOI: 10.1177/17531934211003460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Outcomes measurements after pollicization remains difficult due to the lack of a standardized assessment protocol. This study reports our experience of a global assessment of pollicized thumbs that includes a specific questionnaire for subjective evaluation, a detailed clinical assessment focused on functional outcomes incorporating function and usage of the pollicized thumb. Twenty-seven patients completed the questionnaire, and nine hands were clinically evaluated by a multidisciplinary team composed of hand surgeons and occupational therapists. Subjective evaluations revealed that 24 patients would recommend pollicization. Clinical evaluations revealed that only four out of nine patients properly integrated their pollicized thumb during bimanual activities; however, occupational therapy input allowed the children to compensate for the lack of strength and other difficulties. We propose the use of this global assessment package to analyse function and usage at various capacities, which can be useful for the surgeon, child and parents.Level of evidence: IV.
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Affiliation(s)
- Manon Bachy
- Service de Chirurgie Orthopédique et Réparatrice de l'Enfant, Sorbonne Université - Hôpital Trousseau APHP, Paris, France.,Centre de référence Malformation des Membres CEREFAM, Hôpital National de Saint Maurice, Saint-Maurice, France
| | - Christian Victoria
- Hand and Upper Extremity Service, Hospital for Special Surgery, New York, NY, USA
| | - Coline Martinot-Lagarde
- Centre de référence Malformation des Membres CEREFAM, Hôpital National de Saint Maurice, Saint-Maurice, France
| | - Claudia Romana
- Service de Chirurgie Orthopédique et Réparatrice de l'Enfant, Sorbonne Université - Hôpital Trousseau APHP, Paris, France.,Centre de référence Malformation des Membres CEREFAM, Hôpital National de Saint Maurice, Saint-Maurice, France
| | - Raphael Vialle
- Service de Chirurgie Orthopédique et Réparatrice de l'Enfant, Sorbonne Université - Hôpital Trousseau APHP, Paris, France
| | - Franck Fitoussi
- Service de Chirurgie Orthopédique et Réparatrice de l'Enfant, Sorbonne Université - Hôpital Trousseau APHP, Paris, France.,Centre de référence Malformation des Membres CEREFAM, Hôpital National de Saint Maurice, Saint-Maurice, France
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Kuroiwa T, Koyama T, Fujita K. Coordination of Thumb Pronation and Palmar Abduction During Opposition Movement. JOURNAL OF HAND SURGERY GLOBAL ONLINE 2021; 3:160. [PMID: 35415546 PMCID: PMC8991545 DOI: 10.1016/j.jhsg.2021.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Affiliation(s)
- Konrad Mende
- Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital of Basel, Basel, Switzerland
| | - Michael A Tonkin
- Department of Hand and Peripheral Nerve Surgery, Royal North Shore Hospital, Sydney, Australia.,The Children's Hospital at Westmead, Sydney, Australia.,Medical School, University of Sydney, Sydney, Australia
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9
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Kuroiwa T, Nimura A, Takahashi Y, Sasaki T, Koyama T, Okawa A, Fujita K. Device Development for Detecting Thumb Opposition Impairment Using Carbon Nanotube-Based Strain Sensors. SENSORS 2020; 20:s20143998. [PMID: 32708416 PMCID: PMC7412202 DOI: 10.3390/s20143998] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/07/2020] [Accepted: 07/15/2020] [Indexed: 12/03/2022]
Abstract
Research into hand-sensing is the focus of various fields, such as medical engineering and ergonomics. The thumb is essential in these studies, as there is great value in assessing its opposition function. However, evaluation methods in the medical field, such as physical examination and computed tomography, and existing sensing methods in the ergonomics field have various shortcomings. Therefore, we conducted a comparative study using a carbon nanotube-based strain sensor to assess whether opposition movement and opposition impairment can be detected in 20 hands of volunteers and 14 hands of patients with carpal tunnel syndrome while avoiding existing shortcomings. We assembled a measurement device with two sensors and attached it to the dorsal skin of the first carpometacarpal joint. We measured sensor expansion and calculated the correlation coefficient during thumb motion. The average correlation coefficient significantly increased in the patient group, and intrarater and interrater reliability were good. Thus, the device accurately detected thumb opposition impairment due to carpal tunnel syndrome, with superior sensitivity and specificity relative to conventional manual inspection, and may also detect opposition impairment due to various diseases. Additionally, in the future, it could be used as an easy, affordable, and accurate sensor in sensor gloves.
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Affiliation(s)
- Tomoyuki Kuroiwa
- Department of Orthopaedic and Spinal Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8519, Japan; (T.K.); (T.S.); (T.K.); (A.O.)
| | - Akimoto Nimura
- Department of Functional Joint Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8519, Japan;
| | - Yu Takahashi
- AI Group, Department of 1st Research and Development, Yamaha Corporation, Shizuoka 430-0904, Japan;
| | - Toru Sasaki
- Department of Orthopaedic and Spinal Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8519, Japan; (T.K.); (T.S.); (T.K.); (A.O.)
| | - Takafumi Koyama
- Department of Orthopaedic and Spinal Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8519, Japan; (T.K.); (T.S.); (T.K.); (A.O.)
| | - Atsushi Okawa
- Department of Orthopaedic and Spinal Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8519, Japan; (T.K.); (T.S.); (T.K.); (A.O.)
| | - Koji Fujita
- Department of Functional Joint Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8519, Japan;
- Correspondence: ; Tel.: +81-3-5803-5279
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10
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Sasaki T, Makino K, Nimura A, Suzuki S, Kuroiwa T, Koyama T, Okawa A, Terada H, Fujita K. Assessment of grip-motion characteristics in carpal tunnel syndrome patients using a novel finger grip dynamometer system. J Orthop Surg Res 2020; 15:245. [PMID: 32631378 PMCID: PMC7339582 DOI: 10.1186/s13018-020-01773-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 06/30/2020] [Indexed: 12/02/2022] Open
Abstract
Background Grip strength measurement is widely used in daily medical practice, and it has been reported that the grip strength decreases in patients with carpal tunnel syndrome (CTS). However, conventional grip dynamometers evaluate only the maximum power of total grip strength and cannot measure the time course of grip motion. In this report, we aimed to determine the grip characteristics of CTS patients by measuring the time course of each finger’s grip motion and to analyze the relationship between finger grip strength and subjective symptoms using this new grip system. Methods The grip strength of each finger was measured using the new grip system that has four pressure sensors on the grip parts of each finger of the Smedley grip dynamometer. We analyzed the time course of grip motion and relationship between finger grip strength and subjective symptoms in 104 volunteer and 51 CTS hands. The Japanese Society for Surgery of the Hand version of the Carpal Tunnel Syndrome Instrument (CTSI-JSSH) and the Disability of Arm, Shoulder, and Hand questionnaire (DASH) were used as subjective evaluation scores. Results In the CTS group, the grip time with the index, middle, and ring fingers was longer, and the time at which strength was lost after reaching the maximum was earlier. Patients with severe subjective symptoms tended to not use the index and middle fingers during grip motion. Conclusions This new system that measures each finger’s grip strength at one time and record the time course of grip motion could quantify a patient’s symptoms easily and objectively, which may contribute to the evaluation of hand function.
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Affiliation(s)
- Toru Sasaki
- Department of Orthopaedic and Spinal Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Koji Makino
- Center for Creative Technology, University of Yamanashi, 4-3-11, Takeda, Kofu, Yamanashi, Japan
| | - Akimoto Nimura
- Department of Functional Joint Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Shiro Suzuki
- Department of Functional Joint Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Tomoyuki Kuroiwa
- Department of Orthopaedic and Spinal Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Takafumi Koyama
- Department of Orthopaedic and Spinal Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Atsushi Okawa
- Department of Orthopaedic and Spinal Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan
| | - Hidetsugu Terada
- Department of Mechatronics, University of Yamanashi, 4-3-11, Takeda, Kofu, Yamanashi, Japan
| | - Koji Fujita
- Department of Orthopaedic and Spinal Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
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Affiliation(s)
- Michael Tonkin
- Professor Emeritus, University of Sydney Medical School, St Leonards, Australia
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