| 1. |
- Tillander, Jonatan, 1975, et al.
(författare)
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Osseointegrated titanium implants for limb prostheses attachments: infectious complications.
- 2010
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Ingår i: Clinical orthopaedics and related research. - : Ovid Technologies (Wolters Kluwer Health). - 1528-1132 .- 0009-921X. ; 468:10, s. 2781-2788
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The concept of osseointegration involves direct contact between titanium implant and bone. This transcutaneous prosthetic system for amputees is intended to assure stable long-term fixation. Most metal transcutaneous implants have failed, primarily owing to infection. QUESTIONS/PURPOSES: We determined the frequency and describe the presentation of infectious complications with this novel method. We also evaluated the bacterial flora at the skin-penetration area and its relation to the development of local and implant-related infection. PATIENTS AND METHODS: We prospectively followed 39 patients with arm and leg amputations fitted with transcutaneous osseointegrated titanium implants a mean of 56 months earlier (range, 132-133 months). There were 33 femoral, one tibial, four ulnar, four radial, and three humeral implants. Patients were selected during a 6-month period in 2005 and identically reevaluated after 3 years. Implant infection was defined as definite, probable, or possible based on clinical, radiologic, and microbiologic evidence. RESULTS: The frequency of implant infection was 5% at inclusion and 18% at followup. One patient with infection recovered owing to antibiotic treatment and another patient had the implant removed. Most implant infections had low infectious activity, and in five of the seven patients with infections, prosthetic use was not affected. The most common bacteria in superficial and deep cultures were Staphylococcus aureus and coagulase-negative staphylococci. CONCLUSIONS: Despite frequent colonization around the skin-implant interface by potentially virulent bacteria such as Staphylococcus aureus and bacteria associated with biomedical device infections such as coagulase-negative staphylococci, this titanium implant system for bone-anchored prostheses caused few infections leading to disability or implant removal. LEVEL OF EVIDENCE: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
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| 2. |
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| 3. |
- Berg, Elisabeth, 1951-, et al.
(författare)
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Uppdrag språklyft 1 : Idématerial till Skolverkets "Nya språket lyfter!"
- 2011. - 1
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Bok (populärvet., debatt m.m.)abstract
- Uppdrag språklyft 1 är den första av två idéböcker som utgår från Nya språket lyfter! - Skolverkets bedömningsstöd i svenska och svenska som andraspråk för grundskolans årskurs 1-4. Första boken riktar sig huvudsakligen mot årskurs 1 och 2 och kan med fördel även användas i förskoleklass. Boken har två teman som båda inleds med en högläsningstext, Leksaksfabriken respektive Detektivbyrån. Under högläsningen får läraren många tillfällen att öva läsförståelse och ordkunskap med eleverna. Till de två temana finns en rad roliga och kreativa elevuppdrag som aktivt utvecklar elevernas språk: eleverna sporras att tänka efter, läsa, diskutera och argumentera både muntligt och skriftligt. I anslutning till varje uppdrag hänvisas till de observationspunkter och avstämningar som finns i bedömningsmaterialet Nya språket lyfter! Nya språket lyfter! Författarna ingår i projektgtuppen som på Skolverkets uppdrag utarbetade
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| 4. |
- Brånemark, Rickard, 1960, et al.
(författare)
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A novel osseointegrated percutaneous prosthetic system for the treatment of patients with transfemoral amputation: A prospective study of 51 patients.
- 2014
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Ingår i: The bone & joint journal. - 2049-4408. ; 96:1, s. 106-13
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Tidskriftsartikel (refereegranskat)abstract
- Patients with transfemoral amputation (TFA) often experience problems related to the use of socket-suspended prostheses. The clinical development of osseointegrated percutaneous prostheses for patients with a TFA started in 1990, based on the long-term successful results of osseointegrated dental implants. Between1999 and 2007, 51 patients with 55 TFAs were consecutively enrolled in a prospective, single-centre non-randomised study and followed for two years. The indication for amputation was trauma in 33 patients (65%) and tumour in 12 (24%). A two-stage surgical procedure was used to introduce a percutaneous implant to which an external amputation prosthesis was attached. The assessment of outcome included the use of two self-report questionnaires, the Questionnaire for Persons with a Transfemoral Amputation (Q-TFA) and the Short-Form (SF)-36. The cumulative survival at two years' follow-up was 92%. The Q-TFA showed improved prosthetic use, mobility, global situation and fewer problems (all p < 0.001). The physical function SF-36 scores were also improved (p < 0.001). Superficial infection was the most frequent complication, occurring 41 times in 28 patients (rate of infection 54.9%). Most were treated effectively with oral antibiotics. The implant was removed in four patients because of loosening (three aseptic, one infection). Osseointegrated percutaneous implants constitute a novel form of treatment for patients with TFA. The high cumulative survival rate at two years (92%) combined with enhanced prosthetic use and mobility, fewer problems and improved quality of life, supports the 'revolutionary change' that patients with TFA have reported following treatment with osseointegrated percutaneous prostheses. Cite this article: Bone Joint J 2014;96-B:106-13.
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| 5. |
- Eriksson, Kerstin Margareta, 1955-, et al.
(författare)
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Quality of life and cost-effectiveness of a 3-year trial of lifestyle intervention in primary health care
- 2010
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Ingår i: Archives of Internal Medicine. - Chicago : American Medical Association. - 0003-9926 .- 1538-3679. ; 170:16, s. 1470-1479
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Tidskriftsartikel (refereegranskat)abstract
- Background: Lifestyle interventions reduce cardiovascular risk and diabetes but reports on long term effects on quality of life (QOL) and health care utilization are rare. The aim was to investigate the impact of a primary health care based lifestyle intervention program on QOL and cost-effectiveness over 3 years.Methods: 151 men and women, age 18-65 yr, at moderate-to-high risk for cardiovascular disease, were randomly assigned to either lifestyle intervention with standard care or standard care alone. Intervention consisted of supervised exercise sessions and diet counseling for 3 months, followed by regular group meetings during 3years. Change in QOL was measured with EuroQol (EQ-5D, EQ VAS), the 36-item Short Form Health Survey (SF-36), and the SF-6D. The health economic evaluation was performed from a societal view and a treatment perspective. In a cost-utility analysis the costs, gained quality-adjusted life years (QALY) and savings in health care were considered. Cost-effectiveness was also described using the Net Monetary Benefit Method.Results: Significant differences between groups over the 3-yr period were shown in EQ VAS, SF-6D and SF-36 physical component summary but not in EQ-5D or SF-36 mental component summary. There was a net saving of 47 USD per participant. Costs per gained QALY, savings not counted, were 1,668 – 4,813 USD. Probabilities of cost-effectiveness were 89 – 100 %, when 50 000 USD was used as stakeholder’s threshold of willingness to pay for a gained QALY.Conclusion: Lifestyle intervention in primary care improves QOL and is highly cost-effective in relation to standard care.
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| 6. |
- Frossard, L., et al.
(författare)
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Apparatus for monitoring load bearing rehabilitation exercises of a transfemoral amputee fitted with an osseointegrated fixation: a proof-of-concept study
- 2010
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Ingår i: Gait & Posture. - : Elsevier BV. - 1879-2219 .- 0966-6362. ; 31:2, s. 223-228
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this proof-of-concept study was to determine the relevance of direct measurements to monitor the load applied on the osseointegrated fixation of transfemoral amputees during static load bearing exercises. The objectives were (A) to introduce an apparatus using a three-dimensional load transducer, (B) to present a range of derived information relevant to clinicians, (C) to report on the outcomes of a pilot study and (D) to compare the measurements from the transducer with those from the current method using a weighing scale. One transfemoral amputee fitted with an osseointegrated implant was asked to apply 10 kg, 20 kg, 40 kg and 80 kg on the fixation, using self-monitoring with the weighing scale. The loading was directly measured with a portable kinetic system including a six-channel transducer, external interface circuitry and a laptop. As the load prescribed increased from 10 kg to 80 kg, the forces and moments applied on and around the antero-posterior axis increased by four-fold anteriorly and 14-fold medially, respectively. The forces and moments applied on and around the medio-lateral axis increased by nine-fold laterally and 16-fold from anterior to posterior, respectively. The long axis of the fixation was overloaded and underloaded in 17% and 83% of the trials, respectively, by up to + or - 10%. This proof-of-concept study presents an apparatus that can be used by clinicians facing the challenge of improving basic knowledge on osseointegration, for the design of equipment for load bearing exercises and for rehabilitation programs.
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| 7. |
- Frossard, L., et al.
(författare)
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Load applied on bone-anchored transfemoral prosthesis: Characterization of a prosthesis-A pilot study
- 2013
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Ingår i: Journal of Rehabilitation Research and Development. - : Journal of Rehabilitation Research & Development. - 0748-7711. ; 50:5, s. 619-634
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Tidskriftsartikel (refereegranskat)abstract
- The objectives of this study were to (1) record the inner-prosthesis loading during activities of daily living (ADLs), (2) present a set of variables comparing loading data, and (3) provide an example of characterization of two prostheses. The load was measured at 200 Hz using a multi-axial transducer mounted between the residuum and the knee of an individual with unilateral transfemoral amputation fitted with a bone-anchored prosthesis. The load was measured while using two different prosthetic knees, mechanical (PRO1) and microprocessor-controlled (PRO2), during six ADLs. The characterization of the prostheses was achieved using a set of variables split into four categories, including temporal characteristics, maximum loading, loading slopes, and impulse. Approximately 360 gait cycles were analyzed for each prosthesis. PRO I showed a cadence improved by 19% and 7%, a maximum force on the long axis reduced by 11% and 19%, and an impulse reduced by 32% and 15% during descent of incline and stairs compared with PRO2, respectively. This work confirmed that the proposed apparatus and characterization can reveal how changes of prosthetic components are translated into inner-prosthetic loading.
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| 8. |
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| 9. |
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| 10. |
- Hagberg, Kerstin, 1957, et al.
(författare)
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Reproducibility of the physiological cost index among individuals with a lower-limb amputation and healthy adults
- 2011
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Ingår i: Physiotherapy Research International. - 1471-2865. ; 16:2, s. 92-100
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Tidskriftsartikel (refereegranskat)abstract
- Background and Purpose.The physiological cost index (PCI) is a clinical measurement used to estimate the energy cost of walking. The reproducibility of the PCI has been questioned and no study has investigated the measurement error among individuals with a lower-limb amputation. The aim was to investigate the test–retest reproducibility of the PCI in individuals with a lower-limb amputation and healthy adults. Methods.The study comprised 28 individuals (20 males, eight females, mean age 49 years) with a unilateral amputation due to reasons other than vascular disease and 31 healthy volunteers (20 males, 11 females, mean age 47 years). PCI values were obtained by registering heart rate at rest and during level indoor walking for 5 minutes at a comfortable speed. A within-day test–retest assessment was performed. Reproducibility analyses included intra-class correlation, analyses of systematic differences between measurements, calculation of the smallest detectable change (SDC) and coefficient of variation (CV), and the results were finally visualized using Bland–Altman plots. Results.The reliability in terms of intra-class correlation was excellent for both groups (0.966 and 0.948). In the amputee group, the PCI revealed a mean difference of 0.026 (p = 0.016) between tests (PCI = 0.555, standard deviation [SD] = 0.214 and PCI = 0.581, SD = 0.236, respectively). In the healthy group, there was no systematic difference between tests (PCI = 0.329, SD = 0.114 and PCI = 0.331, SD = 0.110, respectively). The SDC was 0.116 in the amputee group and 0.070 in the healthy group, giving a CV of 20.4% and 21.0%,respectively. Conclusions.The within-day test–retest reproducibility of the PCI was excellent among individuals with lower-limb amputations and healthy adults in terms of intra-class correlation and acceptable in terms of agreement. The SDC, which was calculated for each group, should be considered when demonstrating an individual difference after an intervention. Copyright © 2010 John Wiley & Sons, Ltd
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| 11. |
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| 12. |
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| 13. |
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| 14. |
- Hagberg-Persson, Barbro, et al.
(författare)
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Ämnesprov i svenska och svenska som andraspråk för årskurs 3 : en utprövningsomgång
- 2010
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Subject test of Swedish and of Swedish as a second language for Grade 3 – an initial trial run. In autumn 2007, the Swedish National Agency for Education commissioned the Department of Scandinavian Languages at Uppsala University to develop and construct the subject test of Swedish and of Swedish as a second language for Grade 3. An initial trial run was to be ready for implementation in spring 2009. This report first documents the work on these trials and what it meant for the future of the test. A large part of the report is then given over to the field study carried out in spring 2009. Following this is an account of teachers’ views and pupil results collected along with some reflections on the prospects for the test over the coming years. The first trial run for the Grade 3 subject test was held March–May, 2009. During this period, five teachers from the university observed the proceedings in the form of a field study. In all, 11 schools with a total of 222 pupils were involved. The results from the field study indicate that the different components of the exam were carried out in a way that worked well in general. Both the field observations and teachers’ views confirm this since experiences were on the whole predominantly positive. However, with respect to exam components A and B, the teachers were concerned about whether they would manage to observe every student’s oral proficiency at the same time, even though the two oral components were carried out separately with each half of the class. The pupils’ reading proficiency was tested in two exam components (C and D). Both the field observations and teachers’ views indicate that the two components worked well in general but that the time spent introducing them and the amount of detail in doing so varied among teachers. Components E/F test the pupils’ ability to produce a written narrative. The results here indicate that the written narrative task worked well in general but that some parts should be given more attention. This primarily concerns the instructions and graphic material for the writing task. Component G tests the pupils’ ability to write a descriptive text. Also apparent here is the importance of the clarity of the teacher’s instructions so that pupils can be provided with the best conditions for successfully completing this writing task.
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| 15. |
- Hellstrand Tang, Ulla, 1956, et al.
(författare)
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Comparison of plantar pressure in three types of insole given to patients with diabetes at risk of developing foot ulcers – A two-year, randomized trial
- 2014
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Ingår i: Journal of Clinical and Translational Endocrinology. - : Elsevier BV. - 2214-6237. ; 1:4, s. 121-132
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Tidskriftsartikel (refereegranskat)abstract
- Background: Special insoles and shoes designed to prevent foot ulcers caused by repetitive high pressures are recommended for patients with diabetes who have any of the following risk factors: neuropathy; peripheral vascular disease; foot deformities; previous ulcers; amputation; and skin pathologies. However, there is a need for increased knowledge regarding: a) differences in the peak pressure (PP) and pressure time integral (PTI) for different types of insoles; and b) the properties of the pressure distribution for insoles used over a period of several months. We present the results of a randomized trial to compare the plantar pressures of three commonly used insoles. Objectives: The primary objective was to compare the PP and PTI between three types of insoles. The secondary objective was to explore the long-term pattern of peak plantar pressure distribution and variations in specific regions of interest (ROI). The tertiary objective was to investigate the impacts of insole adjustments, how much the insoles were used, and the levels of patient satisfaction. Methods In a 2-year trial, 114 patients with type 1 (N = 31) or type 2 (N = 83) diabetes (62 men and 52 women; mean age, 57.7 ± 15.4 years; duration of diabetes, 12.3 ± 11.2 years; neuropathy, 38%), were randomized to be supplied with one of three different insoles. The ethylene vinyl acetate (EVA) insoles were used in outdoor walking shoes. The 35 EVA group (N = 39) received soft custom-made insoles composed of EVA of 35 shore A hardness, the 55 EVA group (N = 37) received custom-made insoles composed of EVA of 55 shore hardness, and the control group (N = 38) received prefabricated insoles composed of a hard core with a top layer of soft 12 shore hardness microfiber. Using F-Scan®, the in-shoe plantar pressures were measured at seven ROI (hallux, metatarsal head 1, metatarsal head 2, metatarsal head 4, metatarsal head 5, lateral aspect of the mid-foot, heel) on five occasions during the study period. The plantar-pressure variables used were PP (main outcome) and PTI. The plantar patterns of load were explored, satisfaction and usage of the insoles were rated by the participants, and insole adjustments were recorded. Results:A mixed model analysis estimated lower PP values in the heel regions for the 35 EVA and 55 EVA insoles (171 ± 13 and 161 ± 13 kPa, respectively) than for the prefabricated insoles (234 ± 10 kPa) (p
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| 16. |
- Häggström, Eva, et al.
(författare)
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Comparison of prosthetic costs and service between osseointegrated and conventional suspended transfemoral prostheses.
- 2013
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Ingår i: Prosthetics and orthotics international. - : Ovid Technologies (Wolters Kluwer Health). - 0309-3646. ; 37:2, s. 152-160
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Tidskriftsartikel (refereegranskat)abstract
- Background: Nowadays, a transfemoral amputation prosthesis can be fitted to the skeleton using an osseointegrated implant, that is, without a socket. Treated patients have reported improvements in quality of life.Objectives: To investigate differences in prosthetic costs and service of osseointegrated prostheses compared to socket-suspended prostheses.Study Design: Retrospective cost analysis and survey.Methods: Costs and noted visits during in mean ~10 years were taken from one prosthetic workshop and included 50 patients with unilateral transfemoral amputation (36 socket-suspended prostheses, 20 osseointegrated prostheses, 6 patients used both kinds of prostheses). A survey comprised 71 patients (69% males; mean age = 52.3 year; cause: 66% trauma, 23% tumour, 11% other).Results: Statistically significant fewer workshop visits were shown with osseointegrated prostheses compared to socket-suspended prostheses (cost analysis: 3.1 vs. 7.2 visits/year, survey: 3.4 vs. 9.2 visits/year). The mean total annual cost of new prostheses, services, repairs and adjustments was 14% lower for osseointegrated prostheses than socket-suspended prostheses (€3149 and €3672 respectively, p = 0.632). A subgroup analysis of recent produced prostheses revealed cost of material to account for 92.5% for osseointegrated prostheses and 70% for socket-suspended prostheses.Conclusion: Despite significantly fewer visits for prosthetic service the annual mean costs for osseointegrated prostheses were comparable with socket-suspended prostheses. This study suggests it is due to more advanced prosthetic components being used with osseointegrated prostheses.
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| 17. |
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| 18. |
- Häggström, Eva, et al.
(författare)
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Vibrotactile evaluation: Osseointegrated versus socket-suspended transfemoral prostheses
- 2013
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Ingår i: Journal of Rehabilitation Research and Development. - : Journal of Rehabilitation Research & Development. - 0748-7711 .- 1938-1352. ; 50:10, s. 1423-1434
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Tidskriftsartikel (refereegranskat)abstract
- This study investigated detection thresholds of vibrometric stimuli in patients with transfemoral amputation supplied with osseointegrated (OI) and socket-suspended prostheses. It included 17 patients tested preoperatively with socket-suspended prostheses and after 2 yr with OI prostheses and a control group (n = 17) using socket-suspended prostheses, evaluated once. Assessments on the prosthetic and intact feet were conducted at six frequencies (8, 16, 32, 64, 125, and 250 Hz). Furthermore, measurements were conducted to investigate how vibrometric signals are transmitted through a test prosthesis. The results showed that the OI group had improved ability to detect vibrations through the prosthesis at 125 Hz (p = 0.01) at follow-up compared with the preoperative measurement. Compared with the control group, the 01 group at follow-up had better ability to detect high frequency vibrations through the prosthesis (125 Hz, p = 0.02; 250 Hz, p = 0.03). The vibrometric signal transmitted through the test prosthesis was reduced at 8, 125, and 250 Hz but was amplified at 16, 32, and 64 Hz. Differences between the OI and the control groups were found in the highest frequencies in which the test prosthesis showed reduction of the vibrometric signal. The study provides insight into the mechanisms of vibration transmission between the exterior and bone-anchored as well as socket-suspended amputation prostheses.
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| 19. |
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| 20. |
- Lundberg, Mari, 1969, et al.
(författare)
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My prosthesis as part of me : qualitative analysis of living with an osseointegrated prosthetic limb
- 2011
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Ingår i: Prosthetics and Orthotics International. - : Ovid Technologies (Wolters Kluwer Health). - 0309-3646 .- 1746-1553. ; 35:2, s. 207-214
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Tidskriftsartikel (refereegranskat)abstract
- Background:Bone-anchored prosthesis is still a rather unusual treatment for patients with limb loss.Objectives: The aim of this study was to improve our understanding about the experience of living with an osseointegrated prosthesis (OI-prosthesis) compared to one suspended with a socket, through the use of qualitative research methodology.Study design: A qualitative phenomenological research method.Methods: Thirteen Swedish patients (37–67 years) with unilateral upper or lower limb amputation (10 transfemoral, 2 transhumeral, 1 transradial), who had been using OI-prostheses for 3 to 15 years, were recruited by means of purposive sampling. An audio-taped in-depth interview was performed. The guiding question was ‘How do you experience living with your osseointegrated prosthesis compared to your earlier prostheses suspended with sockets?’. The empirical phenomenological psychological method was used for data analysis.Results: The results showed that all participants described living with an OI-prosthesis as a revolutionary change. These experiences were described in terms of three typologies, called ‘Practical prosthesis’, ‘Pretend limb’ and ‘A part of me’.Conclusions: The most important finding was that the change went beyond the functional improvements, integrating the existential implications in the concept of quality of life.Clinical relevance: This qualitative in-depth interview study on patients using bone-anchored prosthetic limbs showed that all described a revolutionary change in their lives as amputees and the meaning of that change went beyond the functional improvements, integrating existential implications in the concept of quality of life.
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| 21. |
- Rusaw, David, et al.
(författare)
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Bilateral electromyogram response latency following platform perturbation in unilateral transtibial prosthesis users: Influence of weight distribution and limb position
- 2013
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Ingår i: Journal of Rehabilitation Research and Development. - : Journal of Rehabilitation Research & Development. - 0748-7711 .- 1938-1352. ; 50:4, s. 531-544
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Tidskriftsartikel (refereegranskat)abstract
- Appropriate muscular response following an external perturbation is essential in preventing falls. Transtibial prosthesis users lack a foot-ankle complex and associated sensorimotor structures on the side with the prosthesis. The effect of this lack on rapid responses of the lower limb to external surface perturbations is unknown. The aim of the present study was to compare electromyogram (EMG) response latencies of otherwise healthy, unilateral, transtibial prosthesis users (n = 23, mean +/- standard deviation [SD] age =48 +/- 14 yr) and a matched control group (n = 23, mean +/- SD age = 48 +/- 113 yr) following sudden support-surface rotations in the pitch plane (toes-up and toes-down). Perturbations were elicited in various weight-bearing and limb-perturbed conditions. The results indicated that transtibial prosthesis users have delayed responses of multiple muscles of the lower limb following perturbation, both in the intact and residual limbs. Weight-bearing had no influence on the response latency in the residual limb, but did on the intact limb Which limb received the perturbation was found to influence the muscular response, with the intact limb showing a significantly delayed response when the perturbation was received only on the side with a prosthesis. These delayed responses may represent an increased risk of falling for individuals who use transtibial prostheses.
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| 22. |
- Rusaw, David, et al.
(författare)
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Can vibratory feedback be used to improve postural stability in persons with transtibial limb loss?
- 2012
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Ingår i: Journal of rehabilitation research and development. - 1938-1352 .- 0748-7711. ; 49:8, s. 1239-54
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Tidskriftsartikel (refereegranskat)abstract
- The use of vibration as a feedback modality to convey motion of the body has been shown to improve measures of postural stability in some groups of patients. Because individuals using transtibial prostheses lack sensation distal to the amputation, vibratory feedback could possibly be used to improve their postural stability. The current investigation provided transtibial prosthesis users (n = 24, mean age 48 yr) with vibratory feedback proportional to the signal received from force transducers located under the prosthetic foot. Postural stability was evaluated by measuring center of pressure (CoP) movement, limits of stability, and rhythmic weight shift while participants stood on a force platform capable of rotations in the pitch plane (toes up/toes down). The results showed that the vibratory feedback increased the mediolateral displacement amplitude of CoP in standing balance and reduced the response time to rapid voluntary movements of the center of gravity. The results suggest that the use of vibratory feedback in an experimental setting leads to improvements in fast open-loop mechanisms of postural control in transtibial prosthesis users.
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| 23. |
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| 24. |
- Wiig, Monica E., et al.
(författare)
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PXL01 in Sodium Hyaluronate for Improvement of Hand Recovery after Flexor Tendon Repair Surgery: Randomized Controlled Trial.
- 2014
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Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 9:10
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Tidskriftsartikel (refereegranskat)abstract
- Postoperative adhesions constitute a substantial clinical problem in hand surgery. Fexor tendon injury and repair result in adhesion formation around the tendon, which restricts the gliding function of the tendon, leading to decreased digit mobility and impaired hand recovery. This study evaluated the efficacy and safety of the peptide PXL01 in preventing adhesions, and correspondingly improving hand function, in flexor tendon repair surgery.
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