{"id":7506,"date":"2026-04-02T11:58:32","date_gmt":"2026-04-02T11:58:32","guid":{"rendered":"https:\/\/www.proefschriftmaken.nl\/portfolio\/inge-hoevenaren\/"},"modified":"2026-04-02T11:58:38","modified_gmt":"2026-04-02T11:58:38","slug":"inge-hoevenaren","status":"publish","type":"us_portfolio","link":"https:\/\/www.proefschriftmaken.nl\/en\/portfolio\/inge-hoevenaren\/","title":{"rendered":"Inge Hoevenaren"},"content":{"rendered":"","protected":false},"excerpt":{"rendered":"","protected":false},"author":8,"featured_media":7509,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"us_portfolio_category":[45],"class_list":["post-7506","us_portfolio","type-us_portfolio","status-publish","has-post-thumbnail","hentry","us_portfolio_category-new-template"],"acf":{"naam_van_het_proefschift":"Three-Dimensional Stereophotogrammetry in Hand Surgery","samenvatting":"Er is geen Nederlandse samenvatting beschikbaar. De Engelse samenvatting vind je <a href=\"https:\/\/www.proefschriftmaken.nl\/en\/portfolio\/inge-hoevenaren\/\">hier<\/a>.","summary":"Based on the growing number of three-dimensional (3D) teaching models for different anatomic regions and the more extensive use of computer-based models in treatment planning of surgical procedures, the idea of introducing 3D stereophotogrammetry in the field of hand surgery was created. Currently, different imaging techniques like Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are being used for hand imaging. However, these existing techniques have numerous disadvantages, like radiation dose and costs. Compared to these techniques, 3D stereophotogrammetry is a safe and non-invasive technique for surface imaging of the hand, with the possibility of providing an objective basis for quantifying and qualifying clinical treatment outcome. Therefore, the main objective of this thesis was to investigate the usage of this 3D imaging technique for hand imaging and prove its effective use in clinical practice.\n\nThe accuracy of 3D stereophotogrammetry to create reproducible images of the hand was described in Chapter 2. A total of 34 three-dimensional hand photographs were analyzed to investigate the reproducibility, resulting in a small mean registration error. Furthermore, an average hand model was created using landmark based registration. From this study could be concluded that 3D stereophotogrammetry produces precise and reproducible 3D images of the hand. Further efforts to prove the validity of 3D hand images were performed, developing a landmark registration system. The reproducibility of 30 soft tissue landmarks on the hand was determined using 3D stereophotogrammetric images. The results of the analysis of the landmarks, performed on 20 images by two observers, were described in Chapter 3. These study results revealed a high reliability coefficient for intraobserver and interobserver reliability, with more precise identification of the landmarks on the palmar aspect of the hand. It could be concluded that 3D stereophotography can safely produce accurate and reproducible images of the hand, creating a reliable method for soft tissue analysis.\n\nAfter proving the reliability of 3D hand images produced by stereophotogrammetry, we focused on the clinical application of the technique. In the first clinical study (Chapter 4) a group of acromegaly patients in long-term remission of their disease were investigated. A case-control study was performed, in which 3D hand photographs of twelve acromegaly patients and their matched controls were acquired and analyzed. The patients in long-term remission showed to have soft tissue overgrowth of the hand compared to the control subjects, with larger length and width of the hand. These findings underscore that patients have to be informed that even after long-term remission of acromegaly the acral overgrowth persists. Furthermore, 3D stereophotogrammetry is a very promising technique for the follow-up of these patients, since it is fast, accurate, harmless and easy to perform.\n\nLymphedema of the upper extremity is a frequently observed manifestation following breast cancer surgery. To qualify and quantify lymphedema of the upper extremity, and in particular the hand, Chapter 5 described the use of 3D hand imaging for this purpose. A total of 18 patients with unilateral lymphedema of the hand were included, where after 3D hand images of both hands were obtained. The images of the lymphedema hand were compared with the normal unaffected hand of the same patient and linked to self-reported discomfort of the patient. In conclusion, the analyzed hand volume on the affected side was significantly larger compared to the unaffected side. This pilot study proved that changes in hand volume of lymphedema patients can be easily detected by using 3D hand images, creating an opportunity for timely initiation of treatment and evaluating treatment outcome.\n\nWith rejuvenation treatment of the hand gaining popularity, the need for a reliable tool to objectively visualize the changes of the aging hand and to compare different treatment outcomes, is growing. So far, no 3D imaging tool existed to visualize the aging process of the hand. In Chapter 6, this clinical application was investigated. 64 healthy volunteers were divided into four groups based on age and sex. 3D photographs of both hands were captured and analyzed by two different methods. The first method measured the smoothness of the dorsa of the old and young hands, and resulted in a non-significant difference in which the younger dorsa were smoother. In the second method, a color-coded distance map was created, showing a relative volume loss in the intermetacarpal space of the average old hands. On the basis of these findings, specific areas of esthetic treatment of the hand can be identified by 3D imaging, creating patient-tailored treatment options. Furthermore, it allows objective comparison of the outcomes of different rejuvenation treatments.\n\nAfter these first clinical applications, we used 3D stereophotogrammetry during the preoperative planning process of a hand surgical procedure, namely desyndactylization (Chapter 7). 3D hand images were used as the basis for creating a virtual planning tool to design an optimal incision pattern for desyndactylization procedures. After producing a template and testing it on a silicon syndactyly model, 3D hand images were made of three syndactyly patients. Individual incision patterns were created and transferred onto the patient intraoperatively by using 3D printed templates. The planning process was simple to perform with satisfying accuracy and no adverse effects on the surgery process. With future research, the next steps in the process of developing the virtual planning tool will be created.\n\nThe content of this thesis showed the added value of 3D imaging in hand surgery. The usage of 3D hand images adds precision to a surgical procedure and will reduce valuable operating time. Close cooperation between technicians and surgeons will remain very important in implementing this technique in the clinical hand surgery setting. Future research and improvements to the 3D technique will further add to the value of 3D hand imaging.","auteur":"Inge Hoevenaren","auteur_slug":"inge-hoevenaren","publicatiedatum":"5 april 2018","taal":"EN","url_flipbook":"https:\/\/ebook.proefschriftmaken.nl\/ebook\/ingehoevenaren?iframe=true","url_download_pdf":"","url_epub":"","ordernummer":"FTP-202604021156","isbn":"978-94-92896-21-6","doi_nummer":"","naam_universiteit":"Radboud Universiteit","afbeeldingen":7510,"naam_student:":"","binnenwerk":"","universiteit":"Radboud Universiteit","cover":"","afwerking":"","cover_afwerking":"","design":""},"_links":{"self":[{"href":"https:\/\/www.proefschriftmaken.nl\/en\/wp-json\/wp\/v2\/us_portfolio\/7506","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.proefschriftmaken.nl\/en\/wp-json\/wp\/v2\/us_portfolio"}],"about":[{"href":"https:\/\/www.proefschriftmaken.nl\/en\/wp-json\/wp\/v2\/types\/us_portfolio"}],"author":[{"embeddable":true,"href":"https:\/\/www.proefschriftmaken.nl\/en\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/www.proefschriftmaken.nl\/en\/wp-json\/wp\/v2\/comments?post=7506"}],"version-history":[{"count":1,"href":"https:\/\/www.proefschriftmaken.nl\/en\/wp-json\/wp\/v2\/us_portfolio\/7506\/revisions"}],"predecessor-version":[{"id":7507,"href":"https:\/\/www.proefschriftmaken.nl\/en\/wp-json\/wp\/v2\/us_portfolio\/7506\/revisions\/7507"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.proefschriftmaken.nl\/en\/wp-json\/wp\/v2\/media\/7509"}],"wp:attachment":[{"href":"https:\/\/www.proefschriftmaken.nl\/en\/wp-json\/wp\/v2\/media?parent=7506"}],"wp:term":[{"taxonomy":"us_portfolio_category","embeddable":true,"href":"https:\/\/www.proefschriftmaken.nl\/en\/wp-json\/wp\/v2\/us_portfolio_category?post=7506"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}