Go here to read my story about my hand issues.
Here is the kooiman etude website:
http://www.tonkooiman.com/index.php/products/etude2
The thumb rest is completely adjustable, wide, and padded for maximum comfort. I like it because it changes where the weight of the oboe falls. Once the mounting plate is screwed in (it does NOT require new holes) the actual thumb rest part slides on and off so you oboe still fits in a traditional oboe case. I absolutely love it!
Here are some pictures of my thumb rest on my oboe:
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