[On the significance of parosteal tissue in the healing of diaphyseal fractures].
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Animals↗
Biomedical subjects
H K Uhthoff
Publications and source records attributed to H K Uhthoff.
"Bursal reactions" in rotator cuff tearing, the impingement syndrome, and calcifying tendinitis.
Subacromial bursal specimens from 63 patients undergoing surgery for rotator cuff tearing (n = 43), the impingement syndrome (n = 14), and calcifying tendinitis n = 6) were studied to characterize the reactions that develop at the tendinopathy "lesional" sites. Intensity of the bursal reactions and production of type III collagen vary considerably, with the highest incidence of both seen in patients with rotator cuff tears. The intensity of bursal reactions correlated with the degree of formation of perivascular new collagen and type III collagen expression. In 22 of the 63 patients the bursal reaction distant to the tendon lesion was also studied. It was minimal and did not correlate to the lesional bursal findings. A strong correlation, however, existed between surgical appearance and histologic grading. The term "localized bursal reaction" as opposed to bursitis more correctly describes bursal involvement. Resection of bursal tissues should be limited to the lesional tissue that interferes with subacromial motion.
Adult↗
Histologic evidence of degeneration at the insertion of 3 rotator cuff tendons: a comparative study with human cadaveric shoulders.
We determined on histologic examination the degree of degeneration at the insertion of 3 rotator cuff tendons in 76 cadaveric shoulders, 17 of which had a partial tear of the supraspinatus. Fiber thinning, the presence of granulation tissue, and incomplete tearing of fibers, all evidence of degeneration, were quantified separately for each tendon. Among the shoulders that were intact on macroscopy, no significant difference in degeneration score could be found. In all 3 tendons degeneration was more prominent on the articular sides compared with the bursal sides (P < .0001). The degeneration score of partially torn supraspinatus was significantly higher than that of the intact tendons (P < .0001). The extent of granulation tissue, 1 criterion of degeneration, seemed to contribute mostly to this difference. Intrinsic degeneration occurred foremost in the articular side of the rotator cuff and might constitute the primary cause of rotator cuff tearing.
Adult↗
[Embryology of the human hip with special reference to the development of the labra].
For the clinician the knowledge of the intrauterine development of the human hip is of great importance particularly for an understanding of the pathogenesis of congenital hip displacement. Observations based on serial sections of fetal hips from our collection showed that the acetabular roof is generally well developed. The posterior wall, on the other hand, consists mostly of the fibrous labrum and little coverage is provided by cartilage. Since the fetal hip is in a position of flexion, a pressure exerted on the knee will be transmitted to the posterior wall of the acetabulum and not to the acetabular roof. Any additional adduction, often found in utero, will further decrease the coverage. Both, the relative weak posterior structures and the position of adduction, may explain the posterior subluxation observed in one of our specimens.
Acetabulum↗
Bone structure changes in the dog under rigid internal fixation.
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Animals↗
Idiopathic localized gigantism: a 26-year follow-up.
A 26-year follow-up of a case of localized congenital gigantism is presented. This is the longest known follow-up reported. After initial digital amputation, the lesion recurred twice, requiring further surgery. Histology does not show evidence of underlying neurofibromatosis.
Female↗
Early intrauterine presence of congenital dislocation of the knee.
We report the histologic findings of congenital dislocation of both knees of a 19.5-week-old spontaneously aborted fetus. Grossly and histologically, both knees were grade II congenital dislocations (subluxation), which are characterized by hyperextension of the knee with rotatory subluxation. Comparing the morphologic changes to age-matched normal controls allowed us to distinguish between primary and secondary changes. The most impressive fetal abnormalities were partial fibrosis of the quadriceps, absence of a suprapatellar pouch and incomplete patellofemoral joint cavitation. The presence of these findings suggests that they most likely cause, and do not result from, dislocation. This specimen is the first preterm fetus to be described with the features of congenital dislocation of the knee of any type.
Abortion, Spontaneous↗
A possible contribution of undifferentiated cells to post-traumatic osteogenesis.
The contribution of undifferentiated cells to callus formation is difficult to observe during fracture healing and is therefore debated. In adult mongrel dogs these cells can easily be observed in a narrow space separating a freshly inserted screw from the surrounding compact bone. Undifferentiated connective tissue cells invade these spaces from the medullary and, less so, from the periosteal site. They seem to resemble histologically and more so ultrastructurally B-type lymphocytes. They migrate to the site of repair or are brought there by the blood stream. Locally these cells proliferate and differentiated into osteoblasts. The authors prefer to call these cells lymphocyte-like cells.
Animals↗
Development of the foot in prenatal life in relation to idiopathic club foot.
The development of the human foot from the eighth to the twenty-first intrauterine week was studied in 147 specimens. The results documented a stage of "physiologic club foot" characterized by a medial deviation and plantigrade orientation of talar neck and head during the ninth week. At the same time, the calcaneus assumes a position of varus with the forefoot in adduction. By the eleventh week, the foot assumes a normal position. All findings during the stage of physiologic club foot closely resemble those of the intrinsic type of club foot.
Anthropometry↗
Prenatal development around the sustentaculum tali and its relation to talocalcaneal coalitions.
Twenty cartilaginous talocalcaneal bridges were found in 16 cases among 142 feet from 119 embryos and fetuses ranging from 7 to 20 weeks. The cartilaginous bridges were mainly located extraarticularly between the posteromedial portion of the sustentaculum tali and the corresponding part of the talus. The incidence of talocalcaneal bridges was high in the prenatal period, especially during the ninth and tenth week; it was much less common in older specimens. This condition is attributed to either failure of or delay in differentiation of mesenchymal tissue into more specialized tissue between the posterior portion of sustentaculum tali and the corresponding part of the talus during the 7 1/2-8 1/2 postovulatory weeks.
Age Factors↗
Effect of long-term nontraumatic immobilization on metaphyseal spongiosa in young adult and old beagle dogs.
A radiographic and histomorphometric change in volume in the metaphyseal spongiosa in response to long-term immobilization was investigated in young adult and old beagle dogs and compared with changes in diaphyseal compacta of the same bones. Sixty weeks of nontraumatic immobilization of young dogs produced a 66% loss of metaphyseal spongiosa in the third metacarpus, a 50% loss in the radius, and a 25% loss in the humerus. In older animals, the loss amounted to 54%, 46%, and 37%, respectively. In both age groups, the loss of the spongiosa exceeded that of the compacta in the same bones, and, as in the compacta, it was greatest in the small peripheral bones. Although maximal loss occurs during the first 24 to 32 weeks, it may continue to a lesser degree up to 60 weeks and perhaps beyond 60 weeks of immobilization. Since bone loss can occur only on bone surfaces, the earlier and greater loss from the spongiosa may be explained in part by the higher endosteal surface-to-volume ratio of spongy bone. Given a similar bone structure and physiology in man and dog, the observations made in this study may apply to man as well.
Age Factors↗
Calcifying tendinitis of the shoulder: prognostic value of clinical, histologic, and radiologic features in 57 surgically treated cases.
Calcifying tendinitis of the shoulder was studied in 57 patients before and after surgical removal of the calcified material. Many patients with an acute flare of pain prior to surgery also had a "fluffy" calcific deposit on radiograph and histologic evidence of calcium resorption. Conversely, patients with no acute preoperative symptom flare were more likely to have a sharply "defined" calcific deposit on radiograph and less histologic evidence of calcium resorption. Fully 30% of the patients continued to have shoulder pain for more than 12 weeks postoperatively. There were no clinical, radiologic or histologic features which distinguished these patients from those who were symptom free within 6 weeks postoperatively.
Adult↗
[The influence of mechanical factors on the activity of the three bone envelopes].
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Animals↗
A retrospective study of surgically treated cases of tennis elbow.
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Adult↗
The reversal of tissue differentiation around screws.
Mechanical factors influence the morphology and function of differentiated as well as undifferentiated cells. Observations of tissues surrounding screws, during a 4-week period of stability followed by a 4-week period of instability, demonstrate resorption of the newly formed callus and subsequently to screw lossening. Four weeks of instability followed by 4 weeks of stability produced not only a cessation of the osteoclastic activity, but also the appearance of an osteoclastic activity. Thus, the holding power of screws is not finally determined at the moment of their insertion nor after cellular differentiation has occurred around the screws. Local mechanical conditions throughout the period of fracture consolidation are of eqaul importance.
Animals↗
Calcifying tendinitis: a new concept of its pathogenesis.
To elucidate the pathogenesis of calcifying tendinitis, clinical and morphological investigations were done on 46 surgically treated cases. Contrary to the prevalent concept of degeneration preceding dystrophic calcification, we found no evidence for an active or a healed degenerative process. The affected tendon was transformed into fibrocartilage with a predilection for calcification. The formative phase of calcification was followed in course of time by a resorptive phase during which the deposits were surrounded by phagocytosing cells. There was a concomitant proliferation of vascular channels. We found a significant correlation between severe pain and histological signs of resorption. The pathogenetic mechanism of calcifying tendinitis should be reassessed as a unique disorder of the musculotendinous cuff.
Adult↗