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PubMed1984

[Radiographic aspects of the hand in diffuse idiopathic skeletal hyperostosis].

Radiographs of the hand of 53 patients with diffuse idiopathic skeletal hyperostosis (DISH) were compared with 20 acromegalic subjects and 100 matched controls. Bone qualitative changes, characteristic of DISH, include: (1) arrow-heading of the distal phalangeal tufts; (2) enthesopathy of the proximal phalanges; (3) enlarged sesamoid bones; (4) hook-like exostoses at the metacarpophalangeal heads; (5) cortical thickness of diaphyseal tubular bones. Therefore, the hand in this disease appears as a "robust" form, particularly in males, resembling acromegalic pattern, but in this disease, the hand is much more coarse (so called squared hand), especially because of the soft tissue involvement and articular cartilaginous hypertrophy. Only enthesopathy seems to be the most characteristic and peculiar finding of the disease. Quantitative bone change measurements have demonstrated in DISH that metacarpal and Exton Smith indices differ statistically toward the controls. The hand is wider, but in males bone mass may result the same and in female is shortly reduced. Soft tissue alterations, compared with the controls, are not significant. On the contrary, in acromegaly there is a significant statistical difference in all the quantitative measurements of both the skeletal and soft tissue lesions, compared with the controls and patients affected by DISH.

Acromegaly↗
PubMed2001

[Interpositioned metallic prosthesis for hallux rigidus: review of 42 cases with a metatarsophalangeal prosthesis].

PURPOSE OF THE STUDY: We report outcome at a mean 4.8 years follow-up in 42 patients with hallux rigidus treated by metatarsophalangeal interposition thin prosthesis flat concave with a lateral capsular fixation. MATERIALS AND METHODS: The 42 patients were treated from 1987 to 1997. Sixtine prostheses were implanted for osteoarthritis was grade I (n=2), grade II (n=28), and grade III (n=12). Groulier's clinical criteria and Regnauld's radiologic criteria were used to assess outcome. RESULTS: We observed 22 very good, 12 good, 4 fair, and 4 poor results. There was no significant modification in the forefoot morphology. DISCUSSION: The Sixtine prosthesis provided a global improvement in pain and motion though there was an important difference between patients with grade I and grade II osteoarthritis, who experienced major improvement, and those with grade III disease. A good overall result requires proper prosthetic centering. Subluxation or translation does not appear to be compatible with good results. Among 3 cases with overt dislocation, 1 recovered an acceptable articular space with a good overall result. Two poor results and 3 fair results were observed in patients with condensation of the phalangeal base. These bone condensations appeared in postoperative Egyptian feet. The Sixtine prosthesis may protect the interphalangeal articular space of the great toe, avoiding damage and rearward displacement of sesamoid bones. It ensures primary stability and may be left in place. CONCLUSION: We found that the Sixtine prosthesis is best indicated in hallux rigidus patients with grade II osteoarthritis.

Adult↗
PubMed1984

[Biomechanics of the skull and the beak in Ramphastos (Ramphastidae, Aves) I. Description of anatomical elements].

The different cranial kinetic systems described in Birds are limited in Ramphastos by the dorsal and backward position of the nostrils, the shape of the fronto-nasal suture, the lateral fit-in between nasal, lacrymal and frontal bones, and the divergent directions of the 2 otic processes of the quadrate, 5 ligaments joint the posterior skull elements to the quadrate and the mandible. Small sesamoid bones strengthen the external jugo-mandibular ligament in its retro-articular portion. The nomenclature of the aponeuroses is not useful by itself to compare the organizations and homology of the diverses muscular layers in the different birds groups. The differences observed in the relative position of the muscular bundles have to be related to the shape and particular relationships between skeletal structures. We have to consider the osteo-muscular systems as a whole and analyse them from a functional viewpoint.

Animals↗
PubMedDate not supplied

Radiologic abnormalities of the appendicular skeleton of the lion (Panthera leo): incidental findings and Mycobacterium bovis-induced changes.

Thoracic and pelvic limbs from 15 euthanized free-ranging lions (Panthera leo), ranging in age from 16 to 144 months, underwent standard radiographic evaluation. All lions had tested positive for Mycobacterium bovis by means of a modified intradermal tuberculn test. The radiographs of six lions were normal and nine had incidental findings of which six had more than one lesion. Seven lions had lesions suspected to be associated with tuberculosis, which was confirmed in specific joints in two lions. Incidental pathology was classified as traumatic injuries and degenerative or trauma-associated joint disease. The traumatic lesions were fractures of which the most remarkable was a femur malunion. Four lions had fibula and another three lions had metacarpal/tarsal and phalangeal fractures. Joint lesions included glenoid, humeral head, and accessory carpal bone osteophytes. There was evidence of a cranial cruciate ligament rupture in an 8-year-old male. Trauma induced joint lesions were seen in four stifles (fragmented or displaced sesamoid bones, fragmented meniscal ossicle, or mineralized fragments). Radiological abnormalities believed to be caused by M. bovis were present in one stifle, one radiocarpal three tibiotarsal, and one tarsometatarsal joints. These had evidence of septic arthritis with extensive bone formation and capsular mineralization. In one 20-month-old lion, changes typical of a bone abscess were found in a proximal tibia. Radiologic evidence of elbow hygromas were seen in three elbows, all believed to be caused by M. bovis. Lions appeared to cope fairly well with a variety of traumatic injuries and were also susceptible to some of the aging/incidental radiologic findings seen in dogs and cats. The suspected M. bovis osseous lesions were more likely to involve the joints, particularly the tarsal joint and were mainly proliferative.

Animals↗
PubMed1982

[X-ray study of the loaded portions of the skeleton of the upper extremities in athletes engaged in karate].

Roentgenogrammetric analysis demonstrated a more intensive development in the II and III metacarpal hand bones, as well as in the forearm bones in karatists comparing to those in boxers and football players. The transversal diameter of the medullary cavity was less in the karatists. Visual analysis of the roentgenograms demonstrated presence of sesamoid bones in the area of the proximal interphalangeal joints II and III in the fingers of the karatists, waist thickening on the medial surface of the proximal and middle digital phalanges, a sharp thickening of the compact substance layer in the area of the inferior third of the medial surface of the ulnar bone.

Adaptation, Physiological↗
PubMed1998

Bilateral congenital aplasia of the scaphoid.

A case of bilateral congenital aplasia of the carpal scaphoid bone is presented. In contrast to previously reported cases of congenital hypoplasia of the scaphoid, this case was not associated with hypoplasia or absence of thenar and forearm muscles, absence of the sesamoid bones of the thumb, abnormalities of the skeleton of the thumb ray or hypoplasia of the forearm bones.

Adult↗
PubMed2006

Trace elements in human tendons and ligaments.

Tendons and ligaments are key structures in promoting joint movement and maintaining joint stability. Although numerous reviews have detailed their structure, molecular composition, and biomechanical properties, far less attention has been paid to their content of trace elements. Tendons and ligaments are generally rich in calcium, sulfur, and phosphorus, although there are intriguing differences between one tendon/ligament and another. Furthermore, there can be significant regional variations that correlate with the presence or absence of fibrocartilage in the "wrap-around" regions of tendons or ligaments, where they change direction and press against bone. Here, their sulfate and calcium contents are particularly high. This is undoubtedly associated with the high levels of proteoglycans that are found in these cartilaginous tissues and the occasional presence of sesamoid bones within them.

Humans↗
PubMedDate not supplied

Delayed unions and nonunions of stress fractures in athletes.

From 1971 to 1985, 369 athletes presented to us with stress fractures. Of these patients, 10% (37) were treated for development of delayed unions or nonunions. Twenty-seven of the patients were male and 10 were female. Their mean age was 23.1 years (range, 17 to 39). About half of the athletes were involved in endurance sports. The diagnostic criteria for a delayed union or nonunion were clinical and radiological evidence. There was a diagnostic delay of about 3.5 months in the series. Plain radiographs, tomography, and isotope scans were used in the diagnosis. Special radiographic views were also used. In 15 cases (10 hallux sesamoid bone fractures, 1 midtibial shaft fracture, 1 metatarsal V base fracture, 1 tarsal navicular fracture, 1 olecranon fracture, and 1 proximal tibial shaft fracture) nonoperative treatment was used. Operative treatment was used 22 times (5 sesamoid fractures, 5 midtibial fractures, 5 metatarsal V base fractures, 3 tarsal navicular fractures, 3 olecranon fractures, and 1 proximal tibial shaft fracture). Results were good or excellent in 32 cases (86.5%), moderate in 4 cases, and poor in 1 case.

Adolescent↗
PubMed2004

Facilitated ankylosis of the distal interphalangeal joint in a foal.

A 3-month-old Quarter Horse colt sustained a penetrating injury over the coronary band on the right forelimb resulting in an articular bone sequestrum and septic arthritis of the distal interphalangeal joint. Despite aggressive treatment for septic arthritis, severe osteoarthritis and ongoing sepsis resulted in persistent lameness. Facilitated ankylosis of the distal interphalangeal joint was performed using a combination of open surgical debridement, placement of an autogenous cancellous bone graft and stabilisation within a transfixation cast. Bony ankylosis of the joint was observed radiographically 7 weeks following surgery. Evaluation of the horse 30 months following surgery revealed complete fusion of the middle and distal phalanges, and the distal sesamoid bone. The horse is pasture sound and is used as a breeding stallion. This report describes the surgical approach and case management employed to achieve facilitated ankylosis as a treatment for unresolved septic arthritis of the distal interphalangeal joint. This is the first report of successful facilitated ankylosis of the distal interphalangeal joint in a foal.

Animals↗
PubMed1995

[Bipolar dislocation of the first metatarsal bone].

Simultaneous dislocation of the first cuneometatarsal joint and metatarsophalangeal joint is a rare injury. The case of a 22-year-old man is reported, but no previous cases have been reported in the literature. The treatment by closed reduction and pinning was very classical. Occasionally the reducibility of the metatarsophalangeal joint may be made more difficult by the interposition of a sesamoid bone. The simultaneous dislocation occurred because the injury was very severe. After 2 years, the function and mobility of the toe were normal, but radiographs revealed modifications of the Lisfranc joint.

Adult↗
PubMed1997

Targeted disruption of Hoxd-10 affects mouse hindlimb development.

Targeted disruption of the Hoxd-10 gene, a 5' member of the mouse HoxD linkage group, produces mice with hindlimb-specific defects in gait and adduction. To determine the underlying causes of this locomotor defect, mutant mice were examined for skeletal, muscular and neural abnormalities. Mutant mice exhibit alterations in the vertebral column and in the bones of the hindlimb. Sacral vertebrae beginning at the level of S2 exhibit homeotic transformations to adopt the morphology of the next most anterior vertebra. In the hindlimb, there is an anterior shift in the position of the patella, an occasional production of an anterior sesamoid bone, and an outward rotation of the lower part of the leg, all of which contribute to the defects in locomotion. No major alterations in hindlimb musculature were observed, but defects in the nervous system were evident. There was a decrease in the number of spinal segments projecting nerve fibers through the sacral plexus to innervate the musculature of the hindlimb. Deletion of a hindlimb nerve was seen in some animals, and a shift was evident in the position of the lumbar lateral motor column. These observations suggest a role for the Hoxd-10 gene in establishing regional identity within the spinal cord and imply that patterning of the spinal cord may have intrinsic components and is not completely imposed by the surrounding mesoderm.

Animals↗
PubMed1978

[X-ray anatomic features of the skeleton in the 47, XYY syndrome].

The data are represented on the examination of 11 men with 47, XYY karyotype, roengenography of some parts of their skeletals including. The result are compared with the data on investigation of 430 human males chosen from a population. This anomaly in the karyotype stipulates, in the skeletal formation, a tendency to high stature, a certain flattening in the head of the radiocarpal articulation, the kneepan and the distal contour of the femoral bone. Nearly in a half of all observations valgus deviation of the ulnar articulation was somewhat increased, in 3 cases--inhibition of some synostoses in the growth zones of the extremities was noted. A supposition is made that in males the insidence of cleft in sesamoid bones in the lower extremities is increased in the presence of the extra Y-chromosome.

Adult↗
PubMedDate not supplied

Intraosseous gentamicin perfusion of the distal metacarpus in standing horses.

OBJECTIVE: To report tissue gentamicin concentrations after intraosseous (IO) perfusion in standing horses. STUDY DESIGN: In vivo study. ANIMALS OR SAMPLE POPULATION: Twelve horses. METHODS: Sedated horses had a cannulated cortical bone screw inserted into the dorsolateral aspect of the treated metacarpus and a tourniquet applied proximally. Gentamicin (2.2 mg/kg) diluted in sterile saline solution (0.1 mL/kg) was infused through the screw. Two horses were euthanatized at each time interval: 0, 2, 6, 12, 24, and 36 hours. Synovial fluid and bone samples were collected distal to the screw from both forelimbs. Gentamicin concentrations were measured using fluorescence polarization immunoassay. RESULTS: The highest synovial fluid gentamicin concentrations were 385+/-273 microg/mL (mean+/-SD) in the metacarpophalangeal joint, 225+/-205 microg/mL in the proximal interphalangeal joint, 215+/-205 microg/mL in the distal interphalangeal joint, 382+/-195 microg/mL in the digital flexor tendon sheath, and 206+/-161 microg/mL in the navicular bursa. The highest bone concentrations of gentamicin were 55+/-30 microg/g in the distal metacarpus, 34+/-27 microg/g in the proximal, 16+/-15 microg/g in the middle, and 16+/-2.2 microg/g in the distal phalanges, and 27+/-17 microg/g in the proximal and 24+/-11 microg/g in the distal sesamoid bones. CONCLUSION: Standing IO perfusion of gentamicin resulted in local antibiotic concentrations in the synovial structures and bones of the distal aspect of the limb that exceed the reported minimum inhibitory concentration of pathogens commonly implicated in equine orthopedic infections. CLINICAL RELEVANCE: Standing IO perfusion of gentamicin in the distal aspect of the limb should be considered for treatment of orthopedic infections of this region in horses.

Animals↗
PubMed2005

The first metatarsal bone under loading conditions: a finite element analysis.

An individual-based, three-dimensional finite element model of the first metatarsal (MT I) bone was created with fine CT. The three-dimensional model of the bone was fixed proximally at the metatarsocuneiform joint and load was applied on the metatarsal head. Loading conditions were simulated, including muscular forces as described for a normal metatarsophalangeal (MTP) joint during three typical phases of gait as the combination of the load in the contact areas of the sesamoid bones and the base of the proximal phalanx. The resultant strain and stress distributions within the loaded MT I were calculated and visualized with the MTP in different positions.

Adult↗
PubMed1999

Os subfibulare. Investigation of an accessory bone.

During dissection of a cadaver at the Ohio College of Podiatric Medicine, the authors encountered the os subfibulare. The os subfibulare was encased within the peroneus longus and peroneus brevis tendons and initially appeared as though it may have articulated with the left lateral malleolus distally and posteriorly. The ossicle was not associated with any capsular or ligamentous structures. These findings suggest that the os subfibulare is a true sesamoid bone. A review of the literature is presented and the clinical significance of these findings is discussed.

Aged↗
PubMed2005

Evaluation of skin sensitivity after shock wave treatment in horses.

OBJECTIVE: To evaluate the effects of shock wave treatment on cutaneous nerve function, compared with the effects of local nerve block and sedation. ANIMALS: 18 clinically sound Swiss Warmbloods. PROCEDURE: Horses were randomly allocated to 3 groups and received different amounts and types of shock waves (extracorporeal shock wave treatment [ESWT] or radial pressure wave treatment [RPWT]). Horses were sedated with xylazine and levomethadone. Shock waves were applied to the lateral palmar digital nerve at the level of the proximal sesamoid bones on 1 forelimb. Skin sensitivity was evaluated by means of an electrical stimulus at the coronary band before and 5 minutes after sedation and at 4, 24, and 48 hours after application of ESWT or RPWT. On the contralateral forelimb, skin sensitivity was tested before and 10 minutes after an abaxial sesamoid nerve block. RESULTS: No significant changes in skin sensitivity were detected, regardless of the shock wave protocol applied. Mean reaction thresholds after sedation were more than twice the baseline thresholds. After the abaxial sesamoid block, no reaction was recorded in any of the horses. CONCLUSIONS AND CLINICAL RELEVANCE: Application of ESWT or RPWT to the palmar digital nerve had no effect on cutaneous sensation distal to the treated region for at least 2 days after application. The analgesic effect of sedation on reaction to electrical stimuli was distinct but varied among horses.

Analgesia↗
PubMed1996

[Comparative roentgenometry of the hand in aging].

Increasing age is a risk factor for the development of osteoarthrosis of the joints of the hand in adults between 21 and 60 years of age. Only in the very old (> or = 80 years) is osteoarthrosis of the hand part of the age related degeneration. The literature contains different parameters and indices correlating the amounts of minerals and ashes of metacarpal bones. Our results speak in favour of the presumptions published by Exton-Smith et al. (1969 b) that bone mass belongs among the biological characteristics of old age. Our investigations of hand roentgenograms reveal that remodeling of the joint socket as described by pathologists is not a general but an elective phenomenon. With age the wrist shows only an increasing angle of the radial joint surface (males, right hand) and there is a variation of form in the medial sesamoid bone at the first metacarpus (males, left hand).

Absorptiometry, Photon↗