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PubMed2000

Relationships of ultrasonic backscatter with ultrasonic attenuation, sound speed and bone mineral density in human calcaneus.

Ultrasonic attenuation and sound speed have been investigated in trabecular bone by numerous authors. Ultrasonic backscatter has received much less attention. To investigate relationships among these three ultrasonic parameters and bone mineral density (BMD), 30 defatted human calcanei were investigated in vitro. Normalized broadband ultrasonic attenuation (nBUA), sound speed (SOS), and logarithm of ultrasonic backscatter coefficient (LBC) were measured. Bone mineral density was assessed using single-beam dual energy x-ray absorptiometry (DEXA). The correlation coefficients of least squares linear regressions of the three individual ultrasound (US) parameters with BMD were 0.84 (nBUA), 0.84 (SOS) and 0.79 (LBC). The 95% confidence intervals for the correlation coefficients were 0. 69-0.92 (nBUA), 0.68-0.92 (SOS) and 0.60-0.90 (LBC). The correlations among pairs of US variables ranged from 0.63-0.79. Variations in nBUA accounted for r(2) = 62% of the variations in LBC. Variations in SOS accounted for r(2) = 40% of the variations in LBC. These results suggest that ultrasonic backscattering properties may contain substantial information not already contained in nBUA and SOS. A multiple regression model including all three US variables was somewhat more predictive of BMD than a model including only nBUA and SOS.

Absorptiometry, Photon↗
PubMed2002

In vivo performance of a matrix-based quantitative ultrasound imaging device dedicated to calcaneus investigation.

We developed a prototype of an ultrasound (US) bone matrix densitometer, the BEAM scanner, in the context of a European Space Agency research program. This device, which is a contact imaging device, was designed to overcome the limitations of immersion devices in space. Broadband US attenuation (BUA) and speed of sound (SOS) parameters were calculated from the radiofrequency (RF) signal. The principle aim of this study was to evaluate in vivo performance in direct comparison with a currently available device (UBIS 3000, DMS, France). The short-term precision of the BEAM scanner for BUA was estimated at 2.8%, whereas it was 2.3% with UBIS 3000. The short-term precision for SOS was 0.3%, and this was the same as the coefficient of variation (CV) of the UBIS 3000. CVs of 3.4% and 0.6% for midterm precision were found for BUA and SOS, respectively, and UBIS 3000 scores were 3% and 0.4%, respectively. This preliminary study demonstrates the high performance of the BEAM scanner and its new concept offers a wide range of improvements and new applications.

Adult↗
PubMed2002

The calcaneus: sex assessment of prehistoric New Zealand Polynesian skeletal remains.

The increasing pace of urbanisation has meant that prehistoric Polynesian skeletal remains are frequently being recovered in New Zealand. Since such material must often be reinterred quickly, it is important that the sex of individuals be determined from the remains in a relatively short time. For this purpose, discriminant function analysis was utilised for sex determination of prehistoric adult New Zealand Polynesian calcanei (26 male and 22 female). Five measurements were taken and subjected to Statistical Package for the Social Sciences (SPSS) discriminant function analysis. For the discriminant functions derived, accuracy of sex determination ranged from 88.4 to 93.5%. Reduction in error over random assignment by sex ranged from 77 to 87%.

Anthropometry↗
PubMedDate not supplied

Chondroblastoma of the calcaneus: literature review and case presentation.

Chondroblastoma is a benign neoplasm of bone and most often arises from the epiphysis of long bones. Recognition of this tumor can be difficult and is often only confirmed on histological examination. Radiographic studies can demonstrate findings that mimic other tumors such as giant cell and aneurysmal cysts. Proper identification and management of this tumor has as high as a 90% success rate in eradication.

Adult↗
PubMedDate not supplied

Intraosseous lipoma of the calcaneus: a clinicopathologic study of three cases.

Intraosseous lipoma is a neoplasm which has classically been regarded in the literature as a rare bone tumor. The tumor has several distinguishing characteristics on plain film radiograph, magnetic resonance imaging, and computerized tomography scan. Due to appearances that are similar to simple bone cysts, infarctions, and other lesions, intraosseous lipomas are often misdiagnosed, possibly accounting for their purported rarity. Diagnosis based on plain film radiographs, magnetic resonance imaging, and computerized tomography scans, and appropriate treatments are discussed. Three case studies of calcaneal intraosseous lipomas are followed through the treatment course from initial presentation to postoperative follow-up. Radiographic studies and surgical procedures are discussed, as well as surgical pathology results that demonstrate the potential misdiagnosis of this tumor.

Adult↗
PubMed2001

Quantitative ultrasound at the calcaneus in premenopausal women and their postmenopausal mothers.

The aim of the study was to establish a relationship between mothers' and daughters' bone status. Forty-eight postmenopausal women and their 48 premenopausal daughters were evaluated. The analysis was made for the whole group and for two subgroups: 27 healthy mothers and their 27 daughters; and 21 fractured mothers and their 21 daughters. The subgroups were matched for age and years since menopause (YSM), and height, weight, and body mass index (BMI) did not differ significantly. Bone status was evaluated by ultrasound measurement at the heel using the Achilles system (Lunar, Madison, WI), which measures speed of sound (SOS [m/sec]) and broadband ultrasound attenuation (BUA [dB/MHz]). The Achilles software also calculates a stiffness index (SI [%]). Ultrasound values for BUA, SOS, stiffness index, and Z score were significantly lower both in mothers with previous fractures and in their daughters, compared with respective values in mothers without fractures and their daughters. Future values in daughters were predicted using a stepwise, multiple regression analysis separately in the whole group and in the two subgroups. Future values were predicted in two models taking into consideration mothers' present SOS, BUA, and age or present SOS, BUA, and YSM. In both models, daughters' present SOS, BUA, age, height, and weight were taken into consideration. Predictive values were found to be high for daughters of women having had fractures (r = 0.72-0.87, p = 0.015-0.00007, SEE = 6.0-15.8) and lower for all daughters studied (r = 0.38-0.62, p = 0.03-0.0001, SEE = 8.8-21.5). In daughters of mothers without past fractures, prediction was not possible. Heritability of ultrasound values in daughters of women with past fractures ranged between 52% and 76%, whereas in the whole group the range was 14%-40%. In conclusion, the data indicate that, as a group, the daughters of women with osteoporotic fracture are likely to be at an increased risk for fractures because they have relatively low ultrasound values. Their future ultrasound values can be predicted on the basis of a single ultrasound evaluation with the condition that there is a history of maternal past fracture.

Adult↗
PubMed1999

Hip fracture discrimination by imaging ultrasound measurements of the calcaneus.

Quantitative ultrasound measurements of the os calcis have recently been upgraded with imaging facilities. This has made measurements of a specific region of interest possible and improved the reproducibility of the method, but the diagnostic ability of imaging ultrasound has not yet been investigated thoroughly. We measured broadband ultrasound attenuation (BUA) and speed of sound (SOS) using imaging ultrasound as well as forearm bone mineral density (BMDarm) using dual-energy X-ray absorptiometry in three age-matched groups of women: (1) 25 women who were admitted to hospital due to a hip fracture; (2) 23 women who were admitted to hospital due to a fall without any fracture; and (3) 26 normal women. Furthermore, BMD of the hip (BMDhip) was measured in a subgroup of the hip fracture patients and those who had fallen. All measurements were performed during the index hospitalization in order to avoid any influence from bone loss due to immobilization after the fracture. We found a -0.48 SD deviation from expected age-matched values in BUA among the hip fracture patients, whereas the patients who had fallen showed a +0.16 SD deviance. For SOS, the figures were -0.70 SD for the hip fracture group and -0.06 SD for the patients who had fallen. For BMD of the arm we found values of -0.65 SD and +0.08 SD, respectively, whereas the figures for BMD of the hip were -0.66 SD and +0.13 SD, respectively. All parameters were significantly lower in the hip fracture group compared with the patients who had fallen. None of the parameters in the patients who had fallen deviated significantly from expected normal age-matched values. Neither BMD of the arm or BMD of the hip separated hip fracture patients and patients who had fallen significantly better than ultrasound (BUA or SOS) did. We conclude that imaging ultrasound (BUA or SOS) separates age-matched groups of hip fracture and non-fracture patients as well as BMD measurements do.

Aged↗
PubMed1996

[Functional deficits of the foot after calcaneus fracture].

The present study investigated the clinical and functional outcome of calcaneal fractures. 14 patients were evaluated at a mean follow-up of 52 months. Two groups, group A with good and group B with poor calcaneal restoration were distinguished by Böhler's angle. Ten normal subjects were used for comparison. Clinical results were evaluated with a questionnaire, radiography and range of motion measurements. Plantar pressure patterns were recorded with a capacitive pressure distribution platform. A comparison of the injured and healthy foot of all patients revealed a load shift towards lateral foot regions. A comparison of the patient groups with the controls did not reveal more pronounced changes in the poorly restored group. The results demonstrate that a disturbance of foot function persists even after long healing.

Adult↗
PubMed1996

[Dwyer osteotomy with or without lateral stabilization in calcaneus varus with lateral ligament insufficiency of the upper ankle joint].

Varus deformity is a well known problem in the treatment of chronic lateral ankle instability. Surgical correction is recommended occasionally. The goal of this study was to show the effect of a calcaneal Dwyer osteotomy in patients suffering from a functional instability. We examined 6 patients, who underwent 7 calcaneal osteotomies. Postoperatively all patients maintained stability. No recurrence of a supination trauma was observed.

Adult↗
PubMedDate not supplied

[Calcaneus osteotomy in flexible flatfoot in children (long-term results)].

The static of serve flexible flatfeet in children can be positively influenced by the varisation osteotomy of the Calcaneous by Kramer. The method is technically easy and imposes very few complications. This follow-up after a meantime of 12.4 years looks at 30 osteotomies. Subjective results were excellent. Objectively, the results must be regarded as good. Nontheless, the problem remains who should be operated, especially if we keep in mind that the nontreated flatfeet usually develop positively. So this method should remain in the hands of the experienced orthopedic surgeon.

Adolescent↗
PubMedDate not supplied

[Unicameral cyst of the calcaneus: surgical indications, biomechanical calculations and results of follow-up studies].

Between April 1986 and August 1988, 7 patients (6 men, 1 woman) with unicameral calcaneal cysts were seen at the Trauma Hospital in Meidling. In one case both calcanei were affected. In all cases the findings were accidental, as a result of minor injuries. No familial preponderance was observed. The mean age of the patients was 26.6 years (19 to 33). In 3 patients, filling of the cyst was indicated due to risks from sport or occupational activities. Four cysts were therefore filled with fibrin-spongiosa (homologous bone chips). The mean follow-up interval was 19 months. No recurrent cyst formation was observed, and the patients had no complaints. Nor were there any complications. The importance of CT for preoperative diagnosis and postoperative verification of the result is indicated. On the basis of a strut framework model, it is proved mathematically that cyst formation is not of major importance for the "vertical load case"; on the other hand, bending moments occurring in "inclined load cases" (pronation, supination, extension, flexion), are substantially reduced if the cancellous bone in the cavity region is taken into account. As a logical consequence, surgery is indicated in individuals as risk due to occupational or sports activities; in cases which are not subject to stress peaks, however, therapy is unnecessary.

Adult↗
PubMedDate not supplied

[Differential diagnosis of osteomyelitis of the calcaneus].

The authers avalyse 6 cases of calcaneal osteomyelitis with rather chronic development. They present radiological and clinical differential diagnostic problems. Osteomyelitis was to seperate from Sever's disease, benign and malignant bone tumours. In 3 cases only histology or bacteriology allowed the proper diagnosis.

Adolescent↗
PubMed1988

[Advantages in the diagnosis and classification of intra-articular fractures of the calcaneus using computed tomography].

The superiority of CT over conventional radiography in demonstrating intra-articular fractures of the os calcis was demonstrated in 34 patients. The advantages consist in being able to demonstrate the joint without superposition and the exact demonstration of the position, size, shape and number of fragments. Shortening or widening of the os calcis can be easily recognized, as well as fractures of the medial or lateral cortex. At the same time it is possible to evaluate soft tissues, particularly the peroneal ligament. The conventional classification of calcaneal fractures has been newly evaluated in the light of the ability to recognize involvement of the joint and the course of the main fracture lines.

Adolescent↗