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Sample records for late neandertal femur

  1. A late Neandertal femur from Les Rochers-de-Villeneuve, France

    PubMed Central

    Beauval, Cédric; Maureille, Bruno; Lacrampe-Cuyaubère, François; Serre, David; Peressinotto, David; Bordes, Jean-Guillaume; Cochard, David; Couchoud, Isabelle; Dubrasquet, David; Laroulandie, Véronique; Lenoble, Arnaud; Mallye, Jean-Baptiste; Pasty, Sylvain; Primault, Jérôme; Rohland, Nadin; Pääbo, Svante; Trinkaus, Erik

    2005-01-01

    In 2002, a Neandertal partial femoral diaphysis was discovered at Les Rochers-de-Villeneuve (Vienne, France). Radiocarbon dated to ≈40,700 14C years before present, this specimen is one of the most recent Middle Paleolithic Neandertals. The diaphysis derives from an archeological level indicating alternating human and carnivore (mostly hyena) occupation of the cave, reinforcing the close proximity and probable competition of Middle Paleolithic humans with large carnivores for resources and space. Morphological aspects of the diaphysis and ancient DNA extracted from it indicate that it is aligned with the Neandertals and is distinct from early modern humans. However, its midshaft cortical bone distribution places it between other Middle Paleolithic Neandertals and the Châtelperronian Neandertal from La Roche-à-Pierrot, supporting a pattern of changing mobility patterns among late Middle Paleolithic Neandertals on the eve of modern human dispersals into Europe. PMID:15878988

  2. Late Neandertals in Southeastern Iberia: Sima de las Palomas del Cabezo Gordo, Murcia, Spain

    PubMed Central

    Walker, Michael J.; Gibert, Josep; López, Mariano V.; Lombardi, A. Vincent; Pérez-Pérez, Alejandro; Zapata, Josefina; Ortega, Jon; Higham, Thomas; Pike, Alistair; Schwenninger, Jean-Luc; Zilhão, João; Trinkaus, Erik

    2008-01-01

    Middle Paleolithic fossil human remains from the Sima de las Palomas in southeastern Iberia (dated to ≤43,000–40,000 calendar years before present) present a suite of derived Neandertal and/or retained ancestral morphological features in the mandibular symphysis, mandibular ramus, dental occlusal morphology, and distal hand phalanx. These traits are combined with variation in the mandibular corpus, discrete dental morphology, tooth root lengths, and anterior dental size that indicate a frequency difference with earlier Iberian and more northern European Neandertals. The Palomas Neandertals therefore confirm the late presence of Neandertals associated with the Iberian persistence of the Middle Paleolithic, but suggest microevolutionary processes and/or population contact with contemporaneous modern humans to the north. PMID:19074275

  3. Neandertals revised

    PubMed Central

    Roebroeks, Wil; Soressi, Marie

    2016-01-01

    The last decade has seen a significant growth of our knowledge of the Neandertals, a population of Pleistocene hunter-gatherers who lived in (western) Eurasia between ∼400,000 and 40,000 y ago. Starting from a source population deep in the Middle Pleistocene, the hundreds of thousands of years of relative separation between African and Eurasian groups led to the emergence of different phenotypes in Late Pleistocene Europe and Africa. Both recently obtained genetic evidence and archeological data show that the biological and cultural gaps between these populations were probably smaller than previously thought. These data, reviewed here, falsify inferences to the effect that, compared with their near-modern contemporaries in Africa, Neandertals were outliers in terms of behavioral complexity. It is only around 40,000 y ago, tens of thousands of years after anatomically modern humans first left Africa and thousands of years after documented interbreeding between modern humans, Neandertals and Denisovans, that we see major changes in the archeological record, from western Eurasia to Southeast Asia, e.g., the emergence of representational imagery and the colonization of arctic areas and of greater Australia (Sahul). PMID:27274044

  4. Neandertals revised.

    PubMed

    Roebroeks, Wil; Soressi, Marie

    2016-06-01

    The last decade has seen a significant growth of our knowledge of the Neandertals, a population of Pleistocene hunter-gatherers who lived in (western) Eurasia between ∼400,000 and 40,000 y ago. Starting from a source population deep in the Middle Pleistocene, the hundreds of thousands of years of relative separation between African and Eurasian groups led to the emergence of different phenotypes in Late Pleistocene Europe and Africa. Both recently obtained genetic evidence and archeological data show that the biological and cultural gaps between these populations were probably smaller than previously thought. These data, reviewed here, falsify inferences to the effect that, compared with their near-modern contemporaries in Africa, Neandertals were outliers in terms of behavioral complexity. It is only around 40,000 y ago, tens of thousands of years after anatomically modern humans first left Africa and thousands of years after documented interbreeding between modern humans, Neandertals and Denisovans, that we see major changes in the archeological record, from western Eurasia to Southeast Asia, e.g., the emergence of representational imagery and the colonization of arctic areas and of greater Australia (Sahul). PMID:27274044

  5. Neandertal clavicle length

    PubMed Central

    Trinkaus, Erik; Holliday, Trenton W.; Auerbach, Benjamin M.

    2014-01-01

    The Late Pleistocene archaic humans from western Eurasia (the Neandertals) have been described for a century as exhibiting absolutely and relatively long clavicles. This aspect of their body proportions has been used to distinguish them from modern humans, invoked to account for other aspects of their anatomy and genetics, used in assessments of their phylogenetic polarities, and used as evidence for Late Pleistocene population relationships. However, it has been unclear whether the usual scaling of Neandertal clavicular lengths to their associated humeral lengths reflects long clavicles, short humeri, or both. Neandertal clavicle lengths, along with those of early modern humans and latitudinally diverse recent humans, were compared with both humeral lengths and estimated body masses (based on femoral head diameters). The Neandertal do have long clavicles relative their humeri, even though they fall within the ranges of variation of early and recent humans. However, when scaled to body masses, their humeral lengths are relatively short, and their clavicular lengths are indistinguishable from those of Late Pleistocene and recent modern humans. The few sufficiently complete Early Pleistocene Homo clavicles seem to have relative lengths also well within recent human variation. Therefore, appropriately scaled clavicular length seems to have varied little through the genus Homo, and it should not be used to account for other aspects of Neandertal biology or their phylogenetic status. PMID:24616525

  6. Paleobiology and comparative morphology of a late Neandertal sample from El Sidrón, Asturias, Spain

    PubMed Central

    Rosas, Antonio; Martínez-Maza, Cayetana; Bastir, Markus; García-Tabernero, Antonio; Lalueza-Fox, Carles; Huguet, Rosa; Ortiz, José Eugenio; Julià, Ramón; Soler, Vicente; de Torres, Trinidad; Martínez, Enrique; Cañaveras, Juan Carlos; Sánchez-Moral, Sergio; Cuezva, Soledad; Lario, Javier; Santamaría, David; de la Rasilla, Marco; Fortea, Javier

    2006-01-01

    Fossil evidence from the Iberian Peninsula is essential for understanding Neandertal evolution and history. Since 2000, a new sample ≈43,000 years old has been systematically recovered at the El Sidrón cave site (Asturias, Spain). Human remains almost exclusively compose the bone assemblage. All of the skeletal parts are preserved, and there is a moderate occurrence of Middle Paleolithic stone tools. A minimum number of eight individuals are represented, and ancient mtDNA has been extracted from dental and osteological remains. Paleobiology of the El Sidrón archaic humans fits the pattern found in other Neandertal samples: a high incidence of dental hypoplasia and interproximal grooves, yet no traumatic lesions are present. Moreover, unambiguous evidence of human-induced modifications has been found on the human remains. Morphologically, the El Sidrón humans show a large number of Neandertal lineage-derived features even though certain traits place the sample at the limits of Neandertal variation. Integrating the El Sidrón human mandibles into the larger Neandertal sample reveals a north–south geographic patterning, with southern Neandertals showing broader faces with increased lower facial heights. The large El Sidrón sample therefore augments the European evolutionary lineage fossil record and supports ecogeographical variability across Neandertal populations. PMID:17164326

  7. On some aspects of Neandertal zygomatic morphology.

    PubMed

    Janković, Ivor; Ahern, James C M; Smith, Fred H

    2016-04-01

    Neandertals are characterized by a series of well-documented facial characteristics, including midfacial prognathism, large nasal and orbital areas, and a marked supraorbital torus. We provide a comparative morphometric study of another part of this facial complex, the frontal process of the zygomatic. We find that European Neandertals have a distinctly columnar form of the frontal process not found in recent modern humans and most Pleistocene modern humans. Some purportedly modern specimens and specimens pre-dating Neandertals exhibit the same pattern as European Neandertals, while others exhibit the modern human pattern. The columnar form is likely a retention of the ancestral state in Neandertals and the other late Pleistocene specimens that exhibit it, but variation in the pattern seen in early modern humans reveals possible insights into late Pleistocene human evolution. PMID:26725403

  8. Neandertal cannibalism and Neandertal bones used as tools in Northern Europe.

    PubMed

    Rougier, Hélène; Crevecoeur, Isabelle; Beauval, Cédric; Posth, Cosimo; Flas, Damien; Wißing, Christoph; Furtwängler, Anja; Germonpré, Mietje; Gómez-Olivencia, Asier; Semal, Patrick; van der Plicht, Johannes; Bocherens, Hervé; Krause, Johannes

    2016-01-01

    Almost 150 years after the first identification of Neandertal skeletal material, the cognitive and symbolic abilities of these populations remain a subject of intense debate. We present 99 new Neandertal remains from the Troisième caverne of Goyet (Belgium) dated to 40,500-45,500 calBP. The remains were identified through a multidisciplinary study that combines morphometrics, taphonomy, stable isotopes, radiocarbon dating and genetic analyses. The Goyet Neandertal bones show distinctive anthropogenic modifications, which provides clear evidence for butchery activities as well as four bones having been used for retouching stone tools. In addition to being the first site to have yielded multiple Neandertal bones used as retouchers, Goyet not only provides the first unambiguous evidence of Neandertal cannibalism in Northern Europe, but also highlights considerable diversity in mortuary behaviour among the region's late Neandertal population in the period immediately preceding their disappearance. PMID:27381450

  9. Neandertal cannibalism and Neandertal bones used as tools in Northern Europe

    PubMed Central

    Rougier, Hélène; Crevecoeur, Isabelle; Beauval, Cédric; Posth, Cosimo; Flas, Damien; Wißing, Christoph; Furtwängler, Anja; Germonpré, Mietje; Gómez-Olivencia, Asier; Semal, Patrick; van der Plicht, Johannes; Bocherens, Hervé; Krause, Johannes

    2016-01-01

    Almost 150 years after the first identification of Neandertal skeletal material, the cognitive and symbolic abilities of these populations remain a subject of intense debate. We present 99 new Neandertal remains from the Troisième caverne of Goyet (Belgium) dated to 40,500–45,500 calBP. The remains were identified through a multidisciplinary study that combines morphometrics, taphonomy, stable isotopes, radiocarbon dating and genetic analyses. The Goyet Neandertal bones show distinctive anthropogenic modifications, which provides clear evidence for butchery activities as well as four bones having been used for retouching stone tools. In addition to being the first site to have yielded multiple Neandertal bones used as retouchers, Goyet not only provides the first unambiguous evidence of Neandertal cannibalism in Northern Europe, but also highlights considerable diversity in mortuary behaviour among the region’s late Neandertal population in the period immediately preceding their disappearance. PMID:27381450

  10. A Hominin Femur with Archaic Affinities from the Late Pleistocene of Southwest China

    PubMed Central

    Liu, Wu; Bao, Zhende; Taçon, Paul S. C.; Ren, Liang

    2015-01-01

    The number of Late Pleistocene hominin species and the timing of their extinction are issues receiving renewed attention following genomic evidence for interbreeding between the ancestors of some living humans and archaic taxa. Yet, major gaps in the fossil record and uncertainties surrounding the age of key fossils have meant that these questions remain poorly understood. Here we describe and compare a highly unusual femur from Late Pleistocene sediments at Maludong (Yunnan), Southwest China, recovered along with cranial remains that exhibit a mixture of anatomically modern human and archaic traits. Our studies show that the Maludong femur has affinities to archaic hominins, especially Lower Pleistocene femora. However, the scarcity of later Middle and Late Pleistocene archaic remains in East Asia makes an assessment of systematically relevant character states difficult, warranting caution in assigning the specimen to a species at this time. The Maludong fossil probably samples an archaic population that survived until around 14,000 years ago in the biogeographically complex region of Southwest China. PMID:26678851

  11. Use of red ochre by early Neandertals

    PubMed Central

    Roebroeks, Wil; Sier, Mark J.; Nielsen, Trine Kellberg; De Loecker, Dimitri; Parés, Josep Maria; Arps, Charles E. S.; Mücher, Herman J.

    2012-01-01

    The use of manganese and iron oxides by late Neandertals is well documented in Europe, especially for the period 60–40 kya. Such finds often have been interpreted as pigments even though their exact function is largely unknown. Here we report significantly older iron oxide finds that constitute the earliest documented use of red ochre by Neandertals. These finds were small concentrates of red material retrieved during excavations at Maastricht-Belvédère, The Netherlands. The excavations exposed a series of well-preserved flint artifact (and occasionally bone) scatters, formed in a river valley setting during a late Middle Pleistocene full interglacial period. Samples of the reddish material were submitted to various forms of analyses to study their physical properties. All analyses identified the red material as hematite. This is a nonlocal material that was imported to the site, possibly over dozens of kilometers. Identification of the Maastricht-Belvédère finds as hematite pushes the use of red ochre by (early) Neandertals back in time significantly, to minimally 200–250 kya (i.e., to the same time range as the early ochre use in the African record). PMID:22308348

  12. Late Neandertals and the intentional removal of feathers as evidenced from bird bone taphonomy at Fumane Cave 44 ky B.P., Italy

    PubMed Central

    Peresani, Marco; Fiore, Ivana; Gala, Monica; Romandini, Matteo; Tagliacozzo, Antonio

    2011-01-01

    A large and varied avifaunal bone assemblage from the final Mousterian levels of Grotta di Fumane, northern Italy, reveals unusual human modifications on species that are not clearly relatable to feeding or utilitarian uses (i.e., lammergeier, Eurasian black vulture, golden eagle, red-footed falcon, common wood pigeon, and Alpine chough). Cut, peeling, and scrape marks, as well as diagnostic fractures and a breakthrough, are observed exclusively on wings, indicating the intentional removal of large feathers by Neandertals. The species involved, the anatomical elements affected, and the unusual type and location of the human modifications indicate an activity linked to the symbolic sphere and the behavioral modernity of this European autochthonous population. PMID:21368129

  13. Neandertal postcranial remains from the Sima de las Palomas del Cabezo Gordo, Murcia, southeastern Spain.

    PubMed

    Walker, Michael J; Ortega, Jon; López, Mariano V; Parmová, Klára; Trinkaus, Erik

    2011-04-01

    The Sima de las Palomas, southeastern Spain, has yielded a series of Neandertal postcranial remains, including immature and mature isolated elements and the fragmentary partial skeleton of a young adult (Palomas 92). The remains largely conform to the general late archaic/Neandertal morphological pattern in terms of humeral diaphyseal shape, pectoralis major tuberosity size and pillar thickness, ulnar coronoid process height, manual middle phalangeal epiphyseal breadth, manual distal phalangeal tuberosity shape and breadth, femoral diaphyseal shape, and probably body proportions. Palomas 92 contrasts with the Neandertals in having variably gracile hand remains, a more sellar trapezial metacarpal 1 facet, more anteroposteriorly expanded mid-proximal femoral diaphysis, and less robust pedal proximal phalanges. The Palomas Neandertals contrast with more northern European Neandertals particularly in various reflections of overall body size. PMID:21404228

  14. The complete genome sequence of a Neandertal from the Altai Mountains

    PubMed Central

    Prüfer, Kay; Racimo, Fernando; Patterson, Nick; Jay, Flora; Sankararaman, Sriram; Sawyer, Susanna; Heinze, Anja; Renaud, Gabriel; Sudmant, Peter H.; de Filippo, Cesare; Li, Heng; Mallick, Swapan; Dannemann, Michael; Fu, Qiaomei; Kircher, Martin; Kuhlwilm, Martin; Lachmann, Michael; Meyer, Matthias; Ongyerth, Matthias; Siebauer, Michael; Theunert, Christoph; Tandon, Arti; Moorjani, Priya; Pickrell, Joseph; Mullikin, James C.; Vohr, Samuel H.; Green, Richard E.; Hellmann, Ines; Johnson, Philip L. F.; Blanche, Hélène; Cann, Howard; Kitzman, Jacob O.; Shendure, Jay; Eichler, Evan E.; Lein, Ed S.; Bakken, Trygve E.; Golovanova, Liubov V.; Doronichev, Vladimir B.; Shunkov, Michael V.; Derevianko, Anatoli P.; Viola, Bence; Slatkin, Montgomery; Reich, David; Kelso, Janet; Pääbo, Svante

    2014-01-01

    We present a high-quality genome sequence of a Neandertal woman from Siberia. We show that her parents were related at the level of half siblings and that mating among close relatives was common among her recent ancestors. We also sequenced the genome of a Neandertal from the Caucasus to low coverage. An analysis of the relationships and population history of available archaic genomes and 25 present-day human genomes shows that several gene flow events occurred among Neandertals, Denisovans and early modern humans, possibly including gene flow into Denisovans from an unknown archaic group. Thus, interbreeding, albeit of low magnitude, occurred among many hominin groups in the Late Pleistocene. In addition, the high quality Neandertal genome allows us to establish a definitive list of substitutions that became fixed in modern humans after their separation from the ancestors of Neandertals and Denisovans. PMID:24352235

  15. Neandertal birth canal shape and the evolution of human childbirth

    PubMed Central

    Weaver, Timothy D.; Hublin, Jean-Jacques

    2009-01-01

    Childbirth is complicated in humans relative to other primates. Unlike the situation in great apes, human neonates are about the same size as the birth canal, making passage difficult. The birth mechanism (the series of rotations that the neonate must undergo to successfully negotiate its mother's birth canal) distinguishes humans not only from great apes, but also from lesser apes and monkeys. Tracing the evolution of human childbirth is difficult, because the pelvic skeleton, which forms the margins of the birth canal, tends to survive poorly in the fossil record. Only 3 female individuals preserve fairly complete birth canals, and they all date to earlier phases of human evolution. Here we present a virtual reconstruction of a female Neandertal pelvis from Tabun, Israel. The size of Tabun's reconstructed birth canal indicates that childbirth was about as difficult in Neandertals as in present-day humans, but the canal's shape indicates that Neandertals had a more primitive birth mechanism. A significant shift in childbirth apparently occurred quite late in human evolution, during the last few hundred thousand years. Such a late shift underscores the uniqueness of human childbirth and the divergent evolutionary trajectories of Neandertals and the lineage leading to present-day humans. PMID:19380728

  16. The landscape of Neandertal ancestry in present-day humans

    PubMed Central

    Sankararaman, Sriram; Mallick, Swapan; Dannemann, Michael; Prüfer, Kay; Kelso, Janet; Pääbo, Svante; Patterson, Nick; Reich, David

    2014-01-01

    Analyses of Neandertal genomes have revealed that Neandertals have contributed genetic variants to modern humans1–2. The antiquity of Neandertal gene flow into modern humans means that regions that derive from Neandertals in any one human today are usually less than a hundred kilobases in size. However, Neandertal haplotypes are also distinctive enough that several studies have been able to detect Neandertal ancestry at specific loci1,3–8. Here, we have systematically inferred Neandertal haplotypes in the genomes of 1,004 present-day humans12. Regions that harbor a high frequency of Neandertal alleles in modern humans are enriched for genes affecting keratin filaments suggesting that Neandertal alleles may have helped modern humans adapt to non-African environments. Neandertal alleles also continue to shape human biology, as we identify multiple Neandertal-derived alleles that confer risk for disease. We also identify regions of millions of base pairs that are nearly devoid of Neandertal ancestry and enriched in genes, implying selection to remove genetic material derived from Neandertals. Neandertal ancestry is significantly reduced in genes specifically expressed in testis, and there is an approximately 5-fold reduction of Neandertal ancestry on chromosome X, which is known to harbor a disproportionate fraction of male hybrid sterility genes20–22. These results suggest that part of the reduction in Neandertal ancestry near genes is due to Neandertal alleles that reduced fertility in males when moved to a modern human genetic background. PMID:24476815

  17. The accretion model of Neandertal evolution.

    PubMed

    Hawks, J D; Wolpoff, M H

    2001-07-01

    The Accretion model of Neandertal evolution specifies that this group of Late Pleistocene hominids evolved in partial or complete genetic isolation from the rest of humanity through the gradual accumulation of distinctive morphological traits in European populations. As they became more common, these traits also became less variable, according to those workers who developed the model. Its supporters propose that genetic drift caused this evolution, resulting from an initial small European population size and either complete isolation or drastic reduction in gene flow between this deme and contemporary human populations elsewhere. Here, we test an evolutionary model of gene flow between regions against fossil data from the European population of the Middle and Late Pleistocene. The results of the analysis clearly show that the European population was not significantly divergent from its contemporaries, even in a subset of traits chosen to show the maximum differences between Europeans and other populations. The pattern of changes, over time within Europe of the traits in this subset, does not support the Accretion model, either because the characters did not change in the manner specified by the model or because the characters did not change at all. From these data, we can conclude that special phenomena such as near-complete isolation of the European population during the Pleistocene are not required to explain the pattern of evolution in this region. PMID:11525469

  18. Locomotion and body proportions of the Saint-Césaire 1 Châtelperronian Neandertal

    PubMed Central

    Trinkaus, Erik; Ruff, Christopher B.; Churchill, Steven E.; Vandermeersch, Bernard

    1998-01-01

    The initial Upper Paleolithic (Châtelperronian) of western Europe was associated with late European Neandertals, best known through the Saint-Césaire 1 partial skeleton. Biomechanical cross-sectional analysis of the Saint-Césaire 1 femoral diaphysis at the subtrochanteric and midshaft levels, given the plasticity of mammalian diaphyseal cortical bone, provides insights into the habitual levels and patterns of loading on the lower limbs from body mass, proportions, and locomotion. The overall robustnesses of the femoral diaphyses of European Neandertals and early modern humans are similar once contrasts in body proportions are incorporated into the body size scaling. Saint-Césaire 1 matches these samples only if it is provided with Neandertal-like hyperarctic body proportions. And the rounded proximal femoral diaphysis of Saint-Césaire 1 is similar to those of earlier Neandertals, likely also reflecting similar cold-adapted broad pelvic regions. However, although morphologically similar to those of archaic Homo, the Saint-Césaire 1 femoral midshaft exhibits the anteroposterior reinforcement characteristic of early modern humans. Consequently, Saint-Césaire 1 appears as a morphological Neandertal with hyperarctic body proportions who nonetheless had shifted locomotor patterns to more closely resemble those of other Upper Paleolithic humans. PMID:9576971

  19. Cochlear labyrinth volume in Krapina Neandertals.

    PubMed

    Beals, Michaela E; Frayer, David W; Radovčić, Jakov; Hill, Cheryl A

    2016-01-01

    Research with extant primate taxa suggests that cochlear labyrinth volume is functionally related to the range of audible frequencies. Specifically, cochlear volume is negatively correlated with both the high and low frequency limits of hearing so that the smaller the cochlea, the higher the normal range of audible frequencies. The close anatomical relationship between the membranous cochlea and the bony cochlear labyrinth allows for the determination of cochlear size from fossil specimens. This study compares Krapina Neandertal cochlear volumes to extant taxa cochlear volumes. Cochlear volumes were acquired from high-resolution computed tomography scans of temporal bones of Krapina Neandertals, chimpanzees, gorillas, and modern humans. We find that Krapina Neandertals' cochlear volumes are similar to modern Homo sapiens and are significantly larger than chimpanzee and gorilla cochlear volumes. The measured cochlear volume in Krapina Neandertals suggests they had a range of audible frequencies similar to the modern human range. PMID:26603101

  20. Internal nasal floor configuration in Homo with special reference to the evolution of Neandertal facial form.

    PubMed

    Franciscus, Robert G

    2003-06-01

    The presence of a steeply sloping or depressed nasal floor within the nasal cavity of Neandertals is frequently mentioned as a likely specialization or autapomorphy. The depressed nasal floor has also been seen as contributing to a relatively more capacious nasal cavity in Neandertals, which is tied to cold-climate respiratory adaptation and energetics. These observations have been limited largely to a relatively few intact crania, and the character states associated with this trait have not been as precisely codified or analyzed as those published for Plio-Pleistocene hominins (McCollum et al., 1993, J. Hum. Evol. 24, 87; McCollum, 2000, Am. J. Phys. Anthrop. 112, 275). This study examines the internal nasal floor topography in complete crania and isolated maxillae in European, west Asian, and African fossil Homo (n=158) including 25 Neandertals, and a wide range of recent humans from Europe, the Near East, and Africa (n=522). The configuration of the internal nasal floor relative to the nasal cavity entrance is codified as: 1) level, forming a smooth continuous plane; 2) sloped or mildly stepped; or 3) bilevel with a pronounced vertical depression. The frequency of these nasal floor configurations, and their relationship to both nasal margin cresting patterning and a comprehensive set of nasofacial metrics is examined. Neandertals show a high frequency of the bilevel (depressed) configuration in both adults and subadults (80%), but this configuration is also present in lower frequencies in Middle Pleistocene African, Late Pleistocene non-Neandertal (Skhul, Qafzeh), and European Later Upper Paleolithic samples (15%-50%). The bilevel configuration is also present in lower frequencies (ca. 10%) in all recent human samples, but attains nearly 20% in some sub-Saharan African samples. Across extinct and extant Homo (excluding Neandertals), internal nasal floor configuration is not associated with piriform aperture nasal margin patterning, but the two are strongly

  1. The meaning of Neandertal skeletal morphology

    PubMed Central

    Weaver, Timothy D.

    2009-01-01

    A procedure is outlined for distinguishing among competing hypotheses for fossil morphology and then used to evaluate current views on the meaning of Neandertal skeletal morphology. Three explanations have dominated debates about the meaning of Neandertal cranial features: climatic adaptation, anterior dental loading, and genetic drift. Neither climatic adaptation nor anterior dental loading are well supported, but genetic drift is consistent with the available evidence. Climatic adaptation and activity patterns are the most discussed explanations for Neandertal postcranial features. Robust empirical relationships between climate and body form in extant humans and other endotherms currently make climatic adaptation the most plausible explanation for the wide bodies and relatively short limbs of Neandertals, and many additional postcranial features are likely secondary consequences of these overall skeletal proportions. Activity patterns may explain certain Neandertal postcranial features, but unlike the situation for climate, relationships in extant humans between morphology and activities are typically not well established. For both the cranium and the postcranium, changes in diet or activity patterns may underlie why Neandertals and Pleistocene modern humans tend to be more robust than Holocene humans. PMID:19805258

  2. Radiocarbon dates from the Grotte du Renne and Saint-Césaire support a Neandertal origin for the Châtelperronian

    PubMed Central

    Hublin, Jean-Jacques; Talamo, Sahra; Julien, Michèle; David, Francine; Connet, Nelly; Bodu, Pierre; Vandermeersch, Bernard; Richards, Michael P.

    2012-01-01

    The transition from the Middle Paleolithic (MP) to Upper Paleolithic (UP) is marked by the replacement of late Neandertals by modern humans in Europe between 50,000 and 40,000 y ago. Châtelperronian (CP) artifact assemblages found in central France and northern Spain date to this time period. So far, it is the only such assemblage type that has yielded Neandertal remains directly associated with UP style artifacts. CP assemblages also include body ornaments, otherwise virtually unknown in the Neandertal world. However, it has been argued that instead of the CP being manufactured by Neandertals, site formation processes and layer admixture resulted in the chance association of Neanderthal remains, CP assemblages, and body ornaments. Here, we report a series of accelerator mass spectrometry radiocarbon dates on ultrafiltered bone collagen extracted from 40 well-preserved bone fragments from the late Mousterian, CP, and Protoaurignacian layers at the Grotte du Renne site (at Arcy-sur-Cure, France). Our radiocarbon results are inconsistent with the admixture hypothesis. Further, we report a direct date on the Neandertal CP skeleton from Saint-Césaire (France). This date corroborates the assignment of CP assemblages to the latest Neandertals of western Europe. Importantly, our results establish that the production of body ornaments in the CP postdates the arrival of modern humans in neighboring regions of Europe. This new behavior could therefore have been the result of cultural diffusion from modern to Neandertal groups. PMID:23112183

  3. Neandertal growth: what are the costs?

    PubMed

    Mateos, Ana; Goikoetxea, Idoia; Leonard, William R; Martín-González, Jesús Ángel; Rodríguez-Gómez, Guillermo; Rodríguez, Jesús

    2014-12-01

    Energetic approaches have been increasingly used to address key issues in Neandertal palaeoecology and palaeobiology. Previous research has focused exclusively on the energy requirements of adults and highlights the high energy demands of these individuals compared with modern humans. Less attention has been paid to the energy requirements of sub-adult Neandertals, even though this age group could provide clues for a better understanding of Neandertal life history. Accordingly, herein, we estimate the energy costs of maintenance and growth in Neandertal infants and children from one to six years of age and compare these costs with values for modern humans. Statural growth models for two modern human populations (Beasain and Evenki) and an average Neandertal model population are used to establish weight growth models. In turn, these models of body weight growth are used to estimate key components of energetic variables (basal metabolic rate, total energy expenditure, energy of growth and daily energy requirements). Between three and six years of age, Neandertal children have slightly lower basal and growth energy costs than do modern humans of the same age, due primarily to their smaller body mass and slower growth rates. The reduction in energy allocated to growth is likely the result of metabolic adaptations to other somatic factors and thermal stress. Data from contemporary human infants and children suggest that even mild cold stress increases non-shivering thermogenesis, thus elevating metabolic needs by 50% or more. These results suggest that thermal stress likely played a strong role in shaping the delayed developmental patterns and lower energy allocated to growth during early life in Neandertals relative to Homo sapiens. PMID:25439708

  4. Revised direct radiocarbon dating of the Vindija G1 Upper Paleolithic Neandertals

    PubMed Central

    Higham, Tom; Ramsey, Christopher Bronk; Karavanić, Ivor; Smith, Fred H.; Trinkaus, Erik

    2006-01-01

    The 1998/1999 direct dating of two Neandertal specimens from level G1 of Vindija Cave in Croatia to ≈28,000 and ≈29,000 radiocarbon (14C) years ago has led to interpretations concerning the late survival of Neandertals in south-central Europe, patterns of interaction between Neandertals and in-dispersing early modern humans in Europe, and complex biocultural scenarios for the earlier phases of the Upper Paleolithic. Given improvements, particularly in sample pretreatment techniques for bone radiocarbon samples, especially ultrafiltration of collagen samples, these Vindija G1 Neandertal fossils are redated to ≈32,000–33,000 14C years ago and possibly earlier. These results and the recent redating of a number of purportedly old modern human skeletal remains in Europe to younger time periods highlight the importance of fine chronological control when studying this biocultural time period and the tenuous nature of monolithic scenarios for the establishment of modern humans and earlier phases of the Upper Paleolithic in Europe. PMID:16407102

  5. The phenotypic legacy of admixture between modern humans and Neandertals.

    PubMed

    Simonti, Corinne N; Vernot, Benjamin; Bastarache, Lisa; Bottinger, Erwin; Carrell, David S; Chisholm, Rex L; Crosslin, David R; Hebbring, Scott J; Jarvik, Gail P; Kullo, Iftikhar J; Li, Rongling; Pathak, Jyotishman; Ritchie, Marylyn D; Roden, Dan M; Verma, Shefali S; Tromp, Gerard; Prato, Jeffrey D; Bush, William S; Akey, Joshua M; Denny, Joshua C; Capra, John A

    2016-02-12

    Many modern human genomes retain DNA inherited from interbreeding with archaic hominins, such as Neandertals, yet the influence of this admixture on human traits is largely unknown. We analyzed the contribution of common Neandertal variants to over 1000 electronic health record (EHR)-derived phenotypes in ~28,000 adults of European ancestry. We discovered and replicated associations of Neandertal alleles with neurological, psychiatric, immunological, and dermatological phenotypes. Neandertal alleles together explained a significant fraction of the variation in risk for depression and skin lesions resulting from sun exposure (actinic keratosis), and individual Neandertal alleles were significantly associated with specific human phenotypes, including hypercoagulation and tobacco use. Our results establish that archaic admixture influences disease risk in modern humans, provide hypotheses about the effects of hundreds of Neandertal haplotypes, and demonstrate the utility of EHR data in evolutionary analyses. PMID:26912863

  6. Neandertal faces were not long; modern human faces are short

    PubMed Central

    Trinkaus, Erik

    2003-01-01

    Neandertal faces have been described as being derived with respect to their overall length or degree of anterior projection. A comparison of cranial and mandibular indicators of lower facial projection across archaic and modern Homo indicates that Neandertal facial lengths on average are similar to those of preceding archaic Homo and principally contrast with those of recent humans. Neandertal facial length is not derived. The shortness of recent human facial skeletons is the evolutionarily derived condition. PMID:12815095

  7. North African Populations Carry the Signature of Admixture with Neandertals

    PubMed Central

    Civit, Sergi; Arenas, Conxita; Ávila-Arcos, María C.; Bustamante, Carlos D.; Comas, David; Lalueza-Fox, Carles

    2012-01-01

    One of the main findings derived from the analysis of the Neandertal genome was the evidence for admixture between Neandertals and non-African modern humans. An alternative scenario is that the ancestral population of non-Africans was closer to Neandertals than to Africans because of ancient population substructure. Thus, the study of North African populations is crucial for testing both hypotheses. We analyzed a total of 780,000 SNPs in 125 individuals representing seven different North African locations and searched for their ancestral/derived state in comparison to different human populations and Neandertals. We found that North African populations have a significant excess of derived alleles shared with Neandertals, when compared to sub-Saharan Africans. This excess is similar to that found in non-African humans, a fact that can be interpreted as a sign of Neandertal admixture. Furthermore, the Neandertal's genetic signal is higher in populations with a local, pre-Neolithic North African ancestry. Therefore, the detected ancient admixture is not due to recent Near Eastern or European migrations. Sub-Saharan populations are the only ones not affected by the admixture event with Neandertals. PMID:23082212

  8. Comparative perspective on antemortem tooth loss in Neandertals.

    PubMed

    Gilmore, Cassandra C; Weaver, Timothy D

    2016-03-01

    Neandertal specimens with severe antemortem (before death) tooth loss (AMTL) are sometimes interpreted as evidence for human-like behaviors in Neandertals, such as conspecific care or cooking, although it is uncertain whether AMTL frequencies in Neandertals are similar to those in modern humans and exceed those in non-human primates. This study characterizes AMTL (all tooth types) in Neandertals relative to recent human hunter-gatherers and several non-human primate taxa using binomial-normal regression models fit in a Bayesian framework to a sample of 25 Neandertals, 310 recent human hunter-gatherers, 61 chimpanzees, 38 orangutans, and 75 baboons. The probability that a tooth is lost antemortem is modeled to depend on tooth class, taxon, and estimated age at death. Neandertals have odds of AMTL above orangutans and baboons, similar to or somewhat lower than chimpanzees, and below recent humans, if we assume a human-like rate of senescence; or intermediate between chimpanzees and recent humans, if we assume a faster rate of senescence. These findings suggest that Neandertals can only be considered to have frequencies of AMTL above non-human primates if they had more rapid life histories than modern humans. Either Neandertals are not human-like in their life history or their frequency of AMTL. These interpretations are complicated, however, by the substantial inter-population variation in AMTL among recent humans, with some populations having odds of AMTL as low as in non-human primates. These results, together with theoretical considerations, suggest that only high frequencies of AMTL are diagnostic of behavior. Consequently, the behavioral implications of low frequencies of AMTL, such as those found in Neandertals, are ambiguous. Low frequencies in Neandertals could be because they had a low risk of AMTL rather than because they had high mortality from AMTL relative to an average modern human of similar age. PMID:26989018

  9. Evidence for a genetic discontinuity between Neandertals and 24,000-year-old anatomically modern Europeans.

    PubMed

    Caramelli, David; Lalueza-Fox, Carles; Vernesi, Cristiano; Lari, Martina; Casoli, Antonella; Mallegni, Francesco; Chiarelli, Brunetto; Dupanloup, Isabelle; Bertranpetit, Jaume; Barbujani, Guido; Bertorelle, Giorgio

    2003-05-27

    During the late Pleistocene, early anatomically modern humans coexisted in Europe with the anatomically archaic Neandertals for some thousand years. Under the recent variants of the multiregional model of human evolution, modern and archaic forms were different but related populations within a single evolving species, and both have contributed to the gene pool of current humans. Conversely, the Out-of-Africa model considers the transition between Neandertals and anatomically modern humans as the result of a demographic replacement, and hence it predicts a genetic discontinuity between them. Following the most stringent current standards for validation of ancient DNA sequences, we typed the mtDNA hypervariable region I of two anatomically modern Homo sapiens sapiens individuals of the Cro-Magnon type dated at about 23 and 25 thousand years ago. Here we show that the mtDNAs of these individuals fall well within the range of variation of today's humans, but differ sharply from the available sequences of the chronologically closer Neandertals. This discontinuity is difficult to reconcile with the hypothesis that both Neandertals and early anatomically modern humans contributed to the current European gene pool. PMID:12743370

  10. Evidence for a genetic discontinuity between Neandertals and 24,000-year-old anatomically modern Europeans

    PubMed Central

    Caramelli, David; Lalueza-Fox, Carles; Vernesi, Cristiano; Lari, Martina; Casoli, Antonella; Mallegni, Francesco; Chiarelli, Brunetto; Dupanloup, Isabelle; Bertranpetit, Jaume; Barbujani, Guido; Bertorelle, Giorgio

    2003-01-01

    During the late Pleistocene, early anatomically modern humans coexisted in Europe with the anatomically archaic Neandertals for some thousand years. Under the recent variants of the multiregional model of human evolution, modern and archaic forms were different but related populations within a single evolving species, and both have contributed to the gene pool of current humans. Conversely, the Out-of-Africa model considers the transition between Neandertals and anatomically modern humans as the result of a demographic replacement, and hence it predicts a genetic discontinuity between them. Following the most stringent current standards for validation of ancient DNA sequences, we typed the mtDNA hypervariable region I of two anatomically modern Homo sapiens sapiens individuals of the Cro-Magnon type dated at about 23 and 25 thousand years ago. Here we show that the mtDNAs of these individuals fall well within the range of variation of today's humans, but differ sharply from the available sequences of the chronologically closer Neandertals. This discontinuity is difficult to reconcile with the hypothesis that both Neandertals and early anatomically modern humans contributed to the current European gene pool. PMID:12743370

  11. Climate-mediated shifts in Neandertal subsistence behaviors at Pech de l'Azé IV and Roc de Marsal (Dordogne Valley, France).

    PubMed

    Hodgkins, Jamie; Marean, Curtis W; Turq, Alain; Sandgathe, Dennis; McPherron, Shannon J P; Dibble, Harold

    2016-07-01

    Neandertals disappeared from Europe just after 40,000 years ago. Some hypotheses ascribe this to numerous population crashes associated with glacial cycles in the late Pleistocene. The goal of this paper is to test the hypothesis that glacial periods stressed Neandertal populations. If cold climates stressed Neandertals, their subsistence behaviors may have changed-requiring intensified use of prey through more extensive nutrient extraction from faunal carcasses. To test this, an analysis of Neandertal butchering was conducted on medium sized bovid/cervid remains composed of predominately red deer (Cervus elaphus), reindeer (Rangifer tarandus), and roe deer (Capreolus caprelous) deposited during global warm and cold phases from two French sites: Pech de l'Azé IV (Pech IV, Bordes' excavation) and Roc de Marsal (RDM). Analysis of surface modification on high survival long bones and proximal and middle phalanges demonstrates that skeletal elements excavated from the cold levels (RDM Level 4, Pech IV Level I2) at each cave have more cut marks and percussion marks than elements from the warm levels (RDM Level 9, Pech IV Level Y-Z) after controlling for fragment size. At both sites, epiphyseal fragments are rare, and although this pattern can result from carnivore consumption, carnivore tooth marks are almost nonexistent (<0.1%). Alternatively, processing epiphyseal ends for bone grease may have been a Neandertal survival strategy, and epiphyses were more intensively percussed in cold levels than in warm levels at both RDM and Pech IV. The exploitation of low marrow yield elements such as phalanges does not show a consistent pattern relating to climate, but may have been a general Neandertal behavioral characteristic, suggesting that these hominids were regularly on the edge of sufficient nutrient availability even during interglacials. Overall, the faunal assemblages from Roc de Marsal and Pech IV provide some support for the hypothesis that Neandertals were processing

  12. Pediatric Thighbone (Femur) Fracture

    MedlinePlus

    ... fractures in infants under 1 year old is child abuse. Child abuse is also a leading cause of thighbone fracture ... contact sports • Being in a motor vehicle accident • Child abuse Types of Femur Fractures (Classification) Femur fractures vary ...

  13. Neandertals made the first specialized bone tools in Europe

    PubMed Central

    Soressi, Marie; McPherron, Shannon P.; Lenoir, Michel; Dogandžić, Tamara; Goldberg, Paul; Jacobs, Zenobia; Maigrot, Yolaine; Martisius, Naomi L.; Miller, Christopher E.; Rendu, William; Richards, Michael; Skinner, Matthew M.; Steele, Teresa E.; Talamo, Sahra; Texier, Jean-Pierre

    2013-01-01

    Modern humans replaced Neandertals ∼40,000 y ago. Close to the time of replacement, Neandertals show behaviors similar to those of the modern humans arriving into Europe, including the use of specialized bone tools, body ornaments, and small blades. It is highly debated whether these modern behaviors developed before or as a result of contact with modern humans. Here we report the identification of a type of specialized bone tool, lissoir, previously only associated with modern humans. The microwear preserved on one of these lissoir is consistent with the use of lissoir in modern times to obtain supple, lustrous, and more impermeable hides. These tools are from a Neandertal context proceeding the replacement period and are the oldest specialized bone tools in Europe. As such, they are either a demonstration of independent invention by Neandertals or an indication that modern humans started influencing European Neandertals much earlier than previously believed. Because these finds clearly predate the oldest known age for the use of similar objects in Europe by anatomically modern humans, they could also be evidence for cultural diffusion from Neandertals to modern humans. PMID:23940333

  14. The Divergence of Neandertal and Modern Human Y Chromosomes.

    PubMed

    Mendez, Fernando L; Poznik, G David; Castellano, Sergi; Bustamante, Carlos D

    2016-04-01

    Sequencing the genomes of extinct hominids has reshaped our understanding of modern human origins. Here, we analyze ∼120 kb of exome-captured Y-chromosome DNA from a Neandertal individual from El Sidrón, Spain. We investigate its divergence from orthologous chimpanzee and modern human sequences and find strong support for a model that places the Neandertal lineage as an outgroup to modern human Y chromosomes-including A00, the highly divergent basal haplogroup. We estimate that the time to the most recent common ancestor (TMRCA) of Neandertal and modern human Y chromosomes is ∼588 thousand years ago (kya) (95% confidence interval [CI]: 447-806 kya). This is ∼2.1 (95% CI: 1.7-2.9) times longer than the TMRCA of A00 and other extant modern human Y-chromosome lineages. This estimate suggests that the Y-chromosome divergence mirrors the population divergence of Neandertals and modern human ancestors, and it refutes alternative scenarios of a relatively recent or super-archaic origin of Neandertal Y chromosomes. The fact that the Neandertal Y we describe has never been observed in modern humans suggests that the lineage is most likely extinct. We identify protein-coding differences between Neandertal and modern human Y chromosomes, including potentially damaging changes to PCDH11Y, TMSB4Y, USP9Y, and KDM5D. Three of these changes are missense mutations in genes that produce male-specific minor histocompatibility (H-Y) antigens. Antigens derived from KDM5D, for example, are thought to elicit a maternal immune response during gestation. It is possible that incompatibilities at one or more of these genes played a role in the reproductive isolation of the two groups. PMID:27058445

  15. The Neandertals of northeastern Iberia: new remains from the Cova del Gegant (Sitges, Barcelona).

    PubMed

    Quam, Rolf; Sanz, Montserrat; Daura, Joan; Robson Brown, Kate; García-González, Rebeca; Rodríguez, Laura; Dawson, Heidi; Rodríguez, Rosa Flor; Gómez, Sandra; Villaescusa, Lucía; Rubio, Ángel; Yagüe, Almudena; Ortega Martínez, María Cruz; Fullola, Josep Maria; Zilhão, João; Arsuaga, Juan Luis

    2015-04-01

    The present study describes a new juvenile hominin mandible and teeth and a new juvenile humerus from level V of the GP2 gallery of Cova del Gegant (Spain). The mandible (Gegant-5) preserves a portion of the right mandibular corpus from the M1 distally to the socket for the dc mesially, and the age at death is estimated as 4.5-5.0 years. Gegant-5 shows a single mental foramen located under the dm1/dm2 interdental septum, a relatively posterior placement compared with recent hominins of a similar developmental age. The mental foramen in Gegant-5 is also placed within the lower half of the mandibular corpus, as in the previously described late adolescent/adult mandible (Gegant-1) from this same Middle Paleolithic site. The Gegant-5 canine shows pronounced marginal ridges, a distal accessory ridge, and a pronounced distolingual tubercle. The P3 shows a lingually-displaced protoconid cusp tip and a distal accessory ridge. The P4 shows a slightly asymmetrical crown outline, a continuous transverse crest, a mesially placed metaconid cusp tip, a slight distal accessory ridge, and an accessory lingual cusp. The M1 shows a Y5 pattern of cusp contact and a well-developed and deep anterior fovea bounded posteriorly by a continuous midtrigonid crest. Gegant-4 is the distal portion of a left humerus from a juvenile estimated to be between 5 and 7 years old at death. The specimen shows thick cortical bone. Although fragmentary, the constellation of morphological and metric features indicates Neandertal affinities for these specimens. Their spatial proximity at the site and similar ages at death suggest these remains may represent a single individual. The addition of these new specimens brings the total number of Neandertal remains from the Cova del Gegant to five, and this site documents the clearest evidence for Neandertal fossils associated with Middle Paleolithic stone tools in this region of the Iberian Peninsula. PMID:25766902

  16. Neandertal versus Modern Human Dietary Responses to Climatic Fluctuations.

    PubMed

    El Zaatari, Sireen; Grine, Frederick E; Ungar, Peter S; Hublin, Jean-Jacques

    2016-01-01

    The Neandertal lineage developed successfully throughout western Eurasia and effectively survived the harsh and severely changing environments of the alternating glacial/interglacial cycles from the middle of the Pleistocene until Marine Isotope Stage 3. Yet, towards the end of this stage, at the time of deteriorating climatic conditions that eventually led to the Last Glacial Maximum, and soon after modern humans entered western Eurasia, the Neandertals disappeared. Western Eurasia was by then exclusively occupied by modern humans. We use occlusal molar microwear texture analysis to examine aspects of diet in western Eurasian Paleolithic hominins in relation to fluctuations in food supplies that resulted from the oscillating climatic conditions of the Pleistocene. There is demonstrable evidence for differences in behavior that distinguish Upper Paleolithic humans from members of the Neandertal lineage. Specifically, whereas the Neandertals altered their diets in response to changing paleoecological conditions, the diets of Upper Paleolithic humans seem to have been less affected by slight changes in vegetation/climatic conditions but were linked to changes in their technological complexes. The results of this study also indicate differences in resource exploitation strategies between these two hominin groups. We argue that these differences in subsistence strategies, if they had already been established at the time of the first contact between these two hominin taxa, may have given modern humans an advantage over the Neandertals, and may have contributed to the persistence of our species despite habitat-related changes in food availabilities associated with climate fluctuations. PMID:27119336

  17. Kebara 2: new insights regarding the most complete Neandertal thorax.

    PubMed

    Gómez-Olivencia, Asier; Eaves-Johnson, K Lindsay; Franciscus, Robert G; Carretero, José Miguel; Arsuaga, Juan Luis

    2009-07-01

    In this study, we present a new analysis of the costal skeleton of the Kebara 2 Neandertal that challenges the original description of the fossil remains. In addition to correcting an erroneous rib rejoin, we document that Kebara 2 shows significant metric and morphological differences in comparison to a wide range of modern human comparative samples. Moreover, Kebara 2's thorax is large, but it is not an isometrically scaled version of a modern human thorax. We also present updated information regarding additional Neandertal rib remains that weakens the case for previous speculations regarding marked ecogeographical patterning in the Neandertal upper thorax. From these results, in combination with various other lines of evidence, we hypothesize that the large chest of Neandertals, while different from modern humans, is not autapomorphic but instead related to a "primitive body bauplan": wide bodies with high body mass. A large thorax in pre-modern Homo, indicating a large vital capacity, would be consistent with the idea of increased oxygen consumption derived from higher energetic demands of a larger body and higher activity levels when compared to modern industrial samples. The likely presence of larger chests in the large bodied individuals from the middle Pleistocene of Eurasia and Africa (and even from the African lower Pleistocene) calls into question cold climate adaptation as a primary force for this skeletal morphology in Neandertals. PMID:19540563

  18. Neandertal versus Modern Human Dietary Responses to Climatic Fluctuations

    PubMed Central

    El Zaatari, Sireen; Grine, Frederick E.; Ungar, Peter S.; Hublin, Jean-Jacques

    2016-01-01

    The Neandertal lineage developed successfully throughout western Eurasia and effectively survived the harsh and severely changing environments of the alternating glacial/interglacial cycles from the middle of the Pleistocene until Marine Isotope Stage 3. Yet, towards the end of this stage, at the time of deteriorating climatic conditions that eventually led to the Last Glacial Maximum, and soon after modern humans entered western Eurasia, the Neandertals disappeared. Western Eurasia was by then exclusively occupied by modern humans. We use occlusal molar microwear texture analysis to examine aspects of diet in western Eurasian Paleolithic hominins in relation to fluctuations in food supplies that resulted from the oscillating climatic conditions of the Pleistocene. There is demonstrable evidence for differences in behavior that distinguish Upper Paleolithic humans from members of the Neandertal lineage. Specifically, whereas the Neandertals altered their diets in response to changing paleoecological conditions, the diets of Upper Paleolithic humans seem to have been less affected by slight changes in vegetation/climatic conditions but were linked to changes in their technological complexes. The results of this study also indicate differences in resource exploitation strategies between these two hominin groups. We argue that these differences in subsistence strategies, if they had already been established at the time of the first contact between these two hominin taxa, may have given modern humans an advantage over the Neandertals, and may have contributed to the persistence of our species despite habitat-related changes in food availabilities associated with climate fluctuations. PMID:27119336

  19. The false dichotomy: a refutation of the Neandertal indistinguishability claim.

    PubMed

    Wynn, Thomas; Overmann, Karenleigh; Coolidge, Frederick

    2016-06-20

    In the debate about the demise of the Neandertal, several scholars have claimed that humanity's nearest relatives were indistinguishable archaeologically, and thus behaviorally and cognitively, from contemporaneous Homo sapiens. They suggest that to hold otherwise is to characterize Neandertals as inferior to H. sapiens, a false dichotomy that excludes the possibility that the two human types simply differed in ways visible to natural selection, including their cognition. Support of the Neandertal indistinguishability claim requires ignoring the cranial differences between the two human types, which have implications for cognition and behavior. Further, support of the claim requires minimizing asymmetries in the quantity and degree of behavioral differences as attested by the archaeological record. The present paper reviews the evidence for cognitive and archaeological differences between the two human types in support of the excluded middle position. PMID:26708102

  20. Fossil Homo femur from Berg Aukas, northern Namibia.

    PubMed

    Grine, F E; Jungers, W L; Tobias, P V; Pearson, O M

    1995-06-01

    The proximal half of a hominid femur was recovered from deep within a paleokarst feature at the Berg Aukas mine, northern Namibia. The femur is fully mineralized, but it is not possible to place it in geochronological context. It has a very large head, an exceptionally thick diaphyseal cortex, and a very low collodiaphyseal angle, which serve to differentiate it from Holocene homologues. The femur is not attributable to Australopithecus, Paranthropus, or early Homo (i.e., H. habilis sensu lato). Homo erectus femora have a relatively longer and AP flatter neck, and a shaft that exhibits less pilaster than the Berg Aukas specimen. Berg Aukas also differs from early modern femora in several features, including diaphyseal cortical thickness and the degree of subtrochanteric AP flattening. The massive diaphyseal cortex of Berg Aukas finds its closest similarity within archaic H. sapiens (e.g., Castel di Guido) and H. erectus (e.g., KNM-ER 736) samples. It has more cortical bone at midshaft than any other specimen, although relative cortical thickness and the asymmetry of its cross-sectional disposition at this level are comparable with those of other Pleistocene femora. The closest morphological comparisons with Berg Aukas are in archaic (i.e., Middle Pleistocene) H. sapiens and Neandertal samples. PMID:7653506

  1. Anterior dental microwear texture analysis of the Krapina Neandertals

    NASA Astrophysics Data System (ADS)

    Krueger, Kristin L.; Ungar, Peter S.

    2012-12-01

    Some Neandertal anterior teeth show unusual and excessive gross wear, commonly explained by non-dietary anterior tooth use, or using the anterior dentition as a tool, clamp, or third hand. This alternate use is inferred from aboriginal arctic populations, who used their front teeth in this manner. Here we examine anterior dental microwear textures of the Krapina Neandertals to test this hypothesis and further analyze tooth use in these hominins. Microwear textures from 17 Krapina Dental People were collected by white-light confocal profilometry using a 100x objective lens. Four adjacent scans were generated, totaling an area of 204x276 μm, and were analyzed using Toothfrax and SFrax SSFA software packages. The Neandertals were compared to six bioarchaeological/ethnographic samples with reported variation in diet, abrasive load, and non-dietary anterior tooth use. Results indicate that Krapina anterior teeth lack extreme microwear textures expected of hominins exposed to heavy abrasives or those that regularly generated high stresses associated with intense use of the front teeth as tools. Krapina hominins have microwear attributes in common with Coast Tsimshian, Aleut, and Puye Pueblo samples. Collectively, this suggests that the Krapina Neandertals faced moderate abrasive loads and only periodically used their anterior teeth as tools for non-diet related behaviors.

  2. The costal skeleton of Shanidar 3 and a reappraisal of Neandertal thoracic morphology.

    PubMed

    Franciscus, Robert G; Churchill, Steven E

    2002-03-01

    For over a century, Neandertal rib remains have engendered frequent discussions of "barrel-shaped" thoraces, largely in the absence of systematic comparison and hard data. We present here a description of the relatively complete ribcage of the Near Eastern Shanidar 3 Neandertal. We also furnish metric and non-metric comparisons of the Shanidar 3 ribs with other Near Eastern and European Neandertals, the Nariokotome (Homo erectus/ergaster) specimen, Levantine archaic/early modern humans, early and later European modern humans, and a sample of recent Euroamerican males. It is clear from these comparisons that Neandertals share with modern humans the fundamentally human thoracic "bauplan" that first evolved in the early Pleistocene. Yet it is also apparent that the ribcage of Neandertals differ in several anatomical details from those of fully modern humans. Rib curvature, posterior angle, mid-shaft cross-sectional size and shape, and muscle scarring varies considerably among Neandertals and across all samples when considered in isolated ribs. However, normalized metric and discrete patterning across the greater thorax clearly distinguishes Neandertals from our comparative samples. This is most marked in the inferior thorax where Neandertals (and probably earlier Homo) exhibit larger, more rounded and rugose ribs, and a greater costal area (thoracic volume). Greater lower rib cross-sectional robusticity and muscle scarring indicates relatively elevated ventilatory levels. Greater thoracic volume in Neandertals probably reflects greater body mass compared with modern humans since lung volume scales isometrically to body mass among mammals. Neandertal and modern human pulmonary capacity, normalized for body mass differences, was therefore roughly equivalent in the context of detailed differences in thoracic shape. To the extent that cold-climate adaptation is involved, Near Eastern Neandertals appear less "hyper-polar" in thoracic shape than their European counterparts

  3. No Evidence of Neandertal mtDNA Contribution to Early Modern Humans

    PubMed Central

    2004-01-01

    The retrieval of mitochondrial DNA (mtDNA) sequences from four Neandertal fossils from Germany, Russia, and Croatia has demonstrated that these individuals carried closely related mtDNAs that are not found among current humans. However, these results do not definitively resolve the question of a possible Neandertal contribution to the gene pool of modern humans since such a contribution might have been erased by genetic drift or by the continuous influx of modern human DNA into the Neandertal gene pool. A further concern is that if some Neandertals carried mtDNA sequences similar to contemporaneous humans, such sequences may be erroneously regarded as modern contaminations when retrieved from fossils. Here we address these issues by the analysis of 24 Neandertal and 40 early modern human remains. The biomolecular preservation of four Neandertals and of five early modern humans was good enough to suggest the preservation of DNA. All four Neandertals yielded mtDNA sequences similar to those previously determined from Neandertal individuals, whereas none of the five early modern humans contained such mtDNA sequences. In combination with current mtDNA data, this excludes any large genetic contribution by Neandertals to early modern humans, but does not rule out the possibility of a smaller contribution. PMID:15024415

  4. Neandertal nasal structures and upper respiratory tract "specialization".

    PubMed

    Franciscus, R G

    1999-02-16

    Schwartz and Tattersall [Schwartz, J. H. & Tattersall, I. (1996) Proc. Natl. Acad. Sci. USA 93, 10852-10854] have argued for a previously unrecognized suite of autapomorphies in the internal nasal region of Neandertals that make them unique, not only among hominids, but possibly among all other terrestrial mammals. These purported autapomorphies include (i) the development of an internal nasal margin bearing a well developed and vertically oriented medial projection; (ii) a pronounced medial swelling of the lateral nasal wall into the posterior nasal cavity; and (iii) the lack of an ossified roof over the lacrimal groove. In addition, Laitman et al. [Laitman, J. T., Reidenberg, J. S., Marquez, S. & Gannon, P. J. (1996) Proc. Natl. Acad. Sci. USA 93, 10543-10545] pointed to these features as evidence for upper respiratory tract specializations among the Neandertals, indicating potential differences in behavior compared with modern humans. Critically reviewing the anatomical basis for Schwartz and Tattersall's contentions reveals several serious problems with their analysis, including (i) reliance on specimens with damaged, incomplete, or, in some cases, entirely absent relevant anatomy; (ii) failure to consider primary vs. secondary spatial consequences in nasal trait conceptualization; and (iii) failure to consider actual ranges of variation in these traits in both fossil and recent humans. Accordingly, the unique phylogenetic and adaptive "specializations" attributed to Neandertal internal nasal structures are unwarranted. PMID:9990106

  5. Neandertal nasal structures and upper respiratory tract “specialization”

    PubMed Central

    Franciscus, Robert G.

    1999-01-01

    Schwartz and Tattersall [Schwartz, J. H. & Tattersall, I. (1996) Proc. Natl. Acad. Sci. USA 93, 10852–10854] have argued for a previously unrecognized suite of autapomorphies in the internal nasal region of Neandertals that make them unique, not only among hominids, but possibly among all other terrestrial mammals. These purported autapomorphies include (i) the development of an internal nasal margin bearing a well developed and vertically oriented medial projection; (ii) a pronounced medial swelling of the lateral nasal wall into the posterior nasal cavity; and (iii) the lack of an ossified roof over the lacrimal groove. In addition, Laitman et al. [Laitman, J. T., Reidenberg, J. S., Marquez, S. & Gannon, P. J. (1996) Proc. Natl. Acad. Sci. USA 93, 10543–10545] pointed to these features as evidence for upper respiratory tract specializations among the Neandertals, indicating potential differences in behavior compared with modern humans. Critically reviewing the anatomical basis for Schwartz and Tattersall’s contentions reveals several serious problems with their analysis, including (i) reliance on specimens with damaged, incomplete, or, in some cases, entirely absent relevant anatomy; (ii) failure to consider primary vs. secondary spatial consequences in nasal trait conceptualization; and (iii) failure to consider actual ranges of variation in these traits in both fossil and recent humans. Accordingly, the unique phylogenetic and adaptive “specializations” attributed to Neandertal internal nasal structures are unwarranted. PMID:9990106

  6. Genetic evidence for patrilocal mating behavior among Neandertal groups.

    PubMed

    Lalueza-Fox, Carles; Rosas, Antonio; Estalrrich, Almudena; Gigli, Elena; Campos, Paula F; García-Tabernero, Antonio; García-Vargas, Samuel; Sánchez-Quinto, Federico; Ramírez, Oscar; Civit, Sergi; Bastir, Markus; Huguet, Rosa; Santamaría, David; Gilbert, M Thomas P; Willerslev, Eske; de la Rasilla, Marco

    2011-01-01

    The remains of 12 Neandertal individuals have been found at the El Sidrón site (Asturias, Spain), consisting of six adults, three adolescents, two juveniles, and one infant. Archaeological, paleontological, and geological evidence indicates that these individuals represent all or part of a contemporaneous social group of Neandertals, who died at around the same time and later were buried together as a result of a collapse of an underground karst. We sequenced phylogenetically informative positions of mtDNA hypervariable regions 1 and 2 from each of the remains. Our results show that the 12 individuals stem from three different maternal lineages, accounting for seven, four, and one individual(s), respectively. Using a Y-chromosome assay to confirm the morphological determination of sex for each individual, we found that, although the three adult males carried the same mtDNA lineage, each of the three adult females carried different mtDNA lineages. These findings provide evidence to indicate that Neandertal groups not only were small and characterized by low genetic diversity but also were likely to have practiced patrilocal mating behavior. PMID:21173265

  7. The Neandertal type site revisited: interdisciplinary investigations of skeletal remains from the Neander Valley, Germany.

    PubMed

    Schmitz, Ralf W; Serre, David; Bonani, Georges; Feine, Susanne; Hillgruber, Felix; Krainitzki, Heike; Pääbo, Svante; Smith, Fred H

    2002-10-01

    The 1856 discovery of the Neandertal type specimen (Neandertal 1) in western Germany marked the beginning of human paleontology and initiated the longest-standing debate in the discipline: the role of Neandertals in human evolutionary history. We report excavations of cave sediments that were removed from the Feldhofer caves in 1856. These deposits have yielded over 60 human skeletal fragments, along with a large series of Paleolithic artifacts and faunal material. Our analysis of this material represents the first interdisciplinary analysis of Neandertal remains incorporating genetic, direct dating, and morphological dimensions simultaneously. Three of these skeletal fragments fit directly on Neandertal 1, whereas several others have distinctively Neandertal features. At least three individuals are represented in the skeletal sample. Radiocarbon dates for Neandertal 1, from which a mtDNA sequence was determined in 1997, and a second individual indicate an age of approximately 40,000 yr for both. mtDNA analysis on the same second individual yields a sequence that clusters with other published Neandertal sequences. PMID:12232049

  8. The Neandertal type site revisited: Interdisciplinary investigations of skeletal remains from the Neander Valley, Germany

    PubMed Central

    Schmitz, Ralf W.; Serre, David; Bonani, Georges; Feine, Susanne; Hillgruber, Felix; Krainitzki, Heike; Pääbo, Svante; Smith, Fred H.

    2002-01-01

    The 1856 discovery of the Neandertal type specimen (Neandertal 1) in western Germany marked the beginning of human paleontology and initiated the longest-standing debate in the discipline: the role of Neandertals in human evolutionary history. We report excavations of cave sediments that were removed from the Feldhofer caves in 1856. These deposits have yielded over 60 human skeletal fragments, along with a large series of Paleolithic artifacts and faunal material. Our analysis of this material represents the first interdisciplinary analysis of Neandertal remains incorporating genetic, direct dating, and morphological dimensions simultaneously. Three of these skeletal fragments fit directly on Neandertal 1, whereas several others have distinctively Neandertal features. At least three individuals are represented in the skeletal sample. Radiocarbon dates for Neandertal 1, from which a mtDNA sequence was determined in 1997, and a second individual indicate an age of ≈40,000 yr for both. mtDNA analysis on the same second individual yields a sequence that clusters with other published Neandertal sequences. PMID:12232049

  9. A complete Neandertal mitochondrial genome sequence determined by high-throughput sequencing

    PubMed Central

    Green, Richard E.; Malaspinas, Anna-Sapfo; Krause, Johannes; Briggs, Adrian W.; Johnson, Philip L. F.; Uhler, Caroline; Meyer, Matthias; Good, Jeffrey M.; Maricic, Tomislav; Stenzel, Udo; Prüfer, Kay; Siebauer, Michael; Burbano, Hernán A.; Ronan, Michael; Rothberg, Jonathan M.; Egholm, Michael; Rudan, Pavao; Brajković, Dejana; Kućan, Željko; Gušić, Ivan; Wikström, Mårten; Laakkonen, Liisa; Kelso, Janet; Slatkin, Montgomery; Pääbo, Svante

    2008-01-01

    Summary A complete mitochondrial (mt) genome sequence was reconstructed from a 38,000-year-old Neandertal individual using 8,341 mtDNA sequences identified among 4.8 Gb of DNA generated from ~0.3 grams of bone. Analysis of the assembled sequence unequivocally establishes that the Neandertal mtDNA falls outside the variation of extant human mtDNAs and allows an estimate of the divergence date between the two mtDNA lineages of 660,000±140,000 years. Of the 13 proteins encoded in the mtDNA, subunit 2 of cytochrome c oxidase of the mitochondrial electron transport chain has experienced the largest number of amino acid substitutions in human ancestors since the separation from Neandertals. There is evidence that purifying selection in the Neandertal mtDNA was reduced compared to other primate lineages suggesting that the effective population size of Neandertals was small. PMID:18692465

  10. Neonatal postcrania from Mezmaiskaya, Russia, and Le Moustier, France, and the development of Neandertal body form.

    PubMed

    Weaver, Timothy D; Coqueugniot, Hélène; Golovanova, Liubov V; Doronichev, Vladimir B; Maureille, Bruno; Hublin, Jean-Jacques

    2016-06-01

    Neandertal and modern human adults differ in skeletal features of the cranium and postcranium, and it is clear that many of the cranial differences-although not all of them-are already present at the time of birth. We know less, however, about the developmental origins of the postcranial differences. Here, we address this deficiency with morphometric analyses of the postcrania of the two most complete Neandertal neonates-Mezmaiskaya 1 (from Russia) and Le Moustier 2 (from France)-and a recent human sample. We find that neonatal Neandertals already appear to possess the wide body, long pubis, and robust long bones of adult Neandertals. Taken together, current evidence indicates that skeletal differences between Neandertals and modern humans are largely established by the time of birth. PMID:27217565

  11. Neonatal postcrania from Mezmaiskaya, Russia, and Le Moustier, France, and the development of Neandertal body form

    PubMed Central

    Weaver, Timothy D.; Coqueugniot, Hélène; Golovanova, Liubov V.; Doronichev, Vladimir B.; Maureille, Bruno; Hublin, Jean-Jacques

    2016-01-01

    Neandertal and modern human adults differ in skeletal features of the cranium and postcranium, and it is clear that many of the cranial differences—although not all of them—are already present at the time of birth. We know less, however, about the developmental origins of the postcranial differences. Here, we address this deficiency with morphometric analyses of the postcrania of the two most complete Neandertal neonates—Mezmaiskaya 1 (from Russia) and Le Moustier 2 (from France)—and a recent human sample. We find that neonatal Neandertals already appear to possess the wide body, long pubis, and robust long bones of adult Neandertals. Taken together, current evidence indicates that skeletal differences between Neandertals and modern humans are largely established by the time of birth. PMID:27217565

  12. Hyperostosis frontalis interna in a Neandertal from Marillac (Charente, France).

    PubMed

    Garralda, María Dolores; Maureille, Bruno; Vandermeersch, Bernard

    2014-02-01

    The site of Marillac (Charente, France) has yielded an important stratigraphic sequence containing numerous Neandertal remains (some of them with peri-mortem manipulations) from lithofacies 2 (Quina Mousterian). This level has been correlated with MIS 4 and is associated with a TL date of 57,600 ± 4600 years BP (before present). The study of one of the cranial fragments (Marillac 3) revealed a grade 2 or Type B Hyperostosis frontalis interna (HFI), remodelling and altering the internal table of the thick frontal bone. This pathology has been analysed macroscopically together with radiography and sections made using a microscanner and a scanner. The development of the HFI is compared with published evidence for Sangiran 3 (Homo erectus), two other Neandertals (Forbes' Quarry and Shanidar 5), and several archaeological samples. Forbes' Quarry seems to display more advanced HFI than either Shanidar 5 or Marillac 3. The three Neandertals may be considered mature individuals (≥40 years) and it seems likely that the aetiology of this pathology may be associated with hormonal alterations, as has been suggested for past and extant populations. While the prevalence of HFI in contemporary post-menopausal women is well documented, the identification of HFI amongst males from several archaeological samples (Neanderthals, Ancient Egypt, Syrian Bronze Age or the Anasazi), with different stages of development, confirm that the pathology affected both sexes in past populations. Additional data and research are still needed to elucidate the etiopathogenesis of this illness and to better understand the relationship between environmental factors and their possible influences/consequences for the development of metabolic disorders in prehistoric populations. PMID:24491378

  13. Differences between Neandertal and modern human infant and child growth models.

    PubMed

    Martín-González, Jesús A; Mateos, Ana; Goikoetxea, Idoia; Leonard, William R; Rodríguez, Jesús

    2012-07-01

    Studying the emergence of distinctive human growth patterns is essential to understanding the evolution of our species. The large number of Neandertal fossils makes this species the best candidate for a comparative study of growth patterns in archaic and modern humans. Here, Neandertal height growth during infancy and early childhood is described using a mathematical model. Height growth velocities for individuals five years old or younger are modelled as age functions based on different estimates of height and age for a set of ten Neandertal infants and children. The estimated heights of each Neandertal individual are compared with those of two modern human populations based on longitudinal and cross-sectional data. The model highlights differences in growth velocity during infancy (from the age of five months onward). We find that statural growth in Neandertal infants is much slower than that seen in modern humans, Neandertal growth is similar to modern humans at birth, but decreases around the third or fourth month. The markedly slower growth rates of Neandertal infants may be attributable to ontogenetic constraints or to metabolic stress, and contribute to short achieved adult stature relative to modern humans. PMID:22658332

  14. European early modern humans and the fate of the Neandertals

    PubMed Central

    Trinkaus, Erik

    2007-01-01

    A consideration of the morphological aspects of the earliest modern humans in Europe (more than ≈33,000 B.P.) and the subsequent Gravettian human remains indicates that they possess an anatomical pattern congruent with the autapomorphic (derived) morphology of the earliest (Middle Paleolithic) African modern humans. However, they exhibit a variable suite of features that are either distinctive Neandertal traits and/or plesiomorphic (ancestral) aspects that had been lost among the African Middle Paleolithic modern humans. These features include aspects of neurocranial shape, basicranial external morphology, mandibular ramal and symphyseal form, dental morphology and size, and anteroposterior dental proportions, as well as aspects of the clavicles, scapulae, metacarpals, and appendicular proportions. The ubiquitous and variable presence of these morphological features in the European earlier modern human samples can only be parsimoniously explained as a product of modest levels of assimilation of Neandertals into early modern human populations as the latter dispersed across Europe. This interpretation is in agreement with current analyses of recent and past human molecular data. PMID:17452632

  15. Deciduous teeth of the Neandertal mandible from Molare Shelter, near Scario (Salerno, Italy).

    PubMed

    Mallegni, F; Ronchitelli, A T

    1989-08-01

    Excavations at hearth levels at the Molare Shelter in 1985 yielded the mandible of a 3-4-year-old child. The associated lithic artifacts recovered with it are Mousterian. Its features, although quite archaic, are within the known range of variation of Neandertals. Four deciduous molars are still preserved in the mandible. They were compared with other known specimens, which date to the Middle and Upper Pleistocene. The metrical characteristics are surprisingly primitive, within the range of variation of Homo erectus, or at least within that of European Pre-Neandertals, more so than within the variability of typical Neandertal specimens. On the other hand, the morphological characteristics, except for a few that are decidedly plesiomorph, are predominantly Neandertal. PMID:2672830

  16. Excavating Neandertal and Denisovan DNA from the genomes of Melanesian individuals.

    PubMed

    Vernot, Benjamin; Tucci, Serena; Kelso, Janet; Schraiber, Joshua G; Wolf, Aaron B; Gittelman, Rachel M; Dannemann, Michael; Grote, Steffi; McCoy, Rajiv C; Norton, Heather; Scheinfeldt, Laura B; Merriwether, David A; Koki, George; Friedlaender, Jonathan S; Wakefield, Jon; Pääbo, Svante; Akey, Joshua M

    2016-04-01

    Although Neandertal sequences that persist in the genomes of modern humans have been identified in Eurasians, comparable studies in people whose ancestors hybridized with both Neandertals and Denisovans are lacking. We developed an approach to identify DNA inherited from multiple archaic hominin ancestors and applied it to whole-genome sequences from 1523 geographically diverse individuals, including 35 previously unknown Island Melanesian genomes. In aggregate, we recovered 1.34 gigabases and 303 megabases of the Neandertal and Denisovan genome, respectively. We use these maps of archaic sequences to show that Neandertal admixture occurred multiple times in different non-African populations, characterize genomic regions that are significantly depleted of archaic sequences, and identify signatures of adaptive introgression. PMID:26989198

  17. Neandertal Demise: An Archaeological Analysis of the Modern Human Superiority Complex

    PubMed Central

    Villa, Paola; Roebroeks, Wil

    2014-01-01

    Neandertals are the best-studied of all extinct hominins, with a rich fossil record sampling hundreds of individuals, roughly dating from between 350,000 and 40,000 years ago. Their distinct fossil remains have been retrieved from Portugal in the west to the Altai area in central Asia in the east and from below the waters of the North Sea in the north to a series of caves in Israel in the south. Having thrived in Eurasia for more than 300,000 years, Neandertals vanished from the record around 40,000 years ago, when modern humans entered Europe. Modern humans are usually seen as superior in a wide range of domains, including weaponry and subsistence strategies, which would have led to the demise of Neandertals. This systematic review of the archaeological records of Neandertals and their modern human contemporaries finds no support for such interpretations, as the Neandertal archaeological record is not different enough to explain the demise in terms of inferiority in archaeologically visible domains. Instead, current genetic data suggest that complex processes of interbreeding and assimilation may have been responsible for the disappearance of the specific Neandertal morphology from the fossil record. PMID:24789039

  18. Unconstrained cranial evolution in Neandertals and modern humans compared to common chimpanzees.

    PubMed

    Weaver, Timothy D; Stringer, Chris B

    2015-10-22

    A variety of lines of evidence support the idea that neutral evolutionary processes (genetic drift, mutation) have been important in generating cranial differences between Neandertals and modern humans. But how do Neandertals and modern humans compare with other species? And how do these comparisons illuminate the evolutionary processes underlying cranial diversification? To address these questions, we used 27 standard cranial measurements collected on 2524 recent modern humans, 20 Neandertals and 237 common chimpanzees to estimate split times between Neandertals and modern humans, and between Pan troglodytes verus and two other subspecies of common chimpanzee. Consistent with a neutral divergence, the Neandertal versus modern human split-time estimates based on cranial measurements are similar to those based on DNA sequences. By contrast, the common chimpanzee cranial estimates are much lower than DNA-sequence estimates. Apparently, cranial evolution has been unconstrained in Neandertals and modern humans compared with common chimpanzees. Based on these and additional analyses, it appears that cranial differentiation in common chimpanzees has been restricted by stabilizing natural selection. Alternatively, this restriction could be due to genetic and/or developmental constraints on the amount of within-group variance (relative to effective population size) available for genetic drift to act on. PMID:26468243

  19. Patterns of coding variation in the complete exomes of three Neandertals.

    PubMed

    Castellano, Sergi; Parra, Genís; Sánchez-Quinto, Federico A; Racimo, Fernando; Kuhlwilm, Martin; Kircher, Martin; Sawyer, Susanna; Fu, Qiaomei; Heinze, Anja; Nickel, Birgit; Dabney, Jesse; Siebauer, Michael; White, Louise; Burbano, Hernán A; Renaud, Gabriel; Stenzel, Udo; Lalueza-Fox, Carles; de la Rasilla, Marco; Rosas, Antonio; Rudan, Pavao; Brajković, Dejana; Kucan, Željko; Gušic, Ivan; Shunkov, Michael V; Derevianko, Anatoli P; Viola, Bence; Meyer, Matthias; Kelso, Janet; Andrés, Aida M; Pääbo, Svante

    2014-05-01

    We present the DNA sequence of 17,367 protein-coding genes in two Neandertals from Spain and Croatia and analyze them together with the genome sequence recently determined from a Neandertal from southern Siberia. Comparisons with present-day humans from Africa, Europe, and Asia reveal that genetic diversity among Neandertals was remarkably low, and that they carried a higher proportion of amino acid-changing (nonsynonymous) alleles inferred to alter protein structure or function than present-day humans. Thus, Neandertals across Eurasia had a smaller long-term effective population than present-day humans. We also identify amino acid substitutions in Neandertals and present-day humans that may underlie phenotypic differences between the two groups. We find that genes involved in skeletal morphology have changed more in the lineage leading to Neandertals than in the ancestral lineage common to archaic and modern humans, whereas genes involved in behavior and pigmentation have changed more on the modern human lineage. PMID:24753607

  20. Patterns of coding variation in the complete exomes of three Neandertals

    PubMed Central

    Castellano, Sergi; Parra, Genís; Sánchez-Quinto, Federico A.; Racimo, Fernando; Kuhlwilm, Martin; Kircher, Martin; Sawyer, Susanna; Fu, Qiaomei; Heinze, Anja; Nickel, Birgit; Dabney, Jesse; Siebauer, Michael; White, Louise; Burbano, Hernán A.; Renaud, Gabriel; Stenzel, Udo; Lalueza-Fox, Carles; de la Rasilla, Marco; Rosas, Antonio; Rudan, Pavao; Brajković, Dejana; Kucan, Željko; Gušic, Ivan; Shunkov, Michael V.; Derevianko, Anatoli P.; Viola, Bence; Meyer, Matthias; Kelso, Janet; Andrés, Aida M.; Pääbo, Svante

    2014-01-01

    We present the DNA sequence of 17,367 protein-coding genes in two Neandertals from Spain and Croatia and analyze them together with the genome sequence recently determined from a Neandertal from southern Siberia. Comparisons with present-day humans from Africa, Europe, and Asia reveal that genetic diversity among Neandertals was remarkably low, and that they carried a higher proportion of amino acid-changing (nonsynonymous) alleles inferred to alter protein structure or function than present-day humans. Thus, Neandertals across Eurasia had a smaller long-term effective population than present-day humans. We also identify amino acid substitutions in Neandertals and present-day humans that may underlie phenotypic differences between the two groups. We find that genes involved in skeletal morphology have changed more in the lineage leading to Neandertals than in the ancestral lineage common to archaic and modern humans, whereas genes involved in behavior and pigmentation have changed more on the modern human lineage. PMID:24753607

  1. On the phylogenetic position of the pre-Neandertal specimen from Reilingen, Germany.

    PubMed

    Dean, D; Hublin, J J; Holloway, R; Ziegler, R

    1998-05-01

    This paper describes the morphology and phylogenetic significance of a well-preserved fossil human cranium found near Reilingen, Germany in 1978. The specimen consists of two complete parietals, most of the right temporal, and 70% of the occipital. The specimen displays several features characteristic of early "archaic" Homo sapiens: maximum breadth at the supramastoid crests, roughly pentagonal occipital view, an angular torus, superoinferiorly elongate/ anteroposterior shortened squamous temporal, strong mastoid, and separation of the tympanic and mastoid temporal portions. Other features align the Reilingen cranium with the "classic" Neandertals: developed suprainiac fossa, bilaterally protuberant occipital torus, strong juxtamastoid eminence, a highly convex occipital plane, and lambdoid flattening. This morphology and our cephalometric analysis support the assignment of this specimen to a Stage 2 "pre-Neandertal" group (e.g., Steinheim, Swanscombe, and Atapuerca [SH site]). Following an "Accretion Model" of European hominid evolution, Stage 2 succeeds Stage 1 European "early-pre-Neandertals" (e.g., Mauer and Petralona), and precedes both the Saale-Eem Stage 3 "early Neandertals" (e.g., Biache 1), which present greater platycephaly, a reduced mastoid process, an enlarged juxtamastoid eminence, and true "en-bombe" (parieto-occipital form), and Weichsel Stage 4 "Neandertals" (sensu stricto, i.e., "classic" Neandertals). PMID:9614635

  2. Selection and Reduced Population Size Cannot Explain Higher Amounts of Neandertal Ancestry in East Asian than in European Human Populations

    PubMed Central

    Kim, Bernard Y.; Lohmueller, Kirk E.

    2015-01-01

    It has been hypothesized that the greater proportion of Neandertal ancestry in East Asians than in Europeans is due to the fact that purifying selection is less effective at removing weakly deleterious Neandertal alleles from East Asian populations. Using simulations of a broad range of models of selection and demography, we have shown that this hypothesis cannot account for the higher proportion of Neandertal ancestry in East Asians than in Europeans. Instead, more complex demographic scenarios, most likely involving multiple pulses of Neandertal admixture, are required to explain the data. PMID:25683122

  3. Morphology, body proportions, and postcranial hypertrophy of a female Neandertal from the Sima de las Palomas, southeastern Spain

    PubMed Central

    Walker, Michael J.; Ortega, Jon; Parmová, Klara; López, Mariano V.; Trinkaus, Erik

    2011-01-01

    Considerations of Neandertal geographical variation have been hampered by the dearth of remains from Mediterranean Europe and the absence there of sufficiently complete associated postcrania. The 2006 and 2007 excavation of an articulated partial skeleton of a small adult female Neandertal at the Sima de las Palomas, Murcia, southeastern Spain (Sima de las Palomas 96) provides substantial and secure information on body proportions among southern European Neandertals, as well as further documenting the nature of Neandertal biology in southern Iberia. The remains exhibit a suite of cranial, mandibular, dental, and postcranial features, of both Neandertals and archaic Homo generally, that distinguish them from contemporary and subsequent early modern humans. Its lower limbs exhibit the robustness of later Pleistocene Homo generally, and its upper limbs conform to the pattern of elevated robustness of the Neandertals. Its body proportions, including relative clavicular length, distal limb segment lengths, and body mass to stature indicators, conform to the “cold-adapted” pattern of more northern Neandertals. Palomas 96 therefore documents the presence of a suite of “Neandertal” characteristics in southern Iberia and, along with its small body size, the more “Arctic” body proportions of other European Neandertals despite the warmer climate of southern Iberia during marine isotope stage 3. PMID:21646528

  4. Virtual ancestor reconstruction: Revealing the ancestor of modern humans and Neandertals.

    PubMed

    Mounier, Aurélien; Mirazón Lahr, Marta

    2016-02-01

    The timing and geographic origin of the common ancestor of modern humans and Neandertals remain controversial. A poor Pleistocene hominin fossil record and the evolutionary complexities introduced by dispersals and regionalisation of lineages have fuelled taxonomic uncertainty, while new ancient genomic data have raised completely new questions. Here, we use maximum likelihood and 3D geometric morphometric methods to predict possible morphologies of the last common ancestor of modern humans and Neandertals from a simplified, fully resolved phylogeny. We describe the fully rendered 3D shapes of the predicted ancestors of humans and Neandertals, and assess their similarity to individual fossils or populations of fossils of Pleistocene age. Our results support models of an Afro-European ancestral population in the Middle Pleistocene (Homo heidelbergensis sensu lato) and further predict an African origin for this ancestral population. PMID:26852813

  5. Neandertal origin of genetic variation at the cluster of OAS immunity genes.

    PubMed

    Mendez, Fernando L; Watkins, Joseph C; Hammer, Michael F

    2013-04-01

    Analyses of ancient DNA from extinct humans reveal signals of at least two independent hybridization events in the history of non-African populations. To date, there are very few examples of specific genetic variants that have been rigorously identified as introgressive. Here, we survey DNA sequence variation in the OAS gene cluster on chromosome 12 and provide strong evidence that a haplotype extending for ~185 kb introgressed from Neandertals. This haplotype is nearly restricted to Eurasians and is estimated to have diverged from the Neandertal sequence ~125 kya. Despite the potential for novel functional variation, the observed frequency of this haplotype is consistent with neutral introgression. This is the second locus in the human genome, after STAT2, carrying distinct haplotypes that appear to have introgressed separately from both Neandertals and Denisova. PMID:23315957

  6. Neandertal roots: Cranial and chronological evidence from Sima de los Huesos.

    PubMed

    Arsuaga, J L; Martínez, I; Arnold, L J; Aranburu, A; Gracia-Téllez, A; Sharp, W D; Quam, R M; Falguères, C; Pantoja-Pérez, A; Bischoff, J; Poza-Rey, E; Parés, J M; Carretero, J M; Demuro, M; Lorenzo, C; Sala, N; Martinón-Torres, M; García, N; Alcázar de Velasco, A; Cuenca-Bescós, G; Gómez-Olivencia, A; Moreno, D; Pablos, A; Shen, C-C; Rodríguez, L; Ortega, A I; García, R; Bonmatí, A; Bermúdez de Castro, J M; Carbonell, E

    2014-06-20

    Seventeen Middle Pleistocene crania from the Sima de los Huesos site (Atapuerca, Spain) are analyzed, including seven new specimens. This sample makes it possible to thoroughly characterize a Middle Pleistocene hominin paleodeme and to address hypotheses about the origin and evolution of the Neandertals. Using a variety of techniques, the hominin-bearing layer could be reassigned to a period around 430,000 years ago. The sample shows a consistent morphological pattern with derived Neandertal features present in the face and anterior vault, many of which are related to the masticatory apparatus. This suggests that facial modification was the first step in the evolution of the Neandertal lineage, pointing to a mosaic pattern of evolution, with different anatomical and functional modules evolving at different rates. PMID:24948730

  7. Shanidar 3 Neandertal rib puncture wound and paleolithic weaponry.

    PubMed

    Churchill, Steven E; Franciscus, Robert G; McKean-Peraza, Hilary A; Daniel, Julie A; Warren, Brittany R

    2009-08-01

    Since its discovery and initial description in the 1960s, the penetrating lesion to the left ninth rib of the Shanidar 3 Neandertal has been a focus for discussion about interpersonal violence and weapon technology in the Middle Paleolithic. Recent experimental studies using lithic points on animal targets suggest that aspects of weapon system dynamics can be inferred from the form of the bony lesions they produce. Thus, to better understand the circumstances surrounding the traumatic injury suffered by Shanidar 3, we conducted controlled stabbing experiments with replicas of Mousterian and Levallois points directed against the thoraces of pig carcasses. Stabs were conducted under both high and low kinetic energy conditions, in an effort to replicate the usual impact forces associated with thrusting spear vs. long-range projectile weapon systems, respectively. Analysis of the lesions produced in the pig ribs, along with examination of goat ribs subjected primarily to high kinetic energy stabs from an independent experiment, revealed consistent differences in damage patterns between the two conditions. In the case of Shanidar 3, the lack of major involvement of more than one rib, the lack of fracturing of the affected and adjacent ribs, and the lack of bony defects associated with the lesion (such as wastage, hinging, and radiating fracture lines) suggests that the weapon that wounded him was carrying relatively low kinetic energy. While accidental injury or attack with a thrusting spear or knife cannot absolutely be ruled out, the position, angulation, and morphology of the lesion is most consistent with injury by a low-mass, low-kinetic energy projectile weapon. Given the potential temporal overlap of Shanidar 3 with early modern humans in western Asia, and the possibility that the latter were armed with projectile weapon systems, this case carries more than simple paleoforensic interest. PMID:19615713

  8. [Application of the musculo-skeletal modelling software lhpFusionBox to a paleoanthropological problem: the Spyrou Neandertal moves!].

    PubMed

    Chapman, Tara; Semal, Patrick; Moiseev, Fedor; Louryan, Stéphane; Rooze, Marcel; Van Sint Jan, Serge

    2013-01-01

    LhpFusionBox is a program originally designed for biomechanical and clinical studies relating to the musculoskeletal system of anatomically modern humans (AMH). The program has recently been adapted for paleontological purposes and used to reconstruct and biomechanically analyse a fossil hominid. There is no complete Neandertal skeleton in the fossil record. The aim of the study was to reconstruct a complete three-dimensional (3D) model of a Neandertal using the relatively complete Spy II Neandertal and to conduct biomechanical feasibility studies on the knee and hamstring moment arms of the skeleton. Different Neandertal specimens were scaled to the size of Spy II to replace incomplete or missing bones. Biomechanical feasibility studies performed on the knee seem to show that Neandertal and AMHh gait is similar and Neandertals were shown to have larger moment arms in the hamstring muscles, which would have given them a mechanical advantage. The complete Neandertal was printed in 3D and used as the base to create the artistic model of "Spyrou" housed at l'Espace de l'Homme de Spy (EHoS) museum. PMID:23859517

  9. The Reality of Neandertal Symbolic Behavior at the Grotte du Renne, Arcy-sur-Cure, France

    PubMed Central

    Caron, François; d'Errico, Francesco; Del Moral, Pierre; Santos, Frédéric; Zilhão, João

    2011-01-01

    Background The question of whether symbolically mediated behavior is exclusive to modern humans or shared with anatomically archaic populations such as the Neandertals is hotly debated. At the Grotte du Renne, Arcy-sur-Cure, France, the Châtelperronian levels contain Neandertal remains and large numbers of personal ornaments, decorated bone tools and colorants, but it has been suggested that this association reflects intrusion of the symbolic artifacts from the overlying Protoaurignacian and/or of the Neandertal remains from the underlying Mousterian. Methodology/Principal Findings We tested these hypotheses against the horizontal and vertical distributions of the various categories of diagnostic finds and statistically assessed the probability that the Châtelperronian levels are of mixed composition. Our results reject that the associations result from large or small scale, localized or generalized post-depositional displacement, and they imply that incomplete sample decontamination is the parsimonious explanation for the stratigraphic anomalies seen in the radiocarbon dating of the sequence. Conclusions/Significance The symbolic artifacts in the Châtelperronian of the Grotte du Renne are indeed Neandertal material culture. PMID:21738702

  10. Evidence for Neandertal Jewelry: Modified White-Tailed Eagle Claws at Krapina

    PubMed Central

    2015-01-01

    We describe eight, mostly complete white-tailed eagle (Haliaëtus [Haliaeetus] albicilla) talons from the Krapina Neandertal site in present-day Croatia, dating to approximately 130 kyrs ago. Four talons bear multiple, edge-smoothed cut marks; eight show polishing facets and/or abrasion. Three of the largest talons have small notches at roughly the same place along the plantar surface, interrupting the proximal margin of the talon blade. These features suggest they were part of a jewelry assemblage, --- the manipulations a consequence of mounting the talons in a necklace or bracelet. An associated phalanx articulates with one of the talons and has numerous cut marks, some of which are smoothed. These white-tailed eagle bones, discovered more than 100 years ago, all derive from a single level at Krapina and represent more talons than found in the entire European Mousterian period. Presence of eight talons indicates that the Krapina Neandertals acquired and curated eagle talons for some kind of symbolic purpose. Some have argued that Neandertals lacked symbolic ability or copied this behavior from modern humans. These remains clearly show that the Krapina Neandertals made jewelry well before the appearance of modern humans in Europe, extending ornament production and symbolic activity early into the European Mousterian. PMID:25760648

  11. Late Mousterian persistence near the Arctic Circle.

    PubMed

    Slimak, Ludovic; Svendsen, John Inge; Mangerud, Jan; Plisson, Hugues; Heggen, Herbjørn Presthus; Brugère, Alexis; Pavlov, Pavel Yurievich

    2011-05-13

    Palaeolithic sites in Russian high latitudes have been considered as Upper Palaeolithic and thus representing an Arctic expansion of modern humans. Here we show that at Byzovaya, in the western foothills of the Polar Urals, the technological structure of the lithic assemblage makes it directly comparable with Mousterian Middle Palaeolithic industries that so far have been exclusively attributed to the Neandertal populations in Europe. Radiocarbon and optical-stimulated luminescence dates on bones and sand grains indicate that the site was occupied during a short period around 28,500 carbon-14 years before the present (about 31,000 to 34,000 calendar years ago), at the time when only Upper Palaeolithic cultures occupied lower latitudes of Eurasia. Byzovaya may thus represent a late northern refuge for Neandertals, about 1000 km north of earlier known Mousterian sites. PMID:21566192

  12. Evidence supporting an intentional Neandertal burial at La Chapelle-aux-Saints

    PubMed Central

    Rendu, William; Beauval, Cédric; Crevecoeur, Isabelle; Bayle, Priscilla; Balzeau, Antoine; Bismuth, Thierry; Bourguignon, Laurence; Delfour, Géraldine; Faivre, Jean-Philippe; Lacrampe-Cuyaubère, François; Tavormina, Carlotta; Todisco, Dominique; Turq, Alain; Maureille, Bruno

    2014-01-01

    The bouffia Bonneval at La Chapelle-aux-Saints is well known for the discovery of the first secure Neandertal burial in the early 20th century. However, the intentionality of the burial remains an issue of some debate. Here, we present the results of a 12-y fieldwork project, along with a taphonomic analysis of the human remains, designed to assess the funerary context of the La Chapelle-aux-Saints Neandertal. We have established the anthropogenic nature of the burial pit and underlined the taphonomic evidence of a rapid burial of the body. These multiple lines of evidence support the hypothesis of an intentional burial. Finally, the discovery of skeletal elements belonging to the original La Chapelle aux Saints 1 individual, two additional young individuals, and a second adult in the bouffia Bonneval highlights a more complex site-formation history than previously proposed. PMID:24344286

  13. A functional test of Neandertal and modern human mitochondrial targeting sequences

    SciTech Connect

    Gralle, Matthias; Schaefer, Ingo; Seibel, Peter; Paeaebo, Svante

    2010-11-26

    Research highlights: {yields} Two mutations in mitochondrial targeting peptides occurred during human evolution, possibly after Neandertals split off from modern human lineage. {yields} The ancestral and modern human versions of these two targeting peptides were tested functionally for their effects on localization and cleavage rate. {yields} In spite of recent evolution, and to the contrary of other mutations in targeting peptides, these mutations had no visible effects. -- Abstract: Targeting of nuclear-encoded proteins to different organelles, such as mitochondria, is a process that can result in the redeployment of proteins to new intracellular destinations during evolution. With the sequencing of the Neandertal genome, it has become possible to identify amino acid substitutions that occurred on the modern human lineage since its separation from the Neandertal lineage. Here we analyze the function of two substitutions in mitochondrial targeting sequences that occurred and rose to high frequency recently during recent human evolution. The ancestral and modern versions of the two targeting sequences do not differ in the efficiency with which they direct a protein to the mitochondria, an observation compatible with the neutral theory of molecular evolution.

  14. Neandertals' large lower thorax may represent adaptation to high protein diet.

    PubMed

    Ben-Dor, Miki; Gopher, Avi; Barkai, Ran

    2016-07-01

    Humans are limited in their capacity to convert protein into energy. We present a hypothesis that a "bell" shaped thorax and a wide pelvis evolved in Neandertals, at least in part, as an adaptation to a high protein diet. A high protein diet created a need to house an enlarged liver and urinary system in a wider lower trunk. To test the hypothesis, we applied a model developed to identify points of nutritional stress. A ratio of obligatory dietary fat to total animal fat and protein sourced calories is calculated based on various known and estimated parameters. Stress is identified when the obligatory dietary fat ratio is higher than fat content ratios in available prey. The model predicts that during glacial winters, when carbohydrates weren't available, 74%-85% of Neandertals' caloric intake would have had to come from animal fat. Large animals contain around 50% fat calories, and their fat content is diminished during winter, so a significant stressful dietary fat deficit was identified by the model. This deficit could potentially be ameliorated by an increased capability to convert protein into energy. Given that high protein consumption is associated with larger liver and kidneys in animal models, it appears likely that the enlarged inferior section of the Neandertals thorax and possibly, in part, also his wide pelvis, represented an adaptation to provide encasement for those enlarged organs. Behavioral and evolutionary implications of the hypothesis are also discussed. Am J Phys Anthropol 160:367-378, 2016. © 2016 Wiley Periodicals, Inc. PMID:26973080

  15. Brain, calvarium, cladistics: A new approach to an old question, who are modern humans and Neandertals?

    PubMed

    Mounier, Aurélien; Balzeau, Antoine; Caparros, Miguel; Grimaud-Hervé, Dominique

    2016-03-01

    The evolutionary history of the genus Homo is the focus of major research efforts in palaeoanthropology. However, the use of palaeoneurology to infer phylogenies of our genus is rare. Here we use cladistics to test the importance of the brain in differentiating and defining Neandertals and modern humans. The analysis is based on morphological data from the calvarium and endocast of Pleistocene fossils and results in a single most parsimonious cladogram. We demonstrate that the joint use of endocranial and calvarial features with cladistics provides a unique means to understand the evolution of the genus Homo. The main results of this study indicate that: (i) the endocranial features are more phylogenetically informative than the characters from the calvarium; (ii) the specific differentiation of Neandertals and modern humans is mostly supported by well-known calvarial autapomorphies; (iii) the endocranial anatomy of modern humans and Neandertals show strong similarities, which appeared in the fossil record with the last common ancestor of both species; and (iv) apart from encephalisation, human endocranial anatomy changed tremendously during the end of the Middle Pleistocene. This may be linked to major cultural and technological novelties that had happened by the end of the Middle Pleistocene (e.g., expansion of the Middle Stone Age (MSA) in Africa and Mousterian in Europe). The combined study of endocranial and exocranial anatomy offers opportunities to further understand human evolution and the implication for the phylogeny of our genus. PMID:26989014

  16. On the antiquity of language: the reinterpretation of Neandertal linguistic capacities and its consequences

    PubMed Central

    Dediu, Dan; Levinson, Stephen C.

    2013-01-01

    It is usually assumed that modern language is a recent phenomenon, coinciding with the emergence of modern humans themselves. Many assume as well that this is the result of a single, sudden mutation giving rise to the full “modern package.” However, we argue here that recognizably modern language is likely an ancient feature of our genus pre-dating at least the common ancestor of modern humans and Neandertals about half a million years ago. To this end, we adduce a broad range of evidence from linguistics, genetics, paleontology, and archaeology clearly suggesting that Neandertals shared with us something like modern speech and language. This reassessment of the antiquity of modern language, from the usually quoted 50,000–100,000 years to half a million years, has profound consequences for our understanding of our own evolution in general and especially for the sciences of speech and language. As such, it argues against a saltationist scenario for the evolution of language, and toward a gradual process of culture-gene co-evolution extending to the present day. Another consequence is that the present-day linguistic diversity might better reflect the properties of the design space for language and not just the vagaries of history, and could also contain traces of the languages spoken by other human forms such as the Neandertals. PMID:23847571

  17. La Ferrassie 8 Neandertal child reloaded: New remains and re-assessment of the original collection.

    PubMed

    Gómez-Olivencia, Asier; Crevecoeur, Isabelle; Balzeau, Antoine

    2015-05-01

    The first evidence of the partial infant Neandertal skeleton La Ferrassie 8 (LF8) was discovered in 1970, although most of the remains were found in 1973 as part of the 1968-1973 work at the site by H. Delporte. This individual and the other Neandertal children from La Ferrassie were published in the early 1980s by J.-L. Heim, and since then LF8 has been regarded as coming from a poorly documented excavation. The recent rediscovery of the box that contained the hominin bones given by Delporte to Heim in the Muséum national d'Histoire naturelle (MNHN) collection provided new fossils and helped to locate LF8 in the site: level M2 in square 1. Two visits to the Musée d'Archéologie nationale et Domaine national de Saint-Germain-en-Laye (MAN) yielded additional fossil remains from both the 1970 and 1973 excavations and resulted in the discovery of all of the notes from the excavation of H. Delporte between 1968 and 1973. Here the new fossil remains (47 after performing all possible refits), representing significant portions of the cranium, mandible, and vertebral column together with fragmentary hand and costal remains, are described. Unsurprisingly, the morphology of the bony labyrinth and of a complete stapes from the nearly complete left temporal show clear Neandertal affinities. Additionally, a complete reassessment of the original LF8 collection has resulted in the identification of several errors in the anatomical determination. Despite the significant increase in the anatomical representation of LF8, the skeletal remains are still limited to the head, thorax, pelvis, and four hand phalanges, with some very fragile elements relatively well preserved. Different hypotheses are proposed to explain this anatomical representation, which can be tested during future fieldwork. PMID:25805043

  18. Automated Acquisition of Proximal Femur Morphological Characteristics

    NASA Astrophysics Data System (ADS)

    Tabakovic, Slobodan; Zeljkovic, Milan; Milojevic, Zoran

    2014-10-01

    The success of the hip arthroplasty surgery largely depends on the endoprosthesis adjustment to the patient's femur. This implies that the position of the femoral bone in relation to the pelvis is preserved and that the endoprosthesis position ensures its longevity. Dimensions and body shape of the hip joint endoprosthesis and its position after the surgery depend on a number of geometrical parameters of the patient's femur. One of the most suitable methods for determination of these parameters involves 3D reconstruction of femur, based on diagnostic images, and subsequent determination of the required geometric parameters. In this paper, software for automated determination of geometric parameters of the femur is presented. Detailed software development procedure for the purpose of faster and more efficient design of the hip endoprosthesis that ensures patients' specific requirements is also offered

  19. A hominid from the lower Pleistocene of Atapuerca, Spain: possible ancestor to Neandertals and modern humans.

    PubMed

    Bermúdez de Castro, J M; Arsuaga, J L; Carbonell, E; Rosas, A; Martínez, I; Mosquera, M

    1997-05-30

    Human fossil remains recovered from the TD6 level (Aurora stratum) of the lower Pleistocene cave site of Gran Dolina, Sierra de Atapuerca, Spain, exhibit a unique combination of cranial, mandibular, and dental traits and are suggested as a new species of Homo-H. antecessor sp. nov. The fully modern midfacial morphology of the fossils antedates other evidence of this feature by about 650, 000 years. The midfacial and subnasal morphology of modern humans may be a retention of a juvenile pattern that was not yet present in H. ergaster. Homo antecessor may represent the last common ancestor for Neandertals and modern humans. PMID:9162001

  20. Encephalization and allometric trajectories in the genus Homo: Evidence from the Neandertal and modern lineages

    PubMed Central

    Bruner, Emiliano; Manzi, Giorgio; Arsuaga, Juan Luis

    2003-01-01

    The term “encephalization” is commonly used to describe an enlargement in brain size, considered as either absolute endocranial volumes or relative values in relation to body size. It is widely recognized that a considerable endocranial expansion occurred throughout the evolution of the genus Homo. This article aims to evaluate whether this phenomenon was the outcome of distinct evolutionary lineages, reaching similar brain expansions but through different trajectories. Endocranial morphology was studied in a sample of fossil hominines by multivariate approaches using both traditional metrics and geometric morphometrics. The analysis was focused on the transition from a generalized archaic pattern within the genus Homo to the modern morphology and compared with changes that occurred along the Neandertal lineage. The main result was the identification of two different evolutionary trajectories, in which a similar expansion in endocranial size has been reached by different changes in shape. Along the Neandertal lineage we observed maintenance of an “archaic” endocranial model, in which a large amount of variability is based on a single allometric trend. By contrast, when modern endocasts were compared with nonmodern ones, we found important differences apparently led by a parietal expansion. In this light, the origin of our species may have represented the opportunity to surpass the constraints imposed on encephalization by the ontogenetic pattern shared by nonmodern Homo representatives. PMID:14673084

  1. Denisovans, Melanesians, Europeans, and Neandertals: The Confusion of DNA Assumptions and the Biological Species Concept.

    PubMed

    Caldararo, Niccolo

    2016-08-01

    A number of recent articles have appeared on the Denisova fossil remains and attempts to produce DNA sequences from them. One of these recently appeared in Science by Vernot et al. (Science 352:235-239, 2016). We would like to advance an alternative interpretation of the data presented. One concerns the problem of contamination/degradation of the determined DNA sequenced. Just as the publication of the first Neandertal sequence included an interpretation that argued that Neandertals had not contributed any genes to modern humans, the Denisovan interpretation has considerable influence on ideas regarding human evolution. The new papers, however, confuse established ideas concerning the nature of species, as well as the use of terms like premodern, Archaic Homo, and Homo heidelbergensis. Examination of these problems presents a solution by means of reinterpreting the results. Given the claims for gene transfer among a number of Mid Pleistocene hominids, it may be time to reexamine the idea of anagenesis in hominid evolution. PMID:27517578

  2. Symbolic use of marine shells and mineral pigments by Iberian Neandertals

    PubMed Central

    Zilhão, João; Angelucci, Diego E.; Badal-García, Ernestina; d’Errico, Francesco; Daniel, Floréal; Dayet, Laure; Douka, Katerina; Higham, Thomas F. G.; Martínez-Sánchez, María José; Montes-Bernárdez, Ricardo; Murcia-Mascarós, Sonia; Pérez-Sirvent, Carmen; Roldán-García, Clodoaldo; Vanhaeren, Marian; Villaverde, Valentín; Wood, Rachel; Zapata, Josefina

    2010-01-01

    Two sites of the Neandertal-associated Middle Paleolithic of Iberia, dated to as early as approximately 50,000 years ago, yielded perforated and pigment-stained marine shells. At Cueva de los Aviones, three umbo-perforated valves of Acanthocardia and Glycymeris were found alongside lumps of yellow and red colorants, and residues preserved inside a Spondylus shell consist of a red lepidocrocite base mixed with ground, dark red-to-black fragments of hematite and pyrite. A perforated Pecten shell, painted on its external, white side with an orange mix of goethite and hematite, was abandoned after breakage at Cueva Antón, 60 km inland. Comparable early modern human-associated material from Africa and the Near East is widely accepted as evidence for body ornamentation, implying behavioral modernity. The Iberian finds show that European Neandertals were no different from coeval Africans in this regard, countering genetic/cognitive explanations for the emergence of symbolism and strengthening demographic/social ones. PMID:20080653

  3. Handedness in Neandertals from the El Sidrón (Asturias, Spain): Evidence from Instrumental Striations with Ontogenetic Inferences

    PubMed Central

    Estalrrich, Almudena; Rosas, Antonio

    2013-01-01

    The developed cognitive capabilities for Homo sapiens seems to be the result of a specialized and lateralized brain, and as a result of this, humans display the highest degree of manual specialization or handedness among the primates. Studies regarding its emergence and distribution within the genus Homo show that handedness is present very early. The mode in which it was articulated and spread across the different species during the course of human evolution could provide information about our own cognitive capacities. Here we report the manual laterality attributed to eleven 49,000 old Neandertal individuals from El Sidrón cave (Spain), through the study of instrumental or cultural striations on the anterior dentition. Our results show a predominant pattern addressed to right-handers. These results fit within the modern human handedness distribution pattern and provide indirect evidence for behavior and brain lateralization on Neandertals. They support the early establishment of handedness in our genus. Moreover, the individual identified as Juvenile 1 (6–8 years old at death), displays the same striation pattern as the adult Neandertals from the sample, and thereby the ontogenic development of manual laterality in that Neandertal population seems to be similar to that of living modern humans. PMID:23671635

  4. Failure analysis of stainless steel femur fixation plate.

    PubMed

    Hussain, P B; Mohammad, M

    2004-05-01

    Failure analysis was performed to investigate the failure of the femur fixation plate which was previously fixed on the femur of a girl. Radiography, metallography, fractography and mechanical testing were conducted in this study. The results show that the failure was due to the formation of notches on the femur plate. These notches act as stress raisers from where the cracks start to propagate. Finally fracture occurred on the femur plate and subsequently, the plate failed. PMID:15468877

  5. Home-range size in large-bodied carnivores as a model for predicting neandertal territory size.

    PubMed

    Churchill, Steven Emilio; Walker, Christopher Scott; Schwartz, Adam Michael

    2016-05-01

    Adult human foragers expend roughly 30-60 kcal per km in unburdened walking at optimal speeds.(1,2) In the context of foraging rounds and residential moves, they may routinely travel distances of 50-70 km per week, often while carrying loads.(3) Movement on the landscape, then, is arguably the single most expensive item in the activity budgets of hunter-gatherers. Mobility costs may have been greater still for Neandertals. They had stocky, short-limbed physiques that were energetically costly to move(4) and lived in relatively unproductive Pleistocene environments(5) that may have required greater movement to deal with problems of biodepletion and resource patchiness.(6) But just how mobile were the Neandertals? PMID:27312183

  6. Division of labor by sex and age in Neandertals: an approach through the study of activity-related dental wear.

    PubMed

    Estalrrich, Almudena; Rosas, Antonio

    2015-03-01

    The analysis of activity-related dental wear patterns in prehistoric anatomically modern humans and modern hunter-gatherers has shown sex differences attributable to a gendered division of labor. Neandertals are known to have extensive anterior dental wear related to the use of their front teeth as a tool. In this study we analyze the i) cultural striations (scratches on the labial surface of the anterior teeth with a cut-mark morphology), and ii) dental chipping (ante-mortem microfracture involving enamel or both enamel and dentine) in 19 Neandertal individuals from the l'Hortus (France), Spy (Belgium), and El Sidrón (Spain) sites, and compare the characteristics of those traits with the age and sex estimation for the individuals and among samples. The study reveals that all individuals have cultural striations, but those detected on the adult females are longer than the striations found in adult males. Regarding the distribution of dental chipping, the prevalence of this trait is higher in the maxillary dentition of males whereas females have the majority of dental chipping on their mandibular teeth. The differences detected on the overall activity-related dental wear pattern denote a difference or a division of labor by age and sex in Neandertals while using the mouth as a third hand, i.e., in activities other than the provisioning of food, and provide new evidence for the lifestyle of this Pleistocene fossil human species. PMID:25681013

  7. A biomechanical comparison of composite femurs and cadaver femurs used in experiments on operated hip fractures.

    PubMed

    Basso, Trude; Klaksvik, Jomar; Syversen, Unni; Foss, Olav A

    2014-12-18

    Fourth generation composite femurs (4GCFs, models #3406 and #3403) simulate femurs of males <80 years with good bone quality. Since most hip fractures occur in old women with fragile bones, concern is raised regarding the use of standard 4GCFs in biomechanical experiments. In this study the stability of hip fracture fixations in 4GCFs was compared to human cadaver femurs (HCFs) selected to represent patients with hip fractures. Ten 4GCFs (Sawbones, Pacific Research Laboratories, Inc., Vashon, WA, USA) were compared to 24 HCFs from seven females and five males >60 years. Proximal femur anthropometric measurements were noted. Strain gauge rosettes were attached and femurs were mounted in a hip simulator applying a combined subject-specific axial load and torque. Baseline measurements of resistance to deformation were recorded. Standardized femoral neck fractures were surgically stabilized before the constructs were subjected to 20,000 load-cycles. An optical motion tracking system measured relative movements. Median (95% CI) head fragment migration was 0.8mm (0.4 to 1.1) in the 4GCF group versus 2.2mm (1.5 to 4.6) in the cadaver group (p=0.001). This difference in fracture stability could not be explained by observed differences in femoral anthropometry or potential overloading of 4GCFs. 4GCFs failed with fracture-patterns different from those observed in cadavers. To conclude, standard 4GCFs provide unrealistically stable bone-implant constructs and fail with fractures not observed in cadavers. Until a validated osteopenic or osteoporotic composite femur model is provided, standard 4GCFs should only be used when representing the biomechanical properties of young healthy femurs. PMID:25468304

  8. Treatment Options for Distal Femur Fractures.

    PubMed

    von Keudell, Arvind; Shoji, Kristin; Nasr, Michael; Lucas, Robert; Dolan, Robert; Weaver, Michael J

    2016-08-01

    Despite advances in implant design, the management of distal femur fractures remains challenging. Fracture comminution and intra-articular extension can make it difficult to obtain an adequate reduction while preserving the soft tissue attachments to bone fragments to allow for bone healing. Many implant manufacturers have developed optimal anatomically contoured, distal femoral locking plates with percutaneous guides. This environment allows for the application of lateral locked plates in a biologically friendly manner. Although initial reports had high success rates, more recently a high rate of nonunion has been found, particularly in elderly patients. Limited literature is available for the treatment of patients with osteoporotic bone and associated ipsilateral total knee replacement and hip replacement. We present a patient with a distal femur fracture with significant comminution in the setting of an ipsilateral total hip replacement. PMID:27441931

  9. First direct dating of a presumed Pleistocene hominid from China: AMS radiocarbon age of a femur from the Ordos Plateau.

    PubMed

    Keates, Susan G; Hodgins, Gregory W L; Kuzmin, Yaroslav V; Orlova, Lyobov A

    2007-07-01

    Human remains from the Xarusgol Valley, Ordos Plateau, northwestern China, have been considered to date to the Late Pleistocene. In order to ascertain their true age, direct AMS (14)C dating of a femur collected in the early 1920s was conducted. The results demonstrate that the femur is very young, with one sample of 'post-bomb' age and the other sample c. 200 years old. This first direct dating of a Chinese fossil hominid underscores the need to apply the same methodology to other Chinese modern human fossils currently believed to be of Pleistocene age. PMID:17490725

  10. The shape of the distal femur: a palaeopathological comparison of eburnated and non-eburnated femora

    PubMed Central

    Shepstone, L.; Rogers, J.; Kirwan, J.; Silverman, B.

    1999-01-01

    OBJECTIVES—To determine the difference in shape of the distal femur, viewed axially in two dimensions, between eburnated and non-eburnated femora.
METHODS—A comparison of 52 non-eburnated and 16 eburnated femora drawn from a large archeological skeletal population. Eburnation was taken to indicate late stage osteoarthritis. Shape variability, based on landmarks, was quantified using a principal components analysis after a Procrustes alignment.
RESULTS—A statistically significant difference was found between the two groups. This was with respect to the patellar groove and the shape of the medial condyle. The latter difference is consistent with bone remodelling as a knee stabilising mechanism.
CONCLUSIONS—Anatomical shape can be quantified using an uncomplicated statistical technique. It was used to quantify the shape of the distal femur and demonstrate shape differences associated with osteoarthritis of the knee.

 Keywords: osteoarthritis; knee; bone remodelling PMID:10343520

  11. [Long-term results of compression-osteosynthesis with three AO-screws for spongiosa in fractures of the femur-neck (author's transl)].

    PubMed

    Penschuck, C; Zilch, H; Brenner, M

    1982-02-01

    Between 1969 and 1978 in 42 patients fractures of the femur-neck were treated with three AO-screws for spongiosa (screws with a short thread). Late results in these patients are reported. The interval between operation and follow-up was in average 90 months. In no case pseudarthrosis had developed; the rate of necrosis of the femur head was 23.8%. The method is suitable in selected cases of medial fractures of the femur-neck, type I and II, and in lateral fractures, preferably in younger patients. The results in fractures of type III according to Pauwels show, that in advanced age these fractures should be treated with a partial or total prosthesis, because the rate of necrosis of the femur-head cannot be lowered. PMID:7072000

  12. Metastatic disease of the proximal femur.

    PubMed

    Faisham, W I; Zulmi, W; Biswal, B M

    2003-03-01

    Since January 1999, ten patients had undergone surgical treatment for metastatic bony lesions of proximal femur at this centre. Seven of these patients were treated for complete pathological fractures, one for impending fracture and one for revision of internal fixation and loosening of hemiarthroplasty. Primary malignancies were located in breast in four cases, prostate in three and one in lung, thyroid and neurofibrosarcoma. Two patients had died within six months after surgery, four after 1 year while the remaining four were still alive. The mean duration of survival was eleven months. Nine patients had been ambulating pain free and there were no failure of reconstruction. PMID:14556337

  13. Adult Neandertal clavicles from the El Sidrón site (Asturias, Spain) in the context of Homo pectoral girdle evolution.

    PubMed

    Rosas, Antonio; Rodriguez-Perez, Francisco Javier; Bastir, Markus; Estalrrich, Almudena; Huguet, Rosa; García-Tabernero, Antonio; Pastor, Juan Francisco; de la Rasilla, Marco

    2016-06-01

    We undertook a three-dimensional geometric morphometric (3DGM) analysis on 12 new Neandertal clavicle specimens from the El Sidrón site (Spain), dated to 49,000 years ago. The 3DGM methods were applied in a comparative framework in order to improve our understanding of trait polarity in features related to Homo pectoral girdle evolution, using other Neandertals, Homo sapiens, Pan, ATD6-50 (Homo antecessor), and KNM-WT 15000 (Homo ergaster/erectus) in the reference collection. Twenty-nine homologous landmarks were measured for each clavicle. Variation and morphological similarities were assessed through principal component analysis, conducted separately for the complete clavicle and the diaphysis. On average, Neandertal clavicles had significantly larger muscular entheses, double dorsal curvature, clavicle torsion, and cranial orientation of the acromial end than non-Neandertal clavicles; the El Sidrón clavicles fit this pattern. Variation within the samples was large, with extensive overlap between Homo species; only chimpanzee specimens clearly differed from the other specimens in morphometric terms. Taken together, our morphometric analyses are consistent with the following phylogenetic sequence. The primitive condition of the clavicle is manifest in the cranial orientation of both the acromial and sternal ends. The derived condition expressed in the H. sapiens + Neandertal clade is defined by caudal rotation of both the sternal and acromial ends, but with variation in the number of acromia remaining in a certain cranial orientation. Finally, the autapomorphic Neandertal condition is defined by secondarily acquired primitive cranial re-orientation of the acromial end, which varies from individual to individual. These results suggest that the pace of phylogenetic change in the pectoral girdle does not seem to follow that of other postcranial skeletal features. PMID:27260174

  14. The Pech-de-l'Azé I Neandertal child: ESR, uranium-series, and AMS 14C dating of its MTA type B context.

    PubMed

    Soressi, M; Jones, H L; Rink, W J; Maureille, B; Tillier, A-M

    2007-04-01

    The Pech-de-l'Azé I skull and mandible are included in the juvenile Neandertal remains from Europe. However, some preserved features in the cranial skeleton seem to distinguish the specimen from other Neandertal children. Unfortunately, the stratigraphic position and dating of this child has never been clear. Our recent work on unpublished archives show that the Pech-de-l'Azé I Neandertal child was discovered at the bottom of layer 6, attributed to the Mousterian of Acheulean tradition type B. These skull and mandible are the first diagnostic human remains (aside from an isolated tooth) attributed to the Mousterian of Acheulian tradition (MTA) type B. Consequently, we confirm that Neandertals were the makers of this Mousterian industry, which is characterized by unusual high frequencies of Upper Paleolithic type tools, elongated blanks and blades. We were able to date the context of the hominid remains by dating layer 6 and the layers above and beneath it using ESR, coupled ESR/(230)Th/(234)U (coupled ESR/U-series), and AMS (14)C. Coupled ESR/U-series results on 16 mammalian teeth constrain the age of the uppermost layer 7 to 41-58ka, and layer 6 to 37-51ka. The wide spread in each age estimate results mainly from uncertainties in the gamma-dose rate. These ages are concordant with AMS (14)C ages of two bones coming from the top of layer 6, which provide dates of about 41.7-43.6ka cal BP. A combination of stratigraphic arguments and dating results for layers 6 and 7 show that the Neandertal child cannot be older than 51ka or younger than 41ka. The lowermost layer 4 is shown to be older than 43ka by the principle of superposition and ESR dating in the immediately overlying layer 5. This study shows that the MTA type B had been manufactured by Neandertals before the arrival of anatomically modern humans in the local region. Additionally, by providing a firm chronological framework for the specific morphometric the features of Pech-de-l'Azé I Neandertal child, this

  15. Mechanical validation of whole bone composite femur models.

    PubMed

    Cristofolini, L; Viceconti, M; Cappello, A; Toni, A

    1996-04-01

    Composite synthetic models of the human femur have recently become commercially available as substitutes for cadaveric specimens. Their quick diffusion was justified by the advantages they offer as a substitute for real femurs. The present investigation concentrated on an extensive experimental validation of the mechanical behaviour of the whole bone composite model, compared to human fresh-frozen and dried-rehydrated specimens for different loading conditions. First, the viscoelastic behaviour of the models was investigated under simulated single leg stance loading, showing that the little time dependent phenomena observed tend to extinguish within a few minutes of the load application. The behaviour under axial loading was then studied by comparing the vertical displacement of the head as well as the axial strains, by application of a parametric descriptive model of the strain distribution. Finally, a four point bending test and a torsional test were performed to characterize the whole bone stiffness of the femur. In all these tests, the composite femurs were shown to fall well within the range for cadaveric specimens, with no significant differences being detected between the synthetic femurs and the two groups of cadaveric femurs. Moreover, the interfemur variability for the composite femurs was 20-200 times lower than that for the cadaveric specimens, thus allowing smaller differences to be characterized as significant using the same simple size, if the composite femurs are employed. PMID:8964782

  16. Femur Model Reconstruction Based on Reverse Engineering and Rapid Prototyping

    NASA Astrophysics Data System (ADS)

    Tang, Tongming; Zhang, Zheng; Ni, Hongjun; Deng, Jiawen; Huang, Mingyu

    Precise reconstruction of 3D models is fundamental and crucial to the researches of human femur. In this paper we present our approach towards tackling this problem. The surface of a human femur was scanned using a hand-held 3D laser scanner. The data obtained, in the form of point cloud, was then processed using the reverse engineering software Geomagic and the CAD/CAM software CimatronE to reconstruct a digital 3D model. The digital model was then used by the rapid prototyping machine to build a physical model of human femur using 3D printing. The geometric characteristics of the obtained physical model matched that of the original femur. The process of "physical object - 3D data - digital 3D model - physical model" presented in this paper provides a foundation of precise modeling for the digital manufacturing, virtual assembly, stress analysis, and simulated surgery of artificial bionic femurs.

  17. Direct radiocarbon dates for Vindija G1 and Velika Pećina Late Pleistocene hominid remains

    PubMed Central

    Smith, Fred H.; Trinkaus, Erik; Pettitt, Paul B.; Karavanić, Ivor; Paunović, Maja

    1999-01-01

    New accelerator mass spectrometry radiocarbon dates taken directly on human remains from the Late Pleistocene sites of Vindija and Velika Pećina in the Hrvatsko Zagorje of Croatia are presented. Hominid specimens from both sites have played critical roles in the development of current perspectives on modern human evolutionary emergence in Europe. Dates of ≈28 thousand years (ka) before the present (B.P.) and ≈29 ka B.P. for two specimens from Vindija G1 establish them as the most recent dated Neandertals in the Eurasian range of these archaic humans. The human frontal bone from Velika Pećina, generally considered one of the earliest representatives of modern humans in Europe, dated to ≈5 ka B.P., rendering it no longer pertinent to discussions of modern human origins. Apart from invalidating the only radiometrically based example of temporal overlap between late Neandertal and early modern human fossil remains from within any region of Europe, these dates raise the question of when early modern humans first dispersed into Europe and have implications for the nature and geographic patterning of biological and cultural interactions between these populations and the Neandertals. PMID:10535913

  18. Analysis of Aurignacian interstratification at the Châtelperronian-type site and implications for the behavioral modernity of Neandertals

    PubMed Central

    Zilhão, João; d’Errico, Francesco; Bordes, Jean-Guillaume; Lenoble, Arnaud; Texier, Jean-Pierre; Rigaud, Jean-Philippe

    2006-01-01

    The Châtelperronian is a Neandertal-associated archeological culture featuring ornaments and decorated bone tools. It is often suggested that such symbolic items do not imply that Neandertals had modern cognition and stand instead for influences received from coeval, nearby early modern humans represented by the Aurignacian culture, whose precocity would be proven by stratigraphy and radiocarbon dates. The Grotte des Fées at Châtelperron (France) is the remaining case of such a potential Châtelperronian–Aurignacian contemporaneity, but reanalysis shows that its stratification is poor and unclear, the bone assemblage is carnivore-accumulated, the putative interstratified Aurignacian lens in level B4 is made up for the most part of Châtelperronian material, the upper part of the sequence is entirely disturbed, and the few Aurignacian items in levels B4-5 represent isolated intrusions into otherwise in situ Châtelperronian deposits. As elsewhere in southwestern Europe, this evidence confirms that the Aurignacian postdates the Châtelperronian and that the latter’s cultural innovations are better explained as the Neandertals’ independent development of behavioral modernity. PMID:16894152

  19. Possible Further Evidence of Low Genetic Diversity in the El Sidrón (Asturias, Spain) Neandertal Group: Congenital Clefts of the Atlas

    PubMed Central

    Ríos, Luis; Rosas, Antonio; Estalrrich, Almudena; García-Tabernero, Antonio; Bastir, Markus; Huguet, Rosa; Pastor, Francisco; Sanchís-Gimeno, Juan Alberto; de la Rasilla, Marco

    2015-01-01

    We present here the first cases in Neandertals of congenital clefts of the arch of the atlas. Two atlases from El Sidrón, northern Spain, present respectively a defect of the posterior (frequency in extant modern human populations ranging from 0.73% to 3.84%), and anterior (frequency in extant modern human populations ranging from 0.087% to 0.1%) arch, a condition in most cases not associated with any clinical manifestation. The fact that two out of three observable atlases present a low frequency congenital condition, together with previously reported evidence of retained deciduous mandibular canine in two out of ten dentitions from El Sidrón, supports the previous observation based on genetic evidence that these Neandertals constituted a group with close genetic relations. Some have proposed for humans and other species that the presence of skeletal congenital conditions, although without clinical significance, could be used as a signal of endogamy or inbreeding. In the present case this interpretation would fit the general scenario of high incidence of rare conditions among Pleistocene humans and the specific scenariothat emerges from Neandertal paleogenetics, which points to long-term small and decreasing population size with reduced and isolated groups. Adverse environmental factors affecting early pregnancies would constitute an alternative, non-exclusive, explanation for a high incidence of congenital conditions. Further support or rejection of these interpretations will come from new genetic and skeletal evidence from Neandertal remains. PMID:26418427

  20. Possible Further Evidence of Low Genetic Diversity in the El Sidrón (Asturias, Spain) Neandertal Group: Congenital Clefts of the Atlas.

    PubMed

    Ríos, Luis; Rosas, Antonio; Estalrrich, Almudena; García-Tabernero, Antonio; Bastir, Markus; Huguet, Rosa; Pastor, Francisco; Sanchís-Gimeno, Juan Alberto; de la Rasilla, Marco

    2015-01-01

    We present here the first cases in Neandertals of congenital clefts of the arch of the atlas. Two atlases from El Sidrón, northern Spain, present respectively a defect of the posterior (frequency in extant modern human populations ranging from 0.73% to 3.84%), and anterior (frequency in extant modern human populations ranging from 0.087% to 0.1%) arch, a condition in most cases not associated with any clinical manifestation. The fact that two out of three observable atlases present a low frequency congenital condition, together with previously reported evidence of retained deciduous mandibular canine in two out of ten dentitions from El Sidrón, supports the previous observation based on genetic evidence that these Neandertals constituted a group with close genetic relations. Some have proposed for humans and other species that the presence of skeletal congenital conditions, although without clinical significance, could be used as a signal of endogamy or inbreeding. In the present case this interpretation would fit the general scenario of high incidence of rare conditions among Pleistocene humans and the specific scenariothat emerges from Neandertal paleogenetics, which points to long-term small and decreasing population size with reduced and isolated groups. Adverse environmental factors affecting early pregnancies would constitute an alternative, non-exclusive, explanation for a high incidence of congenital conditions. Further support or rejection of these interpretations will come from new genetic and skeletal evidence from Neandertal remains. PMID:26418427

  1. Biomechanics of femur fractures secondary to gunshot wounds.

    PubMed

    Smith, H W; Wheatley, K K

    1984-11-01

    Nonlethal gunshot wounds to the femur produce four classical types of fractures. The 'drill-hole,' incomplete, and 'butterfly' fractures have been described in both clinical and experimental settings. The remote spiral fracture, sometimes attributed to the fall on the femur after wounding, is unique to the weight-loaded femur. A mathematical model relying on the beam in bending and the mechanics of a cylindrical shell is offered. An experimental method utilizing an apparatus (the 'osteoclast') designed to apply torsion, bending, or combined forces to cadaveric long bones is discussed. Femur failure proximal or distal to the impact site of a projectile is a function of stress risers operating at relatively great distances. Predictable primary and secondary peak moment locations for fracture are illustrated. PMID:6502770

  2. Comparison of skull and femur lead levels in adult rats

    SciTech Connect

    Denton, J.E.; Potter, G.D.; Santolucito, J.A.

    1980-12-01

    The purpose of the study was to elucidate the relationship between skull and femur lead levels in laboratory rats. Forty-eight female rats were given one of four lead chloride drinking water solutions: 0.05, 0.58, 17, or 352 ppM lead. Two animals from each group were sacrificed after 3, 6, 9, 12, 15, and 24 weeks of treatment. Both femurs and the frontal and parietal bones of the skull were removed from each animal and analyzed for lead concentration by atomic absorption spectroscopy. A significant accumulation of lead was observed in femurs and skull bones only from animals in the 352 ppM lead treatment group. The lead concentrations of the femurs were significantly higher than skull lead concentrations for all groups and this relationship was described using a linear regression equation.

  3. Sclerosing osteomyelitis as a complication of pediatric femur fracture fixation.

    PubMed

    Mooney, James F

    2014-11-01

    Complications of flexible nailing of pediatric femur fractures include angular and rotational malunions, leg-length discrepancy, and, in rare instances, infection. To our knowledge, the development of a sclerosing type of chronic osteomyelitis, which appears most similar to chronic sclerosing osteomyelitis of Garre', has not been reported as a complication of, or associated with, flexible nail fixation of a pediatric femur fracture. PMID:25171570

  4. Size variation in early human mandibles and molars from Klasies River, South Africa: comparison with other middle and late Pleistocene assemblages and with modern humans.

    PubMed

    Royer, Danielle F; Lockwood, Charles A; Scott, Jeremiah E; Grine, Frederick E

    2009-10-01

    Previous studies of the Middle Stone Age human remains from Klasies River have concluded that they exhibited more sexual dimorphism than extant populations, but these claims have not been assessed statistically. We evaluate these claims by comparing size variation in the best-represented elements at the site, namely the mandibular corpora and M(2)s, to that in samples from three recent human populations using resampling methods. We also examine size variation in these same elements from seven additional middle and late Pleistocene sites: Skhūl, Dolní Vestonice, Sima de los Huesos, Arago, Krapina, Shanidar, and Vindija. Our results demonstrate that size variation in the Klasies assemblage was greater than in recent humans, consistent with arguments that the Klasies people were more dimorphic than living humans. Variation in the Skhūl, Dolní Vestonice, and Sima de los Huesos mandibular samples is also higher than in the recent human samples, indicating that the Klasies sample was not unusual among middle and late Pleistocene hominins. In contrast, the Neandertal samples (Krapina, Shanidar, and Vindija) do not evince relatively high mandibular and molar variation, which may indicate that the level of dimorphism in Neandertals was similar to that observed in extant humans. These results suggest that the reduced levels of dimorphism in Neandertals and living humans may have developed independently, though larger fossil samples are needed to test this hypothesis. PMID:19382177

  5. Effect of Pentoxifylline Administration on an Experimental Rat Model of Femur Fracture Healing With Intramedullary Fixation

    PubMed Central

    Vashghani Farahani, Mohammad Mahdi; Masteri Farahani, Reza; Mostafavinia, Ataroalsadat; Abbasian, Mohammad Reza; Pouriran, Ramin; Noruzian, Mohammad; Ghoreishi, Seyed Kamran; Aryan, Arefe; Bayat, Mohammad

    2015-01-01

    Background: Globally, musculoskeletal injuries comprise a major public health problem that contributes to a large burden of disability and suffering. Pentoxifylline (PTX) has been originally used as a hemorheologic drug to treat intermittent claudication. Previous test tube and in vivo studies reported the beneficial effects of PTX on bony tissue. Objectives: This study aims to evaluate the effects of different dosages of PTX on biomechanical properties that occur during the late phase of the fracture healing process following a complete femoral osteotomy in a rat model. We applied intramedullary pin fixation as the treatment of choice. Materials and Methods: This experimental study was conducted at the Shahid Beheshti University of Medical Sciences, Tehran, Iran. We used the simple random technique to divide 35 female rats into five groups. Group 1 received intraperitoneal (i.p.) PTX (50 mg/kg, once daily) injections, starting 15 days before surgery, and group 2, group 3, and group 4 received 50 mg/kg, 100 mg/kg, and 200 mg/kg i.p. PTX injections, respectively, once daily after surgery. All animals across groups received treatment for six weeks (until sacrificed). Complete surgical transverse osteotomy was performed in the right femur of all rats. At six weeks after surgery, the femurs were subjected to a three-point bending test. Results: Daily administration of 50 mg/kg PTX (groups 1 and 2) decreased the high stress load in repairing osteotomized femurs when compared with the control group. The highest dose of PTX (200 mg/kg) significantly increased the high stress load when compared with the control group (P = 0.030), group 1 (P = 0.023), group 2 (P = 0.008), and group 3 (P = 0.010), per the LSD findings. Conclusions: Treatment with 200 mg/kg PTX accelerated fracture healing when compared with the control group. PMID:26756019

  6. Geometric morphometric analysis reveals sexual dimorphism in the distal femur.

    PubMed

    Cavaignac, Etienne; Savall, Frederic; Faruch, Marie; Reina, Nicolas; Chiron, Philippe; Telmon, Norbert

    2016-02-01

    An individual's sex can be determined by the shape of their distal femur. The goal of this study was to show that differences in distal femur shape related to sexual dimorphism could be identified, visualized, and quantified using 3D geometric morphometric analysis. Geometric morphometric analysis was carried out on CT scans of the distal femur of 256 subjects living in the south of France. Ten landmarks were defined on 3D reconstructions of the distal femur. Both traditional metric and geometric morphometric analyses were carried out on these bone reconstructions; these analyses identified trends in bone shape in sex-based subgroups. Sex-related differences in shape were statistically significant. The subject's sex was correctly assigned in 77.3% of cases using geometric morphometric analysis. This study has shown that geometric morphometric analysis of the distal femur is feasible and has revealed sexual dimorphism differences in this bone segment. This reliable, accurate method could be used for virtual autopsy and be used to perform diachronic and interethnic comparisons. Moreover, this study provides updated morphometric data for a modern population in the south of France. PMID:26743712

  7. SIFT algorithm-based 3D pose estimation of femur.

    PubMed

    Zhang, Xuehe; Zhu, Yanhe; Li, Changle; Zhao, Jie; Li, Ge

    2014-01-01

    To address the lack of 3D space information in the digital radiography of a patient femur, a pose estimation method based on 2D-3D rigid registration is proposed in this study. The method uses two digital radiography images to realize the preoperative 3D visualization of a fractured femur. Compared with the pure Digital Radiography or Computed Tomography imaging diagnostic methods, the proposed method has the advantages of low cost, high precision, and minimal harmful radiation. First, stable matching point pairs in the frontal and lateral images of the patient femur and the universal femur are obtained by using the Scale Invariant Feature Transform method. Then, the 3D pose estimation registration parameters of the femur are calculated by using the Iterative Closest Point (ICP) algorithm. Finally, based on the deviation between the six degrees freedom parameter calculated by the proposed method, preset posture parameters are calculated to evaluate registration accuracy. After registration, the rotation error is less than l.5°, and the translation error is less than 1.2 mm, which indicate that the proposed method has high precision and robustness. The proposed method provides 3D image information for effective preoperative orthopedic diagnosis and surgery planning. PMID:25226990

  8. Periprosthetic Femur Fracture Occuring after Contralateral Neglected Femoral Neck Fracture

    PubMed Central

    Cankaya, Deniz; Toprak, Ali; IKilic, Enver; Bingol, Olgun; Tabak, Yalcin

    2016-01-01

    Introduction: Periprosthetic fractures of the femur are uncommon, but at times may lead to complications especially in elderly patients. As treatment of these fractures is difficult, prevention by identifying the risk factors is the best way to overcome these complex problems. Case Report: A periprosthetic right femur fracture associated with a neglected left femoral neck fracture in the contralateral femur in a 78-year-old elder woman patient is reported in the present article. We discuss the prevention of periprosthetic fractures after hip arthroplasty and address the risk factors associated with this complication. Conclusion: The present case emphasizes the importance of investigating and treating the cause of sudden onset of restriction on full weight-bearing in the contralateral limb, to prevent periprosthetic femoral fracture after hip arthroplasty in elderly patients. PMID:27299115

  9. Fracture of Human Femur Tissue Monitored by Acoustic Emission Sensors

    PubMed Central

    Aggelis, Dimitrios. G.; Strantza, Maria; Louis, Olivia; Boulpaep, Frans; Polyzos, Demosthenes; van Hemelrijck, Danny

    2015-01-01

    The study describes the acoustic emission (AE) activity during human femur tissue fracture. The specimens were fractured in a bending-torsion loading pattern with concurrent monitoring by two AE sensors. The number of recorded signals correlates well with the applied load providing the onset of micro-fracture at approximately one sixth of the maximum load. Furthermore, waveform frequency content and rise time are related to the different modes of fracture (bending of femur neck or torsion of diaphysis). The importance of the study lies mainly in two disciplines. One is that, although femurs are typically subjects of surgical repair in humans, detailed monitoring of the fracture with AE will enrich the understanding of the process in ways that cannot be achieved using only the mechanical data. Additionally, from the point of view of monitoring techniques, applying sensors used for engineering materials and interpreting the obtained data pose additional difficulties due to the uniqueness of the bone structure. PMID:25763648

  10. Femur Fractures in Professional Athletes: A Case Series

    PubMed Central

    Sikka, Robby; Fetzer, Gary; Hunkele, Thomas; Sugarman, Eric; Boyd, Joel

    2015-01-01

    Objective: To discuss return to play after femur fractures in several professional athletes. Background: Femur fractures are rare injuries and can be associated with significant morbidity and mortality. No reports exist, to our knowledge, on return to play after treatment of isolated femur fractures in professional athletes. Return to play is expected in patients with femur fractures, but recovery can take more than 1 year, with an expected decrease in performance. Treatment: Four professional athletes sustained isolated femur fractures during regular-season games. Two athletes played hockey, 1 played football, and 1 played baseball. Three players were treated with anterograde intramedullary nails, and 1 was treated with retrograde nailing. All players missed the remainder of the season. At an average of 9.5 months (range, 7–13 months) from the time of injury, all athletes were able to return to play. One player required the removal of painful hardware, which delayed his return to sport. Final radiographs revealed that all fractures were well healed. No athletes had subjective complaints or concerns that performance was affected by the injury at an average final follow-up of 25 months (range, 22–29 months). Uniqueness: As the size and speed of players increase, on-field trauma may result in significant injury. All players returned to previous levels of performance or exceeded previous statistical performance levels. Conclusions: In professional athletes, return to play from isolated femur fractures treated with either an anterograde or retrograde intramedullary nail is possible within 1 year. Return to the previous level of performance is possible, and it is important to develop management protocols, including rehabilitation guidelines, for such injuries. However, return to play may be delayed by subsequent procedures, including hardware removal. PMID:25680071

  11. Assessment of femur geometrical parameters using EOS™ imaging technology in patients with atypical femur fractures; preliminary results.

    PubMed

    Morin, Suzanne N; Wall, Michelle; Belzile, Etienne L; Godbout, Benoit; Moser, Thomas P; Michou, Laëtitia; Ste-Marie, Louis-Georges; de Guise, Jacques A; Rahme, Elham; Brown, Jacques P

    2016-02-01

    Atypical femur fractures (AFF) arise in the subtrochanteric and diaphyseal regions. Because of this unique distribution, we hypothesized that patients with AFF demonstrate specific geometrical variations of their lower limb whereby baseline tensile forces applied to the lateral cortex are higher and might favor the appearance of these rare stress fractures, when exposed to bisphosphonates. Using the low irradiation 2D-3D X-ray scanner EOS™ imaging technology we aimed to characterize and compare femur geometric parameters between women who sustained bisphosphonate-associated AFF and those who had experienced similar duration of exposure to bisphosphonates but did not sustain fractures. Conditional logistic regression models were constructed to estimate the association between selected geometric parameters and the occurrence of AFF. We identified 16 Caucasian women with AFF and recruited 16 ethnicity-, sex-, age-, height- and cumulative bisphosphonate exposure-matched controls from local osteoporosis clinics. Compared to controls, those with AFF had more lateral femur bowing (-3.2° SD [3.4] versus -0.8° SD [1.9] p=0.02). In regression analysis, lateral femur bowing was associated with the risk of AFF (aOR 1.54; 95% CI 1.04-2.28, p=0.03). Women who sustained a subtrochanteric AFF demonstrated a lesser femoral neck shaft angle (varus geometry) than those with a fracture at a diaphyseal site (121.9 [3.6]° versus 127.6 [7.2]°, p=0.07), whereas femur bowing was more prominent in those with a diaphyseal fracture compared to those with a subtrochanteric fracture (-4.3 [3.2]° versus -0.9 [2.7]°, p=0.07). Our analyses support that subjects with AFF exhibit femoral geometry parameters that result in higher tensile mechanical load on the lateral femur. This may play a critical role in the pathogenesis of AFF and requires further evaluation in a larger size population. PMID:26541215

  12. Effect of fixation devices on radiostrontium clearance in the intact canine femur

    SciTech Connect

    Daum, W.J.; Simmons, D.J.; Chang, S.L.; Lehman, R.C.; Webster, D.

    1985-04-01

    Femoral metaphyseal/diaphyseal blood flow was studied by /sup 85/Sr clearance in unfractured segments of dog femurs following compression plating and various control procedures (drilling with and without application of screws). The animals were tested as early as seven days and as late as two months after surgery. The only statistically significant change in strontium clearance (SrC) was an increase produced by the application of stainless-steel bone screws, with or without plates. The presence or absence of compression had no consistent effect on changes in the rate of SrC. During the period of study, no changes in bone mineralization, haversian porosity, or cortical bone thickness accompanied the SrC alterations.

  13. [Multidimensional corrective osteotomy of the proximal femur using the gamma-nail].

    PubMed

    Moeller, K; Wich, M; Letsch, R

    1998-04-01

    We report on a 57-year-old patient suffering from a complex malposition of proximal femur after osteosynthesis using a condylar plate. For polyaxial correction of the proximal femur we successfully used an intramedullary hip screw system. PMID:9613218

  14. Automatic detection and measurement of femur length from fetal ultrasonography

    NASA Astrophysics Data System (ADS)

    Mukherjee, Prateep; Swamy, Gokul; Gupta, Madhumita; Patil, Uday; Krishnan, Kajoli Banerjee

    2010-03-01

    Femur bone length is used in the assessment of fetal development and in the prediction of gestational age (GA). In this paper, we present a completely automated two-step method for identifying fetal femur and measuring its length from 2D ultrasound images. The detection algorithm uses a normalized score premised on the distribution of anatomical shape, size and presentation of the femur bone in clinically acceptable scans. The measurement process utilizes a polynomial curve fitting technique to determine the end-points of the bone from a 1D profile that is most distal from the transducer surface. The method has been tested with manual measurements made on 90 third trimester femur images by two radiologists. The measurements made by the experts are strongly correlated (Pearson's coefficient = 0.95). Likewise, the algorithm estimate is strongly correlated with expert measurements (Pearson's coefficient = 0.92 and 0.94). Based on GA estimates and their bounds specified in Standard Obstetric Tables, the GA predictions from automated measurements are found to be within +/-2SD of GA estimates from both manual measurements in 89/90 cases and within +/-3SD in all 90 cases. The method presented in this paper can be adapted to perform automatic measurement of other fetal limbs.

  15. Human species and mating systems: Neandertal-Homo sapiens reproductive isolation and the archaeological and fossil records.

    PubMed

    Overmann, Karenleigh; Coolidge, Frederick

    2013-01-01

    The present paper examined the assumption of strong reproductive isolation (RI) between Homo neanderthalensis and Homo sapiens, as well as the question of what form it might have taken, using insights from the parallel case of chimpanzee–bonobo hybridization. RI from hybrid sterility or inviability was thought unlikely based on the short separation-to-introgression timeline. The forms of RI that typically develop in primates have relatively short timelines (especially for partial implementation); they generally preclude mating or influence hybrid survival and reproduction in certain contexts, and they have the potential to skew introgression directionality. These RI barriers are also consistent with some interpretations of the archaeological and fossil records, especially when behavioral, cognitive, morphological, and genetic differences between the two human species are taken into consideration. Differences potentially influencing patterns of survival and reproduction include interspecies violence, Neandertal xenophobia, provisioning behavior, and ontogenetic, morphological, and behavioral differences affecting matters such as kin and mate recognition, infanticide, and sexual selection. These factors may have skewed the occurrence of interbreeding or the survival and reproduction of hybrids in a way that might at least partially explain the pattern of introgression. PMID:24344097

  16. Human proximal femur bone adaptation to variations in hip geometry.

    PubMed

    Machado, M M; Fernandes, P R; Zymbal, V; Baptista, F

    2014-10-01

    The study of bone mass distribution at proximal femur may contribute to understand the role of hip geometry on hip fracture risk. We examined how bone mineral density (BMD) of proximal femur adapts to inter individual variations in the femoral neck length (FNL), femoral neck width (FNW) and neck shaft angle (NSA). A parameterized and dimensionally scalable 3-D finite element model of a reference proximal femur geometry was incrementally adjusted to adopt physiological ranges at FNL (3.90-6.90cm), FNW (2.90-3.46cm), and NSA (109-141º), yielding a set of femora with different geometries. The bone mass distribution for each femur was obtained with a suitable bone remodelling model. The BMDs at the integral femoral neck (FN) and at the intertrochanteric (ITR) region, as well as the BMD ratio of inferomedial to superolateral (IM:SL) regions of FN and BMD ratio of FN:ITR were used to represent bone mass distribution. Results revealed that longer FNLs present greater BMD (g/cm(3)) at the FN, mainly at the SL region, and at the ITR region. Wider FNs were associated with reduced BMD at the FN, particularly at the SL region, and at the ITR region. Larger NSAs up to 129° were associated with BMD diminutions at the FN and ITR regions and with increases of the IM:SL BMD ratio while NSAs larger than 129° resulted in decrease of the IM:SL BMD ratio. These findings suggest hip geometry as moderator of the mechanical loading influence on bone mass distribution at proximal femur with higher FNL favoring the BMD of FN and ITR regions and greater FNW and NSA having the opposite effect. Augmented values of FNL and FNW seem also to favor more the BMD at the superolateral than at the inferomedial FN region. PMID:25016094

  17. The Odocoileus virginianus Femur: Mechanical Behavior and Morphology

    PubMed Central

    Corbiere, Nicole C.; Ciani, Mario J.; Kuxhaus, Laurel

    2016-01-01

    Biomechanical research relies heavily on laboratory evaluation and testing with osseous animal structures. While many femora models are currently in use, including those of the European red deer (Cervus elaphus), the Odocoileus virginianus femur remains undocumented, despite its regional abundance in North America. The objective of this study was to compare biomechanical and morphological properties of the Odocoileus virginianus femur with those of the human and commonly used animal models. Sixteen pairs of fresh-frozen cervine femora (10 male, 6 female, aged 2.1 ± 0.9 years) were used for this study. Axial and torsional stiffnesses (whole bone) were calculated following compression and torsion to failure tests (at rates of 0.1 mm/sec and 0.2°/sec). Lengths, angles, femoral head diameter and position, periosteal and endosteal diaphyseal dimensions, and condylar dimensions were measured. The results show that the cervine femur is closer in length, axial and torsional stiffness, torsional strength, and overall morphology to the human femur than many other commonly used animal femora models; additional morphological measurements are comparable to many other species’ femora. The distal bicondylar width of 59.3mm suggests that cervine femora may be excellent models for use in total knee replacement simulations. Furthermore, the cervine femoral head is more ovoid than other commonly-used models for hip research, making it a more suitable model for studies of hip implants. Thus, with further, more application-specific investigations, the cervine femur could be a suitable model for biomechanical research, including the study of ballistic injuries and orthopaedic device development. PMID:26757205

  18. The Odocoileus virginianus Femur: Mechanical Behavior and Morphology.

    PubMed

    Hedgeland, Mark J; Libruk, Morgan A; Corbiere, Nicole C; Ciani, Mario J; Kuxhaus, Laurel

    2016-01-01

    Biomechanical research relies heavily on laboratory evaluation and testing with osseous animal structures. While many femora models are currently in use, including those of the European red deer (Cervus elaphus), the Odocoileus virginianus femur remains undocumented, despite its regional abundance in North America. The objective of this study was to compare biomechanical and morphological properties of the Odocoileus virginianus femur with those of the human and commonly used animal models. Sixteen pairs of fresh-frozen cervine femora (10 male, 6 female, aged 2.1 ± 0.9 years) were used for this study. Axial and torsional stiffnesses (whole bone) were calculated following compression and torsion to failure tests (at rates of 0.1 mm/sec and 0.2°/sec). Lengths, angles, femoral head diameter and position, periosteal and endosteal diaphyseal dimensions, and condylar dimensions were measured. The results show that the cervine femur is closer in length, axial and torsional stiffness, torsional strength, and overall morphology to the human femur than many other commonly used animal femora models; additional morphological measurements are comparable to many other species' femora. The distal bicondylar width of 59.3mm suggests that cervine femora may be excellent models for use in total knee replacement simulations. Furthermore, the cervine femoral head is more ovoid than other commonly-used models for hip research, making it a more suitable model for studies of hip implants. Thus, with further, more application-specific investigations, the cervine femur could be a suitable model for biomechanical research, including the study of ballistic injuries and orthopaedic device development. PMID:26757205

  19. Characteristics of femorotibial joint geometry in the trochlear dysplastic femur

    PubMed Central

    Frosch, Stephan; Brodkorb, Tobias; Schüttrumpf, Jan Philipp; Wachowski, Martin Michael; Walde, Tim Alexander; Stürmer, Klaus Michael; Balcarek, Peter

    2014-01-01

    The medial and lateral tibia plateau geometry has been linked with the severity of trochlear dysplasia. The aim of the present study was to evaluate the tibial slope and the femoral posterior condylar offset in a cohort of consecutive subjects with a trochlear dysplastic femur to investigate whether the condylar offset correlates with, and thus potentially compensates for, tibial slope asymmetry. Magnetic resonance imaging was used to assess the severity of trochlear dysplasia as well as the tibial slope and posterior offset of the femoral condyles separately for the medial and lateral compartment of the knee joint in 98 subjects with a trochlear dysplastic femur and 88 control subjects. A significant positive correlation was found for the medial tibial slope and the medial posterior condylar offset in the study group (r2 = 0.1566; P < 0.001). This relationship was significant for all subtypes of trochlear dysplasia and was most pronounced in the severe trochlear dysplastic femur (Dejour type D) (r2 = 0.3734; P = 0.04). No correlation was found for the lateral condylar offset and the lateral tibial slope in the study group or for the condylar offset and the tibial slope on both sides in the control group. The positive correlation between the medial femoral condylar offset and the medial tibial slope, that is, a greater degree of the medial tibial slope indicated a larger offset of the medial femoral condyle, appears to represent a general anthropomorphic characteristic of distal femur geometry in patients with a trochlear dysplastic femur. PMID:25040233

  20. A geometric morphometrics comparative analysis of Neandertal humeri (epiphyses-fused) from the El Sidrón cave site (Asturias, Spain).

    PubMed

    Rosas, Antonio; Pérez-Criado, Laura; Bastir, Markus; Estalrrich, Almudena; Huguet, Rosa; García-Tabernero, Antonio; Pastor, Juan Francisco; de la Rasilla, Marco

    2015-05-01

    A new collection of 49,000 year old Neandertal fossil humeri from the El Sidrón cave site (Asturias, Spain) is presented. A total of 49 humeral remains were recovered, representing 10 left and 8 right humeri from adults, adolescents, and a juvenile (not included in the analyses). 3D geometric morphometric (GM) methods as well as classic anthropological variables were employed to conduct a broad comparative analysis by means of mean centroid size and shape comparisons, principal components analysis, and cluster studies. Due to the fragmentary nature of the fossils, comparisons were organized in independent analyses according to different humeral portions: distal epiphysis, diaphysis, proximal epiphysis, and the complete humerus. From a multivariate viewpoint, 3D-GM analyses revealed major differences among taxonomic groups, supporting the value of the humerus in systematic classification. Notably, the Australopithecus anamensis (KP-271) and Homo ergaster Nariokotome (KNM-WT 15000) distal humerus consistently clusters close to those of modern humans, which may imply a primitive condition for Homo sapiens morphology. Australopithecus specimens show a high degree of dispersion in the morphospace. The El Sidrón sample perfectly fits into the classic Neandertal pattern, previously described as having a relatively wide olecranon fossa, as well as thin lateral and medial distodorsal pillars. These characteristics were also typical of the Sima de los Huesos (Atapuerca) sample, African mid-Pleistocene Bodo specimen, and Lower Pleistocene TD6-Atapuerca remains and may be considered as a derived state. Finally, we hypothesize that most of the features thought to be different between Neandertals and modern humans might be associated with structural differences in the pectoral girdle and shoulder joint. PMID:25819346

  1. Creation of a simple distal femur morphology classification system.

    PubMed

    Everhart, Joshua S; Chaudhari, Ajit M W; Flanigan, David C

    2016-06-01

    The purpose of this study is to propose a binary classification system based on simple measurements that summarizes individual, race, and sex-specific differences in distal femur shape. Surface models of 165 distal femurs (79 female, 86 male; 85 African-American, 80 Caucasian, 28.8 ± 7.6 years) were created with a 3-dimensional laser scanner. Surface area, width, length, curvature, and angulation were measured. Knees were classified as either type A or B within five distinct categories: (i) aspect ratio, (ii) trochlear-intercondylar width ratio, (iii) trochlear tilt, (iv) medial-lateral trochlear width ratio, and (v) trochlear sulcus shape. Correlations between these measures and surface area were calculated, and receiver-operator curves were used to select cutoff values between type A and B knees to improve differentiation of femur shapes by sex or race. The cutoff values between type A and B knees for the five categories are as follows: Category I: 0.90, Category II: 0.51, Category III: 1.02, Category IV: 0.67, and Category V: 128.7°. Other than category IV (medial-lateral trochlear width ratio) (p = 0.004, R = 0.22), no categories were correlated with surface area (p > 0.25). Category I (aspect ratio, cutoff = 0.90) best differentiated femurs by sex (p < 0.001, AUC = 0.80), and Category V (sulcus shape) best differentiated femurs by race (p < 0.001, AUC = 0.73). This system uses simple measurements to summarize important individual, race, and sex-specific differences in distal femur shape. It can be used in a clinical setting to provide insight into the relationship between sex or race differences in knee shape and mechanically influenced knee disorders. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:924-931, 2016. PMID:26573967

  2. Effects of long-term rotation and hypergravity on developing rat femurs

    NASA Technical Reports Server (NTRS)

    Smith, S. D.

    1975-01-01

    Male and female Sprague-Dawley rats derived from a single mating were raised for three generations under constant centrifugation at 1.03 G (Rotation Controls) and at 2 G. When the third generation rats were 3 months old, they were sacrificed, and their femurs removed. After fixation and cleaning, the femurs were then measured for length and diameter. Then right femurs were sectioned longitudinally, left femurs transversely. After staining with Hematoxylin and Eosin, right femurs were examined for ossification patterns and left femurs were measured for cortical thickness. All rotation control rats showed marked stimulation of ossification in the femoral head, and males showed significant cortical thinning when compared to non-rotated earth gravity controls. All 2 G femurs showed decreased length and aspect (L/D) ratios, and increased cortical thickness/diameter ratios when compared to earth controls or rotation controls. Ossification of the femoral head was slightly advanced, while the distal epiphyseal plate was thinned.

  3. Intraoperative Periprosthetic Femur Fracture: A Biomechanical Analysis of Cerclage Fixation.

    PubMed

    Frisch, Nicholas B; Charters, Michael A; Sikora-Klak, Jakub; Banglmaier, Richard F; Oravec, Daniel J; Silverton, Craig D

    2015-08-01

    Intraoperative periprosthetic femur fracture is a known complication of total hip arthroplasty (THA) and a variety of cerclage systems are available to manage these fractures. The purpose of this study was to examine the in situ biomechanical response of cerclage systems for fixation of periprosthetic femur fractures that occur during cementless THA. We compared cobalt chrome (CoCr) cables, synthetic cables, monofilament wires and hose clamps under axial compressive and torsional loading. Metallic constructs with a positive locking system performed the best, supporting the highest loads with minimal implant subsidence (both axial and angular) after loading. Overall, the CoCr cable and hose clamp had the highest construct stiffness and least reduction in stiffness with increased loading. They were not demonstrably different from each other. PMID:25765131

  4. Xanthogranulomatous Osteomyelitis of Proximal Femur Masquerading as Benign Bone Tumor.

    PubMed

    Singh, Shailendra; Batra, Sahil; Maini, Lalit; Gautam, Virender Kumar

    2015-08-01

    We describe a case of xanthogranulomatous osteomyelitis (XO) of the proximal femur in a 65-year-old woman who presented with pain of 6 months' duration in the right hip. Plain radiographs showed a lytic well-defined lesion in the right peritrochanteric region suggestive of a benign neoplastic etiology. The gross and histopathologic examination of the curettage specimen was consistent with XO. Xanthogranulomatous osteomyelitis is a rare chronic inflammatory process that is characterized by the presence of a large number of lipid-containing macrophages with an admixture of lymphocytes, plasma cells, and neutrophils. Gross and radiologic examination of this entity can mimic malignancy, and differentiation should be confirmed by histopathologic evaluation. To the best of our knowledge, XO of the femur has not been reported in the English-language literature. The rarity of this condition and its resemblance to bone tumors form the basis of this case report. PMID:26251942

  5. Introgression of Neandertal- and Denisovan-like Haplotypes Contributes to Adaptive Variation in Human Toll-like Receptors.

    PubMed

    Dannemann, Michael; Andrés, Aida M; Kelso, Janet

    2016-01-01

    Pathogens and the diseases they cause have been among the most important selective forces experienced by humans during their evolutionary history. Although adaptive alleles generally arise by mutation, introgression can also be a valuable source of beneficial alleles. Archaic humans, who lived in Europe and Western Asia for more than 200,000 years, were probably well adapted to this environment and its local pathogens. It is therefore conceivable that modern humans entering Europe and Western Asia who admixed with them obtained a substantial immune advantage from the introgression of archaic alleles. Here we document a cluster of three Toll-like receptors (TLR6-TLR1-TLR10) in modern humans that carries three distinct archaic haplotypes, indicating repeated introgression from archaic humans. Two of these haplotypes are most similar to the Neandertal genome, and the third haplotype is most similar to the Denisovan genome. The Toll-like receptors are key components of innate immunity and provide an important first line of immune defense against bacteria, fungi, and parasites. The unusually high allele frequencies and unexpected levels of population differentiation indicate that there has been local positive selection on multiple haplotypes at this locus. We show that the introgressed alleles have clear functional effects in modern humans; archaic-like alleles underlie differences in the expression of the TLR genes and are associated with increased [corrected] microbial resistance and increased allergic disease in large cohorts. This provides strong evidence for recurrent adaptive introgression at the TLR6-TLR1-TLR10 locus, resulting in differences in disease phenotypes in modern humans. PMID:26748514

  6. Introgression of Neandertal- and Denisovan-like Haplotypes Contributes to Adaptive Variation in Human Toll-like Receptors

    PubMed Central

    Dannemann, Michael; Andrés, Aida M.; Kelso, Janet

    2016-01-01

    Pathogens and the diseases they cause have been among the most important selective forces experienced by humans during their evolutionary history. Although adaptive alleles generally arise by mutation, introgression can also be a valuable source of beneficial alleles. Archaic humans, who lived in Europe and Western Asia for more than 200,000 years, were probably well adapted to this environment and its local pathogens. It is therefore conceivable that modern humans entering Europe and Western Asia who admixed with them obtained a substantial immune advantage from the introgression of archaic alleles. Here we document a cluster of three Toll-like receptors (TLR6-TLR1-TLR10) in modern humans that carries three distinct archaic haplotypes, indicating repeated introgression from archaic humans. Two of these haplotypes are most similar to the Neandertal genome, and the third haplotype is most similar to the Denisovan genome. The Toll-like receptors are key components of innate immunity and provide an important first line of immune defense against bacteria, fungi, and parasites. The unusually high allele frequencies and unexpected levels of population differentiation indicate that there has been local positive selection on multiple haplotypes at this locus. We show that the introgressed alleles have clear functional effects in modern humans; archaic-like alleles underlie differences in the expression of the TLR genes and are associated with reduced microbial resistance and increased allergic disease in large cohorts. This provides strong evidence for recurrent adaptive introgression at the TLR6-TLR1-TLR10 locus, resulting in differences in disease phenotypes in modern humans. PMID:26748514

  7. High-Energy Proximal Femur Fractures in Geriatric Patients

    PubMed Central

    Hahnhaussen, Jens; Hak, David J; Weckbach, Sebastian; Ertel, Wolfgang; Stahel, Philip F

    2011-01-01

    Background: There is limited information in the literature on the outcomes and complications in elderly patients who sustain high-energy hip fractures. As the population ages, the incidence of high-energy geriatric hip fractures is expected to increase. The purpose of this study was to analyze the outcomes and complications in patients aged 65 years or older, who sustained a high-energy proximal femur fracture. Methods: Retrospective review of a prospective trauma database from January 2000 to April 2011 at a single US academic level-1 trauma center. Inclusion criteria consisted of all patients of age 65 years or older, who sustained a proximal femur fracture related to a high-energy trauma mechanism. Details concerning injury, acute treatment, and clinical course and outcome were obtained from medical records and radiographs. Results: We identified 509 proximal femur fractures in patients older than 65 years of age, of which 32 (6.3%) were related to a high-energy trauma mechanism. The mean age in the study group was 72.2 years (range 65-87), with a mean injury severity score of 20 points (range 9-57). Three patients died before discharge (9.4%), and 22 of 32 patients sustained at least one complication (68.8%). Blunt chest trauma represented the most frequently associated injury, and the main root cause of pulmonary complications. The patients' age and comorbidities did not significantly correlate with the rate of complications and the 1-year mortality. Conclusions: High-energy proximal femur fractures in elderly patients are not very common and are associated with a low in-hospital mortality rate of less than 10%, despite high rate of complications of nearly 70%. This selective cohort of patients requires a particular attention to respiratory management due to the high incidence of associated chest trauma. PMID:23569690

  8. Indolent infection in nonunion of the distal femur.

    PubMed

    Kim, Ji Wan; Byun, Seong-Eun; Oh, Hyoung Keun; Kim, Jung Jae

    2015-04-01

    In the treatment of nonunions of the distal femur, infection should be excluded. However, it is difficult to determine whether the nonunion is infected or not with negative history and signs of infection. The purpose of this study was to investigate indolent infection as a cause of presumptive aseptic distal femur nonunion. All presumptive aseptic distal femur nonunions treated from 1998 to 2008 were retrospectively reviewed. Any patient with suspected of having an infection clinically was excluded. Multiple tissue cultures were performed at the nonunion site. The main outcomes were to analyze the rate of positive cultures in presumptive aseptic distal femur nonunion and to compare the rate of secondary surgery in positive and negative culture groups. Of the 22 patients, 3 (13.6%) had positive culture results. The organisms cultured were Staphylococcus aureus, Staphylococcus epidermidis, and Enterobacter cloacae. The overall rate of infection was 9.1% (2/22), and one patient underwent a secondary procedure. In the open fracture group, 2 of 10 patients (20%) had positive cultures; all developed infection. In the closed fracture group, 1 of 12 patients (8.3%) had positive culture results, but Infection did not occur in the patient with a 3-week intravenous antibiotic treatment. The postoperative infection rate was 67% (2/3) in patients with positive intraoperative cultures, while 0% (0/18) in the group with negative intraoperative cultures (p<0.001). The presence of indolent infection can be verified in patients with presumptive aseptic nonunion of distal femoral fractures by obtaining intraoperative biopsy tissue cultures. Positive intraoperative culture results were related with postoperative infection. PMID:25189289

  9. [The ECMES [Centro-Medullary Elastic Stabilising Wiring) osteosynthesis method in limb fractures in children. Principle, application on the femur. Apropos of 250 fractures followed-up since 1979].

    PubMed

    Prévot, J; Lascombes, P; Ligier, J N

    The theoretical basis of this new technique were recalled: a closed operation respecting the conjugation cartilages. The material, composed of flexible wires of adequate diameter are bent and stabilised forming a non traumatic fixation which is inserted into the medullary canal of the fractured bone under fluoroscopic surveillance. The second part of this paper deals with the results of 250 fractures of the femur followed up since 1979. Late outcome in terms of complications and stimulation of the post-trauma growth, which is a problem in all forms of fractures in the child, especially of the femur, is presented. PMID:7729190

  10. Late Pleistocene adult mortality patterns and modern human establishment

    PubMed Central

    Trinkaus, Erik

    2011-01-01

    The establishment of modern humans in the Late Pleistocene, subsequent to their emergence in eastern Africa, is likely to have involved substantial population increases, during their initial dispersal across southern Asia and their subsequent expansions throughout Africa and into more northern Eurasia. An assessment of younger (20–40 y) versus older (>40 y) adult mortality distributions for late archaic humans (principally Neandertals) and two samples of early modern humans (Middle Paleolithic and earlier Upper Paleolithic) provides little difference across the samples. All three Late Pleistocene samples have a dearth of older individuals compared with Holocene ethnographic/historical samples. They also lack older adults compared with Holocene paleodemographic profiles that have been critiqued for having too few older individuals for subsistence, social, and demographic viability. Although biased, probably through a combination of preservation, age assessment, and especially Pleistocene mobility requirements, these adult mortality distributions suggest low life expectancy and demographic instability across these Late Pleistocene human groups. They indicate only subtle and paleontologically invisible changes in human paleodemographics with the establishment of modern humans; they provide no support for a life history advantage among early modern humans. PMID:21220336

  11. A method for sex estimation using the proximal femur.

    PubMed

    Curate, Francisco; Coelho, João; Gonçalves, David; Coelho, Catarina; Ferreira, Maria Teresa; Navega, David; Cunha, Eugénia

    2016-09-01

    The assessment of sex is crucial to the establishment of a biological profile of an unidentified skeletal individual. The best methods currently available for the sexual diagnosis of human skeletal remains generally rely on the presence of well-preserved pelvic bones, which is not always the case. Postcranial elements, including the femur, have been used to accurately estimate sex in skeletal remains from forensic and bioarcheological settings. In this study, we present an approach to estimate sex using two measurements (femoral neck width [FNW] and femoral neck axis length [FNAL]) of the proximal femur. FNW and FNAL were obtained in a training sample (114 females and 138 males) from the Luís Lopes Collection (National History Museum of Lisbon). Logistic regression and the C4.5 algorithm were used to develop models to predict sex in unknown individuals. Proposed cross-validated models correctly predicted sex in 82.5-85.7% of the cases. The models were also evaluated in a test sample (96 females and 96 males) from the Coimbra Identified Skeletal Collection (University of Coimbra), resulting in a sex allocation accuracy of 80.1-86.2%. This study supports the relative value of the proximal femur to estimate sex in skeletal remains, especially when other exceedingly dimorphic skeletal elements are not accessible for analysis. PMID:27373600

  12. Proximal femur segmentation in conventional pelvic x ray.

    PubMed

    Pilgram, Roland; Walch, Claudia; Kuhn, Volker; Schubert, Rainer; Staudinger, Roland

    2008-06-01

    A solid and accurate proximal femur segmentation technique using the popular active shape model (ASM) is proposed. For generating an optimal shape prior, the minimum description length, based on 200 supervised manual segmented proximal femur shapes, is used. The segmentation is based on a coarse to fine scaling technique including a profile scale space method. The segmentation results are compared using an optimal defined initial pose and a pose based on a registration technique. Using ideal template initialization, 95% of the shapes have been recovered exactly (average point-to-point error approximately 13 pixels, average point-to-boundary error approximately 7 pixels). Using a template-based initialization based on a registration technique, a successful segmentation rate of approximately 89% is achieved, with an average point-to-point error approximately 12 pixels, and an average point-to-boundary error approximately 8 pixels. With an adequate template initialization and an improved ASM, this method seems to provide an accurate tool for segmentation of the proximal femur shapes on conventional hip overview x-ray images. PMID:18649479

  13. Factors related to curved femur in elderly Japanese women

    PubMed Central

    Tsuchie, Hiroyuki; Miyakoshi, Naohisa; Kasukawa, Yuji; Senma, Seietsu; Narita, Yuichiro; Miyamoto, Seiya; Hatakeyama, Yuji; Sasaki, Kana; Shimada, Yoichi

    2016-01-01

    Background Multiple factors are involved in the development of atypical femoral fractures, and excessive curvature of the femur is thought to be one of them. However, the pathogenesis of femoral curvature is unknown. We evaluated the influence of factors related to bone metabolism and posture on the development of femoral curvature. Methods A total of 139 women participated in the present study. Curvatures were measured using antero-posterior and lateral radiography of the femur. We evaluated some bone and vitamin D metabolism markers in serum, the bone mineral density (BMD), lumbar spine alignment, and pelvic tilt. Results We divided the women into two groups, curved and non-curved groups, based on the average plus standard deviation as the cut-off between the groups. When univariate logistic regression analysis was performed to detect factors affecting femoral curvature, the following were identified as indices significantly affecting the curvature: age of the patients, serum concentrations of calcium, intact parathyroid hormone, pentosidine, homocysteine and 25-hydroxyvitamin D (25(OH)D), and BMD of the proximal femur (P < 0.05) both in the lateral and anterior curvatures. When we used multivariate analyses to assess these factors, only 25(OH)D and age (lateral and anterior standardized odds ratio: 0.776 and 0.385, and 2.312 and 4.472, respectively) affected the femoral curvature (P < 0.05). Conclusion Femoral curvature is strongly influenced by age and serum vitamin D. PMID:27228191

  14. Preparation of the proximal femur in cementless total hip revision.

    PubMed

    Mallory, T H

    1988-10-01

    With an increased incidence of revision for the failed cemented total hip arthroplasty, techniques of revision surgery need meticulous attention to detail. Although the causes of the failed cemented total hip arthroplasty are many, they tend to follow characteristic patterns. The proximal femur can be exposed through an extensive muscle split incision, which offers a complete circumferential view of the femur. The cement removal is enhanced by controlled perforation using high-speed drills. Classification of bony deficits of the proximal femur can be divided into Type I, including intact cortex and medullary content; Type II, in which there is intact cortex but deficient medullary content; and Type III, in which deficits of both the cortex and medullary canal are present. Prosthetic selection is based on residual bone stock. In general, cementless fixation is advocated, with distal fixation using long-stem devices. Augmentation of bone deficits requires the use of segmental prosthetic replacement or fresh-frozen allografts. One hundred sixty patients were followed for two to six years. Satisfactory results have occurred in over 90% of the patients; better results are anticipated in patients with minimal bone deficits. Aseptic loosening requiring rerevision has occurred in 5% of the patient population. Understanding the dynamics of failure and the residual bone deficits allows one to manage the failed cemented total hip arthroplasty with greater efficiency and predictability. PMID:3416541

  15. Developing CT based computational models of pediatric femurs.

    PubMed

    Li, Xinshan; Viceconti, Marco; Cohen, Marta C; Reilly, Gwendolen C; Carré, Matt J; Offiah, Amaka C

    2015-07-16

    The mechanisms of fracture in infants and toddlers are not well understood. There have been very few studies on the mechanical properties of pediatric bones and their responses under fracture loading. A better understanding of fracture mechanisms in children will help elucidate both accidental and non-accidental injuries, as well as bone fragility diseases. The aim of this study is to develop in silico femoral models from CT scans to provide detailed quantitative information regarding the geometry and mechanical response of the femur, with the long term potential of investigating injury mechanisms. Fifteen anonymized QCT scans (aged 0-3 years) were collected and used to create personalized computational models of femurs. The elastic modulus of femur was illustrated at various ages. The models were also subjected to a series of four point bending simulations taking into account a range of loads perpendicular to the femoral shaft. The results showed that mid-shaft cross-section at birth appeared circular, but the diameter in the anteroposterior axis gradually increased with age. The density, and by implication modulus of elasticity at the mid-shaft became more differentiated with growth. Pediatric cortical bone with density close to the peak values found in adults was attained a few weeks after birth. The method is able to capture quantitative variations in geometries, material properties and mechanical responses, and has confirmed the rapid development of bone during the first few years of life using in silico models. PMID:25895643

  16. Uncertainty quantification for personalized analyses of human proximal femurs.

    PubMed

    Wille, Hagen; Ruess, Martin; Rank, Ernst; Yosibash, Zohar

    2016-02-29

    Computational models for the personalized analysis of human femurs contain uncertainties in bone material properties and loads, which affect the simulation results. To quantify the influence we developed a probabilistic framework based on polynomial chaos (PC) that propagates stochastic input variables through any computational model. We considered a stochastic E-ρ relationship and a stochastic hip contact force, representing realistic variability of experimental data. Their influence on the prediction of principal strains (ϵ1 and ϵ3) was quantified for one human proximal femur, including sensitivity and reliability analysis. Large variabilities in the principal strain predictions were found in the cortical shell of the femoral neck, with coefficients of variation of ≈40%. Between 60 and 80% of the variance in ϵ1 and ϵ3 are attributable to the uncertainty in the E-ρ relationship, while ≈10% are caused by the load magnitude and 5-30% by the load direction. Principal strain directions were unaffected by material and loading uncertainties. The antero-superior and medial inferior sides of the neck exhibited the largest probabilities for tensile and compression failure, however all were very small (pf<0.001). In summary, uncertainty quantification with PC has been demonstrated to efficiently and accurately describe the influence of very different stochastic inputs, which increases the credibility and explanatory power of personalized analyses of human proximal femurs. PMID:26873282

  17. Proximal femur segmentation in conventional pelvic x ray

    SciTech Connect

    Pilgram, Roland; Walch, Claudia; Kuhn, Volker; Schubert, Rainer; Staudinger, Roland

    2008-06-15

    A solid and accurate proximal femur segmentation technique using the popular active shape model (ASM) is proposed. For generating an optimal shape prior, the minimum description length, based on 200 supervised manual segmented proximal femur shapes, is used. The segmentation is based on a coarse to fine scaling technique including a profile scale space method. The segmentation results are compared using an optimal defined initial pose and a pose based on a registration technique. Using ideal template initialization, 95% of the shapes have been recovered exactly (average point-to-point error {approx}13 pixels, average point-to-boundary error {approx}7 pixels). Using a template-based initialization based on a registration technique, a successful segmentation rate of {approx}89% is achieved, with an average point-to-point error {approx}12 pixels, and an average point-to-boundary error {approx}8 pixels. With an adequate template initialization and an improved ASM, this method seems to provide an accurate tool for segmentation of the proximal femur shapes on conventional hip overview x-ray images.

  18. [Determination of body height from fragments of the femur].

    PubMed

    Rother, P; Jahn, W; Hunger, H; Kurp, K

    1980-01-01

    Presenting a major problem in connection with reconstructing the height of body from the dimensions of long or pipe bones are the circumstances under which damage is caused thereto in mass accidents such as, for example, plane crashes. Such accidents often result in long bones being fractured completely, so that it is not possible for them to be directly used for reconstructing the height of body. In such cases, use can be made of the methods described by Steel (1970) who determined segments for such long bones as the femur, tibia, and humerus and also set up formulas by use of linear regression analyses, which enable the lengths of single fragments of bones to be used for estimating the overall length of bones which can then be substituted into equations for reconstructing the height of body. The procedure has been verified statistically, and suitable formulas have been established for the femur, which is the bone that lends itself particularly well to estimations of the height of body. When using these formulas, the residual variance is generally as great as 10 cm. Accordingly, it appears inappropriate for public medicolegal officers to calculate a height of body which is beset by a range of variation that is as great as this. Therefore, the 2nd part of this paper presents a possible way of determining the stature of a human body from individual segments of the femur. The limits of these size groups have been determined for data to be recorded in identity cards and other personal documents. The method is based upon the calculation of conditional probability distributions for given lengths of segments. PMID:7215751

  19. Percutaneous Stabilization of Impending Pathological Fracture of the Proximal Femur

    SciTech Connect

    Deschamps, Frederic Farouil, Geoffroy Hakime, Antoine Teriitehau, Christophe Barah, Ali Baere, Thierry de

    2012-12-15

    Objective: Percutaneous osteosynthesis plus cementoplasty (POPC) is a minimally invasive technique that has never been reported before and that we have prospectively evaluated for patients with impending pathological fracture of the proximal femur. Methods: We performed POPC in 12 patients (3 males, 9 females) with metastasis of the proximal femur with a high risk of fracture (Mirels' score {>=}8) between February 2010 and July 2011. Patients were not candidates for standard surgical stabilization. We analyzed the feasibility, duration, and complication of the procedure, the risk of fracture, the decrease in pain (Visual Analog Scale, VAS), and length of stay in hospital. Data were prospectively collected in all patients. Results: The mean Mirels' score was 9.8 {+-} 1.2 (range, 8-11). The technical success was 100%. POPC was performed under general anesthesia (n = 6) or conscious sedation (n = 6). The mean duration was 110 {+-} 43 (range, 60-180) minutes. All patients stood up and walked the second day after the procedure. The average length of stay in the hospital was 4 {+-} 1.6 (range, 2-7) days. We experienced two hematomas in two patients and no thromboembolic complication. For symptomatic patients (n = 8), VAS decreased from 6.5/10 (range, 2-9) before treatment to 1/10 (range, 0-3) 1 month after. No fracture occurred after a median follow-up of 145 (range, 12-608) days. Conclusions: POPC for impending pathological fracture of the proximal femur seems to be a promising alternative for cancer patients who are not candidates for surgical stabilization. Further studies are required to confirm this preliminary experience.

  20. Immune Cell Isolation from Mouse Femur Bone Marrow

    PubMed Central

    Liu, Xiaoyu; Quan, Ning

    2016-01-01

    The bone marrow is the site of hematopoesis and contains mixed population of blood cells including erythrocytes, granulocytes, monocytes, dendritic cells, lymphocytes and hematopoietic stem cells. The following protocol provides a simple and fast method for isolation of bone marrow immune cells (no erythrocytes) from mouse femurs with a yield of approximate 8 × 107 cells in 5 ml culture media (1.6 × 104 cells/μl). Further isolation or flow cytometric analysis might be required for study of specific immune cell types.

  1. Long bone (humerus, femur, tibia) measuring procedure in cadavers.

    PubMed

    Menéndez Garmendia, Antinea; Gómez-Valdés, Jorge A; Hernández, Francisco; Wesp, Julie K; Sánchez-Mejorada, Gabriela

    2014-09-01

    In this work, we present a measuring methodology for long bones of the limbs (humerus, femur, and tibia) of human corpses. Measurements of cadaveric height and long bone lengths were conducted on 72 corpses (20 females and 52 males) from the School of Medicine at the National Autonomous University of Mexico. Additionally, these measurements were compared with those taken from dry bones of a subsample of individuals. Our results show marginal differences (TEM% = 0.59) between cadaveric and dry bone measurements, resulting from different osteometric technical procedures. This note outlines the measuring methodology, which will be subsequently used to create regression formulas for stature estimation. PMID:24611570

  2. The Carbofix™ "Piccolo Proximal femur nail": A new perspective for treating proximal femur lesion. A technique report.

    PubMed

    Zoccali, Carmine; Soriani, Antonella; Rossi, Barbara; Salducca, Nicola; Biagini, Roberto

    2016-12-01

    Metastases to proximal femur are common and surgery is often suggested to prevent fractures; otherwise it is necessary in cases where this has already occurred. Adjuvant radiotherapy is necessary to reduce the risk of local progression. Nevertheless, the success or failure of radiation therapy treatments depends upon the accuracy in which target identification is correct and dose prescription is fulfilled. Unfortunately, the use of titanium nails consistently limits radiation dose; indeed, the presence of ferromagnetic artifacts interferes with target identification. We present the technique for implant a new carbon fiber nail useful to reduce the ferromagnetic artifacts which allows a better adjuvant radiotherapy. PMID:27436924

  3. The management and outcome of open fractures of the femur sustained on the battlefield over a ten-year period.

    PubMed

    Bennett, P M; Sargeant, I D; Myatt, R W; Penn-Barwell, J G

    2015-06-01

    This is a retrospective study of survivors of recent conflicts with an open fracture of the femur. We analysed the records of 48 patients (48 fractures) and assessed the outcome. The median follow up for 47 patients (98%) was 37 months (interquartile range 19 to 53); 31 (66%) achieved union; 16 (34%) had a revision procedure, two of which were transfemoral amputation (4%). The New Injury Severity Score, the method of fixation, infection and the requirement for soft-tissue cover were not associated with a poor outcome. The degree of bone loss was strongly associated with a poor outcome (p = 0.00204). A total of four patients developed an infection; two with S. aureus, one with E. coli and one with A. baumannii. This study shows that, compared with historical experience, outcomes after open fractures of the femur sustained on the battlefield are good, with no mortality and low rates of infection and late amputation. The degree of bone loss is closely associated with a poor outcome. PMID:26033067

  4. Effects of Hip Geometry on Fracture Patterns of Proximal Femur

    PubMed Central

    Kazemi, Seyyed Morteza; Qoreishy, Mohamad; Keipourfard, Ali; Sajjadi, Mohammadreza Minator; Shokraneh, Shahram

    2016-01-01

    Background: Some studies have previously shown that geometry of proximal femur can affect the probability of fracture and type of fracture. It happens since the geometry of the proximal femur determines how a force is applied to its different parts. In this study, we have compared proximal femur’s geometric characteristics in femoral neck (FNF), intertrochanteric (ITF) and Subtrochanteric (STF) fractures. Methods: In this study, 60 patients who had hip fractures were studied as case studies. They were divided into FNF, ITF and STF groups based on their fracture types (20 patients in each group). Patients were studied with x-ray radiography and CT scans. Radiological parameters including femoral neck length from lateral cortex to center of femoral head (FNL), diameter of femoral head (FHD), diameter of femoral neck (FND), femoral head neck offset (FHNO), neck-shaft angle (alpha), femoral neck anteversion (beta) were measured and compared in all three groups. Results: Amount of FNL was significantly higher in STF group compared to FNF (0.011) while ITF and STF as well as FNT and ITF did not show a significant different. Also, FND in FNF group was significantly lower than the other two groups, i.e. ITF and STF. In other cases there were no instances of significant statistical difference. Conclusion: Hip geometry can be used to identify individuals who are at the risk of fracture with special pattern. Also, it is important to have more studies in different populations and more in men. PMID:27517071

  5. Valgus osteotomy for nonunion and neglected neck of femur fractures

    PubMed Central

    Varghese, Viju Daniel; Livingston, Abel; Boopalan, P R; Jepegnanam, Thilak S

    2016-01-01

    Nonunion neck of femur can be a difficult problem to treat, particularly in the young, and is associated with high complication rates of avascular necrosis due to the precarious blood supply and poor biomechanics. The various treatment options that have been described can be broadly divided according to the aim of improving either biology or biomechanics. Surgeries aimed at improving the biology, such as vascularized fibula grafting, have good success rates but require high levels of expertise and substantial resources. A popular surgical treatment aimed at improving the biomechanics-valgus intertrochanteric osteotomy-optimizes conditions for fracture healing by converting shear forces across the fracture site into compressive forces. Numerous variations of this surgical procedure have been developed and successfully applied in clinical practice. As a result, the proximal femoral orientation for obtaining a good functional outcome has evolved over the years, and the present concept of altering the proximal femoral anatomy as little as possible has arisen. This technical objective supports attaining union as well as a good functional outcome, since excessive valgus can lead to increased joint reaction forces. This review summarizes the historical and current literature on valgus intertrochanteric osteotomy treatment of nonunion neck of femur, with a focus on factors predictive of good functional outcome and potential pitfalls to be avoided as well as controversies surrounding this procedure. PMID:27190758

  6. Fat Embolism Syndrome After Femur Fracture Fixation: a Case Report

    PubMed Central

    Akoh, Craig C; Schick, Cameron; Otero, Jesse; Karam, Matthew

    2014-01-01

    Fat embolism syndrome (FES) is a multi-organ disorder with potentially serious sequelae that is commonly seen in the orthopaedic patient population after femur fractures. The major clinical features of FES include hypoxia, pulmonary dysfunction, mental status changes, petechiae, tachycardia, fever, thrombocytopenia, and anemia. Due to technological advances in supportive care and intramedullary reaming techniques, the incidence of FES has been reported as low as 0.5 percent. Here, we present a rare case of FES with cerebral manifestations. A previously healthy 24-year old nonsmoking male was admitted to our hospital after an unrestrained head-on motor vehicle collision. The patient's injuries included a left olecranon fracture and closed bilateral comminuted midshaft femur fractures. The patient went on to develop cerebral fat embolism syndrome (CFES) twelve hours after immediate bilateral intramedullary nail fixation. His symptoms included unresponsiveness, disconjugate gaze, seizures, respiratory distress, fever, anemia, thrombocytopenia, and visual changes. Head computed tomography and brain magnetic resonance imaging showed pathognomonic white-matter punctate lesions and watershed involvement. With early recognition and supportive therapy and seizure therapy, the patient went on to have complete resolution of symptoms without cognitive sequelae. PMID:25328460

  7. Valgus osteotomy for nonunion and neglected neck of femur fractures.

    PubMed

    Varghese, Viju Daniel; Livingston, Abel; Boopalan, P R; Jepegnanam, Thilak S

    2016-05-18

    Nonunion neck of femur can be a difficult problem to treat, particularly in the young, and is associated with high complication rates of avascular necrosis due to the precarious blood supply and poor biomechanics. The various treatment options that have been described can be broadly divided according to the aim of improving either biology or biomechanics. Surgeries aimed at improving the biology, such as vascularized fibula grafting, have good success rates but require high levels of expertise and substantial resources. A popular surgical treatment aimed at improving the biomechanics-valgus intertrochanteric osteotomy-optimizes conditions for fracture healing by converting shear forces across the fracture site into compressive forces. Numerous variations of this surgical procedure have been developed and successfully applied in clinical practice. As a result, the proximal femoral orientation for obtaining a good functional outcome has evolved over the years, and the present concept of altering the proximal femoral anatomy as little as possible has arisen. This technical objective supports attaining union as well as a good functional outcome, since excessive valgus can lead to increased joint reaction forces. This review summarizes the historical and current literature on valgus intertrochanteric osteotomy treatment of nonunion neck of femur, with a focus on factors predictive of good functional outcome and potential pitfalls to be avoided as well as controversies surrounding this procedure. PMID:27190758

  8. Mechanical behaviour of standardized, endoskeleton-including hip spacers implanted into composite femurs

    PubMed Central

    Thielen, T.; Maas, S.; Zuerbes, A.; Waldmann, D.; Anagnostakos, K.; Kelm, J.

    2009-01-01

    Two-stage reconstruction using an antibiotic loaded cement spacer is the preferred treatment method of late hip joint infections. Hip spacers maintain stability of the joint and length of the limb during treatment period. However, as the material strength of bone cement (PMMA) is limited, spacer fractures led to serious complications in the past. This study investigated the load capacity of custom made hip spacers, developed at the 'Klinik für Orthopädie und Orthopädische Chirurgie' (Universitätsklinikum des Saarlandes, Homburg / Saar, Germany), and implanted into composite femurs. In a quasi-static test, non-reinforced spacers tolerated hip joint loads of about 3000 N, whereas reinforced spacers with titanium-grade-two endoskeletons doubled this load up to 6000 N. Even for cyclic loading, endoskeleton-including hip spacers tolerated loads of >4500 N with 500,000 load cycles. Thus, an endoskeleton-including spacer should provide a mobile and functional joint through the treatment course. A generated FE-model was used to determine the fracture stresses and allows for further sensitivity analysis. PMID:19834594

  9. Geode of the femur: an uncommon manifestation potentially reflecting the pathogenesis of rheumatoid arthritis.

    PubMed

    Lee, Wonuk; Terk, Michael R; Hu, Bing; Garber, Elayne K; Weisman, Michael H

    2006-12-01

    Geodes are noted frequently in rheumatoid arthritis (RA), but large geodes of the femur are uncommon. We describe a patient with RA and a large geode in his femur; histological findings were consistent with a rheumatoid nodule and chronically inflamed synovium. We review the literature of large femoral geodes and what this particular manifestation may reflect about the pathogenesis of RA. PMID:17080513

  10. Altering local soft-tissue circulation fails to halt venous drainage from the femur

    SciTech Connect

    Culbertson, M.C. III; Williams, C.D.; Robertson, W.W. Jr.; Janssen, H.F.

    1989-04-01

    It has been suggested that tourniquet application proximal to bone biopsy in an extremity can reduce the number of tumor cells spread through circulation. This study investigates the anatomical pathway through which rapid cell spread could occur. Radioactively labeled 15-mu microspheres were injected into the medullary canal of rat femurs. The ratio of injected particles found in the femur was compared among groups that received application of a tourniquet prior to injection, no tourniquet, or transection of all soft tissue proximal to the injection site. Obliteration of circulation in the soft tissue surrounding the femur with a tourniquet or tissue transection did not alter the spread of particles from the femur. The pulmonary circulation trapped approximately 95% of particles reaching the lungs, limiting their access to peripheral arterial circulation. If the number of particles injected into the femur was increased, the number of particles leaving the femur increased at an even greater rate. These data suggest that (1) a particle can exit the femur without traveling through the soft tissue surrounding the femur; (2) most particles that reach the lung are retained; and (3) the injected bone acts as a sponge, retaining some particles and permitting the rest to enter the venous drainage.

  11. Using of Bezier Interpolation in 3D Reconstruction of Human Femur Bone

    NASA Astrophysics Data System (ADS)

    Toth-Tascau, Mirela; Pater, Flavius; Stoia, Dan Ioan; Menyhardt, Karoly; Rosu, Serban; Rusu, Lucian; Vigaru, Cosmina

    2011-09-01

    The paper is focused on image acquisition and processing of CT scans of a human femur bone in order to obtain 3D reconstructions of the human femur. The objective of the presented study was to obtain 3D realistic model of the human femur bone. The reconstructed model provides useful data to the physician but more important are the data and 3D models that can be used for virtual testing of femoral implants and endoprosthesis. Using the B-spline patch a 3D volume model of the human femur bone can be achieved. This model can be easy imported in any CAD system, resulting a virtual femur model witch can be used in FEM analysis.

  12. Musculoskeletal-based finite element analysis of femur after total hip replacement.

    PubMed

    Meena, Vijay K; Kumar, Mohit; Pundir, Amit; Singh, Suman; Goni, Vijay; Kalra, Parveen; Sinha, Ravindra K

    2016-06-01

    This article evaluates the effect of stress variation on adult femur following total hip replacement using musculoskeletal-based finite element analysis. The aim was to study the changes in stress distribution in the femur after total hip replacement by providing simulated in vivo loading and boundary conditions. The loading and boundary conditions were generated using a musculoskeletal modelling software 'AnyBody' and were applied on femur model, generated from the computed tomography (CT) scan data for standing posture of male patient. The results showed considerable variation in stress distribution pattern in the femur before and after total hip replacement, the metallic implant taking major loads of human body and transferring very less loads to the femur. PMID:27006421

  13. The absorbed dose in femur exposed to diagnostic radiography.

    PubMed

    Salehi, Z; Yusoff, A L

    2013-01-01

    A femur phantom made of wax and a real human bone was used to study the dose during radiographical procedures. The depth dose inside the phantom was determined using DOSXYZnrc, a Monte Carlo simulation software. The results were verified with measurements using TLD-100H. It was found that for 2.5 mm aluminium filtered 84-kVp X-rays, the radiation dose in the bone reached 57 % higher than the surface dose, i.e. 3.23 mGy as opposed to 2.06 mGy at the surface. The use of real bone introduces variations in the bone density in the DOSXYZnrc model, resulting in a lower attenuation effect than expected from solid bone tissues. PMID:23012482

  14. Stress Analysis of Human Femur under Different Loadings

    NASA Astrophysics Data System (ADS)

    Aghili, A. Latif; Hojjati, M. H.; Goudarzi, A. Moazemi; Rabiee, M.

    2011-12-01

    Stress fracture is a type of biomechanical failure of bone caused by loads during intense physical training. This failure is very important for aged persons and athletics. Because of cell death, in some cases after emergency surgery the injured person may suffer from lifelong disability. In this research, a three-dimensional finite element model of human femur has been created and analyzed under single, expanded and partial expanded loads. Analysis has been performed using commercially available software. The material is assumed to have isotropic elastic characteristics. The results indicated that the maximum stress occurred at the inferior root of the femoral neck. The magnitude of the strain shows good agreement with the published experimental results. This verifies the finite element modeling and the simplified model used.

  15. Vascularised fibular grafts for reconstruction of the femur.

    PubMed

    Yajima, H; Tamai, S; Mizumoto, S; Ono, H

    1993-01-01

    From 1979 to 1990 we treated 20 patients with large bone defects or established nonunion of the femur by vascularised fibular grafts. There were 18 men and two women with an average age at operation of 36.6 years (16 to 69). Ten patients had infected nonunion, three had post-traumatic nonunion or a bone defect without infection, four had a defect after tumour resection, and three had other lesions. The mean length of the fibular grafts was 18.1 cm. Postoperative circulatory disturbances needed revision surgery in five patients, including three with circulatory problems in the monitoring flap, but not at their anastomoses. The outcome was successful in 19 of the 20 patients with bone union at means of 6.1 months at the proximal site and 6.6 months at the distal site. Three patients had fractures of the fibular grafts but all these united in two to three months after cast immobilisation. PMID:8421008

  16. Retrograde nailing for distal femur fractures in the elderly

    PubMed Central

    Giddie, Jasdeep; Sawalha, Seif; Parker, Martyn

    2015-01-01

    Introduction: We report the results of treating a series of 56 fractures in 54 elderly patients with a distal femur fracture with a retrograde femoral nail. Methods: Fifty-four of the nails were inserted percutaneously with a closed reduction. After surgery all patients were allowed to weight bear as tolerated. Four fractures were supported in a temporary external splint. Results: The mean age of patients was 80.6 years (range 51–103 years), 52/54 (96%) were females. There were no cases of nail related complications and no re-operations were required. One patient was lost to follow up. The 30-day mortality was 5/54 (9.3%) and the one year mortality was 17/54 (31.5%). Conclusions: Distal femoral nail fixation provides a good method of fixation allowing immediate mobilisation for this group of patients. PMID:27163086

  17. The PFNA® Augmented in Revision Surgery of Proximal Femur Fractures

    PubMed Central

    Scola, Alexander; Gebhard, Florian; Dehner, Christoph; Röderer, Götz

    2014-01-01

    Objectives: Modern implants for proximal femur fracture treatment have clearly improved clinical results. However, complications, including cut-out and loss of reduction, requiring revision surgery still occur. A major challenge in these cases is a loss of bone stock due to the existing implant, which is usually exacerbated by osteoporosis. A potential solution is the augmentation of implants, for example, of the femoral neck blade using bone cement. Materials and Methods: Ten patients (five loosening of femoral neck implant, two pseudarthrosis, two implant failures and one acute fracture) were included. The initial hardware was removed and a PFNA augmented was implanted. The perforated femoral neck blade was augmented using polymethyl methacrylate cement. Clinical and radiological follow-up was performed at a mean of 5.4 months (SD ±4.34). The main outcome parameters were fracture healing and implant-related complications. Results: Technical handling was uneventful in all cases. No cement leakage into the joint occurred in any of the cases. The mean amount of cement injected was 5.3 ml. The fracture healed during follow-up in all cases except two patients who died from causes unrelated to the procedure and prior to complete consolidation. Problem-free elective hardware removal of the PFNA augmented was performed in two cases. Discussion: The PFNA augmented is a potential implant for joint-preserving revision surgery in proximal femur fractures. The augmentation improves implant anchorage in the impaired bone stock. In this preliminary series, no negative biological side effects of the cement (i.e. osteonecrosis) were observed. PMID:25136390

  18. Surgical Treatment of Pathological Fractures Occurring at the Proximal Femur

    PubMed Central

    Choy, Won-Sik; Lee, Sang Ki; Yang, Dae Suk; Jeung, Sang Wook; Choi, Han Gyul; Park, Hyun Jong

    2015-01-01

    Purpose To analyze the results of surgical treatment for pathological fractures at the proximal femur. Materials and Methods Nineteen patients with a pathological fracture were included. The mean age was 65.7 years old. The patients comprised 8 males and 11 females. Primary tumors, types of pathological fractures, surgical procedures, and postoperative complications were recorded. Musculoskeletal Tumor Society (MSTS) functional score was used for functional evaluation. A Kaplan-Meier survival analysis was used to determine survival rate. Results The primary malignancies were 6 cases of breast cancer, 3 cases of lung cancer, 3 cases of renal cell carcinoma, 2 cases of cholangiocarcinoma, 2 cases of hepatocellular carcinoma, 1 case of esophageal cancer, 1 case of colon cancer, and 1 case of ovarian cancer. Pathological fractures included 8 cases of pertrochanteric fractures and 11 cases of subtrochanteric fractures. Intramedullary nailing was performed in 10 cases, and joint replacement surgery was performed in 9 cases. Postoperative complications included local recurrence in 1 case, infection in 1 case, and nail breakage in 1 case. The mean postoperative MSTS score was 21. The mean survival period was 10.6 months. Patient survival rates were 42.1% after 6 months, 26.3% after 12 months, and 10.5% after 24 months. Conclusion Surgical treatment of pathological fractures at the proximal femur provided early ambulation, and excellent pain relief. The surgery was well tolerated emotionally. Surgery is necessary for improving the quality of life in such patients; however, more cases of pathological fractures in these regions should be subjected to detailed analysis. PMID:25683996

  19. Late paternities.

    PubMed

    Cohen, Jean

    2007-06-01

    Late paternities are frequent. Very often these couples ask for medically assisted procreation. In general, it is considered that the couple should not be treated differently from the couple where the father is younger. Recent studies show a certain number of specific risks linked to the late paternities. Doctors and society do not act in the same way towards men and women: a 'sensible age' for women to no longer attempt pregnancy has been set in many countries at 42 years of age, whereas men aged 80 can benefit from IVF attempts and be reimbursed by the state or insurance companies. This is an obvious inequity. PMID:17579995

  20. Three-Dimensional Analysis of the Curvature of the Femoral Canal in 426 Chinese Femurs

    PubMed Central

    Su, Xiu-Yun; Zhao, Zhe; Zhao, Jing-Xin; Zhang, Li-Cheng; Long, An-Hua; Zhang, Li-Hai; Tang, Pei-Fu

    2015-01-01

    Purpose. The human femur has long been considered to have an anatomical anterior curvature in the sagittal plane. We established a new method to evaluate the femoral curvature in three-dimensional (3D) space and reveal its influencing factors in Chinese population. Methods. 3D models of 426 femurs and the medullary canal were constructed using Mimics software. We standardized the positions of all femurs using 3ds Max software. After measuring the anatomical parameters, including the radius of femoral curvature (RFC) and banking angle, of the femurs using the established femur-specific coordinate system, we analyzed and determined the relationships between the anatomical parameters of the femur and the general characteristics of the population. Results. Pearson's correlation analyses showed that there were positive correlations between the RFC and height (r = 0.339, p < 0.001) and the femoral length and RFC (r = 0.369, p < 0.001) and a negative correlation between the femoral length and banking angle (r = −0.223, p < 0.001). Stepwise linear regression analyses showed that the most relevant factors for the RFC and banking angle were the femoral length and gender, respectively. Conclusions. This study concluded that the banking angle of the femur was significantly larger in female than in male. PMID:26640785

  1. Modeling of the mechanical behavior of the human femur: Stress analysis and strain

    NASA Astrophysics Data System (ADS)

    Belaid, Dalila; Bouchoucha, Ali

    2015-12-01

    The strength of bone depends on its state of mineralization, its geometry, and even supported loads. The femur is the longest bone, the largest and strongest of the human skeleton. It provides standing and walking and running, due to its hip joints with the one side, and with the patella and tibia across. The approach of this paper is to numerically model the mechanical behavior of the femur to determine the stress and strain distribution field. Modeling is performed on the ANSYS software. The results show the influence of different positions of the femur in different cases of postures.

  2. Photoelastic stress analysis of internal fixation techniques for femur shaft crack

    NASA Astrophysics Data System (ADS)

    Liu, Tong; Chai, Gin B.; Asundi, Anand K.; Murugiah, Arumaaran

    2001-06-01

    In this paper, a photoelastic stress analysis is carried out for a cracked femur bone with compression plate fixation. A loading rig has been designed and manufactured to apply forces in the physical directions on the 2D modal of the femur bone based on a single-leg-stance. Three femur models made of photoelastic materials had been fabricated with three configurations and loaded. A recently developed three- load to phase shifting method is adopted to extract the full-field quantitative information from the fringe patterns of the loaded models. A comparison shows that the configuration where the screws point away from each other had the best effectiveness.

  3. Compartment syndrome of the thigh complicating surgical treatment of ipsilateral femur and ankle fractures

    NASA Technical Reports Server (NTRS)

    Moore, M. R.; Garfin, S. R.; Hargens, A. R.

    1987-01-01

    A 26-year-old man presented with ipsilateral femur and ankle fractures. The patient was treated with interlocking nail of his femur fracture, followed by open reduction and internal fixation of his ankle fracture under tourniquet control. Postoperatively, the patient developed compartment syndrome of his thigh with elevated pressures, requiring decompressive fasciotomies. This case illustrates the possible complication of treating a femur fracture with intramedullary nailing and then immediately applying a tourniquet to treat an ipsilateral extremity fracture. Because of the complication with this patient, we feel the procedure should be staged, or a tourniquet should be avoided if possible.

  4. Remote nailing of intertrochanteric and subtrochanteric fractures of the femur.

    PubMed

    Waddell, J P

    1983-01-01

    Remote nailing of intertrochanteric and subtrochanteric fractures of the femur is a definite addition to the armamentarium in the management of these injuries. The advantages of the technique are too great to ignore. The surgeon should not be misled, however, into thinking that this is an easy operation or that it represents a panacea for difficult fracture situations. Considerable time must be spent learning the operative technique, its pitfalls and complications, and the postoperative management of patients. After the operation we allow our patients early weight bearing in the knee-extended position, this being maintained by the use of a Jones bandage. We believe that the prevention of knee flexion minimizes stresses across the fracture site and prevents the tendency toward external rotation. Early external rotation deformity in the patient lying in bed may cause concern, but this tendency toward external rotation disappears as soon as the patient begins to walk and bear weight. In the patient with the fracture anatomically reduced and fixed a significant external rotation will not be a problem. The use of remote nailing does not eliminate complications in the surgical treatment of intertrochanteric fractures but merely replaces one set of complications for another. It is our belief that the complications arising from remote nailing in intertrochanteric and subtrochanteric fractures are of less severity to the patient and more easily managed by the surgeon than the more traditional complications occurring as a result of direct attack on the fracture site with the implantation of various nail plate devices. Lower blood loss, shorter operating time, decreased incidence of infection, earlier walking, extremely high rate of union, and extremely low rate of implant failure are sufficient returns for occasional shortening and occasional external rotation deformity, the two complications most frequently mentioned in the literature. Excessive deformity, failure of

  5. SUPRA AND INTRACONDYLAR OPEN FRACTURE OF THE FEMUR IN A MOTOCROSS ATHLETE: CASE REPORT

    PubMed Central

    Filho, Jorge Sayum; Sayum, Jorge; de Carvalho, Rogério Teixeira; Nicolini, Alexandre; Matsuda, Marcelo Mitsuro; Cheng, Wu Tu; Cohen, Moisés

    2015-01-01

    The authors report the case of a patient (amateur motocross competitor) who suffered a fall during a motocross competition resulting in a supra and intracondylar open fracture in the right femur. PMID:27027061

  6. Wave Dispersion and Attenuation on Human Femur Tissue

    PubMed Central

    Strantza, Maria; Louis, Olivia; Polyzos, Demosthenes; Boulpaep, Frans; van Hemelrijck, Danny; Aggelis, Dimitrios G.

    2014-01-01

    Cortical bone is a highly heterogeneous material at the microscale and has one of the most complex structures among materials. Application of elastic wave techniques to this material is thus very challenging. In such media the initial excitation energy goes into the formation of elastic waves of different modes. Due to “dispersion”, these modes tend to separate according to the velocities of the frequency components. This work demonstrates elastic wave measurements on human femur specimens. The aim of the study is to measure parameters like wave velocity, dispersion and attenuation by using broadband acoustic emission sensors. First, four sensors were placed at small intervals on the surface of the bone to record the response after pencil lead break excitations. Next, the results were compared to measurements on a bulk steel block which does not exhibit heterogeneity at the same wave lengths. It can be concluded that the microstructure of the tissue imposes a dispersive behavior for frequencies below 1 MHz and care should be taken for interpretation of the signals. Of particular interest are waveform parameters like the duration, rise time and average frequency, since in the next stage of research the bone specimens will be fractured with concurrent monitoring of acoustic emission. PMID:25196011

  7. Foetal biometry in polyhydramnios: Does femur length fall behind?

    PubMed

    Ipek, Ali; Idilman, Ilkay S; Kurt, Aydın; Cay, Nurdan; Unal, Ozlem; Erdogan, Beyza Doganay; Keskin, Huseyin Levent; Arslan, Halil

    2016-01-01

    We aimed to identify the growth patterns in polyhydramnios, and therefore evaluated 108 singleton pregnancies complicated with polyhydramnios according to the changes in biparietal diameter (BPD), abdominal circumference (AC) and femur length (FL) percentiles. The pregnancy outcomes according to the growth features were analysed. In the study population, BPD and AC percentiles exhibited a significant increase (p = 0.023 and 0.05, respectively), although FL percentiles showed a significant decrease (p = 0.006) according to the changes in third trimester relative to second trimester. In the overgrown group (n = 52), the FL/BPD ratio was lower (p < 0.001), with more foetuses with FL/BPD ratios below 71 (p = 0.05). In conclusion, there was a significant increase in BPD and AC percentiles and a decrease in FL percentiles in third trimester relative to second trimester in foetuses with polyhydramnios. However, we observed a shorter FL and a lower FL/BPD ratio without associated skeletal dysplasia in overgrown foetuses. PMID:26467094

  8. Endoprosthetic proximal femur replacement: metastatic versus primary tumors.

    PubMed

    Potter, Benjamin K; Chow, Vincent E; Adams, Sheila C; Letson, G Douglas; Temple, H Thomas

    2009-12-01

    Few studies have examined the impact of underlying diagnosis on the functional and oncologic outcomes following endoprosthetic proximal femur replacement (PFR). We performed a retrospective review of 61 consecutive cemented bipolar PFR in 59 patients for treatment neoplastic lesions with a minimum follow-up of 24 months. Twenty-two patients had primary bone tumors and 39 had metastatic disease. Average follow-up for the 30 surviving patients was 55.4 months and the mean postoperative survival for the 29 patients who died was 12.2 months. Patients with primary tumors demonstrated significantly better functional outcomes than those with metastatic disease, with mean Musculoskeletal Tumor Society functional scores of 80.2 and 66.8%, respectively (p=0.0002). Age correlated inversely with functional scores (r=-0.48; p=0.0002), while femoral resection length did not. Preoperative pathologic fracture did not appear to adversely impact final functional outcomes. The Kaplan-Meier 5-year implant survival estimate was 92.5%, with aseptic loosening as the endpoint. Both functional results and survival are increased for primary tumors versus metastatic disease following PFR. However, PFR results in excellent local disease control, reliable pain relief and good functional results in both groups, with prosthesis survival exceeding that of the patient in many cases. PMID:18835153

  9. [Experience with dynamic hip screw in retrochanteric and subtrochanteric fractures of upper femur.].

    PubMed

    Weissinger, M; Helmreich, C; Bösel, A

    1995-01-01

    From 1st January 1988 to 31st December 1994, 105 patients were given 106 dynamic hip-screws in the Orthopaedic Department of the Public General Hospital, Zwettl. The average age at the time of operation was 77.6 years and the time lapse between the accident occuring and the operation performed was on average 31 hours. In 94.3% of the cases we could perform a closed reduction and in 88.7% we used a 135 degree-DHS. The four-hole plate dominated in 73.6% of the plates used. Internal complications totalled 23.6% out of which 9.5% of the patients died during their hospitalization. Here one must take note that the patients who died were of advanced age and multimorbid. We carried out clinical and radiological postoperative examinations on 54 patients (51.4%) with 55 operations (51.9%). The postoperative examinations took place on an average of 33 months (2 years and 9 months). The clinical postoperative examinations were carried out according to the Merle D'Aubigne system - 29 excellent, 58 good and 13 poor. The radiological postoperative examinations disclosed an ossian consolidation of 100% for 54 patients with 55 operations. Taking into account the classification of fractures according to the AO we find that the DHS is mainly used to treat fractures A 1/1-, A 1/2- and A 2/2-. With the exception of subtrochanteric fractures in which we have lately been using the Gamma-Nail, we have the DHS as a technically relatively simple and inexpensive implant in the treatment of pertrochanteric fractures of the neck of the femur. PMID:20470515

  10. Lesser Trochanter Migration following Intramedullary Fixation of an Intertrochanteric Femur Fracture

    PubMed Central

    Montoli, Carlo; Pasquali, Cecilia; Paiusco, Elia; Pellecchia, Vincenzo

    2016-01-01

    Intertrochanteric femur fractures are commonly observed in the elderly and may be associated with a complete fracture of the lesser trochanter in over 50% of cases. The migration of the lesser trochanter secondary to the psoas muscle contracture is a rare event. This case report presents a rare case of sudden groin pain three-week status after intramedullary fixation of a intertrochanteric femur fracture. PMID:27006846

  11. [Mechanical changes in the femur induced by a joint prosthesis. Comparative extensometric studies].

    PubMed

    Delecrin, J; Royer, J; Passuty, N; Bainvel, J V

    1991-01-01

    This study using electrical extensometry is aimed at comparing the relative deformations of the same fresh femur before and after the successive implantation of the following titanium prostheses: a cement-free prosthesis with metaphyseal endocortical support, a cemented prosthesis with, then without collar, and finally a screwed titanium prosthesis. The 56 deformation measurement paths produce an overall exploration of the behavior of the femur. The results applied to the same straight section of the femur are different from those of earlier works. The density of the measurement areas has particularly been increased in the upper metaphysis by the use of bidirectional gages. The loading device ensures the absence of variations of the external stress torsion transmitted to the femur between the individual prostheses. The results recorded with the cement-free prosthesis with metaphyseal endocortical support and with the collar-free cemented prosthesis are very similar. The incidence of the "collar effect" is very low in spite of optimal in vitro implantation conditions ensuring good contact between the collar and the neck of the femur. The screwed prosthesis is the implant that most stiffens the upper end of the femur. The testing procedure chosen has allowed recording the deformations caused by the mere insertion of the implants and the bone. The importance of the upper metaphysea endocortical support of the cement-free, screwless implant contributes in ensuring a better primary anchorage, producing stresses that will then foster the secondary anchorage through endosteal osteogenesis. PMID:1843673

  12. The shape of the early hominin proximal femur.

    PubMed

    Harmon, Elizabeth H

    2009-06-01

    Postcranial skeletal variation among Plio-Pleistocene hominins has implications for taxonomy and locomotor adaptation. Although sample size constraints make interspecific comparisons difficult, postcranial differences between Australopithecus afarensis and Australopithecus africanus have been reported (McHenry and Berger: J Hum Evol 35 1998 1-22; Richmond et al.: J Hum Evol 43 [2002] 529-548; Green et al.: J Hum Evol 52 2007 187-200). Additional evidence indicates that the early members of the genus Homo show morphology like recent humans (e.g., Walker and Leakey: The Nariokotome Homo erectus skeleton. Cambridge: Harvard, 1993). Using a larger fossil sample than previous studies and novel methods, the early hominin proximal femur is newly examined to determine whether new data alter the current view of femoral evolution and inform the issue of interspecific morphological variation among australopiths. Two- and three-dimensional data are collected from large samples of recent humans, Pan, Gorilla, and Pongo and original fossil femora of Australopithecus, Paranthropus, and femora of African fossil Homo. The size-adjusted shape data are analyzed using principal components, thin plate spline analysis, and canonical variate analysis to assess shape variation. The results indicate that femora of fossil Homo are most similar to modern humans but share a low neck-shaft angle (NSA) with australopiths. Australopiths as a group have ape-like greater trochanter morphology. A. afarensis differs from P. robustus and A. africanus in attributes of the neck and NSA. However, interspecific femoral variation is low and australopiths are generally morphologically similar. Although the differences are not dramatic, when considered in combination with other postcranial evidence, the adaptive differences among australopiths in craniodental morphology may have parallels in the postcranium. PMID:19012328

  13. Paediatric femur fractures at the emergency department: accidental or not?

    PubMed

    Hoytema van Konijnenburg, Eva M M; Vrolijk-Bosschaart, Thekla F; Bakx, Roel; Van Rijn, Rick R

    2016-01-01

    Only a small proportion of all paediatric fractures is caused by child abuse or neglect, especially in highly prevalent long bone fractures. It can be difficult to differentiate abusive fractures from non-abusive fractures. This article focuses on femoral fractures in young children. Based on three cases, this article presents a forensic evidence-based approach to differentiate between accidental and non-accidental causes of femoral fractures. We describe three cases of young children who were presented to the emergency department because of a suspected femur fracture. Although in all cases, the fracture had a similar location and appearance, the clinical history and developmental stage of the child led to three different conclusions. In the first two cases, an accidental mechanism was a plausible conclusion, although in the second case, neglect of parental supervision was the cause for concern. In the third case, a non-accidental injury was diagnosed and appropriate legal prosecution followed. Any doctor treating children should always be aware of the possibility of child abuse and neglect in children with injuries, especially in young and non-mobile children presenting with an unknown trauma mechanism. If a suspicion of child abuse or neglect arises, a thorough diagnostic work-up should be performed, including a full skeletal survey according to the guidelines of the Royal College of Radiologists and the Royal College of Paediatrics and Child Health. In order to make a good assessment, the radiologist reviewing the skeletal survey needs access to all relevant clinical and social information. PMID:26642309

  14. Osteolysis of the distal femur after total knee arthroplasty.

    PubMed

    Cadambi, A; Engh, G A; Dwyer, K A; Vinh, T N

    1994-12-01

    the study population, statistically significant factors associated with femoral osteolysis included male gender (P < .05), younger age (P < .05), increased patient weight (P < .05), positive tibial osteolysis (P < .001), osteoarthritis (P < .07), and length of time in situ (P < .001). In addition, patients with a Synatomic prosthesis were at increased risk for osteolysis compared to patients with a PCA device (P < .02). The authors postulate that histiocytic granuloma gained access to the proximal femur primarily via the unbonded interface between the smooth metal and bone. PMID:7699370

  15. Outcome of Fetuses with Diagnosis of Isolated Short Femur in the Second Half of Pregnancy

    PubMed Central

    Morales-Roselló, José; Peralta LLorens, Núria

    2012-01-01

    Objectives. To assess the outcome of fetuses with isolated short femur detected at 19–41 weeks and determine to what extent this incidental finding should be a cause of concern in fetuses with a normal previous follow-up. Methods. 156 fetuses with isolated short femur were compared with a control group of 637 fetuses with normal femur length. FL values were converted into Z-scores and classified into 4 groups: control group: Z-score over −2, group 1: Z-score between −2 and −3, group 2: Z-score between −3 and −4, and group 3: Z-score below −4. FL values were plotted with the curves representing Z-scores −2, −3, and −4. To assess fetal outcome, the frequency of SGA, IUGR, abnormal umbilical Doppler (AUD), Down's syndrome, and skeletal dysplasia was determined for each group after delivery, and the relative risk in comparison with the control group was obtained. Finally, ROC curves were drawn in order to evaluate the FL diagnostic ability for the conditions appearing with increased frequency. Results. SGA, IUGR, and AUD were more frequent in the fetuses with short femur. Conversely, none of them presented Down's syndrome or skeletal dysplasia. According to ROC analysis, FL measurement behaved as a good diagnostic test for SGA and IUGR. Conclusions. A short femur diagnosis in a fetus with an otherwise normal follow-up determines just a higher risk of being small (SGA or IUGR). PMID:22577572

  16. Lateral gastrocnemius myocutaneous flap transposition to the midlateral femur: extending the arc of rotation.

    PubMed

    Agarwal, Rishi Raj; Broder, Kevin; Kulidjian, Anna; Bodor, Richard

    2014-05-01

    We report the successful use of an extended lateral gastrocnemius myocutaneous flap for coverage of the midlateral femur using successive delayed elevations. A 62-year-old man underwent wide resection of a liposarcoma of the right anterior thigh with free flap reconstruction and subsequent radiation therapy 10 years before. Four years later, the patient fractured his irradiated femur and was treated with a retrograde intramedullary nail, which subsequently became infected, causing osteomyelitis of the distal femur, septic arthritis of the knee joint, and nonunion of his pathologic fracture. Although advised by numerous surgeons to undergo above-knee amputation, we offered our motivated patient a multidisciplinary approach to clear his infection and pathology; implanted new orthopedic hardware; performed delayed flap reconstruction; and rehabilitated him back to painless, unassisted ambulation. The extended lateral gastrocnemius myocutaneous flap used provided perfused soft tissues and durable coverage for the patient's exposed orthopedic hardware of the midlateral femur, 14 cm above the joint line of the knee. By using this flap to cover a femur defect well above published heights, our patient avoided amputation after years of worsening incapacitation. PMID:24401809

  17. The shape of the hominoid proximal femur: a geometric morphometric analysis

    PubMed Central

    Harmon, Elizabeth H

    2007-01-01

    As part of the hip joint, the proximal femur is an integral locomotor component. Although a link between locomotion and the morphology of some aspects of the proximal femur has been identified, inclusive shapes of this element have not been compared among behaviourally heterogeneous hominoids. Previous analyses have partitioned complex proximal femoral morphology into discrete features (e.g. head, neck, greater trochanter) to facilitate conventional linear measurements. In this study, three-dimensional geometric morphometrics are used to examine the shape of the proximal femur in hominoids to determine whether femoral shape co-varies with locomotor category. Fourteen landmarks are recorded on adult femora of Homo, Pan, Gorilla, Pongo and Hylobates. Generalized Procrustes analysis (GPA) is used to adjust for position, orientation and scale among landmark configurations. Principal components analysis is used to collapse and compare variation in residuals from GPA, and thin-plate spline analysis is used to visualize shape change among taxa. The results indicate that knucklewalking African apes are similar to one another in femoral shape, whereas the more suspensory Asian apes diverge from the African ape pattern. The shape of the human and orangutan proximal femur converge, a result that is best explained in terms of the distinct requirements for locomotion in each group. These findings suggest that the shape of the proximal femur is brought about primarily by locomotor behaviour. PMID:17310545

  18. A device for in vivo measurements of quantitative ultrasound variables at the human proximal femur.

    PubMed

    Barkmann, Reinhard; Laugier, Pascal; Moser, Urs; Dencks, Stefanie; Klausner, Michael; Padilla, Frédéric; Haïat, Guilleaume; Glüer, Claus-C

    2008-01-01

    Quantitative ultrasound (QUS) at the calcaneus has similar power as a bone mineral density (BMD)- measurement using DXA for the prediction of osteoporotic fracture risk. Ultrasound equipment is less expensive than DXA and free of ionizing radiation. As a mechanical wave, QUS has the potential of measuring different bone properties than dual X-ray absorptiometry (DXA,) which depends on X-ray attenuation and might be developed into a tool of comprehensive assessment of bone strength. However, site-specific DXA at the proximal femur shows best performance in the prediction of hip fractures. To combine the potential of QUS with measurements directly at the femur, we developed a device for in vivo QUS measurements at this site. Methods comprise ultrasound transmission through the bone, reflection from the bone surface, and backscatter from the inner trabecular structure. The complete area of the proximal femur can be scanned except at the femoral head, which interferes with the ilium. To avoid edge artifacts, a subregion of the proximal femur in the trochanteric region was selected as measurement region. First, in vivo measurements demonstrate a good signal to noise ratio and proper depiction of the proximal femur on an attenuation image. Our results demonstrate the feasibility of in vivo measurements. Further improvements can be expected by refinement of the scanning technique and data evaluation method to enhance the potential of the new method for the estimation of bone strength. PMID:18599408

  19. The Significance of Rectus Femoris for the Favorable Functional Outcome After Total Femur Replacement

    PubMed Central

    Nakayama, Takayuki; Shimoji, Takashi; Ae, Keisuke; Tanizawa, Taisuke; Gokita, Tabu

    2016-01-01

    Background: In treatment of tumors, we usually reconstruct after resection of the entire femur using only metallic modular endoprostheses among many procedures and defined it as a total femur replacement. We studied the interrelation between the preservation of rectus femoris and the functional outcome after total femur replacement. Methods: We rated the functional outcomes of 21 patients who underwent total femur replacement. We categorized the subjects into 2 groups: group A (rectus femoris preserved) and group B (rectus femoris unpreserved). We examined them based on the Mann-Whitney U test between the 2 groups in average through the Musculoskeletal Tumor Society functional scores. Results: The average score of group A was 20 of 25 (11–25; 80%), whereas the average score of group B was 10 of 25 (4–13; 40%). There was significant difference between the groups (P = 0.00168877). Conclusion: We found that the preservation of rectus femoris is imperative for achieving the favorable functional outcome in total femur replacement.

  20. A new anterolateral approach for type C fractures of the distal femur.

    PubMed

    Bin, Zhang; Song, Luo; Binghua, Wu; Ping, Qiu; Min, Dai

    2014-01-01

    To provide an anatomic basis for treating type C distal femoral fractures by a new anterolateral approach. Twenty surgical procedures were performed in 10 adult cadaveric specimens using a new anterolateral approach followed by dissection of all lower limbs. The main anterolateral muscles and ligaments were observed. Vessels and nerves related to the new anterolateral approach were also evaluated. Full exposure of the distal femur was achieved. The iliotibial band was protected, and damage to the quadriceps femoris was reduced. The distance between the common peroneal nerve and the new incision line at the level of the lateral epicondyle of the femur was (χ̄ ± s) 8.19 ± 0.79 cm (range, 7.48-9.57 cm). This new anterolateral approach to the distal femur is safe. Although it induces slight soft tissue damage, its exposure is excellent. Knee rehabilitation can be performed in the early postoperative period. PMID:25437603

  1. Pterosauria from the Late Triassic of Southern Brazil

    NASA Astrophysics Data System (ADS)

    Bonaparte, J. F.; Schultz, C. L.; Soares, M. B.

    A few postcranial remains of a Late Triassic pterosaur from the early Coloradian Caturrita Formation of Rio Grande do Sul are communicated. The general morphology of the coracoid, proximal portion of the humerus, femur, tibia and fibula suggests that it is more primitive than the pterosaurs from the Norian of northern Italy. The morphology and proportions of the different bones support their assignment to a primitive pterosaur. An almost complete maxilla with three teeth is tentatively referred to the same taxon because it was collected at some distance from the postcrania cited above.

  2. The Analysis of Biomechanical Properties of Proximal Femur after Implant Removal

    PubMed Central

    Yang, Jae Hyuk; Jung, Tae Gon; Honnurappa, Arjun Rupanagudi; Cha, Jae Min; Ham, Chang Hwa; Kim, Tae Yoon

    2016-01-01

    Introduction. To compare the biomechanical stability of the femur following the removal of proximal femoral nail antirotation (PFNA-II) and dynamic hip screw (DHS). Material and Methods. 56 paired cadaveric femurs were used as experimental and control groups. In the experimental group, PFNA-II and DHS were randomly inserted into femurs on both sides and then removed. Thereafter, compression load was applied until fracture occurred; biomechanical stability of the femurs and associated fracture patterns were studied. Results. The ultimate load and stiffness of the control group were 6227.8 ± 1694.1 N and 990.5 ± 99.8 N/mm, respectively. These were significantly higher than experimental group (p = 0.014, <0.001) following the removal of PFNA-II (4085.6 ± 1628.03 N and 656.3 ± 155.3 N/mm) and DHS (4001.9 ± 1588.3 N and 656.3 ± 155.3 N/mm). No statistical differences in these values were found between the 2 device groups (p = 0.84, 0.71), regardless of age groups. However, fracture patterns were different between two devices, intertrochanteric and subtrochanteric fractures. Conclusions. Mechanical stability of the proximal femurs does not differ after the removal of 2 different of fixation devices regardless of the age. However, it was significantly lower compared to an intact femur. Different fracture patterns have been shown following the removal of different fixation devices as there are variations in the site of stress risers for individual implants. PMID:27597807

  3. The Analysis of Biomechanical Properties of Proximal Femur after Implant Removal.

    PubMed

    Yang, Jae Hyuk; Jung, Tae Gon; Honnurappa, Arjun Rupanagudi; Cha, Jae Min; Ham, Chang Hwa; Kim, Tae Yoon; Suh, Seung Woo

    2016-01-01

    Introduction. To compare the biomechanical stability of the femur following the removal of proximal femoral nail antirotation (PFNA-II) and dynamic hip screw (DHS). Material and Methods. 56 paired cadaveric femurs were used as experimental and control groups. In the experimental group, PFNA-II and DHS were randomly inserted into femurs on both sides and then removed. Thereafter, compression load was applied until fracture occurred; biomechanical stability of the femurs and associated fracture patterns were studied. Results. The ultimate load and stiffness of the control group were 6227.8 ± 1694.1 N and 990.5 ± 99.8 N/mm, respectively. These were significantly higher than experimental group (p = 0.014, <0.001) following the removal of PFNA-II (4085.6 ± 1628.03 N and 656.3 ± 155.3 N/mm) and DHS (4001.9 ± 1588.3 N and 656.3 ± 155.3 N/mm). No statistical differences in these values were found between the 2 device groups (p = 0.84, 0.71), regardless of age groups. However, fracture patterns were different between two devices, intertrochanteric and subtrochanteric fractures. Conclusions. Mechanical stability of the proximal femurs does not differ after the removal of 2 different of fixation devices regardless of the age. However, it was significantly lower compared to an intact femur. Different fracture patterns have been shown following the removal of different fixation devices as there are variations in the site of stress risers for individual implants. PMID:27597807

  4. Application of retrograde dissection method for isolation of bone marrow cells from rat femurs and tibiae.

    PubMed

    Li, C M; Fu, B M; Zhang, L C; Tang, B; Zhu, L; Zhao, Y; Zhang, J

    2016-01-01

    Currently, there is no practical and efficient method for the isolation of bone marrow cells (BMCs) from rat femurs and tibiae. Here, we attempted to develop a rapid, simple, effective, and non-contaminating method for the isolation of BMCs from rat femurs and tibiae. Rat femurs and tibiae were dissected from the ankle to the hip joint; subsequently, a three-step "locate-slide-twist" procedure was performed using scissors and forceps to remove the femurs and tibiae completely, from the surrounding musculature. The bones were flushed with phosphate-buffered saline to harvest BMCs. The femurs and tibiae were dissected in 1.8 ± 0.6 min, and the BMC suspension preparation time was 13.1 ± 2.3 min. The bone marrow cavities did not incur any fractures or injuries during the isolation. Culture of harvested BMCs for 72 h led to a significant increase in cell number from 4.4 ± 0.3 x 106 to 6.9 ± 0.7 x 10(6) (P < 0.01) with no significant decrease in viability (98.1 ± 0.6% vs 96.2 ± 1.1%; P > 0.05). Microscopic examination of the isolated BMCs after the 72-h incubation period revealed the no-microbial or muscle cell contamination. Furthermore, flow cytometry revealed that cultured BMCs (72-h culture) grew well. Here, we have reported a rapid, simple, effective, and non-contaminating method for the isolation of BMCs from rat femurs and tibiae by using retrograde dissection. This method can be used to harvest a large number of viable BMCs without the risk of contamination from muscle and connective tissues. PMID:27323101

  5. The epidemiology and treatment of femur fractures at a northern tanzanian referral centre

    PubMed Central

    Hollis, Alexander Conor; Ebbs, Samuel Robert; Mandari, Faiton Ndesanjo

    2015-01-01

    Introduction Femoral fractures are the most common presenting injury at the orthopaedic department in a large Tanzanian hospital. To date, there has been no current examination of the epidemiology of femoral fractures and the disease burden has not been quantified. Methods A retrospective descriptive study of patient records in the orthopaedic department at Kilimanjaro Christian Medical Centre (KCMC) was performed. Patient demographics, aetiology of fractures, diagnosis and treatment were all recorded. Results A total of 540 consecutive patient admission records were reviewed over a 9 month period. Of these 540 cases, 213 (39%) were diagnosed with a femoral fracture. The 21-30 age group were the most commonly affected by femur fractures (20% n = 42). Within this group, motor traffic accidents (MTA) were the cause of 71% of injuries (n = 30). For males, MTA's caused 59% of all femur fractures (n = 80), while falls were the most common cause of femur fractures in females (70%; n = 49). 80% of the fractures in the 51-100 age group were caused by falls (n = 52). In both the male and female groups the most common fracture seen was mid shaft femoral fracture (males 33% (n = 48), females 25% (n = 18)). The most common treatment was skeletal traction used in 40% (n = 85) of patients. Conclusion Femur fracture most commonly presented in males under age 30. Femur fracture was most commonly cause by MTAs in males and by falls in females. The most common diagnosis was mid shaft of femur fracture. Skeletal traction was the most frequent treatment. PMID:26977245

  6. Extreme femoral valgus and patella dislocation following lateral plate fixation of a pediatric femur fracture.

    PubMed

    Ezzat, Ahmed; Iobst, Christopher

    2016-07-01

    A 15-year-old boy presented with a 35° femoral valgus deformity, leg-length discrepancy, painful retained hardware, and a lateral dislocation of the patella 4 years after undergoing lateral plate fixation of a distal femur fracture. Femoral valgus is a possible complication of lateral plate fixation in up to 30% of pediatric distal femur fractures. With this patient's unusual combination of deformities as an example, we suggest early hardware removal after fracture union to prevent the development of deformity. If plate removal is not chosen, then continued close monitoring of the patient is necessary until skeletal maturity. PMID:27243610

  7. Management of distal femur fractures with modern plates and nails: state of the art.

    PubMed

    Beltran, Michael J; Gary, Joshua L; Collinge, Cory A

    2015-04-01

    Fractures of the distal femur, even those with articular extension, are well suited to surgical fixation with modern precontoured anatomic plates and nails. Numerous adjuvant techniques are available to the treating surgeon to obtain and maintain reduction while preserving fracture biology. Yet despite their proven track record and benefits over older implants, technical errors are common and must be overcome with proper preoperative planning and intraoperative attention to detail. This review summarizes the current state of the art regarding distal femur fractures, with an emphasis on relevant modern plate and nail surgical techniques, tempered by our current understanding of implant biomechanics, fracture healing, and long-term outcomes. PMID:25793566

  8. Femur ontogeny in humans and great apes: heterochronic implications for hominid évolution

    NASA Astrophysics Data System (ADS)

    Tardieu, Christine

    1997-12-01

    Did the first hominids have a short developmental period similar to that of the great apes, or a longer period closer to that of modern humans? Some morphological modifications undergone by the human femur during growth are shown to be excellent markers of different developmental stages. The femur of the first hominids ( Australopithecus afarensis) shows only features of infantile growth, whereas characters of both infantile and adolescent growth are typical of later hominids ( Homo). In the first australopithecines the period of peripubertal growth would have still been short. The prolongation of the adolescent period appears to be a characteristic of Homo.

  9. Late Occurring Medial Migration of a Lag Screw in Gamma Nailing

    PubMed Central

    van Hoef, S.; Fuchs, M. C. H. W.; ten Broeke, R. H. M.

    2016-01-01

    An 81-year-old female was treated for a pertrochanteric multifragmentary fracture of the proximal femur with a third-generation Gamma nail. After 3 months she presented herself again with acute pain and inability to bear weight on the leg. Radiographs showed medial migration of the lag screw. She was treated with a total hip arthroplasty, after which she was successfully discharged. In this case report the possible causes of this late and unusual complication are discussed. PMID:27313926

  10. Osteoporosis and low bone mass at the femur neck or lumbar spine in older adults: United States, 2005-2008

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Many current clinical guidelines recommend that assessment of osteoporosis or low bone mass, as defined by the World Health Organization (WHO) (1), be based on bone mineral density at either the femur neck region of the proximal femur (hip) or the lumbar spine (2,3). This data brief presents the mos...

  11. A PTH-responsive circadian clock operates in ex vivo mouse femur fracture healing site.

    PubMed

    Kunimoto, Tatsuya; Okubo, Naoki; Minami, Yoichi; Fujiwara, Hiroyoshi; Hosokawa, Toshihiro; Asada, Maki; Oda, Ryo; Kubo, Toshikazu; Yagita, Kazuhiro

    2016-01-01

    The circadian clock contains clock genes including Bmal1 and Period2, and it maintains an interval rhythm of approximately 24 hours (the circadian rhythm) in various organs including growth plate and articular cartilage. As endochondral ossification is involved not only in growth plate but also in fracture healing, we investigated the circadian clock functions in fracture sites undergoing healing. Our fracture models using external fixation involved femurs of Period2::Luciferase knock-in mice which enables the monitoring of endogenous circadian clock state via bioluminescence. Organ culture was performed by collecting femurs, and fracture sites were observed using bioluminescence imaging systems. Clear bioluminescence rhythms of 24-hour intervals were revealed in fracture healing sites. When parathyroid hormone (PTH) was administered to fractured femurs in organ culture, peak time of Period2::Luciferase activity in fracture sites and growth plates changed, indicating that PTH-responsive circadian clock functions in the mouse femur fracture healing site. While PTH is widely used in treating osteoporosis, many studies have reported that it contributes to improvement of fracture healing. Future studies of the role of this local clock in wound healing may reveal a novel function of the circadian timing mechanism in skeletal cells. PMID:26926165

  12. Association between femur size and a focal defect of the superior femoral neck.

    PubMed

    Gee, A H; Treece, G M; Tonkin, C J; Black, D M; Poole, K E S

    2015-12-01

    Within each sex, there is an association between hip fracture risk and the size of the proximal femur, with larger femurs apparently more susceptible to fracture. Here, we investigate whether the thickness and density of the femoral cortex play a role in this association: might larger femurs harbour focal, cortical defects? To answer this question, we used cortical bone mapping to measure the distribution of cortical mass surface density (CMSD, mg/cm(2)) in cohorts of 308 males and 125 females. Principal component analysis of the various femoral surfaces led to a measure of size that is linearly independent from shape. After mapping the data onto a canonical femur surface, we used statistical parametric mapping to identify any regions where CMSD depends on size, allowing for other confounding covariates including shape. Our principal finding was a focal patch on the superior femoral neck, where CMSD is reduced by around 1% for each 1% increase in proximal-distal size (p<0.000005 in the males, p<0.001 in the females). This finding appears to be consistent with models of functional adaptation, and may help with the design of interventional strategies for reducing fracture risk. PMID:26142930

  13. QCT-based failure analysis of proximal femurs under various loading orientations.

    PubMed

    Mirzaei, Majid; Keshavarzian, Maziyar; Alavi, Fatemeh; Amiri, Pegah; Samiezadeh, Saeid

    2015-06-01

    In this paper, the variations of the failure strength and pattern of human proximal femur with loading orientation were analysed using a novel quantitative computed tomography (QCT)-based linear finite element (FE) method. The QCT images of 4 fresh-frozen femurs were directly converted into voxel-based finite element models for the analyses of the failure loads and patterns. A new geometrical reference system was used for the alignment of the mechanical loads on the femoral head. A new method was used for recognition and assortment of the high-risk elements using a strain energy-based measure. The FE results were validated with the experimental results of the same specimens and the results of similar case studies reported in the literature. The validated models were used for the computational investigation of the failure loads and patterns under 15 different loading conditions. A consistent variation of the failure loads and patterns was found for the 60 different analysed cases. Finally, it was shown that the proposed procedure can be used as a reliable tool for the failure analysis of proximal femurs, e.g. identification of the relevant loading directions for specific failure patterns, or determination of the loading conditions under which the proximal femurs are failure-prone. PMID:25731689

  14. Adaptation of the lateral distal femur DXA scan technique to adults with disabilities.

    PubMed

    Henderson, Richard C; Henderson, Brent A; Kecskemethy, Heidi H; Hidalgo, Sebastian T; Nikolova, Beth Ann; Sheridan, Kevin; Harcke, H Theodore; Thorpe, Deborah E

    2015-01-01

    The technique that best addresses the challenges of assessing bone mineral density in children with neuromuscular impairments is a dual-energy X-ray absorptiometry (DXA) scan of the lateral distal femur. The purpose of this study was to adapt this technique to adults with neuromuscular impairments and to assess the reproducibility of these measurements. Thirty-one adults with cerebral palsy had both distal femurs scanned twice, with the subject removed and then repositioned between each scan (62 distal femurs, 124 scans). Each scan was independently analyzed twice by 3 different technologists of varying experience with DXA (744 analyses). Precision of duplicate analyses of the same scan was good (range: 0.4%-2.3%) and depended on both the specific region of interest and the experience of the technologist. Precision was reduced when comparing duplicate scans, ranging from 7% in the metaphyseal (cancellous) region to 2.5% in the diaphyseal (cortical) region. The least significant change was determined as recommended by the International Society for Clinical Densitometry for each technologist and each region of interest. Obtaining reliable, reproducible, and clinically relevant assessments of bone mineral density in adults with neuromuscular impairments can be challenging. The technique of obtaining DXA scans of the lateral distal femur can be successfully applied to this population but requires a commitment to developing the necessary expertise. PMID:24932899

  15. POLYCHLORINATED BIPHENYL (AROCLOR 1254) INDUCED NEPHROTOXICITY, CHANGES IN FEMUR MORPHOMETRY AND CALCIUM METABOLISM

    EPA Science Inventory

    Experiments were performed to investigate the effects of polychlorinated biphenyl (PCB) on calcium metabolism, femur morphometry, and nephrotoxicity. ischer 344 rats Here dosed daily 1G for 5, 10 or 15 weeks with 0, 0.1, 1, 10 or 25 mg PCB/kg body weight. fter 5, 10 and 15 weeks,...

  16. Clinical and functional comparison of endoprosthetic replacement with intramedullary nailing for treating proximal femur metastasis

    PubMed Central

    Gao, Hua; Liu, Zhenyu; Wang, Baojun; Guo, Ai

    2016-01-01

    Objective: To evaluate the clinical and functional outcomes of modular endoprosthetic replacement (EPR) compared to proximal femur intramedullary nailing (IMN) for the treatment of proximal femur metastases. Methods: We retrospectively studied the records of patients with proximal femur metastatic lesions treated with surgical stabilization between January 2007 and December 2014 in terms of operation time, blood loss, postoperative score, soreness, Karnofsky performance score (KPS) and survival time. Results: There were 34 patients treated with surgical stabilization. The mean follow-up period was 12.1?.6 months (range: 10-47 months). Thirteen were treated with EPR and 21 were stabilized with IMN (20 males, 14 females; mean age: 68.7 years). The median survival time was 11.0 months for both groups (P=0.147). The operation time, blood loss and Harris score of IMN group were lower than those of EPR group (P=0.001, P=0.001, P=0.002, respectively). Conclusions: Both EPR and IMN for treating proximal femur metastasis achieved effective clinical outcomes. Therefore, the suitable surgical methods depended on the general conditions and medical requirements of patients, as well as the technical advantages of the doctor. PMID:27199518

  17. Femur-mounted navigation system for the arthroscopic treatment of femoroacetabular impingement

    NASA Astrophysics Data System (ADS)

    Park, S. H.; Hwang, D. S.; Yoon, Y. S.

    2013-07-01

    Femoroacetabular impingement stems from an abnormal shape of the acetabulum and proximal femur. It is treated by resection of damaged soft tissue and by the shaping of bone to resemble normal features. The arthroscopic treatment of femoroacetabular impingement has many advantages, including minimal incisions, rapid recovery, and less pain. However, in some cases, revision is needed owing to the insufficient resection of damaged bone from a misreading of the surgical site. The limited view of arthroscopy is the major reason for the complications. In this research, a navigation method for the arthroscopic treatment of femoroacetabular impingement is developed. The proposed navigation system consists of femur attachable measurement device and user interface. The bone mounted measurement devices measure points on head-neck junction for registration and position of surgical instrument. User interface shows the three-dimensional model of patient's femur and surgical instrument position that is tracked by measurement device. Surgeon can know the three-dimensional anatomical structure of hip joint and surgical instrument position on surgical site using navigation system. Surface registration was used to obtain relation between patient's coordinate at the surgical site and coordinate of three-dimensional model of femur. In this research, we evaluated the proposed navigation system using plastic model bone. It is expected that the surgical tool tracking position accuracy will be less than 1 mm.

  18. The influence of simvastatin in rats mandible and femur bone mass under Freund's adjuvant arthritis.

    PubMed

    Seferos, Nikos; Pantopoulou, Alkistis; Kotsiou, Antonia; Rallis, Georgios; Tesseromatis, Christine

    2012-01-01

    OBJECTIVES. Complete Freund's Adjuvant (CFA)-induced arthritis in rats has been used widely as a model of rodent arthropathy and polyarthritis followed by osteoporosis, decreased bone formation and increased bone formation. Osteoporosis is characterized by rapid reduce of bone mass affecting more than 100 million people worldwide. Periodontitis a chronic inflammatory, of multifactorian origin disease has been associated with general osteoporosis. Protective bone-specific anabolic and antiresorptive effects of HMG-CoA reductase inhibitors have also been evaluated in normal and osteoporotic bone. AIM. The aim of the study was to investigate mandible and femur bone density in Freund's adjuvant induced arthritis rats under the influence of simvastatin. METHODS. Three groups (A, B, C) of 7 Wistar male rats each aged 3 months, (292±48.38 g) were used. A control. Group B and C subjected experimental arthritis via complete Freund's adjuvant injected in right paw. Group C was treated with simvastatin 0.5 mg/kg/daily po 14 days. Femur, mandible were isolated and sizes parameters, biochemical serum findings and BMD were estimated. RESULTS. CFA established by paw diameter, adrenals and spleen weight increase and thymus weight decrease, while biochemical serum findings were also affected. Reduced femur, mandible weight and general bone mass parameters BMD evaluated via DEXA occurred and restored under simvastatin treatment. CONCLUSIONS. CFA induced mandible and femur injuries are repaired by ssimvatatin treatment that could be therapeutically useful. PMID:23037783

  19. A COMPARISON OF SKULL AND FEMUR LEAD LEVELS IN ADULT RATS

    EPA Science Inventory

    The purpose of the study was to elucidate the relationship between skull and femur lead levels in laboratory rats. Forty-eight female rats were given one of four lead chloride drinking water solutions: 0.05, 0.58, 17, or 352 ppm lead. Two animals from each group were sacrificed a...

  20. Tea drinking habits and osteoporotic hip/femur fractures: A case-control study

    PubMed Central

    Huang, Chenshu; Tang, Rongrui

    2016-01-01

    Objective: To explore the relationship between tea drinking habits and osteoporotic hip/femur fractures. Methods: Paired case-control method was used for face-to-face interviews from January 2010 to June 2014. Patients (n=435) with newly osteoporotic hip/femur fracture and 435 controls with the same gender and age (±3) were given questionnaire survey. The survey content included general situation, detailed tea drinking and other diet condition, health-related behavior and family history of fractures, etc. Results: Single factor logistic analysis showed that the habit of drinking tea can significantly reduce the risk of hip/femur fracture. Cumulative year of tea drinking, the cumulative amount of tea and tea concentration (low dose group) have the maximum protection for fracture, while the high dose group is weaker in protection (trend test, P<0.05). After adjustment for age, energy, BMI, education degree, parents’ history of fracture, second hand smoke exposure, calcium supplements, and equivalent energy consumption of physical activity, etc, the above association still showed significant linear trend, but the associated strength was slightly reduced. But stratified analysis found that the effect of tea drinking was only statistically significant in men. And there were no statistically significant differences of people with different education degree. Conclusions: Regular tea drinking can reduce the risk of osteoporotic hip/femur fractures in middle-aged and elderly men. PMID:27182250

  1. Detecting Early Biomechanical Effects of Zoledronic Acid on Femurs of Osteoporotic Female Rats

    PubMed Central

    Palacio, Evandro Pereira; Müller, Sérgio Swain; Sardenberg, Trajano; Mizobuchi, Roberto Ryuiti; Galbiatti, José Antônio; Durigan, Alcides; Savarese, Aniello; Ortolan, Érika Veruska Paiva

    2012-01-01

    Aim. To investigate the biomechanical effects of zoledronic acid (ZA) on femurs of female osteoporotic rats after follow-up periods of 9 and 12 months. Methods. Eighty female Wistar rats were prospectively assessed. At 60 days of age, the animals were randomly divided into two groups: bilateral oophorectomy (O) (n = 40) and sham surgery (S) (n = 40). At 90 days of age, groups O and S were randomly subdivided into four groups, according to whether 0.1 mg/kg of ZA or distilled water (DW) was intraperitoneally administered: OZA (n = 20), ODW (n = 20), SZA (n = 20), and SDW (n = 20). The animals were sacrificed at 9 and 12 months after the administration of the substances, and then their right femurs were removed and analyzed biomechanically. Axial compression tests that focused on determining the maximum load (N), yield point (N), and stiffness coefficient (N/mm) of the proximal femur were performed in the biomechanical study. Results. ZA significantly increased the maximum load and yield point, reducing the stiffness coefficient concerning the oophorectomy status and follow-up period. Conclusion. Zoledronic acid, at a dose of 0.1 mg/kg, significantly increased the maximum loads and yield points and reduced the stiffness coefficients in the femurs of female rats with osteoporosis caused by bilateral oophorectomy. PMID:23304634

  2. Fatigue performance of composite analogue femur constructs under high activity loading.

    PubMed

    Chong, Alexander C M; Friis, Elizabeth A; Ballard, Gregory P; Czuwala, Peter J; Cooke, Francis W

    2007-07-01

    Synthetic mechanical analogue bone models are valuable tools for consistent analysis of implant performance in both equilibrium and fatigue biomechanical testing. Use of these models has previously been limited by the poor fatigue performance when tested under realistic service loads. An objective was to determine whether a new analogue bone model (Fourth-Generation) using enhanced analogue cortical bone provides significantly improved resistance to high load fracture and fatigue as compared to the current (Third-Generation) bone models in clinically relevant in situ type testing of total hip implants. Six Third-Generation and six Fourth-Generation mechanical analogue proximal femur models were implanted with a cemented mock hip arthroplasty. Each specimen was loaded at 5 Hz in simulated one-legged stance under load control with a maximum compressive load of 2670 N and load ratio of 0.1. Average complete structural failure in Third-Generation femurs occurred at 3.16 million cycles; all specimens exhibited substantial displacement and crazing at well below 3 million cycles. In contrast, all Fourth-Generation femurs sustained 10 million cycles without complete structural failure and showed little change in actuator deflection. The Fourth-Generation femur model performance was sufficient to allow the model to be used in biomechanically relevant load bearing levels with an intramedullary device without model compromise that would affect test results. PMID:17390224

  3. Femur bone strength in Tyrannosaurus rex: A study of sexual dimorphism

    NASA Astrophysics Data System (ADS)

    Lee, Scott

    2012-04-01

    Tyrannosaurus rex is the iconic species of a fearsome predator and is held in fascination by virtually everyone. Like many other species, Tyrannosaurs rex displayed sexual dimorphism with the females larger than the males. The femur bones of 14 fossil specimens were examined to determine if the maximum running abilities were significantly different for the two genders. No significant difference is observed.

  4. Cemented allograft-prosthesis composite reconstruction for the proximal femur tumor

    PubMed Central

    Min, Li; Tang, Fan; Duan, Hong; Zhou, Yong; Zhang, Wen-li; Shi, Rui; Tu, Chong-qi

    2015-01-01

    Introduction Cemented allograft-prosthesis composite (APC) reconstruction is one option following resection of the proximal femur tumor. However, rare studies have focused on the indications and complications. The goal of the present study was to (1) ascertain the indications for cemented APC arthroplasty in the proximal femur; (2) identify the detailed perioperative management; and (3) illustrate our experiences to avoid the complications of cemented APC. Materials and methods A total 28 patients who underwent cemented APC reconstruction of the proximal femur after tumor resection were retrospectively evaluated at a median follow-up of 56 months. Clinical records and radiographs were reviewed to evaluate patients’ outcome. Results In our series, excluding three cases of death that had a short follow-up period, union occurred in 22 (88.0%) patients (range 9–18 months). Nonunion of the greater trochanter was seen in six of the 12 patients (50.0%). Eight (32.0%) hips had resorption. There were two (8.0%) hips that were observed to have asymptomatic wear of the acetabulum. The average Musculoskeletal Tumor Society (MSTS) score was 26.5 points. The average Harris Hip Score (HHS) score was 80.6 points. There were no cases of recurrence, but metastasis was found in two hips. Conclusions Mastering indications, perioperative management, and complication prevention are all very important in the APC reconstruction after resection of the proximal femur. PMID:26345329

  5. A PTH-responsive circadian clock operates in ex vivo mouse femur fracture healing site

    PubMed Central

    Kunimoto, Tatsuya; Okubo, Naoki; Minami, Yoichi; Fujiwara, Hiroyoshi; Hosokawa, Toshihiro; Asada, Maki; Oda, Ryo; Kubo, Toshikazu; Yagita, Kazuhiro

    2016-01-01

    The circadian clock contains clock genes including Bmal1 and Period2, and it maintains an interval rhythm of approximately 24 hours (the circadian rhythm) in various organs including growth plate and articular cartilage. As endochondral ossification is involved not only in growth plate but also in fracture healing, we investigated the circadian clock functions in fracture sites undergoing healing. Our fracture models using external fixation involved femurs of Period2::Luciferase knock-in mice which enables the monitoring of endogenous circadian clock state via bioluminescence. Organ culture was performed by collecting femurs, and fracture sites were observed using bioluminescence imaging systems. Clear bioluminescence rhythms of 24-hour intervals were revealed in fracture healing sites. When parathyroid hormone (PTH) was administered to fractured femurs in organ culture, peak time of Period2::Luciferase activity in fracture sites and growth plates changed, indicating that PTH-responsive circadian clock functions in the mouse femur fracture healing site. While PTH is widely used in treating osteoporosis, many studies have reported that it contributes to improvement of fracture healing. Future studies of the role of this local clock in wound healing may reveal a novel function of the circadian timing mechanism in skeletal cells. PMID:26926165

  6. A comparative study of orthotropic and isotropic bone adaptation in the femur

    PubMed Central

    Geraldes, Diogo M; Phillips, Andrew T M

    2014-01-01

    Functional adaptation of the femur has been studied extensively by embedding remodelling algorithms in finite element models, with bone commonly assumed to have isotropic material properties for computational efficiency. However, isotropy is insufficient in predicting the directionality of bone's observed microstructure. A novel iterative orthotropic 3D adaptation algorithm is proposed and applied to a finite element model of the whole femur. Bone was modelled as an optimised strain-driven adaptive continuum with local orthotropic symmetry. Each element's material orientations were aligned with the local principal stress directions and their corresponding directional Young's moduli updated proportionally to the associated strain stimuli. The converged predicted density distributions for a coronal section of the whole femur were qualitatively and quantitatively compared with the results obtained by the commonly used isotropic approach to bone adaptation and with ex vivo imaging data. The orthotropic assumption was shown to improve the prediction of bone density distribution when compared with the more commonly used isotropic approach, whilst producing lower comparative mass, structurally optimised models. It was also shown that the orthotropic approach can provide additional directional information on the material properties distributions for the whole femur, an advantage over isotropic bone adaptation. Orthotropic bone models can help in improving research areas in biomechanics where local structure and mechanical properties are of key importance, such as fracture prediction and implant assessment. © 2014 The Authors. International Journal for Numerical Methods in Biomedical Engineering published by John Wiley & Sons, Ltd. PMID:24753477

  7. Bone Morphology in 46 BXD Recombinant Inbred Strains and Femur-Tibia Correlation

    PubMed Central

    Zhang, Yueying; Lu, Lu; Hasty, Karen A.

    2015-01-01

    We examined the bone properties of BXD recombinant inbred (RI) mice by analyzing femur and tibia and compared their phenotypes of different compartments. 46 BXD RI mouse strains were analyzed including progenitor C57BL/6J (n = 16) and DBA/2J (n = 15) and two first filial generations (D2B6F1 and B6D2F1). Strain differences were observed in bone quality and structural properties (P < 0.05) in each bone profile (whole bone, cortical bone, or trabecular bone). It is well known that skeletal phenotypes are largely affected by genetic determinants and genders, such as bone mineral density (BMD). While genetics and gender appear expectedly as the major determinants of bone mass and structure, significant correlations were also observed between femur and tibia. More importantly, positive and negative femur-tibia associations indicated that genetic makeup had an influence on skeletal integrity. We conclude that (a) femur-tibia association in bone morphological properties significantly varies from strain to strain, which may be caused by genetic differences among strains, and (b) strainwise variations were seen in bone mass, bone morphology, and bone microarchitecture along with bone structural property. PMID:25811045

  8. Femur specific polyaffine model to regularize the log-domain demons registration

    NASA Astrophysics Data System (ADS)

    Seiler, Christof; Pennec, Xavier; Ritacco, Lucas; Reyes, Mauricio

    2011-03-01

    Osteoarticular allograft transplantation is a popular treatment method in wide surgical resections with large defects. For this reason hospitals are building bone data banks. Performing the optimal allograft selection on bone banks is crucial to the surgical outcome and patient recovery. However, current approaches are very time consuming hindering an efficient selection. We present an automatic method based on registration of femur bones to overcome this limitation. We introduce a new regularization term for the log-domain demons algorithm. This term replaces the standard Gaussian smoothing with a femur specific polyaffine model. The polyaffine femur model is constructed with two affine (femoral head and condyles) and one rigid (shaft) transformation. Our main contribution in this paper is to show that the demons algorithm can be improved in specific cases with an appropriate model. We are not trying to find the most optimal polyaffine model of the femur, but the simplest model with a minimal number of parameters. There is no need to optimize for different number of regions, boundaries and choice of weights, since this fine tuning will be done automatically by a final demons relaxation step with Gaussian smoothing. The newly developed synthesis approach provides a clear anatomically motivated modeling contribution through the specific three component transformation model, and clearly shows a performance improvement (in terms of anatomical meaningful correspondences) on 146 CT images of femurs compared to a standard multiresolution demons. In addition, this simple model improves the robustness of the demons while preserving its accuracy. The ground truth are manual measurements performed by medical experts.

  9. Can CT image deblurring improve finite element predictions at the proximal femur?

    PubMed

    Falcinelli, Cristina; Schileo, Enrico; Pakdel, Amirreza; Whyne, Cari; Cristofolini, Luca; Taddei, Fulvia

    2016-10-01

    The aim of this study was to determine if a CT image deblurring algorithm can improve CT-based FE modelling accuracy at the proximal femur. Experimental data (CT scans of fourteen proximal fresh-frozen cadaveric femurs, non-destructive surface strain measurements in stance and sideways fall loading configurations on all femurs, and failure loads obtained in stance for seven specimens, in sideways fall for the other seven) were taken from a recent study (Schileo et al., 2014). An estimate of the 3D Point Spread Function for each CT scan was used within a deconvolution solver to perform the deblurring. The most proximal regions of three specimens were scanned using an HRpQCT scanner and compared to the original and deblurred CT images to quantify errors in bone contour estimates and determine correlation of intensity values within the bone contours. Subject-specific FE models of the proximal femur were generated. The accuracy of deblurred FE predictions against experimental measurements was compared to the published (non-deblurred) FE results. When compared to HRpQCT, CT deblurring led to lower mean surface distances (0.31 vs. 0.49mm) and higher CT intensity correlations with respect to the original CT. All indicators of strain prediction accuracy were significantly improved in deblurred FE models, more markedly at the femoral neck (peak error reduced by 38%). Failure load prediction, based on a simple elastic limit model, was also improved in deblurred FE models, although differently for stance and sideways fall loading conditions. In stance, correlation was unchanged, but specimen-wise errors were reduced (mean error 10% vs. 15%). In sideways fall, correlation notably increased (R(2)=0.95 vs. 0.81), despite a general overestimation of failure load. In summary, the proposed CT deblurring technique yielded moderate but significant improvements in FE predictions, and may thus be considered a first step toward the improvement of CT-based FE models of the human femur

  10. Treatment of fractures of the femur with the Grosse-Kempf rod.

    PubMed

    Acker, J H; Murphy, C; D'Ambrosia, R

    1985-11-01

    Intramedullary rod placement provides excellent fixation for many fractures of the femur. It also carries a high union rate, a low infection rate, and a shortened hospital stay for the patient. Certain fractures of the femur are not suitable for fixation with a standard intramedullary and alone. Use of the Grosse-Kempf rod, with interlocking screws, allows for stable fixation for long oblique fractures, spiral fractures, comminuted fractures, segmental fractures, fractures with a butterfly fragment, and fractures located in the proximal or distal shaft of the femur. The Louisiana State University (LSU) Orthopedic experience in the use of the Grosse-Kempf rod is presented in this article. We have treated a total of 60 fractures of the femur in 58 patients with this fixation system. This series consists of 58 acute fractures, one established nonunion, and one established infected nonunion. All patients in the group of acute fractures and who have had adequate follow up and time have healed. This group consists of 29 healed fractures and four fractures which are healing, but have recently had the static screw removed. Eight patients were lost to follow up, two died of causes unrelated to the treatment, and 17 have been placed recently and have not had time to heal. There was one instance of wound infection in the acute fracture group, associated with the distal screws, but this has not required rod removal. The Grosse-Kempf rod provides the treating physician with another option in the treatment of fractures of the femur not suitable for use by the standard intramedullary rod. The procedure is difficult, but we have found it to be reliable in treatment of difficult fractures. PMID:3832028

  11. Two-Stage Surgical Treatment for Non-Union of a Shortened Osteoporotic Femur

    PubMed Central

    Said, Galal Zaki; Farouk, Osama Ahmed; Said, Hatem Galal

    2013-01-01

    Introduction We report a case of non-union with severe shortening of the femur following diaphysectomy for chronic osteomyelitis. Case Presentation A boy, aged 16 years presented with a dangling and excessively short left lower limb. He was using an elbow crutch in his right hand to help him walk. He had a history of diaphysectomy for chronic osteomyelitis at the age of 9. Examination revealed a freely mobile non-union of the left femur. The femur was the seat of an 18 cm shortening and a 4 cm defect at the non-union site; the knee joint was ankylosed in extension. The tibia and fibula were 10 cm short. Considering the extensive shortening in the femur and tibia in addition to osteoporosis, he was treated in two stages. In stage I, the femoral non-union was treated by open reduction, internal fixation and iliac bone grafting. The patient was then allowed to walk with full weight bearing in an extension brace for 7 months. In Stage II, equalization of leg length discrepancy (LLD) was achieved by simultaneous distraction of the femur and tibia by unilateral frames. At the 6 month follow- up, he was fully weight bearing without any walking aid, with a heel lift to compensate the 1.5 cm shortening. Three years later he reported that he was satisfied with the result of treatment and was leading a normal life as a university student. Conclusions Two-stage treatment succeeded to restore about 20 cm of the femoral shortening in a severely osteoporotic bone. It has also succeeded in reducing the treatment time of the external fixator. PMID:24350147

  12. Proximal femur of Australopithecus africanus from Member 4, Makapansgat, South Africa.

    PubMed

    Reed, K E; Kitching, J W; Grine, F E; Jungers, W L; Sokoloff, L

    1993-09-01

    A left proximal femur (MLD 46) from Member 4, Makapansgat, South Africa is described and analyzed. It consists of the head, neck, and a small segment of the shaft that extends to just below the lesser trochanter. The femur exhibits degenerative joint disease in the form of marginal osteophyte formation and thus its taxonomic identity has been somewhat obscured. Consideration of all like-sized mammalian femora from Makapansgat suggests that the femur is that of either a felid or hominid. Comparison of MLD 46 to femora of extent and extinct felids reveals that MLD 46 does not possess two morphological features that are characteristic of felids, namely a deep, prolonged trochanteric fossa and a high neck-shaft angle. Simple shape variables (ratios) and multivariate analyses consistently place MLD 46 with modern and fossil hominids, and most closely align it with the australopithecines. We conclude that the femur is most reasonably attributable to Australopithecus africanus, which is the only hominid yet identified from Makapansgat. Despite its pathological condition, MLD 46 is the most complete proximal femur known for A. africanus, thereby permitting further morphological comparisons with homologues of A. afarensis and Paranthropus. Marginal osteophytes of mammalian femoral heads characteristically occur in individuals of advanced age, suggesting that MLD 46 may have lived some time with the disease. Finally, MLD 46 is considerably larger than the previously described specimen, Sts 14, from Sterkfontein Member 4. There may be as great a contrast in body size in A. africanus as there is between the large and small specimens of A. afarensis. PMID:8238286

  13. Three-dimensional Effect of the Single Plane Proximal Femur Osteotomy

    PubMed Central

    2015-01-01

    Purpose Three-dimensional (3D) effects of the single plane osteotomies of the proximal femur are compared and analyzed by the trigonometric method. Materials and Methods The shape of proximal femur was simplified as a bent line. The bent line is the continuation of the three points-the center of the femoral head, the center of femoral neck at the base, and the center of the femoral shaft. Then rotated the proximal femur at the junction of the neck and shaft with the each rotation axis of X, Y, Z, defined the frontal plane as a XY plane, sagittal plane as a YZ plane, and transverse plane as a XZ plane. Results The varus osteotomy of the proximal femur in the frontal plane with the rotation axis 'Z' that meant the increase of the X coordinate and the decrease of Y coordinate with constant Z coordinate (Δx>Δy, Δz=0) resulted in decreased anteversion in the transverse plane and increased flexion in the sagittal plane. The derotation osteotomy (Δx>Δz, Δy=0) resulted in varus in the frontal plane and extension in the sagittal plane. The flexion osteotomy (Δz>Δy, Δx=0) resulted in increased anteversion in the transverse plane and varus in the frontal plane. Conclusion Single plane osteotomy for the proximal femur results in the angular correction in all three planes and may have the similar 3D effect of the certain double or triple osteotomy. So single plane osteotomy could be enough to correct some complex deformities.

  14. Ipsilateral Fracture Shaft Femur with Neglected Dislocation of Prosthesis: A Case Report

    PubMed Central

    Jain, Mantu; Bihari, Amar Jyoti; Sriramka, Bhavna

    2013-01-01

    Introduction: Neglected hip dislocation is rare in today’s world and after prosthesis replacement even rarer finding. However such patients may not report to surgeons until they develop secondary complications. Management of such patient’s is a challenge to the treating surgeon and need to be tailored suiting to patient’s demands, expectations and constraints of financial resources. We did not find a similar case in the electronic and print media and therefore report this case which was innovatively managed. Case Report: A 60 year farmer presented with fracture shaft femur and ipsilateral dislocation prosthesis of right hip. He had a hemiarthroplasty done for fracture neck of femur in the past but used to walk with a lurch since he started to ambulate after discharge. However he was satisfied despite “some problems” which had caused shortening of his limb. The patient was informed of the various treatment options and their possible complications. He expressed his inability to afford a Total Hip Arthroplasty (THA) at any stage and consented for other options discussed with him. The patient was positioned supine and adductor tenotomy done. Next he was positioned laterally and the fracture was fixed with heavy duty broad dynamic compression plate and screws. The wound was temporarily closed. Now through the previous scar via posterior approach the hip was exposed. The prosthesis was found to be firmly fixed to the proximal femur. The acetabulum was cleared with fibrous tissue. All attempts the prosthesis to relocate the prosthesis failed after several attempts and it was best decided to leave alone. Post operatively period was uneventful. At follow up he refused for any further manoeuvre in future inform of heavy traction and attempts to reduce the same. At one year when he was walking unaided and his X-rays showed that fracture had well united his SF-36 score was PCS - 49.6 and MCS – 51.9. Conclusion: Ipsilateral shaft femur fracture in chronically

  15. Surgically Relevant Bony and Soft Tissue Anatomy of the Proximal Femur

    PubMed Central

    Philippon, Marc J.; Michalski, Max P.; Campbell, Kevin J.; Goldsmith, Mary T.; Devitt, Brian M.; Wijdicks, Coen A.; LaPrade, Robert F.

    2014-01-01

    Background: Hip endoscopy facilitates the treatment of extra-articular disorders of the proximal femur. Unfortunately, current knowledge of proximal femur anatomy is limited to qualitative descriptions and lacks surgically relevant landmarks. Purpose: To provide a quantitative and qualitative analysis of proximal femur anatomy in reference to surgically relevant bony landmarks. Study Design: Descriptive laboratory study. Methods: Fourteen cadaveric hemipelvises were dissected. A coordinate measuring device measured dimensions and interrelationships of the gluteal muscles, hip external rotators, pectineus, iliopsoas, and joint capsule in reference to osseous landmarks. Results: The vastus tubercle, superomedial border of the greater trochanter, and femoral head-neck junction were distinct and reliable osseous landmarks. The anteroinferior tip of the vastus tubercle was 17.1 mm (95% CI: 14.5, 19.8 mm) anteroinferior to the center of the gluteus medius lateral insertional footprint and was 22.9 mm (95% CI: 20.1, 25.7 mm) inferolateral to the center of the gluteus minimus insertional footprint. The insertions of the piriformis, conjoint tendon of the hip (superior gemellus, obturator internus, and inferior gemellus), and obturator externus were identified relative to the superomedial border of the greater trochanter. The relationship of the aforementioned footprints were 49% (95% CI: 43%, 54%), 42% (95% CI: 33%, 50%), and 64% (95% CI: 59%, 69%) from the anterior (0%) to posterior (100%) margins of the superomedial border of the greater trochanter, respectively. The hip joint capsule attached distally on the proximal femur 18.2 mm (95% CI: 14.2, 22.2 mm) from the head-neck junction medially on average. Conclusion: The vastus tubercle, superomedial border of the greater trochanter, and the femoral head-neck junction were reliable osseous landmarks for the identification of the tendinous and hip capsular insertions on the proximal femur. Knowledge of the

  16. Bilateral Neck of Femur Fractures in a Bilateral Below-Knee Amputee: A Unique Case.

    PubMed

    Lancer, Hannah R; Smitham, Peter; Ray, Pinak

    2016-01-01

    According to the National Hip Fracture Database, over 64,000 patients were admitted with a hip fracture across England, Wales, and Northern Ireland in 2013, but very few are bilateral, and there are no current cases in the literature of bilateral neck of femur fractures in a patient with bilateral below-knee amputations. We present a case of a 69-year-old bilateral below-knee amputee male admitted to the emergency department with bilateral hip pain and radiological evidence of bilateral displaced neck of femur fractures. The patient subsequently underwent synchronous bilateral total hip replacements under general anaesthetic and an epidural and then went on to make a full recovery. He was discharged 27 days after arrival in hospital. Outpatient follow-up at 3 months has shown that the patient has returned to a similar level of preinjury function and is still able to carry out his daily activities with walking aids and bilateral leg prostheses. PMID:26881162

  17. Anisotropic analysis of trabecular architecture in human femur bone radiographs using quaternion wavelet transforms.

    PubMed

    Sangeetha, S; Sujatha, C M; Manamalli, D

    2014-01-01

    In this work, anisotropy of compressive and tensile strength regions of femur trabecular bone are analysed using quaternion wavelet transforms. The normal and abnormal femur trabecular bone radiographic images are considered for this study. The sub-anatomic regions, which include compressive and tensile regions, are delineated using pre-processing procedures. These delineated regions are subjected to quaternion wavelet transforms and statistical parameters are derived from the transformed images. These parameters are correlated with apparent porosity, which is derived from the strength regions. Further, anisotropy is also calculated from the transformed images and is analyzed. Results show that the anisotropy values derived from second and third phase components of quaternion wavelet transform are found to be distinct for normal and abnormal samples with high statistical significance for both compressive and tensile regions. These investigations demonstrate that architectural anisotropy derived from QWT analysis is able to differentiate normal and abnormal samples. PMID:25571265

  18. Dynamic Bending Tolerance and Elastic-Plastic Material Properties of the Human Femur

    PubMed Central

    Funk, J. R.; Kerrigan, J. R.; Crandall, J. R.

    2004-01-01

    The objective of this study was to provide data on the structural tolerance and material properties of the human femur in dynamic bending. Fifteen (15) isolated femurs from eight (8) males were tested in either posterior-to-anterior or lateral-to-medial three-point bending. The failure moment was 458 ± 95 Nm and did not differ significantly with loading direction. A method was developed to estimate the elastic-plastic material properties of the bone using both force-deflection data and strain gauge measurements. The bone material appeared to yield at about one third of the ultimate strain level prior to fracture. It is hoped that these data will aid in the development of injury criteria and finite element models for predicting injuries to pedestrians and vehicle occupants. PMID:15319127

  19. Radiographic anatomy of the proximal femur: correlation with the occurrence of fractures

    PubMed Central

    Pires, Robinson Esteves Santos; Prata, Eric Fontes; Gibram, Athos Vilela; Santos, Leandro Emilio Nascimento; Lourenço, Paulo Roberto Barbosa de Toledo; Belloti, João Carlos

    2012-01-01

    Objective To evaluate the correlation between radiographic parameters of the proximal femur anatomy and fractures. Methods Three hundred and five digital x-rays of the pelvis were analyzed in the anteroposterior view. Of these x-rays, twenty-seven showed femoral neck or transtrochanteric fractures. The anatomical parameters analyzed were: femoral neck width (FNW), femoral neck length (FNL), femoral axis length (FAL), cervicodiaphyseal angle (CDA), acetabular tear-drop distance (ATD) and great trochanter-pubic symphysis distance (GTPSD). The analysis was performed by comparing the results of the x-rays with and without proximal femoral fracture, to establish a correlation between them. Results No differences were found between the anatomical parameters of the groups with and without proximal femoral fracture. Conclusion There was no association between anatomical changes in the proximal femur and greater susceptibility to fractures. Level of evidence IV, Cross-sectional Study. PMID:24453585

  20. Bilateral Neck of Femur Fractures in a Bilateral Below-Knee Amputee: A Unique Case

    PubMed Central

    Lancer, Hannah R.

    2016-01-01

    According to the National Hip Fracture Database, over 64,000 patients were admitted with a hip fracture across England, Wales, and Northern Ireland in 2013, but very few are bilateral, and there are no current cases in the literature of bilateral neck of femur fractures in a patient with bilateral below-knee amputations. We present a case of a 69-year-old bilateral below-knee amputee male admitted to the emergency department with bilateral hip pain and radiological evidence of bilateral displaced neck of femur fractures. The patient subsequently underwent synchronous bilateral total hip replacements under general anaesthetic and an epidural and then went on to make a full recovery. He was discharged 27 days after arrival in hospital. Outpatient follow-up at 3 months has shown that the patient has returned to a similar level of preinjury function and is still able to carry out his daily activities with walking aids and bilateral leg prostheses. PMID:26881162

  1. Bilateral Neck Femur Fracture Following a Generalized Seizure- A Rare Case Report

    PubMed Central

    M Shah, Harshad; Grover, Amit; Gadi, Daksh; Sudarshan, K

    2014-01-01

    Hip fractures are one of the most common injuries which present to an orthopaedic surgeon. Most of these cases are unilateral .Bilateral simultaneous femur neck fracture is a rare occurrence. We report a case of a bilateral neck femur fracture in a 30 year male following a generalized tonic clonic seizure in view of its rarity and also to increase the awareness of such rare injuries. The patient was operated within 3 hours. At 5 months, the patient had good radiological and functional outcome. During a convulsion, there is a powerful and forceful contraction of muscles which may lead to fracture or dislocation. The incidence of fractures following a convulsion is 1.1%. A delay in diagnosis can lead to complications like avascular necrosis, osteoarthritis, non union, functional disability and legal consequences. All orthopaedic surgeons and emergency physicians should be aware of such uncommon injuries to ensure early diagnosis and treatment. PMID:25692154

  2. Bilateral neck femur fracture following a generalized seizure- a rare case report.

    PubMed

    M Shah, Harshad; Grover, Amit; Gadi, Daksh; Sudarshan, K

    2014-10-01

    Hip fractures are one of the most common injuries which present to an orthopaedic surgeon. Most of these cases are unilateral .Bilateral simultaneous femur neck fracture is a rare occurrence. We report a case of a bilateral neck femur fracture in a 30 year male following a generalized tonic clonic seizure in view of its rarity and also to increase the awareness of such rare injuries. The patient was operated within 3 hours. At 5 months, the patient had good radiological and functional outcome. During a convulsion, there is a powerful and forceful contraction of muscles which may lead to fracture or dislocation. The incidence of fractures following a convulsion is 1.1%. A delay in diagnosis can lead to complications like avascular necrosis, osteoarthritis, non union, functional disability and legal consequences. All orthopaedic surgeons and emergency physicians should be aware of such uncommon injuries to ensure early diagnosis and treatment. PMID:25692154

  3. Forensic Applicability of Femur Subtrochanteric Shape to Ancestry Assessment in Thai and White American Males.

    PubMed

    Tallman, Sean D; Winburn, Allysha P

    2015-09-01

    Ancestry assessment from the postcranial skeleton presents a significant challenge to forensic anthropologists. However, metric dimensions of the femur subtrochanteric region are believed to distinguish between individuals of Asian and non-Asian descent. This study tests the discriminatory power of subtrochanteric shape using modern samples of 128 Thai and 77 White American males. Results indicate that the samples' platymeric index distributions are significantly different (p≤0.001), with the Thai platymeric index range generally lower and the White American range generally higher. While the application of ancestry assessment methods developed from Native American subtrochanteric data results in low correct classification rates for the Thai sample (50.8-57.8%), adapting these methods to the current samples leads to better classification. The Thai data may be more useful in forensic analysis than previously published subtrochanteric data derived from Native American samples. Adapting methods to include appropriate geographic and contemporaneous populations increases the accuracy of femur subtrochanteric ancestry methods. PMID:25845441

  4. Laser ablation ICP-MS analysis of the radial distribution of lead in the femur of Alligator mississippiensis.

    PubMed

    Seltzer, Michael D; Lance, Valentine A; Elsey, Ruth M

    2006-06-15

    A laser ablation ICP-MS technique has been used to examine the radial distribution of lead in transverse sections of alligator femur. Annual bone growth in the femur results in the deposition of incremental layers of calcified tissue at the periphery of existing bone. Patterns of lead concentration within these layers provide a record of time-dependent accumulation from which exposure history can potentially be deduced. Femur specimens obtained from captive-reared alligators exhibited levels of lead accumulation that were entirely consistent with previously documented clinical signs of lead intoxication. In contrast, femurs obtained from wild alligators contained only minor amounts of lead that were likely accumulated as a result of incidental exposure. PMID:15982720

  5. The surgical management and treatment of metastatic lesions in the proximal femur

    PubMed Central

    Feng, Helin; Wang, Jin; Xu, Jianfa; Chen, Wei; Zhang, Yingze

    2016-01-01

    Abstract Review current treatments of metastatic lesions in the proximal femur. We reviewed published literature related to diagnosis and surgical treatments and summarized current treatment options. Surgical management mainly consist of internal fixation, hip replacement, and percutaneous femoroplasty (PFP) which has been newly applied in clinical practice. An appropriate series of treatments is necessary for patients to avoid the occurrence of paraplegia and prolong survival time. PMID:27428183

  6. Damage characterization on human femur bone by means of ultrasonics and acoustic emission

    NASA Astrophysics Data System (ADS)

    Strantza, M.; Polyzos, D.; Louis, O.; Boulpaep, F.; Van Hemelrijck, D.; Aggelis, D. G.

    2015-07-01

    Human bone tissue is characterized as a material with high brittleness. Due to this nature, visible signs of cracking are not easy to be detected before final failure. The main objective of this work is to investigate if the acoustic emission (AE) technique can offer valuable insight to the fracture process of human femur specimens as in other engineering materials characterization. This study describes the AE activity during fracture of whole femur bones under flexural load. Before fracture, broadband AE sensors were used in order to measure parameters like wave velocity dispersion and attenuation. Waveform parameters like the duration, rise time and average frequency, were also examined relatively to the propagation distance as a preparation for the AE monitoring during fracture. After the ultrasonic study, the samples were partly cast in concrete and fixed as cantilevers. A point load was applied on the femur head, which due to the test geometry resulted in a combination of two different patterns of fracture, bending and torsion. Two AE broadband sensors were placed in different points of the sample, one near the fixing end and the other near the femur head. Preliminary analysis shows that parameters like the number of acquired AE signals and their amplitude are well correlated with the load history. Furthermore, the parameters of rise time and frequency can differentiate the two fracture patterns. Additionally, AE allows the detection of the load at the onset of fracture from the micro-cracking events that occur at the early loading stages, allowing monitoring of the whole fracture process. Parameters that have been used extensively for monitoring and characterization of fracture modes of engineering materials seem to poses characterization power in the case of bone tissue monitoring as well.

  7. Association of sarcopenia and physical activity with femur bone mineral density in elderly women

    PubMed Central

    Lee, Inhwan; Ha, Changduk; Kang, Hyunsik

    2016-01-01

    [Purpose] This study examined the association of femur bone mineral density (BMD) with body composition and physical activity in elderly women. [Methods] This was a cross sectional study involving 119 women with mean age of 73.1±5.5 years. Body composition parameters including body mass index (BMI), percent of body fat (%BF), appendicular skeletal muscle mass (ASM) index and femur BMD was measured by dual-energy X-ray absorptiometry (DXA). Physical activity was assessed by the uniaxial accelerometer for 7 consecutive days including weekends. Based on femur BMD T-scores, subjects were classified as optimal group, osteopenia group, and osteoporosis group. Based on ASM index, subjects were classified as normal group and sarcopenia group. According to WHO recommendations of physical activity for elderly, the subjects were classified as active group or inactive group. Logistic regression analyses were used to determine the odds ratio (OR) for osteopenia and osteoporosis. [Results] There were linear decreases for body composition parameters including weight (P=.023), BMI (P=.039), lean mass (P=.032), ASM index (P=.007) and physical activity parameters including daily of step (P<.001), low intensity physical activity (P<.001), moderate intensity physical activity (P=.001) across femur BMD levels. Compared to the normal group (OR=1), the sarcopenia group had a significantly higher OR (OR=4.823; P=.042), and the inactive group had a significantly higher OR (OR=5.478; P=.005) having osteopenia and osteoporosis when compared to the active group (OR=1). [Conclusion] The findings of this study suggested that physical activity along with a healthy nutrition should be promoted as a preventive strategy against osteopenia and osteoporosis in elderly women. PMID:27298809

  8. Thigh muscle volume in relation to age, sex and femur volume.

    PubMed

    Maden-Wilkinson, T M; McPhee, J S; Rittweger, J; Jones, D A; Degens, H

    2014-02-01

    Secular changes and intra-individual differences in body shape and size can confound cross-sectional studies of muscle ageing. Normalising muscle mass to height squared is often suggested as a solution for this. We hypothesised that normalisation of muscle volume to femur volume may be a better way of determining the extent of muscle lost with ageing (sarcopenia). Thigh and femur muscle volumes were measured from serial magnetic resonance imaging sections in 20 recreationally active young men (mean age 22.4 years), 25 older men (72.3 years), 18 young women (22.1 years) and 28 older women (72.0 years). There were no age-related differences in femur volume. The relationship between thigh muscle volume and femur volume (R (2) = 0.76; exponent of 1.12; P < 0.01) was stronger than that with height (R (2) = 0.49; exponent of 3.86; P < 0.01) in young participants. For young subjects, the mean muscle/bone ratios were 16.0 and 14.6 for men and women, respectively. For older men and women, the mean ratios were 11.6 and 11.5, respectively. The Z score for the thigh muscle/bone volume ratio relative to young subjects was -2.2 ± 0.7 for older men and -1.4 ± 0.8 for older women. The extent of sarcopenia judged by the muscle/bone ratio was approximately twice that determined when normalising to height squared. These data suggest that the muscle/bone ratio captures the intra-individual loss of muscle mass during ageing, and that the age-related loss of muscle mass may be underestimated when normalised to height squared. The quadriceps seems relatively more affected by ageing than other thigh muscles. PMID:23934008

  9. [Effect of low stress environment on bone density and geome-morphology of rat femur].

    PubMed

    Liu, Yingxi; Zhao, Wenzhi; Zhang, Jun; Li, Shouju; Li, Jingnian; Sun, Xiaojiang

    2005-12-01

    6-week old rats were subjected to sciatic nerve resection and the right hindlimbs were then under a low stress environment. Bone mineral density (BMD) of different regions and geome-morphological parameters of femurs were measured. The results showed that the increase in the diameter, subperiosteal area and bone mineral density of femurs were suppressed obviously under low stress environment. But the sensitivity of BMD of different regions of the femur to the low stress environment was different. The suppression of the increase in femoral BMD was composed of an early impairment in the gain of BMD at the femoral metaphysis, which is rich in trabecular bone, and a sustained reduction in the gain of BMD at the femoral diaphysis, which is rich in cortical bone. The results of geome-morphology suggested that the early reduction in the increase of BMD at the metaphysis was due to an enhancement of bone resorption, whereas the suppression of gain in cortical bone mass and size is the result of a sustained reduction of periosteal bone formation. PMID:16422090

  10. Low-grade central osteosarcoma of distal femur, resembling fibrous dysplasia

    PubMed Central

    Vasiliadis, Haris S; Arnaoutoglou, Christina; Plakoutsis, Sotiris; Doukas, Michalis; Batistatou, Anna; Xenakis, Theodoros A

    2013-01-01

    We report a case of a 32 year-old male, admitted for a lytic lesion of the distal femur. One month after the first X-ray, clinical and imaging deterioration was evident. Open biopsy revealed fibrous dysplasia. Three months later, the lytic lesion had spread to the whole distal third of the femur reaching the articular cartilage. The malignant clinical and imaging features necessitated excision of the lesion and reconstruction with a custom-made total knee arthroplasty. Intra-operatively, no obvious soft tissue infiltration was evident. Nevertheless, an excision of the distal 15.5 cm of the femur including 3.0 cm of the surrounding muscles was finally performed. The histological examination of the excised specimen revealed central low-grade osteosarcoma. Based on the morphological features of the excised tumor, allied to the clinical findings, the diagnosis of low-grade central osteosarcoma was finally made although characters of a fibrous dysplasia were apparent. Central low-grade osteosarcoma is a rare, well-differentiated sub-type of osteosarcoma, with clinical, imaging, and histological features similar to benign tumours. Thus, initial misdiagnosis is usual with the condition commonly mistaken for fibrous dysplasia. Central low-grade osteosarcoma is usually treated with surgery alone, with rare cases of distal metastases. However, regional recurrence is quite frequent after close margin excision. PMID:24147271

  11. Shape Ontogeny of the Distal Femur in the Hominidae with Implications for the Evolution of Bipedality

    PubMed Central

    Tallman, Melissa

    2016-01-01

    Heterochrony has been invoked to explain differences in the morphology of modern humans as compared to other great apes. The distal femur is one area where heterochrony has been hypothesized to explain morphological differentiation among Plio-Pleistocene hominins. This hypothesis is evaluated here using geometric morphometric data to describe the ontogenetic shape trajectories of extant hominine distal femora and place Plio-Pleistocene hominins within that context. Results of multivariate statistical analyses showed that in both Homo and Gorilla, the shape of the distal femur changes significantly over the course of development, whereas that of Pan changes very little. Development of the distal femur of Homo is characterized by an elongation of the condyles, and a greater degree of enlargement of the medial condyle relative to the lateral condyle, whereas Gorilla are characterized by a greater degree of enlargement of the lateral condyle, relative to the medial. Early Homo and Australopithecus africanus fossils fell on the modern human ontogenetic shape trajectory and were most similar to either adult or adolescent modern humans while specimens of Australopithecus afarensis were more similar to Gorilla/Pan. These results indicate that shape differences among the distal femora of Plio-Pleistocene hominins and humans cannot be accounted for by heterochrony alone; heterochrony could explain a transition from the distal femoral shape of early Homo/A. africanus to modern Homo, but not a transition from A. afarensis to Homo. That change could be the result of genetic or epigenetic factors. PMID:26886416

  12. Implant Augmentation: Adding Bone Cement to Improve the Treatment of Osteoporotic Distal Femur Fractures

    PubMed Central

    Wähnert, Dirk; Hofmann-Fliri, Ladina; Richards, R. Geoff; Gueorguiev, Boyko; Raschke, Michael J.; Windolf, Markus

    2014-01-01

    Abstract The increasing problems in the field of osteoporotic fracture fixation results in specialized implants as well as new operation methods, for example, implant augmentation with bone cement. The aim of this study was to determine the biomechanical impact of augmentation in the treatment of osteoporotic distal femur fractures. Seven pairs of osteoporotic fresh frozen distal femora were randomly assigned to either an augmented or nonaugmented group. In both groups, an Orthopaedic Trauma Association 33 A3 fractures was fixed using the locking compression plate distal femur and cannulated and perforated screws. In the augmented group, additionally, 1 mL of polymethylmethacrylate cement was injected through the screw. Prior to mechanical testing, bone mineral density (BMD) and local bone strength were determined. Mechanical testing was performed by cyclic axial loading (100 N to 750 N + 0.05N/cycle) using a servo-hydraulic testing machine. As a result, the BMD as well as the axial stiffness did not significantly differ between the groups. The number of cycles to failure was significantly higher in the augmented group with the BMD as a significant covariate. In conclusion, cement augmentation can significantly improve implant anchorage in plating of osteoporotic distal femur fractures. PMID:25415673

  13. Periosteal chondroma of the femur: A case report and review of the literature

    PubMed Central

    ZHENG, KAI; YU, XIUCHUN; XU, SONGFENG; XU, MING

    2015-01-01

    Periosteal chondroma is a rare benign cartilage tumor located on the cortical bone, which may be mistaken clinically and histologically for other and more common tumors in this location. The current study reports the case of periosteal chondroma located in the distal femur of a 14-year-old female. A non-tender swelling, 5×4 cm in diameter, was identified on computed tomography, a radiological study of which revealed an overhanging edge and a radiolucent shadow with stippled calcification in radiographs and a lobular heterogeneous mass in magnetic resonance imaging. Cytological examination of the excision biopsy revealed cellular pleomorphism and binucleate cells. The patient underwent en bloc resection of the tumor and covering periosteum, and the histological diagnosis was subsequently determined to be periosteal chondroma. The present study also reviews nine previously reported cases of periosteal chondroma in the femur, with a discussion of the demographic characteristics, imaging features, differential diagnosis and treatment of bone tumors in this location. This study aims to inform clincians that periosteal chondromas may occur in the distal femur although osteochondromas are more common and to discuss making a differential diagnosis between periosteal chondroma and other bone tumors. PMID:25789014

  14. Shape Ontogeny of the Distal Femur in the Hominidae with Implications for the Evolution of Bipedality.

    PubMed

    Tallman, Melissa

    2016-01-01

    Heterochrony has been invoked to explain differences in the morphology of modern humans as compared to other great apes. The distal femur is one area where heterochrony has been hypothesized to explain morphological differentiation among Plio-Pleistocene hominins. This hypothesis is evaluated here using geometric morphometric data to describe the ontogenetic shape trajectories of extant hominine distal femora and place Plio-Pleistocene hominins within that context. Results of multivariate statistical analyses showed that in both Homo and Gorilla, the shape of the distal femur changes significantly over the course of development, whereas that of Pan changes very little. Development of the distal femur of Homo is characterized by an elongation of the condyles, and a greater degree of enlargement of the medial condyle relative to the lateral condyle, whereas Gorilla are characterized by a greater degree of enlargement of the lateral condyle, relative to the medial. Early Homo and Australopithecus africanus fossils fell on the modern human ontogenetic shape trajectory and were most similar to either adult or adolescent modern humans while specimens of Australopithecus afarensis were more similar to Gorilla/Pan. These results indicate that shape differences among the distal femora of Plio-Pleistocene hominins and humans cannot be accounted for by heterochrony alone; heterochrony could explain a transition from the distal femoral shape of early Homo/A. africanus to modern Homo, but not a transition from A. afarensis to Homo. That change could be the result of genetic or epigenetic factors. PMID:26886416

  15. Finite element analysis of a femur to deconstruct the paradox of bone curvature.

    PubMed

    Jade, Sameer; Tamvada, Kelli H; Strait, David S; Grosse, Ian R

    2014-01-21

    Most long limb bones in terrestrial mammals exhibit a longitudinal curvature and have been found to be loaded in bending. Bone curvature poses a paradox in terms of the mechanical function of limb bones, for many believe the curvature in these bones increases bending stress, potentially reducing the bone's load carrying capacity (i.e., its mechanical strength). The aim of this study is to investigate the role of longitudinal bone curvature in the design of limb bones. In particular, it has been hypothesized that bone curvature results in a trade-off between the bone's mechanical strength and its bending predictability. We employed finite element analysis (FEA) of abstract and realistic human femora to address this issue. Geometrically simplified human femur models with different curvatures were developed and analyzed with a commercial FEA tool to examine how curvature affects the bone's bending predictability and load carrying capacity. Results were post-processed to yield probability density functions (PDFs) describing the circumferential location of maximum equivalent stress for various curvatures in order to assess bending predictability. To validate our findings, a finite element model was built from a CT scan of a real human femur and compared to the simplified femur model. We found general agreement in trends but some quantitative differences most likely due to the geometric differences between the digitally reconstructed and the simplified finite element models. As hypothesized by others, our results support the hypothesis that bone curvature can increase bending predictability, but at the expense of bone strength. PMID:24099719

  16. Low-grade myxofibrosarcoma following a metal implantation in femur: a case report

    PubMed Central

    2014-01-01

    Myxofibrosarcoma is a myxoid variant of malignant fibrous histiocytoma that most commonly involves the extremities of elderly people. However, a primary myxofibrosarcoma with bone invasion in young adults is extremely rare. Herein, we report the case of a 31-year-old male with a gradually enlarging left thigh mass, who had a history of left femur fracture and received an open reduction and internal fixation with titanium alloy plates and screws 33 months previously. Imaging investigations revealed an irregularly shaped soft tissue mass around the left femur shaft and a partial bone defect in the middle one-third of the left femur. Pathological examination of the resected specimen showed a multi-nodular appearance, abundant myxoid matrix and elongated curvilinear capillaries. Immunohistochemical studies revealed that the tumor cells was positive for VIM and MDM2, and was negative for CK, MSA, SMA, DES, S-100 and CD34. Labeling index of Ki-67 was 25%. Based on the morphological finding and immunostaining, it was diagnosed as a low-grade myxofibrosarcoma. The clinical and imaging examinations did not reveal the evidence of a primary cancer elsewhere, and the patient had no personal or family history of malignancy. To our knowledge, this is the first case of a primary myxofibrosarcoma developed following a fracture and metal implantation in young adults. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1745984882113605 PMID:24444015

  17. Predicting the biomechanical strength of proximal femur specimens with Minkowski functionals and support vector regression

    NASA Astrophysics Data System (ADS)

    Yang, Chien-Chun; Nagarajan, Mahesh B.; Huber, Markus B.; Carballido-Gamio, Julio; Bauer, Jan S.; Baum, Thomas; Eckstein, Felix; Lochmüller, Eva-Maria; Link, Thomas M.; Wismüller, Axel

    2014-03-01

    Regional trabecular bone quality estimation for purposes of femoral bone strength prediction is important for improving the clinical assessment of osteoporotic fracture risk. In this study, we explore the ability of 3D Minkowski Functionals derived from multi-detector computed tomography (MDCT) images of proximal femur specimens in predicting their corresponding biomechanical strength. MDCT scans were acquired for 50 proximal femur specimens harvested from human cadavers. An automated volume of interest (VOI)-fitting algorithm was used to define a consistent volume in the femoral head of each specimen. In these VOIs, the trabecular bone micro-architecture was characterized by statistical moments of its BMD distribution and by topological features derived from Minkowski Functionals. A linear multiregression analysis and a support vector regression (SVR) algorithm with a linear kernel were used to predict the failure load (FL) from the feature sets; the predicted FL was compared to the true FL determined through biomechanical testing. The prediction performance was measured by the root mean square error (RMSE) for each feature set. The best prediction result was obtained from the Minkowski Functional surface used in combination with SVR, which had the lowest prediction error (RMSE = 0.939 ± 0.345) and which was significantly lower than mean BMD (RMSE = 1.075 ± 0.279, p<0.005). Our results indicate that the biomechanical strength prediction can be significantly improved in proximal femur specimens with Minkowski Functionals extracted from on MDCT images used in conjunction with support vector regression.

  18. Reconstruction of large traumatic segmental defects of the femur using segmental allograft with vascularized fibula inlay.

    PubMed

    Ridha, Hyder; Bernard, Jason; Gateley, David; Vesely, Martin J

    2011-07-01

    Segmental defects of the distal femur following trauma pose a reconstructive challenge. A stable reconstruction capable of withstanding high forces while allowing early mobility is paramount. The Capanna technique of reconstruction combining allograft with vascularized bone graft provides such a construct and has been described for oncological resection. We describe a modified Capanna technique, the "inlay" construct. Three reconstructions were performed for distal femoral segmental loss following trauma. One patient had bilateral reconstructions. Bone defects measuring 11, 9, and 8 cm were reconstructed using a large segmental allograft and free fibular flap inlay assembly. Both patients made uneventful recoveries and achieved full weight-bearing without walking aids 6 months postreconstruction. Range of movement of each knee joint achieved at least 90 degrees of active flexion. We have shown that large segmental traumatic defects of the femur can be successfully reconstructed using segmental allograft with vascularized fibula inlay. This reconstruction provides early mechanical stability, protecting the fibula from fracturing and allowing axial loading of healing bone. The inlay assembly allows a large area of bony contact between allograft and vascularized bone, optimizing bony healing. It is a good alternative to other established techniques of managing significant segmental defects of the distal femur. PMID:21717390

  19. Three-dimensional measurement of femur based on structured light scanning

    NASA Astrophysics Data System (ADS)

    Li, Jie; Ouyang, Jianfei; Qu, Xinghua

    2010-03-01

    Osteometry is fundamental to study the human skeleton. It has been widely used in palaeoanthropology, bionics, and criminal investigation for more than 200 years. The traditional osteometry is a simple 1-dimensional measurement that can only get 1D size of the bones in manual step-by-step way, even though there are more than 400 parameters to be measured. For today's research and application it is significant and necessary to develop an advanced 3-dimensional osteometry technique. In this paper a new 3D osteometry is presented, which focuses on measurement of the femur, the largest tubular bone in human body. 3D measurement based on the structured light scanning is developed to create fast and precise measurement of the entire body of the femur. The cloud data and geometry model of the sample femur is established in mathematic, accurate and fast way. More than 30 parameters are measured and compared with each other. The experiment shows that the proposed method can meet traditional osteometry and obtain all 1D geometric parameters of the bone at the same time by the mathematics model, such as trochanter-lateral condyle length, superior breadth of shaft, and collo-diaphyseal angle, etc. In the best way, many important geometric parameters that are very difficult to measure by existing osteometry, such as volume, surface area, and curvature of the bone, can be obtained very easily. The overall measuring error is less than 0.1mm.

  20. Three-dimensional measurement of femur based on structured light scanning

    NASA Astrophysics Data System (ADS)

    Li, Jie; Ouyang, Jianfei; Qu, Xinghua

    2009-12-01

    Osteometry is fundamental to study the human skeleton. It has been widely used in palaeoanthropology, bionics, and criminal investigation for more than 200 years. The traditional osteometry is a simple 1-dimensional measurement that can only get 1D size of the bones in manual step-by-step way, even though there are more than 400 parameters to be measured. For today's research and application it is significant and necessary to develop an advanced 3-dimensional osteometry technique. In this paper a new 3D osteometry is presented, which focuses on measurement of the femur, the largest tubular bone in human body. 3D measurement based on the structured light scanning is developed to create fast and precise measurement of the entire body of the femur. The cloud data and geometry model of the sample femur is established in mathematic, accurate and fast way. More than 30 parameters are measured and compared with each other. The experiment shows that the proposed method can meet traditional osteometry and obtain all 1D geometric parameters of the bone at the same time by the mathematics model, such as trochanter-lateral condyle length, superior breadth of shaft, and collo-diaphyseal angle, etc. In the best way, many important geometric parameters that are very difficult to measure by existing osteometry, such as volume, surface area, and curvature of the bone, can be obtained very easily. The overall measuring error is less than 0.1mm.

  1. Computer assisted 3D pre-operative planning tool for femur fracture orthopedic surgery

    NASA Astrophysics Data System (ADS)

    Gamage, Pavan; Xie, Sheng Quan; Delmas, Patrice; Xu, Wei Liang

    2010-02-01

    Femur shaft fractures are caused by high impact injuries and can affect gait functionality if not treated correctly. Until recently, the pre-operative planning for femur fractures has relied on two-dimensional (2D) radiographs, light boxes, tracing paper, and transparent bone templates. The recent availability of digital radiographic equipment has to some extent improved the workflow for preoperative planning. Nevertheless, imaging is still in 2D X-rays and planning/simulation tools to support fragment manipulation and implant selection are still not available. Direct three-dimensional (3D) imaging modalities such as Computed Tomography (CT) are also still restricted to a minority of complex orthopedic procedures. This paper proposes a software tool which allows orthopedic surgeons to visualize, diagnose, plan and simulate femur shaft fracture reduction procedures in 3D. The tool utilizes frontal and lateral 2D radiographs to model the fracture surface, separate a generic bone into the two fractured fragments, identify the pose of each fragment, and automatically customize the shape of the bone. The use of 3D imaging allows full spatial inspection of the fracture providing different views through the manipulation of the interactively reconstructed 3D model, and ultimately better pre-operative planning.

  2. Optimal Mass Distribution Prediction for Human Proximal Femur with Bi-modulus Property.

    PubMed

    Shi, Jiao; Cai, Kun; Qin, Qing H

    2014-12-01

    Simulation of the mass distribution in a human proximal femur is important to provide a reasonable therapy scheme for a patient with osteoporosis. An algorithm is developed for prediction of optimal mass distribution in a human proximal femur under a given loading environment. In this algorithm, the bone material is assumed to be bi-modulus, i.e., the tension modulus is not identical to the compression modulus in the same direction. With this bi-modulus bone material, a topology optimization method, i.e., modified SIMP approach, is employed to determine the optimal mass distribution in a proximal femur. The effects of the difference between two moduli on the final material distribution are numerically investigated. Numerical results obtained show that the mass distribution in bi-modular bone materials is different from that in traditional isotropic material. As the tension modulus is less than the compression modulus for bone tissues, the amount of mass required to support tension loads is greater than that required by isotropic material for the same daily activities including one-leg stance, abduction and adduction. PMID:26336694

  3. ANATOMIC STUDY OF THE PROXIMAL THIRD OF THE FEMUR: FEMOROACETABULAR IMPACT AND THE CAM EFFECT

    PubMed Central

    Labronici, Pedro José; Alves, Sergio Delmonte; da Silva, Anselmo Fernandes; Giuberti, Gilberto Ribeiro; de Azevedo Neto, Justino Nóbrega; Mezzalira Penedo, Jorge Luiz

    2015-01-01

    To analyze anatomical variations of the proximal end of femur that could cause a femoroacetabular impact. Methods: 199 skeletically mature anatomical specimens of femurs were used. The femurs were measured in order to determine the anteversion angle of the femoral neck, neckshaft angle, sphericity of the femoral head at anteroposterior and superoinferior, angle between epiphysis and the anterior femoral neck, angle between epiphysis and the neck at lateral plane, anteroposterior distance at 5mm of the head and neck junction and anteroposterior distance of the neck base. Results: we found that the impact subgroup presented a significantly larger junction diameter of 5mm (p = 0.0001) and cam-head (%) (p= 0.0001), while base-cam (%) (p = 0.0001) showed a significantly smaller diameter than the subgroup without impact. It was identified that cam-head (%) ≤ 80 e base-cam (%) ≤ 73 were identified as the optimal impact points. Conclusion: our study showed that the effect cam, caused by anatomical variations of the proximal femoral end focused the head-neck junction and base of the neck-junction head-neck. These rates can be predictive factors of the impact. PMID:26998462

  4. Investigation of hyperelastic models for nonlinear elastic behavior of demineralized and deproteinized bovine cortical femur bone.

    PubMed

    Hosseinzadeh, M; Ghoreishi, M; Narooei, K

    2016-06-01

    In this study, the hyperelastic models of demineralized and deproteinized bovine cortical femur bone were investigated and appropriate models were developed. Using uniaxial compression test data, the strain energy versus stretch was calculated and the appropriate hyperelastic strain energy functions were fitted on data in order to calculate the material parameters. To obtain the mechanical behavior in other loading conditions, the hyperelastic strain energy equations were investigated for pure shear and equi-biaxial tension loadings. The results showed the Mooney-Rivlin and Ogden models cannot predict the mechanical response of demineralized and deproteinized bovine cortical femur bone accurately, while the general exponential-exponential and general exponential-power law models have a good agreement with the experimental results. To investigate the sensitivity of the hyperelastic models, a variation of 10% in material parameters was performed and the results indicated an acceptable stability for the general exponential-exponential and general exponential-power law models. Finally, the uniaxial tension and compression of cortical femur bone were studied using the finite element method in VUMAT user subroutine of ABAQUS software and the computed stress-stretch curves were shown a good agreement with the experimental data. PMID:26953961

  5. Diets containing leguminous seeds influence chromium content in the rat femur bone.

    PubMed

    Gralak, M A; Leontowicz, H; Leontowicz, M; Debski, B

    2002-01-01

    Leguminous seeds contain a lot of antinutritional factors (ANFs) such as protease inhibitors, lectins and condensed tannins which can affect bioavailability of nutrients. Detrimental effect of protease inhibitors can be decreased by sulphur amino acids addition. Moreover, most of the leguminous ANFs are thermolabile. Hence, legumes tested in our study were extruded and/or diets were supplemented with methionine and cystine (0.15% + 0.15%). The present experiment was performed for 28 days on 90 Wistar rats divided into nine feeding groups. Semipurified diets (10% casein) were supplemented (10%), except the control one, with soybean (S) or faba bean (F), raw (R) or extruded (E), with addition of sulphur amino acids (SAA) or without them. The Cr concentration was determined in the femur bone. Total feed intake during whole trial widely varied among the groups and was the lowest in SR (289 g) and FR (294 g) groups. There was no correlation between feed intake and Cr content in the femur bone. Generally, 10% soybean in the diet decreased Cr concentration in the bones, and faba bean increased it. The SAA addition to diets generally increased femur Cr content. However, there was a significant interaction between SAA supplementation and extrusion of faba bean, hence, the effect of their combination was unclear. PMID:11944585

  6. Lateral drill holes decrease strength of the femur: an observational study using finite element and experimental analyses

    PubMed Central

    2013-01-01

    Background Internal fixation of femoral fractures requires drilling holes through the cortical bone of the shaft of the femur. Intramedullary suction reduces the fat emboli produced by reaming and nailing femoral fractures but requires four suction portals to be drilled into the femoral shaft. This work investigated the effect of these additional holes on the strength of the femur. Methods Finite element analysis (FEA) was used to calculate compression, tension and load limits which were then compared to the results from mechanical testing. Models of intact femora and fractured femora internally fixed with intramedullary nailing were generated. In addition, four suction portals, lateral, anterior and posterior, were modelled. Stresses were used to calculate safety factors and predict fatigue. Physical testing on synthetic femora was carried out on a universal mechanical testing machine. Results The FEA model for stresses generated during walking showed tensile stresses in the lateral femur and compression stresses in the medial femur with a maximum sheer stress through the neck of the femur. The lateral suction portals produced tensile stresses up to over 300% greater than in the femur without suction portals. The anterior and posterior portals did not significantly increase stresses. The lateral suction portals had a safety factor of 0.7, while the anterior and posterior posts had safety factors of 2.4 times walking loads. Synthetic bone subjected to cyclical loading and load to failure showed similar results. On mechanical testing, all constructs failed at the neck of the femur. Conclusions The anterior suction portals produced minimal increases in stress to loading so are the preferred site should a femur require such drill holes for suction or internal fixation. PMID:24004617

  7. Effect of amputation level on the stress transferred to the femur by an artificial limb directly attached to the bone.

    PubMed

    Newcombe, L; Dewar, M; Blunn, G W; Fromme, P

    2013-12-01

    Attachment of an artificial limb directly to the skeleton has a number of potential benefits and the technique has been implemented for several amputation sites. In this paper the transfer of stress from an external, transfemoral prosthesis to the femur during normal walking activity is investigated. The stress distribution in the femur and at the implant-bone interface is calculated using finite element analysis for the 3D geometry and inhomogeneous, anisotropic material properties obtained from a CT scan of a healthy femur. Attachment of the prosthetic leg at three different levels of amputation is considered. Stress concentrations are found at the distal end of the bone and adjacent to the implant tip and stress shielding is observed adjacent to the implant. It is found that the stress distribution in the femur distal to the epiphysis, where the femur geometry is close to cylindrical, can be predicted from a cylindrical finite element model, using the correct choice of bone diameter as measured from a radiograph. Proximal to the lesser trochanter the stress decreases as the femur geometry diverges significantly from a cylinder. The stress concentration at the distal, resected end of the bone is removed when a collared implant is employed. These findings form the basis for appropriate settings of an external fail-safe device to protect the bone from excessive stress in the event of an undue load. PMID:23953406

  8. Automatic multi-parametric quantification of the proximal femur with quantitative computed tomography

    PubMed Central

    Bonaretti, Serena; Saeed, Isra; Harnish, Roy; Recker, Robert; Burghardt, Andrew J.; Keyak, Joyce H.; Harris, Tamara; Khosla, Sundeep; Lang, Thomas F.

    2015-01-01

    Background Quantitative computed tomography (QCT) imaging is the basis for multiple assessments of bone quality in the proximal femur, including volumetric bone mineral density (vBMD), tissue volume, estimation of bone strength using finite element modeling (FEM), cortical bone thickness, and computational-anatomy-based morphometry assessments. Methods Here, we present an automatic framework to perform a multi-parametric QCT quantification of the proximal femur. In this framework, the proximal femur is cropped from the bilateral hip scans, segmented using a multi-atlas based segmentation approach, and then assigned volumes of interest through the registration of a proximal femoral template. The proximal femur is then subjected to compartmental vBMD, compartmental tissue volume, FEM bone strength, compartmental surface-based cortical bone thickness, compartmental surface-based vBMD, local surface-based cortical bone thickness, and local surface-based cortical vBMD computations. Consequently, the template registrations together with vBMD and surface-based cortical bone parametric maps enable computational anatomy studies. The accuracy of the segmentation was validated against manual segmentations of 80 scans from two clinical facilities, while the multi-parametric reproducibility was evaluated using repeat scans with repositioning from 22 subjects obtained on CT imaging systems from two manufacturers. Results Accuracy results yielded a mean dice similarity coefficient of 0.976±0.006, and a modified Haussdorf distance of 0.219±0.071 mm. Reproducibility of QCT-derived parameters yielded root mean square coefficients of variation (CVRMS) between 0.89-1.66% for compartmental vBMD; 0.20-1.82% for compartmental tissue volume; 3.51-3.59% for FEM bone strength; 1.89-2.69% for compartmental surface-based cortical bone thickness; and 1.08-2.19% for compartmental surface-based cortical vBMD. For local surface-based assessments, mean CVRMS were between 3.45-3.91% and 2

  9. Ontogeny of the female femur: geometric morphometric analysis applied on current living individuals of a Spanish population.

    PubMed

    Pujol, Aniol; Rissech, Carme; Ventura, Jacint; Badosa, Joaquim; Turbón, Daniel

    2014-09-01

    In this study we describe the development of the female femur based on the analysis of high-resolution radiographic images by means of geometric morphometrics, while assessing the usefulness of this method in these kinds of studies. The material analysed consisted of digital images in DICOM format (telemetries), corresponding to 184 left femora in anterior view, obtained from the database of the Hospital Sant Joan de Déu of Barcelona (Spain). Bones analysed corresponded to individuals from 9 to 14 years old. Size and shape variation of the entire femur was quantified by 22 two-dimensional landmarks. Landmark digitisation errors were assessed using Procrustes anova test. Centroid size (CS) variation with age was evaluated by an anova test. Shape variation was assessed by principal component analysis. A mancova test between the first five principal components and age, using the CS as covariable, was applied. Results indicated that both size and shape vary significantly with age. Several age-related shape changes remained significant after removing the allometric effect. In general, an increase in the robustness of the bone and noticeable phenotypic changes in certain areas of the femur were observed. During growth in the proximal region of the femur, the collo-diaphyseal angle decreases, the neck of the femur widens and the fovea moves to a lower position, standing more in line with the plane of the neck. Likewise, the size of the greater and lesser trochanters increase. In the distal region, a significant increase of epiphyseal dimensions was recorded, mainly in the medial condyle. The angular remodelling of the neck and the bicondylar region of the femur in females continues until 13 years old. The information provided in the present study increases our knowledge on the timing and morphology of the femur during development, and in particular the morphology of the different femoral ossification centres during development. PMID:24975495

  10. Ontogeny of the female femur: geometric morphometric analysis applied on current living individuals of a Spanish population

    PubMed Central

    Pujol, Aniol; Rissech, Carme; Ventura, Jacint; Badosa, Joaquim; Turbón, Daniel

    2014-01-01

    In this study we describe the development of the female femur based on the analysis of high-resolution radiographic images by means of geometric morphometrics, while assessing the usefulness of this method in these kinds of studies. The material analysed consisted of digital images in DICOM format (telemetries), corresponding to 184 left femora in anterior view, obtained from the database of the Hospital Sant Joan de Déu of Barcelona (Spain). Bones analysed corresponded to individuals from 9 to 14 years old. Size and shape variation of the entire femur was quantified by 22 two-dimensional landmarks. Landmark digitisation errors were assessed using Procrustes anova test. Centroid size (CS) variation with age was evaluated by an anova test. Shape variation was assessed by principal component analysis. A mancova test between the first five principal components and age, using the CS as covariable, was applied. Results indicated that both size and shape vary significantly with age. Several age-related shape changes remained significant after removing the allometric effect. In general, an increase in the robustness of the bone and noticeable phenotypic changes in certain areas of the femur were observed. During growth in the proximal region of the femur, the collo-diaphyseal angle decreases, the neck of the femur widens and the fovea moves to a lower position, standing more in line with the plane of the neck. Likewise, the size of the greater and lesser trochanters increase. In the distal region, a significant increase of epiphyseal dimensions was recorded, mainly in the medial condyle. The angular remodelling of the neck and the bicondylar region of the femur in females continues until 13 years old. The information provided in the present study increases our knowledge on the timing and morphology of the femur during development, and in particular the morphology of the different femoral ossification centres during development. PMID:24975495

  11. Morphometric evaluation of proximal femur in patients with unilateral total hip prosthesis.

    PubMed

    Iyem, Cıhan; Güvençer, Mustafa; Karatosun, Vasfı; Unver, Bayram

    2014-04-01

    It is important to know the morphometric characteristics of the proximal femur. This is necessary to reduce the risk of complications related to surgical procedures performed in the area due to vascular, metabolic, or traumatic causes. It is of importance for achieving the alignment of the prosthesis to be implanted as well. The aim of this study was to evaluate the morphometric characteristics of the proximal femur and to establish a database for making and performing total hip prosthesis. Anteroposterior (AP) pelvic radiographs of 162 cases, with a mean age of 65.6 years, who had undergone unilateral total hip arthroplasty were used in this study. Femoral head diameter (FHD), femoral neck width (FNW), femoral neck length (FNL), femoral neck axis length (FNAL), intertrochanteric line length (ILL), and neck-shaft angle (NSA) were measured on radiographs obtained digitally using setrapacs media. FHD was found to be 48.1 ± 3.7 mm, FNW 35.4 ± 4.2 mm, FNL 30.8 ± 6.1 mm, FNAL 98.6 ± 9.4 mm, ILL 81.1 ± 7.9 mm, and NSA 130.4 ± 5.1° on average. The comparison of the mean values for females and males revealed a statistically significant difference between the FHD, FNW, FNL, FNAL, and ILL (P = 0.000). There was no statistically significant difference in NSA between males and females (P = 0.356). A weak correlation was found between age and parameter values using correlation analysis (r < 0.24, P > 0.05). In morphometric assessment of the proximal femur, taking into consideration regional and sexual differences is of importance for prosthesis design and surgical success. PMID:23650122

  12. Investigation of Association Between Hip Osteoarthritis Susceptibility Loci and Radiographic Proximal Femur Shape

    PubMed Central

    Thiagarajah, Shankar; Wilkinson, J. Mark; Panoutsopoulou, Kalliope; Day‐Williams, Aaron G.; Cootes, Timothy F.; Wallis, Gillian A.; Loughlin, John; Arden, Nigel; Birrell, Fraser; Carr, Andrew; Chapman, Kay; Deloukas, Panos; Doherty, Michael; McCaskie, Andrew; Ollier, William E. R.; Rai, Ashok; Ralston, Stuart H.; Spector, Timothy D.; Valdes, Ana M.; Wallis, Gillian A.; Mark Wilkinson, J.; Zeggini, Eleftheria

    2015-01-01

    Objective To test whether previously reported hip morphology or osteoarthritis (OA) susceptibility loci are associated with proximal femur shape as represented by statistical shape model (SSM) modes and as univariate or multivariate quantitative traits. Methods We used pelvic radiographs and genotype data from 929 subjects with unilateral hip OA who had been recruited previously for the Arthritis Research UK Osteoarthritis Genetics Consortium genome‐wide association study. We built 3 SSMs capturing the shape variation of the OA‐unaffected proximal femur in the entire mixed‐sex cohort and for male/female‐stratified cohorts. We selected 41 candidate single‐nucleotide polymorphisms (SNPs) previously reported as being associated with hip morphology (for replication analysis) or OA (for discovery analysis) and for which genotype data were available. We performed 2 types of analysis for genotype–phenotype associations between these SNPs and the modes of the SSMs: 1) a univariate analysis using individual SSM modes and 2) a multivariate analysis using combinations of SSM modes. Results The univariate analysis identified association between rs4836732 (within the ASTN2 gene) and mode 5 of the female SSM (P = 0.0016) and between rs6976 (within the GLT8D1 gene) and mode 7 of the mixed‐sex SSM (P = 0.0003). The multivariate analysis identified association between rs5009270 (near the IFRD1 gene) and a combination of modes 3, 4, and 9 of the mixed‐sex SSM (P = 0.0004). Evidence of associations remained significant following adjustment for multiple testing. All 3 SNPs had previously been associated with hip OA. Conclusion These de novo findings suggest that rs4836732, rs6976, and rs5009270 may contribute to hip OA susceptibility by altering proximal femur shape. PMID:25939412

  13. Parathyroid hormone resets the cartilage circadian clock of the organ-cultured murine femur

    PubMed Central

    Okubo, Naoki; Fujiwara, Hiroyoshi; Minami, Yoichi; Kunimoto, Tatsuya; Hosokawa, Toshihiro; Umemura, Yasuhiro; Inokawa, Hitoshi; Asada, Maki; Oda, Ryo; Kubo, Toshikazu

    2015-01-01

    Background and purpose The circadian clock governs endogenous day-night variations. In bone, the metabolism and growth show diurnal rhythms. The circadian clock is based on a transcription-translation feedback loop composed of clock genes including Period2 (Per2), which encodes the protein period circadian protein homolog 2. Because plasma parathyroid hormone (PTH) levels show diurnal variation, we hypothesized that PTH could carry the time information to bone and cartilage. In this study, we analyzed the effect of PTH on the circadian clock of the femur. Patients and methods Per2::Luciferase (Per2::Luc) knock-in mice were used and their femurs were organ-cultured. The bioluminescence was measured using photomultiplier tube-based real-time bioluminescence monitoring equipment or real-time bioluminescence microscopic imaging devices. PTH or its vehicle was administered and the phase shifts were calculated. Immunohistochemistry was performed to detect PTH type 1 receptor (PTH1R) expression. Results Real-time bioluminescence monitoring revealed that PTH reset the circadian rhythm of the Per2::Luc activity in the femurs in an administration time-dependent and dose-dependent manner. Microscopic bioluminescence imaging revealed that Per2::Luc activity in the growth plate and the articular cartilage showed that the circadian rhythms and their phase shifts were induced by PTH. PTH1R was expressed in the growth plate cartilage. Interpretation In clinical practice, teriparatide (PTH (1-34)) treatment is widely used for osteoporosis. We found that PTH administration regulated the femoral circadian clock oscillation, particularly in the cartilage. Regulation of the local circadian clock by PTH may lead to a more effective treatment for not only osteoporosis but also endochondral ossification in bone growth and fracture repair. PMID:25765847

  14. Strain and micromotion in intact and resurfaced composite femurs: experimental and numerical investigations.

    PubMed

    Pal, Bidyut; Gupta, Sanjay; New, Andrew M R; Browne, Martin

    2010-07-20

    Understanding the load transfer within a resurfaced femur is necessary to determine the influence of mechanical factors on potential failure mechanisms such as early femoral neck fractures and stress shielding. In this study, an attempt has been made to measure the stem-bone micromotion and implant cup-bone relative displacements (along medial-lateral and anterior-posterior direction), in addition to surface strains at different locations and orientations on the proximal femur and to compare these measurements with those predicted by equivalent FE models. The loading and the support conditions of the experiment were closely replicated in the FE models. A new experimental set-up has been developed, with specially designed fixtures and load application mechanism, which can effectively impose bending and deflection of the tested femurs, almost in any direction. High correlation coefficient (0.92-0.95), low standard error of the estimate (170-379 muepsilon) and low percentage error in regression slope (12.8-17.5%), suggested good agreement between the numerical and measured strains. The effect of strain shielding was observed in two (out of eight) strain gauges located on the posterior side. A pronounced strain increase occurred in strain gauges located on the anterior head and neck regions after implantation. Experimentally measured stem-bone micromotion and implant cup-bone relative displacements (0-13.7 microm) were small and similar in trends predicted by the FE models (0-25 microm). Despite quantitative deviations in the measured and numerical results, it appears that the FE model can be used as a valid predictor of the actual strain and stem-bone micromotion. PMID:20392448

  15. Bone density of the radius, spine, and proximal femur in osteoporosis

    SciTech Connect

    Mazess, R.B.; Barden, H.; Ettinger, M.; Schultz, E.

    1988-02-01

    Bone mineral density (BMD) was measured in 140 normal young women (aged 20 to 39 years) and in 423 consecutive women over age 40 referred for evaluation of osteoporosis. Lumbar spine and proximal femur BMD was measured using dual-photon absorptiometry (/sup 153/Gd), whereas the radius shaft measurement used single-photon absorptiometry (/sup 125/I). There were 324 older women with no fractures, of which 278 aged 60 to 80 years served as age-matched controls. There were 99 women with fractures including 32 with vertebral and 22 with hip fractures. Subsequently, another 25 women with hip fractures had BMD measured in another laboratory; their mean BMD was within 2% of that of the original series. The mean age in both the nonfracture and fracture groups was 70 +/- 5 years. The BMD in the age-matched controls was 20% to 25% below that of normal young women for the radius, spine, and femur, but the Ward's triangle region of the femur showed even greater loss (35%). The mean BMD at all sites in the crush fracture cases was about 10% to 15% below that of age-matched controls. Spinal abnormality was best discriminated by spine and femoral measurements (Z score about 0.9). In women with hip fractures, the BMD was 10% below that of age-matched controls for the radius and the spine, and the BMD for the femoral sites was about 25% to 30% below that of age-matched control (Z score about 1.6). Femoral densities gave the best discrimination of hip fracture cases and even reflected spinal osteopenia. In contrast, neither the spine nor the radius reflected the full extent of femoral osteopenia in hip fracture.

  16. Mechanical Properties of a Single Cancellous Bone Trabeculae Taken from Bovine Femur

    NASA Astrophysics Data System (ADS)

    Enoki, Shinichi; Sato, Mitsuhiro; Tanaka, Kazuto; Katayama, Tsutao

    The increase of patients with osteoporosis is becoming a social problem, thus it is an urgent issue to find its prevention and treatment methods. Since cancellous bone is metabolically more active than cortical bone, cancellous bone is often used for diagnosis of osteoporosis and has received much attention within the study of bone. Bone is a hierarchically structured material and its mechanical properties vary at different structural levels, therefore it is important to break down the mechanical testing of bone according to the various levels within bone material. Mechanical properties of cancellous bone is said to be depended on quantities and orientation of trabecular bone. It is supposed that mechanical properties of trabecular bone are constant without depending on any structural arrangement and parts. However, such assumption has not been established in studies of trabecular bone. Furthermore test results have a large margin of error caused by insufficient shape assessment. In this study, three point bending tests of single cancellous bone trabeculae extracted from bovine femur were conducted to evaluate the effects of directions to the femur major axis direction on the mechanical properties. X-ray μCT was used to obtain shape of trabecular bone specimens. Furthermore compression tests of cancellous bone specimens, which were extracted in 10mm cubic geometry, were conducted for evaluation of directional properties.There were small difference in the elastic modulus of the trabecular bones which were extracted in parallel and in perpendicular to the major axis of femur. Considering from the results that the cancellous bone specimens, which were extracted in 10mm cubic geometry, have different elastic properties depending on the tested directions; the bone structure has larger influence than bone material property on the mechanical properties of cancellous bone.

  17. In vivo strains in the femur of the nine-banded armadillo (Dasypus novemcinctus).

    PubMed

    Copploe, Joseph V; Blob, Richard W; Parrish, John H A; Butcher, Michael T

    2015-08-01

    The capacity of limb bones to resist the locomotor loads they encounter depends on both the pattern of those loads and the material properties of the skeletal elements. Among mammals, understanding of the interplay between these two factors has been based primarily on evidence from locomotor behaviors in upright placentals, which show limb bones that are loaded predominantly in anteroposterior bending with minimal amounts of torsion. However, loading patterns from the femora of opossums, marsupials using crouched limb posture, show appreciable torsion while the bone experiences mediolateral (ML) bending. These data indicated greater loading diversity in mammals than was previously recognized, and suggested the possibility that ancestral loading patterns found in sprawling lineages (e.g., reptilian sauropsids) might have been retained among basal mammals. To further test this hypothesis, we recorded in vivo locomotor strains from the femur of the nine-banded armadillo (Dasypus novemcinctus), a member of the basal xenarthran clade of placental mammals that also uses crouched limb posture. Orientations of principal strains and magnitudes of shear strains indicate that armadillo femora are exposed to only limited torsion; however, bending is essentially ML, placing the medial aspect of the femur in compression and the lateral aspect in tension. This orientation of bending is similar to that found in opossums, but planar strain analyses indicate much more of the armadillo femur experiences tension during bending, potentially due to muscles pulling on the large, laterally positioned third trochanter. Limb bone safety factors were estimated between 3.3 and 4.3 in bending, similar to other placental mammals, but lower than opossums and most sprawling taxa. Thus, femoral loading patterns in armadillos show a mixture of similarities to both opossums (ML bending) and other placentals (limited torsion and low safety factors), along with unique features (high axial tension

  18. Strain distribution in the proximal Human femur during in vitro simulated sideways fall.

    PubMed

    Zani, Lorenzo; Erani, Paolo; Grassi, Lorenzo; Taddei, Fulvia; Cristofolini, Luca

    2015-07-16

    This study assessed: (i) how the magnitude and direction of principal strains vary for different sideways fall loading directions; (ii) how the principal strains for a sideways fall differ from physiological loading directions; (iii) the fracture mechanism during a sideways fall. Eleven human femurs were instrumented with 16 triaxial strain gauges each. The femurs were non-destructively subjected to: (a) six loading configurations covering the range of physiological loading directions; (b) 12 configurations simulating sideways falls. The femurs were eventually fractured in a sideways fall configuration while high-speed cameras recorded the event. When the same force magnitude was applied, strains were significantly larger in a sideways fall than for physiological loading directions (principal compressive strain was 70% larger in a sideways fall). Also the compressive-to-tensile strain ratio was different: for physiological loading the largest compressive strain was only 30% larger than the largest tensile strain; but for the sideways fall, compressive strains were twice as large as the tensile strains. Principal strains during a sideways fall were nearly perpendicular to the direction of principal strains for physiological loading. In the most critical regions (medial part of the head-neck) the direction of principal strain varied by less than 9° between the different physiological loading conditions, whereas it varied by up to 17° between the sideways fall loading conditions. This was associated with a specific fracture mechanism during sideways fall, where failure initiated on the superior-lateral side (compression) followed by later failure of the medially (tension), often exhibiting a two-peak force-displacement curve. PMID:25843261

  19. Is Taking an Antiplatelet Agent a Contraindication for Early Surgery in Displaced Femur Neck Fracture?

    PubMed Central

    Yoo, Hyun-Seung; Byun, Young-Soo; Kim, Min-Guek

    2015-01-01

    Purpose The purpose of this study was to evaluate whether we have to stop the antiplatelet agents prior to hemiarthroplasty surgery in patients with displaced femur neck fractures to reduce postoperative complications. Materials and Methods We enrolled forty-three patients with displaced femur neck fractures who were treated by bipolar hemiarthroplasty and were taking antiplatelet agents. Group I included 21 patients who discontinued antiplatelet agents and had delayed operations at an average 5.7 days and group II included 22 patients who had had early operations within 24 hours without stopping the antiplatelet agents. We compared the pre- and postoperative levels of hemoglobin, the volume of postoperative transfusion requirement and complications. Student's t-test and chi-square test were used for statistical analysis. Results The average differences between preoperative and postoperative hemoglobin was 1.4±0.4 g/dL decrease in group I and 2.1±0.5 g/dL decrease in group II (P<0.001). Patients who received a blood transfusion were 11 in group I and 13 in group II (P=0.66). Total number of blood transfusion was 13 pints in group I and 18 pints in group II (P=0.23). Pneumonia occurred in one patient in each group. Four pressure sores and three diaper rashes were developed in group I. But there were no patients requiring massive transfusion, reoperation due to hematoma and infection in each group. Conclusion Although continuous taking of antiplatelet agents in displaced femur neck fracture is associated with an increased risk of postoperative bleeding, taking an antiplatelet agent itself is not a contraindication of early surgery.

  20. Time intervals in the treatment of fractured femurs as indicators of the quality of trauma systems

    PubMed Central

    Elliott, Iain; Marmor, Meir; Caldwell, Amber; Coughlin, Richard; Gosselin, Richard A

    2014-01-01

    Abstract Objective To investigate the use of time intervals in the treatment of fractured femurs as indicators of the quality of trauma systems. Methods Time intervals from injury to admission, admission to surgery and surgery to discharge for patients with isolated femur fractures in four low- and middle-income countries were compared with the corresponding values from one German hospital, an Israeli hospital and the National Trauma Data Bank of the United States of America by means of Student’s t-tests. The correlations between the time intervals recorded in a country and that country’s expenditure on health and gross domestic product (GDP) were also evaluated using Pearson’s product moment correlation coefficient. Findings Relative to patients from high-income countries, those from low- and middle-income countries were significantly more likely to be male and to have been treated by open femoral nailing, and their intervals from injury to admission, admission to surgery and surgery to discharge were significantly longer. Strong negative correlations were detected between the interval from injury to admission and government expenditure on health, and between the interval from admission to surgery and the per capita values for total expenditure on health, government expenditure on health and GDP. Strong positive correlations were detected between the interval from surgery to discharge and general government expenditure on health. Conclusion The time intervals for the treatment of femur fractures are relatively long in low- and middle-income countries, can easily be measured, and are highly correlated with accessible and quantifiable country data on health and economics. PMID:24391299

  1. Do Elderly Patients Fare Worse Following Operative Treatment of Distal Femur Fractures Using Modern Techniques?

    PubMed Central

    Shulman, Brandon S.; Patsalos-Fox, Bianka; Lopez, Nicole; Konda, Sanjit R.; Tejwani, Nirmal C.; Egol, Kenneth A.

    2014-01-01

    Background: The purpose of this study was to compare the functional outcomes and quality of life of older and younger patients with similarly treated distal femur fractures. Methods: We conducted an assessment of 57 patients who sustained distal femur fractures (Orthopaedic Trauma Association Type 33B, C) and underwent surgical treatment at our academic medical center. Patients were divided into 2 groups for analysis: an elderly cohort of patients aged 65 or older and a comparison cohort of patients younger than age of 65. A retrospective review of demographics, preoperative ambulatory status, radiographic data, and physical examination data was collected from the medical records. Follow-up functional data were collected via telephone at a mean of 2.5 years (range 6 months-8 years) using a Short Musculoskeletal Functional Assessment (SMFA). All patients underwent standard operative treatment of either nail or plate fixation. Results: There was no statistical difference in gender, fracture type, surgical technique, surgeon, or institution where the surgery was performed. The percentage of patients with healed fractures at 6-months follow-up was not significantly different between the cohorts. The elderly cohort had slightly worse knee range of motion at 3, 6, and 12 months postoperatively but there was not a statistically significant difference between the groups. The SMFA Daily Activity, Functional, and Bother indices were significantly worse in the older cohort (P < .01, P = .01, P = .02, respectively). However, there was no significant difference in the SMFA Emotional or Mobility indices. Conclusion: Despite lower quality of life and functional scores, this study suggests that relatively good clinical outcomes can be achieved with surgical fixation of distal femoral fractures in the elderly patients. Age should not be used as a determinate in deciding against operative treatment of distal femur fractures in the elderly patients. PMID:24660097

  2. Skeletal metastatic disease of the femur: results by management with intramedullary nailing.

    PubMed

    Märdian, S; Schaser, K-D; Ruppert, M; Melcher, I; Haas, N P; Schwabe, P

    2015-01-01

    PURPOSE OF THE STUDY This study aimed to analyse the outcome following intramedullary nailing for metastases of the femur in a large cohort with special regard to mechanical, implant associated complications and patient survival. Furthermore, we aimed to identify factors influencing the overall survival. MATERIAL AND METHODS All patients (n = 74) that underwent intramedullary nailing for metastatic disease of the femur between 2004 and 2008 and were retrospectively reviewed. Data were recorded from the patients' medical record and the outpatients' clinics files. Details about the tumour biology, the surgery performed as well as the postoperative care were documented. Survival data were extracted from patient records or obtained via communication with outpatient oncologists or the community registration office. RESULTS 74 (28 (37.8%) male, 46 (62.2%) female; p = 0.048) patients with a mean age of 64.4 ± 11.7 years were included. Breast (25, 33.8%), lung (18, 24.3%), bone marrow (7, 9.5%) and kidney (6, 8.1%) were the primary tumours in more than 75% of all patients. The mean overall survival was 17.5 (95% CI: 9.6 - 25.5) months. Patients with osseous metastases had a significant longer survival than patients with visceral and/or cerebral metastases (p = 0.025 and p = 0.032). CONCLUSION Intramedullary nailing represents a valuable fixation method for pathologic fractures or impending fractures of the femur in patients with an advanced stage of metastatic disease. It provides adequate stability to outlast the patient s remaining life-span. However, the balance must be found between therapeutic resignation and surgical overtreatment since operative treatment may be accompanied with serious complications. Key words: bone metastases, intramedullary nailing, metastatic disease, cement augmentation, osteolytic defect. PMID:26317289

  3. Ligament of the head of femur: A comprehensive review of its anatomy, embryology, and potential function.

    PubMed

    Perumal, Vivek; Woodley, Stephanie J; Nicholson, Helen D

    2016-03-01

    The functional significance of the ligament of the head of femur (LHF), or ligamentum teres has often been debated. Having gained recent attention in clinical practice, it is suggested to partly provide some mechanical stability to the hip joint. However, the anatomy of this ligament is not well studied. This paper systematically reviews the anatomy of the LHF with the aim of exploring our current understanding of this structure and identifying any gaps in knowledge regarding its morphology and function. A systematic search of Medline, Embase, ProQuest, Web of Science, and Scopus databases was undertaken and relevant data extracted, analyzed. A total of 69 references were obtained, that included 53 full text articles, three published abstracts, and 13 textbooks. Many publications related to clinical studies (n = 11) rather than gross anatomy (n = 7), with one report on variation of the LHF. Considerable inconsistency in the naming and description of the LHF morphology was observed. Variable attachment sites were reported except for the acetabular notch, transverse acetabular ligament, and the femoral fovea. Presence and patency of the ligamental arteries supplying the head of the femur and their exact location were variably described and were often incomplete. The LHF is believed to be taught in extreme hip adduction, but there is little evidence to support this. In conclusions, further investigation of the anatomy of the LHF is recommended, particularly to clarify its mechanical role, innervation, and vascular contribution to the developing and adult femur, so to better inform clinical practice. Clin. Anat. 29:247-255, 2016. © 2015 Wiley Periodicals, Inc. PMID:26480296

  4. Fatal Fat Embolism following Replacement Arthroplasty for Transcervical Fractures of Femur

    PubMed Central

    Gresham, G. A.; Kuczyǹski, A.; Rosborough, D.

    1971-01-01

    Seven cases are reported of death in old people associated with transcervical fractures of the femur and occurring shortly after insertion of a Thompson prosthesis. They are compared with six fatalities following similar injury but not surgically treated and with three which followed internal fixation. Positive controls for massive fat embolism were selected from fatal cases of multiple and severe skeletal fractures due to road accidents. It seems likely that patients undergoing this operation are peculiarly susceptible to lethal fat embolism. The clinical features, diagnosis, pathological aspects, and prevention of fat embolism are discussed. Imagesp618-a PMID:5580720

  5. [Multidimensional corrective osteotomy of the distal femur using a retrograde femoral nail].

    PubMed

    Wich, M; Veltin, J; Höllen, I; Letsch, R

    1999-08-01

    We report the case of a 62-year-old woman with marked valgus and limitation of extension of the right knee joint as the result of a supracondylar fracture of the femur, originally treated by internal fixation with a dynamic condylar screw. Two years later, revision osteotomy with retrograde femoral nailing was carried out to achieve variation and improve extension. Within a week of operation the patient's right leg was fully weight bearing with normal axial positioning. A retrograde locking nail provides satisfactory and stable internal fixation in cases of revision. PMID:10484909

  6. Osteoid osteoma of the proximal femur: new techniques in diagnosis and treatment

    SciTech Connect

    Kumar, S.J.; Harcke, H.T.; MacEwen, G.D.; Ger, E.

    1984-11-01

    The nonspecific symptoms and radiographic findings associated with osteoid osteoma in the proximal femur mimic inflammatory conditions and delay diagnosis. A review of four cases showed high resolution computerized axial tomography in conjunction with a radioisotope bone scan best demarcated the location and size of the lesion. The combination of careful preoperative localization and intraoperative use of a radiation probe made adequate resection possible while limiting the amount of bone excised. This technique eliminated the need for internal fixation and reduced the duration of the recovery period.

  7. Revision Arthroplasty Using a MUTARS® Prosthesis in Comminuted Periprosthetic Fracture of the Distal Femur.

    PubMed

    Choi, Hyung Suk; Nho, Jae Hwi; Kim, Chung Hyun; Kwon, Sai Won; Park, Jong Seok; Suh, You Sung

    2016-11-01

    Periprosthetic fractures after total knee arthroplasty (TKA) are gradually increasing, reflecting extended lifespan, osteoporosis, and the increasing proportion of the elderly during the past decade. Supracondylar periprosthetic femoral fracture is a potential complication after TKA. Generally, open reduction and internal fixation are the conventional option for periprosthetic fracture after TKA. However, the presence of severe comminution with component loosening can cause failure of internal fixation. Although the current concept for periprosthetic fracture is open reduction and internal fixation, we introduce an unusual case of revision arthroplasty using a MUTARS® prosthesis for a comminuted periprosthetic fracture in the distal femur after TKA, with technical tips. PMID:27593884

  8. Stature estimation based on dimensions of the bony pelvis and proximal femur.

    PubMed

    Giroux, Carolyn L; Wescott, Daniel J

    2008-01-01

    Pelin et al. recently showed that sacral height measured on lateral magnetic resonance images can be used with moderate accuracy to reconstruct stature in males. In most forensic anthropological cases, however, sacral dimensions must be obtained from dry bones. In this study, the relationship between stature and sacral height, hip height, and femur head diameter measured on dry bone was evaluated for American Blacks and Whites of both sexes (n = 247). There are significant correlation between stature and these three dimensions, but the results suggest that none of the dimensions predict stature with the accuracy needed to be useful in forensic anthropological investigations. PMID:18279242

  9. Lung carcinoma presenting with pathologic femur fracture and false-positive pregnancy test result.

    PubMed

    Maughan, Brandon C; Kamat, Achyut

    2012-09-01

    β-Human chorionic gonadotropin (βhCG) assays are routinely used to test for pregnancy. However, βhCG may be elevated in conditions other than pregnancy. We describe a case of metastatic lung adenocarcinoma presenting with a pathologic femur fracture and a false-positive urine pregnancy test. Lung cancer is the most common nongestational malignancy that produces βhCG among reproductive-age women. Emergency physicians should consider this rare cause of a positive pregnancy test result in women who deny recent sexual intercourse, especially if the patient is older than 40 years, has a history of tobacco use, or presents with respiratory complaints. PMID:22424649

  10. High Salt Diets, Bone Strength and Mineral Content of Mature Femur After Skeletal Unloading

    NASA Technical Reports Server (NTRS)

    Liang, Michael T. C.

    1998-01-01

    It is known that high salt diets increase urinary calcium (Ca) loss, but it is not known whether this effect weakens bone during space flight. The Bone Hormone Lab has studied the effect of high salt diets on Ca balance and whole body Ca in a space flight model (2,8). Neither the strength nor mineral content of the femurs from these studies has been evaluated. The purpose of this study was to determine the effect of high salt diets (HiNa) and skeletal unloading on femoral bone strength and bone mineral content (BMC) in mature rats.

  11. Treatment of Bifocal Cyst Hydatid Involvement in Right Femur with Teicoplanin Added Bone Cement and Albendazole

    PubMed Central

    Pazarci, Ozhan; Oztemur, Zekeriya; Bulut, Okay

    2015-01-01

    Although bone involvement associated with cyst hydatid is rarely seen, it can cause unintended results such as high recurrence rate, infection, sepsis, or amputation of relevant extremity. Because of this reason, its treatment is difficult and disputed. In the case of bifocal bone cyst hydatid in right femur, along with albendazole treatment, result of resecting cyst surgically and its treatment with teicoplanin with added bone cement is given. In conclusion, since the offered treatment method both supports bone in terms of mechanical aspect and also can prevent secondary infection, the method is thought to be a good and safe treatment approach. PMID:26236523

  12. Closing wedge osteotomy of the tibia and the femur in the treatment of gonarthrosis

    PubMed Central

    Sherman, Courtney

    2009-01-01

    New developments in osteotomy techniques and methods of fixation have caused a renewed interest in closing wedge osteotomies of the tibia and femur in the treatment of gonarthrosis. The rationale, definition and techniques of closing wedge tibial and femoral osteotomies in the treatment of gonarthrosis are discussed. The principal indications include unicompartmental medial and much less so, varus knee gonarthrosis and unicompartmental lateral or valgus knee gonarthrosis with a well-maintained range of motion in patients who are physiologically young. Newer techniques have provided more rigid fixation and improved accuracy of correction. PMID:19830426

  13. Ligament of the head of the femur in the orangutan and Indian elephant.

    PubMed Central

    Crelin, E. S.

    1988-01-01

    A literature search revealed that for over 100 years there has been a consensus that the ligament of the head of the femur (LHF) is absent in the orangutan and elephant. A dissection of the hip joints of an adult orangutan and an adult Indian elephant exposed, in each joint, a robust LHF that is functionally important. These LHFs are easily overlooked during a cursory examination of the hip joints because of the way they differ from the human LHF. Images FIG. 1 FIG. 2 FIG. 3 FIG. 4 FIG. 5 FIG. 6 PMID:3201784

  14. 3D structural measurements of the proximal femur from 2D DXA images using a statistical atlas

    NASA Astrophysics Data System (ADS)

    Ahmad, Omar M.; Ramamurthi, Krishna; Wilson, Kevin E.; Engelke, Klaus; Bouxsein, Mary; Taylor, Russell H.

    2009-02-01

    A method to obtain 3D structural measurements of the proximal femur from 2D DXA images and a statistical atlas is presented. A statistical atlas of a proximal femur was created consisting of both 3D shape and volumetric density information and then deformably registered to 2D fan-beam DXA images. After the registration process, a series of 3D structural measurements were taken on QCT-estimates generated by transforming the registered statistical atlas into a voxel volume. These measurements were compared to the equivalent measurements taken on the actual QCT (ground truth) associated with the DXA images for each of 20 human cadaveric femora. The methodology and results are presented to address the potential clinical feasibility of obtaining 3D structural measurements from limited angle DXA scans and a statistical atlas of the proximal femur in-vivo.

  15. The Effect of Irreversible Electroporation on the Femur: Experimental Study in a Rabbit Model

    PubMed Central

    Song, Yue; Zheng, Jingjing; Yan, Mingwei; Ding, Weidong; Xu, Kui; Fan, Qingyu; Li, Zhao

    2015-01-01

    Irreversible electroporation (IRE) is a novel ablation method that has been tested in humans with lung, prostate, kidney, liver, lymph node and presacral cancers. As a new non-thermal treatment, the use of IRE to ablate tumors in the musculoskeletal system might reduce the incidence of fractures. We aimed to determine the ablation threshold of cortical bone and to evaluate the medium- and long-term healing process and mechanical properties of the femur in a rabbit model post-IRE ablation. The ablation threshold of cortical bone was between 1090 V/cm and 1310 V/cm (120 pulses). IRE-ablated femurs displayed no detectable fracture but did exhibit signs of recovery, including osteoblast regeneration, angiogenesis and bone remodeling. In the ablation area, revascularization appeared at 4 weeks post-IRE. Osteogenic activity peaked 8 weeks post-IRE and remained high at 12 weeks. The mechanical strength decreased briefly 4 weeks post-IRE but returned to normal levels within 8 weeks. Our experiment revealed that IRE ablation preserved the structural integrity of the bone cortex, and the ablated bone was able to regenerate rapidly. IRE may hold unique promise for in situ bone tissue ablation because rapid revascularization and active osteogenesis in the IRE ablation area are possible. PMID:26655843

  16. Absence of femoral cortical thickening in long-term bisphosphonate users: Implications for atypical femur fractures

    PubMed Central

    Chen, Foster; Wang, Zhong; Bhattacharyya, Timothy

    2014-01-01

    The radiographs of patients on long term bisphosphonates with atypical femur fractures demonstrate markedly thick cortices at the site of the fracture. We conducted a prospective clinical study to determine if cortical thickening is increased in long term bisphosphonate users. We recruited 43 patients who had taken bisphosphonates for more than 5 years. A group of 45 healthy volunteers and 12 patients recently diagnosed with osteoporosis served as controls. We measured the cortical thickening as the ratio of femoral cortical thickness to diameter of the femur, and looked for cortical beaking. No difference in the cortical thickness ratio was observed between long term bisphosphonate users and osteoporotic controls (0.53 vs. 0.54, p= 0.659). No cases of cortical beaking were seen and no increase in thigh pain was observed. The power of the study was 95% to detect a 10% difference in cortical thickness ratio. We conclude that long term bisphosphonate use does not produce a generalized increase in subtrochanteric femoral cortical thickening in the majority of patients. PMID:24468718

  17. The Tribology of Explanted Hip Resurfacings Following Early Fracture of the Femur

    PubMed Central

    Lord, James K.; Langton, David J.; Nargol, Antoni V.F.; Meek, R.M. Dominic; Joyce, Thomas J.

    2015-01-01

    A recognized issue related to metal-on-metal hip resurfacings is early fracture of the femur. Most theories regarding the cause of fracture relate to clinical factors but an engineering analysis of failed hip resurfacings has not previously been reported. The objective of this work was to determine the wear volumes and surface roughness values of a cohort of retrieved hip resurfacings which were removed due to early femoral fracture, infection and avascular necrosis (AVN). Nine resurfacing femoral heads were obtained following early fracture of the femur, a further five were retrieved due to infection and AVN. All fourteen were measured for volumetric wear using a co-ordinate measuring machine. Wear rates were then calculated and regions of the articulating surface were divided into “worn” and “unworn”. Roughness values in these regions were measured using a non-contacting profilometer. The mean time to fracture was 3.7 months compared with 44.4 months for retrieval due to infection and AVN. Average wear rates in the early fracture heads were 64 times greater than those in the infection and AVN retrievals. Given the high wear rates of the early fracture components, such wear may be linked to an increased risk of femoral neck fracture. PMID:26501331

  18. Sex Assessment Using the Femur and Tibia in Medieval Skeletal Remains from Ireland: Discriminant Function Analysis.

    PubMed

    Novak, Mario

    2016-04-01

    Sex determination based on discriminant function analysis of skeletal measurements is probably the most effective method for assessment of sex in archaeological and contemporary populations due to various reasons, but it also suffers from limitations such as population specificity. In this paper standards for sex assessment from the femur and tibia in the medieval Irish population are presented. Six femoral and six tibial measurements obtained from 56 male and 45 female skeletons were subjected to discriminant function analysis. Average accuracies obtained by this study range between 87.1 and 97%. The highest level of accuracy (97%) was achieved when using combined variables of the femur and tibia (maximum diameter of femoral head and circumference at tibial nutrient foramen), as well as two variables of the tibia (proximal epiphyseal breadth and circumference at nutrient foramen). Discriminant functions using a single variable provided accuracies between 87.1 and 96% with the circumference at the level of the tibial nutrient foramen providing the best separation. High accuracy rates obtained by this research correspond to the data recorded in other studies thus confirming the importance of discriminant function analysis in assessment of sex in both archaeological and forensic contexts. PMID:27301232

  19. Generation of an Atlas of the Proximal Femur and Its Application to Trabecular Bone Analysis

    PubMed Central

    Carballido-Gamio, Julio; Folkesson, Jenny; Karampinos, Dimitrios C.; Baum, Thomas; Link, Thomas M.; Majumdar, Sharmila; Krug, Roland

    2013-01-01

    Automatic placement of anatomically corresponding volumes of interest and comparison of parameters against a standard of reference are essential components in studies of trabecular bone. Only recently, in vivo MR images of the proximal femur, an important fracture site, could be acquired with high-spatial resolution. The purpose of this MRI trabecular bone study was two-fold: (1) to generate an atlas of the proximal femur to automatically place anatomically corresponding volumes of interest in a population study and (2) to demonstrate how mean models of geodesic topological analysis parameters can be generated to be used as potential standard of reference. Ten females were used to generate the atlas and geodesic topological analysis models, and 10 females were used to demonstrate the atlas-based trabecular bone analysis. All alignments were based on three-dimensional (3D) multiresolution affine transformations followed by 3D multiresolution free-form deformations. Mean distances less than 1 mm between aligned femora, and sharp edges in the atlas and in fused gray-level images of registered femora indicated that the anatomical variability was well accommodated and explained by the free-form deformations. PMID:21432904

  20. Surgical Treatment of Undisplaced Femur Neck Fractures in Dementia Patients Using Proximal Femoral Nail Antirotation

    PubMed Central

    Park, Bong-Ju; Min, Woong-Bae

    2015-01-01

    Purpose People with dementia have poor mobility and discharge outcomes following hip fractures. The purpose of this study was to evaluate the clinical and radiological results of internal fixation of undisplaced femur neck fractures (Garden types 1 and 2) by proximal femoral nail antirotation (PFNA) in dementia patients. Materials and Methods We studied retrospectively 19 patients with undisplaced femur neck fracture. All patients were over 70 years of age, walked independently with a cane or crutches and suffered moderate-to-severe dementia. Patients were treated with PFNA and followed-up for more than 2 years. Revision, loss of fixation, complications, and walking ability outcomes were measured. Results In walking-ability evaluation, patients showed an average decrease of just 0.2 points at the final follow-up. Walking ability was evaluated from before injury to 4 weeks after surgery and decreased by less than 0.5 points. Radiological bone union was achieved in 17 cases; the average time to bone union was 4.14 months (range, 2.5-7 months). Complications included non-union in two cases and femoral head avascular necrosis in one case of non-union. Conclusion We found that for patients with osteoporotic bone tissues in their femoral heads or patients (e.g., those suffering dementia) for whom cooperating with medical workers for postoperative walking control or rehabilitation exercises is difficult, implanting a mechanically stable spiral blade for fixation of femoral neck fractures could facilitate walking after surgery. PMID:27536620

  1. Multiobjective topology optimization of trabecular Bone Structure in the spine and the femur: Implications for biomimcry

    NASA Astrophysics Data System (ADS)

    Elbanna, Ahmed; Peetz, Darin

    Bone is classically considered to be a self-optimizing structure in accordance with Wolff's law. However, while the structure's ability to adapt to changing stress patterns has been well documented, whether it is fully optimal for compliance is less certain (Sigmund, 2002). Given the complexity of many biological systems, it is expected that this structure serves several purposes. We present a multi-objective topology optimization formulation for trabecular bone in the human body at two locations: the vertebrae and the femur. We account for the effect of different conflicting objectives such as maximization of stiffness, maximization of surface area, and minimization of buckling susceptibility. Our formulation enables us to determine the relative role of each of these objective in optimizing the structure. Moreover, it provides an opportunity to explore what structural features have to evolve to meet a certain objective requirements that may have been absent otherwise. For example, inclusion of stability considerations introduce numerous horizontal and diagonal members in the topology in the case of human vertebrae under vertical loading. However, the stability is found to play a lesser role in the case of the femur bone optimization. Our formulation enables investigation of bone adaptation at different locations of the body as well as under different loading and boundary conditions (e.g. healthy and diseased discs for the case of the spine). We discuss the implications of our findings on developing design rules for bio-inspired and bio-mimetic architectured materials. National Science Foundation: CMMI.

  2. Metastatic adenocarcinoma of Proximal Femur treated by Custom made Hip Prosthesis

    PubMed Central

    Pal, Chandra Prakash; Gupta, Surabhi; Kumar, Deepak; Singh, Pulkesh

    2012-01-01

    Introduction: Bone is the third most common site of metastatic disease. Treatment of metastatic tumours of proximal femur usually used to be either palliative in the form of radiotherapy and chemotherapy or a very radical in form of hemipelvectomy and hip disarticulation. Both forms of treatment were associated with dismal outcomes. Now with the technological advancement and refinement in surgeries a custom made hip prosthesis offers a much better treatment option to the surgeon and a good quality life to the patient. Case presentation: We are presenting a case of metastatic adenocarcinoma of upper end of left femur with pathological fracture with a small primary in right lung treated with custom made hip prosthesis. Patient received chemotherapy for primary lesion and is doing well at 11 months of follow up. Conclusion: This case is being presented on account of its unusual presentation and to give emphasis that in spite of metastatic disease, patient can be considered for limb salvage and megaprosthesis to improve his/her quality of life. This can be considered provided patient’s general condition permits and if only a single solitary metastasis is present.

  3. A new device to treat intra-capsular fracture neck of femur non-union.

    PubMed

    Mukherjee, P; Ashworth, M J

    2010-12-01

    In adolescents and young adults, femoral neck fractures often result from high-velocity trauma. These fractures are usually of vertical shear pattern. There is an increased incidence of avascular necrosis and non-union, which is difficult to treat. Non-union of fractured neck of femur in young adults is a serious problem. There is growing evidence that these fractures should be treated with an angle-stable device to improve biomechanics at the fracture site. An ideal implant should prevent varus deformation and retroversion of the fracture in order to prevent failure of the osteosynthesis and thus preventing cut-out of implant and non-union at the fracture site. We report the first use of an Orthofix Gottfried Percutaneous Compression Plate (PC.C.P.) (Orthofix, Guilford, UK) to treat a non-union of an intra-capsular fractured neck of femur. We recommend this, in combination with autologous bone grafting, via a mini hip modification of the Smith-Petersen approach. PMID:21286362

  4. What is the role of bosentan in healing of femur fractures in a rat model?

    PubMed

    Aydin, Ali; Halici, Zekai; Akpinar, Erol; Aksakal, A Murat; Saritemur, Murat; Yayla, Muhammed; Kunak, C Semih; Cadirci, Elif; Atmaca, H Tarik; Karcioglu, S Sena

    2015-09-01

    The purpose of this study was to examine the effects bosentan (which is a strong vasoconstrictor) on bone fracture pathophysiology, and investigate the roles of the nonselective endothelin 1 receptor blocker bosentan on the bone fractures formed in rats through radiographic, histopathologic, and immunohistochemical methods. The rats were divided into three groups (six rats in each group): a femoral fracture control group, a femoral fracture plus bosentan at 50 mg/kg group, and a femoral fracture plus bosentan at 100 mg/kg group. The femoral fracture model was established by transversely cutting the femur at the midsection. After manual reduction, the fractured femur was fixed with intramedullary Kirschner wires. The radiographic healing scores of the bosentan 100 and 50 mg/kg groups were significantly better that those of the fracture control group. The fracture callus percent of new bone in the bosentan 100 mg/kg group was significantly greater than that in the control group. Also, semiquantitative analysis showed higher positive vascular endothelial growth factor and osteocalcin staining and lower positive endothelin receptor type A staining in the treatment groups than in the control group. Bosentan treatment also decreased tissue endothelin 1 expression relative to that in the fracture control group. As a result of our study, the protective effect of bosentan was shown in experimental femoral fracture healing in rats by radiographic, histopathologic, and molecular analyses. PMID:25298328

  5. RELIABILITY OF LATERAL DISTAL FEMUR DUAL ENERGY X-RAY ABSORPTIOMETRY MEASURES

    PubMed Central

    Mueske, Nicole M.; Chan, Linda S.; Wren, Tishya A. L.

    2013-01-01

    Dual-energy x-ray absorptiometry (DXA) of the lateral distal femur (LDF) has been suggested for patients with metal implants or joint contractures preventing DXA scanning at conventional anatomical sites. This study assessed variability in LDF DXA measures due to repeat scanning using data from 5 healthy young adults who had 3 unilateral scans with repositioning between scans. Variability due to image analysis was evaluated in 10 children who underwent bilateral LDF scans with each scan being analyzed 3 times by 2 raters. Regions of interest (ROIs) were defined in the anterior distal metaphysis (R1), metadiaphysis (R2), and diaphysis (R3) as described previously. An additional region (R4) was defined in the metaphysis similar to R1 but centered in the medullary canal. Variability was consistently lower for bone mineral density (BMD) than for bone mineral content (BMC) and bone area; R4 was more repeatable than R1; and variability due to repeat scanning was negligible. These results suggest that DXA measures of the lateral distal femur are reliable and may be useful when standard DXA measures cannot be obtained, but it is recommended that a central, rather than anterior, ROI be used in the metaphysis. PMID:23541123

  6. [Original vacuum dressing for the treatment of open femur fracture with gangrene immobilized by external fixation].

    PubMed

    Debarge, R; Pinaroli, A; Caillot, J-L; Voiglio, E-J

    2008-02-01

    We report a case of gangrene, which developed following an open fracture of the femur immobilized with an external fixator in a 45-year-old patient. A conventional vacuum dressing (VAC Therapy) could not be applied with the external fixator in place. An original vacuum dressing was thus fashioned after surgical debridement. Scabs were covered with calcium alginate. The lower limb was enveloped in sterile dressings and vacuum was achieved by suction with gastric tubes under adhesive films. The dressing was redone every 48 h in a surgical setting. Antibiotic prophylaxis enabled cure of the infection. Budding appeared within two weeks enabling skin grafting. Centro-medullary nailing was undertaken on day 30 to accelerate bone healing. At three months from the trauma, the initial loss of sensitivity in the leg and foot noted at the first weight bearing required programmed disarticulation of the knee after femur and wound healing. At six months, the patient had resumed his occupational activities and was pain free. This type of dressing could be useful for tissue loss over a fracture immobilized with an external fixator. This type of assembly can easily be installed in the operating room. PMID:18342034

  7. The Tribology of Explanted Hip Resurfacings Following Early Fracture of the Femur.

    PubMed

    Lord, James K; Langton, David J; Nargol, Antoni V F; Meek, R M Dominic; Joyce, Thomas J

    2015-01-01

    A recognized issue related to metal-on-metal hip resurfacings is early fracture of the femur. Most theories regarding the cause of fracture relate to clinical factors but an engineering analysis of failed hip resurfacings has not previously been reported. The objective of this work was to determine the wear volumes and surface roughness values of a cohort of retrieved hip resurfacings which were removed due to early femoral fracture, infection and avascular necrosis (AVN). Nine resurfacing femoral heads were obtained following early fracture of the femur, a further five were retrieved due to infection and AVN. All fourteen were measured for volumetric wear using a co-ordinate measuring machine. Wear rates were then calculated and regions of the articulating surface were divided into "worn" and "unworn". Roughness values in these regions were measured using a non-contacting profilometer. The mean time to fracture was 3.7 months compared with 44.4 months for retrieval due to infection and AVN. Average wear rates in the early fracture heads were 64 times greater than those in the infection and AVN retrievals. Given the high wear rates of the early fracture components, such wear may be linked to an increased risk of femoral neck fracture. PMID:26501331

  8. TOMOGRAFIC AND TENSIOMETRIC ASSESSMENT ON FEMURS FROM OOPHORECTOMIZED RATS SUBJECTED TO HORMONE REPLACEMENT THERAPY

    PubMed Central

    Martynetz, Fábio Alexandre; Pessole Biondo-Simões, Maria de Lourdes; Martynetz, Juliano Rodrigo; Martynetz, Tatiana Daher; Zimerman, Elise; Neto, Heraldo Mello

    2015-01-01

    Objective: To analyze the biomechanical and tomographic effects of hormone replacement therapy (HRT) on femurs from rats subjected to induced menopause. Methods: Forty-five adult Wistar rats were divided equally into three groups. The first and second groups consisted of rats subjected to oophorectomy, and the third was the control group, consisting of nonoophorectomized rates. After verifying that hormone failure had occurred (exfoliative cytological test), only the first group received HRT, over a two-month period. After this period, the femurs were disarticulated and subjected to biomechanical tests in a universal testing machine to evaluate their strength, and were subjected to tomographic evaluation to determine the bone mineral density. Results: The exfoliative cytological test showed that hormone failure was induced in all the oophorectomized animals. A significant difference (p = 0.030) in maximum strength measurements was observed between the groups (higher in the group with HRT). Greater bone fragility was observed in the oophorectomized animals without HRT than in those with HRT (p = 0.010), in relation to the control group (p = 0.0107). There was greater bone strength in the oophorectomized rats with HRT than in those without HRT, and these values were similar to those of the control group (p = 0.179). In the tomographic evaluation, no significant differences were found between the groups (p = 0.625). Conclusion: A significant increase in bone strength was observed with the use of HRT. However, treatment with HRT did not show any significant change in bone mineral density. PMID:27019837

  9. Increased infection risk after hip hemiarthroplasty in institutionalized patients with proximal femur fracture.

    PubMed

    Gallardo-Calero, Irene; Larrainzar-Coghen, Thais; Rodriguez-Pardo, Dolors; Pigrau, Carles; Sánchez-Raya, Judith; Amat, Carles; Lung, Maily; Carrera, Luis; Corona, Pablo S

    2016-04-01

    In patients undergoing hip hemiarthroplasty (HHA) secondary to proximal femur fracture, acute periprosthetic joint infection (PJI) is one of the most important complications. We have detected an increased risk of PJI in chronic institutionalized patients (CIPs), and a higher number of early postoperative infections are caused by Gram-negative bacteria (GNB), not covered by the current prophylaxis (cefazolin in noninstitutionalized patients (NIPs) and cotrimoxazole in CIPs). We sought to compare infection characteristics between NIPs and CIPs, analyzing predisposing factors, causative pathogens, and antibiotic prophylaxis-related microbiological characteristics. We performed a retrospective review of our prospective institutional database to identify all patients consecutively admitted for HHA to treat proximal femur fracture at our centre between 2011 and 2013. PJI was diagnosed in 21 of 381 (5.51%) patients, with 10 of 105 (9.52%) in the CIP group and 11 of 276 (3.99%) in the NIP group, and statistical significance was achieved. GNB accounted for PJI in 14 (66.67%) patients. We detected a single case of methicillin-resistant Staphylococcus aureus (MRSA) infection in the NIP group. We confirm a higher risk of acute PJI among institutionalized patients, commonly caused by Gram-negative microorganisms, which are not covered by the current prophylaxis. New prophylactic strategies should be investigated in order to reduce this problem. PMID:26857632

  10. Risk of septic knee following retrograde intramedullary nailing of open and closed femur fractures

    PubMed Central

    2012-01-01

    Background One potential complication of retrograde femoral nailing in the treatment of femur fractures is the risk of septic knee. This risk theoretically increases in open fractures as a contaminated fracture site has the potential to seed the instrumentation being passed in and out of the sterile intraarticular starting point. There are few studies examining this potential complication in a relatively commonly practiced technique. Methods All patients who received a retrograde femoral nail for femur fracture between September 1996 and November 2006 at a Level 1 trauma center were retrospectively reviewed. This yielded 143 closed fractures, 38 open fractures and 4 closed fractures with an ipsilateral traumatic knee arthrotomy. Patient follow-up records were reviewed for documentation of septic knee via operative notes, wound culture or knee aspirate data, or the administration of antibiotics for suspected septic knee. Results No evidence of septic knee was found in the 185 fractures examined in the dataset. Utilizing the Wilson confidence interval, the rate of septic knee based on our population was no greater than 2%, with that of the open fracture group alone being 9%. Conclusions Based on these results and review of the literature, the risk of septic knee in retrograde femoral nailing of both open and closed femoral shaft fractures appears low but potentially not insignificant. Funding There was no outside source of funding from either industry or other organization for this study. PMID:22340770

  11. Radiographic study on the anatomical characteristics of the proximal femur in Brazilian adults☆

    PubMed Central

    de Farias, Tércio Henrique Soares; Borges, Vinícius Quadros; de Souza, Eduardo Soares; Miki, Natália; Abdala, Fernando

    2015-01-01

    Objective To ascertain the geometry of the femur in the Brazilian population by means of a radiographic study and to correlate the values with regard to sex and right/left side. Methods Five hundred anteroposterior radiographs of the pelvis of skeletally mature patients (250 of each sex) who did not present any osteoarthrosis, fractures or tumoral or infectious lesions were analyzed. The length and width of the femoral neck, length of the femoral axis, neck-shaft angle and femoral offset were measured. Results The following means were observed: 36.54 mm for the length of the femoral neck; 37.48 mm for the width of the femoral neck; 108.42 mm for the length of the femoral axis; 130.47° for the neck-shaft angle; and 44.4 mm for the femoral offset. Conclusion The mean values for the main measurements on the proximal femur in Brazilians differed from those of previous studies. It could also be shown that there was a statistically significant mean difference between men and women for all the variables, both on the left and on the right side, and that the men had greater means than the women. PMID:26229891

  12. An Uncemented Spreading Stem for the Fixation in the Metaphyseal Femur: A Preliminary Report

    PubMed Central

    Burger, Daniel; Pumberger, Matthias; Fuchs, Bruno

    2016-01-01

    Surgical treatment to restore full range of motion and full weight bearing after extensive femoral bone resection in patients with primary or metastatic femoral tumours is individually challenging. Especially when the remaining distal or proximal bone is very short, a rigid fixation of an implant is difficult to achieve due to the reverse funnel shape of the metaphysis. Herein, we present a novel implant design using a spreading mechanism in the distal part of the prosthesis for rigid, uncemented fixation in the remaining femoral bone after extensive tumour resection of the femur. We present the outcome of 5 female patients who underwent implantation of this spreading stem after extensive proximal or distal femoral bone resection. There was no radiological or clinical loosening or implant-related revision surgery in our follow-up (mean 21.46 months, range 3.5–46 months). This uncemented spreading stem may therefore represent an alternative option for fixation of a prosthetic device in the remaining metaphyseal femur. PMID:27293377

  13. Development of a balanced experimental-computational approach to understanding the mechanics of proximal femur fractures.

    PubMed

    Helgason, B; Gilchrist, S; Ariza, O; Chak, J D; Zheng, G; Widmer, R P; Ferguson, S J; Guy, P; Cripton, P A

    2014-06-01

    The majority of people who sustain hip fractures after a fall to the side would not have been identified using current screening techniques such as areal bone mineral density. Identifying them, however, is essential so that appropriate pharmacological or lifestyle interventions can be implemented. A protocol, demonstrated on a single specimen, is introduced, comprising the following components; in vitro biofidelic drop tower testing of a proximal femur; high-speed image analysis through digital image correlation; detailed accounting of the energy present during the drop tower test; organ level finite element simulations of the drop tower test; micro level finite element simulations of critical volumes of interest in the trabecular bone. Fracture in the femoral specimen initiated in the superior part of the neck. Measured fracture load was 3760N, compared to 4871N predicted based on the finite element analysis. Digital image correlation showed compressive surface strains as high as 7.1% prior to fracture. Voxel level results were consistent with high-speed video data and helped identify hidden local structural weaknesses. We found using a drop tower test protocol that a femoral neck fracture can be created with a fall velocity and energy representative of a sideways fall from standing. Additionally, we found that the nested explicit finite element method used allowed us to identify local structural weaknesses associated with femur fracture initiation. PMID:24629624

  14. Cortical thickness of the femur and long-term bisphosphonate use.

    PubMed

    Niimi, Rui; Kono, Toshibumi; Nishihara, Atsushi; Hasegawa, Masahiro; Matsumine, Akihiko; Kono, Toshihiko; Sudo, Akihiro

    2015-02-01

    Femoral cortical thickening has been mentioned in reports of atypical subtrochanteric/femoral shaft (ST/FS) fractures, which are associated with long-term bisphosphonate (BP) use. However, whether thickening precedes BP use or results from BP use, as well as the role BPs may play in cortical thickening remain unclear. The purpose of this study was to investigate the relationship between cortical thickness and BP use. We enrolled 142 patients (mean age 79 years) who had taken BPs for more than 5 years, and enrolled 426 osteoporosis patients who had not used BPs as controls. We performed a case-control study of patients with long-term BP use and controls matched for age, sex, and levels of activities of daily living (ADLs) (1:3 ratio). On femoral radiographs, we measured femoral cortical thickness in three regions: 5 cm and 12.5 cm below the lesser trochanter and in the region of maximal cortical thickness. We compared cortical thicknesses between patients taking BP and controls and evaluated longitudinal changes in cortical thickness. There were no significant differences in cortical thickness between long-term BP users and controls. In addition, after further use of BP for a minimum of 1 year, we observed no significant differences in the changes in cortical thickness at any level of the femur. In conclusion, our study did not find evidence of cortical thickening at the ST/FS area of the femur with long-term BP use. PMID:25156261

  15. Associated ilium and femur from Koobi Fora, Kenya, and postcranial diversity in early Homo.

    PubMed

    Ward, Carol V; Feibel, Craig S; Hammond, Ashley S; Leakey, Louise N; Moffett, Elizabeth A; Plavcan, J Michael; Skinner, Matthew M; Spoor, Fred; Leakey, Meave G

    2015-04-01

    During the evolution of hominins, it is generally accepted that there was a shift in postcranial morphology between Australopithecus and the genus Homo. Given the scarcity of associated remains of early Homo, however, relatively little is known about early Homo postcranial morphology. There are hints of postcranial diversity among species, but our knowledge of the nature and extent of potential differences is limited. Here we present a new associated partial ilium and femur from Koobi Fora, Kenya, dating to 1.9 Ma (millions of years ago) that is clearly attributable to the genus Homo but documents a pattern of morphology not seen in eastern African early Homo erectus. The ilium and proximal femur share distinctive anatomy found only in Homo. However, the geometry of the femoral midshaft and contour of the pelvic inlet do not resemble that of any specimens attributed to H. erectus from eastern Africa. This new fossil confirms the presence of at least two postcranial morphotypes within early Homo, and documents diversity in postcranial morphology among early Homo species that may reflect underlying body form and/or adaptive differences. PMID:25747316

  16. Individual-specific multi-scale finite element simulation of cortical bone of human proximal femur

    NASA Astrophysics Data System (ADS)

    Ascenzi, Maria-Grazia; Kawas, Neal P.; Lutz, Andre; Kardas, Dieter; Nackenhorst, Udo; Keyak, Joyce H.

    2013-07-01

    We present an innovative method to perform multi-scale finite element analyses of the cortical component of the femur using the individual's (1) computed tomography scan; and (2) a bone specimen obtained in conjunction with orthopedic surgery. The method enables study of micro-structural characteristics regulating strains and stresses under physiological loading conditions. The analysis of the micro-structural scenarios that cause variation of strain and stress is the first step in understanding the elevated strains and stresses in bone tissue, which are indicative of higher likelihood of micro-crack formation in bone, implicated in consequent remodeling or macroscopic bone fracture. Evidence that micro-structure varies with clinical history and contributes in significant, but poorly understood, ways to bone function, motivates the method's development, as does need for software tools to investigate relationships between macroscopic loading and micro-structure. Three applications - varying region of interest, bone mineral density, and orientation of collagen type I, illustrate the method. We show, in comparison between physiological loading and simple compression of a patient's femur, that strains computed at the multi-scale model's micro-level: (i) differ; and (ii) depend on local collagen-apatite orientation and degree of calcification. Our findings confirm the strain concentration role of osteocyte lacunae, important for mechano-transduction. We hypothesize occurrence of micro-crack formation, leading either to remodeling or macroscopic fracture, when the computed strains exceed the elastic range observed in micro-structural testing.

  17. The Effect of Irreversible Electroporation on the Femur: Experimental Study in a Rabbit Model.

    PubMed

    Song, Yue; Zheng, Jingjing; Yan, Mingwei; Ding, Weidong; Xu, Kui; Fan, Qingyu; Li, Zhao

    2015-01-01

    Irreversible electroporation (IRE) is a novel ablation method that has been tested in humans with lung, prostate, kidney, liver, lymph node and presacral cancers. As a new non-thermal treatment, the use of IRE to ablate tumors in the musculoskeletal system might reduce the incidence of fractures. We aimed to determine the ablation threshold of cortical bone and to evaluate the medium- and long-term healing process and mechanical properties of the femur in a rabbit model post-IRE ablation. The ablation threshold of cortical bone was between 1090 V/cm and 1310 V/cm (120 pulses). IRE-ablated femurs displayed no detectable fracture but did exhibit signs of recovery, including osteoblast regeneration, angiogenesis and bone remodeling. In the ablation area, revascularization appeared at 4 weeks post-IRE. Osteogenic activity peaked 8 weeks post-IRE and remained high at 12 weeks. The mechanical strength decreased briefly 4 weeks post-IRE but returned to normal levels within 8 weeks. Our experiment revealed that IRE ablation preserved the structural integrity of the bone cortex, and the ablated bone was able to regenerate rapidly. IRE may hold unique promise for in situ bone tissue ablation because rapid revascularization and active osteogenesis in the IRE ablation area are possible. PMID:26655843

  18. Femur Window Chamber Model for In Vivo Cell Tracking in the Murine Bone Marrow.

    PubMed

    Chen, Yonghong; Maeda, Azusa; Bu, Jiachuan; DaCosta, Ralph

    2016-01-01

    Bone marrow is a complex organ that contains various hematopoietic and non-hematopoietic cells. These cells are involved in many biological processes, including hematopoiesis, immune regulation and tumor regulation. Commonly used methods for understanding cellular actions in the bone marrow, such as histology and blood counts, provide static information rather than capturing the dynamic action of multiple cellular components in vivo. To complement the standard methods, a window chamber (WC)-based model was developed to enable serial in vivo imaging of cells and structures in the murine bone marrow. This protocol describes a surgical procedure for installing the WC in the femur, in order to facilitate long-term optical access to the femoral bone marrow. In particular, to demonstrate its experimental utility, this WC approach was used to image and track neutrophils within the vascular network of the femur, thereby providing a novel method to visualize and quantify immune cell trafficking and regulation in the bone marrow. This method can be applied to study various biological processes in the murine bone marrow, such as hematopoiesis, stem cell transplantation, and immune responses in pathological conditions, including cancer. PMID:27500928

  19. Femoral head diameter in subcapital fracture of the femur in Ibadan, Nigeria.

    PubMed

    Ogunlade, S O; Omololu, A B; Alonge, T O; Obajimi, M O

    2004-09-01

    Subcapital fracture of the femur is common in the elderly patients though the incidence is less in our environment than in the western world. Primary prosthetic replacement is the method of treatment in the majority of the patients. To facilitate this, a foreknowledge of the femoral head diameter is necessary. To determine the diameter of the femoral head and its magnification on radiograph among patients with hip fractures seen in South-West Nigeria, all patients with subcapital fracture of the neck of femur seen between March 1997 and February 2002 were included in the study. The femoral heads were measured on the radiographic film using a transparent ruler and after extraction of the femoral head during surgery using callipers. There were 25 patients in all, the mean age of patients was 73.2 years. Fall at home accounted for 70% of the cases. The femoral head diameter was between 42 mm and 50 mm in 92% of patients while magnification of femoral head diameter on radiograph was 10-14% in 92% of cases. The usaof 10-14% magnification of femoral head on radiograph would help the surgeon determine the size of prosthetic head before commencement of surgery. PMID:15819470

  20. [Change in procedure and re-osteosynthesis of the femur. Definition and retrospective analysis].

    PubMed

    Erhart, J; Mousavi, M; Schuster, R; Kolonja, A; Bockhorn, G; Vécsei, V

    2001-10-01

    The change of treatment modality in osteosynthesis is based on two principles. On one hand, one can exchange the implant as part of a two step procedure to reduce side effects of stabilizing fractures. On the other hand, a reosteosynthesis may be required for treatment of complications. A retrospective analysis was undertaken to differentiate the situation of indication, technique and results of patients with fractures of the femur. Indications for two step procedure of therapy at the femur are limited to fractures of polytraumatized patients and fractures with severe soft tissue damage. External fixator devices have been used for stabilization of long bone fractures with severe soft tissue damage using the two step procedure in the past decades; nowadays unreamed nailing is commonly preferred. Reosteosynthesis may be appropriate for the treatment of failing of osteosynthesis; they can also be used due to delayed union or nonunion of fractures, osseous deficiency or infection. In the case of failing osteosynthesis, the reasons for failing have to be studied thoroughly and a variety of subsequent procedures has to be taken into consideration for successful treatment. PMID:11699307

  1. Confocal scanning optical microscopy of a 3-million-year-old Australopithecus afarensis femur.

    PubMed

    Bromage, T G; Goldman, H M; McFarlin, S C; Perez Ochoa, A; Boyde, A

    2009-01-01

    Portable confocal scanning optical microscopy (PCSOM) has been specifically developed for the noncontact and nondestructive imaging of early human fossil hard tissues, which here we describe and apply to a 3-million-year-old femur from the celebrated Ethiopian skeleton, "Lucy," referred to Australopithecus afarensis. We examine two bone tissue parameters that demonstrate the potential of this technology. First, subsurface reflection images from intact bone reveal bone cell spaces, the osteocyte lacunae, whose density is demonstrated to scale negatively with body size, reflecting aspects of metabolism and organismal life history. Second, images of a naturally fractured cross section near to Lucy's femoral mid-shaft, which match in sign those of transmitted circularly polarized light, reveal relative collagen fiber orientation patterns that are an important indicator of femoral biomechanical efficacy. Preliminary results indicate that Lucy was characterized by metabolic constraints typical for a primate her body size and that in her femur she was adapted to habitual bipedalism. Limitations imposed by the transport and invasive histology of unique or rare fossils motivated development of the PCSOM so that specimens may be examined wherever and whenever nondestructive imaging is required. PMID:19191265

  2. Treatment of a Femur Nonunion with Microsurgical Corticoperiosteal Pedicled Flap from the Medial Femoral Condyle

    PubMed Central

    Guzzini, Matteo; Guidi, Marco; Civitenga, Carolina; Ferri, Germano; Ferretti, Andrea

    2016-01-01

    Introduction. The vascularized corticoperiosteal flap is harvested from the medial femoral condyle and it is nourished by the articular branch of the descending genicular artery and the superomedial genicular artery. This flap is usually harvested as a free flap for the reconstruction of bone defects at forearm, distal radius, carpus, hand, and recently at lower limb too. Case Report. A 50-year-old Caucasian man referred to our department for hypertrophic nonunion of the distal femur, refractory to the conservative treatments. The first surgical choice was the revision of the nail and the bone reconstruction with a corticoperiosteal pedicled flap from the medial femoral condyle. We considered union to have occurred 3.5 months after surgery when radiographs showed bridging of at least three of the four bony cortices and clinically the patient was able to walk with full weight bearing without any pain. At the last follow-up (25 months), the patient was completely satisfied with the procedure. Discussion. The corticoperiosteal flap allows a faster healing of fractures with a minimal morbidity at the donor site. We suggest that the corticoperiosteal pedicled flap graft is a reliable and effective treatment for distal femur nonunion. PMID:27064589

  3. The first record of a sauropod dinosaur from the Late Cretaceous phosphates of Morocco

    NASA Astrophysics Data System (ADS)

    Pereda Suberbiola, Xabier; Bardet, Nathalie; Iarochène, Mohamed; Bouya, Baâdi; Amaghzaz, Mbarek

    2004-09-01

    Sauropod dinosaur remains have been discovered recently in the Late Cretaceous (Maastrichtian) phosphatic deposits of the Oulad Abdoun Basin, near Khouribga (central Morocco). The material consists of right hindlimb bones (femur, tibia and fibula) from a small-sized individual. The marine associated fauna, mainly selachians, actinopterygians, turtles, mosasaurids and plesiosaurs, suggests a marine depositional environment, so that the dinosaur remains may be a remnant of a floating carcass. The femur exhibits a prominent lateral bulge on the proximal one-third, a diagnostic feature of Titanosauriformes. The Moroccan sauropod lacks synapomorphies of Titanosauria and less inclusive clades (i.e., distal tibia expanded transversely to twice mid-shaft breadth; femoral distal condyles angled dorsomedially relative to the shaft); therefore, it is here assigned to a basal titanosauriform as Titanosauriformes indet. This is the first sauropod reported from the Maastrichtian of Morocco and one of the few dinosaur records from the uppermost Cretaceous formations of northern Africa. This discovery confirms the wide geographical distribution of Titanosauriformes during the Late Cretaceous and supports their survival into the Late Maastrichtian of Africa.

  4. Cycling with Functional Electrical Stimulation Before and After a Distal Femur Fracture in a Man with Paraplegia

    PubMed Central

    Marino, Ralph J.; Oleson, Christina V.; Schmidt-Read, Mary; Modlesky, Christopher M.

    2015-01-01

    Case Presentation: A man with chronic paraplegia sustained a distal femur fracture following an unrelated fall while enrolled in a study examining musculoskeletal changes after 6 months of cycling with functional electrical stimulation (FES). After healing, he restarted and completed the study. Management and Outcome: Study measures included areal bone mineral density, trabecular bone microarchitecture, cortical bone macroarchitecture, serum bone formation/resorption markers, and muscle volume. The patient made small gains in bone- and muscle-related measures. Bone markers had not returned to baseline prior to restarting cycling, which may have impacted results. Discussion: This case shows that cycling with FES may be safely resumed after distal femur fracture. PMID:26689692

  5. Generation of 3D shape, density, cortical thickness and finite element mesh of proximal femur from a DXA image.

    PubMed

    Väänänen, Sami P; Grassi, Lorenzo; Flivik, Gunnar; Jurvelin, Jukka S; Isaksson, Hanna

    2015-08-01

    Areal bone mineral density (aBMD), as measured by dual-energy X-ray absorptiometry (DXA), predicts hip fracture risk only moderately. Simulation of bone mechanics based on DXA imaging of the proximal femur, may help to improve the prediction accuracy. Therefore, we collected three (1-3) image sets, including CT images and DXA images of 34 proximal cadaver femurs (set 1, including 30 males, 4 females), 35 clinical patient CT images of the hip (set 2, including 27 males, 8 females) and both CT and DXA images of clinical patients (set 3, including 12 female patients). All CT images were segmented manually and landmarks were placed on both femurs and pelvises. Two separate statistical appearance models (SAMs) were built using the CT images of the femurs and pelvises in sets 1 and 2, respectively. The 3D shape of the femur was reconstructed from the DXA image by matching the SAMs with the DXA images. The orientation and modes of variation of the SAMs were adjusted to minimize the sum of the absolute differences between the projection of the SAMs and a DXA image. The mesh quality and the location of the SAMs with respect to the manually placed control points on the DXA image were used as additional constraints. Then, finite element (FE) models were built from the reconstructed shapes. Mean point-to-surface distance between the reconstructed shape and CT image was 1.0 mm for cadaver femurs in set 1 (leave-one-out test) and 1.4 mm for clinical subjects in set 3. The reconstructed volumetric BMD showed a mean absolute difference of 140 and 185 mg/cm(3) for set 1 and set 3 respectively. The generation of the SAM and the limitation of using only one 2D image were found to be the most significant sources of errors in the shape reconstruction. The noise in the DXA images had only small effect on the accuracy of the shape reconstruction. DXA-based FE simulation was able to explain 85% of the CT-predicted strength of the femur in stance loading. The present method can be used to

  6. Shape of the intercondylar notch of the human femur: a comparison of osteoarthritic and non-osteoarthritic bones from a skeletal sample

    PubMed Central

    Shepstone, L; Rogers, J; Kirwan, J; Silverman, B

    2001-01-01

    OBJECTIVES—To compare objectively the shape of the intercondylar notch in human osteoarthritic and non-osteoarthritic femora.
METHODS—A sample of 96 human femora from a large skeletal population were selected for study. These femora included subjects with evidence of late stage osteoarthritis (that is, with eburnation present) and subjects with no such evidence. The distal end of the femur, viewed axially, was recorded with a video camera, and digitised computer images were produced. The outline of the intercondylar notch was extracted and represented mathematically as two functions. A functional principal components analysis was used to identify important modes of shape variation. These variations in shape were compared between eburnated and non-eburnated femora.
RESULTS—A statistically significant difference in the shape of the intercondylar notch was found between the two groups. The difference related mostly to the shape of the edge of the medial condyle: in the non-osteoarthritic group this tended to exhibit a concavity; in the osteoarthritic group it tended to be straight.
CONCLUSIONS—This observed difference may be a predisposing factor to the development of osteoarthritis. The morphology of the intercondylar notch is related to the functioning of and possible damage to the cruciate ligaments, and damage to the cruciate ligaments is a known risk factor for osteoarthritis. Alternatively, this difference may be due to bony remodelling secondary to the onset of osteoarthritis, perhaps in response to altered biomechanics.

 PMID:11557655

  7. Complications in late pregnancy.

    PubMed

    Meguerdichian, David

    2012-11-01

    Complications of late pregnancy are managed infrequently in the emergency department and, thus, can pose a challenge when the emergency physician encounters acute presentations. An expert understanding of the anatomic and physiologic changes and possible complications of late pregnancy is vital to ensure proper evaluation and care for both mother and fetus. This article focuses on the late pregnancy issues that the emergency physician will face, from the bleeding and instability of abruptio placentae to the wide spectrum of complications and management strategies encountered with preterm labor. PMID:23137403

  8. Prolonged femoral external fixation after natural disaster: successful late conversion to intramedullary nail aboard the USNS Mercy hospital ship.

    PubMed

    Sechriest, V Franklin; Lhowe, David W

    2008-01-01

    After the 9.0 magnitude earthquake and tsunami of December 26, 2004, orthopaedic injuries were a major healthcare problem in parts of South East Asia. We report our late encounter with an Indonesian patient treated acutely with external fixation of a femur fracture. We describe our procedure for conversion of prolonged external fixation (59 days) to an intramedullary nail (IMN) aboard the USNS Mercy and provide two-year follow-up. A review of current literature on conversion of femoral external fixation to IMN is included. This report highlights the potential pitfalls of external fixation of femur fractures in an austere post-natural disaster environment where orthopaedic follow-up care may be delayed or nonexistent. PMID:19069035

  9. Use of femur bone density to segregate wild from farmed Dybowski's frog (Rana dybowskii).

    PubMed

    Yang, Shu Hui; Huang, Xiao Ming; Xia, Rui; Xu, Yan Chun; Dahmer, Thomas D

    2011-04-15

    Wildlife has been utilized by humans throughout history and demand continues to grow today. Farming of wildlife can supplement the supply of wild-harvested wildlife products and, in theory, can reduce pressure on free-ranging populations. However, poached wildlife products frequently enter legal markets where they are fraudulently sold as farmed wildlife products. To effectively close this illegal trade in wild-captured wildlife, there is a need to discriminate wild products from farmed products. Because of the strong market demand for wild-captured frog meat and the resulting strong downward pressure on wild populations, we undertook research to develop a method to discriminate wild from farmed Dybowski's frog (Rana dybowskii) based on femur bone density. We measured femur bone density (D(f)) as the ratio of bone mass to bone volume. D(f) of wild frogs revealed a slightly increasing linear trend with increasing age (R(2)=0.214 in males and R(2)=0.111 in females, p=0.000). Wild males and wild females of age classes from 2 to ≥ 5 years had similar D(f) values. In contrast, 2-year-old farmed frogs showed significantly higher D(f) values (p=0.000) among males (mean D(f)=0.623 ± 0.011 g/ml, n=32) than females (mean D(f)=0.558 ± 0.011 g/ml, n=27). For both sexes, D(f) of wild frogs was significantly higher than that of farmed frogs (p=0.000). Among males, 87.5% (28 of 32 individuals) of farmed frogs were correctly identified as farmed frogs and 86.3% (69 of 80 individuals) of wild frogs were correctly identified as wild frogs. These results suggest that femur bone density is one reliable tool for discriminating between wild and farmed Dybowski's frog. This study also highlights a novel strategy with explicit forensic potential to discriminate wild from captive bred wildlife species. PMID:20933347

  10. Time domain optical coherence tomography investigation of bone matrix interface in rat femurs

    NASA Astrophysics Data System (ADS)

    Rusu, Laura-Cristina; Negruá¹±iu, Meda-Lavinia; Sinescu, Cosmin; Hoinoiu, Bogdan; Topala, Florin-Ionel; Duma, Virgil-Florin; Rominu, Mihai; Podoleanu, Adrian G.

    2013-08-01

    The materials used to fabricate scaffolds for tissue engineering are derived from synthetic polymers, mainly from the polyester family, or from natural materials (e.g., collagen and chitosan). The mechanical properties and the structural properties of these materials can be tailored by adjusting the molecular weight, the crystalline state, and the ratio of monomers in the copolymers. Quality control and adjustment of the scaffold manufacturing process are essential to achieve high standard scaffolds. Most scaffolds are made from highly crystalline polymers, which inevitably result in their opaque appearance. Their 3-D opaque structure prevents the observation of internal uneven surface structures of the scaffolds under normal optical instruments, such as the traditional light microscope. The inability to easily monitor the inner structure of scaffolds as well as the interface with the old bone poses a major challenge for tissue engineering: it impedes the precise control and adjustment of the parameters that affect the cell growth in response to various mimicked culture conditions. The aim of this paper is to investigate the interface between the femur rat bone and the new bone that is obtained using a method of tissue engineering that is based on different artificial matrixes inserted in previously artificially induced defects. For this study, 15 rats were used in conformity with ethical procedures. In all the femurs a round defect was induced by drilling with a 1 mm spherical Co-Cr surgical drill. The matrixes used were Bioss and 4bone. These materials were inserted into the induced defects. The femurs were investigated at 1 week, 1 month, 2 month and three month after the surgical procedures. The interfaces were examined using Time Domain (TD) Optical Coherence Tomography (OCT) combined with Confocal Microscopy (CM). The optical configuration uses two single mode directional couplers with a superluminiscent diode as the source centered at 1300 nm. The scanning

  11. Development and testing of texture discriminators for the analysis of trabecular bone in proximal femur radiographs

    SciTech Connect

    Huber, M. B.; Carballido-Gamio, J.; Fritscher, K.; Schubert, R.; Haenni, M.; Hengg, C.; Majumdar, S.; Link, T. M.

    2009-11-15

    Purpose: Texture analysis of femur radiographs may serve as a potential low cost technique to predict osteoporotic fracture risk and has received considerable attention in the past years. A further application of this technique may be the measurement of the quality of specific bone compartments to provide useful information for treatment of bone fractures. Two challenges of texture analysis are the selection of the best suitable texture measure and reproducible placement of regions of interest (ROIs). The goal of this in vitro study was to automatically place ROIs in radiographs of proximal femur specimens and to calculate correlations between various different texture analysis methods and the femurs' anchorage strength. Methods: Radiographs were obtained from 14 femoral specimens and bone mineral density (BMD) was measured in the femoral neck. Biomechanical testing was performed to assess the anchorage strength in terms of failure load, breakaway torque, and number of cycles. Images were segmented using a framework that is based on the usage of level sets and statistical in-shape models. Five ROIs were automatically placed in the head, upper and lower neck, trochanteric, and shaft compartment in an atlas subject. All other subjects were registered rigidly, affinely, and nonlinearly, and the resulting transformation was used to map the five ROIs onto the individual femora. Results: In each ROI, texture features were extracted using gray level co-occurence matrices (GLCM), third-order GLCM, morphological gradients (MGs), Minkowski dimensions (MDs), Minkowski functionals (MFs), Gaussian Markov random fields, and scaling index method (SIM). Coefficients of determination for each texture feature with parameters of anchorage strength were computed. In a stepwise multiregression analysis, the most predictive parameters were identified in different models. Texture features were highly correlated with anchorage strength estimated by the failure load of up to R{sup 2

  12. Single Stage Treatment of Non – Union of Transcervical Neck Femur Fracture with Shepherd Crook Deformity of Proximal Femur in A Case of Fibrous Dysplasia using Dynamic Hip Screw Fixation

    PubMed Central

    VK, Kandhari; SS, Bava; MM, Desai; RN, Wade

    2015-01-01

    Introduction: Fibrous dysplasia is a rare benign disorder of the skeletal system characterized by fibro osseous proliferation with intervening areas of normal or immature bone in the intramedullary region. It can either be a monostotic (involves one bone) or a polyostotic (involves more than one bone) presentation and usually occurs equally in males and females. Deformities like scoliosis and shepherd’s crook deformity are frequently encountered in the polyostotic form. We report a rare managed case of bilateral non-union of the pathological fracture of femur neck with shepherd’s crook deformity of the proximal femur in a case of polyostotic fibrous dysplasia. Case Report: A 16 years old female case of polyostotic fibrous dysplasia had bilateral Shepherd’s crook deformity of the proximal femur with bilateral non – union of pathological fracture of neck femur. We managed each side in one stage with two osteotomies. On the right side, first oblique osteotomy was done from just distal to the greater trochanter up to the level of the neck and the second; lateral closing wedge abduction osteotomy was done at the subtrochanteric level. 2 months later on the left side double lateral closing wedge abduction osteotomies were performed both at the subtrochanteric level. Fixation of both the sides was done using a 135° Dynamic Richard’s screw with a long side plate to span the osteotomy sites and the lesion. Post – operatively we achieved a neck shaft angle of 135° on right side and 133° on the left side. Follow up imaging showed union at both the osteotomy sites bilaterally and also at the site of the pathological fracture of neck femur. Presently, at 18 months post – operatively, patient is walking full weight bearing without support and there are no signs of recurrence of lesions of fibrous dysplasia or the deformity. Conclusion: Double osteotomy is an easy and effective method to correct the shepherd’s crook deformity and achieve correct mechanical

  13. Probabilistic finite element analysis of the uncemented hip replacement--effect of femur characteristics and implant design geometry.

    PubMed

    Dopico-González, Carolina; New, Andrew M; Browne, Martin

    2010-02-10

    In the present study, a probabilistic finite element tool was assessed using an uncemented total hip replacement model. Fully bonded and frictional interfaces were investigated for combinations of three proximal femurs and two implant designs, the Proxima short stem and the IPS hip stem prostheses. The Monte Carlo method was used with two performance indicators: the percentage of bone volume that exceeded specified strain limits and the maximum nodal micromotion. The six degrees of freedom of bone-implant relative position, magnitude of the hip contact force (L), and spatial direction of L were the random variables. The distal portion of the proximal femurs was completely constrained and some of the main muscle forces acting in the hip were applied. The coefficients of the linear approximation between the random variables and the output were used as the sensitivity values. In all cases, bone-implant position related parameters were the most sensitive parameters. The results varied depending on the femur, the implant design and the interface conditions. Values of maximum nodal micromotion agreed with results from previous studies, confirming the robustness of the implemented computational tool. It was demonstrated that results from a single model study should not be generalised to the entire population of femurs and that bone variability is an important factor that should be investigated in such analyses. PMID:19896129

  14. Intramedullary nailing of the femur with an inflatable self-locking nail: comparison with locked nailing.

    PubMed

    Lepore, Luciano; Lepore, Stefano; Maffulli, Nicola

    2003-01-01

    We report a comparative study between an inflatable expandable nail and a traditional locked intramedullary implant in closed fractures of the femoral shaft. We matched each of 43 patients who had undergone intramedullary fixation with an inflatable expandable nail with a patient of the same sex, age (within 2 years), and fracture who had undergone statically locked intramedullary fixation with traditional nails. The mean duration of surgery was significantly shorter in the patients who were treated with the inflatable expandable nail. There were no differences in average blood loss, transfusion requirements, or hospitalization. Five of the patients who underwent traditional nailing required dynamization to achieve union. The inflatable expandable nail allows effective management of diaphyseal fractures of the femur. Interlocking is not necessary, operative times are reduced, and exposure to ionizing radiation is minimized. At present, however, the inflatable expandable nail used in the this investigation is markedly more expensive than traditional devices. PMID:14648267

  15. Clinical outcomes of total hip arthroplasty for fractured neck of femur in patients over 75 years.

    PubMed

    Travis, Elizabeth C; Tan, Ruth S; Funaki, Penisimani; McChesney, Steve J; Patel, Sandeep C; Brogan, Kit

    2015-02-01

    To date, there has been little research into the clinical outcomes of total hip arthroplasty (THA) for intracapsular neck of femur (NOF) fracture in the very elderly. 44 patients over 75years underwent THA for an intracapsular NOF fracture over a two year period. Oxford Hip Scores were obtained from 37 patients with a mean score of 39.7 (range 11-47). Katz Index Scores were collected from 36 patients with a mean pre-operative score of 5.9 and post operative score of 5.7. THA in this population gives patients the best opportunity to return to premorbid function. When complications occur there is a catastrophic effect on independence. Therefore it is important to select these patients' appropriately and to optimise their medical condition peri-operatively. PMID:25311164

  16. [Prolonged coma due to fat embolism syndrome after fracture of the femur].

    PubMed

    Ruiz-Gimeno, J I; Ferre, M A; Napal, M T; Pelegrín, F

    2006-03-01

    A 24-year-old male came to the emergency department with a diaphyseal fracture of the femur resulting from a motorcycle accident. Neurological deterioration was progressive, although a computed tomography scan was normal. Endotracheal intubation for mechanical ventilation was necessary. His condition progressed to sepsis and multiorgan failure before resolving. Magnetic resonance images of the brain suggested a fat embolism. The presence of a patent foramen ovale was investigated. The patient remained in a state of coma vigil for 3 months after the accident. After ruling out other more likely causes of neurological deterioration after trauma with fractures, fat embolism should be suspected. The prognosis for the neurological manifestations of fat embolism syndrome are generally good. Severe cases suggest massive (paradoxical) embolization of the brain and are associated with a patent foramen ovale. Early diagnosis will identify the patient at high surgical risk. A favorable course and outcome have been reported with preoperative closure of the foramen ovale. PMID:16671262

  17. A bounded iterative closest point method for minimally invasive registration of the femur.

    PubMed

    Rodriguez y Baena, Ferdinando; Hawke, Trevor; Jakopec, Matjaz

    2013-10-01

    This article describes a novel method for image-based, minimally invasive registration of the femur, for application to computer-assisted unicompartmental knee arthroplasty. The method is adapted from the well-known iterative closest point algorithm. By utilising an estimate of the hip centre on both the preoperative model and intraoperative patient anatomy, the proposed 'bounded' iterative closest point algorithm robustly produces accurate varus-valgus and anterior-posterior femoral alignment with minimal distal access requirements. Similar to the original iterative closest point implementation, the bounded iterative closest point algorithm converges monotonically to the closest minimum, and the presented case includes a common method for global minimum identification. The bounded iterative closest point method has shown to have exceptional resistance to noise during feature acquisition through simulations and in vitro plastic bone trials, where its performance is compared to a standard form of the iterative closest point algorithm. PMID:23959859

  18. The rapid transit system for patients with fractures of proximal femur.

    PubMed Central

    Sikorski, J M; Davis, N J; Senior, J

    1985-01-01

    The rapid transit system for patients with fractures of the proximal femur consists of immediate internal fixation or replacement of the fractured bone under spinal anaesthesia, without any sedation. Patients are mobilised within hours of surgery and sent home as soon as they can walk. They are supervised at home by both an experienced physiotherapist and a visiting nurse. Sixty nine patients admitted to a metropolitan teaching hospital were considered for the system and 50 were accepted. Their age distribution and level of general ill health were comparable with those in other series. The rapid transit system resulted in 90% of patients accepted being discharged to their homes within the first five days, with a lower morbidity and a mortality at three months of 7%. Using the rapid transit system rehabilitation in the original environment is difficult only if the patient lives alone, and even then temporary support is often enough to allow them to return home. PMID:3918621

  19. Pathological fractures of the proximal femur due to solitary bone cyst: classification, methods of treatment.

    PubMed

    Miu, A

    2015-01-01

    Fractures are a very important issue in a child's orthopedic pathology. Neglected a good amount of time, being considered "not too serious", or "rare", having better and faster healing methods and not leaving sequels, like in the case of adults, a child's fractures remain an important chapter of traumatology in general. Because of the raising prevalence of child osteoarticular traumas, as well as new less invasive treatment methods, this theme is always to date. The paper analyzes particular cases of bone fractures that appeared due to minor traumas, on bones with a high brittleness, localized especially on the long bones. Although these fractures on a pathological bone can be seen at all levels of the human skeleton, this paper focuses on fractures located in the proximal third part of the femur. A group of children admitted in the Pediatric Orthopedic Department of "M.S. Curie" Hospital-Bucharest with this diagnostic, were analyzed between 2009 and 2013. PMID:26664486

  20. Atraumatic intracapsular neck of femur fractures after prolonged bisphosphonate treatment: a new atypical variant?

    PubMed Central

    Khan, Sameer Khalid; Savaridas, Terence; Hemers, Jennifer S.; Maarouf, Zouheir; Orgee, Jane M.; Orr, Michael M.

    2016-01-01

    Summary We present 2 cases of elderly females presenting with atraumatic, near-vertical (Pauwells grade 3), intracapsular neck of femur fractures. Following diagnosis of osteoporosis on DEXA scans, they had received alendronic acid for 7 and 10 years respectively. Routine blood tests and serum estimations of calcium, vitamin-D and thyroid-stimulating hormone, done at admission, were within the normal ranges. These patients were managed with a hemiarthroplasty and a dynamic hip screw (DHS) respectively, following discontinuation of bisphosphonates. We present these 2 cases in light of emerging evidence that associates long-term bisphosphonate use with atypical low energy femoral fractures. Only subtrochanteric/diaphyseal fractures have been reported to date. We present a new variant of atypical femoral neck fractures in metaphyseal bone related to prolonged bisphosphonate therapy. PMID:27252743

  1. Individual-specific multi-scale finite element simulation of cortical bone of human proximal femur

    SciTech Connect

    Ascenzi, Maria-Grazia; Kardas, Dieter; Nackenhorst, Udo; Keyak, Joyce H.

    2013-07-01

    We present an innovative method to perform multi-scale finite element analyses of the cortical component of the femur using the individual’s (1) computed tomography scan; and (2) a bone specimen obtained in conjunction with orthopedic surgery. The method enables study of micro-structural characteristics regulating strains and stresses under physiological loading conditions. The analysis of the micro-structural scenarios that cause variation of strain and stress is the first step in understanding the elevated strains and stresses in bone tissue, which are indicative of higher likelihood of micro-crack formation in bone, implicated in consequent remodeling or macroscopic bone fracture. Evidence that micro-structure varies with clinical history and contributes in significant, but poorly understood, ways to bone function, motivates the method’s development, as does need for software tools to investigate relationships between macroscopic loading and micro-structure. Three applications – varying region of interest, bone mineral density, and orientation of collagen type I, illustrate the method. We show, in comparison between physiological loading and simple compression of a patient’s femur, that strains computed at the multi-scale model’s micro-level: (i) differ; and (ii) depend on local collagen-apatite orientation and degree of calcification. Our findings confirm the strain concentration role of osteocyte lacunae, important for mechano-transduction. We hypothesize occurrence of micro-crack formation, leading either to remodeling or macroscopic fracture, when the computed strains exceed the elastic range observed in micro-structural testing.

  2. Evaluation of the generality and accuracy of a new mesh morphing procedure for the human femur.

    PubMed

    Grassi, Lorenzo; Hraiech, Najah; Schileo, Enrico; Ansaloni, Mauro; Rochette, Michel; Viceconti, Marco

    2011-01-01

    Various papers described mesh morphing techniques for computational biomechanics, but none of them provided a quantitative assessment of generality, robustness, automation, and accuracy in predicting strains. This study aims to quantitatively evaluate the performance of a novel mesh-morphing algorithm. A mesh-morphing algorithm based on radial-basis functions and on manual selection of corresponding landmarks on template and target was developed. The periosteal geometries of 100 femurs were derived from a computed tomography scan database and used to test the algorithm generality in producing finite element (FE) morphed meshes. A published benchmark, consisting of eight femurs for which in vitro strain measurements and standard FE model strain prediction accuracy were available, was used to assess the accuracy of morphed FE models in predicting strains. Relevant parameters were identified to test the algorithm robustness to operative conditions. Time and effort needed were evaluated to define the algorithm degree of automation. Morphing was successful for 95% of the specimens, with mesh quality indicators comparable to those of standard FE meshes. Accuracy of the morphed meshes in predicting strains was good (R(2)>0.9, RMSE%<10%) and not statistically different from the standard meshes (p-value=0.1083). The algorithm was robust to inter- and intra-operator variability, target geometry refinement (p-value>0.05) and partially to the number of landmark used. Producing a morphed mesh starting from the triangularized geometry of the specimen requires on average 10 min. The proposed method is general, robust, automated, and accurate enough to be used in bone FE modelling from diagnostic data, and prospectively in applications such as statistical shape modelling. PMID:21036655

  3. The best location for proximal locking screw for femur interlocking nailing: A biomechanical study

    PubMed Central

    Karaarslan, Ahmet A; Karakaşli, Ahmet; Aycan, Hakan; Çeçen, Berivan; Yildiz, Didem Venüs; Sesli, Erhan

    2016-01-01

    Background: Proximal locking screw deformation and screw fracture is a frequently seen problem for femur interlocking nailing that affects fracture healing. We realized that there is lack of literature for the right level for the proximal locking screw. We investigated the difference of locking screw bending resistance between the application of screws on different proximal femoral levels. Materials and Methods: We used a total of 80 proximal locking screws for eight groups, 10 screws for each group. Three-point bending tests were performed on four types of screws in two different trochanteric levels (the lesser trochanter and 20 mm proximal). We determined the yield points at three-point bending tests that a permanent deformation started in the locking screws using an axial compression testing machine. Results: The mean yield point value of 5 mm threaded locking screws applied 20 mm proximal of lesser trochanter was 1022 ± 49 (range 986–1057) (mean ± standard deviation, 95% confidence interval). On the other hand, the mean yield point value of the same type of locking screws applied on the lesser trochanteric level was 2089 ± 249 (range 1911–2268). Which means 103% increase of screw resistance between two levels (P = 0.000). In all screw groups, on the lesser trochanter line we determined 98–174% higher than the yield point values of the same type of locking screws in comparison with 20 mm proximal to the lesser trochanter (P = 0.000). Conclusion: According to our findings, there is twice as much difference in locking screw bending resistance between these two application levels. To avoid proximal locking screw deformation, locking screws should be placed in the level of the lesser trochanter in nailing of 1/3 middle and distal femur fractures. PMID:26955183

  4. Results of 32 Allograft-prosthesis Composite Reconstructions of the Proximal Femur

    PubMed Central

    Larousserie, Frédérique; Thévenin, Fabrice; Piperno-Neumann, Sophie; Anract, Philippe

    2009-01-01

    The use of allograft-prosthesis composites for reconstruction after bone tumor resection at the proximal femur has generated considerable interest since the mid1980s on the basis that their use would improve function and survival, and restore bone stock. Although functional improvement has been documented, it is unknown whether these composites survive long periods and whether they restore bone stock. We therefore determined long-term allograft-prosthesis composite survival, identified major complications that led to revision, and determined whether allograft bone stock could be spared at the time of revision. We also compared the radiographic appearance of allografts sterilized by gamma radiation and fresh-frozen allografts. We retrospectively reviewed 32 patients with bone malignancy in the proximal femur who underwent reconstruction with a cemented allograft-prosthesis composite. The allograft-prosthesis composite was a primary reconstruction for 23 patients and a revision procedure for nine. The minimum followup was 2 months (median, 68 months; range, 2–232 months). The cumulative incidence of revision for any reason was 14% at 5 years (95% confidence interval, 1%–28%) and 19% at 10 years (95% confidence interval, 3%–34%). Nine patients (28%) had revision of the reconstruction during followup; four of these patients had revision surgery for infection. Allografts sterilized by gamma radiation showed worse resorption than fresh-frozen allografts. Based on reported results, allograft-composite prostheses do not appear to improve survival compared with megaprostheses. Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence. PMID:19851817

  5. Obesity does not affect the healing of femur fractures in mice.

    PubMed

    Histing, T; Andonyan, A; Klein, M; Scheuer, C; Stenger, D; Holstein, J H; Veith, N T; Pohlemann, T; Menger, M D

    2016-07-01

    Obesity is reported to be both protective and deleterious to bone. Lipotoxicity and inflammation might be responsible for bone loss through inhibition of osteoblasts and activation of osteoclasts. However, little is known whether obesity affects the process of fracture healing. Therefore, we studied the effect of high fat diet-induced (HFD) obesity on callus formation and bone remodelling in a closed femur fracture model in mice. Thirty-one mice were fed a diet containing 60kJ% fat (HFD) for a total of 20 weeks before fracture and during the entire postoperative observation period. Control mice (n=31) received a standard diet containing 10kJ% fat. Healing was analyzed using micro-CT, biomechanical, histomorphometrical, immunohistochemical, serum and protein biochemical analysis at 2 and 4 weeks after fracture. HFD-fed mice showed a higher body weight and increased serum concentrations of leptin and interleukin-6 compared to controls. Within the callus tissue Western blot analyses revealed a higher expression of transcription factor peroxisome proliferator-activated receptor y (PPARy) and a reduced expression of runt-related transcription factor 2 (RUNX2) and bone morphogenetic protein (BMP)-4. However, obesity did not affect the expression of BMP-2 and did not influence the receptor activator of nuclear factor κB (RANK)/RANK ligand/osteoprotegerin (OPG) pathway during fracture healing. Although the bones of HFD-fed animals showed an increased number of adipocytes within the bone marrow, HFD did not increase callus adiposity. In addition, radiological and histomorphometric analysis could also not detect significant differences in bone formation between HFD-fed animals and controls. Accordingly, HFD did not affect bending stiffness after 2 and 4 weeks of healing. These findings indicate that obesity does not affect femur fracture healing in mice. PMID:27156834

  6. Wavelet-based signal processing of in vitro ultrasonic measurements at the proximal femur.

    PubMed

    Dencks, Stefanie; Barkmann, Reinhard; Padilla, Frédéric; Haïat, Guillaume; Laugier, Pascal; Glüer, Claus-C

    2007-06-01

    To estimate osteoporotic fracture risk, several techniques for quantitative ultrasound (QUS) measurements at peripheral sites have been developed. As these techniques are limited in the prediction of fracture risk of the central skeleton, such as the hip, we are developing a QUS device for direct measurements at the femur. In doing so, we noticed the necessity to improve the conventional signal processing because it failed in a considerable number of measurements due to multipath transmission. Two sets of excised human femurs (n = 6 + 34) were scanned in transmission mode. Instead of using the conventional methods, the radio-frequency signals were processed with the continuous wavelet transform to detect their time-of-flights for the calculation of speed-of-sound (SOS) in bone. The SOS-values were averaged over a region similar to the total hip region of dual X-ray absorptiometry (DXA) measurements and compared with bone mineral density (BMD) measured with DXA. Testing six standard wavelets, this algorithm failed for only 0% to 6% of scan in test set 1 compared with 29% when using conventional algorithms. For test set 2, it failed for 2% to 12% compared with approximately 40%. SOS and BMD correlated significantly in both test sets (test set 1: r2 = 0.87 to 0.92, p < 0.007; test set 2: r2 = 0.68 to 0.79, p < 0.0001). The correlations are comparable with correlations recently reported. However, the number of evaluable signals could be substantially increased, which improves the perspectives of the in vivo measurements. PMID:17445965

  7. Enhancing fixation strength in periprosthetic femur fractures by orthogonal plating-A biomechanical study.

    PubMed

    Lenz, Mark; Stoffel, Karl; Gueorguiev, Boyko; Klos, Kajetan; Kielstein, Heike; Hofmann, Gunther O

    2016-04-01

    Orthogonal plate osteosynthesis enhances fixation stability in periprosthetic femur fractures. Another option are locking attachment plates (LAP) allowing bicortical locking screw placement lateral to the prosthesis stem. Stability of lateral plate osteosynthesis with two LAP (2LAP) was compared to anterolateral orthogonal plate osteosynthesis (OP) with one LAP in a periprosthetic femur fracture model. In six pairs of fresh frozen human femora with cemented Charnley hip prosthesis, a transverse osteotomy was set distal to the tip of the prosthesis simulating a Vancouver type B1 fracture. Each pair was instrumented using a plate tensioner with either one lateral plate and two LAP, or two orthogonal anterolateral plates and one LAP. Stiffness was determined in a four-point-bending test prior to cyclic testing (2Hz) with physiologic profile and progressively increasing load up to catastrophic construct failure. Paired t-test and Wilcoxon-signed-rank test were used for statistical evaluation at a level of significance p = 0.05. The OP construct exhibited a significantly higher number of cycles and load to failure (39,627 cycles ± 4,056; 4,463 N ± 906) compared to the 2LAP construct (32,927 cycles ± 3,487; 3,793 N ± 849), p < 0.01. Mediolateral bending and torsional stiffness of the OP (1610 N/mm ± 249; 16.9 Nm/mm ± 6.3) were significantly higher compared to 2 LAP (1077 N/mm ± 189; 12.1 Nm/mm ± 3.9), p = 0.03 for both comparisons. Orthogonal plate osteosynthesis is a valuable option in periprosthetic fracture surgery, offering increased stability compared to a single lateral plate fixed with two LAP. PMID:26447634

  8. Less invasive percutaneous wave plating of simple femur shaft fractures: A prospective series.

    PubMed

    Angelini, Alessandro Janson; Livani, Bruno; Flierl, Michael A; Morgan, Steven J; Belangero, William Dias

    2010-06-01

    In developing nations, fixation of femoral shaft fractures with intramedullary (IM) nails can pose significant challenges. Use of IM implants is commonly limited by availability, funds or patient's physique. Conversely, traditional compression plates are usually readily available at a much lower cost, making bridge plating of femur fractures a frequently used surgical technique. We hypothesised that less invasive percutaneous plate osteosynthesis (MIPPO) of femoral shaft fractures has a similar outcome compared to IM nailing. The study is designed as a prospective case series at a Level 1 university trauma centre. Fifty-seven patients with simple femur shaft fractures (Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) type A) were enrolled between April 2001 and December 2005 and followed up for a minimum of 1 year or until fracture union. Primary outcome measures included union rate and time to union. Secondary outcome parameters were hardware failure, malalignment, infection and need for revision surgery. The mean age of the study cohort was 24.7 years. Fifty-four patients sustained associated systems injury. Primary union occurred in 54 patients in an average time of 13 weeks. Two patients presented with implant failure, and one patient displayed signs of delayed union. Six patients developed valgus deformities, whereas five patients displayed external rotation malalignment. One patient developed a superficial wound infection, and another presented with a deep infection. Bridge wave plating represents a safe and efficacious treatment alternative to IM nailing for simple femoral shaft fractures in countries where IM nails are limited by availability, costs and patient's physical characteristics. PMID:20170914

  9. Distal Femur Morphology of Iranian Population and Correlation With Current Prostheses

    PubMed Central

    Moghtadaei, Mehdi; Moghimi, Javad; Shahhoseini, Gholamreza

    2016-01-01

    Background: Maintaining proper size and rotation of components of total knee arthroplasty is mandatory for optimal longevity. Ethnical differences may affect the fitness of prostheses that were manufactured mainly based on Caucasian dimensions. Objectives: To evaluate the distal femur morphology of the Iranian population at the level of standard cuts simulated via computed tomography. Patients and Methods: During 2013, 150 consecutive patients (96 males and 54 females) from the outpatient Department of Orthopedic Surgery of Rasoul Akram Hospital with knee CT scans were studied. We entered cases with apparent normal extremity alignment and bone maturity. Exclusion criteria were history of fracture or conditions affecting knee profile. Standard cuts were simulated on the CT scan using the Marco Pacs program. For each bone, anteroposterior (AP), mediolateral (ML), and aspect ratio (ML/AP) were measured. Values were compared with the sizing of four currently available prostheses. Results: The mean age of the patients was 43 years (range: 17 to 80). All isolated parameters were higher in men significantly (P < 0.001). However, the aspect ratio did not show any significant difference (1.51 ± 0.11 vs 1.46 ± 0.1), suggestive of a similar configuration of distal femur profiles between genders. Ultimately, close correlations were observed among simulated cuts and size-matched femoral components of the prostheses. For females, however, components were mostly overhang mediolaterally except for one gender-specific subset. Decrement in the aspect ratio for larger knees was another mismatch with current prostheses that preserve an almost constant ratio throughout all sizes. Conclusions: Our findings may be applied by manufacturers to design prostheses more compatible with Asian populations. Alterations to the shape of components should be considered to provide optimal coverage. PMID:27186388

  10. Compartmental bone morphometry in the mouse femur: reproducibility and resolution dependence of microtomographic measurements.

    PubMed

    Kohler, T; Beyeler, M; Webster, D; Müller, R

    2005-11-01

    Microcomputed tomography (microCT) is widely used for nondestructive bone phenotyping in small animals, especially in the mouse. Here, we investigated the reproducibility and resolution dependence of microCT analysis of microstructural parameters in three different compartments in the mouse femur. Reproducibility was assessed with respect to precision error (PE%CV) and intraclass correlation coefficient (ICC). We examined 14 left femurs isolated postmortem from two strains of mice (seven per group). Measurements and analyses were repeated five times on different days. In a second step, analysis was repeated again five times for a single measurement. Resolution dependence was assessed by high-resolution measurements (10 microm) in one strain and subsequent image degrading. Reproducibility was better in full bone compartment and in cortical bone compartment in the diaphysis (PE%CV = 0.06-2.16%) than in trabecular compartment in the distal metaphysis (PE(%CV) = 0.59-5.24%). Nevertheless, ICC (0.92-1.00) showed a very high reliability of the assessed parameters in all regions, indicating very small variances within repeated measurements compared to the population variances. Morphometric indices computed from lower- and higher-resolution images displayed in general only weak dependence and were highly correlated with each other (R2 = 0.91-0.99). The results show that parameters in the full and cortical compartments were very reproducible, whereas precision in the trabecular compartment was somewhat lower. Nevertheless, all compartmental analysis methods were very robust, as shown by the high ICC values, demonstrating high suitability for application in inbred strains, where highest precision is needed due to small population variances. PMID:16283571

  11. Size and shape variation in the proximal femur of Australopithecus africanus.

    PubMed

    Harmon, Elizabeth

    2009-06-01

    Aside from use as estimates of body mass dimorphism and fore to hind limb joint size comparisons, postcranial elements have not often contributed to assessments of variation in Australopithecus africanus. Meanwhile, cranial, facial, and dental size variation is interpreted to be high or moderately high. Further, the cranial base and face express patterns of structural (shape) variation, which are interpreted by some as evidence for the presence of multiple species. Here, the proximal femur is used to consider postcranial size and shape variation in A. africanus. Original fossils from Makapansgat and Sterkfontein, and samples from Homo, Pan, Gorilla, and Pongo were measured. Size variation was assessed by comparing the A. africanus coefficient of variation to bootstrapped distributions of coefficient of variation samples for each taxon. Shape variation was assessed from isometrically adjusted shape variables. First, the A. africanus standard deviation of log transformed shape variables was compared to bootstrapped distributions of logged standard deviations in each taxon. Second, shape variable based Euclidean distances between fossil pairs were compared to pairwise Euclidean distance distributions in each reference taxon. The degree of size variation in the A. africanus proximal femur is consistent with that of a single species, and is most comparable to Homo and Pan, lower than A. afarensis, and lower than some estimates of cranial and dental variation. Some, but not all, shape variables show more variation in A. africanus than in extant taxa. The degree of shape difference between some fossils exceeds the majority of pairwise differences in the reference taxa. Proximal femoral shape, but not size, variation is consistent with high estimates of A. africanus cranial variation. PMID:19446306

  12. Huge Subchondral Cyst Communicating with Medulary Canal of Femur in OA Knee-Treated by Extension Stem and Bone Grafting

    PubMed Central

    Rajani, Amyn M; Kumar, Ritesh; Shyam, Ashok

    2014-01-01

    Introduction: We report an osteoarthritic patient with huge sub-chondral cyst-like lesions in the Anterior part of distal femur. Deep and large bone defects and severe lateral laxity due to Advanced osteoarthritis was successfully treated with semi-constrained type total knee arthroplasty with long stem. Case Report: A 70yrs old Female was admitted in our institution diagnosed with severe bilateral Osteoarthritis. The x-rays showed bone on bone Tricompartment OA Knee with Varus Malalignment. She was posted for Single Stage Bilateral Total Knee Replacement and as planned the Left Knee Was Operated first. After exposure, Proximal Tibial, Distal Femoral Cuts and measurement of extension gaps the synovium from the anterior Femur was removed and sizing was done. The AP cut was then proceeded with. We spotted a small Osteochondral Cyst in the Anterior Femur which was curretted to remove the cystic material, which is when we realised that the cyst was large and communicating with the medulary canal. The remaining Femoral preparations was done keeping in mind the risk of iatrogenic fracture and extension Stem was used in the femur. The defect was then packed cancellous bone graft. Conclusion: If suspected a Preoperative MRI should be done to exclude any sub-chondral cysts osteochondral defects and any surprise during surgery. Usually one should keep extension stems ready for difficult cases. Operating surgeon should know his implants very well, as in many standard implants extension stems can only be used when distal femur cuts are taken accordingly as 5° Valgus. Mini incision should be avoided because it may fail to reveal such surprises and may land into periprosthetic fractures. PMID:27298967

  13. Short-term muscle atrophy caused by botulinum toxin-A local injection impairs fracture healing in the rat femur.

    PubMed

    Hao, Yongqiang; Ma, Yongcheng; Wang, Xuepeng; Jin, Fangchun; Ge, Shengfang

    2012-04-01

    Damaged bone is sensitive to mechanical stimulation throughout the remodeling phase of bone healing. Muscle damage and muscular atrophy associated with open fractures and subsequent fixation are not beneficial to maintaining optimum conditions for mechanical stability. The aim of this study was to investigate whether local muscle atrophy and dysfunction affect fracture healing in a rat femur fracture model. We combined the rat model of a short period atrophy of the quadriceps with femur fracture. Forty-four-month-old male Wistar rats were adopted for this study. Two units of botulinum toxin-A (BXTA) were administered locally into the right side of the quadriceps of each rat, while the same dose of saline was injected into the contralateral quadriceps. After BXTA had been fully absorbed by the quadriceps, osteotomy was performed in both femurs with intramedullary fixation. Gross observation and weighing of muscle tissue, X-ray analysis, callus histology, and bone biomechanical testing were performed at different time points up to 8 weeks post-surgery. Local injection of BXTA led to a significant decrease in the volume and weight of the quadriceps compared to the control side. At the eighth week, the left side femurs of the saline-injected quadriceps almost reached bony union, and fibrous calluses were completely calcified into woven bone. However, a gap was still visible in the BXTA-treated side on X-ray images. As showed by bone histology, there were no mature osseous calluses or woven bone on the BXTA-treated side, but a resorption pattern was evident. Biomechanical testing indicated that the femurs of the BXTA-treated side exhibited inferior mechanical properties compared with the control side. The inferior outcome following BXTA injection, compared with saline injection, in terms of callus resistance may be the consequence of unexpected load and mechanical unsteadiness caused by muscle atrophy and dysfunction. PMID:21919046

  14. A novel framework for the temporal analysis of bone mineral density in metastatic lesions using CT images of the femur

    NASA Astrophysics Data System (ADS)

    Knoop, Tom H.; Derikx, Loes C.; Verdonschot, Nico; Slump, Cornelis H.

    2015-03-01

    In the progressive stages of cancer, metastatic lesions in often develop in the femur. The accompanying pain and risk of fracture dramatically affect the quality of life of the patient. Radiotherapy is often administered as palliative treatment to relieve pain and restore the bone around the lesion. It is thought to affect the bone mineralization of the treated region, but the quantitative relation between radiation dose and femur remineralization remains unclear. A new framework for the longitudinal analysis of CT-scans of patients receiving radiotherapy is presented to investigate this relationship. The implemented framework is capable of automatic calibration of Hounsfield Units to calcium equivalent values and the estimation of a prediction interval per scan. Other features of the framework are temporal registration of femurs using elastix, transformation of arbitrary Regions Of Interests (ROI), and extraction of metrics for analysis. Build in Matlab, the modular approach aids easy adaptation to the pertinent questions in the explorative phase of the research. For validation purposes, an in-vitro model consisting of a human cadaver femur with a milled hole in the intertrochanteric region was used, representing a femur with a metastatic lesion. The hole was incrementally stacked with plates of PMMA bone cement with variable radiopaqueness. Using a Kolmogorov-Smirnov (KS) test, changes in density distribution due to an increase of the calcium concentration could be discriminated. In a 21 cm3 ROI, changes in 8% of the volume from 888 ± 57mg • ml-1 to 1000 ± 80mg • ml-1 could be statistically proven using the proposed framework. In conclusion, the newly developed framework proved to be a useful and flexible tool for the analysis of longitudinal CT data.

  15. Evaluation of calabash chalk effect on femur bone morphometry and mineralization in young wistar rats: A pilot study

    PubMed Central

    Ekong, Moses B; Ekanem, Theresa B; Sunday, Abraham O; Aquaisua, Aquaisua N; Akpanabiatu, Monday I

    2012-01-01

    Background: Calabash chalk, a popularly consumed geophagic material in Nigeria has been reported to contain lead, arsenic, alpha lindane, endrin, and endosulfan 11 among other pollutants. Aim: The continuous exposure of young children to this chalk necessitated this study on the bone morphometry and mineralization in young Wistar rats. Materials and Methods: Fourteen young (weanling) Wistar rats of both sexes weighing 54-72 g were assigned into two groups of seven animals each. Group I served as control, while group II was the test group (TG). 40 mg/ml of C. chalk was administered as suspension to the test animals in group II. Animals in the control group were orally treated with 1ml of distilled water. Administration of the C. chalk in the animals lasted for 28 days, and the animals were sacrificed on day 29, using chloroform anaesthesia. The femur bones were dissected out, cleaned of flesh and sun-dried. The lengths and weights of the femur bones were measured using graphite furnace atomic mass spectrophotometer. Results: Results showed 1.6% decrease in body weight change in the TG, insignificant decreases in the weights and lengths of both the right and left femur bones, and significant decreased (P < 0.0126) organ-somatic index, and femur bones concentrations (mg/l) of zinc, phosphate, carbonate, calcium, sodium, and potassium (P < 0.05). Conclusion: In conclusion, this study showed that C. chalk may alter growth rate, and cause de-mineralization in the femur bone, hence, it may be detrimental to bone growth. PMID:23776822

  16. Late-term abortion.

    PubMed

    Epner, J E; Jonas, H S; Seckinger, D L

    1998-08-26

    Recent proposed federal legislation banning certain abortion procedures, particularly intact dilatation and extraction, would modify the US Criminal Code such that physicians performing these procedures would be liable for monetary and statutory damages. Clarification of medical procedures is important because some of the procedures used to induce abortion prior to viability are identical or similar to postviability procedures. This article reviews the scientific and medical information on late-term abortion and late-term abortion techniques and includes data on the prevalence of late-term abortion, abortion-related mortality and morbidity rates, and legal issues regarding fetal viability and the balance of maternal and fetal interests. According to enacted American Medical Association (AMA) policy, the use of appropriate medical terminology is critical in defining late-term abortion procedures, particularly intact dilatation and extraction, which is a variant of but distinct from dilatation and evacuation. The AMA recommends that the intact dilatation and extraction procedure not be used unless alternative procedures pose materially greater risk to the woman and that abortions not be performed in the third trimester except in cases of serious fetal anomalies incompatible with life. Major medical societies are urged to collaborate on clinical guidelines on late-term abortion techniques and circumstances that conform to standards of good medical practice. More research on the advantages and disadvantages of specific abortion procedures would help physicians make informed choices about specific abortion procedures. Expanded ongoing data surveillance systems estimating the prevalence of abortion are also needed. PMID:9728645

  17. Lateness to School Remediation Game

    ERIC Educational Resources Information Center

    Ugwuegbulam, Charles N.; Ibrahim, Haj. Naheed

    2015-01-01

    Primary and secondary school in Nigeria encourage punctuality to school yet a good number of the learners came late to school. This is especially true in the case of day students. Learners who come late to school are usually punished in one way or the other yet the lateness to school phenomenon still persist. Lateness to school behaviour affects…

  18. Late Mitochondrial Acquisition, Really?

    PubMed Central

    Degli Esposti, Mauro

    2016-01-01

    This article provides a timely critique of a recent Nature paper by Pittis and Gabaldón that has suggested a late origin of mitochondria in eukaryote evolution. It shows that the inferred ancestry of many mitochondrial proteins has been incorrectly assigned by Pittis and Gabaldón to bacteria other than the aerobic proteobacteria from which the ancestor of mitochondria originates, thereby questioning the validity of their suggestion that mitochondrial acquisition may be a late event in eukaryote evolution. The analysis and approach presented here may guide future studies to resolve the true ancestry of mitochondria. PMID:27289097

  19. Radiocarbon dating the late Middle Paleolithic and the Aurignacian of the Swabian Jura.

    PubMed

    Conard, Nicholas J; Bolus, Michael

    2008-11-01

    Many lines of evidence point to the period between roughly 40 and 30 ka BP as the period in which modern humans arrived in Europe and displaced the indigenous Neandertal populations. At the same time, many innovations associated with the Upper Paleolithic--including new stone and organic technologies, use of personal ornaments, figurative art, and musical instruments--are first documented in the European archaeological record. Dating the events of this period is challenging for several reasons. In the period about six to seven radiocarbon half-lives ago, variable preservation, pre-treatment, and sample preparation can easily lead to a lack of reproducibility between samples and laboratories. A range of biological, cultural, and geological processes can lead to mixing of archaeological strata and their contents. Additionally, some data sets point to this period as a time of significant spikes in levels of atmospheric radiocarbon. This paper assesses these questions in the context of the well-excavated and intensively studied caves of Geissenklösterle and Hohle Fels in the Swabian Jura of southwestern Germany. We conclude that variable atmospheric radiocarbon production contributes to the problems of dating the late Middle Paleolithic and the early Upper Paleolithic. To help establish a reliable chronology for the Swabian Aurignacian, we are beginning to focus our dating program on short-lived, stratigraphically secure features to see if they yield reproducible results. This approach may help to test competing explanations for the noisy and often non-reproducible results that arise when trying to date the transition from the Middle to the Upper Paleolithic. PMID:18926559

  20. Ipsilateral obturator type of hip dislocation with fracture shaft femur in a child: a case report and literature review.

    PubMed

    Arjun, R H H; Kumar, Vishal; Saibaba, Balaji; John, Rakesh; Guled, Uday; Aggarwal, Sameer

    2016-09-01

    The incidence of traumatic hip dislocations in children is rising in this fast developing world along with increasing numbers of high-velocity road traffic accidents. Anterior dislocation of the hip has a lower incidence compared with posterior dislocation of the hip. We encountered a rare case of the obturator type of anteriorly dislocated hip associated with ipsilateral fracture of the shaft femur in an 11-year-old child. This is a highly unusual injury combination and the mechanism of injury is obscure. Only two similar cases have been reported in the English literature to date. Closed reduction of the hip using a hitherto undescribed technique and an intramedullary interlocking nail was performed in this case. At 6 months of follow-up, the fracture shaft femur has united and the child is bearing full weight on the limb. PMID:27128394

  1. Stemmed TKA in a femur with a total hip arthroplasty: is there a safe distance between the stem tips?

    PubMed

    Soenen, Marc; Baracchi, Matteo; De Corte, Ronny; Labey, Luc; Innocenti, Bernardo

    2013-09-01

    When a stemmed TKA is needed in a femur in which a THA is already present, choosing an appropriate length for the TKA stem is crucial. Many surgeons intuitively fear that the distance between the stem tips correlates with the femur risk for fracture (RF). However, to date, no biomechanical data to support this intuition are available. Therefore, in this study, the RF in such a configuration was determined and compared for several activities, using a finite element modeling technique. During gait and sideways falling no difference in RF among different stem lengths was shown. However, a clear threshold appears during four-point bending. Stem tip distances shorter than 110 mm dramatically increased RF and, in osteoporotic bone, will certainly lead to fracture (RF>1) and thus should be avoided. PMID:23489732

  2. The microvascular osteocutaneous femur transplant for covering combined alveolar ridge and floor of the mouth defects: preliminary report.

    PubMed

    Gaggl, Alexander; Bürger, Heinz; Chiari, Friedrich Michael

    2008-04-01

    In this preliminary report, the surgical technique of an oral defect coverage using the microvascular osteocutaneous flap from the distal medial femur is described and three clinical cases are reported. The new flap was used for covering combined defects of the alveolar ridge and the neighboring floor of the mouth after tumor surgery and irradiation. The bone part of the flap was supplied by the descending genicular artery and the soft tissue part by their first emission-the saphenous artery. Anastomoses were performed between the common part of the flap pedicle and cervical arteries or veins. There were no severe complications or transplant loss. All patients were successfully treated with dental implants (n = 12) 4 to 6 months after ridge reconstruction. The microvascular osteocutaneous femur transplant can be used successfully in individual reconstruction of the alveolar ridge and the neighboring floor of the mouth after tumor resection. PMID:18454356

  3. Is the Patellar Pubic Percussion Test useful to diagnose only femur fractures or something else? Two case reports.

    PubMed

    Segat, M; Casonato, O; Margelli, M; Pillon, S

    2016-02-01

    In the literature, the utility of the Patellar Pubic Percussion Test (PPPT) to diagnose occult fractures of the femur is well described. However, up to now there are no studies demonstrating the efficacy of this test in recognizing fractures of the pelvis. In this two case report a positive PPPT allowed the therapist to recognize clinical conditions requiring caution, protecting patients from a potentially unsuitable treatment. Both patients had a negative pelvis and femur x-ray after a fall, but the clinical findings and a positive PPPT lead the physiotherapist to suggest further examinations. In these two cases the PPPT seemed to be a useful diagnostic tool to identify periacetabular, ileo-pubic and ischio-pubic ramus fractures. These findings suggest that PPPT could be positive even for a bone lesion in any of the transit points of the vibration, from the patella to the pubic symphysis. PMID:26403611

  4. Biomechanical research of joint III. An experimental biomechanical research on the Femur's articular surface of knee of pongidae

    NASA Astrophysics Data System (ADS)

    Renxiang, Zhang; Zuyun, Lan; Wenji, Qu

    1986-06-01

    In this paper, moiré contour fringes is applied to study the femur's articular surface of the knee of Pongidae. The preliminary division of the femur's articular surface of knee into three types is proposed. The moiré contour fringes ofthe medial condyle is taken as a mark according to the references. Owing to the fact that the moiré contour fringes obtained from experiments after the 2nd order of fringe basically follow a certain rule, an investigation is made on the distribution of the angle α which is defined as the angle of the major axis of the 2nd order's near-oval shaped moiré contour fringe on the medial condyle with the horizontal axis. Preliminary distribution graphs are given in the paper.

  5. Intramedullary pressure in reamed and unreamed nailing of the femur and tibia--an in vitro study in intact, human bones.

    PubMed

    Heim, D; Schlegel, U; Perren, S M

    1993-01-01

    The generation of intramedullary pressure during nailing of the femur and the tibia using reamed and unreamed nailing techniques was investigated and compared in an in vitro study in intact, cadaveric human bones. The pressure was assessed by distal supracondylar measurements via a small hole in the metaphyseal cortex. No significant difference in the intramedullary pressure increase was seen in the femur whether a reamed or unreamed nailing technique was used in contrast to the tibia (p = 0.01). A distal venting hole in the femur did not lower the increase in pressure during insertion of an unreamed nail. Using the cannulated cutter to open the medullary canal showed a significant increase in pressure compared to the use of the awl in the femur (p = 0.01), but not in the tibia. PMID:8168877

  6. Unifocal Granuloma of Femur due to Langerhans' Cell Histiocytosis: A Case Report and Review of the Literature

    PubMed Central

    Singh, Harpreet; Kaur, Satnam; Yuvarajan, P.; Jain, Nishant; Maini, Lalit

    2010-01-01

    The radiological diagnosis of osteolytic lesions of the long bones in pediatric population constitutes a challenge when the case history and clinical data are uncharacteristic. We believe that the description of few clinically and histologically proven cases to verify the existence of radiological signs useful for diagnosis may be of interest. Here, we describe a case of Langerhans' cell histiocytosis (LCH) presenting as unifocal eosinophilic granuloma of femur along with a brief review of the literature. PMID:20811571

  7. Predicting the biomechanical strength of proximal femur specimens with bone mineral density features and support vector regression

    NASA Astrophysics Data System (ADS)

    Huber, Markus B.; Yang, Chien-Chun; Carballido-Gamio, Julio; Bauer, Jan S.; Baum, Thomas; Nagarajan, Mahesh B.; Eckstein, Felix; Lochmüller, Eva; Majumdar, Sharmila; Link, Thomas M.; Wismüller, Axel

    2012-03-01

    To improve the clinical assessment of osteoporotic hip fracture risk, recent computer-aided diagnosis systems explore new approaches to estimate the local trabecular bone quality beyond bone density alone to predict femoral bone strength. In this context, statistical bone mineral density (BMD) features extracted from multi-detector computed tomography (MDCT) images of proximal femur specimens and different function approximations methods were compared in their ability to predict the biomechanical strength. MDCT scans were acquired in 146 proximal femur specimens harvested from human cadavers. The femurs' failure load (FL) was determined through biomechanical testing. An automated volume of interest (VOI)-fitting algorithm was used to define a consistent volume in the femoral head of each specimen. In these VOIs, the trabecular bone was represented by statistical moments of the BMD distribution and by pairwise spatial occurrence of BMD values using the gray-level co-occurrence (GLCM) approach. A linear multi-regression analysis (MultiReg) and a support vector regression algorithm with a linear kernel (SVRlin) were used to predict the FL from the image feature sets. The prediction performance was measured by the root mean square error (RMSE) for each image feature on independent test sets; in addition the coefficient of determination R2 was calculated. The best prediction result was obtained with a GLCM feature set using SVRlin, which had the lowest prediction error (RSME = 1.040+/-0.143, R2 = 0.544) and which was significantly lower that the standard approach of using BMD.mean and MultiReg (RSME = 1.093+/-0.133, R2 = 0.490, p<0.0001). The combined sets including BMD.mean and GLCM features had a similar or slightly lower performance than using only GLCM features. The results indicate that the performance of high-dimensional BMD features extracted from MDCT images in predicting the biomechanical strength of proximal femur specimens can be significantly improved by

  8. Adjustment of traumatic femur shortening assisted by an intramedullar skeletal kinetic distractor: a case report

    PubMed Central

    2013-01-01

    Introduction Distal comminuted femoral fractures with joint involvement are highly challenging for the surgeon. We present a potential therapeutic concept that aims especially at the treatment of posttraumatic leg length discrepancy. Case presentation This case report describes a polytraumatized 19-year-old German woman. Among other injuries she had a third grade open distal comminuted femoral fracture with a long distance metaphyseal osseous defect. As a primary care procedure an external fixation was applied at first. On day 13, an open reconstruction of her distal femur and the articular surface was performed by screw osteosynthesis, shortening and intramedullary nailing. Due to delayed osseous consolidation an autologous cancellous bone grafting was performed twice. In addition to the second cancellous bone graft an allogeneic cortical bone graft was implemented. A 6.5cm posttraumatic leg length shortening after osseous consolidation was the result. The entire leg length shortening was successfully treated 16 months after her accident with the help of an intramedullar skeletal kinetic distractor. Conclusions With the help of the current case report of a patient with polytrauma and a third grade open distal comminuted femoral fracture with joint involvement and a long distance osseous defect, we present a potential therapeutic concept that aims especially at the treatment of posttraumatic leg length discrepancy. PMID:23971536

  9. The Early Result of Cementless Arthroplasty for Femur Neck Fracture in Elderly Patients with Severe Osteoporosis

    PubMed Central

    Seo, Jae-Seong; Shin, Seong-Kee; Jun, Sung-Han; Cho, Chang-Ho

    2014-01-01

    Purpose The purposes of the current study were to assess the early results of cementless hip arthroplasty (HA) for femoral neck fractures in elderly patients with severe osteoporosis and to compare the clinical outcomes between those who underwent total HA (THA) or bipolar hemiarthroplasty (BHA). Materials and Methods From April 2011 to May 2012, we performed 87 cementless HAs for displaced femoral neck fractures in elderly patients (≥65 years) with severe osteoporosis. Among them, we studied 70 hips that were able to be followed-up for >24 months. Of these, 34 underwent THA and 36 underwent BHA. Clinical results were evaluated using the Harris hip score (HHS), Koval classification, and radiographs. Results Only one instance of femoral stem loosening was observed. Additionally, no dislocations were observed and no revision surgeries were required. The mean changes in the functional items of the HHS scores were 2.8 and 5.2 for those who underwent THA and BHA, respectively (P<0.05). According to the Koval classification used for the ambulatory status analysis, the mean perioperative change in the grade was 0.8 (0-4), with no significant differences noted between the THA and BHA groups. Conclusion The early results of cementless HA for femur neck fractures in elderly patients with osteoporosis were satisfactory, and THA was found to have a functional advantage over BHA.

  10. Improving analgesia in fractured neck of femur with a standardised fascia iliaca block protocol

    PubMed Central

    Watson, Paul; Rugonfalvi-Kiss, Szabolcs

    2016-01-01

    Fractured neck of femur (NOF) causes significant morbidity and pain for patients; adequate analgesia is an essential component of patient centred care. Patients experiencing greater pain during treatment for fractured NOF are slower to mobilise and have poorer health-related quality of life. NICE guidance suggests considering adding nerve blocks if paracetamol and opioids do not provide sufficient preoperative pain relief. We set out to audit pain levels in this group of patients in a small District General Hospital and to develop a protocol to improve analgesia provision if required. We identified that patients waiting a long time for fixation of fractured NOF could benefit from safe, effective analgesia by way of fascia iliaca compartment block (FICB). We drew up a protocol and held training sessions bringing about a culture change to provide an excellent standard of analgesia for these patients. Most patients reported much better levels of analgesia post-block and junior doctors felt more empowered. Further developments considered are training of senior ED nurses to administer FICB (in keeping with the AAGBI position statement) and a fascia iliaca catheter placement service. PMID:27239308

  11. Does Computer-Assisted Femur First THR Improve Musculoskeletal Loading Conditions?

    PubMed Central

    Weber, Tim A.; Dendorfer, Sebastian; Grifka, Joachim; Verkerke, Gijsbertus J.; Renkawitz, Tobias

    2015-01-01

    We have developed a novel, computer-assisted operation method for minimal-invasive total hip replacement (THR) following the concept of “femur first/combined anteversion,” which incorporates various aspects of performing a functional optimization of the prosthetic stem and cup position (CAS FF). The purpose of this study is to assess whether the hip joint reaction forces and patient's gait parameters are being improved by CAS FF in relation to conventional THR (CON). We enrolled 60 patients (28 CAS FF/32 CON) and invited them for gait analysis at three time points (preoperatively, postop six months, and postop 12 months). Data retrieved from gait analysis was processed using patient-specific musculoskeletal models. The target parameters were hip reaction force magnitude (hrf), symmetries, and orientation with respect to the cup. Hrf in the CAS FF group were closer to a young healthy normal. Phase-shift symmetry showed an increase in the CAS FF group. Hrf orientation in the CAS FF group was closer to optimum, though no edge or rim-loading occurred in the CON group as well. The CAS FF group showed an improved hrf orientation in an early stage and a trend to an improved long-term outcome. PMID:26582355

  12. Pathological fractures of the proximal femur due to solitary bone cyst: classification, methods of treatment

    PubMed Central

    Miu, A

    2015-01-01

    Fractures are a very important issue in a child’s orthopedic pathology. Neglected a good amount of time, being considered “not too serious”, or “rare”, having better and faster healing methods and not leaving sequels, like in the case of adults, a child’s fractures remain an important chapter of traumatology in general. Because of the raising prevalence of child osteoarticular traumas, as well as new less invasive treatment methods, this theme is always to date. The paper analyzes particular cases of bone fractures that appeared due to minor traumas, on bones with a high brittleness, localized especially on the long bones. Although these fractures on a pathological bone can be seen at all levels of the human skeleton, this paper focuses on fractures located in the proximal third part of the femur. A group of children admitted in the Pediatric Orthopedic Department of “M.S. Curie” Hospital-Bucharest with this diagnostic, were analyzed between 2009 and 2013. PMID:26664486

  13. Management of septic complications following modular endoprosthetic reconstruction of the proximal femur.

    PubMed

    Funovics, Philipp T; Hipfl, Christian; Hofstaetter, Jochen G; Puchner, Stephan; Kotz, Rainer I; Dominkus, Martin

    2011-10-01

    In a retrospective single-centre study 170 consecutive patients were included who received a Kotz modular prosthesis after resection of bone tumours of the proximal femur to evaluate the management of prosthetic infection. Infection occurred in 12 of 166 patients available for follow-up (six males; six females; mean age, 47 years; range, ten to 75 years) after a mean of 39 months (range, one to 166 months; infection rate, 7.2%). Mean follow-up was 54 months (range, four to 200 months). One patient died of septic shock. Two patients were treated by wound revision only. Treatment of infection in the remaining patients was one-stage revision in eight and hip disarticulation in one. Infection control by one-stage revision was achieved in five of eight patients; re-infection occurred in three patients and was successfully treated by further revision in all of them. The overall success rate for controlling infection was 83.3%. PMID:20803013

  14. Regional variation of intracortical porosity in the midshaft of the human femur: age and sex differences

    PubMed Central

    Thomas, C David L; Feik, Sophie A; Clement, John G

    2005-01-01

    This study investigated age and sex differences in patterns of porosity distribution in the midshaft of the human femur. Cross-sections were obtained from 168 individuals from a modern Australian population. The sample comprised 73 females and 95 males, aged between 20 and 97 years. Microradiographs were made of 100-µm sections and pore and bone areas were determined using image processing software. Initially the sample was divided by age: young (20–44 years), middle (45–64 years) and old (65+ years), but it was found that analysis on the basis of the ratio of medullary area to total subperiosteal area gave clearer results. The cortex was divided into three rings radially and into octants circumferentially and the porosity of each segment was calculated. Results showed that a pattern with raised porosity in the posterior and anterolateral regions, and with greater porosity in the inner parts of the cortex, becomes more pronounced with age. In males this pattern develops steadily; in females there are much greater differences between the middle and older groups than earlier in life. The patterns observed are consistent with progressive bone loss occurring along a neutral axis of the cortex where bending stress is lowest and the mechanical advantage of the bone is least. PMID:15730477

  15. A patient with focal fibrocartilaginous dysplasia in the distal femur and review of the literature.

    PubMed

    Ando, Akira; Hatori, Masahito; Hosaka, Masami; Hagiwara, Yoshihiro; Kita, Atsushi; Ochiai, Tatsuhiro; Itoi, Eiji

    2008-08-01

    Focal fibrocartilaginous dysplasia (FFCD) is a rare and benign bone lesion that induces bowing deformity of the long bones in young children. Excessive production of fibrocartilage by abnormal differentiation in the metaphysis or by trauma during delivery or after birth is thought to cause growth disturbance. Radiologically, the lesion is characterized by a lucent defect with marginal sclerosis in the medial metaphysis of the long bone. However, there have been few reports about the initial radiological changes of FFCD before bowing started. We report a patient with FFCD in the left distal femur in whom the radiological changes were serially observed during the course of the disorder. A 2-week-old boy first visited our hospital because of left thigh pain. Plain radiographs did not show any abnormal findings at that time. At 10 weeks, a well-defined lucent defect with bony fragment inside was observed in the distal femoral medial cortex. At 1 year, this bony fragment gradually vanished but varus deformity progressed and reached approximately 40 degrees at the age of 2. After removal of the lesion, osteotomy and immobilization was performed with Ilizarov external fixator comprising rings, rods and wires. Complete bone union was achieved 3 months after operation. It is noteworthy that we could observe the initial radiological changes of FFCD before varus deformity occurred. As far as we know, there have been no descriptions of the bony fragment inside a lucent defect of the lesion. Radiological features may vary in the early phase of FFCD. PMID:18679004

  16. The Frank Stinchfield Award: Morphologic features of the acetabulum and femur: anteversion angle and implant positioning.

    PubMed

    Maruyama, M; Feinberg, J R; Capello, W N; D'Antonio, J A

    2001-12-01

    Morphologic features of the hips, in particular those features germane to determination of acetabular and femoral anteversion angles and femoral head offset, were studied in 50 male and 50 female human skeletons with bilateral normal joints. Four distinct configurations were identified relative to the anterior acetabular ridge. The majority (121, 60.5%) were curved; 51 (25.5%) were angular; 19 (9.5%) were irregular; and nine (4.5%) were straight. The acetabular anteversion angle measured 19.9 degrees +/- 6.6 degrees (range, 7 degrees-42 degrees) and was significantly larger in females (21.3 degrees +/- 7.1 degrees) versus males (18.5 degrees +/- 5.8 degrees). The notch acetabular angle, which can be identified easily intraoperatively, was defined as the angle created at the intersection of a line from the sciatic notch along the posterior acetabular ridge and a line from the posterior to the anterior acetabular wall. This angle is almost perpendicular (89.0 degrees +/- 3.5 degrees) and, therefore, may provide an accurate estimate of acetabular anteversion during cup placement. Awareness of the anatomic differences between genders for acetabular anteversion angle, anterolateral bowing of the femur, and neck shaft angle may help reduce the relatively higher incidence of dislocation in females and may lead to different implant designs for male and female patients. PMID:11764371

  17. Brown tumors of the femur and pelvis secondary to a parathyroid carcinoma: report of one case.

    PubMed

    Radulescu, Dan; Chis, Bogdan; Donca, Valer; Munteanu, Valentin

    2014-07-01

    Brown tumors result from excess osteoclast activity and consist of collections of osteoclasts intermixed with fibrous tissue and poorly mineralized woven bone. They are secondary to hyperparathyroidism (HPT). Their incidence is higher in primary than in secondary hyperparathyroidism. We report a 69 years-old male, admitted in a state of confusion, lethargy and bedridden, with a pathological fracture of the femur caused by a brown tumor. The laboratory examination revealed a hypercalcemia (8.85 mEq/L), with high levels of ionized Ca (5.48 mEq/L), serum alkaline phosphatases (416 U/L) and serum parathormone (120 pg/mL). Ultrasound examination of the neck showed a large parathyroid tumor, probably corresponding to a carcinoma. A primary HPT was diagnosed. The patient was hydrated and high doses of diuretics and bisphosphonates were administered. After correction of serum calcium and neurologic symptoms, the patient was operated, performing an extensive resection of the tumor. The pathology report confirmed the diagnosis of parathyroid carcinoma. PMID:25378013

  18. Recognizing different tissues in human fetal femur cartilage by label-free Raman microspectroscopy

    NASA Astrophysics Data System (ADS)

    Kunstar, Aliz; Leijten, Jeroen; van Leuveren, Stefan; Hilderink, Janneke; Otto, Cees; van Blitterswijk, Clemens A.; Karperien, Marcel; van Apeldoorn, Aart A.

    2012-11-01

    Traditionally, the composition of bone and cartilage is determined by standard histological methods. We used Raman microscopy, which provides a molecular "fingerprint" of the investigated sample, to detect differences between the zones in human fetal femur cartilage without the need for additional staining or labeling. Raman area scans were made from the (pre)articular cartilage, resting, proliferative, and hypertrophic zones of growth plate and endochondral bone within human fetal femora. Multivariate data analysis was performed on Raman spectral datasets to construct cluster images with corresponding cluster averages. Cluster analysis resulted in detection of individual chondrocyte spectra that could be separated from cartilage extracellular matrix (ECM) spectra and was verified by comparing cluster images with intensity-based Raman images for the deoxyribonucleic acid/ribonucleic acid (DNA/RNA) band. Specific dendrograms were created using Ward's clustering method, and principal component analysis (PCA) was performed with the separated and averaged Raman spectra of cells and ECM of all measured zones. Overall (dis)similarities between measured zones were effectively visualized on the dendrograms and main spectral differences were revealed by PCA allowing for label-free detection of individual cartilaginous zones and for label-free evaluation of proper cartilaginous matrix formation for future tissue engineering and clinical purposes.

  19. Growth characteristics of the fetal ligament of the head of femur: significance in congenital hip disease.

    PubMed Central

    Walker, J. M.

    1980-01-01

    Measurement of the length and width of the ligament of the head of femur (ligamentum teres) in 140 normal human fetuses between 12 weeks and term provides limits for growth changes in this structure. These observations provide no morphological evidence of a significant difference between males and females, or between the right and left sides, to explain the female and left hip preponderance reported in congenital hip disease. The ligament is shown to be variable in length, width, and shape, and it is not a distinctly linear structure through linearity may increase with age. Tests of femoral head mobility support the opinion that this ligament must play a role in fetal and neonatal hip joint stability. Weak correlation only was demonstrated between the ligament variables and acetabular depth, which suggests that ligament shape and socket shape are not closely related. Comparison of measurements from normal and 12 dysplastic or subluxated joints provides no evidence to support previous observations that this structure is unusually long in abnormal hip joints which are not frankly dislocated. Images FIG. 1 PMID:7445537

  20. Fat emboli syndrome in isolated fractures of the tibia and femur.

    PubMed

    Ganong, R B

    1993-06-01

    The fat emboli syndrome (FES) was studied in otherwise healthy young skiers with isolated fractures of the tibia and femur treated from 1980 until 1991. During the first year, 13 of 56 tibial and femoral fractures developed FES. The overall incidence of FES was 23%: 19% among fractured tibiae and 75% among fractured femora. Thirty-three percent of displaced transverse tibial fractures developed FES. During the next ten year, only those tibial or femoral fractures that developed FES were studied. There were 44 such cases. Symptoms included a mean PO2 of 45 mm Hg and a fever of 39 degrees. In addition, 40% of the patients had petechiae. The mean patient age was 26 years. None of the patients had other significant injuries or illnesses, 75% received oxygen, and 9% received steroids. None of the patients received mechanical ventilation. All cases had developed by the third day of hospitalization, and the duration of the syndrome was less than four days in 86% of the patients. The mortality rate was 0%. In 50% of the patients, hospitalization was prolonged because of FES; otherwise, there were no complications. This study of isolated femoral and tibial fractures in healthy young skiers demonstrates that FES occurs more commonly than previously thought, is not associated with mortality, and causes little morbidity. Treatment should consist of supportive care only, with specific care directed toward the underlying injury. PMID:8504602

  1. Alterations in Trabecular Bone Microarchitecture in the Ovine Spine and Distal Femur Following Ovariectomy

    PubMed Central

    Kreipke, Tyler C.; Rivera, Nicole C.; Garrison, Jacqueline G.; Easley, Jeremiah T.; Turner, A. Simon; Niebur, Glen L.

    2014-01-01

    Osteoporosis is a bone disease resulting in increased fracture risk as a result of alterations in both the quantity and quality of bone. Bone quality is a combination of metabolic and microarchitectural properties of bone that can help to explain the increased susceptibility to fracture. Translational animal models are essential to understanding the pathology and evaluating potential treatments of this disease. Large animal models, such as the ovariectomized sheep, have been used as a model for post-menopausal osteoporosis. However, long-term studies have not been carried out to observe the effects of ovariectomy after more than one year. This study employed micro-computed tomography to quantify changes in microarchitectural and mechanical parameters in the femoral condyles and vertebral bodies of sheep that were sacrificed one or two years following ovariectomy. In the vertebral body, microarchitectural characteristics were significantly degraded following one year of ovariectomy in comparison to controls. The mechanical anisotropy, determined from micro-scale finite element models, was also greater in the ovariectomized groups, although the fabric tensor anisotropy was similar. There was no greater architectural degradation following two years of ovariectomy compared to one. Ovariectomy had minimal effects on the trabecular architecture of the distal femur even after two years. These results indicate that the vertebral body is the preferred anatomic site for studying bone from the ovariectomized sheep model, and that the architectural changes stabilize after the first year. PMID:24720887

  2. Supracondylar osteotomy of the paediatric femur using the locking compression plate: a refined surgical technique.

    PubMed

    Brunner, Reinald; Camathias, Carlo; Gaston, Mark; Rutz, Erich

    2013-12-01

    Locking compression plates (LCP) have been developed for paediatric patients, and these provide safe bone fixation and allow for immediate weight-bearing. These plates are becoming increasingly popular and are proving to especially useful for the treatment of proximal and distal (supracondylar) femoral osteotomies. They are thought to provide better grip in osteoporotic bone. The technique has been described in the provider's manual as well as recently by Joeris et al. (Int Orthop 2012: 36:2299-2306). The LCP system offers optimal stability after the final fixation, but temporary fixation using the originally described method is unstable, and we consider the medialisation instrument unsatisfactory as it has very small contact area with the lateral aspect of the femur and does not provide sound rotational control. For this reason we have developed a technique whereby temporary, stable fixation using fine K-wires can be attained for the proximal, diaphyseal fragment, following sound fixation with locking screws of the distal fragment. This procedure allows for full clinical (including rotation) and radiographic assessment intraoperatively, as well as fine adjustment in all three planes. This modification enables optimal correction before the final fixation and avoids unnecessary, large drill holes which may otherwise act as dangerous tress risers, endangering stability and weight-bearing. Here we describe a refined technique of the supracondylar femoral osteotomy using the paediatric LCP Condylar Plate. PMID:24432123

  3. A New Hadrosauroid Dinosaur from the Early Late Cretaceous of Shanxi Province, China

    PubMed Central

    Wang, Run-Fu; You, Hai-Lu; Xu, Shi-Chao; Wang, Suo-Zhu; Yi, Jian; Xie, Li-Juan; Jia, Lei; Li, Ya-Xian

    2013-01-01

    Background The origin of hadrosaurid dinosaurs is far from clear, mainly due to the paucity of their early Late Cretaceous close relatives. Compared to numerous Early Cretaceous basal hadrosauroids, which are mainly from Eastern Asia, only six early Late Cretaceous (pre-Campanian) basal hadrosauroids have been found: three from Asia and three from North America. Methodology/Principal Findings Here we describe a new hadrosauroid dinosaur, Yunganglong datongensis gen. et sp. nov., from the early Late Cretaceous Zhumapu Formation of Shanxi Province in northern China. The new taxon is represented by an associated but disarticulated partial adult skeleton including the caudodorsal part of the skull. Cladistic analysis and comparative studies show that Yunganglong represents one of the most basal Late Cretaceous hadrosauroids and is diagnosed by a unique combination of features in its skull and femur. Conclusions/Significance The discovery of Yunganglong adds another record of basal Hadrosauroidea in the early Late Cretaceous, and helps to elucidate the origin and evolution of Hadrosauridae. PMID:24204734

  4. Holding power of three different pin designs in the femur and ulna of the common buzzard (Buteo buteo).

    PubMed

    López García, Mariano; López Beceiro, Ana M; Valcárcel Juárez, Víctor; Muñoz Guzón, Fernando; González Cantalapiedra, Antonio

    2011-12-01

    External skeletal fixation is generally considered the best stabilization technique for immobilizing avian long bone fractures, but one of its major complications is the failure of bone-fixation pin interface or the loss of holding power. Consequently, this study is aimed at elucidating which pin design offers more pull-out strength in certain bones of the common buzzard (Buteo buteo). To achieve this objective, three pin designs (a smooth design and two negative profile threaded designs, with different thread pitch) were placed in five positions along the femur and ulna of the common buzzard. The pin pull-out strength was measured with the purpose of comparing medullary and pneumatic bones, insertion sites, and pin designs. Threaded pins with negative profile showed greater holding power than smooth pins (P < 0.05). When comparing holding power between the ulna and femur, no differences were found for smooth pins, whereas threaded pins showed more pull-out strength in the ulna than in the femur (P < 0.05). There were no differences observed related to pin location along the same bone when considering the same pin type. These results suggest that negative profile threaded pins have more holding power than smooth pins and that pneumatic bones provide less pull-out strength to negative profile threaded pins than medullary bones. PMID:22204047

  5. Effects of ethanol consumption and alcohol detoxification on the biomechanics and morphology the bone in rat femurs.

    PubMed

    Garcia, J A D; Souza, A L T; Cruz, L H C; Marques, P P; Camilli, J A; Nakagaki, W R; Esteves, A; Rossi-Junior, W C; Fernandes, G J M; Guerra, F D; Soares, E A

    2015-11-01

    The objective of this study was to verify the effects of ethanol consumption and alcohol detoxification on the biomechanics, area and thickness of cortical and trabecular bone in rat femur. This was an experimental study in which 18 male Wistar rats were used, with 40 days of age, weighing 179 ± 2.5 g. The rats were divided into three groups (n=06): CT (control), AC (chronic alcoholic), DT (detoxification). After experimental procedures, the animals were euthanized by an overdose of the anesthetic and their femurs were collected for mechanical testing and histological processing. All animals did not present malnutrition or dehydration during experimentation period. Morphometric analysis of cortical and trabecular bones in rat femurs demonstrated that AC animals showed inferior dimensions and alcohol detoxification (DT) allowed an enhancement in area and thickness of cortical and trabecular bone. Material and structural properties data of AC group highlighted the harmful effects of ethanol on bone mechanical properties. The results of this study demonstrated that chronic alcoholic rats (AC) presented major bone damage in all analyzed variables. Those findings suggested that alcohol detoxification is highly suggested in pre-operative planning and this corroborates to the success of bone surgery and bone tissue repair. Thanks to the financial support offered by PROBIC - UNIFENAS. PMID:26675916

  6. Three-dimensional reconstruction method for measuring the knee valgus angle of the femur in northern Chinese adults*

    PubMed Central

    Liu, Tong; Wang, Chen-yu; Xiao, Jian-lin; Zhu, Lan-yu; Li, Xue-zhou; Qin, Yan-guo; Gao, Zhong-li

    2014-01-01

    The purpose of this study was to establish a method for measuring the knee valgus angle from the anatomical and mechanical axes on three-dimensional reconstruction imaging models, and to use this method for estimating an average knee valgus angle value for northern Chinese adults. Computed tomographic angiography data in DICOM format for 128 normal femurs from 64 adult subjects were chosen for analysis. After the femur images were subjected to three-dimensional reconstruction, the deepest point in the intercondylar notch (point A), the midpoint of the medullary cavity 20 cm above the knee-joint line (point B), and the landmark of the femoral head rotation center (point C) were identified on each three-dimensional model. The knee valgus angle was defined as the angle enclosed by the distal femoral anatomical axis (line AB) and the femoral mechanical axis (line AC). The average (mean±SD) of knee valgus angle for the 128 femurs was 6.20°±1.20° (range, 3.05° to 10.64°). Significant positive correlations were found between the knee valgus angles of the right and left sides and between the knee valgus angle and age. During total knee arthroplasty, choosing a valgus cut angle of approximately 6° may achieve a good result in reestablishing the natural mechanical alignment of the lower extremity for patients of northern Chinese ethnicity. Larger valgus cut angles should be chosen for older patients. PMID:25091990

  7. Achieving ligament stability and correct rotational alignment of the femur in knee arthroplasty: a study using the Medial Pivot knee.

    PubMed

    Shakespeare, David; Kinzel, Vera; Ledger, Michael

    2005-12-01

    In a series of 90 Medial Pivot arthroplasties rotational alignment of the femur was achieved by provisionally reconstructing the lateral side of the joint and tensioning the medial side with feeler gauges. Axial CT scans were employed to measure the rotational alignment relative to surgical epicondylar axis. In valgus knees the cutting block was externally rotated to adjust for posterolateral bone loss. The mean rotational alignment of the femur was 0.6 degrees of external rotation (S.D. 1.3, range 3 degrees of ER to 4 degrees of IR). The mean laxity of the medial ligament was 1 mm in flexion (SD 1, range 0-5 mm) and 0.5 mm in flexion (S.D. 0.5, range 0-2 mm) In those knees in which the medial ligament had been released the CT alignment was perfect, but when internally rotated against the hip 3-4 mm of gapping was noted. In valgus knees the mean rotation of the femoral component was 0.8 degrees of internal rotation (S.D. 1.5, range 1 degrees of IR to 4 degrees of ER). In spite of externally rotating the cutting block there was still a tendency to internally rotate the femur in some knees. This simple technique achieves the two goals of ligament stability and correct rotational alignment in a high proportion of cases. It may be applicable to any instrument system which employs posterior referencing. PMID:15967668

  8. Design and Development of Potential Tissue Engineering Scaffolds from Structurally Different Longitudinal Parts of a Bovine-Femur

    NASA Astrophysics Data System (ADS)

    Pramanik, Sumit; Pingguan-Murphy, Belinda; Cho, Jongman; Osman, Noor Azuan Abu

    2014-07-01

    The complex architecture of the cortical part of the bovine-femur was examined to develop potential tissue engineering (TE) scaffolds. Weight-change and X-ray diffraction (XRD) results show that significant phase transformation and morphology conversion of the bone occur at 500-750°C and 750-900°C, respectively. Another breakthrough finding was achieved by determining a sintering condition for the nucleation of hydroxyapatite crystal from bovine bone via XRD technique. Scanning electron microscopy results of morphological growth suggests that the concentration of polymer fibrils increases (or decreases, in case of apatite crystals) from the distal to proximal end of the femur. Energy-dispersive analysis of X-ray, Fourier transform infrared, micro-computer tomography, and mechanical studies of the actual composition also strongly support our microscopic results and firmly indicate the functionally graded material properties of bovine-femur. Bones sintered at 900 and 1000°C show potential properties for soft and hard TE applications, respectively.

  9. Robust QCT/FEA Models of Proximal Femur Stiffness and Fracture Load During a Sideways Fall on the Hip

    PubMed Central

    Dragomir-Daescu, Dan; Buijs, Jorn Op Den; McEligot, Sean; Dai, Yifei; Entwistle, Rachel C.; Salas, Christina; Melton, L. Joseph; Bennet, Kevin E.; Khosla, Sundeep; Amin, Shreyasee

    2013-01-01

    Clinical implementation of quantitative computed tomography-based finite element analysis (QCT/FEA) of proximal femur stiffness and strength to assess the likelihood of proximal femur (hip) fractures requires a unified modeling procedure, consistency in predicting bone mechanical properties, and validation with realistic test data that represent typical hip fractures, specifically, a sideways fall on the hip. We, therefore, used two sets (n = 9, each) of cadaveric femora with bone densities varying from normal to osteoporotic to build, refine, and validate a new class of QCT/FEA models for hip fracture under loading conditions that simulate a sideways fall on the hip. Convergence requirements of finite element models of the first set of femora led to the creation of a new meshing strategy and a robust process to model proximal femur geometry and material properties from QCT images. We used a second set of femora to cross-validate the model parameters derived from the first set. Refined models were validated experimentally by fracturing femora using specially designed fixtures, load cells, and high speed video capture. CT image reconstructions of fractured femora were created to classify the fractures. The predicted stiffness (cross-validation R2 = 0.87), fracture load (cross-validation R2 = 0.85), and fracture patterns (83% agreement) correlated well with experimental data. PMID:21052839

  10. Implementation of boundary conditions in modeling the femur is critical for the evaluation of distal intramedullary nailing.

    PubMed

    Bayoglu, Riza; Okyar, A Fethi

    2015-11-01

    In previous numerical and experimental studies of the intramedullary nail-implanted human femur several simplifications to model the boundary and loading conditions during pre-clinical testing have been proposed. The distal end of the femur was fixed in the majority of studies dealing with the biomechanics of the lower extremity, be it numerical or experimental, which resulted in obviously non-physiological deflections. Per contra, Speirs et al. (2007) proclaimed physiological deflections as a result of constraining the femur in a novel statically determinate fashion in combination with using a complex set of muscle forces. In tandem with this, we have shown that not only the deflections but also the stress and strain predictions turn out to be much lower in magnitude, as a result of using the latter approach. To illustrate the dramatic change in results, we compared these results with those of two other models employing commonly used boundary and loading conditions in retrograde stabilization of a distal diaphyseal fracture. The model used herewith resulted in more realistic femoral cortical strains, lower stresses on both the nail and the screws, as well as such deflections in the overall structure. PMID:26341599

  11. Tibial turn-up procedure as an alternative to rotationplasty in a 4-year-old with osteosarcoma of the distal femur.

    PubMed

    Tate, Rebecca; Gerrand, Craig; Hale, Juliet

    2015-01-01

    Reconstruction of the distal femur after resection for primary bone tumour in very young patients presents a considerable challenge. The risks and benefits of the available reconstructive options need to be carefully balanced. We report a case of osteosarcoma of the distal femur in a 4-year-old boy that was, unusually, treated by amputation and a tibial turn-up procedure; we discuss the rationale for the procedure and report the results at early follow-up. PMID:25305046

  12. Late Babylonian Astrology

    NASA Astrophysics Data System (ADS)

    Steele, John M.

    The last five centuries BC saw the development of several new forms of astrology in Babylonia. Key to these new astrological techniques was the invention of the zodiac in about 400 BC. These new forms of astrology include personal horoscopes, astral medicine, and the exploitation of geometrical relationships between the position of heavenly bodies. Several Late Babylonian astrological doctrines were later adopted within Greek astrology.

  13. In Situ Parameter Identification of Optimal Density-Elastic Modulus Relationships in Subject-Specific Finite Element Models of the Proximal Femur

    PubMed Central

    Cong, Alexander; Buijs, Jorn Op Den; Dragomir-Daescu, Dan

    2010-01-01

    Quantitative computed tomography based finite element analysis of the femur is currently being investigated as a method for non-invasive stiffness and strength predictions of the proximal femur. The specific objective of this study was to determine better conversion relationships from QCT-derived bone density to elastic modulus, in order to achieve accurate predictions of the overall femoral stiffness in a fall-on-the-hip loading configuration. Twenty-two femurs were scanned, segmented and meshed for finite element analysis. The elastic moduli of the elements were assigned according to the average density in the element. The femurs were then tested to fracture and force-displacement data was collected to calculate femoral stiffness. Using a training set of nine femurs, finite element analyses were performed and the parameters of the density-elastic modulus relationship were iteratively adjusted to obtain optimal stiffness predictions in a least-squares sense. The results were then validated on the remaining 13 femurs. Our novel procedure resulted in parameter identification of both power and sigmoid functions for density-elastic modulus conversion for this specific loading scenario. Our in situ estimated power law achieved improved predictions compared to published power laws, and the sigmoid function yielded even smaller prediction errors. In the future, these results will be used to further improve the femoral strength predictions of our finite element models. PMID:21030287

  14. Role of loads and prosthesis material properties on the mechanics of the proximal femur after total hip arthroplasty.

    PubMed

    Cheal, E J; Spector, M; Hayes, W C

    1992-05-01

    The objective of this study was to establish the role of loads and prosthesis material properties on the mechanics of the proximal femur after total hip arthroplasty. We developed a three-dimensional finite element model of an intact human femur and the same femur with a conventional collared straight-stem femoral component. Using published data, we defined two sets of loading conditions: one that represented three phases of gait, and one that represented four different extreme loads. The four extreme loads were based on the peak joint contact forces that occur during stair ascent and isometric contraction of various muscle groups. The model was analyzed with three different material properties for the prosthesis, including cobalt-chromium alloy, titanium alloy, and a carbon fiber-reinforced polymer (CFRP) laminate. We assumed that the implant was stable, with rigid bonding, collar contact, and no cement. To address femoral component loosening, we examined the shear stresses at the implant-bone interface; to address adaptive bone remodeling, we examined the principal stresses in the supporting cortical bone relative to those in the intact femur. Our analyses of the various loading conditions demonstrated large out-of-plane bending movements and torsional moments, especially for the load representing stair ascent. Based on stepwise multiple regressions, the maximum shear stresses at the implant-bone interface in the distal region were dependent on the total applied axial force and torsion; the maximum shear stresses in the proximal region were dependent on the axial component of the joint contact force alone. Reduction in the prosthesis stiffness, by substitution of the CFRP material properties, resulted in lower interface shear stresses at the distal end of the stem and higher interface shear stresses at the more proximal sections, consistent with the findings of others. We fit equations, based on composite beam theory, to the maximum implant-bone interface shear

  15. A Systematic Review and Meta-Analysis of Ilizarov Methods in the Treatment of Infected Nonunion of Tibia and Femur

    PubMed Central

    Li, Jiantao; Li, Zhirui; Liu, Jianheng; Wang, Guoqi; Wang, Song; Zhang, Lihai; Mao, Zhi; Tang, Peifu

    2015-01-01

    Background Infected nonunion of tibia and femur are common in clinical practice, however, the treatment of these diseases has still been a challenge for orthopaedic surgeons. Ilizarov methods can eradicate infection, compensate bone defects and promote the bone union through progressive bone histogenesis. The objective of this systematic review was to review current available studies reporting on Ilizarov methods in the treatment of infected nonunion of tibia and femur, and to perform meta-analysis of bone and functional results and complications to evaluate the efficacy of Ilizarov methods. Methods A comprehensive literature search was performed from the SCI, PubMed, Cochrane Library; and Embase between January 1995 and August 2015. Some major data were statistically analyzed using weighted means based on the sample size in each study by SPSS 13.0, including number of patients, mean age, mean previous surgical procedures, mean bone defects, mean length of follow-up, bone union, complications per patient, external fixation time, and external fixation index(EFI). Bone results (excellent, good, fair and poor rate), functional results (excellent, good, fair and poor rate) and complications were analyzed by Stata 9.0. Findings A total of 590 patients from 24 studies were included in this systematic review. The average of bone union rate was 97.26% in all included studies. The poor rate in bone results and functional results was 8% (95%CI, 0.04–0.12; I2 = 44.1%, P = 0.065) and 10% (95%CI, 0.05–0.14; I2 = 34.7%, P = 0.121) in patients with infected nonunion of tibia and femur treated by Ilizarov methods. The rate of refracture, malunion, infectious recurrence, knee stiffness, amputation, limb edema and peroneal nerve palsy was respectively 4%, 7%, 5%, 12%, 4%, 13% and 13%. Conclusions Our systematic review showed that the patients with infected nonunion of tibia and femur treated by Ilizarov methods had a low rate of poor bone and functional results. Therefore

  16. Sartorius muscle pedicle iliac bone graft for the treatment of avascular necrosis of femur head

    PubMed Central

    Vaishya, Raju; Agarwal, Amit Kumar; Gupta, Nishint; Vijay, Vipul

    2016-01-01

    Avascular necrosis (AVN) of femoral head needs to be addressed early in the course of the disease, to prevent progression to osteoarthritis. A revascularizing procedure which can help preserve the head should be considered in young adults to alleviate the need for total hip arthroplasty. We included 40 cases (53 hips) of AVN of femoral head operated with Sartorius muscle pedicle iliac bone grafting, done by the senior author. Early post-operative rehabilitation was done. The weight bearing was delayed for 6 weeks. All the patients were followed clinically and radiologically at regular intervals. The operated femoral heads, were grouped according to Ficat’s staging: 24 in stage IIA (45.3%), 22 in stage IIB (41.5%) and 07 in stage III (13.2%). The average duration of surgery was 85 min (range: 55–130 min). The total duration of follow-up was average 4.2 years (range: 2.2–15 years).The Harris hip score was excellent (>90) in 18 hips (33.96%), good (80–89) in 24 hips (45.28%), fair (70–79) in 9 hips (17%) and poor (<70) in 2 hips (3.7%). AVN of the femoral head is a painful and disabling condition in young adults. Sartorius muscle pedicle bone graft technique allows adequate decompression, re vascularization and osteogenesis of the femur head in Ficat’s stage IIa, IIb and III, in young adults. This is an effective and easy technique to adopt with excellent to good results in 80% cases and is associated with only minimal complications. PMID:27583161

  17. Assessment of femur length for fetal biometry in Malaysian pregnant women

    NASA Astrophysics Data System (ADS)

    Ramli, Ramzun Maizan; Adam, Noraina; Jaafar, Mohamad Suhaimi; Rahman, Azhar Abdul; Mustafa, Iskandar Shahrim; Radzi, Yasmin; Nordin, Suriani; Kamarudin, Izyani

    2013-05-01

    The fetal biometry assessment of femur length (FL) was developed in most countries to evaluate the foetus growth. In this study, the FL values for Malaysia population were determined. A prospective study was conducted and a number of 6501 pregnant women were involved with 12372 FL data were collected, performed at antenatal care clinic of Hospital Pulau Pinang, Malaysia. The SPSS software version 17 (regression analysis and paired sample t-test) were used for analysis. The FL values of this study were constructed and rapid FL growth rate in second trimester (2.59 mm/week) than third trimester (1.43 mm/week) was observed. By ethnicity, no significant difference (p ≥ 0.05) was found between the FL values for fetuses of Malay and Indian ethnic's mother (t = -2.042), however these two groups shows significantly (p < 0.05) higher values than those of Chinese ethnic's mother (t = 4.019, 4.083; accordingly). The FL values of Malaysian resulted as significant difference with the common reference FL values from USA and UK, and also with selected Asian populations (India, China, Korea and Japan). As conclusion, it is strong suggested that medical practitioner in Malaysia should avoid in using biometry references based on other population to avoid under- or over-estimation and for accurate assessment of the fetus growth. As this study involved local Malaysian fetuses, therefore the medical practitioner can use the FL values of this study as reference value for fetus biometry assessment in Malaysia.

  18. Representation to the accident and emergency department within 1-year of a fractured neck of femur

    PubMed Central

    2011-01-01

    Background The fractured neck of femur (NOF) is a leading cause of morbidity and mortality. The mortality attendant upon such fractures is 10% at 1 month and 30% at one year with a cost to the NHS of £1.4 billion annually. This retrospective study sought to examine rates and prevailing trends in representation to A&E in the year following a NOF fracture in an attempt to identify the leading causes behind the morbidity and mortality associated with this fracture. Methods 1108 patients who suffered a fractured NOF between 1 January 2002 and 31 December 2007 were identified from a University Hospital A&E database. This database was then used to identify those patients who represented within 1-year following the initial fracture. The presenting complaint, provisional diagnosis and the outcome of this presentation were identified at this time. Results 234 patients (21%) returned to A&E on 368 occasions in the year following a hip fracture. 77% (284/368) of these presentations necessitated admission. Falls, infection and fracture were the leading causes of representation. Falls accounted for 20% (57/284) of admissions; 20.7% of patients were admitted because of a fracture, while 56.6% of admissions were for medical ailments of which infection was the chief precipitant (28% (45/161)). Discussion The causes for representation are varied and multifactorial. The results of this study suggest that some of those events or ailments necessitating readmission may be obviated and potentially reduced by interventions that can be instituted during the primary admission and continued following discharge. PMID:22189063

  19. Epidemiology of fractures of the proximal third of the femur in elderly patients☆

    PubMed Central

    Daniachi, Daniel; Netto, Alfredo dos Santos; Ono, Nelson Keiske; Guimarães, Rodrigo Pereira; Polesello, Giancarlo Cavalli; Honda, Emerson Kiyoshi

    2015-01-01

    Objective This was an epidemiological study on fractures of the proximal third of the femur in elderly patients who were treated at a teaching hospital in the central region of São Paulo. Methods The subjects were patients over the age of 60 years who were attended over a 1-year period. A questionnaire seeking basic sociodemographic data and information on comorbidities presented and medications used was drawn up. The circumstances of the fractures and their characteristics, the treatment instituted and the intra-hospital mortality rate were evaluated. Results The 113 patients included in the study presented a mean age of 79 years. The ratio between the sexes was three women to each man. Only 30.4% of the patients reported having osteoporosis and only 0.9% had had treatment for the disease. Low-energy trauma was the cause of 92.9% of the fractures. Femoral neck fractures accounted for 42.5% of the fractures and trochanteric fractures, 57.5%. Five patients did not undergo operations; 39 underwent joint replacement; and 69 underwent osteosynthesis. The mean length of hospital stay was 13.5 days and the mean length of waiting time until surgery was 7 days. The intra-hospital mortality rate was 7.1%. Conclusion The patients attended at this institution presented an epidemiological profile similar to what is found in the Brazilian literature. Chronic kidney failure is a significant factor with regard to intra-hospital mortality. Preventive measures such as early diagnosis and treatment of osteoporosis and regular physical activity practices were not implemented. PMID:26401497

  20. The locomotion of Babakotia radofilai inferred from epiphyseal and diaphyseal morphology of the humerus and femur.

    PubMed

    Marchi, Damiano; Ruff, Christopher B; Capobianco, Alessio; Rafferty, Katherine L; Habib, Michael B; Patel, Biren A

    2016-09-01

    Palaeopropithecids, or "sloth lemurs," are a diverse clade of large-bodied Malagasy subfossil primates characterized by their inferred suspensory positional behavior. The most recently discovered genus of the palaeopropithecids is Babakotia, and it has been described as more arboreal than Mesopropithecus, but less than Palaeopropithecus. In this article, the within-bone and between-bones articular and cross-sectional diaphyseal proportions of the humerus and femur of Babakotia were compared to extant lemurs, Mesopropithecus and Palaeopropithecus in order to further understand its arboreal adaptations. Additionally, a sample of apes and sloths (Choloepus and Bradypus) are included as functional outgroups composed of suspensory adapted primates and non-primates. Results show that Babakotia and Mesopropithecus both have high humeral/femoral shaft strength proportions, similar to extant great apes and sloths and indicative of forelimb suspensory behavior, with Babakotia more extreme in this regard. All three subfossil taxa have relatively large femoral heads, also associated with suspension in modern taxa. However, Babakotia and Mesopropithecus (but not Palaeopropithecus) have relatively small femoral head surface area to shaft strength proportions suggesting that hind-limb positioning in these taxa during climbing and other behaviors was different than in extant great apes, involving less mobility. Knee and humeral articular dimensions relative to shaft strengths are small in Babakotia and Mesopropithecus, similar to those found in modern sloths and divergent from those in extant great apes and lemurs, suggesting more sloth-like use of these joints during locomotion. Mesopropithecus and Babakotia are more similar to Choloepus in humerofemoral head and length proportions while Palaeopropithecus is more similar to Bradypus. These results provide further evidence of the suspensory adaptations of Babakotia and further highlight similarities to both extant suspensory

  1. Primary Cementless Hip Arthroplasty in Unstable Intertrochanteric Femur Fracture in Elderlys: Short-term Results

    PubMed Central

    Cho, Hyung Lae; Cho, Hong

    2014-01-01

    Purpose This study was aimed to explore and report the short term results of primary cementless hip arthroplasty in treatment of unstable intertrochanteric femur fracture in elderlys. Materials and Methods Between March 2009 and Feburary 2012, 35 arthroplasty cases performed by single surgeon and followed up for more than one year were evaluated. They were 21 females and 14 males with mean age of 78 years (range, 71-92 years). Preoperative evaluation was performed by American Society of Anesthesia score. Retrospective evaluation was performed by operative time, transfusion amount, time to operation days, hospital stay and time to full weight bearing. Clinically, ambulatory ability was checked by Parker and Palmer (P&P) score and function of hip was appraised by Harris hip score (HSS). Radiologically, bone healing of fractured trochanteric fragment and presence of subsidence, stress shielding or osteolysis were checked. Results Fracture type was 11 cases of A2.2, 18 cases of A2.3 and 6 cases of A3.3. Femoral stems used were 8 cases of rectangular tapered wedge type and 27 cases of fluted modular distal fixation type. P&P score improved from mean preinjury score of 7.1 to mean postoperative last follow-up score of 6.5. Median HHS at last follow-up was 75. Mean time to full weight bearing was 47 days (24-79 days). Postoperative complications were one case of linear periprosthetic femoral fracture and one case of postoperative dislocation. Conclusion Cementless hip replacement arthroplasty could be a good option for unstable intertrochanteric femoral fracture in elderlys.

  2. Use of DXA-Based Structural Engineering Models of the Proximal Femur to Discriminate Hip Fracture

    PubMed Central

    Yang, Lang; Peel, Nicola; Clowes, Jackie A; McCloskey, Eugene V; Eastell, Richard

    2011-01-01

    Several DXA-based structural engineering models (SEMs) of the proximal femur have been developed to estimate stress caused by sideway falls. Their usefulness in discriminating hip fracture has not yet been established and we therefore evaluated these models. The hip DXA scans of 51 postmenopausal women with hip fracture (30 femoral neck, 17 trochanteric, and 4 unspecified) and 153 age-, height-, and weight-matched controls were reanalyzed using a special version of Hologic’s software that produced a pixel-by-pixel BMD map. For each map, a curved-beam, a curved composite-beam, and a finite element model were generated to calculate stress within the bone when falling sideways. An index of fracture risk (IFR) was defined over the femoral neck, trochanter, and total hip as the stress divided by the yield stress at each pixel and averaged over the regions of interest. Hip structure analysis (HSA) was also performed using Hologic APEX analysis software. Hip BMD and almost all parameters derived from HSA and SEM were discriminators of hip fracture on their own because their ORs were significantly >1. Because of the high correlation of total hip BMD to HSA and SEM-derived parameters, only the bone width discriminated hip fracture independently from total hip BMD. Judged by the area under the receiver operating characteristics curve, the trochanteric IFR derived from the finite element model was significant better than total hip BMD alone and similar to the total hip BMD plus bone width in discriminating all hip fracture and femoral neck fracture. No index was better than total hip BMD for discriminating trochanteric fractures. In conclusion, the finite element model has the potential to replace hip BMD in discriminating hip fractures. PMID:18767924

  3. Sartorius muscle pedicle iliac bone graft for the treatment of avascular necrosis of femur head.

    PubMed

    Vaishya, Raju; Agarwal, Amit Kumar; Gupta, Nishint; Vijay, Vipul

    2016-08-01

    Avascular necrosis (AVN) of femoral head needs to be addressed early in the course of the disease, to prevent progression to osteoarthritis. A revascularizing procedure which can help preserve the head should be considered in young adults to alleviate the need for total hip arthroplasty. We included 40 cases (53 hips) of AVN of femoral head operated with Sartorius muscle pedicle iliac bone grafting, done by the senior author. Early post-operative rehabilitation was done. The weight bearing was delayed for 6 weeks. All the patients were followed clinically and radiologically at regular intervals. The operated femoral heads, were grouped according to Ficat's staging: 24 in stage IIA (45.3%), 22 in stage IIB (41.5%) and 07 in stage III (13.2%). The average duration of surgery was 85 min (range: 55-130 min). The total duration of follow-up was average 4.2 years (range: 2.2-15 years).The Harris hip score was excellent (>90) in 18 hips (33.96%), good (80-89) in 24 hips (45.28%), fair (70-79) in 9 hips (17%) and poor (<70) in 2 hips (3.7%). AVN of the femoral head is a painful and disabling condition in young adults. Sartorius muscle pedicle bone graft technique allows adequate decompression, re vascularization and osteogenesis of the femur head in Ficat's stage IIa, IIb and III, in young adults. This is an effective and easy technique to adopt with excellent to good results in 80% cases and is associated with only minimal complications. PMID:27583161

  4. Biomechanical properties of osteoporotic rat femurs after different hormonal treatments: genistein, estradiol, and estradiol/progesterone

    PubMed Central

    Azboy, İbrahim; Özkaya, Mustafa; Demir, Teyfik; Demirtaş, Abdullah; Kağan Arslan, Arslan; Özkul, Emin; Akcan, Adnan; Tolunay, Tolga

    2016-01-01

    Introduction: The purpose of the study is to compare the effects of genistein, estradiol, estradiol/progesterone combination on the bone mineral density and biomechanical properties of ovariectomized rats’ bone. Methods: 50 female adult Sprague-Dawley rats were divided into five groups. Bilaterally ovaeriectomy were performed in all groups except the sham-operated group. Groups were a sham-operated group and a control group (water was given), estradiol treated group (17-β estradiol 0.015 mg/kg per day), genistein treated group (genistein 10 mg/kg per day), and an estradiol/progesterone combination group (17-β estradiol 0.015 mg/kg plus drosperinone 0.028 mg/kg per day). The water or hormones were implemented in relevant groups for eight weeks by orogasthric catheter. The bone mineral density and biomechanical properties of the femur were analyzed. Results: Genistein, estradiol, and estradiol/progesterone groups increased bone mineral density significantly compared to the control group. In diaphysis and metaphysis bending test, all groups had higher peak load values than the control group. There were statistically significant differences between the estrogen/progesterone group and control group in diaphysis bending with regard to peak load. There were statistically significant differences between the estradiol and control groups in metaphysis bending with regard to peak load. In axial rotation test, all groups had higher peak torque values than the control groups. Conclusions: Genistein, estradiol and estrogen/progesterone combination improved the biomechanical properties of the ovariectomized rat bone. Genistein which has less side effects may be considered as an alternative in the treatment of postmenopausal osteoporosis. PMID:27194109

  5. Effects of skeletal unloading on the vasomotor properties of the rat femur principal nutrient artery

    PubMed Central

    Prisby, Rhonda D.; Behnke, Bradley J.; Allen, Matthew R.

    2015-01-01

    Spaceflight and prolonged bed rest induce deconditioning of the cardiovascular system and bone loss. Previous research has shown declines in femoral bone and marrow perfusion during unloading and with subsequent reloading in hindlimb-unloaded (HU) rats, an animal model of chronic disuse. We hypothesized that the attenuated bone and marrow perfusion may result from altered vasomotor properties of the bone resistance vasculature. Therefore, the purpose of this study was to determine the effects of unloading on the vasoconstrictor and vasodilator properties of the femoral principal nutrient artery (PNA), the main conduit for blood flow to the femur, in 2 wk HU and control (CON) rats. Vasoconstriction of the femoral PNA was assessed in vitro using norepinephrine, phenylephrine, clonidine, KCl, endothelin-1, arginine vasopressin, and myogenic responsiveness. Vasodilation through endothelium-dependent [acetylcholine, bradykinin, and flow-mediated dilation (FMD)] and endothelium-independent mechanisms [sodium nitroprusside (SNP) and adenosine] were also determined. Vasoconstrictor responsiveness of the PNA from HU rats was not enhanced through any of the mechanisms tested. Endothelium-dependent vasodilation to acetylcholine (CON, 86 ± 3%; HU, 48 ± 7% vasodilation) and FMD (CON, 61 ± 9%; HU, 11 ± 11% vasodilation) were attenuated in PNAs from HU rats, while responses to bradykinin were not different between groups. Endothelium-independent vasodilation to SNP and adenosine were not different between groups. These data indicate that unloading-induced decrements in bone and marrow perfusion and increases in vascular resistance are not the result of enhanced vasoconstrictor responsiveness of the bone resistance arteries but are associated with reductions in endothelium-dependent vasodilation. PMID:25635000

  6. Late embryogenesis abundant proteins

    PubMed Central

    Olvera-Carrillo, Yadira; Reyes, José Luis

    2011-01-01

    Late Embryogenesis Abundant (LEA) proteins accumulate at the onset of seed desiccation and in response to water deficit in vegetative plant tissues. The typical LEA proteins are highly hydrophilic and intrinsically unstructured. They have been classified in different families, each one showing distinctive conserved motifs. In this manuscript we present and discuss some of the recent findings regarding their role in plant adaptation to water deficit, as well as those concerning to their possible function, and how it can be related to their intrinsic structural flexibility. PMID:21447997

  7. Late Washing efficiency

    SciTech Connect

    Morrissey, M.F.

    1992-08-31

    Interim Waste Technology has demonstrated the Late Washing concept on the Experimental Laboratory Filter (ELF) at TNX. In two tests, washing reduced the [NO{sub 2}{sup {minus}}] from 0.08 M to approximately 0.01 M on slurries with 2 year equivalent radiation exposures and 9.5 wt. % solids. For both washes, the [NO{sub 2}{sup {minus}}] decreased at rates near theoretical for a constant volume stirred vessel, indicating approximately l00% washing efficiency. Permeate flux was greater than 0.05 gpm/ft{sup 2} for both washes at a transmembrane pressure of 50 psi and flow velocity of 9 ft/sec.

  8. A new enigmatic Late Miocene mylodontoid sloth from northern South America.

    PubMed

    Rincón, Ascanio D; McDonald, H Gregory; Solórzano, Andrés; Flores, Mónica Núñez; Ruiz-Ramoni, Damián

    2015-02-01

    A new genus and species of sloth (Eionaletherium tanycnemius gen. et sp. nov.) recently collected from the Late Miocene Urumaco Formation, Venezuela (northern South America) is herein described based on a partial skeleton including associated femora and tibiae. In order to make a preliminary analysis of the phylogenetic affinities of this new sloth we performed a discriminate analysis based on several characters of the femur and tibia of selected Mylodontoidea and Megatherioidea sloths. The consensus tree produced indicates that the new sloth, E. tanycnemius, is a member of the Mylodontoidea. Surprisingly, the new taxon shows some enigmatic features among Neogene mylodontoid sloths, e.g. femur with a robust lesser trochanter that projects medially and the straight distinctly elongated tibia. The discovery of E. tanycnemius increases the diversity of sloths present in the Urumaco sequence to ten taxa. This taxon supports previous studies of the sloth assemblage from the Urumaco sequence as it further indicates that there are several sloth lineages present that are unknown from the better sampled areas of southern South America. PMID:26064594

  9. A new enigmatic Late Miocene mylodontoid sloth from northern South America

    PubMed Central

    Rincón, Ascanio D.; McDonald, H. Gregory; Solórzano, Andrés; Flores, Mónica Núñez; Ruiz-Ramoni, Damián

    2015-01-01

    A new genus and species of sloth (Eionaletherium tanycnemius gen. et sp. nov.) recently collected from the Late Miocene Urumaco Formation, Venezuela (northern South America) is herein described based on a partial skeleton including associated femora and tibiae. In order to make a preliminary analysis of the phylogenetic affinities of this new sloth we performed a discriminate analysis based on several characters of the femur and tibia of selected Mylodontoidea and Megatherioidea sloths. The consensus tree produced indicates that the new sloth, E. tanycnemius, is a member of the Mylodontoidea. Surprisingly, the new taxon shows some enigmatic features among Neogene mylodontoid sloths, e.g. femur with a robust lesser trochanter that projects medially and the straight distinctly elongated tibia. The discovery of E. tanycnemius increases the diversity of sloths present in the Urumaco sequence to ten taxa. This taxon supports previous studies of the sloth assemblage from the Urumaco sequence as it further indicates that there are several sloth lineages present that are unknown from the better sampled areas of southern South America. PMID:26064594

  10. Locally applied simvastatin improves fracture healing at late period in osteoporotic rat

    NASA Astrophysics Data System (ADS)

    Tian, Faming; Zhang, Liu; Kang, Yuchuan; Zhang, Junshan; Ao, Jiao; Yang, Fang

    effect of simvastatin locally applied from a bioactive polymer coating of implants on osteoporotic fracture healing at late period. Methods:Femur fracture model was established on normal or osteotoporotic mature female SD rats, intramedullary stabilization was achieved with uncoated titanium Kirschnerwires in normal rats(group A),with polymer-only coated vs. polymer plus simvastatin coated titanium Kirschner wires in osteoporotic rats(group B and C, respectively).Femurs were harvested after 12 weeks, and underwent radiographic and histologic analysis, as well as immunohistochemical evaluation for BMP-2 expression. Results:Radiographic results demonstrated progressed callus in the simvastatin-treated groups compared to the uncoated group.The histologic analysis revealed a significantly processed callus with irregular-shaped newly formed bone trabeculae in simvastatin-treated group. Immunohistochemical evaluation showed markedly higher expression levels of B:MP-2 in simvastatin-treated group.Conclusions: The present study revealed a improved fracture healing under local application of simvastatin in osteoporotic rat,which might partially from upregulation of the B:MP-2 expression at fractured site.

  11. Image-Based Macro-Micro Finite Element Models of a Canine Femur with Implant Design Implications

    NASA Astrophysics Data System (ADS)

    Ghosh, Somnath; Krishnan, Ganapathi; Dyce, Jonathan

    2006-06-01

    In this paper, a comprehensive model of a bone-cement-implant assembly is developed for a canine cemented femoral prosthesis system. Various steps in this development entail profiling the canine femur contours by computed tomography (CT) scanning, computer aided design (CAD) reconstruction of the canine femur from CT images, CAD modeling of the implant from implant blue prints and CAD modeling of the interface cement. Finite element analysis of the macroscopic assembly is conducted for stress analysis in individual components of the system, accounting for variation in density and material properties in the porous bone material. A sensitivity analysis is conducted with the macroscopic model to investigate the effect of implant design variables on the stress distribution in the assembly. Subsequently, rigorous microstructural analysis of the bone incorporating the morphological intricacies is conducted. Various steps in this development include acquisition of the bone microstructural data from histological serial sectioning, stacking of sections to obtain 3D renderings of void distributions, microstructural characterization and determination of properties and, finally, microstructural stress analysis using a 3D Voronoi cell finite element method. Generation of the simulated microstructure and analysis by the 3D Voronoi cell finite element model provides a new way of modeling complex microstructures and correlating to morphological characteristics. An inverse calculation of the material parameters of bone by combining macroscopic experiments with microstructural characterization and analysis provides a new approach to evaluating properties without having to do experiments at this scale. Finally, the microstructural stresses in the femur are computed using the 3D VCFEM to study the stress distribution at the scale of the bone porosity. Significant difference is observed between the macroscopic stresses and the peak microscopic stresses at different locations.

  12. Experimental validation of a finite element model of the proximal femur using digital image correlation and a composite bone model.

    PubMed

    Dickinson, A S; Taylor, A C; Ozturk, H; Browne, M

    2011-01-01

    Computational biomechanical models are useful tools for supporting orthopedic implant design and surgical decision making, but because they are a simplification of the clinical scenario they must be carefully validated to ensure that they are still representative. The goal of this study was to assess the validity of the generation process of a structural finite element model of the proximal femur employing the digital image correlation (DIC) strain measurement technique. A finite element analysis model of the proximal femur subjected to gait loading was generated from a CT scan of an analog composite femur, and its predicted mechanical behavior was compared with an experimental model. Whereas previous studies have employed strain gauging to obtain discreet point data for validation, in this study DIC was used for full field quantified comparison of the predicted and experimentally measured strains. The strain predicted by the computational model was in good agreement with experimental measurements, with R(2) correlation values from 0.83 to 0.92 between the simulation and the tests. The sensitivity and repeatability of the strain measurements were comparable to or better than values reported in the literature for other DIC tests on tissue specimens. The experimental-model correlation was in the same range as values obtained from strain gauging, but the DIC technique produced more detailed, full field data and is potentially easier to use. As such, the findings supported the validity of the model generation process, giving greater confidence in the model's predictions, and digital image correlation was demonstrated as a useful tool for the validation of biomechanical models. PMID:21186906

  13. [Clinical results of the treatment of chronic hematogenous osteomyelitis of the femur by operation. A series of 165 cases].

    PubMed

    Ziani, F; Daoud, A; Martini, M

    1992-01-01

    Between 1968 and 1987 the authors treated 165 cases of chronic haematogenous osteomyelitis of the femur by operation. The procedure used combined decompression, sequestrectomy and saucerization in 161 cases, and sequestrectomy alone in 4. Chemotherapy was used in association for between 10 and 60 days. Eleven patients, thought to be healed, were lost to follow-up after 4 months. The remainder were reviewed for between 4 and 252 months, 124 for more than one year. After the first operation 105 lesions (64%) healed completely, while 60 (36%) relapsed. Of these, 48 were treated by further operation and 12 by drainage of the abscess. Nine patients relapsed twice and there were 3 or more relapses in a further 9. When last seen, 147 lesions were healed and 18 had a permanent sinus. Special features in relation to the femur are discussed, including destructive lesions of the knee and hip joints, the high incidence of stiffness of the knee even in the absence of radiographic evidence of destruction (48.5%), and the danger of injuries to the femoral vessels when using an approach through a medial sinus. The frequency of occurrence of lesions on both medial and posterior aspects of the femur has led the authors to recommend definitive surgical approaches, especially the true postero-lateral and antero-medial routes. Unsatisfactory results after operation may be due to the difficulty in performing sequestrectomy in deep and extensive lesions, problems in undertaking adequate saucerization and the lack of muscle to fill the residual cavity. PMID:1428315

  14. Comparative Study Using Intramedullary K-wire Fixation Over Titanium Elastic Nail in Paediatric Shaft Femur Fractures

    PubMed Central

    Anand, Tushar; Singh, Sudhir

    2014-01-01

    Background: Fracture shaft femur is common paediatric trauma leading to significant morbidity. Conservative treatments available are associated with prolonged periods of immobilization. Use of flexible intramedullary implant allows early rehabilitation in diaphyseal fractures of femur in children. Aim: The aim of the present study is to compare fixation of diaphyseal femur fracture by titanium elastic nail and intramedullary K-wires in children. Setting and Design: Prospective randomized study in a tertiary care hospital. Material and Methods: Fifty-two children between 6 years and 14 years of age with femoral shaft fracture were assigned either in Group I or Group II based on computer generated random numbers. In Group I closed percutaneous intramedullary K- wire fixation and in Group II closed percutaneous intramedullary titanium elastic nail was used to fix the fractures. Partial weight bearing was allowed after 6 weeks of surgery and full weight bearing at clinico-radiological union. Results: Average time of radiological union was 6 to 10 weeks in both groups. In both the groups two cases had entry site irritation which resolved with early implant removal. One case in both the groups had unacceptable mal-alignment. Both the groups had few cases of limb-length discrepancy, which was in acceptable limit, except two cases of TENS. There was no statistically significant difference between the results of both the groups. But, using K-wires significantly reduced the cost of treatment. Conclusion: Most of such fractures in our society are neglected because of high cost of treatment. Providing a cheaper alternative in form of K-wires may be beneficial for the patients from low socio-economic status. PMID:25584251

  15. Recurrent Proximal Femur Fractures in a Teenager With Osteogenesis Imperfecta on Continuous Bisphosphonate Therapy: Are We Overtreating?

    PubMed

    Vasanwala, Rashida F; Sanghrajka, Anish; Bishop, Nicholas J; Högler, Wolfgang

    2016-07-01

    Long-term bisphosphonate (BP) therapy in adults with osteoporosis is associated with atypical femoral fractures, caused by increased material bone density and prolonged suppression of bone remodeling which may reduce fracture toughness. In children with osteogenesis imperfecta (OI), long-term intravenous BP therapy improves bone structure and mass without further increasing the already hypermineralized bone matrix, and is generally regarded as safe. Here we report a teenage girl with OI type IV, who was started on cyclical intravenous pamidronate therapy at age 6 years because of recurrent fractures. Transiliac bone biopsy revealed classical structural features of OI but unusually low bone resorption surfaces. She made substantial improvements in functional ability, bone mass, and fracture rate. However, after 5 years of pamidronate therapy she started to develop recurrent, bilateral, nontraumatic, and proximal femur fractures, which satisfied the case definition for atypical femur fractures. Some fractures were preceded by periosteal reactions and prodromal pain. Pamidronate was discontinued after 7 years of therapy, following which she sustained two further nontraumatic femur fractures, and continued to show delayed tibial osteotomy healing. Despite rodding surgery, and very much in contrast to her affected, untreated, and normally mobile mother, she remains wheelchair-dependent. The case of this girl raises questions about the long-term safety of BP therapy in some children, in particular about the risk of oversuppressed bone remodeling with the potential for microcrack accumulation, delayed healing, and increased stiffness. The principal concern is whether there is point at which benefit from BP therapy could turn into harm, where fracture risk increases again. This case should stimulate debate whether current adult atypical femoral fracture guidance should apply to children, and whether low-frequency, low-dose cyclical, intermittent, or oral treatment

  16. Atypical femur fracture in an adolescent boy treated with bisphosphonates for X-linked osteoporosis based on PLS3 mutation.

    PubMed

    van de Laarschot, Denise M; Zillikens, M Carola

    2016-10-01

    Long-term use of bisphosphonates has raised concerns about the association with Atypical Femur Fractures (AFFs) that have been reported mainly in postmenopausal women. We report a case of an 18-year-old patient with juvenile osteoporosis based on X-linked osteoporosis due to a PLS3 mutation who developed a low trauma femoral fracture after seven years of intravenous and two years of oral bisphosphonate use, fulfilling the revised ASBMR diagnostic criteria of an AFF. The occurrence of AFFs has not been described previously in children or adolescents. The underlying monogenetic bone disease in our case strengthens the possibility of a genetic predisposition at least in some cases of AFF. We cannot exclude that a transverse fracture of the tibia that also occurred after a minor trauma at age 16 might be part of the same spectrum of atypical fractures related to the use of bisphosphonates. In retrospect our patient experienced prodromal pain prior to both the tibia and the femur fracture. Case reports of atypical fractures in children with a monogenetic bone disease such as Osteogenesis Imperfecta (OI) or juvenile osteoporosis are important to consider in the discussion about optimal duration of bisphosphonate therapy in growing children. In conclusion, this case report 1) highlights that AFFs also occur in adolescents treated with bisphosphonates during childhood and pain in weight-bearing bones can point towards this diagnosis 2) supports other reports suggesting that low trauma fractures of other long bones besides the femur may be related to long-term use of bisphosphonates 3) strengthens the concept of an underlying genetic predisposition in some cases of AFF, now for the first time reported in X-linked osteoporosis due to a mutation in PLS3 and 4) should be considered in decisions about the duration of bisphosphonate therapy in children with congenital bone disorders. PMID:27477003

  17. [Late postcontusion secondary glaucoma].

    PubMed

    Chiseliţă, D; Vancea, P; Filiman, O; Brănişteanu, D; Bredetean, M; Poiata, I

    1995-01-01

    The investigation of 33 patients with late postcontusional glaucoma subjected to surgery and followed up for 25 +/- 8.24 months has revealed: the interval accident-surgery is shorter in the close-angle combined forms; the essential mechanisms responsible for glaucoma occurrence are: the alteration of trabecular meshwork (for open-angle glaucoma) and pupillary block (for close angle glaucoma); simple cases required antiglaucoma surgery (trabeculectomy, peripheral iridectomy) and the mixed ones required combined (trabeculectomy, lens extraction, lens implant) or sequential surgeries (antiglaucoma surgery, vitrectomy etc); the glaucomatous process was stopped in 83.4% of the open-angle glaucoma cases and progressed in 23.5% of the close-angle glaucoma cases; the functional improvements post antiglaucoma surgery combined with removal of opacities are lessened by the higher frequency of severe per- and post-operative complication. PMID:7654676

  18. CT analysis of the upper end of the femur: The asterisk sign and ischaemic bone necrosis of the femoral head

    SciTech Connect

    Dihlmann, W.

    1982-08-01

    In computed tomography (CT) of the head of the femur, a star-shaped structure can be seen which we refer to as the asterisk or asterisk sign. The asterisk is formed by thickened weight-bearing bone trabeculae. It can be shown by CT that the asterisk exhibits a characteristic change in ischaemic bone necrosis of the femoral head, even when the disease is in an early stage. CT of the hip joint is therefore an important examination for early diagnosis of ischaemic diesease of the femoral head.

  19. Reconstructive treatment of sclerosing osteomyelitis of the entire femur of 30 years' duration with avoidance of segmental resection.

    PubMed

    Bettin, D; Rolauffs, B; von Eiff, C; Sciuk, J

    1999-01-01

    We describe the successful operative treatment of a patient with chronic sclerosing osteomyelitis of the femur in which en bloc resection was avoided. Therapy consisted of combined endoscopic, computed tomography and bone scan-guided fenestration and intramedullary reaming, with removal of all sclerotic zones and normalization of the cortical thickness. An adequate supply of oxygen to the area was ensured by improved vascularisation and the application of hydrogen peroxide. At the medium term follow-up no recurrence was seen, and hip and knee function was normal. PMID:10392527

  20. Use of proton pump inhibitors and risk of hip/femur fracture: a population-based case-control study

    PubMed Central

    Pouwels, S.; Lalmohamed, A.; Souverein, P.; Cooper, C.; Veldt, B. J.; Leufkens, H. G.; de Boer, A.; van Staa, T.

    2010-01-01

    Summary Previous studies evaluated the association between proton pump inhibitor (PPI) use and subsequent fracture risk, but they showed ambiguous results. Therefore, the objective was to evaluate this association in a different study population. Our findings show that there is probably no causal relationship between PPI use and hip fracture risk. Introduction Previous studies evaluated the association between PPI use and subsequent fracture risk, but they showed ambiguous results. To further test these conflicting results, the objective of this study was to evaluate the association between the use of PPIs and the risk of hip/femur fracture in a different study population. Methods A case-control study was conducted using data from the Dutch PHARMO record linkage system. The study population included 6,763 cases aged 18 years and older with a first hip/femur fracture during enrolment and 26,341 age-, gender- and region-matched controls. Results Current users of PPIs had an increased risk of hip/femur fracture yielding an adjusted odds ratio (AOR) of 1.20 (95% CI 1.04–1.40). Fracture risk attenuated with increasing durations of use, resulting in AORs of 1.26 (95% CI 0.94–1.68) in the first 3 months, 1.31 (95% CI 0.97–1.75) between 3 and 12 months, 1.18 (95% CI 0.92–1.52) between 13 and 36 months and 1.09 (95% CI 0.81–1.47) for use longer than 36 months. Conclusion Our findings show that there is probably no causal relationship between PPI use and hip fracture risk. The observed association may be the result of unmeasured distortions: although current use of PPIs was associated with a 1.2-fold increased risk of hip/femur fracture, the positive association was attenuated with longer durations of continuous use. Our findings do not support that discontinuation of PPIs decreases risk of hip fracture in elderly patients. PMID:20585937

  1. Osteoblast-osteocyte transformation. A SEM densitometric analysis of endosteal apposition in rabbit femur

    PubMed Central

    Pazzaglia, Ugo E; Congiu, Terenzio; Sibilia, Valeria; Quacci, Daniela

    2014-01-01

    Transformation of osteoblasts into osteocytes is marked by changes in volume and cell shape. The reduction of volume and the entrapment process are correlated with the synthesis activity of the cell which decreases consequently. This transformation process has been extensively investigated by transmission electron microscopy (TEM) but no data have yet been published regarding osteoblast-osteocyte dynamic histomorphometry. Scanning electron microscope (SEM) densitometric analysis was carried out to determine the osteoblast and open osteocyte lacunae density in corresponding areas of a rabbit femur endosteal surface. The lining cell density was 4900.1 ± 30.03 n mm−2, the one of open osteocyte lacunae 72.89 ± 22.55 n mm−2. This corresponds to an index of entrapment of one cell every 67.23 osteoblasts (approximated by defect). The entrapment sequence begins with flattening of the osteoblast and spreading of equatorial processes. At first these are covered by the new apposed matrix and then also the whole cellular body of the osteocyte undergoing entrapment. The dorsal aspect of the cell membrane suggests that closure of the osteocyte lacuna may be partially carried out by the same osteoblast-osteocyte which developed a dorsal secretory territory. A significant proportion of the endosteal surface was analysed by SEM, without observing any evidence of osteoblast mitotic figures. This indicates that recruitment of the pool of osteogenic cells in cortical bone lamellar systems occurs prior to the entrapment process. No further additions occurred once osteoblasts were positioned on the bone surface and began lamellar apposition. The number of active osteoblasts on the endosteal surface exceeded that of the cells which become incorporated as osteocytes (whose number was indicated by the number of osteocyte lacunae). Therefore such a balance must be equilibrated by the osteoblasts' transformation in resting lining cells or by apoptosis. The current work

  2. Proximal Femoral Nail Antirotation in Treatment of Fractures of Proximal Femur

    PubMed Central

    Sadic, Sahmir; Custovic, Svemir; Jasarevic, Mahir; Fazlic, Mirsad; Smajic, Nedim; Hrustic, Asmir; Vujadinovic, Aleksandar; Krupic, Ferid

    2014-01-01

    Introduction: Fractures of the proximal femur and hip are relatively common injuries in adults and common source of morbidity and mortality among the elderly. Many methods have been recommended for the treatment of intertrochanteric fractures. Material and methods: We retrospective analyzed all the patients with fractures of the hip treated with proximal femoral nail antirotation (PFNA) at the Clinic of Orthopedic and Traumatology, University Clinical Centre Tuzla from the first of January 2012 to 31 December 2012 years. The study included 63 patients averaged 73.6±11.9 years (range, 29 to 88 years). Fracture type was classified as intertrochanteric (Arbeitsgemeinschaft für Osteosynthesefragen classification 31.A.1, A.2 and A.3) and subtrochanteric fractures (Seinsheimer classification). Results and discussion: The ratio between the genders female-male was 1.6:1. There was statistically significant difference prevalence of female compared to male patients (p=0.012). There were 31 left and 32 right hip fractured. Low energy trauma was the cause of fractures in 57(90.5%) patients. Averaged waiting time for hospitalization was 3.2±7.5 days (range, 0 to 32 days). 44 patients were admitted the same day upon injuring. The average waiting time for the treatment was 3.6±5.7 days. The ratio between with or without co-existent disease was 4.7:1. During the three months postoperatively with ASA score 3 and 4 six patients died. There were no significant differences in deaths from ASA score 1 and 2 (p=0.52). Reoperation for the treatment of implant or fracture-related complications was required in three (4.7%) patients (infection, reimplantation and extraction). Three patient developed deep vein thrombosis. Statistically significant difference was found in the deaths in the first three months compared to the next three months (p=0.02). We found statistically significant difference between pre-injury and postoperative mobility score (p=0.0001). Conclusion: PFNA is an

  3. The inpatient fracture neck of femur: an important subgroup of patients.

    PubMed

    Green, Carl M; Zeiton, Moez; Foulkes, Katherine; Barrie, Jim

    2014-12-01

    Fractured neck of femur (FNOF) is an increasing problem for the National Health Service (NHS) with 61,508 recorded on the National Hip Fracture Database (NHFD) in 2012–2013 and treatment of such patients is estimated to cost the NHS £1.5 billion per year. Inpatients falling in hospital and sustain a FNOF have rarely been studied as a separate group of patients to assess standards of patient care, time to operative management, and patient mortality. Of 694 patients sustaining an acute FNOF at a single trust between January 2012 and June 2013, 40 patients (5.8%) sustained an inpatient FNOF. 19 patients (47.5%) were male and 15 patients (37.5%) had an ASA grade of 4 or 5, compared to 153 patients (23.4%) and 127 patients (19.4%) respectively of “community” FNOF. 39 of 40 patients received operative management. Patients with an “inpatient” FNOF were less likely to be admitted to an orthopaedic ward within 4 h (30%) and receive operative management within 48 h (65%) according to “Blue Book” standards. Results according to best practice tariff (BPT) were also significantly reduced for the “inpatient” FNOF group, with 23 patients (57.5%) receiving operative management within 36 h and only 19 patients (47.5%) achieving BPT compared to 76.5% and 72.5% respectively for “community” FNOF patients. Mortality among inpatients reached 40% at 120 days and 50% at 1 year, significantly higher than community FNOF patients after multivariate analysis. Patients sustaining an “inpatient” FNOF are more likely to have significant medical co-morbidity and require aggressive medical and surgical management, especially due to their increased risk of mortality post-operatively. Such injuries have direct and indirect financial implications to a health care trust, which can be minimised by prompt management of these patients. This study highlights the need for a standardised protocol of management of this important subgroup of patients and for further work on falls

  4. Exploring inter-subject anatomic variability using a population of patient-specific femurs and a statistical shape and intensity model.

    PubMed

    Bah, Mamadou T; Shi, Junfen; Browne, Martin; Suchier, Yanneck; Lefebvre, Fabien; Young, Philippe; King, Leonard; Dunlop, Doug G; Heller, Markus O

    2015-10-01

    This paper is motivated by the need to accurately and efficiently measure key periosteal and endosteal parameters of the femur, known to critically influence hip biomechanics following arthroplasty. The proposed approach uses statistical shape and intensity models (SSIMs) to represent the variability across a wide range of patients, in terms of femoral shape and bone density. The approach feasibility is demonstrated by using a training dataset of computer tomography scans from British subjects aged 25-106 years (75 male and 34 female). For each gender, a thousand new virtual femur geometries were generated using a subset of principal components required to capture 95% of the variance in both female and male training datasets. Significant differences were found in basic anatomic parameters between females and males: anteversion, CCD angle, femur and neck lengths, head offsets and radius, cortical thickness, densities in both Gruen and neck zones. The measured anteversion for female subjects was found to be twice as high as that for male subjects: 13 ± 6.4° vs. 6.3 ± 7.8° using the training datasets compared to 12.96 ± 6.68 vs. 5.83 ± 9.2 using the thousand virtual femurs. No significant differences were found in canal flare indexes. The proposed methodology is a valuable tool for automatically generating a large specific population of femurs, targeting specific patients, supporting implant design and femoral reconstructive surgery. PMID:26363532

  5. Personalized x-ray reconstruction of the proximal femur via a non-rigid 2D-3D registration

    NASA Astrophysics Data System (ADS)

    Yu, Weimin; Zysset, Philippe; Zheng, Guoyan

    2015-03-01

    In this paper we present a new approach for a personalized X-ray reconstruction of the proximal femur via a non-rigid registration of a 3D volumetric template to 2D calibrated C-arm images. The 2D-3D registration is done with a hierarchical two-stage strategy: the global scaled rigid registration stage followed by a regularized deformable b-spline registration stage. In both stages, a set of control points with uniform spacing are placed over the domain of the 3D volumetric template and the registrations are driven by computing updated positions of these control points, which then allows to accurately register the 3D volumetric template to the reference space of the C-arm images. Comprehensive experiments on simulated images, on images of cadaveric femurs and on clinical datasets are designed and conducted to evaluate the performance of the proposed approach. Quantitative and qualitative evaluation results are given, which demonstrate the efficacy of the present approach.

  6. Less invasive surgery using external fixator for the treatment of subtrochanteric femur fracture in a high-risk geriatric patient.

    PubMed

    Atik, O Şahap; Can, Fatih I; Şenol, M Selçuk; Eren, Toygun K

    2016-08-01

    A 90-year-old female patient was admitted to our clinic complaining of pain in her left hip which occurred due to fall from a chair. Her medical history included memory loss and mental changes associated with Alzheimer's disease and depression. Patient's cooperation and orientation were weak. Range of motion of the left hip was restricted and painful. Radiographs of the left hip demonstrated subtrochanteric comminuted fracture of femur. Laboratory tests revealed anemia and liver insufficiency. Departments of internal medicine and anesthesiology reported high risk for surgery. Surgery was performed under spinal anesthesia on radiolucent table and in supine position. Using fluoroscopy, subtrochanteric comminuted fracture of femur was reduced. Proximally, two Schanz screws were placed through femoral neck and head in axial plane, and distally, three Schanz screws were placed through femoral shaft in coronal plane. Finally, fixation of the screws was achieved with an external fixator which was made of carbon fiber rods. Patient was allowed to sit in the bed and move around with a wheelchair as of the day of surgery. No infection or loosening of fixator occurred. PMID:27499322

  7. Influence of effective number of pulses on the morphological structure of teeth and bovine femur after femtosecond laser ablation

    NASA Astrophysics Data System (ADS)

    Nicolodelli, Gustavo; de Fátima Zanirato Lizarelli, Rosane; Salvador Bagnato, Vanderlei

    2012-04-01

    Femtosecond lasers have been widely used in laser surgery as an instrument for contact-free tissue removal of hard dental, restorative materials, and osseous tissues, complementing conventional drilling or cutting tools. In order to obtain a laser system that provides an ablation efficiency comparable to mechanical instruments, the laser pulse rate must be maximal without causing thermal damage. The aim of this study was to compare the different morphological characteristics of the hard tissue after exposure to lasers operating in the femtosecond pulse regime. Two different kinds of samples were irradiated: dentin from human extracted teeth and bovine femur samples. Different procedures were applied, while paying special care to preserving the structures. The incubation factor S was calculated to be 0.788+/-0.004 for the bovine femur bone. These results indicate that the incubation effect is still substantial during the femtosecond laser ablation of hard tissues. The plasma-induced ablation has reduced side effects, i.e., we observe less thermal and mechanical damage when using a superficial femtosecond laser irradiation close to the threshold conditions. In the femtosecond regime, the morphology characteristics of the cavity were strongly influenced by the change of the effective number of pulses.

  8. Numerical investigations on the strain-adaptive bone remodelling in the periprosthetic femur: Influence of the boundary conditions

    PubMed Central

    Behrens, Bernd-Arno; Nolte, Ingo; Wefstaedt, Patrick; Stukenborg-Colsman, Christina; Bouguecha, Anas

    2009-01-01

    Background There are several numerical investigations on bone remodelling after total hip arthroplasty (THA) on the basis of the finite element analysis (FEA). For such computations certain boundary conditions have to be defined. The authors chose a maximum of three static load situations, usually taken from the gait cycle because this is the most frequent dynamic activity of a patient after THA. Materials and methods The numerical study presented here investigates whether it is useful to consider only one static load situation of the gait cycle in the FE calculation of the bone remodelling. For this purpose, 5 different loading cases were examined in order to determine their influence on the change in the physiological load distribution within the femur and on the resulting strain-adaptive bone remodelling. First, four different static loading cases at 25%, 45%, 65% and 85% of the gait cycle, respectively, and then the whole gait cycle in a loading regime were examined in order to regard all the different loadings of the cycle in the simulation. Results The computed evolution of the apparent bone density (ABD) and the calculated mass losses in the periprosthetic femur show that the simulation results are highly dependent on the chosen boundary conditions. Conclusion These numerical investigations prove that a static load situation is insufficient for representing the whole gait cycle. This causes severe deviations in the FE calculation of the bone remodelling. However, accompanying clinical examinations are necessary to calibrate the bone adaptation law and thus to validate the FE calculations. PMID:19371424

  9. Micro-computed tomography assisted distal femur metaphyseal blunt punch compression for determining trabecular bone strength in mice.

    PubMed

    Sankar, Uma; Pritchard, Zachary J; Voor, Michael J

    2016-05-01

    Shorter generation time and the power of genetic manipulation make mice an ideal model system to study bone biology as well as bone diseases. However their small size presents a challenge to perform strength measurements, particularly of the weight-bearing cancellous bone in the murine long bones. We recently developed an improved method to measure the axial compressive strength of the cancellous bone in the distal femur metaphysis in mice. Transverse micro-computed tomography image slices that are 7µm thick were used to locate the position where the epiphysis-metaphysis transition occurs. This enabled the removal of the distal femur epiphysis at the exact transition point exposing the full extent of metaphyseal trabecular bone, allowing more accurate and consistent measurement of its strength. When applied to a murine model system consisting of five month old male wild-type (WT) and Ca(2+)/calmodulin dependent protein kinase kinase 2 (CaMKK2) knockout (KO) Camkk2(-/-) mice that possess recorded differences in trabecular bone volume, data collected using this method showed good correlation between bone volume fraction and strength of trabecular bone. In combination with micro-computed tomography and histology, this method will provide a comprehensive and consistent assessment of the microarchitecture and tissue strength of the cancellous bone in murine mouse models. PMID:26947030

  10. Noninvasive Femur Bone Volume Estimation Based on X-Ray Attenuation of a Single Radiographic Image and Medical Knowledge

    NASA Astrophysics Data System (ADS)

    Kiattisin, Supaporn; Chamnongthai, Kosin

    Bone Mineral Density (BMD) is an indicator of osteoporosis that is an increasingly serious disease, particularly for the elderly. To calculate BMD, we need to measure the volume of the femur in a noninvasive way. In this paper, we propose a noninvasive bone volume measurement method using x-ray attenuation on radiography and medical knowledge. The absolute thickness at one reference pixel and the relative thickness at all pixels of the bone in the x-ray image are used to calculate the volume and the BMD. First, the absolute bone thickness of one particular pixel is estimated by the known geometric shape of a specific bone part as medical knowledge. The relative bone thicknesses of all pixels are then calculated by x-ray attenuation of each pixel. Finally, given the absolute bone thickness of the reference pixel, the absolute bone thickness of all pixels is mapped. To evaluate the performance of the proposed method, experiments on 300 subjects were performed. We found that the method provides good estimations of real BMD values of femur bone. Estimates shows a high linear correlation of 0.96 between the volume Bone Mineral Density (vBMD) of CT-SCAN and computed vBMD (all P<0.001). The BMD results reveal 3.23% difference in volume from the BMD of CT-SCAN.

  11. Treatment of femur fractures in school-aged children using elastic stable intramedullary nailing: a systematic review.

    PubMed

    Baldwin, Keith; Hsu, Jason E; Wenger, Dennis R; Hosalkar, Harish S

    2011-09-01

    Femur fractures are common long-bone injuries in school-aged children (6-12 years). Among the various acceptable treatment options, elastic stable intramedullary nailing (ESIN) has gained popularity over recent years although the level of evidence for ESIN is low. This study was a systematic review of the literature to examine the outcomes and complications of ESIN in school-aged children and to critically evaluate the quality of the available literature. Although most complications were minor, some series report complication rates of more than 50%. Union rates are high. Malunion or mechanical axis malalignment, on the other hand, is common, and leg length discrepancy and overgrowth are also not unusual. Symptomatic implants are common, particularly if the distal ends of the nail are left long and prominent. Refracture was noted to be uncommon in this population. ESIN is a well-accepted and reliable option for treatment of femur fractures in school-aged children. Advantages are decreased length of hospital stay, early return to function, and high union rates. Care must be taken to obtain and maintain reduction, and caution is advised in older and heavier children. PMID:21829144

  12. What makes an accurate and reliable subject-specific finite element model? A case study of an elephant femur.

    PubMed

    Panagiotopoulou, O; Wilshin, S D; Rayfield, E J; Shefelbine, S J; Hutchinson, J R

    2012-02-01

    Finite element modelling is well entrenched in comparative vertebrate biomechanics as a tool to assess the mechanical design of skeletal structures and to better comprehend the complex interaction of their form-function relationships. But what makes a reliable subject-specific finite element model? To approach this question, we here present a set of convergence and sensitivity analyses and a validation study as an example, for finite element analysis (FEA) in general, of ways to ensure a reliable model. We detail how choices of element size, type and material properties in FEA influence the results of simulations. We also present an empirical model for estimating heterogeneous material properties throughout an elephant femur (but of broad applicability to FEA). We then use an ex vivo experimental validation test of a cadaveric femur to check our FEA results and find that the heterogeneous model matches the experimental results extremely well, and far better than the homogeneous model. We emphasize how considering heterogeneous material properties in FEA may be critical, so this should become standard practice in comparative FEA studies along with convergence analyses, consideration of element size, type and experimental validation. These steps may be required to obtain accurate models and derive reliable conclusions from them. PMID:21752810

  13. The use of small interfering RNAs to inhibit adipocyte differentiation in human preadipocytes and fetal-femur-derived mesenchymal cells

    SciTech Connect

    Xu, Y.; Mirmalek-Sani, S.-H.; Yang, X.; Zhang, J.; Oreffo, R.O.C. . E-mail: roco@soton.ac.uk

    2006-06-10

    RNA interference (RNAi) has been used in functional genomics and offers innovative approaches in the development of novel therapeutics. Human mesenchymal stem cells offer a unique cell source for tissue engineering/regeneration strategies. The current study examined the potential of small interfering RNAs (siRNA) against human peroxisome proliferator activated receptor gamma (PPAR{gamma}) to suppress adipocyte differentiation (adipogenesis) in human preadipocytes and fetal-femur-derived mesenchymal cells. Adipogenesis was investigated using cellular and biochemical analysis. Transient transfection with PPAR{gamma}-siRNA using a liposomal-based strategy resulted in a significant inhibition of adipogenesis in human preadipocytes and fetal-femur-derived mesenchymal cells, compared to controls (cell, liposomal and negative siRNA). The inhibitory effect of PPAR{gamma}-siRNA was supported by testing human PPAR{gamma} mRNA and adipogenic associated genes using reverse transcription polymerase chain reaction (RT-PCR) to adiponectin receptor 1 and 2 as well as examination of fatty acid binding protein 3 (FABP{sub 3}) expression, an adipocyte-specific marker. The current studies indicate that PPAR{gamma}-siRNA is a useful tool to study adipogenesis in human cells, with potential applications both therapeutic and in the elucidation of mesenchymal cell differentiation in the modulation of cell differentiation in human mesenchymal cells.

  14. Influence of effective number of pulses on the morphological structure of teeth and bovine femur after femtosecond laser ablation.

    PubMed

    Nicolodelli, Gustavo; Lizarelli, Rosane de Fátima Zanirato; Bagnato, Vanderlei Salvador

    2012-04-01

    Femtosecond lasers have been widely used in laser surgery as an instrument for contact-free tissue removal of hard dental, restorative materials, and osseous tissues, complementing conventional drilling or cutting tools. In order to obtain a laser system that provides an ablation efficiency comparable to mechanical instruments, the laser pulse rate must be maximal without causing thermal damage. The aim of this study was to compare the different morphological characteristics of the hard tissue after exposure to lasers operating in the femtosecond pulse regime. Two different kinds of samples were irradiated: dentin from human extracted teeth and bovine femur samples. Different procedures were applied, while paying special care to preserving the structures. The incubation factor S was calculated to be 0.788±0.004 for the bovine femur bone. These results indicate that the incubation effect is still substantial during the femtosecond laser ablation of hard tissues. The plasma-induced ablation has reduced side effects, i.e., we observe less thermal and mechanical damage when using a superficial femtosecond laser irradiation close to the threshold conditions. In the femtosecond regime, the morphology characteristics of the cavity were strongly influenced by the change of the effective number of pulses. PMID:22559697

  15. Modeling late Paleozoic glaciation

    SciTech Connect

    Crowley, T.J.; Baum, S.K. )

    1992-06-01

    Late Paleozoic glaciation on Gondwana is associated with changes in geography, solar luminosity, and estimated CO{sub 2} levels. To assess the relative importance of these boundary conditions, the authors conducted a suite of climate model simulations for the periods before, during, and after peak mid-Carboniferous ({approximately}300 Ma) glaciation (340, 300, and 255 and 225 Ma, respectively). Orbital insolation values favorable for glaciation and interglaciation were used for each time interval. Results indicate that changes in geography cause significant changes in snow area, but the temporal trend is not consistent with the geologic record for glaciation. Combined CO{sub 2}-plus-geography changes yield the best agreement with observations. In addition, interglacial orbital configurations result in almost ice-free conditions for the glacial interval at 300 Ma, at a time of low CO{sub 2}. The large simulated glacial-interglacial snowline fluctuations for Permian-Carboniferous time may explain cyclothem fluctuations at these times. Overall, results support the importance of the CO{sub 2} paradigm, but also indicate that a fuller understanding of past climate change requires consideration of paleogeographic, luminosity, and orbital insolation changes.

  16. A supervised texton based approach for automatic segmentation and measurement of the fetal head and femur in 2D ultrasound images

    NASA Astrophysics Data System (ADS)

    Zhang, Lei; Ye, Xujiong; Lambrou, Tryphon; Duan, Wenting; Allinson, Nigel; Dudley, Nicholas J.

    2016-02-01

    This paper presents a supervised texton based approach for the accurate segmentation and measurement of ultrasound fetal head (BPD, OFD, HC) and femur (FL). The method consists of several steps. First, a non-linear diffusion technique is utilized to reduce the speckle noise. Then, based on the assumption that cross sectional intensity profiles of skull and femur can be approximated by Gaussian-like curves, a multi-scale and multi-orientation filter bank is designed to extract texton features specific to ultrasound fetal anatomic structure. The extracted texton cues, together with multi-scale local brightness, are then built into a unified framework for boundary detection of ultrasound fetal head and femur. Finally, for fetal head, a direct least square ellipse fitting method is used to construct a closed head contour, whilst, for fetal femur a closed contour is produced by connecting the detected femur boundaries. The presented method is demonstrated to be promising for clinical applications. Overall the evaluation results of fetal head segmentation and measurement from our method are comparable with the inter-observer difference of experts, with the best average precision of 96.85%, the maximum symmetric contour distance (MSD) of 1.46 mm, average symmetric contour distance (ASD) of 0.53 mm while for fetal femur, the overall performance of our method is better than the inter-observer difference of experts, with the average precision of 84.37%, MSD of 2.72 mm and ASD of 0.31 mm.

  17. Effects of Vitamin D and Calcium Supplementation on Micro-architectural and Densitometric Changes of Rat Femur in a Microgravity Simulator Model

    PubMed Central

    Kouhnavard, Marjan; Nasli Esfahani, Ensieh; Montazeri, Mohammad; Hashemian, Seyed Jafar; Mehrazma, Mitra; Larijani, Bagher; Nezami Asl, Amir; Khoshvaghti, Amir; Falsafi, Ammar; Lalehfar, Komeil; Malekpour, Keyvan; Vosugh, Mehran

    2014-01-01

    Background: Revealing data on the role of vitamin D and calcium supplementation in bone health has led some to suggest that vitamin D and calcium treatment could also play a role in protecting bone against microgravity-induced mineral loss. Objectives: The aim of the present study was to investigate the effects of vitamin D and calcium administration on microscopic and densitometric changes of rat femur in a Microgravity Simulator Model. Materials and Methods: After designing a Microgravity Simulator Model, 14 rats were placed in the cages as follows: seven rats as osteoporosis group and seven rats received oral supplement of calcium/vitamin D as the treatment group. Animals were sacrificed after eight weeks and then both femurs were removed. Bone mineral density was measured for one femur from each animal, and morphologic studies were evaluated for the contralateral femur. Results: Bone mineral density of the whole femur in the treatment group was significantly higher than the osteoporosis group (0.168 ± 0.005 vs. 0.153 ± 0.006, P = 0.003). Also, bone mineral content of the whole femur was significantly higher in treatment group (0.415 ± 0.016 vs. 0.372 ± 0.019, P = 0.003). However, resorption eroded surface percentage was higher in the osteoporosis group (18.86 ± 3.71% vs. 9.71 ± 1.61%, P = 0.002). Conclusions: According to the results of this study, vitamin D and calcium administration might have protective effects against microgravity-induced mineral loss in a Rat Microgravity Simulator Model. PMID:25068054

  18. A supervised texton based approach for automatic segmentation and measurement of the fetal head and femur in 2D ultrasound images.

    PubMed

    Zhang, Lei; Ye, Xujiong; Lambrou, Tryphon; Duan, Wenting; Allinson, Nigel; Dudley, Nicholas J

    2016-02-01

    This paper presents a supervised texton based approach for the accurate segmentation and measurement of ultrasound fetal head (BPD, OFD, HC) and femur (FL). The method consists of several steps. First, a non-linear diffusion technique is utilized to reduce the speckle noise. Then, based on the assumption that cross sectional intensity profiles of skull and femur can be approximated by Gaussian-like curves, a multi-scale and multi-orientation filter bank is designed to extract texton features specific to ultrasound fetal anatomic structure. The extracted texton cues, together with multi-scale local brightness, are then built into a unified framework for boundary detection of ultrasound fetal head and femur. Finally, for fetal head, a direct least square ellipse fitting method is used to construct a closed head contour, whilst, for fetal femur a closed contour is produced by connecting the detected femur boundaries. The presented method is demonstrated to be promising for clinical applications. Overall the evaluation results of fetal head segmentation and measurement from our method are comparable with the inter-observer difference of experts, with the best average precision of 96.85%, the maximum symmetric contour distance (MSD) of 1.46 mm, average symmetric contour distance (ASD) of 0.53 mm; while for fetal femur, the overall performance of our method is better than the inter-observer difference of experts, with the average precision of 84.37%, MSD of 2.72 mm and ASD of 0.31 mm. PMID:26758386

  19. Peripartum Primary Prophylaxis Inferior Vena Cava Filter Placement in a Patient with Stage IV B-Cell Lymphoma Presenting with a Pathologic Femur Fracture

    PubMed Central

    Sherer, David M.; Dalloul, Mudar; Behar, Henry James; Salame, Ghadir; Holland, Roy; Zinn, Harry; Abulafia, Ovadia

    2015-01-01

    Background Pulmonary embolus (PE) remains a leading etiology of maternal mortality in the developed world. Increasing utilization of retrievable inferior vena cava (IVC) filter placement currently includes pregnant patients. Case A 22-year-old woman at 27 weeks' gestation was diagnosed with Stage IV high-grade malignant B cell lymphoma following pathologic femur fracture. Significant risk factors for PE led to placement of primary prophylaxis IVC filter before cesarean delivery, open reduction and internal fixation of the fractured femur, and chemotherapy. Conclusion This case supports that primary prophylaxis placement of IVC filters in highly selected pregnant patients may assist in decreasing PE-associated maternal mortality. PMID:26495170

  20. Photoelastic and thermoelastic measurement of stress on the proximal femur before and after implantation of a hip prosthesis with retention of the femoral neck.

    PubMed

    Refior, Jans Jürgen; Schidlo, Christoph; Plitz, Wolfgang; Heining, Sandro

    2002-05-01

    This study demonstrated the improved medial support and the transfer of load onto the retained neck of the femur using seven fresh frozen femurs. Results confirm the reliability of the thermoelastic stress analysis method, which is comparable to the photoelastic surface coating method, but with greater sensitivity. The loading pattern after stem implantation shows a homogeneous transfer of force onto the preserved femoral neck. After femoral neck removal, an inhomogeneous increase of the intertrochanteric compression loading was observed. Therefore, improved biomechanical conditions are created for a permanently stable implantation of stem prostheses with retention of the femoral neck. PMID:12046909

  1. Early and Late Onset Sepsis in Late Preterm Infants

    PubMed Central

    Cohen-Wolkowiez, Michael; Moran, Cassandra; Benjamin, Daniel K.; Cotten, C. Michael; Clark, Reese H.; Benjamin, Daniel K.; Smith, P. Brian

    2009-01-01

    Background Preterm birth is increasing worldwide, and late preterm births, which comprise more than 70% of all preterm births, account for much of the increase. Early and late onset sepsis results in significant mortality in extremely preterm infants, but little is known about sepsis outcomes in late preterm infants. Methods This is an observational cohort study of infants < 121 days of age (119,130 infants less than or equal to 3 days of life and 106,142 infants between 4 and 120 days of life) with estimated gestational age at birth between 34 and 36 weeks, admitted to 248 neonatal intensive care units in the United States between 1996 and 2007. Results During the study period, the cumulative incidence of early and late onset sepsis was 4.42 and 6.30 episodes per 1000 admissions, respectively. Gram-positive organisms caused the majority of early and late onset sepsis episodes. Infants with early onset sepsis caused by Gram-negative rods and infants with late onset sepsis were more likely to die than their peers with sterile blood cultures (OR 4.39, 95% CI 1.71–11.23, P=0.002; and OR 3.37, 95% CI 2.35–4.84, P<0.001, respectively). Conclusion Late preterm infants demonstrate specific infection rates, pathogen distribution, and mortality associated with early and late onset sepsis. The results of this study are generalizable to late preterm infants admitted to the special care nursery or neonatal intensive care unit. PMID:19953725

  2. EVALUATION OF PRESENTATION OF SIGNS AND SYMPTOMS OF FEMOROACETABULAR IMPINGEMENT AFTER EPIPHYSIOLYSIS OF THE PROXIMAL FEMUR

    PubMed Central

    Krüger, Fábio Peng; de Britto, Paulo Sérgio Gérzon; Neto, Lauro Machado; Schwartsmann, Carlos Roberto

    2015-01-01

    The long-bone fractures occur most frequently in the tibial shaft. Adequate treatment of such fractures avoids consolidation failure, skewed consolidation and reoperation. To classify these fractures, the AO/OTA classification method is still used, but it is worthwhile getting to know the Ellis classification method, which also includes assessment of soft-tissue injuries. There is often an association with compartmental syndrome, and early diagnosis can be achieved through evaluating clinical parameters and constant clinical monitoring. Once the diagnosis has been made, fasciotomy should be performed. It is always difficult to assess consolidation, but the RUST method may help in this. Radiography is assessed in two projections, and points are scored for the presence of the fracture line and a visible bone callus. Today, the dogma of six hours for cleaning the exposed fracture is under discussion. It is considered that an early start to intravenous antibiotic therapy and the lesion severity are very important. The question of early or late closure of the lesion in an exposed fracture has gone through several phases: sometimes early closure has been indicated and sometimes late closure. Currently, whenever possible, early closure of the lesion is recommended, since this diminishes the risk of infection. Milling of the canal when the intramedullary nail is introduced is still a controversial subject. Despite strong personal positions in favor of milling, studies have shown that there may be some advantage in relation to closed fractures, but not in exposed fractures. PMID:27027007

  3. Cutmark data and their implications for the planning depth of Late Pleistocene societies.

    PubMed

    Soulier, Marie-Cécile; Morin, Eugène

    2016-08-01

    Cutmarks provide empirical evidence for the exploitation of animal resources by past human groups. Their study may contribute substantially to our knowledge of economic behavior, including the procurement of prey and the analysis of butchery sequences. Butchering practices can be investigated using cutmark illustrations recorded on bone templates. In this paper, quantitative data on cutmarks were derived from published and unpublished cutmark drawings for 27 French assemblages dated between the late Middle Paleolithic and the final Upper Paleolithic. The analysis of cutmark data on meaty long bones (humerus, radio-ulna, femur, tibia) highlights strong variations in cutmark length and orientation in the sample that potentially reflect significant shifts in meat processing strategies during the Late Pleistocene. The present study shows that long longitudinal cutmarks are considerably more frequent during the Late Glacial Maximum than in the early Upper Paleolithic. Although the number of studies is small, actualistic data generated in controlled settings indicate that long longitudinal cutmarks are commonly produced during filleting, an activity closely associated with meat preservation, as is the case with drying and smoking. Because they provide information on possible changes in the capacity for anticipation, these results have potentially important implications for the logistical and economic organization of Paleolithic hominins. PMID:27457544

  4. Instantiation and registration of statistical shape models of the femur and pelvis using 3D ultrasound imaging.

    PubMed

    Barratt, Dean C; Chan, Carolyn S K; Edwards, Philip J; Penney, Graeme P; Slomczykowski, Mike; Carter, Timothy J; Hawkes, David J

    2008-06-01

    Statistical shape modelling potentially provides a powerful tool for generating patient-specific, 3D representations of bony anatomy for computer-aided orthopaedic surgery (CAOS) without the need for a preoperative CT scan. Furthermore, freehand 3D ultrasound (US) provides a non-invasive method for digitising bone surfaces in the operating theatre that enables a much greater region to be sampled compared with conventional direct-contact (i.e., pointer-based) digitisation techniques. In this paper, we describe how these approaches can be combined to simultaneously generate and register a patient-specific model of the femur and pelvis to the patient during surgery. In our implementation, a statistical deformation model (SDM) was constructed for the femur and pelvis by performing a principal component analysis on the B-spline control points that parameterise the freeform deformations required to non-rigidly register a training set of CT scans to a carefully segmented template CT scan. The segmented template bone surface, represented by a triangulated surface mesh, is instantiated and registered to a cloud of US-derived surface points using an iterative scheme in which the weights corresponding to the first five principal modes of variation of the SDM are optimised in addition to the rigid-body parameters. The accuracy of the method was evaluated using clinically realistic data obtained on three intact human cadavers (three whole pelves and six femurs). For each bone, a high-resolution CT scan and rigid-body registration transformation, calculated using bone-implanted fiducial markers, served as the gold standard bone geometry and registration transformation, respectively. After aligning the final instantiated model and CT-derived surfaces using the iterative closest point (ICP) algorithm, the average root-mean-square distance between the surfaces was 3.5mm over the whole bone and 3.7mm in the region of surgical interest. The corresponding distances after aligning the

  5. Prediction of micromotion initiation of an implanted femur under physiological loads and constraints using the finite element method.

    PubMed

    Andreaus, U; Colloca, M

    2009-07-01

    In cementless total hip replacement surgery the conditions for micromotion initiation at the bone-stem interface and the role of stair climbing versus gait in promoting incipient slipping deserve attention. The goal of the present paper was to propose a finite element approach for analysing the structural behaviour of hip joint prostheses under physiological loadings and boundary conditions, which allows the prediction of micromotion initiation with low computational effort. In this paper, three-dimensional (3D) finite element analyses were performed of intact and implanted human femurs in order to address the above-mentioned problems. Accurate finite element models based on computed tomography images of a human femur were employed; tetrahedral elements were used to construct the models and the contact options of a full bond between the femoral bone and stem were also used. The shear strains at the contact between femoral bone and stem were evaluated. Two loading cases, namely walking and stair climbing, were applied to investigate the effect of different loading conditions on the shear strain patterns. Shear strains in the z direction can be reasonably considered a significant stimulus of slip initiation or fibrous tissue formation or both at the bone-stem interface, whereas shear strains in the x-y plane can be assumed to be a sensible measurement of the tendency to implant-bone micromotion under torsional loads. Comparisons with other studies are complicated by the difference in the methods and testing conditions used. If mobilization is to be initiated, rotational displacements at the interface should be sensible and significant parameters, i.e. the material, should be distorted to some extent. Thus, for a particular point on the bone-metal interface, the maximum shear strain in any direction within the interface plane will indicate the likelihood of slippage initiation at that point. The different femur states (intact and implanted) and loading conditions

  6. Early Definitive Fixation of an Open Periprosthetic Femur Fracture in the Polytraumatized Patient: A Case Report and Review of the Literature

    PubMed Central

    Aleem, Ilyas S; Bhandari, Mohit; Elizalde, Sebastian Rodriguez

    2016-01-01

    Introduction: Periprosthetic fractures of the femur after total hip arthroplasty are increasing in frequency. In the polytraumatized patient with long-bone fracture, an ongoing debate exists regarding early definitive stabilization versus initial damage control orthopaedics, followed by delayed fixation. It remains to be seen whether this rationale applies to the polytraumatized patient with periprosthetic fracture. Case presentation: We present the case of a 73-years old Caucasian woman who sustained bilateral Gustillo-Anderson grade III open femur fractures; the fracture on the right was a Vancouver C open periprosthetic fracture after cemented total hip arthroplasty. After massive fluid resuscitation in the trauma bay she was taken to the intensive care unit in a hemodynamically unstable condition. She was subsequently operated and underwent early definitive fixation of both femurs with the rationale of potentially reducing pulmonary complications and promoting early mobilization. Conclusion: Early definitive stabilization versus delayed fixation in the polytraumatized patient with an open periprosthetic femur fracture is reviewed. Although several treatment algorithms based on fracture classification and implant stability exist, further study is required to delineate the preferred method and timeline of fixation for this growing cohort of patients. PMID:27299122

  7. The effect of ovariectomy and ovarian steroid treatment on growth hormone and insulin-like growth factor-I levels in the rat femur.

    PubMed

    Suliman, I A; El-Bakri, N K; Adem, A; Mustafa, A; Lindgren, J U

    2001-11-01

    Growth hormone (GH) and insulin-like growth factor-I (IGF-I) are known to play an important role in bone metabolism. The regulation of plasma levels of GH and IGF-I by ovarian steroids is well known, however, their effect on local GH and IGF-I is still unclear. In this study, we investigated the effect of ovariectomy and ovarian steroid treatment on the femur GH and IGF-I levels as well as on bone density in the rat. Nine month-old rats were ovariectomized (OVX) or sham-operated (SHAM) and 9 weeks after the surgery they were treated with daily s.c. injections of either 17beta-estradiol (OVX + E), progesterone (OVX + P), or vehicle (OVX + V) for another 10 weeks. GH and IGF-I levels in the femur extracts were measured by specific radioimmunoassay (RIA). Ovariectomy decreased GH and had no effect on IGF-I levels. Estradiol treatment increased femur GH and IGF-I levels compared to SHAM rats. Progesterone restored GH and increased IGF-I levels. Ovariectomy decreased, estrogen restored and progesterone partially restored femur bone density. Our results demonstrate that ovariectomy and ovarian steroids modulate the levels of GH and IGF-I in the bone of aged OVX rats. However, these effects appear to be limited to supraphysiological concentrations of estradiol and progesterone. PMID:11780998

  8. Comparison between mechanical stress and bone mineral density in the femur after total hip arthroplasty by using subject-specific finite element analyses.

    PubMed

    Ike, Hiroyuki; Inaba, Yutaka; Kobayashi, Naomi; Hirata, Yasuhide; Yukizawa, Yohei; Aoki, Chie; Choe, Hyonmin; Saito, Tomoyuki

    2015-08-01

    The mechanism underling bone mineral density (BMD) loss that occurs in the femur after total hip arthroplasty (THA) remains unknown. We compared the equivalent stress and strain energy density (SED) to BMD in the femur after THA using subject-specific finite element analyses. Twenty-four patients who had undergone primary cementless THA were analysed. BMD was measured using dual-energy X-ray absorptiometry (DEXA) at 1 week and 3, 6 and 12 months after THA. Seven regions of interest (ROIs) were defined in accordance with Gruen's system (ROIs 1-7). Computed tomography images of the femurs were acquired pre- and postoperatively, and the images were converted into three-dimensional finite element (FE) models. Equivalent stress and SED were analysed and compared with DEXA data. BMD was maintained 1 year after THA in ROIs 3, 4, 5 and 6, whereas BMD decreased in ROIs 1, 2 and 7. FE analysis revealed that equivalent stress in ROIs 3, 4, 5 and 6 was much higher than that in ROIs 1, 2 and 7. A significant correlation was observed between the rate of changes in BMD and equivalent stress. Reduction of equivalent stress may contribute to decrease in BMD in the femur after THA. PMID:24661022

  9. Dual Energy X-Ray Absorptiometry of the Distal Femur May Be More Reliable than the Proximal Tibia in Spinal Cord Injury

    PubMed Central

    Morse, Leslie R.; Lazzari, Antonio A.; Battaglino, Ricardo; Stolzmann, Kelly L.; Matthess, Kirby R.; Gagnon, David R.; Davis, Samuel A.; Garshick, Eric

    2009-01-01

    Objective Although spinal cord injury frequently results in low impact fractures at the distal femur and proximal tibia, there are no standard clinical protocols for assessing bone mineral density at these sites. We evaluated the precision of dual energy x-ray absorptiometry scanning at two skeletal sites at the knee (proximal femur and distal tibia) in individuals with spinal cord injury. Design Cross-sectional. Setting VA Medical Center. Participants 20 subjects with chronic SCI. Interventions Not Applicable. Main Outcome Measures Precision as determined by root mean square coefficient of variation (RMS-CV) and root mean standard deviation (RMS-SD). Results At the distal femur the root RMS-CV was 3.01% and the RMS-SD was 0.025 g/cm2. At the proximal tibia the RMS-CV was 5.91% and the RMS-SD was 0.030 g/cm2. Conclusions Precision at the distal femur is greater than the proximal tibia and we recommend it as the preferred site for the longitudinal assessment of bone mineral density at the knee in chronic spinal cord injury. PMID:19406303

  10. Helping the Habitually Late Student.

    ERIC Educational Resources Information Center

    Bergman, Jerry

    1978-01-01

    The author gives three major reasons for a student being habitually late to class: resistance, disorganization, or unavoidable schedule conflicts. He makes specific suggestions to teachers for dealing with the disorganized and resistant latecomers. (SJL)

  11. Late Blooming or Language Problem?

    MedlinePlus

    ... and Swallowing / Disorders and Diseases Late Blooming or Language Problem? Parents are smart. They listen to their ... or not their child is developing speech and language at a normal rate. If parents think that ...

  12. Through-knee amputation for a patient with proximal femur focal deficiency and tibial hemimelia: surgical anatomy and clinical implications.

    PubMed

    Lloyd, Selvyn; Rashid, Abdul Halim Abd; Das, Srijit; Ibrahim, Sharaf

    2014-03-01

    Tibial hemimelia is a rare anomaly of unknown etiology. This condition can occur sporadically or may have a familial inheritance. It is characterized by deficiency of the tibia with a relatively intact fibula. The anomaly may be unilateral or bilateral. We report a case of a 2-year-old girl who presented with right lower limb deformity since birth. She was diagnosed with proximal femur focal deficiency with absence of the ipsilateral tibia. She presented with a shorter right lower limb and a deformed foot. She was treated with a through-knee amputation. Anatomical dissection of the amputated limb was carried out to verify the anomalies. The dissection showed that the distal phalanx of the great toe was trifid. The anatomical and clinical significance of this interesting case is discussed. PMID:24158808

  13. Hydatid Disease of the Femur with an Extraosseous Extent due to a Former Biopsy Complicated by a Pathological Fracture

    PubMed Central

    Ciftdemir, M.; Sezer, A.; Puyan, F. O.; Copuroglu, C.; Ozcan, M.

    2012-01-01

    Hydatid disease of the bone represents about 1–2.5% of all human hydatid disease. Spine is the most affected part of the skeleton with 50% incidence of all bone hydatidosis. Extraspinal bone hydatidosis is much rare. Diagnosis is difficult in the bone hydatid disease. Bone tumors, tumor-like lesions, and specific and nonspecific infections should be considered in the differential diagnosis. Radiological, laboratory, and clinical findings combined with strong element of suspicion are the key for diagnosis. Bone biopsies should be avoided because of the danger of anaphylaxis, sensitization, and spread. This paper describes the management of a patient with primary hydatidosis of the femur, which had been complicated by an extraosseous involvement, cortical erosion, and a pathological fracture due to a former needle biopsy. PMID:23259111

  14. Biomechanical and histologic investigation of cemented total hip arthroplasties. A study of autopsy-retrieved femurs after in vivo cycling.

    PubMed

    Maloney, W J; Jasty, M; Burke, D W; O'Connor, D O; Zalenski, E B; Bragdon, C; Harris, W H

    1989-12-01

    Eleven whole anatomic specimens of the femur were retrieved at autopsy from patients who previously had cemented total hip arthroplasty. Implant duration ranged from 0.5 to 210 months. Clinically and roentgenographically the implants were stable. A detailed biomechanical analysis evaluated bone strains and implant stability in both the single-limb stance and stair-climbing positions using a 100-pound spinal load. The stability offered by cement in these well-fixed prostheses was remarkable, with the maximum axial micromotion being 40 mu. This is a reflection of intimate osseointegration at the bone-cement interface with only rare intervening fibrous tissue. The strain gauge and photoelastic strain-coating studies revealed that marked stress shielding in the proximal medial femoral cortex persists long after a cemented femoral component is inserted. Even 17 years after surgery, the strain in the calcar region did not normalize. PMID:2582664

  15. Acute fracture of the neck of the femur. An assessment of perfusion of the head by dynamic MRI.

    PubMed

    Konishiike, T; Makihata, E; Tago, H; Sato, T; Inoue, H

    1999-07-01

    We performed dynamic MRI of the femoral head within 48 hours of injury on 22 patients with subcapital fracture of the neck of the femur and on a control group of 20 of whom ten were healthy subjects and ten were patients with an intertrochanteric fracture. Three MRI patterns emerged when the results between the fractured side and the contralateral femoral head were compared. In all of the control group and in those patients who had undisplaced fractures (Garden stages I and II), perfusion of the femoral head was considered to be at the same level as on the unaffected side. In patients with displaced fractures (Garden stages III and IV) almost all the femoral heads on the fractured side were impaired or totally avascular, although some had the same level of perfusion as the unaffected side. We conclude that dynamic MRI, a new non-invasive imaging technique, is useful for evaluating the perfusion of the femoral head. PMID:10463727

  16. Influence of Lateral Muscle Loading in the Proximal Femur after Fracture Stabilization with a Trochanteric Gamma Nail (TGN)

    NASA Astrophysics Data System (ADS)

    Sitthiseripratip, Kriskrai; Mahaisavariya, Banchong; Suwanprateeb, Jintamai; Bohez, Erik; Vander Sloten, Jos

    The purpose of this study was to investigate the influence of lateral muscle loading on the stress/strain distributions of the trochanteric Gamma nail (TGN) fixation within the healed, trochanteric and subtrochanteric femoral fractures by means of a finite element method. The effect of three muscle groups, the abductors (ABD), the vastus lateralis (VL) and the iliotibial band (ITB), were investigated. The analytical results showed that addition of lateral muscle forces, iliotibial band and vastus lateralis, produced compensation of forces and reduction of bending moments in the bone and in the trochanteric Gamma nail especially in the lateral aspect. The iliotibial band produced a higher impact as compared to the vastus lateralis. Therefore in the finite element analysis of the proximal femur with the trochanteric Gamma nail fracture fixation should include the lateral muscle forces to simulate load condition with maximal physiological relevance to the closed nailing technique.

  17. The use of the Ilizarov method as a salvage procedure in infected nonunion of the distal femur with bone loss.

    PubMed

    Saridis, A; Panagiotopoulos, E; Tyllianakis, M; Matzaroglou, C; Vandoros, N; Lambiris, E

    2006-02-01

    We reviewed 13 patients with infected nonunion of the distal femur and bone loss, who had been treated by radical surgical debridement and the application of an Ilizarov external fixator. All had severely restricted movement of the knee and a mean of 3.1 previous operations. The mean length of the bony defect was 8.3 cm and no patient was able to bear weight. The mean external fixation time was 309.8 days. According to Paley's grading system, eight patients had an excellent clinical and radiological result and seven excellent and good functional results. Bony union, the ability to bear weight fully, and resolution of the infection were achieved in all the patients. The external fixation time was increased when the definitive treatment started six months or more after the initial trauma, the patient had been subjected to more than four previous operations and the initial operation had been open reduction and internal fixation. PMID:16434530

  18. Femur bone repair in ovariectomized rats under the local action of alendronate, hydroxyapatite and the association of alendronate and hydroxyapatite

    PubMed Central

    Canettieri, Antonio Carlos Victor; Colombo, Carlos Eduardo Dias; Chin, Chung Man; Faig-Leite, Horácio

    2009-01-01

    An evaluation was made of the local action of alendronate sodium (A), hydroxyapatite (HA) and the association of both substances (A + HA), in different molar concentrations, on the femur bone repair of ovariectomized rats. Ninety-eight animals were divided into seven groups: control (C), starch (S), alendronate 1 mol (A1), alendronate 2 mols (A2), hydroxyapatite 1 mol (HA1), hydroxyapatite 2 mols (HA2) and the association of alendronate + hydroxyapatite (A + HA). Rats weighing about 250 g were ovariectomized and 2.5-mm diameter bone defects were made on the left femur 30 days later. Each experimental group had defects filled with appropriate material, except for group C (control). The animals were killed 7 and 21 days after surgery. Histological, histomorphometric and statistical analyses of bone neoformation in the bone defect site were performed. From the histological standpoint, the major differences occurred after 21 days. All specimens in groups C, S, HA1 and HA2 presented linear closure of the bone defect, and most animals in groups A1, A2 and A + HA showed no bone neoformation in the central area of the defect. No statistically significant difference was found among the experimental groups after 7 days; after 21 days, group HA2 presented the highest amount of neoformed bone. There was no significant difference among groups A1, A2 and A + HA in the two study periods. It was concluded that alendronate, either isolated or in association with hydroxyapatite, had an adverse effect on bone repair in this experimental model. Moreover, the hydroxyapatite used here proved to be biocompatible and osteoconductive, with group HA2 showing the best results. PMID:19765106

  19. THE INFLUENCE OF URINARY TRACT INFECTIONS ON TREATMENT OF FRACTURE OF PROXIMAL FEMUR IN PATIENTS WITH SYSTEMIV OSTEOPOROSIS.

    PubMed

    Palshina, A M; Bannaev, I F; Palshin, G A; Shamaeva, S Kh; Yadrikhinskaya, V N; Komissarov, A N; Krivoshapkina, A G

    2015-01-01

    In the structure of intrahospital infections the infections of urinary tract make up from 20 to 40%. This problem represents special medical-social significance for trauma departments as patients with trauma are being in forced situation for along time. 380 patients older than 60 years (average age 73.6 ± 9.2 years) with a fracture of proximal femur against background of the systemic osteoporosis having in-patient treatment in the trauma department of the Republic Hospital No2 were being examined and treated from 2011 to 2013. Urinary tract infections were diagnosed in 130 (34.2%) patients (average age 77.3 ± 8.3 years). Women (80%-82%) with the average age 77.7 ± 8.2 years prevailed by gender signs. From them 40 (30.8%) patients admitted with prehospital urinary tract infections and intrahospital urinary tract infections were diagnosed in 90 (69.2%) patients. In etiological structure of urinary tract infections the part of gram-negative microorganisms made up 47.4%, the leading role belonged to the family of Enterobacteriaceae. Escherichia coli (23.3%) and Klibsiella pneumonia (12%) were the most significant from them. Gram-positive microorganisms 44% were sown in the second place. More frequently Enterococci (33.6%) were separated such as Enterococcus faecium (18.1%) and Enterococcus faecalis (15.5%). Intrahospital urinary tract infections resistant to antimicrobial therapy were observed in 6.7% patients with systemic osteoporosis and fracture of proximal femur. The average duration of preoperative preparation and in-patient treatment of patients with fracture of proximal femurand concomitant urinary tract infections is much more (3.9 days and 5.4 bed-days correspondingly) higher than the average indications of all operated patients in the department. PMID:26887137

  20. Improving bone strength prediction in human proximal femur specimens through geometrical characterization of trabecular bone microarchitecture and support vector regression

    PubMed Central

    Huber, Markus B.; Carballido-Gamio, Julio; Bauer, Jan S.; Baum, Thomas; Eckstein, Felix; Lochmüller, Eva; Majumdar, Sharmila; Link, Thomas M.; Wismüller, Axel

    2014-01-01

    We investigate the use of different trabecular bone descriptors and advanced machine learning tech niques to complement standard bone mineral density (BMD) measures derived from dual-energy x-ray absorptiometry (DXA) for improving clinical assessment of osteoporotic fracture risk. For this purpose, volumes of interest were extracted from the head, neck, and trochanter of 146 ex vivo proximal femur specimens on multidetector computer tomography. The trabecular bone captured was characterized with (1) statistical moments of the BMD distribution, (2) geometrical features derived from the scaling index method (SIM), and (3) morphometric parameters, such as bone fraction, trabecular thickness, etc. Feature sets comprising DXA BMD and such supplemental features were used to predict the failure load (FL) of the specimens, previously determined through biomechanical testing, with multiregression and support vector regression. Prediction performance was measured by the root mean square error (RMSE); correlation with measured FL was evaluated using the coefficient of determination R2. The best prediction performance was achieved by a combination of DXA BMD and SIM-derived geometric features derived from the femoral head (RMSE: 0.869 ± 0.121, R2: 0.68 ± 0.079), which was significantly better than DXA BMD alone (RMSE: 0.948 ± 0.119, R2: 0.61 ± 0.101) (p < 10−4). For multivariate feature sets, SVR outperformed multiregression (p < 0.05). These results suggest that supplementing standard DXA BMD measurements with sophisticated femoral trabecular bone characterization and supervised learning techniques can significantly improve biomechanical strength prediction in proximal femur specimens. PMID:24860245

  1. Tissue level microstructure and mechanical properties of the femoral head in the proximal femur of fracture patients

    NASA Astrophysics Data System (ADS)

    Lü, Linwei; Meng, Guangwei; Gong, He; Zhu, Dong; Gao, Jiazi; Fan, Yubo

    2015-04-01

    This study aims to investigate the regional variations of trabecular morphological parameters and mechanical parameters of the femoral head, as well as to determine the relationship between trabecular morphological and mechanical parameters. Seven femoral heads from patients with fractured proximal femur were scanned using a micro-CT system. Each femoral head was divided into 12 sub-regions according to the trabecular orientation. One trabecular cubic model was reconstructed from each sub-region. A total of 81 trabecular models were reconstructed, except three destroyed sub-regions from two femoral heads during the surgery. Trabecular morphological parameters, i.e. trabecular separation (Tb.Sp), trabecular thickness (Tb.Th), specific bone surface (BS/BV), bone volume fraction (BV/TV), structural model index (SMI), and degree of anisotropy (DA) were measured. Micro-finite element analyses were performed for each cube to obtain the apparent Young's modulus and tissue level von Mises stress distribution under 1 % compressive strain along three orthogonal directions, respectively. Results revealed significant regional variations in the morphological parameters (). Young's moduli along the trabecular orientation were significantly higher than those along the other two directions. In general, trabecular mechanical properties in the medial region were lower than those in the lateral region. Trabecular mechanical parameters along the trabecular orientation were significantly correlated with BS/BV, BV/TV, Tb.Th, and DA. In this study, regional variations of microstructural features and mechanical properties in the femoral head of patients with proximal femur fracture were thoroughly investigated at the tissue level. The results of this study will help to elucidate the mechanism of femoral head fracture for reducing fracture risk and developing treatment strategies for the elderly.

  2. Proximal Femoral Nail Antirotation Versus Reverse Less Invasive Stabilization System-distal Femur for Treating Proximal Femoral Fractures

    PubMed Central

    Jiang, Xuan; Wang, Ying; Ma, XinLong; Ma, JianXiong; Wang, Chen; Zhang, ChengBao; Han, Zhe; Sun, Lei; Lu, Bin

    2016-01-01

    Abstract The aim of this study was to compare the effectiveness and safety of 2 surgical techniques that are used to treat proximal femoral fractures. A systematic literature search (up to December 2014) was conducted in Medline, Embase, PubMed, and The Cochrane Central Register of Controlled Trials to screen for studies comparing proximal femoral nail antirotation (PFNA) with less invasive stabilization system–distal femur (LISS-DF) for proximal femoral fractures. Two authors independently assessed the methodological quality of the included studies and extracted data. Surgical information and postoperative outcomes were analyzed. A total of 7 studies with 361 patients who satisfied the eligibility criteria included 3 randomized controlled trials and 4 case-controlled trials associated with PFNA versus LISS in treating proximal femoral fractures. Our results demonstrated that there was a significant reduction in hospital stay and time to weight-bearing ambulation and bone healing for PFNA compared with LISS (odds ratio [OR] −1.48, 95% confidence interval [CI] −2.92 to −0.05; OR −7.08, 95% CI −8.32 to −5.84; OR −2.71, 95% CI −4.76 to 0.67). No statistically significant difference was observed between the 2 groups for operative time, blood loss volume, Harris hip score, and incidence of complications. Based on the results of this analysis, we inferred that PFNA is safer and more effective than reverse LISS-DF in patients undergoing osteosynthesis for proximal femoral fractures, and that PFNA is associated with reduced hospital stays and reduced time to weight-bearing ambulation and bone healing. Nonetheless, in certain cases in which PFNA is not suitable due to abnormal structure of the proximal femur or particularly unstable fractures, the LISS plate technique could be a useful alternative. PMID:27057840

  3. Cortical thickness estimation of the proximal femur from multi-view dual-energy X-ray absorptiometry (DXA)

    NASA Astrophysics Data System (ADS)

    Tsaousis, N.; Gee, A. H.; Treece, G. M.; Poole, K. E. S.

    2013-02-01

    Hip fracture is the leading cause of acute orthopaedic hospital admission amongst the elderly, with around a third of patients not surviving one year post-fracture. Although various preventative therapies are available, patient selection is difficult. The current state-of-the-art risk assessment tool (FRAX) ignores focal structural defects, such as cortical bone thinning, a critical component in characterizing hip fragility. Cortical thickness can be measured using CT, but this is expensive and involves a significant radiation dose. Instead, Dual-Energy X-ray Absorptiometry (DXA) is currently the preferred imaging modality for assessing hip fracture risk and is used routinely in clinical practice. Our ambition is to develop a tool to measure cortical thickness using multi-view DXA instead of CT. In this initial study, we work with digitally reconstructed radiographs (DRRs) derived from CT data as a surrogate for DXA scans: this enables us to compare directly the thickness estimates with the gold standard CT results. Our approach involves a model-based femoral shape reconstruction followed by a data-driven algorithm to extract numerous cortical thickness point estimates. In a series of experiments on the shaft and trochanteric regions of 48 proximal femurs, we validated our algorithm and established its performance limits using 20 views in the range 0°-171°: estimation errors were 0:19 +/- 0:53mm (mean +/- one standard deviation). In a more clinically viable protocol using four views in the range 0°-51°, where no other bony structures obstruct the projection of the femur, measurement errors were -0:07 +/- 0:79 mm.

  4. Effects of different loading patterns on the trabecular bone morphology of the proximal femur using adaptive bone remodeling.

    PubMed

    Banijamali, S Mohammad Ali; Oftadeh, Ramin; Nazarian, Ara; Goebel, Ruben; Vaziri, Ashkan; Nayeb-Hashemi, Hamid

    2015-01-01

    In this study, the changes in the bone density of human femur model as a result of different loadings were investigated. The model initially consisted of a solid shell representing cortical bone encompassing a cubical network of interconnected rods representing trabecular bone. A computationally efficient program was developed that iteratively changed the structure of trabecular bone by keeping the local stress in the structure within a defined stress range. The stress was controlled by either enhancing existing beam elements or removing beams from the initial trabecular frame structure. Analyses were performed for two cases of homogenous isotropic and transversely isotropic beams.Trabecular bone structure was obtained for three load cases: walking, stair climbing and stumbling without falling. The results indicate that trabecular bone tissue material properties do not have a significant effect on the converged structure of trabecular bone. In addition, as the magnitude of the loads increase, the internal structure becomes denser in critical zones. Loading associated with the stumbling results in the highest density;whereas walking, considered as a routine daily activity, results in the least internal density in different regions. Furthermore, bone volume fraction at the critical regions of the converged structure is in good agreement with previously measured data obtained from combinations of dual X-ray absorptiometry (DXA) and computed tomography (CT). The results indicate that the converged bone architecture consisting of rods and plates are consistent with the natural bone morphology of the femur. The proposed model shows a promising means to understand the effects of different individual loading patterns on the bone density. PMID:25392856

  5. Simultaneous Bilateral Femur Neck Fracture in A Young Adult with Chronic Renal Failure- A Case Report and Review of Literature

    PubMed Central

    V, Sathyanarayana; Patel, Maulik Tulsibhai; S, Raghavan; D, Naresh

    2015-01-01

    Introduction: Pathological bilateral femoral neck fracture due to renal osteodystrophy is rare. This is a report of a chronic renal failure patient who had sustained bilateral intra-capsular displaced fracture neck of femur following an episode of convulsion and the difficulties encountered in early diagnosis and treatment. The pathophysiology of renal osteodystrophy and the treatment of hip fractures in patients with renal failure are also discussed. Case Report: A 23 years old male patient admitted with h/o dysuria, pyuria and loss of appetite since 3 months. He was a known case of chronic renal failure and reflux nephropathy. On investigating, patient’s renal parameters were high and he was started with haemodialysis. The next day patient had c/o bilateral hip pain and inability to move bilateral lower limbs following an episode of seizure. Radiograph of pelvis showed vertical sub capital fractures of bilateral neck of femur. In this patient, considering his age, general condition & prognosis, an elective surgery in the form of bilateral uncemented modular bipolar hemiarthroplasty was done. Conclusion: Overall risk of hip fracture among patients with chronic renal failure is considerably higher than in the general population, independent of age and gender. Simultaneous spontaneous bilateral fractures of the femoral neck are rare and a delayed diagnosis is usual. The study of etiological factors of these fractures is essential to guide us in choosing the treatment of choice. Obviously patient’s age, life expectancy as well as renal co morbidity has an influence over deciding treatment and outcome. PMID:27299091

  6. Late effects from hadron therapy

    SciTech Connect

    Blakely, Eleanor A.; Chang, Polly Y.

    2004-06-01

    Successful cancer patient survival and local tumor control from hadron radiotherapy warrant a discussion of potential secondary late effects from the radiation. The study of late-appearing clinical effects from particle beams of protons, carbon, or heavier ions is a relatively new field with few data. However, new clinical information is available from pioneer hadron radiotherapy programs in the USA, Japan, Germany and Switzerland. This paper will review available data on late tissue effects from particle radiation exposures, and discuss its importance to the future of hadron therapy. Potential late radiation effects are associated with irradiated normal tissue volumes at risk that in many cases can be reduced with hadron therapy. However, normal tissues present within hadron treatment volumes can demonstrate enhanced responses compared to conventional modes of therapy. Late endpoints of concern include induction of secondary cancers, cataract, fibrosis, neurodegeneration, vascular damage, and immunological, endocrine and hereditary effects. Low-dose tissue effects at tumor margins need further study, and there is need for more acute molecular studies underlying late effects of hadron therapy.

  7. The relationship between fractures and DXA measures of BMD in the distal femur of children and adolescents with cerebral palsy or muscular dystrophy.

    PubMed

    Henderson, Richard C; Berglund, Lisa M; May, Ryan; Zemel, Babette S; Grossberg, Richard I; Johnson, Julie; Plotkin, Horacio; Stevenson, Richard D; Szalay, Elizabeth; Wong, Brenda; Kecskemethy, Heidi H; Harcke, H Theodore

    2010-03-01

    Children with limited or no ability to ambulate frequently sustain fragility fractures. Joint contractures, scoliosis, hip dysplasia, and metallic implants often prevent reliable measures of bone mineral density (BMD) in the proximal femur and lumbar spine, where BMD is commonly measured. Further, the relevance of lumbar spine BMD to fracture risk in this population is questionable. In an effort to obtain bone density measures that are both technically feasible and clinically relevant, a technique was developed involving dual-energy X-ray absorptiometry (DXA) measures of the distal femur projected in the lateral plane. The purpose of this study is to test the hypothesis that these new measures of BMD correlate with fractures in children with limited or no ability to ambulate. The relationship between distal femur BMD Z-scores and fracture history was assessed in a cross-sectional study of 619 children aged 6 to 18 years with muscular dystrophy or moderate to severe cerebral palsy compiled from eight centers. There was a strong correlation between fracture history and BMD Z-scores in the distal femur; 35% to 42% of those with BMD Z-scores less than -5 had fractured compared with 13% to 15% of those with BMD Z-scores greater than -1. Risk ratios were 1.06 to 1.15 (95% confidence interval 1.04-1.22), meaning a 6% to 15% increased risk of fracture with each 1.0 decrease in BMD Z-score. In clinical practice, DXA measure of BMD in the distal femur is the technique of choice for the assessment of children with impaired mobility. PMID:19821773

  8. The Relationship Between Fractures and DXA Measures of BMD in the Distal Femur of Children and Adolescents With Cerebral Palsy or Muscular Dystrophy

    PubMed Central

    Henderson, Richard C; Berglund, Lisa M; May, Ryan; Zemel, Babette S; Grossberg, Richard I; Johnson, Julie; Plotkin, Horacio; Stevenson, Richard D; Szalay, Elizabeth; Wong, Brenda; Kecskemethy, Heidi H; Harcke, H Theodore

    2010-01-01

    Children with limited or no ability to ambulate frequently sustain fragility fractures. Joint contractures, scoliosis, hip dysplasia, and metallic implants often prevent reliable measures of bone mineral density (BMD) in the proximal femur and lumbar spine, where BMD is commonly measured. Further, the relevance of lumbar spine BMD to fracture risk in this population is questionable. In an effort to obtain bone density measures that are both technically feasible and clinically relevant, a technique was developed involving dual-energy X-ray absorptiometry (DXA) measures of the distal femur projected in the lateral plane. The purpose of this study is to test the hypothesis that these new measures of BMD correlate with fractures in children with limited or no ability to ambulate. The relationship between distal femur BMD Z-scores and fracture history was assessed in a cross-sectional study of 619 children aged 6 to 18 years with muscular dystrophy or moderate to severe cerebral palsy compiled from eight centers. There was a strong correlation between fracture history and BMD Z-scores in the distal femur; 35% to 42% of those with BMD Z-scores less than −5 had fractured compared with 13% to 15% of those with BMD Z-scores greater than −1. Risk ratios were 1.06 to 1.15 (95% confidence interval 1.04–1.22), meaning a 6% to 15% increased risk of fracture with each 1.0 decrease in BMD Z-score. In clinical practice, DXA measure of BMD in the distal femur is the technique of choice for the assessment of children with impaired mobility. © 2010 American Society for Bone and Mineral Research PMID:19821773

  9. Protocol for a randomized controlled trial on risk adapted damage control orthopedic surgery of femur shaft fractures in multiple trauma patients

    PubMed Central

    Rixen, Dieter; Steinhausen, Eva; Sauerland, Stefan; Lefering, Rolf; Meier, Matthias; Maegele, Marc G; Bouillon, Bertil; Neugebauer, Edmund AM

    2009-01-01

    Background Fractures of the long bones and femur fractures in particular are common in multiple trauma patients, but the optimal management of femur fractures in these patients is not yet resolved. Although there is a trend towards the concept of "Damage Control Orthopedics" (DCO) in the management of multiple trauma patients with long bone fractures as reflected by a significant increase in primary external fixation of femur fractures, current literature is insufficient. Thus, in the era of "evidence-based medicine", there is the need for a more specific, clarifying trial. Methods/Design The trial is designed as a randomized controlled open-label multicenter study. Multiple trauma patients with femur shaft fractures and a calculated probability of death between 20 and 60% will be randomized to either temporary fracture fixation with fixateur externe and defined secondary definitive treatment (DCO) or primary reamed nailing (early total care). The primary objective is to reduce the extent of organ failure as measured by the maximum sepsis-related organ failure assessment (SOFA) score. Discussion The Damage Control Study is the first to evaluate the risk adapted damage control orthopedic surgery concept of femur shaft fractures in multiple trauma patients in a randomized controlled design. The trial investigates the differences in clinical outcome of two currently accepted different ways of treating multiple trauma patients with femoral shaft fractures. This study will help to answer the question whether the "early total care" or the „damage control” concept is associated with better outcome. Trial registration Current Controlled Trials ISRCTN10321620 PMID:19691847

  10. Late-Notice HIE Investigation

    NASA Technical Reports Server (NTRS)

    Hejduk, M. D.

    2016-01-01

    Provide a response to MOWG action item 1410-01: Analyze close approaches which have required mission team action on short notice. Determine why the approaches were identified later in the process than most other events. Method: Performed an analysis to determine whether there is any correlation between late notice event identification and space weather, sparse tracking, or high drag objects, which would allow preventive action to be taken Examined specific late notice events identified by missions as problematic to try to identify root cause and attempt to relate them to the correlation analysis.

  11. Late Silurian plutons in Yucatan

    NASA Astrophysics Data System (ADS)

    Steiner, M. B.; Walker, J. Douglas

    1996-08-01

    U-Pb measurements of zircons from two composite plutons in the Maya Mountains of the Yucatan Block (Belize) give Late Silurian ages. Zircons from one of the five compositional phases of the Mountain Pine Ridge pluton yield an age of 418±3.6 Ma. A second compositional phase gives a minimum age of 404 Ma, and zircons from a third phase, although plagued with high common Pb, yield ages consistent with the other two. Zircons from one compositional phase of the Hummingbird-Mullins River pluton indicate an age of about 410-420 Ma. These data demonstrate that two of the three Maya Mountains plutons residing among the strata of the Late Pennsylvanian through Permian Santa Rosa Group are older than that sedimentation. Although the third pluton was not dated, both the similarity of sedimentary facies patterns adjacent to it to those adjacent to one of the plutons dated as Late Silurian and a published single Rb-Sr age of 428 ± 41 Ma suggest this third pluton also was emergent during Santa Rosa deposition. Thus the new U/Pb dates and other data suggest that all three Maya Mountains plutons pre-date Late Carboniferous sedimentation and that none intrude the Santa Rosa Group. Although very uniform ages of about 230 Ma amongst all plutons, derived from abundant earlier dating by the K-Ar system, led to the conclusion that intrusion mostly had occurred in the Late Triassic, the U-Pb ages (obtained from the same sites as the K-Ar dates) demonstrate that the K-Ar ages do not derive from a Late Triassic intrusive episode. The K-Ar dates probably are a signature of the rifting associated with Pangean breakup and formation of the Gulf of Mexico. In a reconstructed Pangea, the position of the Maya Mountains Late Silurian plutons suggests that the Late Silurian Acadian-Caledonian orogen of eastern North America extended through the region of the future Gulf of Mexico. Finally, the U-Pb ages of the Maya Mountains plutons are the same as those of a group of shocked zircons found in the

  12. Early and Late Retirement Exits

    ERIC Educational Resources Information Center

    Brougham, Ruby R.; Walsh, David A.

    2009-01-01

    The current study proposes that personal need fulfillment (relatedness, generativity, identity, growth, and finances) predicts early and late retirement intentions. The personal needs of 160 full-time older employees were measured by personal goals, job satisfactions, job characteristics, and intrinsic motivation. Results suggest that the personal…

  13. Planetary science: Ubiquitous late veneer

    NASA Astrophysics Data System (ADS)

    Brenan, James

    2012-09-01

    Iron-loving elements are thought to have been added to Mars, Earth and the Moon after core formation. An analysis of meteorites formed in the first two to three million years of Solar System history suggests that a similar late veneer was added elsewhere too.

  14. Late onset globoid cell leukodystrophy.

    PubMed Central

    Grewal, R P; Petronas, N; Barton, N W

    1991-01-01

    A 29 year old male with onset of globoid cell leukodystrophy at age 14 is described. This is the first case of enzymatically confirmed globoid cell leukodystrophy with onset of symptoms after the age of ten. This patient is unique because of the late onset and slow progression and extends the clinical spectrum of globoid cell leukodystrophy. Images PMID:1800646

  15. LATE-AGE ONSET SCLERODERMA

    PubMed Central

    Manno, Rebecca L.; Wigley, Fredrick M.; Gelber, Allan C.; Hummers, Laura K.

    2011-01-01

    OBJECTIVE Although patients who develop scleroderma (SSc) later in life (≥ 65 years) may express the entire clinical spectrum of disease, we hypothesize that patients with late-age onset incur a different risk for specific organ manifestations of disease compared to those with younger-age onset SSc. METHODS In total, 2300 SSc patients were evaluated between 1990–2009 and reviewed from a university-based Scleroderma Center cohort. Demographic profile, SSc subtype, autoantibody status, Medsger severity scores, pulmonary function tests, echocardiography, and right heart catheterization parameters were compared between late-age versus younger-age onset patients. RESULTS Overall, 2084 (91%) patients developed SSc prior to age 65; whereas 216 (9%) were ≥65 years. Late-age onset patients had a significantly higher proportion of anti-centromere antibodies (42% vs 27%; p=0.001) compared to younger-age onset. Risk of pulmonary hypertension (OR 1.77; 95%CI 1.00, 3.12), muscle weakness (OR 1.85; 95%CI 1.30, 2.64), renal impairment (OR 2.83; 95%CI 1.98, 4.04) and cardiac disease (OR 2.69; 95%CI 1.92, 3.78) was greater among those with late-age onset SSc; although risk of digital ischemia (OR 0.64; 95%CI 0.47, 0.86) was reduced. The cumulative incidence of pulmonary hypertension at 5 years was greater among those with late-age (9%) compared to younger-age (2.5%) onset SSc (log-rank, p<0.001). CONCLUSION These findings suggest that older SSc patients are at greater risk for pulmonary hypertension, renal impairment, cardiac disease, and muscle weakness. Awareness of the distinct risk for specific organ manifestations in SSc, in particular pulmonary hypertension, should guide the care of older SSc patients whose disease begins after age 65 years. PMID:21685299

  16. Disseminated metastatic disease of osteosarcoma of the femur in the abdomen: unusual metastatic pattern on Tc-99m MDP bone scan.

    PubMed

    Karacalioglu, Ozgur; Ilgan, Seyfettin; Kuzhan, Okan; Emer, Ozdes; Ozguven, Mehmet

    2006-07-01

    A 25-year-old patient with osteosarcoma of the right distal femur underwent a bone scintigraphy with Tc-99m methylene diphosphonate (MDP). Whole-body bone scan revealed extensive metastatic disease in the abdominal region. Abdominal computerized tomography confirmed the presence of ascites and calcified masses on the greater omentum and peritoneal surfaces. Here we describe a case of unusual metastatic pattern of an osteosarcoma showing extensive intraabdominal metastases without prominent lung involvement after intensive chemotherapy. PMID:16922473

  17. Intravenous analgesia with opioids versus femoral nerve block with 0.2% ropivacaine as preemptive analgesic for fracture femur: A randomized comparative study

    PubMed Central

    Singh, Arvinder Pal; Kohli, Vaneet; Bajwa, Sukhminder Jit Singh

    2016-01-01

    Background and Objective: Femoral fractures are extremely painful and pain invariably worsens on any movement. Anesthesia for fracture femur surgery is usually provided by spinal block. This study was undertaken to compare the analgesic effects of femoral nerve block (FNB) using nerve stimulator with 0.2% ropivacaine (15 ml) and intravenous (I.V.) fentanyl before patient positioning for fracture femur surgery under spinal anesthesia. Materials and Methods: A prospective, randomized, double-blind, comparative study was conducted on 60 American Society of Anesthesiologists I and II patients (18–60 years) scheduled for femur surgery under combined spinal epidural anesthesia. Patients in Group I (n = 30), were administered FNB using nerve stimulator with 0.2% ropivacaine (15 ml) and in Group II patients (n = 30), I.V. fentanyl 0.5 μg/kg was given as preemptive analgesia. Parameters observed included time to spinal anesthesia, intra-operative and postoperative visual analog scale (VAS) for any pain and postoperative epidural top-ups dosages. Results: Demographic profile was comparable in both the groups. VAS at 2 min in Group I was 5.63 and in Group II it was 8.00. Satisfaction score was better in Group I as compared to Group II patients. Time to administer subarachnoid block was 17.80 min in patients of Group I as compared to 25.03 min in Group II patients. Postoperatively, VAS scores were lower in Group I than Group II patients. The frequency of epidural top-ups was higher in Group II than in Group I patients. Conclusions: FNB is comparatively better in comparison to I.V. fentanyl when used as preemptive and postoperative analgesic in patients being operated for fracture femur. PMID:27212771

  18. Fracture Healing in Mice Lacking Pten in Osteoblasts: A Micro-Computed Tomography Image-Based Analysis of the Mechanical Properties of the Femur

    PubMed Central

    Collins, Caitlyn J.; Vivanco, Juan; Sokn, Scott; Williams, Bart O.; Burgers, Travis A.; Ploeg, Heidi-Lynn

    2014-01-01

    In the United States, approximately 8 million osseous fractures are reported annually, of which 5-10% fail to create a bony union. Osteoblast-specific deletion of the gene Pten in mice has been found to stimulate bone growth and accelerate fracture healing. Healing rates at four weeks increased in femurs from Pten osteoblast conditional knock-out mice (Pten-CKO) compared to wild-type mice (WT) of the same genetic strain as measured by an increase in mechanical stiffness and failure load in four-point bending tests. Preceding mechanical testing, each femur was imaged using a Skyscan 1172 micro-computed tomography (μCT) scanner (Skyscan, Kontich, Belgium). The present study used μCT image-based analysis to test the hypothesis that the increased femoral fracture force and stiffness in Pten-CKO were due to greater section properties with the same effective material properties as that of the WT. The second moment of area and section modulus were computed in ImageJ 1.46 (National Institutes of Health) and used to predict the effective flexural modulus and the stress at failure for fourteen pairs of intact and callus WT and twelve pairs of intact and callus Pten-CKO femurs. For callus and intact femurs, the failure stress and tissue mineral density of the Pten-CKO and WT were not different; however, the section properties of the Pten-CKO were more than twice as large 28 days post-fracture. It was therefore concluded, when the gene Pten was conditionally knocked-out in osteoblasts, the resulting increased bending stiffness and force to fracture were due to increased section properties. PMID:25498366

  19. In-vitro comparison of LC-DCP- and LCP-constructs in the femur of newborn calves – a pilot study

    PubMed Central

    2012-01-01

    Background To compare the biomechanical in-vitro characteristics of limited-contact dynamic compression plate (LC-DCP) and locking compression plate (LCP) constructs in an osteotomy gap model of femoral fracture in neonatal calves. Pairs of intact femurs from 10 calves that had died for reasons unrelated to the study were tested. A 7-hole LC-DCP with six 4.5 mm cortical screws was used in one femur and a 7-hole LCP with four 5.0 mm locking and two 4.5 mm cortical screws was used in the corresponding femur. The constructs were tested to failure by cyclic compression at a speed of 2 mm/s within six increasing force levels. Results The bone-thread interface was stripped in 21 of 80 cortical screws (26.3%) before a pre-set insertion torque of 3 Nm was achieved. Only 3 corresponding intact pairs of constructs could be statistically compared for relative structural stiffness, actuator excursion and width of the osteotomy gap. Relative structural stiffness was significantly greater, actuator excursion and width of the osteotomy gap were significantly smaller in the LCP constructs. While failure occurred by loosening of the screws in the LC-DCP constructs, locking constructs failed by cutting large holes in the soft distal metaphyseal bone. Conclusions An insertion torque sufficient to provide adequate stability in femurs of newborn calves could not be achieved reliably with 4.5 mm cortical screws. Another limiting factor for both constructs was the weak cancellous bone of the distal fracture fragment. LCP constructs were significantly more resistant to compression than LC-DCP constructs. PMID:22909337

  20. High saturated fat diet alters the lipid composition of triacylglycerol and polar lipids in the femur of dam and offspring rats.

    PubMed

    Miotto, Paula M; Castelli, Laura M; Amoye, Foyinsola; Ward, Wendy E; LeBlanc, Paul J

    2015-06-01

    Previous work has shown that dietary lipids alter femur lipid composition. Specifically, we have shown that exposure to high saturated fatty acid (SFA) diets in utero, during suckling, or post-weaning alters femur total lipid composition, resulting in higher percent bone mass in males and females and bone mineral density (BMD) in female offspring with no effect on bone mineral outcomes in dams. Comparatively, high n-3 polyunsaturated fatty acid (PUFA) diets increase femur polar (PL) lipid n-3 content, which has been associated with increased bone mineral content and strength. However, the extent that PL or triacylglycerol (TAG) lipids change with high SFA diets is unknown. The current investigation examined the influence of a high SFA diet (20 % lard by weight) on femur PL and TAG lipid composition in 5-month old female Wistar rats (fed high SFA diet from age 28 days onwards; dams) and their 19-day old offspring (exposed to high SFA in utero and during suckling; pups). High SFA exposure resulted in increased monounsaturates and decreased n-3 and n-6 PUFA in the TAG fraction in both dams and pups, and higher SFA and n-6:n-3 ratio in dams only. The PL fraction showed decreased n-6 PUFA in both dams and pups. The magnitude of the diet-mediated responses, specifically TAG 18:1 and PL n-6 PUFA, may have contributed to the previously reported altered BMD, which was supported with correlation analysis. Future research should investigate the relationship of diet-induced changes in bone lipids on bone structure, as quantified through micro-computed tomography. PMID:25920746

  1. Accumulation of heavy metals and As in liver, hair, femur, and lung of Persian jird (Meriones persicus) in Darreh Zereshk copper mine, Iran.

    PubMed

    Khazaee, Manoochehr; Hamidian, Amir Hossein; Alizadeh Shabani, Afshin; Ashrafi, Sohrab; Mirjalili, Seyyed Ali Ashghar; Esmaeilzadeh, Esmat

    2016-02-01

    Rodents frequently serve as bioindicator to monitor the quality of the environment. Concentrations of 11 elements (Cd, Co, Ti, Fe, Mn, Cu, Sb, As, Sr, Ni, and Cr) were investigated and compared in liver, hair, femur, and lung of the Persian jird (Meriones persicus) from Darreh Zereshk copper mine, Iran. Metals were determined in different tissues of 39 individuals of Persian jird, collected by snap trap in 2014 from five areas of Darreh Zereshk copper mine. Samples were prepared by wet digestion method, and the contents of elements were analyzed with ICP-OES (VARIAN, 725-ES) instrument. Cadmium, Sb, and Co were below the limit of detection, and Mn and As were found only in hair and liver tissues. We detected the highest concentration of Cu, As, Ti, Fe, Mn, Cr, and Ni in hair in comparison with other tissues. Significant higher levels of Ti in femur and hair; Fe in liver and hair; Mn in liver; As in hair; Sr in lung; Cr in lung, hair, femur, and liver; Cu in femur; and Ni in liver and lung tissues were observed in females. Nearly all element concentrations in the tissues of Persian jird from flotation site, Darreh Zereshk and Hasan Abad villages and leaching site (mining areas) were higher than those from tailing dump site (reference site). We found the highest concentrations of As in liver and hair; Ni and Cr in liver, hair, and lung; and Sr in lung and hair tissues of Persian jird in leaching site. We tried to specify the status of elements before fully exploitation of Darreh Zereshk copper mine by using bioindicator species. Based on our achievements, initial activities did not strongly pollute the surrounded environment of the mine. The high abundance of Persian jird as well as their several proper features makes them a suitable species for biomonitoring programs especially for further studies will be performed after full exploitation of Darreh Zereshk copper mine. PMID:26498968

  2. Histological analysis of the effects of a static magnetic field on bone healing process in rat femurs

    PubMed Central

    Puricelli, Edela; Ulbrich, Lucienne M; Ponzoni, Deise; Filho, João Julio da Cunha

    2006-01-01

    Background The aim of this study was to investigate, in vivo, the quality of bone healing under the effect of a static magnetic field, arranged inside the body. Methods A metallic device was developed, consisting of two stainless steel washers attached to the bone structure with titanium screws. Twenty-one Wistar rats (Rattus novergicus albinus) were used in this randomized experimental study. Each experimental group had five rats, and two animals were included as control for each of the groups. A pair of metal device was attached to the left femur of each animal, lightly touching a surgically created bone cavity. In the experimental groups, washers were placed in that way that they allowed mutual attraction forces. In the control group, surgery was performed but washers, screws or instruments were not magnetized. The animals were sacrificed 15, 45 and 60 days later, and the samples were submitted to histological analysis. Results On days 15 and 45 after the surgical procedure, bone healing was more effective in the experimental group as compared to control animals. Sixty days after the surgical procedure, marked bone neoformation was observed in the test group, suggesting the existence of continued magnetic stimulation during the experiment. Conclusion The magnetic stainless steel device, buried in the bone, in vivo, resulted in increased efficiency of the experimental bone healing process. PMID:17125508

  3. A Study of Inflammatory/Necrosis Biomarkers in the Fracture of the Femur Treated with Proximal Femoral Nail Antirotation

    PubMed Central

    Marino, Mariapaola; Palmieri, Giuseppe; Peruzzi, Marco; Scuderi, Flavia; Bartoccioni, Emanuela

    2015-01-01

    Pertrochanteric fractures are common injuries in adults and source of morbidity and mortality among the elderly. Different surgical techniques were recommended for their treatment but undoubtedly they add an additional inflammatory trauma along the fracture itself. Many attempts to quantify the degree of approach-related trauma are carried out through measurements of systemic inflammatory parameters. In this study we prospectively analyzed laboratory data of 20 patients over eighty with pertrochanteric fracture of the femur treated with proximal femoral nail antirotation (PFNA). This is an excellent device for osteosynthesis because it can be easily and quickly inserted by a mini-incision providing stable fixation and early full mobilization. Serum tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP), and plasma creatin kinase (CK) were evaluated 1 hour preoperatively and 24 hours postoperatively. Our results show that PFNA did not induce significant increments in serum levels of inflammatory cytokines TNF-α and IL-6; CRP was elevated preoperatively in correlation with waiting time for surgery; CRP and CK showed a significant increment in the first postoperatory day; CK increment was correlated with surgical time length. We conclude that, for the markers we analyzed, PFNA shows a low biomechanical-inflammatory profile that represents an advantage over other techniques. PMID:26074676

  4. Femur-bending properties as influenced by gravity. V - Strength vs. calcium and gravity in rats exposed for 2 weeks

    NASA Technical Reports Server (NTRS)

    Wunder, Charles C.; Cook, Kenneth M.; Watkins, Stanley R.; Moressi, William J.

    1987-01-01

    The dependence of gravitationally related changes in femur bone strength on the comparable changes in calcium content was investigated in rats exposed to chronic simulations of altered gravity from the 28th to 42nd day of age. Zero G was simulated by harness suspension and 3 G by centrifugation. Bone strength (S) was determined by bending (using modified quasi-static cantilever bending methods and equipment described by Wunder et al., 1977 and 1979) and Ca content (C, by mass pct) determined by atomic absorption spectrometry; results were compared with data obtained on both normal and harnessed control animals at 1 G. Multiple regression showed significant dependence of S upon earth's gravity, independent from C, for which there was no significant coefficient of partial regression. It is suggested that the lack of S/C correlation might have been due to the fact that considerable fraction of the calcium in these young, developing bones has not yet crystallized into the hydroxyapatite which provides strength.

  5. Clinical and Radiologic Outcomes among Bipolar Hemiarthroplasty, Compression Hip Screw and Proximal Femur Nail Antirotation in Treating Comminuted Intertrochanteric Fractures

    PubMed Central

    Suh, You-Sung; Nho, Jae-Hwi; Kim, Seong-Min; Hong, Sijohn; Choi, Hyung-Suk

    2015-01-01

    Purpose In comminuted intertrochanteric fractures, various operative options have been introduced. The purpose of this study was to determine whether there were differences in clinical and radiologic outcomes among bipolar hemiarthroplasty (BH), compression hip screw (CHS) and proximal femur nail antirotation (PFNA) in treating comminuted intertrochanteric fractures (AO/OTA classification, A2 [22, 23]) Materials and Methods We retrospectively evaluated total 150 patients (BH, 50; CHS, 50; PFNA, 50) who were operated due to intertrochanteric fractures from March 2010 to December 2012 and were older than 65 years at the time of surgery. We compared these three groups for radiologic and clinical outcomes at 12 months postoperatively, including Harris Hip Score, mobility (Koval stage), visual analogue scale and radiologic limb length discrepancy (shortening). Results There was no statistical significance among three groups in clinical outcomes including Harris Hip Score, mobility (Koval stage), visual analogue scale. However, there was significant differences in radiologic limb discrepancy in plain radiographs at 12 months postoperatively (radiologic shortening: BH, 2.3 mm; CHS, 5.1 mm; PFNA, 3.0 mm; P=0.000). Conclusion There were no clinical differences among BH, PFNA, and CHS in this study. However, notable limb length shortening could be originated during fracture healing in osteosynthesis, compared to arthroplasty (BH

  6. Doped tricalcium phosphate scaffolds by thermal decomposition of naphthalene: Mechanical properties and in vivo osteogenesis in a rabbit femur model.

    PubMed

    Ke, Dongxu; Dernell, William; Bandyopadhyay, Amit; Bose, Susmita

    2015-11-01

    Tricalcium phosphate (TCP) is a bioceramic that is widely used in orthopedic and dental applications. TCP structures show excellent biocompatibility as well as biodegradability. In this study, porous β-TCP scaffolds were prepared by thermal decomposition of naphthalene. Scaffolds with 57.64% ± 3.54% density and a maximum pore size around 100 μm were fabricated via removing 30% naphthalene at 1150°C. The compressive strength for these scaffolds was 32.85 ± 1.41 MPa. Furthermore, by mixing 1 wt % SrO and 0.5 wt % SiO2 , pore interconnectivity improved, but the compressive strength decreased to 22.40 ± 2.70 MPa. However, after addition of polycaprolactone coating layers, the compressive strength of doped scaffolds increased to 29.57 ± 3.77 MPa. Porous scaffolds were implanted in rabbit femur defects to evaluate their biological property. The addition of dopants triggered osteoinduction by enhancing osteoid formation, osteocalcin expression, and bone regeneration, especially at the interface of the scaffold and host bone. This study showed processing flexibility to make interconnected porous scaffolds with different pore size and volume fraction porosity, while maintaining high compressive mechanical strength and excellent bioactivity. Results show that SrO/SiO2 -doped porous TCP scaffolds have excellent potential to be used in bone tissue engineering applications. PMID:25504889

  7. Percutaneous K-Wire Fixation for Femur Shaft Fractures in Children: A Treatment Concepts for Developing Countries

    PubMed Central

    Sahu, RL

    2013-01-01

    Background: Fractures shaft femur is a major cause of morbidity and mortality in patients with lower extremity injuries. Aims: The aim of this study was to evaluate the efficacy of intramedullary Kirschner wires for the treatment of femoral shaft fracture in children. Subjects and Methods: This prospective study was conducted in the Department of Orthopaedic surgery in M. M. Medical College from June 2005 to June 2010. Sixty eight children with a mean age of 7.7 years (range, 2-14 years) were recruited from Emergency and out patient department having closed fracture of femoral shaft. All patients were operated under general anesthesia. All patients were followed for twelve months. Results: Out of sixty eight patients, sixty four patients underwent union in 42 to 70 days with a mean of 56 days. Touch down weight bearing was started on 2nd post-operative day. Complications found in four patients who had insignificant delayed union which were united next three weeks. Intramedullary Kirschner-wires were removed after an average of five months without any complications. The results were excellent in 94.1% (64/68) and good in 5.8% (4/68). Conclusion: This technique is simple, quick to perform, safe and reliable and avoids prolonged hospitalization with good results and is economical. PMID:23919189

  8. Fibrous Dysplasia with Massive Cartilaginous Differentiation (Fibrocartilaginous Dysplasia) in the Proximal Femur: A Case Report and Review of the Literature.

    PubMed

    Morioka, Hideo; Kamata, Yasuhiro; Nishimoto, Kazumasa; Susa, Michiro; Kikuta, Kazutaka; Horiuchi, Keisuke; Sasaki, Aya; Kameyama, Kaori; Nakamura, Masaya; Matsumoto, Morio

    2016-01-01

    Fibrous dysplasia (FD) is a monostotic or polyostotic benign bone lesion with spindle-cell proliferation in woven bone and stroma. Rarely, cartilaginous differentiation can be seen in the lesions of FD. FD with massive cartilaginous differentiation is called fibrocartilaginous dysplasia (FCD) and is considered a rare variant of FD. Although pathological findings of FD show irregular immature bone formation without osteoblastic rimming in fibrous tissue, and rarely show very small amounts of cartilage, histological images of FCD are said to show that cartilage with a relatively high cell density is present in the majority and that FD-like findings are seen in parts of it. The most characteristic feature of FCD on images is calcification in the lesions reflecting cartilaginous tissue. On the other hand, typical radiographic findings of FD include shadows with a ground-glass appearance and thinning and bulging of the cortical bone, the observation if calcification is not usual. Therefore, in the diagnosis of FCD, differentiation from multiple enchondromatosis, Ollier disease, chondrosarcoma, and chondrosarcoma secondary to FD is necessary, and it seems important to make a careful diagnosis based not only on the pathological findings but also on imaging and clinical findings. Herein, we report on a case of FD of the proximal femur associated with intralesional extensive carti laginous differentiation in which a pathological fracture occurred during follow-up, with a review of the literature. PMID:27293399

  9. The Characterization of Mechanical Properties of a Rabbit Femur-Anterior Cruciate Ligament-Tibia Complex During Cyclic Loading

    NASA Astrophysics Data System (ADS)

    Sekiguchi, Hidetaka; Han, Jungsoo; Ryu, Jaiyoung; Han, Changsoo

    The purpose of this study was to investigate the effect of cyclic loading, which produced the condition of ACLs during sports activities, on tensile properties of femur-ACL-tibia complexes (FATCs). Paired FATCs of 40 New Zealand white rabbits were tested on a materials testing machine. One specimen of each pair was designated as a control and loaded until failure. The contralateral specimen was loaded cyclically (1.4 Hz, 1 hr.) with 20%, 30%, 40%, or 50% of ultimate tensile strength (UTS) of the control and then loaded until failure. The UTS and mode of failure were recorded after each test. Five specimens ruptured during cyclic loading in the 50% group. In the 40% group, the mean value of UTS of cycled specimens was significantly lower than that of controls. There was no statistically significant difference in UTS values between control and cycled specimens in the 20% and 30% groups. Cycled specimens had a significantly higher incidence of substance failure than controls. Our results demonstrated that FATCs have the strength to withstand cyclic loading within normal sports activity levels. However, FACTs can be damaged by cyclic loading under strenuous sports activity levels. We speculate that cyclic loading makes the ACL substance weaker than the insertion site.

  10. Differential expression of vascular endothelial growth factor in human fetal skeletal site-specific tissues: Mandible versus femur.

    PubMed

    Marini, Mirca; Bertolai, Roberto; Ambrosini, Stefano; Sarchielli, Erica; Vannelli, Gabriella Barbara; Sgambati, Eleonora

    2015-04-01

    Vascular endothelial growth factor (VEGF) is a well-known mediator that signals through pathways in angiogenesis and osteogenesis. Angiogenesis and bone formation are coupled during either skeletal development or bone remodeling and repair occurring in postnatal life. In this study, we examined for the first time the expression of VEGF in human fetal mandibular and femoral bone in comparison with the respective adult tissues. Similarly to other craniofacial bones, but at variance with the axial and appendicular skeleton, during development mandible does not arise from mesoderm but neural crest cells of the neuroectoderm germ layer, and undergoes intramembranous instead of endochondral ossification. By quantitative real-time PCR technique, we could show that VEGF gene expression levels were significantly higher in fetal than in adult samples, especially in femoral tissue. Western blotting analysis confirmed higher protein expression of VEGF in the fetal femur respect to the mandible. Moreover, immunohistochemistry revealed that in both fetal tissues VEGF expression was mainly localized in pre- and osteoblasts. Differential expression of VEGF in femoral and mandibular bone tissues could be related to their different structure, function and development during organogenesis. PMID:25769656

  11. Spaceflight has compartment- and gene-specific effects on mRNA levels for bone matrix proteins in rat femur

    NASA Technical Reports Server (NTRS)

    Evans, G. L.; Morey-Holton, E.; Turner, R. T.

    1998-01-01

    In the present study, we evaluated the possibility that the abnormal bone matrix produced during spaceflight may be associated with reduced expression of bone matrix protein genes. To test this possibility, we investigated the effects of a 14-day spaceflight (SLS-2 experiment) on steady-state mRNA levels for glyceraldehyde-3-phosphate dehydrogenase (GAPDH), osteocalcin, osteonectin, and prepro-alpha(1) subunit of type I collagen in the major bone compartments of rat femur. There were pronounced site-specific differences in the steady-state levels of expression of the mRNAs for the three bone matrix proteins and GAPDH in normal weight-bearing rats, and these relationships were altered after spaceflight. Specifically, spaceflight resulted in decreases in mRNA levels for GAPDH (decreased in proximal metaphysis), osteocalcin (decreased in proximal metaphysis), osteonectin (decreased in proximal and distal metaphysis), and collagen (decreased in proximal and distal metaphysis) compared with ground controls. There were no changes in mRNA levels for matrix proteins or GAPDH in the shaft and distal epiphysis. These results demonstrate that spaceflight leads to site- and gene-specific decreases in mRNA levels for bone matrix proteins. These findings are consistent with the hypothesis that spaceflight-induced decreases in bone formation are caused by concomitant decreases in expression of genes for bone matrix proteins.

  12. Using anisotropic 3D Minkowski functionals for trabecular bone characterization and biomechanical strength prediction in proximal femur specimens

    NASA Astrophysics Data System (ADS)

    Nagarajan, Mahesh B.; De, Titas; Lochmüller, Eva-Maria; Eckstein, Felix; Wismüller, Axel

    2014-04-01

    The ability of Anisotropic Minkowski Functionals (AMFs) to capture local anisotropy while evaluating topological properties of the underlying gray-level structures has been previously demonstrated. We evaluate the ability of this approach to characterize local structure properties of trabecular bone micro-architecture in ex vivo proximal femur specimens, as visualized on multi-detector CT, for purposes of biomechanical bone strength prediction. To this end, volumetric AMFs were computed locally for each voxel of volumes of interest (VOI) extracted from the femoral head of 146 specimens. The local anisotropy captured by such AMFs was quantified using a fractional anisotropy measure; the magnitude and direction of anisotropy at every pixel was stored in histograms that served as a feature vectors that characterized the VOIs. A linear multi-regression analysis algorithm was used to predict the failure load (FL) from the feature sets; the predicted FL was compared to the true FL determined through biomechanical testing. The prediction performance was measured by the root mean square error (RMSE) for each feature set. The best prediction performance was obtained from the fractional anisotropy histogram of AMF Euler Characteristic (RMSE = 1.01 ± 0.13), which was significantly better than MDCT-derived mean BMD (RMSE = 1.12 ± 0.16, p<0.05). We conclude that such anisotropic Minkowski Functionals can capture valuable information regarding regional trabecular bone quality and contribute to improved bone strength prediction, which is important for improving the clinical assessment of osteoporotic fracture risk.

  13. Late running is not too late against Alzheimer's pathology.

    PubMed

    Herring, Arne; Münster, Yvonne; Metzdorf, Judith; Bolczek, Bastien; Krüssel, Sarah; Krieter, David; Yavuz, Ilkay; Karim, Fro; Roggendorf, Constanze; Stang, Anthony; Wang, Yachao; Hermann, Dirk M; Teuber-Hanselmann, Sarah; Keyvani, Kathy

    2016-10-01

    In the last decade a vast number of animal studies have produced overwhelming evidence that exercise not only compensates for memory loss by increasing brain plasticity and cognitive reserve but also directly counteracts Alzheimer-like pathology when provided before disease onset or in early disease stages. But so far, there is little knowledge about therapeutic effects of training when started in advanced disease stages. In the present study we show that following seven months of sedentary life style five months of wheel running, started four months after disease onset was still able to mitigate at least some aspects of the full-blown Alzheimer's pathology in TgCRND8 mice. Late running had mild but significant effects on structural plasticity by increasing the dendritic complexity. It further reduced beta-amyloid (Aβ) plaque burden and enhanced Aβ clearance across the blood-brain barrier, along with attenuating microgliosis, inflammation, oxidative stress, and autophagy deficits, resulting in better memory performance and less agitation. However, unlike early exercise, late running did not affect abnormal amyloid precursor protein metabolism, tau pathology, or angiogenesis. These results allow concluding that it is never too late to counteract Alzheimer's disease with physical training but the earlier the intervention starts, the more pronounced is the therapeutic potential. PMID:27312772

  14. Comparative limb bone loading in the humerus and femur of the tiger salamander: testing the 'mixed-chain' hypothesis for skeletal safety factors.

    PubMed

    Kawano, Sandy M; Economy, D Ross; Kennedy, Marian S; Dean, Delphine; Blob, Richard W

    2016-02-01

    Locomotion imposes some of the highest loads upon the skeleton, and diverse bone designs have evolved to withstand these demands. Excessive loads can fatally injure organisms; however, bones have a margin of extra protection, called a 'safety factor' (SF), to accommodate loads that are higher than normal. The extent to which SFs might vary amongst an animal's limb bones is unclear. If the limbs are likened to a chain composed of bones as 'links', then similar SFs might be expected for all limb bones because failure of the system would be determined by the weakest link, and extra protection in other links could waste energetic resources. However, Alexander proposed that a 'mixed-chain' of SFs might be found amongst bones if: (1) their energetic costs differ, (2) some elements face variable demands, or (3) SFs are generally high. To test whether such conditions contribute to diversity in limb bone SFs, we compared the biomechanical properties and locomotor loading of the humerus and femur in the tiger salamander (Ambystoma tigrinum). Despite high SFs in salamanders and similar sizes of the humerus and femur that would suggest similar energetic costs, the humerus had lower bone stresses, higher mechanical hardness and larger SFs. SFs were greatest in the anatomical regions where yield stresses were highest in the humerus and lowest in the femur. Such intraspecific variation between and within bones may relate to their different biomechanical functions, providing insight into the emergence of novel locomotor capabilities during the invasion of land by tetrapods. PMID:26596535

  15. Fracture of the Femur of A Newborn after Cesarean Section for Breech Presentation and Fibroid Uterus : A Case Report and Literature Review

    PubMed Central

    Farikou, Ibrahima; Bernadette, Ngo Nonga; Daniel, Handy Eone; Aurélien, Sosso Maurice

    2014-01-01

    Introduction: The practice of cesarean section is known to decrease the occurrence of long bone fractures. We present here an unusual diaphyseal fracture of the femur of a newborn after cesarean section, the only case observed in our 14 years of practice. Case Report: The patient was a 3.4-kg female child born at 38 weeks of gestation. The mother was a primipara and aged 39 years. Ultrasound examination at 20th week revealed intrauterine fibroids with a breech presentation. Therefore, elective cesarean section was indicated. There was no apparent bone disorder that could predispose to sustain femur fracture. The fracture was treated successfully with a bilateral spica cast. The cesarean section was indicated in an aged primipara, bearer of uterine fibroids, and breech presentation. She had a good general health status, but her bone density was unknown since this examination is not routinely performed in our clinical settings in Africa. Conclusion: Elderly age, primipara status, presence of uterine fibroids, and breech presentation are usual indications for cesarean section. However, there are not many reports on femur fracture after cesarean section. Our present case suggests that despite the latest advances in delivery techniques, cesarean section for breech presentation predisposes the neonate to femoral fractures.

  16. Associations of Age, BMI, and Years of Menstruation with Proximal Femur Strength in Chinese Postmenopausal Women: A Cross-Sectional Study

    PubMed Central

    Kang, Huili; Chen, Yu-Ming; Han, Guiyuan; Huang, Hua; Chen, Wei-Qing; Wang, Xidan; Zhu, Ying-Ying; Xiao, Su-Mei

    2016-01-01

    This study aimed to elucidate the associations of age, BMI, and years of menstruation with proximal femur strength in Chinese postmenopausal women, which may improve the prediction of hip fracture risk. A cross-sectional study was conducted in 1322 Chinese postmenopausal women recruited from communities. DXA images were used to generate bone mineral density (BMD) and geometric parameters, including cross-sectional area (CSA), outer diameter (OD), cortical thickness (CT), section modulus (SM), buckling ratio (BR) at the narrow neck (NN), intertrochanter (IT), and femoral shaft (FS). Relationships of age, BMI, and years of menstruation with bone phenotypes were analyzed with the adjustment of height, age at menarche, total daily physical activity, education, smoking status, calcium tablet intake, etc. Age was associated with lower BMD, CSA, CT, SM, and higher BR (p < 0.05), which indicated a weaker bone strength at the proximal femur. BMI and years of menstruation had the positive relationships with proximal femur strength (p < 0.05). Further analyses showed that the ranges of absolute value of change slope per year, per BMI or per year of menstruation were 0.14%–1.34%, 0.20%–2.70%, and 0.16%–0.98%, respectively. These results supported that bone strength deteriorated with aging and enhanced with higher BMI and longer time of years of menstruation in Chinese postmenopausal women. PMID:26805871

  17. Implant augmentation: adding bone cement to improve the treatment of osteoporotic distal femur fractures: a biomechanical study using human cadaver bones.

    PubMed

    Wähnert, Dirk; Hofmann-Fliri, Ladina; Richards, R Geoff; Gueorguiev, Boyko; Raschke, Michael J; Windolf, Markus

    2014-11-01

    The increasing problems in the field of osteoporotic fracture fixation results in specialized implants as well as new operation methods, for example, implant augmentation with bone cement. The aim of this study was to determine the biomechanical impact of augmentation in the treatment of osteoporotic distal femur fractures.Seven pairs of osteoporotic fresh frozen distal femora were randomly assigned to either an augmented or nonaugmented group. In both groups, an Orthopaedic Trauma Association 33 A3 fractures was fixed using the locking compression plate distal femur and cannulated and perforated screws. In the augmented group, additionally, 1 mL of polymethylmethacrylate cement was injected through the screw. Prior to mechanical testing, bone mineral density (BMD) and local bone strength were determined. Mechanical testing was performed by cyclic axial loading (100 N to 750 N + 0.05N/cycle) using a servo-hydraulic testing machine.As a result, the BMD as well as the axial stiffness did not significantly differ between the groups. The number of cycles to failure was significantly higher in the augmented group with the BMD as a significant covariate.In conclusion, cement augmentation can significantly improve implant anchorage in plating of osteoporotic distal femur fractures. PMID:25415673

  18. Surgical Treatment of an Infected Nonunion of the Middle Third of the Femur Associated with Femoral Shortening in a Hemophilia Patient

    PubMed Central

    Salduz, Ahmet; Kaya, Özcan; Balci, Halil İbrahim; Akgul, Turgut; Dikici, Fatih; Zülfikar, Bülent; Kocaoğlu, Mehmet

    2016-01-01

    The management of nonunion and limb length discrepancy has remained a constant challenge in hemophilic patients. In this study, we aimed to present the treatment of femur infected nonunion and limb length discrepancy in a twenty-seven-year-old patient with hemophilia type A. A 27-year-old male patient with hemophilia type A referred to our institution for the treatment of right femur infected nonunion and 10 cm shortness of the femur. Resection of the nonunion site and bone-to-bone fixation with autologous bone grafting were performed. Compression to the pseudoarthrosis site and distraction from new osteotomy site were applied with the unilateral external fixator. Union was achieved, and 6 cm lengthening was obtained according to the initial length. Patient was followed up for 7 years. After this treatment, the patient is able to walk with full weight bearing on the affected extremity with 4 cm shortening which is compensated by the heel lift. The results of this case indicate that limb lengthening and treatment of nonunion with the external fixation could be reliable and effective method for hemophilic patients. PMID:27073706

  19. Automatic construction of an anatomical coordinate system for three-dimensional bone models of the lower extremities--pelvis, femur, and tibia.

    PubMed

    Kai, Shin; Sato, Takashi; Koga, Yoshio; Omori, Go; Kobayashi, Koichi; Sakamoto, Makoto; Tanabe, Yuji

    2014-03-21

    Automated methods for constructing patient-specific anatomical coordinate systems (ACSs) for the pelvis, femur and tibia were developed based on the bony geometry of each, derived from computed tomography (CT). The methods used principal axes of inertia, principal component analysis (PCA), cross-sectional area, and spherical and ellipsoidal surface fitting to eliminate the influence of rater's bias on reference landmark selection. Automatic ACSs for the pelvis, femur, and tibia were successfully constructed on each 3D bone model using the developed algorithm. All constructions were performed within 30s; furthermore, between- and within- rater errors were zero for a given CT-based 3D bone model, owing to the automated nature of the algorithm. ACSs recommended by the International Society of Biomechanics (ISB) were compared with the automatically constructed ACS, to evaluate the potential differences caused by the selection of the coordinate system. The pelvis ACSs constructed using the ISB-recommended system were tilted significantly more anteriorly than those constructed automatically (range, 9.6-18.8°). There were no significant differences between the two methods for the femur. For the tibia, significant differences were found in the direction of the anteroposterior axis; the anteroposterior axes identified by ISB were more external than those in the automatic ACS (range, 17.5-25.0°). PMID:24456665

  20. Forecasting Proximal Femur and Wrist Fracture Caused by a Fall to the Side during Space Exploration Missions to the Moon and Mars

    NASA Technical Reports Server (NTRS)

    Lewandowski, Beth E.; Myers, Jerry G.; Sulkowski, C.; Ruehl, K.; Licata, A.

    2008-01-01

    The possibility of bone fracture in space is a concern due to the negative impact it could have on a mission. The Bone Fracture Risk Module (BFxRM) developed at the NASA Glenn Research Center is a statistical simulation that quantifies the probability of bone fracture at specific skeletal locations for particular activities or events during space exploration missions. This paper reports fracture probability predictions for the proximal femur and wrist resulting from a fall to the side during an extravehicular activity (EVA) on specific days of lunar and Martian exploration missions. The risk of fracture at the proximal femur on any given day of the mission is small and fairly constant, although it is slightly greater towards the end of the mission, due to a reduction in proximal femur bone mineral density (BMD). The risk of wrist fracture is greater than the risk of hip fracture and there is an increased risk on Mars since it has a higher gravitational environment than the moon. The BFxRM can be used to help manage the risk of bone fracture in space as an engineering tool that is used during mission operation and resource planning.

  1. Late Onset Clozapine Induced Agranulocytosis

    PubMed Central

    Velayudhan, Rajmohan; Kakkan, Sushil

    2014-01-01

    Agranulocytosis is defined as an absolute neutrophil count less than 100/mm3 in association with infectious disease. The risk of agranulocytosis is 0.38% of all clozapine treated cases and there is a relatively lesser incidence in Indian population. The risk of clozapine-induced agranulocytosis and neutropenia is highest in the first 6 months and higher in the initial 18 months after the onset of treatment. There have been very few reports of neutropenia and agranulocytosis after this period. There have so far been no reports of late onset clozapine induced agranulocytosis has been reported from India. A case of late onset clozapine induced agranulocytosis with possible mechanism of the same is reported. PMID:25336778

  2. Information about the Late Effects of Polio

    MedlinePlus

    ... health professionals Handbook on the Late Effects of Poliomyelitis for Physicians and Survivors Late Effects of Polio ... Contact info@post-polio.org. Remember POLIO? Polio (poliomyelitis or infantile paralysis) triggers memories of closed swimming ...

  3. Melatonin can Ameliorate Radiation-Induced Oxidative Stress and Inflammation-Related Deterioration of Bone Quality in Rat Femur.

    PubMed

    Çakir, Zelal Ünlü; Demirel, Can; Kilciksiz, Sevil Cagiran; Gürgül, Serkan; Zincircioğlu, S Burhanedtin; Erdal, Nurten

    2016-06-01

    The aim of the present study was to evaluate the radioprotective effects of melatonin on the biomechanical properties of bone in comparison to amifostine (WR-2721). Forty Sprague Dawley rats were divided equally into 5 groups namely; control (C), irradiation (R; single dose of 50 Gy), irradiation + WR-2721 (R + WR-2721; irradiation + 200 mg/kg WR-2721) radiation + melatonin 25 mg/kg (R + M25; irradiation + 25 mg/kg melatonin), and radiation + melatonin 50 mg/kg (R + M50; irradiation + 50 mg/kg melatonin). In order to measure extrinsic (organ-level mechanical properties of bone; the ultimate strength, deformation, stiffness, energy absorption capacity) and intrinsic (tissue-level mechanical properties of bone; ultimate stress, ultimate strain, elastic modulus, toughness) features of the bone, a three-point bending (TPB) test was performed for biomechanical evaluation. In addition, a bone mineral density (BMD) test was carried out. The BMD and extrinsic properties of the diaphyseal femur were found to be significantly higher in the R + M25 group than in group R (p < 0.05). A significant increase was observed in R + M50 (p < 0.05) in comparison to group R in the cross-sectional area of the femoral shaft and elastic modulus parameter. The protective effect of melatonin was similar to that of WR-2721. Thus, biomechanical quality of irradiated bone can be ameliorated by free radical scavenger melatonin. PMID:27052631

  4. IINFLUENCE OF THE IMMUNOSUPPRESSANT TACROLIMUS (FK-506) ON THE FLEXURAL STRENGTH OF FEMUR: A STUDY IN RATS

    PubMed Central

    Pithon, Matheus Melo; de Andrade, Ana Carolina Dias Viana; de Brito Rodrigues, Vinícius; dos Santos, Rogério Lacerda

    2015-01-01

    Objective: To evaluate the resistance to femoral fractures among rats treated with the immunosuppressant tacrolimus FK-506 and compare these to untreated rats and rats treated with placebo. Methods: Ninety male Wistar rats were used. The animals were nine weeks old and weighed between 220 g and 280 g. The immunosuppressive agent tacrolimus was used in this study at a dose of 2 mg/kg/day, administered orally. The suspension was administered using an insulin syringe, and the maintenance therapeutic dose was sufficient to maintain the immunosuppressive activity. The animals were randomly divided into three groups (n = 30): group 1, no substance administered; group 2, administration of the immunosuppressant tacrolimus FK-506; and group 3, administration of the vehicle alone. Treatment with FK-506 was administered for 28 days. Total leukocyte counts and differential counts (lymphocytes, monocytes, eosinophils and neutrophils) were evaluated in order to monitor the immunosuppressive effect. Bone densitometry analysis by means of dual-energy x-ray absorptiometry (DXA) was also performed before and after administration of the drug. To evaluate the resistance to flexion, a support device was developed so that mechanical tests using an EMIC universal testing machine could be carried out. Results: The results from the flexion resistance tests showed statistical differences between groups 1 and 2 (p = 0.001) and between groups 2 and 3 (p = 0.001). No statistical difference was found between groups 1 and 3 (p = 0.995). Conclusions: The femurs of rats treated with the immunosuppressive agent had lower mechanical strength than did those of normal rats and those that received placebo. PMID:27022554

  5. Evaluation of laser photobiomodulation on bone defect in the femur of osteoporotic rats: a Raman spectral study

    NASA Astrophysics Data System (ADS)

    Soares, Luiz Guilherme P.; Aciole, Jouber Mateus d. S.; Neves, Bruno Luiz R. C.; Silveira, Landulfo; Pinheiro, Antônio L. B.

    2015-03-01

    Phototherapies have shown positive effects on the bone repair process, increasing the blood supply to the injured area. The aim of this study was to assess through Raman spectroscopy, the efficacy of laser phototherapy (λ = 780 nm, P = 70 mW, CW, 20.4 J/cm2 per session, 163.2 J/cm2 per treatment) on the bone repair process of osteoporotic rats. The osteoporosis induction was achieved by ovariectomy surgery. Thirty Wistar rats were divided into 4 groups (Basal; OVX, OVX + Clot and OVX + Clot + Laser), then subdivided into 2 subgroups according to the experimental time (15 and 30 days). After the osteoporosis induction time (60 days), a bone defect with 2 mm was created with a trephine drill in the right femur in the animals of groups OVX, Clot and Clot + Laser. After surgery, the irradiation protocol was applied in the same groups on repeated sessions every 48 hours during 15 days. The samples were analyzed by Raman Spectroscopy to assess the inorganic content of phosphate and carbonated hydroxyapatite (~960 and 1070 cm-1, respectively) and organic lipids and proteins (~1454 cm-1). Statistical analysis (ANOVA, Student-T test) showed significant difference between groups Basal, OVX + Clot, and OVX + Clot + Laser for the inorganic content peaks at ~960 (p≤0.001), and ~1070 cm-1 (p≤0.001) in both periods of 15 and 30 days, however on peak at ~1450 cm-1 no differences were detected. It was concluded that the Laser phototherapy increased deposition of HA on bone repair process of osteoporotic rats.

  6. The effect of hydroxyapatite coated screw in the lateral fragility fractures of the femur. A prospective randomized clinical study.

    PubMed

    Pesce, V; Maccagnano, G; Vicenti, G; Notarnicola, A; Moretti, L; Tafuri, S; Vanni, D; Salini, V; Moretti, B

    2014-01-01

    Due to a growing numbers of lateral fragility fractures of the femur and their high social costs the need to work out an effective strategy in order to find a better solution for these patients is warranted. From January 2010 to July 2011, we carried out a prospective randomized clinical study comparing the results of patients with femoral lateral fractures treated by nail and cephalic hydroxyapatite coated screws (study group including 27 patients) compared to the patients with the same fractures treated with nail and head standard screws (control group including 27 patients). We defined the two parts of the femoral neck as ROI 1 (under the head screw) and ROI 2 (above the femoral screw) on the AP view. The bone density of the two areas was calculated using DEXA at T0 (1st day post-surgery), at T1 (40th day post-surgery), at T2 (3 months later), at T3 (1 year later). The clinical-radiography evaluations were based on the Harris Hip Score (HHS), ADL test and x-ray views of the hip. As far as the bone mineral density average of ROI 1 and ROI 2 is concerned, we found a significant statistical increase at T1 and T3 in the study group, while it was not significant in the control group. We could account for this data through the higher mechanical stability of hydroxyapatite coated screws than standard screws. In fact, this material was responsible for improved implant osteointegration. Thanks to a 1 year follow-up we were able to demonstrate the implant utility associated with augmentation and the importance of densitometry exams such as easily repeatable and low cost diagnostics to prevent the onset of complications linked to screw loosening. PMID:24750798

  7. Low-level laser therapy to the mouse femur enhances the fungicidal response of neutrophils against Paracoccidioides brasiliensis.

    PubMed

    Burger, Eva; Mendes, Ana Carolina S C; Bani, Giulia M A C; Brigagão, Maísa R P L; Santos, Gérsika B; Malaquias, Luiz Cosme C; Chavasco, Jorge Kleber; Verinaud, Liana M; de Camargo, Zoilo P; Hamblin, Michael R; Sperandio, Felipe F

    2015-02-01

    Neutrophils (PMN) play a central role in host defense against the neglected fungal infection paracoccidioidomycosis (PCM), which is caused by the dimorphic fungus Paracoccidioides brasiliensis (Pb). PCM is of major importance, especially in Latin America, and its treatment relies on the use of antifungal drugs. However, the course of treatment is lengthy, leading to side effects and even development of fungal resistance. The goal of the study was to use low-level laser therapy (LLLT) to stimulate PMN to fight Pb in vivo. Swiss mice with subcutaneous air pouches were inoculated with a virulent strain of Pb or fungal cell wall components (Zymosan), and then received LLLT (780 nm; 50 mW; 12.5 J/cm2; 30 seconds per point, giving a total energy of 0.5 J per point) on alternate days at two points on each hind leg. The aim was to reach the bone marrow in the femur with light. Non-irradiated animals were used as controls. The number and viability of the PMN that migrated to the inoculation site was assessed, as well as their ability to synthesize proteins, produce reactive oxygen species (ROS) and their fungicidal activity. The highly pure PMN populations obtained after 10 days of infection were also subsequently cultured in the presence of Pb for trials of protein production, evaluation of mitochondrial activity, ROS production and quantification of viable fungi growth. PMN from mice that received LLLT were more active metabolically, had higher fungicidal activity against Pb in vivo and also in vitro. The kinetics of neutrophil protein production also correlated with a more activated state. LLLT may be a safe and non-invasive approach to deal with PCM infection. PMID:25675431

  8. Experiment K-6-01. Distribution and biochemistry of mineral and matrix in the femurs of rats

    NASA Technical Reports Server (NTRS)

    Arnaud, S.; Mechanic, G.; Buckendahl, P.; Bromage, T.; Boyde, A.; Elliott, J.; Katz, E.; Durnova, G

    1990-01-01

    Previous analyses of the composition of mineral and matrix in the bone of young rats following space flight has revealed deficits in calcium, phosphorus, and osteocalcin, a non-collagenous protein, without an associated decrease in collagen. To characterize the location and nature of this mineralization defect in a weight bearing long bone, the femur, researchers attempted to relate the spatial distribution of mineral in situ in the proximal, central and distal thirds of the femoral diaphysis to the biochemical composition of bone from the same area. Biochemical analyses revealed lower concentrations of calcium, phosphorus and osteocalcin but not collagen only in the central third of the diaphysis of the flight animals (F) compared to synchronous controls (S). Collagen concentration was reduced only in the proximal third of the diaphysis, where all 3 crosslinks, expressed as nM/mol collagen were higher in F than S. A new technique, x ray microtomography, with a resolution of 26 microns, was used to obtain semi-quantitative data on mineral distribution in reconstructed sections of wet whole bone. To improve the resolution of the mineral density distribution, images of the surfaces of cut sections were analyzed by backscattered electrons in a scanning electron microscope (BSE). There was good agreement between the results of the two stereochemical techniques which revealed distinct patterns of mineralization in transverse and longitudinal directions of the diaphysis. The novel methodology developed for this flight experiment shows considerable promise in elucidating the biochemical nature of what appear to be regional alterations in the mineralization of long bones of animals exposed to spaceflight.

  9. Rotational assessment of distal femur and its relevance in total knee arthroplasty: analysis by magnetic resonance imaging*

    PubMed Central

    Loures, Fabricio Bolpato; Furtado Neto, Sebastião; Pinto, Robson de Lima; Kinder, André; Labronici, Pedro José; Góes, Rogério Franco de Araújo; Marchiori, Edson

    2015-01-01

    Objective To define the distal femur rotation pattern in a Brazilian population, correlating such pattern with the one suggested by the arthroplasty instruments, and analyzing the variability of each anatomic parameter. Materials and Methods A series of 101 magnetic resonance imaging studies were evaluated in the period between April and June 2012. The epidemiological data collection was performed with the aid of the institution’s computed imaging system, and the sample included 52 male and 49 female patients. The measurements were made in the axial plane, with subsequent correlation and triangulation with the other plans. The posterior condylar line was used as a reference for angle measurements. Subsequently, the anatomical and surgical transepicondylar axes and the anteroposterior trochlear line were specified. The angles between the reference line and the studied lines were calculated with the aid of the institution’s software. Results The mean angle between the anatomical transepicondylar axis and the posterior condylar line was found to be 6.89°, ranging from 0.25° to 12°. For the surgical transepicondylar axis, the mean value was 2.89°, ranging from –2.23° (internal rotation) to 7.86°, and for the axis perpendicular to the anteroposterior trochlear line, the mean value was 4.77°, ranging from –2.09° to 12.2°. Conclusion The anatomical transepicondylar angle showed mean values corresponding to the measurement observed in the Caucasian population. The utilized instruments are appropriate, but no anatomical parameter proved to be steady enough to be used in isolation. PMID:26543278

  10. Late blight – Is resistance futile?

    Technology Transfer Automated Retrieval System (TEKTRAN)

    This article will provide an overview of late blight resistance research that has been done within the USDA/ARS and the University of Wisconsin-Madison. The article is meant to be an informative look at the history of late blight resistance and the ability of the late blight pathogen to overcome res...

  11. 24 CFR 241.1105 - Late charges.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 2 2011-04-01 2011-04-01 false Late charges. 241.1105 Section 241...-Eligibility Requirements § 241.1105 Late charges. The note and security instrument may provide for the lender's collection of a late charge, not to exceed 2 cents for each dollar of each payment to interest...

  12. 24 CFR 242.38 - Late charge.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Late charge. 242.38 Section 242.38... FOR HOSPITALS Mortgage Requirements § 242.38 Late charge. The mortgage may provide for the collection by the mortgagee of a late charge in accordance with terms, conditions, and standards of HUD for...

  13. 24 CFR 235.1216 - Late charge.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Late charge. 235.1216 Section 235... § 235.1216 Late charge. The mortgage may provide for the collection by the mortgagee of a late charge... date upon which payment is due. Such charge shall not be included in the assistance payment....

  14. 12 CFR 560.33 - Late charges.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 5 2011-01-01 2011-01-01 false Late charges. 560.33 Section 5