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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. Late neandertals in southeastern Iberia: Sima de las Palomas del Cabezo Gordo, Murcia, Spain.

    PubMed

    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

    2008-12-30

    Middle Paleolithic fossil human remains from the Sima de las Palomas in southeastern Iberia (dated to 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.

  4. 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

  5. New data on the late Neandertals: direct dating of the Belgian Spy fossils.

    PubMed

    Semal, Patrick; Rougier, Hélène; Crevecoeur, Isabelle; Jungels, Cécile; Flas, Damien; Hauzeur, Anne; Maureille, Bruno; Germonpré, Mietje; Bocherens, Hervé; Pirson, Stéphane; Cammaert, Laurence; De Clerck, Nora; Hambucken, Anne; Higham, Thomas; Toussaint, Michel; van der Plicht, Johannes

    2009-04-01

    In Eurasia, the period between 40,000 and 30,000 BP saw the replacement of Neandertals by anatomically modern humans (AMH) during and after the Middle to Upper Paleolithic transition. The human fossil record for this period is very poorly defined with no overlap between Neandertals and AMH on the basis of direct dates. Four new (14)C dates were obtained on the two adult Neandertals from Spy (Belgium). The results show that Neandertals survived to at least approximately 36,000 BP in Belgium and that the Spy fossils may be associated to the Lincombian-Ranisian-Jerzmanowician, a transitional techno-complex defined in northwest Europe and recognized in the Spy collections. The new data suggest that hypotheses other than Neandertal acculturation by AMH may be considered in this part of Europe.

  6. 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

  7. The origin of Neandertals

    PubMed Central

    Hublin, J. J.

    2009-01-01

    Western Eurasia yielded a rich Middle (MP) and Late Pleistocene (LP) fossil record documenting the evolution of the Neandertals that can be analyzed in light of recently acquired paleogenetical data, an abundance of archeological evidence, and a well-known environmental context. Their origin likely relates to an episode of recolonization of Western Eurasia by hominins of African origin carrying the Acheulean technology into Europe around 600 ka. An enhancement of both glacial and interglacial phases may have played a crucial role in this event, as well as in the subsequent evolutionary history of the Western Eurasian populations. In addition to climatic adaptations and an increase in encephalization, genetic drift seems to have played a major role in their evolution. To date, a clear speciation event is not documented, and the most likely scenario for the fixation of Neandertal characteristics seems to be an accretion of features along the second half of the MP. Although a separation time for the African and Eurasian populations is difficult to determine, it certainly predates OIS 11 as phenotypic Neandertal features are documented as far back as and possibly before this time. It is proposed to use the term “Homo rhodesiensis” to designate the large-brained hominins ancestral to H. sapiens in Africa and at the root of the Neandertals in Europe, and to use the term “Homo neanderthalensis” to designate all of the specimens carrying derived metrical or non-metrical features used in the definition of the LP Neandertals. PMID:19805257

  8. 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

  9. 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

    2016-07-06

    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.

  10. 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

  11. The expert Neandertal mind.

    PubMed

    Wynn, Thomas; Coolidge, Frederick L

    2004-04-01

    Cognitive neuropsychology, cognitive anthropology, and cognitive archaeology are combined to yield a picture of Neandertal cognition in which expert performance via long-term working memory is the centerpiece of problem solving. This component of Neandertal cognition appears to have been modern in scope. However, Neandertals' working memory capacity, which is the ability to hold a variety of information in active attention, may not have been as large as that of modern humans. This characteristic helps us understand features of the archaeological record, such as the rarity of innovation, and allows us to make empirically based speculations about Neandertal personality.

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

    PubMed

    Curnoe, Darren; Ji, Xueping; 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.

  13. 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

  14. Early and late intramedullary nailing of femur fracture: A single center experience

    PubMed Central

    Alobaidi, Ahmad S.; Al-Hassani, Ammar; El-Menyar, Ayman; Abdelrahman, Husham; Tuma, Mazin; Al-Thani, Hassan; Aldosari, Mohammed A.

    2016-01-01

    Background: Femur fracture (FF) is a common injury, and intramedullary nailing (IMN) is the standard surgical fixation. However, the time of intervention remains controversial. We aimed to describe the reamed IMN (rIMN) timing and hospital outcomes in trauma patients presenting with FF. Materials and Methods: A retrospective analysis was conducted for all patients admitted with FF and they underwent fixation at level 1 trauma unit between January 2010 and January 2012. Patients were divided into Group I with early rIMN (<12 h) and Group II with late rIMN (≥12 h). Patients’ demographics, clinical presentations, mechanism of injury, pulmonary complications, organ failure, length of stay, and mortality were described. Results: A total of 307 eligible patients with FF were identified (156 patients in Group I and 151 patients in Group II). Patients in Group II were older (36 ± 18 vs. 29 ± 9; P = 0.001) and had higher rate of polytrauma (35% vs. 18%, P = 0.001), head injury (5% vs. 12%, P = 0.68) and bilateral FF (10.7% vs. 5.1%; P = 0.07) in comparison to Group I. Group II had longer stay in Intensive Care Unit (7 [1–56] vs. 2 [1–17] days; P = 0.009) and hospital (13 [2–236] vs. 9 [1–367]; P = 0.001). There were no significant differences in outcomes between the two groups in terms of sepsis, renal failure, fat embolism, adult respiratory distress syndrome and death. Conclusions: Based on this analysis, we believe that early rIMN is safe in appropriately selected cases. In patients with traumatic FFs, early rIMN is associated with low hospital complications and shorter hospital stay. The rate of pulmonary complications is almost the same in the early and late group. Further prospective randomized studies with large sample size would be ideal using the information garnered from the present study. PMID:27722116

  15. 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.

  16. 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

  17. Lower limb entheseal morphology in the Neandertal Krapina population (Croatia, 130,000 BP).

    PubMed

    Mariotti, Valentina; Belcastro, Maria Giovanna

    2011-06-01

    Although the Neandertal locomotor system has been shown to differ from Homo sapiens, characteristics of Neandertal entheses, the skeletal attachments for muscles, tendons, ligaments and joint capsules, have never been specifically investigated. Here, we analyse lower limb entheses of the Krapina Neandertal bones (Croatia, 130,000 BP) with the aim of determining how they compare with modern humans, using a standard developed by our research group for describing modern human entheseal variability. The entheses examined are those of the gluteus maximus, iliopsoas and vastus medialis on the femur, the quadriceps tendon on the patella, and soleus on the tibia. For the entheses showing a different morphological pattern from H. sapiens, we discuss the possibility of recognising genetic versus environmental causes. Our results indicate that only the gluteus maximus enthesis (the gluteal tuberosity), falls out of the modern human range of variation. It displays morphological features that could imply histological differences from modern humans, in particular the presence of fibrocartilage. In both H. sapiens and the Krapina Neandertals, the morphological pattern of this enthesis is the same in adult and immature femurs. These results can be interpreted in light of genetic differences between the two hominins. The possibility of functional adaptations to higher levels of mechanical load during life in the Neandertals seems less likely. The particular morphology and large dimensions of the Krapina enthesis, and perhaps its fibrocartilaginous nature, could have been selected for in association with other pelvic and lower limb characteristics, even if genetic drift cannot be ruled out.

  18. A Draft Sequence of the Neandertal Genome

    PubMed Central

    Green, Richard E.; Li, Heng; Zhai, Weiwei; Fritz, Markus Hsi-Yang; Hansen, Nancy F.; Durand, Eric Y.; Malaspinas, Anna-Sapfo; Jensen, Jeffrey D.; Marques-Bonet, Tomas; Alkan, Can; Prüfer, Kay; Meyer, Matthias; Burbano, Hernán A.; Good, Jeffrey M.; Schultz, Rigo; Aximu-Petri, Ayinuer; Butthof, Anne; Höber, Barbara; Höffner, Barbara; Siegemund, Madlen; Weihmann, Antje; Nusbaum, Chad; Lander, Eric S.; Russ, Carsten; Novod, Nathaniel; Affourtit, Jason; Egholm, Michael; Verna, Christine; Rudan, Pavao; Brajkovic, Dejana; Kucan, Željko; Gušic, Ivan; Doronichev, Vladimir B.; Golovanova, Liubov V.; Lalueza-Fox, Carles; de la Rasilla, Marco; Fortea, Javier; Rosas, Antonio; Schmitz, Ralf W.; Johnson, Philip L. F.; Eichler, Evan E.; Falush, Daniel; Birney, Ewan; Mullikin, James C.; Slatkin, Montgomery; Nielsen, Rasmus; Kelso, Janet; Lachmann, Michael; Reich, David; Pääbo, Svante

    2016-01-01

    Neandertals, the closest evolutionary relatives of present-day humans, lived in large parts of Europe and western Asia before disappearing 30,000 years ago. We present a draft sequence of the Neandertal genome composed of more than 4 billion nucleotides from three individuals. Comparisons of the Neandertal genome to the genomes of five present-day humans from different parts of the world identify a number of genomic regions that may have been affected by positive selection in ancestral modern humans, including genes involved in metabolism and in cognitive and skeletal development. We show that Neandertals shared more genetic variants with present-day humans in Eurasia than with present-day humans in sub-Saharan Africa, suggesting that gene flow from Neandertals into the ancestors of non-Africans occurred before the divergence of Eurasian groups from each other. PMID:20448178

  19. 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

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

    PubMed

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

    2012-11-13

    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.

  1. Absolute and relative endocranial size in Neandertals and later Pleistocene Homo.

    PubMed

    Gallagher, Andrew

    2014-10-01

    Eurasian Neandertals encompass the entire observed range of recent and fossil Homo sapiens in absolute, but not relative endocranial volume, and Neandertals attest an average EQ significantly lower than their Upper Pleistocene successors. While the cognitive, social, and evolutionary implications of this phenomenon have been emphasised, the statistical basis of a mean inference of EQ in the Neandertal hypodigm has not been appropriately demonstrated. A demonstrable male bias in the available postcranial, not cranial, series has skewed perceptions of Neandertal brain-to-body size scaling towards a rejection of the null hypothesis. A simple resolution to this problem is a concise assessment of paired associated covariates against a suitable recent human comparator series. Permutations of Fisher's z and Student's t statistics are valid metrics in tests of significance in single datum hypotheses. Bootstrapped single observation tests determined significance in body size, absolute and relative endocranial volume in Pleistocene archaic, early modern, and late Pleistocene H. sapiens. With respect to absolute ECV, all current Middle-Upper Pleistocene crania fall within the substantial recent Homo range. Nevertheless, simple indices derived from raw and modified data in normal and logarithmic space reveal that Western European Neandertal males approach the lower extremes of our observed size range in relative ECV, yet none exceed statistical significance. Results confirm that relative ECV/brain size in Neandertals was not significantly depressed relative to recent and fossil H. sapiens and this is consistent with a substantial body of data from living humans dismissing any simple correspondence of relative brain size with intelligence and, by extension, evolutionary success.

  2. 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

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

    PubMed

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

    2006-01-17

    The 1998/1999 direct dating of two Neandertal specimens from level G(1) of Vindija Cave in Croatia to approximately 28,000 and approximately 29,000 radiocarbon ((14)C) 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 G(1) Neandertal fossils are redated to approximately 32,000-33,000 (14)C 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.

  4. Neandertal mandibles from the Sima de las Palomas del Cabezo Gordo, Murcia, southeastern Spain.

    PubMed

    Walker, Michael J; Lombardi, A Vincent; Zapata, Josefina; Trinkaus, Erik

    2010-06-01

    The Middle Paleolithic levels of the Sima de las Palomas have yielded eight partial mandibles (Palomas 1, 6, 7, 23, 49, 59, 80, and 88). Palomas 7, 49, 80, and 88 are immature, and Palomas 49, 59, 80, and 88 are among the latest Neandertals (approximately 40,000 cal BP). Palomas 1 is geologically older (approximately 50,000-60,000 cal BP), and the other three were found ex situ. The mandibles exhibit a suite of characteristics that align them with the Neandertals among later Pleistocene humans, including symphyseal morphology, symphyseal orientation, corpus robusticity, distal mental foramen position, retromolar space presence, wide immature dental arcade, and high-coronoid process with an asymmetrical mandibular notch. However, Palomas 6 lacks a retromolar space, Palomas 59 has a narrow lateral corpus, and Palomas 80 has a mesial mental foramen and open mandibular foramen. The Palomas mandibles therefore help to document that the late Middle Paleolithic of southern Iberia was the product of Neandertals. They also reinforce the presence of variability in both metric and discrete aspects of Neandertal mandibular morphology, both within and across samples, some of which may be temporal and/or geographic in nature.

  5. The Neandertal vertebral column 1: the cervical spine.

    PubMed

    Gómez-Olivencia, Asier; Been, Ella; Arsuaga, Juan Luis; Stock, Jay T

    2013-06-01

    This paper provides a metric analysis of the Neandertal cervical spine in relation to modern human variation. All seven cervical vertebrae have been analysed. Metric data from eight Neandertal individuals are compared with a large sample of modern humans. The significance of morphometric differences is tested using both z-scores and two-tailed Wilcoxon signed rank tests. The results identify significant metric and morphological differences between Neandertals and modern humans in all seven cervical vertebrae. Neandertal vertebrae are mediolaterally wider and dorsoventrally longer than modern humans, due in part to longer and more horizontally oriented spinous processes. This suggests that Neandertal cervical morphology was more stable in both mid-sagittal and coronal planes. It is hypothesized that the differences in cranial size and shape in the Neandertal and modern human lineages from their Middle Pleistocene ancestors could account for some of the differences in the neck anatomy between these species.

  6. Dynamics of genetic and morphological variability within Neandertals.

    PubMed

    Hawks, John

    2012-01-01

    Paleogenomics may suggest changes to the way anthropologists have discussed the dynamics and morphological diversity among Neandertals. Genetic comparisons show that later Neandertals had relatively low autosomal genetic variation compared to recent humans. The known mitochondrial sample from Neandertals covers a broader geographic and temporal range, and shows greater diversity. This review addresses how genetic data compare to morphological and archaeological evidence about Neandertal variation and dynamics. Traditional views emphasized the morphological differences between western and eastern Neandertal populations, and between early and later Neandertals. Genomes broadly support these groupings, without resolving the outstanding question of the affinities of specimens from southwest Asia. However, the pattern of genetic variation appears to reject a long, in situ transformation of Neandertal groups over time, suggesting instead a more rapid process of regional dispersal and partial population replacement. Archaeological indicators sample dynamics on a much finer timescale than morphological or genetic evidence, and point to dispersal and turnover among Neandertals on a regional scale. In this way, genetic evidence may provide a bridge between the timescales relevant to morphological and archaeological comparisons. New ways of looking at the morphology of Neandertals may yield a better picture of their interactions and movements.

  7. IBD Sharing between Africans, Neandertals, and Denisovans

    PubMed Central

    Povysil, Gundula

    2016-01-01

    Interbreeding between ancestors of humans and other hominins outside of Africa has been studied intensively, while their common history within Africa still lacks proper attention. However, shedding light on human evolution in this time period about which little is known, is essential for understanding subsequent events outside of Africa. We investigate the genetic relationships of humans, Neandertals, and Denisovans by identifying very short DNA segments in the 1000 Genomes Phase 3 data that these hominins share identical by descent (IBD). By focusing on low frequency and rare variants, we identify very short IBD segments with high confidence. These segments reveal events from a very distant past because shorter IBD segments are presumably older than longer ones. We extracted two types of very old IBD segments that are not only shared among humans, but also with Neandertals and/or Denisovans. The first type contains longer segments that are found primarily in Asians and Europeans where more segments are found in South Asians than in East Asians for both Neandertal and Denisovan. These longer segments indicate complex admixture events outside of Africa. The second type consists of shorter segments that are shared mainly by Africans and therefore may indicate events involving ancestors of humans and other ancient hominins within Africa. Our results from the autosomes are further supported by an analysis of chromosome X, on which segments that are shared by Africans and match the Neandertal and/or Denisovan genome were even more prominent. Our results indicate that interbreeding with other hominins was a common feature of human evolution starting already long before ancestors of modern humans left Africa. PMID:28158547

  8. 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

  9. Morphology and function of Neandertal and modern human ear ossicles

    PubMed Central

    David, Romain; Gunz, Philipp; Schmidt, Tobias; Spoor, Fred; Hublin, Jean-Jacques

    2016-01-01

    The diminutive middle ear ossicles (malleus, incus, stapes) housed in the tympanic cavity of the temporal bone play an important role in audition. The few known ossicles of Neandertals are distinctly different from those of anatomically modern humans (AMHs), despite the close relationship between both human species. Although not mutually exclusive, these differences may affect hearing capacity or could reflect covariation with the surrounding temporal bone. Until now, detailed comparisons were hampered by the small sample of Neandertal ossicles and the unavailability of methods combining analyses of ossicles with surrounding structures. Here, we present an analysis of the largest sample of Neandertal ossicles to date, including many previously unknown specimens, covering a wide geographic and temporal range. Microcomputed tomography scans and 3D geometric morphometrics were used to quantify shape and functional properties of the ossicles and the tympanic cavity and make comparisons with recent and extinct AMHs as well as African apes. We find striking morphological differences between ossicles of AMHs and Neandertals. Ossicles of both Neandertals and AMHs appear derived compared with the inferred ancestral morphology, albeit in different ways. Brain size increase evolved separately in AMHs and Neandertals, leading to differences in the tympanic cavity and, consequently, the shape and spatial configuration of the ossicles. Despite these different evolutionary trajectories, functional properties of the middle ear of AMHs and Neandertals are largely similar. The relevance of these functionally equivalent solutions is likely to conserve a similar auditory sensitivity level inherited from their last common ancestor. PMID:27671643

  10. Neandertal DNA sequences and the origin of modern humans.

    PubMed

    Krings, M; Stone, A; Schmitz, R W; Krainitzki, H; Stoneking, M; Pääbo, S

    1997-07-11

    DNA was extracted from the Neandertal-type specimen found in 1856 in western Germany. By sequencing clones from short overlapping PCR products, a hitherto unknown mitochondrial (mt) DNA sequence was determined. Multiple controls indicate that this sequence is endogenous to the fossil. Sequence comparisons with human mtDNA sequences, as well as phylogenetic analyses, show that the Neandertal sequence falls outside the variation of modern humans. Furthermore, the age of the common ancestor of the Neandertal and modern human mtDNAs is estimated to be four times greater than that of the common ancestor of human mtDNAs. This suggests that Neandertals went extinct without contributing mtDNA to modern humans.

  11. 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

  12. Pediatric Thighbone (Femur) Fracture

    MedlinePlus

    .org Thighbone (Femur) Fractures In Children Page ( 1 ) The thighbone (femur) is the largest and strongest bone in the body. It can break ... Cause Statistics The most common cause of thighbone fractures in infants under 1 year old is child ...

  13. Femur fracture repair - discharge

    MedlinePlus

    ... page: //medlineplus.gov/ency/patientinstructions/000166.htm Femur fracture repair - discharge To use the sharing features on this page, please enable JavaScript. You had a fracture (break) in the femur in your leg. It ...

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

    PubMed

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

    2016-04-07

    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.

  15. The Divergence of Neandertal and Modern Human Y Chromosomes

    PubMed Central

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

    2016-01-01

    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

  16. 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.

  17. 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

  18. Genetic characterization of the ABO blood group in Neandertals

    PubMed Central

    2008-01-01

    Background The high polymorphism rate in the human ABO blood group gene seems to be related to susceptibility to different pathogens. It has been estimated that all genetic variation underlying the human ABO alleles appeared along the human lineage, after the divergence from the chimpanzee lineage. A paleogenetic analysis of the ABO blood group gene in Neandertals allows us to directly test for the presence of the ABO alleles in these extinct humans. Results We have analysed two male Neandertals that were retrieved under controlled conditions at the El Sidron site in Asturias (Spain) and that appeared to be almost free of modern human DNA contamination. We find a human specific diagnostic deletion for blood group O (O01 haplotype) in both Neandertal individuals. Conclusion These results suggest that the genetic change responsible for the O blood group in humans predates the human and Neandertal divergence. A potential selective event associated with the emergence of the O allele may have therefore occurred after humans separated from their common ancestor with chimpanzees and before the human-Neandertal population divergence. PMID:19108732

  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.

  20. The vertebral column of the Regourdou 1 Neandertal.

    PubMed

    Gómez-Olivencia, Asier; Couture-Veschambre, Christine; Madelaine, Stéphane; Maureille, Bruno

    2013-06-01

    The Regourdou 1 partial skeleton was found in 1957 in level IV of the eponymous site located in Montignac-sur-Vézère (Dordogne, France) and until now it has been only partially published. The ongoing revision of the faunal remains from the site has yielded additional fossils that pertain to this skeleton. Here we study the vertebral column of this individual, providing for the first time detailed descriptions for all of the fossils and reassessing the anatomical position of all of the fragments. The vertebral column of Regourdou 1 is one of the most complete in the Neandertal fossil record with at least 20 pre-sacral vertebrae (seven cervicals, nine thoracic and four lumbars), a partial sacrum and a fragmentary first coccygeal vertebra. When compared with modern humans, the vertebrae of Regourdou 1 display significant metric differences, and fit well within the range of Neandertal variability. A preliminary analysis of the most complete thoracic vertebrae of this individual indicates that Neandertals displayed significant differences from modern humans in the thoracic spine, which adds to the differences already observed in the cervical and lumbar regions. Finally, we have also observed mild signs of osteoarthrosis, albeit to a lower degree of that present in other Neandertals such as La Chapelle-aux-Saints, La Ferrassie 1 or Shanidar 3. This is consistent with the younger adult age for Regourdou 1.

  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. Functional morphology of the Neandertal scapular glenoid fossa.

    PubMed

    Macias, Marisa E; Churchill, Steven E

    2015-01-01

    Neandertals and Homo sapiens are known to differ in scapular glenoid fossa morphology. Functional explanations may be appropriate for certain aspects of glenoid fossa morphology; however, other factors--e.g., allometry, evolutionary development--must be addressed before functional morphology is considered. Using three-dimensional geometric morphometrics, shape of the scapular glenoid fossa was compared among Neandertals, early and recent modern humans, chimpanzees, orangutans, Australopithecus afarensis, and Au. sediba. Permutation analysis revealed that side, sex, and lifestyle did not correlate with shape. Of the features we found to differ between groups, anterior glenoid rim morphology and fossa curvature did not correlate with the aforementioned shape variables; thus, a functional explanation is appropriate for these components of glenoid fossa shape. Shared morphology among recent humans and chimpanzees (to the exclusion of Neandertals and orangutans) suggests independent forces contributing to these morphological configurations. Potential explanations include adaptations to habitual behavior and locomotor adaptations in the scapulae of recent humans and chimpanzees; these explanations are supported by clinical and experimental literature. The absence of these morphological features in Neandertals may support the lack of these selective forces on their scapular glenoid fossa morphology.

  3. Genetic evidence for patrilocal mating behavior among Neandertal groups

    PubMed Central

    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

  4. 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

  5. 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

  6. 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

  7. 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.

  8. 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

  9. Anterior dental microwear textures show habitat-driven variability in Neandertal behavior.

    PubMed

    Krueger, Kristin L; Ungar, Peter S; Guatelli-Steinberg, Debbie; Hublin, Jean-Jacques; Pérez-Pérez, Alejandro; Trinkaus, Erik; Willman, John C

    2017-04-01

    The causes of Neandertal anterior tooth wear patterns, including labial rounding, labial scratches, and differential anterior-posterior wear, have been debated for decades. The most common explanation is the "stuff-and-cut" hypothesis, which describes Neandertals clamping down on a piece of meat and slicing a portion close to their lips. "Stuff-and-cut" has been accepted as a general aspect of Neandertal behavior without fully assessing its variability. This study analyzes anterior dental microwear textures across habitats, locations, and time intervals to discern possible variation in Neandertal anterior tooth-use behavior. Forty-five Neandertals from 24 sites were analyzed, represented by high-resolution replicas of permanent anterior teeth. The labial surface was scanned for antemortem microwear using a white-light confocal profiler. The resultant 3D-point clouds, representing 204 × 276 μm for each specimen, were uploaded into SSFA software packages for texture characterization. Statistical analyses, including MANOVAs, ANOVAs, and pairwise comparisons, were completed on ranked microwear data. Neandertal descriptive statistics were also compared to 10 bioarchaeological samples of known or inferred dietary and behavioral regimes. The Neandertal sample varied significantly by habitat, suggesting this factor was a principal driving force for differences in Neandertal anterior tooth-use behaviors. The Neandertals from open habitats showed significantly lower anisotropy and higher textural fill volume than those inhabiting more closed, forested environments. The texture signature from the open-habitat Neandertals was most similar to that of the Ipiutak and Nunavut, who used their anterior teeth for intense clamping and grasping behaviors related to hide preparation. Those in more closed habitats were most similar to the Arikara, who did not participate in non-dietary behaviors. These Neandertal individuals had a broad range of texture values consistent with non

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

    PubMed Central

    Weaver, Timothy D.; Stringer, Chris B.

    2015-01-01

    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

  11. Neandertal demise: an archaeological analysis of the modern human superiority complex.

    PubMed

    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.

  12. 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.

  13. 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

  14. 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

  15. Dating the demise: neandertal extinction and the establishment of modern humans in the southern Caucasus.

    PubMed

    Adler, Daniel S; Bar-Yosef, Ofer; Belfer-Cohen, Anna; Tushabramishvili, Nicholas; Boaretto, E; Mercier, N; Valladas, H; Rink, W J

    2008-11-01

    This paper considers the recent radiometric dating (14C-AMS, TL, ESR) of 76 late Middle and early Upper Paleolithic samples from Ortvale Klde Rockshelter, located in the Republic of Georgia. We present a critical evaluation of each date based on its stratigraphic and archaeological context, its pretreatment and contamination history, and its resulting accuracy and precision, the goal being to establish a sound chronology for the site. Only by systematically identifying aberrant dates within a data set and isolating them from further analysis can we hope to understand cultural and biological phenomena on an accurate temporal scale. Based on the strict discard protocol outlined here, we omit 25% of the dated samples from the analysis. The remaining data speak to the lengthy tenure of Neandertals in the region, but also to their relatively rapid demise and the establishment of modern human populations approximately 38-34 ka 14C BP (42-39 kacalBP(Hulu)). We compare these chronometric data with those from the neighboring sites of Bronze and Dzudzuana caves, as well as Mezmaiskaya Cave, located in the northern Caucasus. While the lack of key contextual information limit our ability to subject these other data sets to the same critical evaluation procedure, they provide the first interregional temporal assessment of the Middle to Upper Paleolithic "transition," the results of which suggest an initial expansion of modern humans into the southern Caucasus followed by expansion along the Black Sea coast and into the northern Caucasus.

  16. Selection and reduced population size cannot explain higher amounts of Neandertal ancestry in East Asian than in European human populations.

    PubMed

    Kim, Bernard Y; Lohmueller, Kirk E

    2015-03-05

    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.

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

    PubMed

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

    2011-06-21

    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.

  18. 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

  19. Archaeology. The makers of the Protoaurignacian and implications for Neandertal extinction.

    PubMed

    Benazzi, S; Slon, V; Talamo, S; Negrino, F; Peresani, M; Bailey, S E; Sawyer, S; Panetta, D; Vicino, G; Starnini, E; Mannino, M A; Salvadori, P A; Meyer, M; Pääbo, S; Hublin, J-J

    2015-05-15

    The Protoaurignacian culture is pivotal to the debate about the timing of the arrival of modern humans in western Europe and the demise of Neandertals. However, which group is responsible for this culture remains uncertain. We investigated dental remains associated with the Protoaurignacian. The lower deciduous incisor from Riparo Bombrini is modern human, based on its morphology. The upper deciduous incisor from Grotta di Fumane contains ancient mitochondrial DNA of a modern human type. These teeth are the oldest human remains in an Aurignacian-related archaeological context, confirming that by 41,000 calendar years before the present, modern humans bearing Protoaurignacian culture spread into southern Europe. Because the last Neandertals date to 41,030 to 39,260 calendar years before the present, we suggest that the Protoaurignacian triggered the demise of Neandertals in this area.

  20. Hand to Mouth in a Neandertal: Right-Handedness in Regourdou 1

    PubMed Central

    Volpato, Virginie; Macchiarelli, Roberto; Guatelli-Steinberg, Debbie; Fiore, Ivana; Bondioli, Luca; Frayer, David W.

    2012-01-01

    We describe and analyze a Neandertal postcranial skeleton and dentition, which together show unambiguous signs of right-handedness. Asymmetries between the left and right upper arm in Regourdou 1 were identified nearly 20 years ago, then confirmed by more detailed analyses of the inner bone structure for the clavicle, humerus, radius and ulna. The total pattern of all bones in the shoulder and arm reveals that Regourdou 1 was a right-hander. Confirmatory evidence comes from the mandibular incisors, which display a distinct pattern of right oblique scratches, typical of right-handed manipulations performed at the front of the mouth. Regourdou's right handedness is consistent with the strong pattern of manual lateralization in Neandertals and further confirms a modern pattern of left brain dominance, presumably signally linguistic competence. These observations along with cultural, genetic and morphological evidence indicate language competence in Neandertals and their European precursors. PMID:22937134

  1. Timing of human protein evolution as revealed by massively parallel capture of Neandertal nuclear DNA sequences

    PubMed Central

    Burbano, Hernán A.; Hodges, Emily; Green, Richard E.; Briggs, Adrian W.; Krause, Johannes; Meyer, Matthias; Good, Jeffrey M.; Maricic, Tomislav; Johnson, Philipp L.F.; Xuan, Zhenyu; Rooks, Michelle; Bhattacharjee, Arindam; Brizuela, Leonardo; Albert, Frank W.; de la Rasilla, Marco; Fortea, Javier; Rosas, Antonio; Lachmann, Michael; Hannon, Gregory J.; Pääbo, Svante

    2010-01-01

    Whole genome shotgun sequencing is now possible for extinct organisms, as well as the targeted capture of specific regions. However, targeted resequencing of megabase sized parts of nuclear genomes has yet to be demonstrated for ancient DNA. Here we show that hybridization capture on microarrays can be used to generate large scale targeted data from Neandertal DNA even in the presence of ~99.8% microbial DNA. It is thus now possible to generate high quality data from large regions of the nuclear genome from Neandertals and other extinct organisms. Using this approach we have sequenced ~14,000 protein coding positions that have been inferred to have changed on the human lineage since the last common ancestor shared with chimpanzees. We identify 88 amino acid substitutions that have become fixed in all humans since the divergence from the Neandertals. PMID:20448179

  2. 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.

  3. 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.

  4. The Roc de Marsal Neandertal child: a reassessment of its status as a deliberate burial.

    PubMed

    Sandgathe, Dennis M; Dibble, Harold L; Goldberg, Paul; McPherron, Shannon P

    2011-09-01

    Whether Neandertals buried their dead has considerable bearing on the debate concerning the nature of their cultural behavior. Among the claims for intentional Neandertal burial in Europe, the child from Roc de Marsal has long been one of the less contentious examples because its articulated skeleton was found in what has become widely accepted as an intentionally excavated pit. However, what is known about the context of the Roc de Marsal remains from the original descriptions, coupled with new stratigraphic, sedimentological, and archaeological data on the site from recent excavations, cast serious doubt on this interpretation.

  5. A fossil hominoid proximal femur from Kikorongo Crater, southwestern Uganda.

    PubMed

    DeSilva, Jeremy; Shoreman, Eleanor; MacLatchy, Laura

    2006-06-01

    The external morphology of a fragmentary right proximal femur from southwestern Uganda is described here. Discovered in the Kikorongo Crater of Queen Elizabeth National Park in 1961, this specimen was informally assigned to Homo sapiens (although never described) and tentatively dated to the late Pleistocene. However, because aspects of the external morphology of the femur align the fossil with the African great apes, we suggest that the Kikorongo femur may be the first postcranial fossil of the genus Pan. Like the African apes, the Kikorongo specimen lacks both an obturator externus groove and an intertrochanteric line. It has a short femoral neck with a circular cross section, and a narrow and deep superior notch. Using resampling statistics and discriminant function analysis, the Kikorongo femur clustered with the genus Pan, as opposed to Gorilla or Homo. However, if the specimen is from Pan, it would be large for this taxon. Furthermore, features that clearly distinguish the external morphology of Plio-Pleistocene hominin proximal femora from African ape femora, such as the shape of the femoral neck in cross section and femoral neck length, have converged in Holocene humans and African apes. Unfortunately, the internal morphology of the femoral neck of the Kikorongo fossil was not discernable. Although we hypothesize that the Kikorongo femur is from the genus Pan, there is such variability in the proximal femora of modern humans that, although it would be an unusual human, it remains possible that this fossil represents H. sapiens.

  6. [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.

  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.

  8. 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

  9. Dietary reconstruction of the El Sidrón Neandertal familial group (Spain) in the context of other Neandertal and modern hunter-gatherer groups. A molar microwear texture analysis.

    PubMed

    Estalrrich, Almudena; El Zaatari, Sireen; Rosas, Antonio

    2017-03-01

    Here, we present the analysis of occlusal molar microwear textures of eight individuals from the El Sidrón Neandertal group (Spain). The aims of the study were: 1) to document potential age-, sex-, and maternal lineage-related differences in diet within a Neandertal familial group, and 2) to place the diet of El Sidrón individuals in the context of those of other Neandertal groups. This study also offers an interpretation of the diet of the El Sidrón Neandertals by comparing their microwear signatures to those of recent hunter-gatherer populations with diverse but known diets. The intra-group examination of the microwear signatures are consistent with the females of the El Sidrón group having had more abrasive diets or having used their teeth in more para-masticatory activities than did the males. Aside from the potential sex-related differences in diet, no additional intra-group dietary separation, such as by age group or maternal lineage, was observed. In comparison to other Neandertals, El Sidrón individuals, as a group, have microwear signatures most similar to those of other Neandertals from wooded habitats and different from those that lived in more open habitats. This result is expected based on the available paleoenvironmental reconstructions from El Sidrón Cave. The diet of the El Sidrón Neandertals, just like their Neandertal counterparts from similar wooded habitats, is interpreted as having been mixed, consisting of both meat and vegetable foods.

  10. X-Ray Exam: Femur (Upper Leg)

    MedlinePlus

    ... Old Feeding Your 1- to 2-Year-Old X-Ray Exam: Femur (Upper Leg) KidsHealth > For Parents > X-Ray Exam: Femur (Upper Leg) Print A A A ... español Radiografía: fémur What It Is A femur X-ray is a safe and painless test that uses ...

  11. 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

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

    PubMed

    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

    2014-01-07

    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.

  13. 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.

  14. Neandertal Humeri May Reflect Adaptation to Scraping Tasks, but Not Spear Thrusting

    PubMed Central

    Shaw, Colin N.; Hofmann, Cory L.; Petraglia, Michael D.; Stock, Jay T.; Gottschall, Jinger S.

    2012-01-01

    Unique compared with recent and prehistoric Homo sapiens, Neandertal humeri are characterised by a pronounced right-dominant bilateral strength asymmetry and an anteroposteriorly strengthened diaphyseal shape. Remodeling in response to asymmetric forces imposed during regular underhanded spear thrusting is the most influential explanatory hypothesis. The core tenet of the “Spear Thrusting Hypothesis”, that underhand thrusting requires greater muscle activity on the right side of the body compared to the left, remains untested. It is unclear whether alternative subsistence behaviours, such as hide processing, might better explain this morphology. To test this, electromyography was used to measure muscle activity at the primary movers of the humerus (pectoralis major (PM), anterior (AD) and posterior deltoid (PD)) during three distinct spear-thrusting tasks and four separate scraping tasks. Contrary to predictions, maximum muscle activity (MAX) and total muscle activity (TOT) were significantly higher (all values, p<.05) at the left (non-dominant) AD, PD and PM compared to the right side of the body during spear thrusting tasks. Thus, the muscle activity required during underhanded spearing tasks does not lend itself to explaining the pronounced right dominant strength asymmetry found in Neandertal humeri. In contrast, during the performance of all three unimanual scraping tasks, right side MAX and TOT were significantly greater at the AD (all values, p<.01) and PM (all values, p<.02) compared to the left. The consistency of the results provides evidence that scraping activities, such as hide preparation, may be a key behaviour in determining the unusual pattern of Neandertal arm morphology. Overall, these results yield important insight into the Neandertal behavioural repertoire that aided survival throughout Pleistocene Eurasia. PMID:22815742

  15. Neandertal humeri may reflect adaptation to scraping tasks, but not spear thrusting.

    PubMed

    Shaw, Colin N; Hofmann, Cory L; Petraglia, Michael D; Stock, Jay T; Gottschall, Jinger S

    2012-01-01

    Unique compared with recent and prehistoric Homo sapiens, Neandertal humeri are characterised by a pronounced right-dominant bilateral strength asymmetry and an anteroposteriorly strengthened diaphyseal shape. Remodeling in response to asymmetric forces imposed during regular underhanded spear thrusting is the most influential explanatory hypothesis. The core tenet of the "Spear Thrusting Hypothesis", that underhand thrusting requires greater muscle activity on the right side of the body compared to the left, remains untested. It is unclear whether alternative subsistence behaviours, such as hide processing, might better explain this morphology. To test this, electromyography was used to measure muscle activity at the primary movers of the humerus (pectoralis major (PM), anterior (AD) and posterior deltoid (PD)) during three distinct spear-thrusting tasks and four separate scraping tasks. Contrary to predictions, maximum muscle activity (MAX) and total muscle activity (TOT) were significantly higher (all values, p<.05) at the left (non-dominant) AD, PD and PM compared to the right side of the body during spear thrusting tasks. Thus, the muscle activity required during underhanded spearing tasks does not lend itself to explaining the pronounced right dominant strength asymmetry found in Neandertal humeri. In contrast, during the performance of all three unimanual scraping tasks, right side MAX and TOT were significantly greater at the AD (all values, p<.01) and PM (all values, p<.02) compared to the left. The consistency of the results provides evidence that scraping activities, such as hide preparation, may be a key behaviour in determining the unusual pattern of Neandertal arm morphology. Overall, these results yield important insight into the Neandertal behavioural repertoire that aided survival throughout Pleistocene Eurasia.

  16. 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.

  17. 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

  18. 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.

  19. Posttraumatic cortical defect of femur.

    PubMed

    Nadarajah, Jeyaseelan; Srivastava, Deep N; Malhotra, Rajesh; Palaniswamy, Aravindh

    2013-01-01

    Posttraumatic cortical defect of bone is a rare entity which occurs in a maturing skeleton following green stick or torus fracture. Most of the cases are asymptomatic and they are detected incidentally on radiograph. These lesions usually require no treatment. However, the appearance of these lesions can mimic various pathological conditions affecting bone. Knowledge about this entity is important as it avoids unnecessary investigations. We present this case as the occurrence of this entity in femur is very rare and the child was symptomatic.

  20. The Neandertal lower right deciduous second molar from Trou de l'Abîme at Couvin, Belgium.

    PubMed

    Toussaint, Michel; Olejniczak, Anthony J; El Zaatari, Sireen; Cattelain, Pierre; Flas, Damien; Letourneux, Claire; Pirson, Stéphane

    2010-01-01

    A human lower right deciduous second molar was discovered in 1984 at the entrance of Trou de l'Abîme at Couvin (Belgium). In subsequent years the interpretation of this fossil remained difficult for various reasons: (1) the lack of taxonomically diagnostic elements which would support its attribution to either Homo (sapiens) neanderthalensis or H. s. sapiens; (2) the absence of any reliable chronostratigraphic interpretation of the sedimentary sequence of the site; (3) the contradiction between archaeological interpretations, which attributed the lithic industry to a transitional facies between the Middle and Early Upper Palaeolithic, and the radiocarbon date of 46,820+/-3,290BP obtained from animal bone remains associated with the tooth and the flint tools. Thanks to recent progress regarding these three aspects, the tooth from Trou de l'Abîme may now be studied in detail. Analyses of the morphology and enamel thickness of the fossil yielded diagnostic characters consistent with an attribution to Neandertals. Re-examination of the lithic industry of Couvin shows that it corresponds to the late Middle Palaeolithic rather than a transitional facies. Furthermore, a new analysis of the site stratigraphy indicates that the unit situated above the archaeological layer in which the tooth was found is probably a palaeosol of brown soil type. Comparison with the regional cave sequences as well as with the reference sequence from the Belgian loess belt tends to show that the most recent palaeosol of this type is dated between 42,000 and 40,000BP. This is consistent with both a recently obtained AMS result at 44,500BP and the published conventional date.

  1. Stratigraphic context and direct dating of the Neandertal mandible from Cova del Gegant (Sitges, Barcelona).

    PubMed

    Daura, J; Sanz, M; Pike, A W G; Subirà, M E; Fornós, J J; Fullola, J M; Julià, R; Zilhão, J

    2010-07-01

    Stratigraphic study of the Cova del Gegant's sedimentary fill revealed different cycles of accumulation of typical interior cave and delta facies. A precise chronology for these deposits, the faunal remains and stone tools contained therein was obtained by radiocarbon, U-Th and OSL. Our results indicate that the Upper Pleistocene archaeological sequence dates between 49.3 +/- 1.8 ka BP, the U-Th age of the overlying flowstone, and 60.0 +/- 3.9 ka BP, the OSL age of the basal deposits. We have also directly dated the site's Neandertal mandible to 52.3 +/- 2.3 ka by U-Th.

  2. 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

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

    PubMed

    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

    2010-01-19

    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.

  4. 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

  5. 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

  6. Morphometry of Proximal Femur in Indian Population

    PubMed Central

    Joshi, Sheetal; Tuli, Anita; Raheja, Shashi; Jain, Priyanka; Srivastava, Priyanka

    2017-01-01

    Introduction Total hip arthroplasty is a commonly performed surgery now-a-day. There are regional and racial variations in the stature of the population worldwide. So there is always need of population specific data for making best fit prosthesis. Aim The present study was done to measure the parameters of proximal femur and to analyse their correlation by using standard statistical analysis. Materials and Methods Ninety one dry bones (44 left and 47 right) were used. Femur Head Diameter (FHD), Femur Neck Length (FNL), Femur Neck Diameter (FND), Femur Neck Thickness (FNT), Cervicodiaphyseal Angle (CDA) was directly measured with the help of anthropometric instruments. Femur Head Offset (FHO) and Vertical Offset (VO) were measured in the anteroposterior digital photographs. Results Normally distributed variables were compared using Student’s t-test (Unpaired data) to analyse significant effect. There was a significant difference between right and left side of FND and CDA. Pearson correlation coefficient was used to analyse the relationship among variables. FHO had high correlation with the VO (0.687, p<0.001). Conclusion These parameters can be used for designing the prosthesis and plates for hip joint reconstructive surgeries suitable for Indian population. PMID:28384844

  7. Pathological fracture of the femur ten years after successful radiation therapy for metastatic breast cancer.

    PubMed

    Hatano, Hiroshi; Morita, Tetsuro; Kobayashi, Hiroto; Ito, Takui; Segawa, Hiroyuki; Saito, Mari

    2004-01-01

    We describe a case involving a 75-year-old woman presenting with a femur fracture 10 years after radiation therapy for metastatic breast cancer, which developed in the right femur. The lesion showed complete response with bone healing following radiation therapy; however, the patient sustained a femur fracture ten years later. Histological examination of the specimens obtained from the lesion revealed features of radiation osteonecrosis, but there was no histological evidence of tumor. To our knowledge, there has been no reported case of pathological fracture ten years after radiation therapy from radiation osteonecrosis rather than progression of the metastatic lesion. Late complications of radiation therapy should be considered with care, even when metastatic lesions demonstrate complete response to treatment.

  8. The relevance of the first ribs of the El Sidrón site (Asturias, Spain) for the understanding of the Neandertal thorax.

    PubMed

    Bastir, Markus; García-Martínez, Daniel; Estalrrich, Almudena; García-Tabernero, Antonio; Huguet, Rosa; Ríos, Luis; Barash, Alon; Recheis, Wolfgang; de la Rasilla, Marco; Rosas, Antonio

    2015-03-01

    Reconstructing the morphology of the Neanderthal rib cage not only provides information about the general evolution of human body shape but also aids understanding of functional anatomy and energetics. Despite this paleobiological importance there is still debate about the nature and extent of variations in the size and shape of the Neandertal thorax. The El Sidrón Neandertals can be used to contribute to this debate, providing new costal remains ranging from fully preserved and undistorted ribs to highly fragmented elements. Six first ribs are particularly well preserved and offer the opportunity to analyze thorax morphology in Neandertals. The aims of this paper are to present this new material, to compare the ontogenetic trajectories of the first ribs between Neandertals and modern humans, and, using geometric morphometrics, to test the hypothesis of morphological integration between the first rib and overall thorax morphology. The first ribs of the El Sidrón adult Neandertals are smaller in centroid size and tend to be less curved when compared with those of modern humans, but are similar to Kebara 2. Our results further show that the straightening of the first ribs is significantly correlated with a straightening of the ribs of the upper thorax (R = 0.66; p < 0.0001) in modern humans, suggesting modularity in the upper and lower thorax units as reported in other hominins. It also supports the hypothesis that the upper thorax of Neandertals differs in shape from modern humans with more anteriorly projecting upper ribs during inspiration. These differences could have biomechanical consequences and account for stronger muscle attachments in Neandertals. Different upper thorax shape would also imply a different spatial arrangement of the shoulder girdle and articulation with the humerus (torsion) and its connection to the upper thorax. Future research should address these inferences in the context of Neandertal overall body morphology.

  9. [Fractures of the shaft of the femur].

    PubMed

    Lögters, T; Windolf, J; Flohé, S

    2009-07-01

    The femur is the largest, longest and strongest bone in the human skeleton. Fractures of the shaft of the femur can result from high energy as well as low energy trauma and 30% of patients have multiple injuries. In the clinical diagnostic special attention must be paid to the peripheral neurovascular status as well as the possibility of a compartment syndrome. Fractures of the femur shaft are defined according to the AO classification. Treatment is as a rule operative, except for children up the end of 4 years old. Medullary nailing is nowadays the method of choice and the nails can be implanted in an anterograde or retrograde direction. The introduction of nails after boring out the medullar is associated with an increased healing rate in comparison to non-boring techniques. Various techniques are available for the often promising method of repositioning and the intraoperative controls. Plating is reserved only for special situations. External fixation is of great value in adults for temporary fixation of fractures of the femur shaft. Full weight bearing is possible immediately following the operation depending on the type of fracture and method of treatment. Uncomplicated fracture healing does not result in a reduction in the ability to work. Despite the generally good prognosis and improvement in design and technology of implants, fractures of the femur shaft still represent a special challenge for the treating casualty surgeon.

  10. A Neandertal mandible from the Cova del Gegant (Sitges, Barcelona, Spain).

    PubMed

    Daura, J; Sanz, M; Subirá, M E; Quam, R; Fullola, J M; Arsuaga, J L

    2005-07-01

    A human mandible from the site of Cova del Gegant is described here for the first time and compared with other Middle and Upper Pleistocene representatives of the genus Homo from Europe and Southwest Asia. The specimen was recovered from sediments which also yielded Mousterian stone tools and Pleistocene fauna. The preserved morphology of the mandible, particularly in the region of the mental foramen, clearly aligns it with the Neandertals, making the Cova del Gegant the only known site in Catalonia documenting diagnostic human skeletal remains in association with Middle Paleolithic stone tools. This represents an important new addition to the human fossil record from the Iberian Peninsula and joins the Bañolas mandible in documenting the course of human evolution in the northern Mediterranean region of Spain.

  11. A Gradualist Scenario for Language Evolution: Precise Linguistic Reconstruction of Early Human (and Neandertal) Grammars.

    PubMed

    Progovac, Ljiljana

    2016-01-01

    In making an argument for the antiquity of language, based on comparative evidence, Dediu and Levinson (2013) express hope that some combinations of structural features will prove so conservative that they will allow deep linguistic reconstruction. I propose that the earliest stages of syntax/grammar as reconstructed in Progovac (2015a), based on a theoretical and data-driven linguistic analysis, provide just such a conservative platform, which would have been commanded also by Neandertals and the common ancestor. I provide a fragment of this proto-grammar, which includes flat verb-noun compounds used for naming and insult (e.g., rattle-snake, cry-baby, scatter-brain), and paratactic (loose) combinations of such flat structures (e.g., Come one, come all; You seek, you find). This flat, binary, paratactic platform is found in all languages, and can be shown to serve as foundation for any further structure building. However, given the degree and nature of variation across languages in elaborating syntax beyond this proto-stage, I propose that hierarchical syntax did not emerge once and uniformly in all its complexity, but rather multiple times, either within Africa, or after dispersion from Africa. If so, then, under the uniregional hypothesis, our common ancestor with Neandertals, H. heidelbergensis, could not have commanded hierarchical syntax, but "only" the proto-grammar. Linguistic reconstructions of this kind are necessary for formulating precise and testable hypotheses regarding language evolution. In addition to the hominin timeline, this reconstruction can also engage, and negotiate between, the fields of neuroscience and genetics, as I illustrate with one specific scenario involving FOXP2 gene.

  12. A Gradualist Scenario for Language Evolution: Precise Linguistic Reconstruction of Early Human (and Neandertal) Grammars

    PubMed Central

    Progovac, Ljiljana

    2016-01-01

    In making an argument for the antiquity of language, based on comparative evidence, Dediu and Levinson (2013) express hope that some combinations of structural features will prove so conservative that they will allow deep linguistic reconstruction. I propose that the earliest stages of syntax/grammar as reconstructed in Progovac (2015a), based on a theoretical and data-driven linguistic analysis, provide just such a conservative platform, which would have been commanded also by Neandertals and the common ancestor. I provide a fragment of this proto-grammar, which includes flat verb-noun compounds used for naming and insult (e.g., rattle-snake, cry-baby, scatter-brain), and paratactic (loose) combinations of such flat structures (e.g., Come one, come all; You seek, you find). This flat, binary, paratactic platform is found in all languages, and can be shown to serve as foundation for any further structure building. However, given the degree and nature of variation across languages in elaborating syntax beyond this proto-stage, I propose that hierarchical syntax did not emerge once and uniformly in all its complexity, but rather multiple times, either within Africa, or after dispersion from Africa. If so, then, under the uniregional hypothesis, our common ancestor with Neandertals, H. heidelbergensis, could not have commanded hierarchical syntax, but “only” the proto-grammar. Linguistic reconstructions of this kind are necessary for formulating precise and testable hypotheses regarding language evolution. In addition to the hominin timeline, this reconstruction can also engage, and negotiate between, the fields of neuroscience and genetics, as I illustrate with one specific scenario involving FOXP2 gene. PMID:27877146

  13. Statistical Analyses of Femur Parameters for Designing Anatomical Plates

    PubMed Central

    2016-01-01

    Femur parameters are key prerequisites for scientifically designing anatomical plates. Meanwhile, individual differences in femurs present a challenge to design well-fitting anatomical plates. Therefore, to design anatomical plates more scientifically, analyses of femur parameters with statistical methods were performed in this study. The specific steps were as follows. First, taking eight anatomical femur parameters as variables, 100 femur samples were classified into three classes with factor analysis and Q-type cluster analysis. Second, based on the mean parameter values of the three classes of femurs, three sizes of average anatomical plates corresponding to the three classes of femurs were designed. Finally, based on Bayes discriminant analysis, a new femur could be assigned to the proper class. Thereafter, the average anatomical plate suitable for that new femur was selected from the three available sizes of plates. Experimental results showed that the classification of femurs was quite reasonable based on the anatomical aspects of the femurs. For instance, three sizes of condylar buttress plates were designed. Meanwhile, 20 new femurs are judged to which classes the femurs belong. Thereafter, suitable condylar buttress plates were determined and selected. PMID:28044087

  14. Statistical Analyses of Femur Parameters for Designing Anatomical Plates.

    PubMed

    Wang, Lin; He, Kunjin; Chen, Zhengming

    2016-01-01

    Femur parameters are key prerequisites for scientifically designing anatomical plates. Meanwhile, individual differences in femurs present a challenge to design well-fitting anatomical plates. Therefore, to design anatomical plates more scientifically, analyses of femur parameters with statistical methods were performed in this study. The specific steps were as follows. First, taking eight anatomical femur parameters as variables, 100 femur samples were classified into three classes with factor analysis and Q-type cluster analysis. Second, based on the mean parameter values of the three classes of femurs, three sizes of average anatomical plates corresponding to the three classes of femurs were designed. Finally, based on Bayes discriminant analysis, a new femur could be assigned to the proper class. Thereafter, the average anatomical plate suitable for that new femur was selected from the three available sizes of plates. Experimental results showed that the classification of femurs was quite reasonable based on the anatomical aspects of the femurs. For instance, three sizes of condylar buttress plates were designed. Meanwhile, 20 new femurs are judged to which classes the femurs belong. Thereafter, suitable condylar buttress plates were determined and selected.

  15. Paleoclimate during Neandertal and anatomically modern human occupation at Amud and Qafzeh, Israel: the stable isotope data.

    PubMed

    Hallin, Kristin A; Schoeninger, Margaret J; Schwarcz, Henry P

    2012-01-01

    The δ(13)C(en) and δ(18)O(en) values of goat and gazelle enamel carbonate indicate that Neandertals at Amud Cave, Israel (53-70 ka) lived under different ecological conditions than did anatomically modern humans at Qafzeh Cave, Israel (approximately 92 ka). During the Last Glacial Period, Neandertals at Amud Cave lived under wetter conditions than those in the region today. Neither faunal species ate arid-adapted C(4) plants or drought-stressed C(3) plants. The variation in gazelle δ(18)O(en) values suggests multiple birth seasons, which today occur under wetter than normal conditions. The magnitude and pattern of intra-tooth variation in goat δ(18)O(en) values indicate that rain fell throughout the year unlike today. Anatomically modern humans encountered a Qafzeh Cave region that was more open and arid than Glacial Period Amud Cave, and more open than today's Upper Galilee region. Goat δ(13)C(en) values indicate feeding on varying amounts of C(4) plants throughout the year. The climate apparently ameliorated higher in the sequence; but habitats remained more open than at Amud Cave. Both gazelles and goats fed on C(3) plants in brushy habitats without any inclusion of C(4) plants. The magnitude of intra-tooth variation in goat δ(18)O(en) values, however, suggest that some rain fell throughout the year, and the relative representation of woodland dwelling species indicates the occurrence of woodlands in the region. Climate differences affecting the distribution of plants and animals appear to be the significant factor contributing to behavioral differences previously documented between Neandertals and anatomically modern humans in the region. Climate forcing probably affected the early appearances of anatomically modern humans, although not the disappearance of Neandertals from the Levant.

  16. Paleoneurology of two new neandertal occipitals from El Sidrón (asturias, Spain) in the context of homo endocranial evolution.

    PubMed

    Peña-Melián, Angel; Rosas, Antonio; García-Tabernero, Antonio; Bastir, Markus; De La Rasilla, Marco

    2011-08-01

    The endocranial surface description and comparative analyses of two new neandertal occipital fragments (labelled SD-1149 and SD-370a) from the El Sidrón site (Asturias, Spain) reveal new aspects of neandertal brain morphological asymmetries. The dural sinus drainage pattern, as observed on the sagittal-transverse system, as well as the cerebral occipito-petalias, point out a slightly differential configuration of the neandertal brain when compared to other Homo species, especially H. sapiens. The neandertal dural sinus drainage pattern is organized in a more asymmetric mode, in such a way that the superior sagittal sinus (SSS) drains either to the right or to the left transverse sinuses, but in no case in a confluent mode (i.e. simultaneous continuation of SSS with both right (RTS) and left (LTS) transverse sinuses). Besides, the superior sagittal sinus shows an accentuated deviation from of the mid-sagittal plane in its way to the RTS in 35% of neandertals. This condition, which increases the asymmetry of the system, is almost nonexistent neither in the analyzed Homo fossil species sample nor in that of anatomically modern humans. Regarding the cerebral occipito-petalias, neandertals manifest one of the lowest percentages of left petalia of the Homo sample (including modern H. sapiens). As left occipito-petalia is the predominant pattern in hominins, it seems as if neandertals would have developed a different pattern of brain hemispheres asymmetry. Finally, the relief and position of the the cerebral sulci and gyri impressions observed in the El Sidrón occipital specimens look similar to those observed in modern H. sapiens.

  17. Comparing models on the genealogical relationships among Neandertal, Cro-Magnoid and modern Europeans by serial coalescent simulations.

    PubMed

    Belle, E M S; Benazzo, A; Ghirotto, S; Colonna, V; Barbujani, G

    2009-03-01

    Populations of anatomically archaic (Neandertal) and early modern (Cro-Magnoid) humans are jointly documented in the European fossil record, in the period between 40 000 and 25 000 years BP, but the large differences between their cultures, morphologies and DNAs suggest that the two groups were not close relatives. However, it is still unclear whether any genealogical continuity between them can be ruled out. Here, we simulated a broad range of demographic scenarios by means of a serial coalescence algorithm in which Neandertals, Cro-Magnoids and modern Europeans were either part of the same mitochondrial genealogy or of two separate genealogies. Mutation rates, population sizes, population structure and demographic growth rates varied across simulations. All models in which anatomically modern (that is, Cro-Magnoid and current) Europeans belong to a distinct genealogy performed better than any model in which the three groups were assigned to the same mitochondrial genealogy. The maximum admissible level of gene flow between Neandertals and the ancestors of current Europeans is 0.001% per generation, one order of magnitude lower than estimated in previous studies not considering genetic data on Cro-Magnoid people.

  18. 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.

  19. Endoprosthetic reconstruction for metastatic phaeochromocytoma in the distal femur: A case report.

    PubMed

    Srikanth, Kanchana Pala; Srinivas, Chirukuri; Gowrishankarswamy, Lakshmipura Gangadharaiah; Chandrasekar, Chikkamuniyappa

    2016-01-01

    Metastatic spread of malignant phaeochromocytoma is known to involve multiple organs including the axial skeleton. Its presentation as a solitary lesion in the long bones of the extremities is extremely rare. We report a unique case of solitary metastatic phaeochromocytoma presenting in the distal femur, 16 years after excision of primary abdominal tumor. A 60 year old female, operated for adrenal phaeochromocytoma 16 years back was detected to have a bone tumor in her left distal femur. Chest and abdominal CT evaluation including bone scintigraphy confirmed the lesion to be solitary. Magnetic resonance imaging of the left femur revealed the tumor to be of aggressive nature. It involved whole of the distal femoral metaphysis with bone destruction, soft tissue extension and an impending pathological fracture. The tumor was histopathologically confirmed to be phaeochromocytoma. Patient underwent wide surgical resection of the tumor along with simultaneous endoprosthetic reconstruction. Following surgery, rehabilitation was rapid and effortless with patient ambulating independently. She had pain free full range of knee movements and resumed her daily activity uneventfully. On 18 months follow up the patient had no recurrence or complications. Late and solitary skeletal metastasis of malignant phaeochromocytoma although rare, can occur in the distal femur mimicking a primary bone tumor. Wide surgical excision and simultaneous endoprosthetic reconstruction should be considered as a treatment option. This not only permits limb salvage and early rehabilitation, but also restores form and function of the limb.

  20. 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.

  1. 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.

  2. Subtrochanteric fractures of the femur: update.

    PubMed

    Barbosa de Toledo Lourenço, Paulo Roberto; Pires, Robinson Esteves Santos

    2016-01-01

    Because of the anatomical peculiarities of the subtrochanteric region, treatment of fractures in this region remains challenging. The undeniable evolution of implants has not been accompanied by the expected decrease in the complication rate. The aim of this study was to discuss critical points in detail, such as preoperative planning, reduction tactics and the current scientific evidence concerning treatment of subtrochanteric fractures of the femur.

  3. Genetic Adaptation and Neandertal Admixture Shaped the Immune System of Human Populations.

    PubMed

    Quach, Hélène; Rotival, Maxime; Pothlichet, Julien; Loh, Yong-Hwee Eddie; Dannemann, Michael; Zidane, Nora; Laval, Guillaume; Patin, Etienne; Harmant, Christine; Lopez, Marie; Deschamps, Matthieu; Naffakh, Nadia; Duffy, Darragh; Coen, Anja; Leroux-Roels, Geert; Clément, Frederic; Boland, Anne; Deleuze, Jean-François; Kelso, Janet; Albert, Matthew L; Quintana-Murci, Lluis

    2016-10-20

    Humans differ in the outcome that follows exposure to life-threatening pathogens, yet the extent of population differences in immune responses and their genetic and evolutionary determinants remain undefined. Here, we characterized, using RNA sequencing, the transcriptional response of primary monocytes from Africans and Europeans to bacterial and viral stimuli-ligands activating Toll-like receptor pathways (TLR1/2, TLR4, and TLR7/8) and influenza virus-and mapped expression quantitative trait loci (eQTLs). We identify numerous cis-eQTLs that contribute to the marked differences in immune responses detected within and between populations and a strong trans-eQTL hotspot at TLR1 that decreases expression of pro-inflammatory genes in Europeans only. We find that immune-responsive regulatory variants are enriched in population-specific signals of natural selection and show that admixture with Neandertals introduced regulatory variants into European genomes, affecting preferentially responses to viral challenges. Together, our study uncovers evolutionarily important determinants of differences in host immune responsiveness between human populations.

  4. 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.

  5. 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

  6. Periprosthetic proximal femur fractures: current concepts.

    PubMed

    Parvizi, Javad; Vegari, David N

    2011-06-01

    With the increase in demand for total hip and knee arthroplasty, the orthopaedic community has seen a dramatic increase in periprosthetic fractures. Given the high morbidity and mortality associated with these fractures, the orthopaedic surgeon needs to be prepared to deal with this difficult problem. The purpose of this article is to provide the surgeon with an algorithmic approach that allows for easy classification and treatment options for periprosthetic fractures of the proximal femur. Such an approach should prevent the mismanagement of these complications.

  7. 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.

  8. 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

  9. 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

  10. Lifelong sedentary behaviour and femur structure.

    PubMed

    Fonseca, H; Gonçalves, D; Figueiredo, P; Mota, M P; Duarte, J A

    2011-05-01

    The aim of the present study was to analyze the lifelong differences of femur structure in sedentary and physically active animal models. Thirty male C57BL/6 mice, 2 months old, were either: i) housed in cages with running wheel (AA; n=10), ii) housed in cages without running wheel (AS; n=10), iii) or sacrificed without intervention (Y; n=10). AA and AS animals were sacrificed after 23 months of housing. Right femur structure was analyzed in all animals by histomorphometry. Significant differences in several microarchitectural parameters of cancellous and cortical bone were identified between Y mice and both groups of aged mice, as well as between AA and AS groups. Lifelong physically active mice had significantly higher cancellous bone surface (Cn.BS) and trabecular number (Tb.N) and decreased trabecular separation (Tb.Sp) at both epiphyses when compared to AS animals. No differences were observed between Y and AA groups regarding osteocyte number (N.Ot) despite its significant reduction in AS animals, suggesting that age alone was not a cause for decreases in N.Ot. Our results suggest that the reduced bone quality observed in the elderly is not only a consequence of age but also of lack of physical activity since sedentary behaviour significantly aggravated the degenerative age-related bone differences.

  11. Neandertal mobility and large-game hunting: the exploitation of reindeer during the Quina Mousterian at Chez-Pinaud Jonzac (Charente-Maritime, France).

    PubMed

    Niven, Laura; Steele, Teresa E; Rendu, William; Mallye, Jean-Baptiste; McPherron, Shannon P; Soressi, Marie; Jaubert, Jacques; Hublin, Jean-Jacques

    2012-10-01

    Neandertals were effective hunters of large ungulates throughout their geographic and temporal ranges. Equipped with this knowledge, researchers in paleoanthropology continue to seek insight on the relationships between hunting and subsistence strategies with other components of the Neandertals' niche, such as mobility, site use, and lithic technology. The Quina Mousterian deposits from the rockshelter site of Chez Pinaud Jonzac (Charente-Maritime, France; hereafter Jonzac) offer an excellent opportunity to pursue these issues. This paper focuses on the extensive and well-preserved skeletal remains of reindeer (Rangifer tarandus) recovered from recent excavations of the site, representing at least 18 individuals that were hunted by Neandertals during the fall through winter. Our zooarchaeological results indicate that all ages of reindeer were hunted but adult individuals predominate. No bias is evident in the comparable frequencies of males and females. These prey were butchered on-site, with abundant evidence of meat filleting and marrow exploitation. In the excavated sample, the absence of hearths and the almost complete lack of burned bones or stones suggest that Neandertals were not using fire to assist with processing the reindeer carcasses. The zooarchaeological results presented here indicate that reindeer were hunted during a restricted window of time when they were seasonally abundant in the local area near Jonzac. Taken together with the lithic industry based on bifacial elements, the evidence is consistent with a pattern of site use by highly mobile hunter-gatherers making frequent, short-term visits. Ongoing research at Jonzac and other Quina Mousterian localities will contribute to a better understanding of Neandertal behavior during cold climate phases.

  12. 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.

  13. 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.

  14. Anatomy-based 3D skeleton extraction from femur model.

    PubMed

    Gharenazifam, Mina; Arbabi, Ehsan

    2014-11-01

    Using 3D models of bones can highly improve accuracy and reliability of orthopaedic evaluation. However, it may impose excessive computational load. This article proposes a fully automatic method for extracting a compact model of the femur from its 3D model. The proposed method works by extracting a 3D skeleton based on the clinical parameters of the femur. Therefore, in addition to summarizing a 3D model of the bone, the extracted skeleton would preserve important clinical and anatomical information. The proposed method has been applied on 3D models of 10 femurs and the results have been evaluated for different resolutions of data.

  15. Pitfalls in the application of distal femur plates for fractures.

    PubMed

    Collinge, Cory A; Gardner, Michael J; Crist, Brett D

    2011-11-01

    Despite design features intended to aid the surgeon in restoring proper alignment, malunion and implant-related problems are relatively common after a distal femur fracture treated with plate fixation. This article presents case examples of these problems followed by a discussion of the relevant distal femoral anatomy, design features of modern locked distal femur plating systems, and technical points necessary to avoid malunion and implant-related problems when using these devices.

  16. “Atypical” atypical femur fractures and use of bisphosphonates

    PubMed Central

    van de Laarschot, Denise M.; Somford, Matthijs P.; Jager, Agnes; Oei, Edwin H.; Bos, P. Koen; Zillikens, M. Carola

    2016-01-01

    Summary Background Atypical femur fractures (AFFs) present a rare but serious condition associated with use of bisphosphonates. Underlying mechanisms and clinical risk factors remain unclear. According to the diagnostic criteria formulated by the ASBMR, a lateral localization of an AFF is required. Case history We present a patient who developed bilateral leg pain while using an oral bisphosphonate and aromatase inhibitor in the course of adjuvant treatment for breast cancer. Initially she was diagnosed with bone metastases and received radiotherapy on the right femur. However, the bilateral periosteal reactions of the subtrochanteric femur are highly suggestive of AFFs. Our case meets all criteria for AFF except that she presented with lesions at the medial side of the femur. Therefore they could be best described as “atypical” atypical femur fractures. Discussion Since the pathogenesis of AFFs is not fully understood, we cannot rule out that AFFs also occur in the medial femur or in other weight-baring bones. Hence we propose that medial stress reactions belong to a spectrum of atypical fractures associated with use of antiresorptive drugs. The localization may depend on yet unknown biomechanical factors. Conclusion We propose that these periosteal reactions of the subtrochanteric femur are in fact AFFs with uncommon medial localization and could hence be considered “atypical” AFFs. We recommend being alert of AFFs in patients with bone pain and medial subtrochanteric lesions. More epidemiological studies are needed to investigate the occurrence of both medial and lateral AFFs and to gain more insight into its frequency and pathogenesis. PMID:28228783

  17. 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

  18. Far cortical locking screws in distal femur fractures.

    PubMed

    Adams, John D; Tanner, Stephanie L; Jeray, Kyle J

    2015-03-01

    Distal femur fractures routinely heal by secondary bone healing, which relies on interfragmentary motion. Periarticular locking plates are commonly used for fixation in distal femur fractures but are associated with a high nonunion rate, likely due to the stiffness of the constructs. Far cortical locking (FCL) screws are designed to allow micromotion at the near cortex while maintaining purchase in only the far cortex. Although clinical data are limited, these screws have been shown in biomechanical studies to provide excellent interfragmentary motion, and animal models have shown increased callus formation compared with traditional locking screws. The purpose of this study was to examine the clinical effects that FCL screws have on healing in distal femur fractures treated with locked constructs. In this retrospective case series, 15 patients with a distal femur fracture treated with MotionLoc screws (Zimmer, Warsaw, Indiana) were analyzed. Serial radiographs were evaluated for callus presence and time to union. All fractures were either 33-A3 or 33-C2 according to the AO classification system, and 5 (33%) were open. Bone loss was recorded in 2 patients. There were no nonunions, and average time to union was 24 weeks. There were no implant failures, and all 5 open fractures, including the 2 with bone loss, healed without intervention. There was 1 reoperation due to painful hardware. Although this is a small case series, these results are promising. Far cortical locking screws may provide the answer to the high nonunion rate associated with distal femur fractures treated with traditional locked constructs.

  19. Curvature reduces bending strains in the quokka femur

    PubMed Central

    McCabe, Kyle; Henderson, Keith; Pantinople, Jess; Milne, Nick

    2017-01-01

    This study explores how curvature in the quokka femur may help to reduce bending strain during locomotion. The quokka is a small wallaby, but the curvature of the femur and the muscles active during stance phase are similar to most quadrupedal mammals. Our hypothesis is that the action of hip extensor and ankle plantarflexor muscles during stance phase place cranial bending strains that act to reduce the caudal curvature of the femur. Knee extensors and biarticular muscles that span the femur longitudinally create caudal bending strains in the caudally curved (concave caudal side) bone. These opposing strains can balance each other and result in less strain on the bone. We test this idea by comparing the performance of a normally curved finite element model of the quokka femur to a digitally straightened version of the same bone. The normally curved model is indeed less strained than the straightened version. To further examine the relationship between curvature and the strains in the femoral models, we also tested an extra-curved and a reverse-curved version with the same loads. There appears to be a linear relationship between the curvature and the strains experienced by the models. These results demonstrate that longitudinal curvature in bones may be a manipulable mechanism whereby bone can induce a strain gradient to oppose strains induced by habitual loading. PMID:28348929

  20. Longitudinal growth of the rabbit femur after vascular and periosteal interference.

    PubMed

    Kuijpers-Jagtman, A M; Bex, J H; Maltha, J C; Daggers, J G

    1988-01-01

    Results are presented of a radiological study with metallic implants concerning the growth in length of the rabbit femur following longitudinal sectioning of the periosteum, with and without stripping, circumferential periosteal division, with and without stripping, and vascular interference. Periosteal sectioning (except in the case of longitudinal sectioning) had the effect of increasing the ultimate length of the femur. The distal epiphysial plate was stimulated after longitudinal sectioning with stripping; both growth plates were stimulated after circumferential periosteal sectioning, with and without stripping. This stimulation was evident until fairly late in the growth period. There are no indications for any inhibition during the last phase of growth. Experimental interference of the subchondral vascularisation had no effect, whilst ligation of the nutrient artery had only a very limited curbing effect on the longitudinal growth due to restraining of the proximal growth plate. It was concluded that the growth stimulation following periosteal damage cannot be the result of vascular interference the diaphysial area. It was hypothesized that the periosteum plays a role as a local regulatory factor in the fine regulation of the growth of the epiphysial plates, acting as an intermediary and transmitting mechanical stimuli generated by other local factors to the epiphysial plates.

  1. Trabecular architecture analysis in femur radiographic images using fractals.

    PubMed

    Udhayakumar, G; Sujatha, C M; Ramakrishnan, S

    2013-04-01

    Trabecular bone is a highly complex anisotropic material that exhibits varying magnitudes of strength in compression and tension. Analysis of the trabecular architectural alteration that manifest as loss of trabecular plates and connection has been shown to yield better estimation of bone strength. In this work, an attempt has been made toward the development of an automated system for investigation of trabecular femur bone architecture using fractal analysis. Conventional radiographic femur bone images recorded using standard protocols are used in this study. The compressive and tensile regions in the images are delineated using preprocessing procedures. The delineated images are analyzed using Higuchi's fractal method to quantify pattern heterogeneity and anisotropy of trabecular bone structure. The results show that the extracted fractal features are distinct for compressive and tensile regions of normal and abnormal human femur bone. As the strength of the bone depends on architectural variation in addition to bone mass, this study seems to be clinically useful.

  2. 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

  3. 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

  4. The pelvis and femur of Ardipithecus ramidus: the emergence of upright walking.

    PubMed

    Lovejoy, C Owen; Suwa, Gen; Spurlock, Linda; Asfaw, Berhane; White, Tim D

    2009-10-02

    The femur and pelvis of Ardipithecus ramidus have characters indicative of both upright bipedal walking and movement in trees. Consequently, bipedality in Ar. ramidus was more primitive than in later Australopithecus. Compared with monkeys and Early Miocene apes such as Proconsul, the ilium in Ar. ramidus is mediolaterally expanded, and its sacroiliac joint is located more posteriorly. These changes are shared with some Middle and Late Miocene apes as well as with African apes and later hominids. However, in contrast to extant apes, bipedality in Ar. ramidus was facilitated by craniocaudal shortening of the ilium and enhanced lordotic recurvature of the lower spine. Given the predominant absence of derived traits in other skeletal regions of Ar. ramidus, including the forelimb, these adaptations were probably acquired shortly after divergence from our last common ancestor with chimpanzees. They therefore bear little or no functional relationship to the highly derived suspension, vertical climbing, knuckle-walking, and facultative bipedality of extant African apes.

  5. Osseous Hydatidosis of Femur in a Patient with Fracture Non-union: An Uncommon Entity

    PubMed Central

    Prabhu, Anne Jennifer; George, Shyjumon

    2016-01-01

    Hydatid disease caused by the larval form of the parasitic tapeworm, Echinococcus granulosus, commonly affects the liver and lungs. Bone involvement by Hydatid is extremely uncommon and is reported in 1-3% of cases. It is often a dormant disease, presenting at a late stage with non-specific clinical and radiological findings. Usually they occur as an isolated entity without liver/lung involvement and a clinical suspicion of this disease is not possible. We report a rare case of Hydatid cyst of femur in a 25-year-old female, with unresolving non-union of fracture for five years. The occurrence of this disease in atypical locations and lack of a specific radiological sign makes the diagnosis challenging and it is important for the orthopaedicians and pathologists to be aware of this entity for a precise diagnosis. PMID:28208867

  6. Case report 207: Giant cell reparative granuloma of left femur arising in polyostatic fibrous dysplasia

    SciTech Connect

    De Smet, A.A.; Travers, H.; Neff, J.R.

    1982-08-01

    Diagnosis and differential diagnosis of lytic lesions in the femur are discussed. Roentgenograms, a tomogram and pathological studies of a giant cell reparative granuloma of left femur arising in polyostotic fibrous dysplasia are presented.

  7. 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.

  8. Fibrous Dysplasia in the Epiphysis of the Distal Femur

    PubMed Central

    Noh, Jung Ho; Lee, Jae Woo

    2017-01-01

    Fibrous dysplasia is a common benign skeletal lesion that may involve a single bone or multiple bones. Although fibrous dysplasia can affect any bone, monostotic fibrous dysplasia of the long bone typically occurs in the diaphysis or metaphysis. We report a very rare case of monostotic fibrous dysplasia involving the epiphysis of the distal femur in a young man. PMID:28231652

  9. Osteosynthesis of the proximal femur anchorage of a cervical nail.

    PubMed

    el Banna, S; Burny, F; Bourgois, R; Donkerwolcke, M; Moulart, F

    1994-01-01

    One of the factors determining the stability of osteosynthesis is the mechanical strength of the bone fragments required for the anchorage of the implant. The aim is to study the driving of a Thornton nail in the proximal epiphysis of a human femur as a way to measure the strength of the trabecular bone and to predict the stability of the implanted system.

  10. 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.

  11. Electron microprobe analysis of elemental distribution in excavated human femurs

    SciTech Connect

    Lambert, J.B.; Simpson, S.V.; Buikstra, J.E.; Hanson, D.

    1983-12-01

    Elemental distributions have been determined for femur cross sections of eight individuals from the Gibson and Ledders Woodland sites. The analyses were obtained by x-ray fluorescence with a scanning electron microscope. Movement of an element from soil to bone should give rise to inhomogeneous distributions within the bone. We found that the distributions of zinc, strontium, and lead are homogeneous throughout the femur. In contrast, iron, aluminum, potassium, and manganese show clear buildup along the outer surface of the femur and sometimes along the inner (endosteal) surface, as the result of postmortem enrichment. The buildup penetrates 10-400 micron into the femur. The major elements calcium and sodium show homogeneous distributions, but considerable material could be lost by leaching (10-15%) without causing a palpable effect on the electron maps. Magnesium shows buildup on the outer edge of some samples. These results suggest that diagenetic contamination may exclude Fe, Al, K, Mn, and probably Mg from use as indicators of ancient data. The homogeneous distributions of Zn, Sr, and Pb suggest that these elements are not altered appreciably and may serve as useful dietary indicators.

  12. 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

  13. An alternative model of vascularized bone marrow transplant: partial femur transplantation.

    PubMed

    Chen, Jian-Wu; Chen, Chen; Su, Ying-Jun; Yan, Lun; Wang, Shi-Ping; Guo, Shu-Zhong

    2014-12-01

    The vascularized whole femur transplantation model is one of the commonly used vascularized bone marrow transplant models. It involves technical complexity and morbidities. To optimize this model, we took 2/3 femur as the carrier of bone marrow cells, and developed a vascularized partial femur model. Four experimental groups were carried out, namely, the syngeneic partial femur transplantation, allogeneic partial femur transplantation with or without cyclosporine A, and allogeneic whole femur transplantation with cyclosporine A. The results showed that the partial femur model was technically simpler and shortened the operative and ischemia time compared to the whole femur model. Gross and histologic appearance confirmed the viability of femur, and its bone marrow inside the bone could also maintain normal morphologically at 60-day posttransplant. Besides, donor multilineage chimerism could be continuously detected in immunosuppressed allogeneic partial femur recipients at 1-, 2-, 3-, 4-, and 8-week posttransplant, and it showed no significant differences when compared with whole femur transplantation. Meanwhile, long-term engraftment of donor-origin cells was also confirmed in recipients' bone marrow, lymph nodes, and spleen, but not in thymus. Therefore, the vascularized partial femur can serve as a continuous resource of bone morrow cells and may provide a useful tool for the study of immune tolerance in vascularized composite allotransplantation.

  14. Modular endoprosthetic replacement for metastatic tumours of the proximal femur

    PubMed Central

    Chandrasekar, Coonoor R; Grimer, Robert J; Carter, Simon R; Tillman, Roger M; Abudu, Adesegun T

    2008-01-01

    Background and aims Endoprosthetic replacements of the proximal femur are commonly required to treat destructive metastases with either impending or actual pathological fractures at this site. Modular prostheses provide an off the shelf availability and can be adapted to most reconstructive situations for proximal femoral replacements. The aim of this study was to assess the clinical and functional outcomes following modular tumour prosthesis reconstruction of the proximal femur in 100 consecutive patients with metastatic tumours and to compare them with the published results of patients with modular and custom made endoprosthetic replacements. Methods 100 consecutive patients who underwent modular tumour prosthetic reconstruction of the proximal femur for metastases using the METS system from 2001 to 2007 were studied. The patient, tumour and treatment factors in relation to overall survival, local control, implant survival and complications were analysed. Functional scores were obtained from surviving patients. Results and conclusion There were 45 male and 55 female patients. The mean age was 60.2 years. The indications were metastases. Seventy five patients presented with pathological fracture or with failed fixation and 25 patients were at a high risk of developing a fracture. The mean follow up was 15.9 months [range 0–77]. Three patients died within 2 weeks following surgery. 69 patients have died and 31 are alive. Of the 69 patients who were dead 68 did not need revision surgery indicating that the implant provided single definitive treatment which outlived the patient. There were three dislocations (2/5 with THR and 1/95 with unipolar femoral heads). 6 patients had deep infections. The estimated five year implant survival (Kaplan-Meier analysis) was 83.1% with revision as end point. The mean TESS score was 64% (54%–82%). We conclude that METS modular tumour prosthesis for proximal femur provides versatility; low implant related complications and

  15. 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.

  16. 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

  17. 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

  18. How The Rapid Climatic Variability of The Last Ice Age Affected Neandertal Extinction and Cultural Changes During The Upper Palaeolithic

    NASA Astrophysics Data System (ADS)

    D'Errico, F.; Sanchez Goñi, M.-F.; Vanhaeren, M.; Grousset, F.; Valladas, H.

    We present a synthesis of the results obtained in the framework of a multidisciplinary research project funded by the ECLIPSE CNRS program the objectif of which is to explore possible relationships between cultural and climatic changes during the OIS 1- 3. With this goal in mind, a comprehensive database including European Palaeolithic sites location and C14 conventional and AMS dates was created and correlated to climatic variations as established by continental and marine proxies. This database in- cludes the C14 dates from living sites and painted caves as well as palaeoclimatic data (isotopes, pollen, foraminifers, alkenones, Ice Rafted Detritus) from IMAGES marine cores and, in particular, from two cores retrieved off the Iberian margin. Correlation of archeological and climatic data for the Middle-Upper Palaeolithic transition indicates that at a global scale, climate was not the driving force determining the colonisation of Europe by Anatomically Modern Humans. At a regional scale, however, climate might have conditionned the timing of this colonisation and of neandertal extinction, particularly in the mediterranean area. We also found that a clear and previously unde- tected synchronism exists between the beginning of each Heinrich events (4 to1) and the developpment of Upper Palaeolithic cultures (Aurignacian, Gravettian, Solutrean and Magdalenian respectively). Cave art also seems affected by the climatic variabil- ity. We discovered that a major gap in cave art production corresponding to the period between 22.7 and 19.4 ky 14C BP (26 and 23.3 cal ky BP) is contemporary with the Heinrich 2 climatic deterioration.

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

    PubMed

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

    2016-01-07

    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.

  20. A long femur scan field does not alter proximal femur bone mineral density measurements by dual-energy X-ray absorptiometry.

    PubMed

    McKiernan, Fergus Eoin; Hocking, Jane; Cournoyer, Susan; Berg, Richard L; Linneman, James

    2011-01-01

    A longer dual-energy X-ray absorptiometry (DXA) femur scan field might be useful for the detection of atypical, subtrochanteric femur fractures (ASFF). Thirty adult subjects underwent triplicate measures of femoral neck (FN) and total hip (TH) bone mineral density (BMD) by DXA using a conventional (i.e., short) and a longer femur scan field. Differences in measured BMD between the 2 scan field lengths were small and less than the precision error inherent in DXA testing. A longer proximal femur scan field does not substantially alter BMD measurements made at the FN and TH and may be useful for the detection of ASFF in clinical practice.

  1. Short adolescence in early hominids: infantile and adolescent growth of the human femur.

    PubMed

    Tardieu, C

    1998-10-01

    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? Evidence from studies on dental and facial growth favors the first point of view. Additional evidence presented in this report is provided by a morphogenetic analysis of the lower limb. Some morphological modifications undergone by the human femur during infantile and adolescent growth are shown to be excellent markers of different developmental stages. The angular remodelling of the femoral diaphysis, which results in femoral bicondylar angle, is a marker of infancy, while the reshaping of the distal femoral epiphysis is a marker of adolescence. This reshaping of the bony epiphysis consists of the strong projection of the external lip of the femoral trochlea, the increase of the radius of curvature of the external condyle, and the anteroposterior lengthening of the whole epiphysis. The growth spurt in linear dimensions of the femur, characteristic of human adolescence, is shown to be associated with qualitative changes of the distal femoral epiphysis engendered by the late closure of the distal epiphysis. The femur of the first hominids (Australopithecus afarensis) shows only features of infantile growth, whereas characters of both precocious and later growth are typical of later hominids (Homo). The absence of the derived epiphyseal features in Australopithecus would be linked to their early epiphyseal closure and short adolescent growth period; their presence in Homo would have been promoted by their delayed epiphyseal closure and prolonged adolescent growth period. The transition from Australopithecus to Homo appears to have involved a heterochronic process of time hypermorphosis (Gould, [1977], Ontogeny and Phylogeny [Cambridge: Harvard University Press]) in which the size of the femur increases, the epiphysis is modified, and the period of peripubertal growth is prolonged. The shape of the distal epiphyses of KNM

  2. Fatigue fracture of the femur after navigated total knee replacement.

    PubMed

    Panasiuk, Michał; Bończak, Oktawiusz

    2009-01-01

    We present a case of fatigue fracture of the femur after navigated total knee arthroplasty with the Orthopilot system. A 60-year-old woman with rheumatoid arthritis and osteoporosis (T-score = -3.1) reported increasing pain of the thigh 8 weeks after the surgery. A fatigue fracture of the right femur through the pinholes was diagnosed and stabilized with an intramedullary nail, achieving union and a good functional result. To our knowledge, this is the first described fracture through the pinholes after Orthopilot-assisted surgery with 4.5 mm threaded pins for tracker fixation. We believe that the number of such complications is underestimated because reports are not published. Patients with osteoporosis should be informed about the possibility of this complicating fracture if they are undergoing navigated surgery.

  3. Effects of extracorporeal shock waves on immature rabbit femurs.

    PubMed

    Saisu, Takashi; Takahashi, Kenji; Kamegaya, Makoto; Mitsuhashi, Shigeru; Wada, Yuichi; Moriya, Hideshige

    2004-05-01

    We hypothesized that extracorporeal shock waves induce overgrowth and local increases in bone mineral content (BMC) in immature long bones. Immature male rabbits (n=14; 9 weeks old) were randomized equally between group I, which received 1000 100 MPa shock waves on the femoral shaft and group II, which received 5000. Unexposed femurs were used as controls. No fractures occurred in group I; three occurred in group II. Six weeks after exposure, the length and width were significantly larger (1.0 and 14.9%, respectively), and the BMC was significantly higher (22.8%) than those of control femurs in group I. These results of differences in width and BMC might be clinically useful.

  4. Femur Neck Fracture in a Young Marfan Syndrome Patient.

    PubMed

    Kwon, Yong-Uk; Kong, Gyu-Min; Park, Jun-Ho

    2016-12-01

    Marfan syndrome is an autosomal dominant and could decrease bone mineral density. So patients with Marfan syndrome could vulnerable to trauma in old ages. We present the first report, to the best of our knowledge, of a rare fracture of the femoral neck with a minor traumatic history in a juvenile Marfan syndrome patient whose physis is still open. Although the patient is young, her bone mineral density was low and the geometry of femur is changed like old ages. The femur neck fracture in children is very rare and only caused by high energy trauma, we concluded that the Marfan syndrome makes the bone weaker in young age and preventative medications to avoid fractures in younger Marfan syndrome patients are necessary in early ages.

  5. Adamantinoma of the proximal femur: a case report.

    PubMed

    Ii, Sadao; Tsuchiya, Hiroyuki; Takazawa, Koutaro; Minato, Hiroshi; Tomita, Katsuro

    2004-01-01

    Adamantinoma is a rare low-grade malignant bone tumor with an indolent course. The tibia is involved in 85%-90% of long-bone cases. We encountered a patient with primary adamantinoma of the proximal femur. A 60-year-old woman fell and fractured her proximal left femur in the area of a cystic lesion. She underwent an osteosynthesis procedure, and bone union was obtained. After 3 years she developed pain in the left thigh, and a radiographic abnormality was found at the fracture site. A metastatic bone tumor was suspected, and curettage and cementing were carried out. Histologically, we found an epithelial component but failed to detect any primary cancer. Local recurrence became evident after another 6 years. A marginal excision was performed and a bipolar femoral prosthesis was implanted. We finally diagnosed the patient with adamantinoma. In this report we describe the characteristics of this tumor and discuss the reasoning concerning the differential diagnosis and therapeutic plan.

  6. 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.

  7. Femur Neck Fracture in a Young Marfan Syndrome Patient

    PubMed Central

    Kwon, Yong-Uk; Park, Jun-Ho

    2016-01-01

    Marfan syndrome is an autosomal dominant and could decrease bone mineral density. So patients with Marfan syndrome could vulnerable to trauma in old ages. We present the first report, to the best of our knowledge, of a rare fracture of the femoral neck with a minor traumatic history in a juvenile Marfan syndrome patient whose physis is still open. Although the patient is young, her bone mineral density was low and the geometry of femur is changed like old ages. The femur neck fracture in children is very rare and only caused by high energy trauma, we concluded that the Marfan syndrome makes the bone weaker in young age and preventative medications to avoid fractures in younger Marfan syndrome patients are necessary in early ages. PMID:28097118

  8. [Pathological proximal femur fracture: consider also primary bone tumour].

    PubMed

    van de Sande, Michiel A J; van Rijswijk, Carla S P; Dijkstra, P D Sander; Taminiau, Antonie M H

    2010-01-01

    Two male and one female patient, aged 64, 70 and 51 respectively, were surgically treated for pathological fracture of the proximal femur without preoperative biopsy. In contrast to their benign radiological diagnosis, all three patients were finally diagnosed as having a malignant primary bone tumour. The proximal femur is the primary location of pathological fractures in the appendicular skeleton. Metastases to bone are the most common cause of a destructive lesion of the skeleton in an adult. Although rare, a primary bone tumour must be included in differential diagnosis of a pathological fracture. A systematic diagnostic strategy is critical to avoid complications that make curative treatment impossible. A solitary bone lesion seen on radiography should never be assumed to be a bone metastasis. Without further diagnostic research, surgical treatment for a pathological fracture should never be commenced before a definitive diagnosis is made.

  9. The Safe Zone for External Fixator Pins in the Femur

    DTIC Science & Technology

    2012-11-01

    need to be placed more than a centimeter from the fracture to avoid potential pin track infection of fracture hematoma .17 FIGURE 3. Drawing...joint after high-energy periarticular fracture or dislo- cation.1–6 Optimal placement of pins requires a thorough knowledge of cross-sectional limb...distal femur fracture applications, a location which has previously been demonstrated to place neurovascular structures at risk with interlocking of

  10. Conservative treatment of a BCG osteomyelitis of the femur.

    PubMed Central

    Pauker, M; Seelefreund, M; Morain, G

    1977-01-01

    A 3-year-old boy presented with an osteolytic lesion and periosteal reaction in the distal metaphysis of the right femur which failed to respond to immobilization and intensive antibiotic treatment. Since the infection seemed to be of low virulence and fewer than 4 years had elapsed since BCG vaccination BCG osteomyelitis was suspected. Tuberculostatic treatment led to rapid recovery and surgical measures were unnecessary. Images Fig. 1 Fig. 2 PMID:871219

  11. Splitting of the Proximal Femur With a New Femoral Nail

    DTIC Science & Technology

    2010-04-01

    offset from the top of this particular nail to its long axis. Key Words: lateral entry, trochanteric nail , intramedullary nailing , femur, complication...trochanteric intramedullary femoral nailing . J Orthop Trauma. 2005;19:681–686. 8. McConnell T, Tornetta P III, Benson E, et al. Gluteus medius tendon injury...Germany: Stryker Trauma; 2006: 191–199. 11. Gerhard Küntscher. Practice of Intramedullary Nailing . Translated by Herman Rinne. Springfield, IL: Thomas

  12. 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.

  13. 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.

  14. Load along the femur shaft during activities of daily living.

    PubMed

    D'Angeli, V; Belvedere, C; Ortolani, M; Giannini, S; Leardini, A

    2013-08-09

    A comprehensive knowledge of the loads applied during activities of daily living to the femur shaft is necessary to the design of direct attachments of relevant prostheses. A motion analysis system was used together with an established protocol with skin markers to estimate the three components of the forces and moments acting on ten equidistant points along the full femur shaft. Twenty healthy young volunteers were analyzed while performing three repetitions of the following tasks: level walking at three different speeds, straight-line and with sudden changes of direction to the right and to the left, stairs ascending and descending, squat, rising from a chair and sitting down. Average load patterns, after normalisation for body weight and height, were calculated over subjects for each point, about the three anatomical axes, and for each motor task. These patterns were found consistent over subjects, but different among the anatomical axes and tasks. In general, the moments were observed limitedly influenced by the progression speed, and higher for more proximal points. The moments were also higher in abd/adduction (8.1% body weight*height on average), nearly three times larger than those in flex/extension (2.6) during stair descending. The largest value over all moments was 164.8 N m, abd/adduction in level walking at high speed. The present results should be of value also for a most suitable level for amputation in transfemoral amputation, for in-vitro mechanical tests and for finite element models of the femur.

  15. 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.

  16. Finite element analysis of the femur during stance phase of gait based on musculoskeletal model simulation.

    PubMed

    Seo, Jeong-Woo; Kang, Dong-Won; Kim, Ju-Young; Yang, Seung-Tae; Kim, Dae-Hyeok; Choi, Jin-Seung; Tack, Gye-Rae

    2014-01-01

    In this study, the accuracy of the inputs required for finite element analysis, which is mainly used for the biomechanical analysis of bones, was improved. To ensure a muscle force and joint contact force similar to the actual values, a musculoskeletal model that was based on the actual gait experiment was used. Gait data were obtained from a healthy male adult aged 29 who had no history of musculoskeletal disease and walked normally (171 cm height and 72 kg weight), and were used as inputs for the musculoskeletal model simulation to determine the muscle force and joint contact force. Among the phases of gait, which is the most common activity in daily life, the stance phase is the most affected by the load. The results data were extracted from five events in the stance phase: heel contact (ST1), loading response (ST2), early mid-stance (ST2), late mid-stance (ST4), and terminal stance (ST5). The results were used as the inputs for the finite element model that was formed using 1.5mm intervals computed tomography (CT) images and the maximum Von-Mises stress and the maximum Von-Mises strain of the right femur were examined. The maximum stress and strain were lowest at the ST4. The maximum values for the femur occurred in the medial part and then in the lateral part after the mid-stance. In this study, the results of the musculoskeletal model simulation using the inverse-dynamic analysis were utilized to improve the accuracy of the inputs, which affected the finite element analysis results, and the possibility of the bone-specific analysis according to the lapse of time was examined.

  17. [Surgical treatment of pathologic fractures of the humerus and femur].

    PubMed

    Gruber, G; Zacherl, M; Leithner, A; Giessauf, C; Glehr, M; Clar, H; Windhager, R

    2009-04-01

    The life expectancy of patients with malignant tumours and the incidence of osseous metastases have increased over the last decades. Operations for skeletal metastases of the extremities represent the most frequent surgery in orthopaedic oncology. The purpose of this study was to evaluate and compare the different operative treatment options for patients with pathologic fractures of the humerus and femur in terms of complications, postoperative recovery, and survival.From 2000 to 2005, 109 patients were surgically treated for pathologic fractures of the humerus (n=19) or femur (n=90). The study group consisted of 60 women and 43 men, with a mean age of 67 years (13-88). Breast carcinoma (36%) was the most common primary tumour, followed by kidney (17%) and bronchial (16%) carcinoma. Of all patients, 75 (73%) had numerous skeletal metastases, and 38 (37%) had visceral metastases.Wide or marginal resection was performed in seven fractures of the humerus and 14 fractures of the femur; intralesional resection was done in seven humeral and 73 femoral fractures; and stabilisation alone was done in five fractures of the humerus and three fractures of the femur. The median survival time for all patients was 6 months (0-102). The survival rate at 1 year was 25% (25% for both humeral and femoral fractures), 15% at 2 years (17% for humeral and 15% for femoral fractures), and 8% at 3 years (16% for humeral and 7% for femoral fractures). The overall complication rate was 11%, and revision surgeries were performed in seven patients (6.4%). The majority of patients (n=65; 60%), especially those with fractures close to the articular joint, were successfully treated with endoprosthetic replacement. Patients with fractures stabilised by intramedullary nails had shorter operating times, a shorter hospital stay, and fewer complications than patients treated with plating systems. Therefore, we recommend intralesional resection of the metastasis and stabilisation with intramedullary

  18. Bone Mineral Density, Mechanical, Microstructural Properties and Mineral Content of the Femur in Growing Rats Fed with Cactus Opuntia ficus indica (L.) Mill. (Cactaceae) Cladodes as Calcium Source in Diet.

    PubMed

    Hernández-Becerra, Ezequiel; Gutiérrez-Cortez, Elsa; Del Real, Alicia; Rojas-Molina, Alejandra; Rodríguez-García, Mario; Rubio, Efraín; Quintero-García, Michelle; Rojas-Molina, Isela

    2017-02-04

    Mechanical, microstructural properties, mineral content and bone mineral density (BMD) of the femur were evaluated in growing rats fed with Opuntia ficus indica (L.) Mill. (Cactaceae) cladodes at different maturity stages as calcium source. Male weanling rats were fed with cladodes at early maturity stage (25 and 60 days of age, belonging to groups N-60 and N-200, respectively) and cladodes at late maturity stage (100 and 135 days of age, belonging to groups N-400 and N-600, respectively) for 6 weeks. Additionally, a control group fed with calcium carbonate as calcium source was included for comparative purposes. All diets were fitted to the same calcium content (5 g/kg diet). The failure load of femurs was significantly lower (p ≤ 0.05) in groups N-60 and N-200 in comparison to N-400, N-600 and control groups. The cortical width (Ct.Wi) and trabecular thickness (Tb.Th) of the femurs in control and N-600 groups were significantly higher (p ≤ 0.05) than Ct.Wi and Tb.Th of femurs in groups N-60 and N-200. Trabecular separation of the femurs in N-60 and N-200 groups showed the highest values compared with all experimental groups. The highest calcium content in the femurs were observed in control, N-600 and N-400 groups; whereas the lowest phosphorus content in the bones were detected in N-200, N-600 and N-400 groups. Finally, the BMD in all experimental groups increased with age; nevertheless, the highest values were observed in N-600 and control groups during pubertal and adolescence stages. The results derived from this research demonstrate, for the first time, that the calcium found in Opuntia ficus indica cladodes is actually bioavailable and capable of improving mineral density and mechanical and microstructural properties of the bones. These findings suggest that the consumption of cladodes at late maturity stage within the diet might have a beneficial impact on bone health.

  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. [Reduplication of femur - course observation and treatment (author's transl)].

    PubMed

    Stürz, H; Matzen, K A; Witt, A N

    1980-12-01

    The paper reports on the further growth of the leg in the case of a 7- year-old boy with congenital reduplication of the femur, tibial aplasia and dysplasia of the foot, who was treated conservatively until now. The possibilities of conservative and operative treatment to reconstruct the limb and to improve the function were discussed and finally the operative treatment carried out is explained. The case report is an example of the variety of problems in the reconstruction of dysplastic limbs in childhood.

  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.

  2. 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.

  3. 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

  4. Surgical treatment of metastatic disease of the femur.

    PubMed

    Swanson, K C; Pritchard, D J; Sim, F H

    2000-01-01

    Nearly every malignant neoplasm has been described as having the capability to metastasize to bone. Of the estimated 1.2 million new cases of cancer diagnosed annually, more than 50% will eventually demonstrate skeletal metastasis. Advances in systemic and radiation therapy have led to a considerable improvement in the prognosis of patients with metastatic disease. As a result, orthopaedic surgeons are being asked with increasing frequency to evaluate and treat the manifestations of skeletal metastases. The femur is commonly the site of large impending lesions and complete pathologic fractures. Although the health status of some patients may preclude operative intervention, established pathologic fractures of the femur and metastatic lesions deemed likely to progress to imminent fracture generally should be treated surgically. A rational approach to selection of the proper treatment for these problems includes consideration of the patient's overall medical condition and the type, location, size, and extent of the tumor. Treatment principles are the same regardless of location. A construct should ideally provide enough stability to allow immediate full weight bearing with enough durability to last the patient's expected lifetime. All areas of weakened bone should be addressed at the time of surgery in anticipation of disease progression. To minimize disease progression and possible implant or internal fixation failure, postoperative external-beam irradiation should be considered.

  5. 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

  6. 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

  7. Accuracy of femur reconstruction from sparse geometric data using a statistical shape model.

    PubMed

    Zhang, Ju; Besier, Thor F

    2017-04-01

    Sparse geometric information from limited field-of-view medical images is often used to reconstruct the femur in biomechanical models of the hip and knee. However, the full femur geometry is needed to establish boundary conditions such as muscle attachment sites and joint axes which define the orientation of joint loads. Statistical shape models have been used to estimate the geometry of the full femur from varying amounts of sparse geometric information. However, the effect that different amounts of sparse data have on reconstruction accuracy has not been systematically assessed. In this study, we compared shape model and linear scaling reconstruction of the full femur surface from varying proportions of proximal and distal partial femur geometry in combination with morphometric and landmark data. We quantified reconstruction error in terms of surface-to-surface error as well as deviations in the reconstructed femur's anatomical coordinate system which is important for biomechanical models. Using a partial proximal femur surface, mean shape model-based reconstruction surface error was 1.8 mm with 0.15° or less anatomic axis error, compared to 19.1 mm and 2.7-5.6° for linear scaling. Similar results were found when using a partial distal surface. However, varying amounts of proximal or distal partial surface data had a negligible effect on reconstruction accuracy. Our results show that given an appropriate set of sparse geometric data, a shape model can reconstruct full femur geometry with far greater accuracy than simple scaling.

  8. Sex determination using discriminant analysis of the medial and lateral condyles of the femur in Koreans.

    PubMed

    Kim, Deog-Im; Kwak, Dai-Soon; Han, Seung-Ho

    2013-12-10

    The proximal and distal parts of the femur show the differences between the sexes. Head diameter and the breadth of the epicondyle of the femur are known to distinguish males from females. The proximal end of the femur is studied to determine sex using discriminant analysis but; its distal end is not done. This study aims to develop an equation specific to Koreans by using the medial and lateral condyles of the femur, and to demonstrate the usefulness of equations for specific population groups. We used three-dimensional images from 202 Korean femurs. Twelve variables were measured with a computer program after the femurs were in alignment. Eleven variables showed a statistically significant difference between the sexes (P<0.01). The most accurate equation used width of the medial and lateral condyles (WDC), with of the medial condyle (WMC), depth of the lateral condyle (DLC), and depth of the intercondylar notch (DIN) (94.1%), and is as follows: D = 0.336 × WDC + (-0.097) × WMC + (-0.153) × DLC + 0.372 × DIN - 20.912. The second highest accuracy was 90.1% for the width dimensional group and WDC. This study shows that the medial and lateral condyles of the femur should be helpful for sex determination in situations where the skull and pelvis are missing and part of the femur is available. The study also demonstrates the need for different equations for different population groups.

  9. [Atypical subtrochanteric femur fracture under alendronate therapy in spite of an intramedullar implant].

    PubMed

    Sobotta, H-P; Gösling, T

    2017-02-01

    There are a number of case reports about women undergoing long-term bisphosphonate therapy who have suffered an atypical subtrochanteric or femoral shaft fracture due to an inadequate trauma.The present case reports on a patient who underwent a subtrochanteric femur fracture with the inserted AO femur interlocking nail.

  10. Femur fractures in relatively low speed frontal crashes: the possible role of muscle forces.

    PubMed

    Tencer, Allan F; Kaufman, Robert; Ryan, Kathy; Grossman, David C; Henley, Brad M; Mann, Fred; Mock, Charles; Rivara, Fred; Wang, Stewart; Augenstein, Jeffery; Hoyt, David; Eastman, Brent

    2002-01-01

    In a sample of relatively low speed frontal collisions (mean collision speed change of 40.7 kph) the only major injury suffered by the partly or fully restrained occupant was a femur fracture. However, femur load measurements from standardized barrier crash tests for similar vehicles at a greater speed change (mean of 56.3 kph) showed that in almost all the cases, the occupant's femur would not have fractured because the loads were below fracture threshold. In order to address this discrepancy, the load in the femurs of the occupants in the crash sample were estimated and compared with the femur fracture threshold. Femur load was estimated by inspecting the scene and measuring deformations in each vehicle, defining occupant points of contact and interior surface intrusion, and calculating crash change in velocity and deceleration. From this data, the measured femoral loads from standardized crash test data in a comparable vehicle were scaled to the actual crash by considering crash deceleration, occupant weight, and restraint use. All the occupants (7 males, average age 26.7 years, 13 females, average age 36 years) sustained at least a transverse midshaft fracture of the femur with comminution, which is characteristic of axial compressive impact, causing bending and impaction of the femur. However, the estimated average maximum axial load was 8187 N (S.D. = 4343N), and the average probability for fracture was only 19% (based on the femur fracture risk criteria). In 13 crashes the fracture probability was less than 10%. Two factors were considered to explain the discrepancy. The occupant's femur was out of position (typically the driver's right front leg on the brake) and did not impact the knee bolster, instead hitting stiffer regions of the dashboard. Also, since most victims were drivers with their foot on the brake to avoid the collision, additional compressive force on the femur probably resulted from muscle contraction due to bracing for impact. Adding the

  11. [Progress on tantalum rod implanting for the treatment of femur head necrosis].

    PubMed

    Tang, Xiao-kang; Ye, Fu-sheng; Tong, Pei-jian; Fan, Yan-hua; Li, Min; Ying, Hang; Xiao, Lu-wei

    2013-07-01

    Incorrect treatment for femur head necrosis can cause collapse of femoral head and tresult in severe harm for the patients (especially for the patient with middle-aged and young). The structure and mechanics characteristics of tantalum rod is similar to bone tissue, it higher strength and can adapt the internal environment of organism, so it has a large potency in treating femur head necrosis. Treatment of early femur head necrosis with tantalum rod implanting had alreadly widey applied at home and abroad, the method has the advantages of simple operation, little risk, less complication and beseems the patient with stage I - II of ARCO. But reasons that the difficult diagnosis of early femur head necrosis, localized effect of tantalum rod, different experience of medical worker,caused the contentions about effect of tantalum rod implanting. With development of science, tantalum rod implanting combined with correlative biotechnology should raise the effect in treating femur head necrosis.

  12. Osteoporosis or Low Bone Mass at the Femur Neck or Lumbar Spine in Older Adults: United States, 2005-2008

    MedlinePlus

    ... Bone Mass at the Femur Neck or Lumbar Spine in Older Adults: United States, 2005–2008 Recommend ... density at either the femur neck or lumbar spine? Nine percent of persons aged 50 years and ...

  13. Vascularized bone graft from the supracondylar region of the femur.

    PubMed

    Doi, Kazuteru; Hattori, Yasunori

    2009-01-01

    Free vascularized thin corticoperiosteal grafts and small periosteal bone grafts harvested from the supracondylar region of the femur are described. These grafts are nourished from the articular branch of the descending genicular artery and vein. Unlike currently used vascularized bone grafts, this graft can be successfully harvested with disturbing the vascularity. Thin corticoperiosteal grafts consist of periosteum with a thin layer of outer cortical bone and include the cambium layer, which has a better osteogenic capacity. This graft is elastic and readily conforms to the recipient bed configuration. Thin corticoperiosteal grafts were used for fracture nonunion of the long bone with smaller bone defect and to treat forty-six patients with avascular necrosis of the body of the talus, scaphoid, and lunate bone.

  14. Analysis of the biocompatibility of ALCAP ceramics in rat femurs.

    PubMed

    Mattie, D R; Bajpai, P K

    1988-12-01

    Ceramics composed of aluminum, calcium, and phosphorus oxides (ALCAP) were tested for compatibility as bone replacement biomaterials. Implantation of ALCAP ceramics in rat femurs had no deleterious effect on body weights, organ/body weight ratios, muscle, bone, blood, and kidney function. Aluminum resorbed from ALCAP ceramic bone implants was excreted in the urine and was not deposited in adjacent muscle. Plasma levels of aluminum were not elevated in rats implanted with ALCAP ceramics. Alkaline phosphatase activity of excised implant sites indicated greater bone formation in ALCAP ceramic implants than in bone autografts. Radiographs and implant histology demonstrated excellent bone association with implants and ingrowth of new bone into ALCAP ceramic implants. ALCAP ceramics are biocompatible and suitable for reconstruction of bone.

  15. Growth after extendible endoprosthetic replacement of the distal femur.

    PubMed

    Cool, W P; Carter, S R; Grimer, R J; Tillman, R M; Walker, P S

    1997-11-01

    We report our results in 24 children with malignant primary bone tumours of the distal femur treated with a Stanmore extendible endoprosthesis (SEER). This consists of a femoral component that can be lengthened, a constrained knee and an uncemented sliding tibial component which crosses the proximal tibial physeal plate perpendicularly. The average age of the patients at diagnosis was ten years and the mean follow-up was 4.7 years (2.5 to 7.9). The mean growth of the affected tibia was 76% (18 to 136) and of the fibula 83% (15 to 750) of the growth of the unaffected limb. Measurement of growth arrest lines showed that the mean growth of the proximal tibial physis on the affected side was 69% (43 to 100) of that of the normal side. The great variability in the growth of the physis cannot yet be explained.

  16. 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.

  17. Determination of muscle effort at the proximal femur rotation osteotomy

    NASA Astrophysics Data System (ADS)

    Sachenkov, O.; Hasanov, R.; Andreev, P.; Konoplev, Yu

    2016-11-01

    The paper formulates the problem of biomechanics of a new method for treatment of Legg-Calve-Perthes disease. Numerical calculations of the rotational flexion osteotomy have been carried out for a constructed mathematical model of the hip joint, taking into account the main set of muscles. The work presents the results of the calculations and their analysis. The results have been compared with the clinical data. The calculations of the reactive forces arising in the acetabulum and the proximal part of the femur allowed us to reveal that this reactive force changes both in value and direction. These data may be useful for assessing the stiffness of an external fixation device used in orthopedic intervention and for evaluating the compression in the joint.

  18. Is clinical measurement of anatomic axis of the femur adequate?

    PubMed

    Wu, Chi-Chuan

    2017-03-23

    Background and purpose - The accuracy of using clinical measurement from the anterior superior iliac spine (ASIS) to the center of the knee to determine an anatomic axis of the femur has rarely been studied. A radiographic technique with a full-length standing scanogram (FLSS) was used to assess the adequacy of the clinical measurement. Patients and methods - 100 consecutive young adult patients (mean age 34 (20-40) years) with chronic unilateral lower extremity injuries were studied. The pelvis and intact contralateral lower extremity images in the FLSS were selected for study. The angles between the tibial axis and the femoral shaft anatomic axis (S-AA), the piriformis anatomic axis (P-AA), the clinical anatomic axis (C-AA), and the mechanical axis (MA) were compared between sexes. Results - Only the S-AA and C-AA angles were statistically significantly different in the 100 patients (3.6° vs. 2.8°; p = 0.03). There was a strong correlation between S-AA, P-AA, and C-AA angles (r > 0.9). The average intersecting angle between MA and S-AA in the femur in the 100 patients was 5.5°, and it was 4.8° between MA and C-AA. Interpretation - Clinical measurement of an anatomic axis from the ASIS to the center of the knee may be an adequate and acceptable method to determine lower extremity alignment. The optimal inlet for antegrade femoral intramedullary nailing may be the lateral edge of the piriformis fossa.

  19. Development of a locking femur nail for mice.

    PubMed

    Holstein, J H; Menger, M D; Culemann, U; Meier, C; Pohlemann, T

    2007-01-01

    We herein report on a novel locking intramedullary nail system in a murine closed femur fracture model. The nail system consists of a modified 24-gauge injection needle and a 0.1-mm-diameter tungsten guide wire. Rotation stability was accomplished by flattening the proximal and distal end of the needle. Torsional mechanical testing of the implants in osteotomized cadaveric femora revealed a superiority of the locking nail (3.9+/-1.0 degrees rotation at a torque of 0.9 Nmm, n=10) compared to the unmodified injection needle (conventional nail; 52.4+/-3.2 degrees, n=10, p<0.05). None of the implants, however, achieved the rotation stability of unfractured femora (0.3+/-0.5 degrees, n=10). In a second step, we tested the feasibility of the in vivo application of the locking nail to stabilize a closed femoral midshaft fracture in C57BL/6 mice. Of interest, none of the 10 animals showed a dislocation of the locking nail over a 5-week period, while 3 of 4 animals with conventional nail fracture stabilization showed a significant pin dislocation within the first 3 days (p<0.05). Mechanical testing after 5-weeks stabilization with the locking nail revealed an appropriate bone healing with a torque at failure of 71.6+/-3.4% and a peak rotation before failure of 68.4+/-5.3% relative to the unfractured contralateral femur. With the advantage that closed fractures can be fixed with rotation stability, the herein introduced model may represent an ideal tool to study bone healing in transgenic and knockout mice.

  20. Biomechanical measurements of axial crush injury to the distal condyles of human and synthetic femurs.

    PubMed

    Crookshank, Meghan; Coquim, Jason; Olsen, Michael; Schemitsch, Emil H; Bougherara, Habiba; Zdero, Rad

    2012-04-01

    Few studies have evaluated the 'bulk' mechanical properties of human longbones and even fewer have compared human tissue to the synthetic longbones increasingly being used by researchers. Distal femur fractures, for example, comprise about 6% of all femur fractures, but the mechanical properties of the distal condyles of intact human and synthetic femurs have not been well quantified in the literature. To this end, the distal portions of a series of 16 human fresh-frozen femurs and six synthetic femurs were prepared identically for mechanical testing. Using a flat metal plate, an axial 'crush' force was applied in-line with the long axis of the femurs. The two femur groups were statistically compared and values correlated to age, size, and bone quality. Results yielded the following: crush stiffness (human, 1545 +/- 728 N/mm; synthetic, 3063 +/- 1243 N/mm; p = 0.002); crush strength (human, 10.3 +/- 3.1 kN; synthetic, 12.9 < or = 1.7 kN; p = 0.074); crush displacement (human, 6.1 +/- 1.8 mm; synthetic, 2.8 +/- 0.3 mm; p = 0.000); and crush energy (human, 34.8 +/- 15.9J; synthetic, 18.1 +/- 5.7J; p = 0.023). For the human femurs, there were poor correlations between mechanical properties versus age, size, and bone quality (R2 < or = 0.18), with the exception of crush strength versus bone mineral density (R2 = 0.33) and T-score (R2 = 0.25). Human femurs failed mostly by condyle 'roll back' buckling (15 of 16 cases) and/or unicondylar or bicondylar fracture (7 of 16 cases), while synthetic femurs all failed by wedging apart of the condyles resulting in either fully or partially displaced condylar fractures (6 of 6 cases). These findings have practical implications on the use of a flat plate load applicator to reproduce real-life clinical failure modes of human femurs and the appropriate use of synthetic femurs. To the authors' knowledge, this is the first study to have done such an assessment on human and synthetic femurs.

  1. Simultaneous Periprosthetic Fractures of the Femur and the Acetabulum After Bipolar Hip Arthroplasty

    PubMed Central

    Verettas, Dionysios-Alexandros; Chloropoulou, Pelagia-Paraskevi; Drosos, Georgios; Vogiatzaki, Theodosia; Tilkeridis, Konstantinos; Kazakos, Konstantinos

    2016-01-01

    Patient: Female, 68 Final Diagnosis: Periprosthetic fractures of the acetabulum and femur after bipolar hip arthroplasty Symptoms: Inability to walk Medication: — Clinical Procedure: Revision cup and internal fixation femur Specialty: Orhopedics and Traumatology Objective: Rare co-existance of disease or pathology Background: Although periprosthetic fractures of the femur are a recognized complication of total hip arthroplasty, periprosthetic fractures of the acetabulum are rare. Simultaneous periprosthetic fractures of both the acetabulum and the femur have not been reported, to our knowledge. Case Report: We report a simultaneous fracture of the acetabulum and the femur in a 68-year-old female patient who had previously sustained a subcapital fracture of the femur, treated with a bipolar uncemented prosthesis. We discuss the possible mechanism of this combination of fractures. Conclusions: Simultaneous periprosthetic fractures of the femur and the acetabulum can occur if, in the presence of osteoporotic bone, the metallic femoral head has migrated medially in the acetabulum while the femoral stem is not loose. PMID:28003639

  2. Ossification of the femur and tibia of the post-hatching Japanese quail.

    PubMed

    Ahmed, Yasser A; Soliman, Soha A; Abdel-Hafez, Enas A

    2013-09-01

    The current study aimed to describe the histological changes of the femur and tibia of the post-hatching quail. Femur and tibia from 1-day- to 6-weeks post-hatching quail were processed for light microscopy. Histological examination revealed that endochondral ossification was a delayed process in the development of femur and tibia preceded by periosteal ossification. Femur and tibia of 1-day-post-hatching quail consisted of growth cartilage enclosed in a tube of periosteal bone collar. The collar extended toward the epiphysis dividing it into articular cartilage proper and lateral articular cartilage. Down to the articular cartilage, there was a physeal growth cartilage, in which the chondrocytes were organized into resting, proliferative and hypertrophic zones. Focal areas of hypertrophic chondrocytes were observed in the epiphysis of the tibia but not of the femur, which acted as a nidus for formation of the secondary ossification centre after in 2-week-posthathcing quail. Primary ossification centre was seen in both femur and tibia after 2 weeks and ossification continued replacing the cartilage until the 6th week when only permanent articular cartilage remained. Cartilage canals were present in both femur and tibia starting from the day 1, but chondrified and completely disappeared after the 6th week. The current study suggests that the periosteal ossification preceded the endochondral ossification and plays an important role in quail long bones development.

  3. 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

  4. Short-stem reconstruction for megaendoprostheses in case of an ultrashort proximal femur

    PubMed Central

    2014-01-01

    Background Tumors of the distal femur and diaphysis with proximal metaphyseal extension into the femur present a challenge for limb salvage. The conventional treatment consists of limb salvage with total femur replacement. This case study aims to present preliminary results and experience with short-stem reconstruction, focusing on the mechanical stability of the procedure. Methods Sixteen short stems were implanted in 15 patients. The patients’ mean age was 33,3 years (range 11–73). In 10 patients, the stem was used for distal femur reconstruction, in one patient for diaphyseal reconstruction, and in four for a stump lengthening procedure. All of the patients had a primary sarcoma in their history. The mean follow-up period was 37 months (range 5–95 months). The clinical and functional follow-up data were analyzed. Results Ten patients (67%) were still alive at the time of evaluation. Three complications associated with the stem were noted. In one case, there was aseptic loosening after 58 months; in another, aseptic loosening occurred because the diameter of the stem had initially been too small; and in one case, there was breakage of the fixation screw, without any clinical symptoms. The average Musculoskeletal Tumor Society score for all patients was 23 (range 9–28). The mean result for the distal femur replacement was 24 (range 22–28). None of the surviving patients with distal femur replacements needed any crutches or had a Trendelenburg limp. Both living patients who underwent a stump lengthening procedure were able to walk with an exoprosthesis. Conclusions The short stem is a good solution that can prevent or delay proximal femur resection in patients with tumors extending into the proximal metaphyseal femur. Additional risks of proximal femur resection, such as dislocation, opening of another oncological compartment, Trendelenburg limp, and chondrolysis can be avoided. PMID:24885859

  5. Late results.

    PubMed

    Daly, B D

    1999-08-01

    Pneumonectomy is performed for a number of benign and malignant conditions. It is most commonly performed for lung cancer. Adjuvant and neoadjuvant protocols have increased the number of these operations being performed and the long-term results are improving. Pneumonectomy may also be performed for metastases to lung and for mesothelioma with encouraging results. Some bronchial adenomas require pneumonectomy. Treatment of resistant mycobacteria or the complications of tuberculosis frequently require pneumonectomy. Late bronchopleural fistulae, esophagopleural fistulae, and empyema may occur.

  6. 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.

  7. Distal Femur Locking Plate: The Answer to All Distal Femoral Fractures

    PubMed Central

    Garg, Sudhir Kumar; Gupta, Parmanand; Jangira, Vivek; Singh, Jagdeep; Rana, Sudhir

    2016-01-01

    Introduction Good results have been published by researchers with distal femur nail, dynamic condylar screw and even addition of a medial plate to a distal femur locking plate for treating distal femur fractures. By this study, we explore the capability of a distal femur locking plate to counter distal femur fractures of extra- articular, partial or intra- articular nature. Positive results have been published by various groups from all over the world. Aim To study the functional and radiological outcome of distal femoral fractures in skeletally mature patients treated by open reduction and internal fixation with distal femur locking plate. Materials and Methods This was a prospective study conducted from January 2012 to March 2014 at the Government Medical College and Hospital (GMCH) with a 2 year follow-up. Twenty five skeletally mature patients with post-traumatic distal femur fractures were included. Patients with open grade 3B and 3C distal femur fractures, according to the Gustilo- Anderson classification and pathological distal femur fractures were excluded from the study. Patients with any fracture other than the distal femur in the ipsilateral limb were excluded from the study. Follow-up at 3 months, 6 months, 1 year and 2 years was carried out and evaluation was done according to the Neer scoring system. The statistical data analysis was carried out using SPSS version 20 (IBM, Chicago, USA). The p-value <0.05 was considered significant. Results Following all principles of fracture reduction, union was achieved in all patients with mean time to radiological union being 19 weeks. The mean Range of Motion (ROM) was 109 degrees with 20 patients having a Neer score graded as excellent to satisfactory. Our study had nine cases which required additional surgeries. Out of these, all nine cases required bone grafting, three also required antibiotic cement bead insertion initially. Three patients developed complications in the form of infection (two cases) and mal

  8. Pathological Fracture of the Femur by Metastatic Carcinoma Penis-a Rare Presentation.

    PubMed

    Hussain, Shabbir; Solanki, Fanindra Singh; Sharma, Deepti B; Sharma, Dhananjay

    2016-04-01

    We report herein a clinical case of a patient with femur fracture due to metastasis from penile squamous cell carcinoma. A young man, who was treated for carcinoma penis, presented with pathological fracture of femur and lung metastasis from metastatic carcinoma penis after 18 months. Long bone metastasis from penile cancer is extremely rare, to the best of our knowledge; this is the first report of a patient with penile cancer spread to the femur from primary squamous cell carcinoma of the penis.

  9. 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.

  10. [Fractures of the proximal femur: rehabilitation and socioeconomic repercussions].

    PubMed

    Meine, J; Regazzoni, P; König, W

    1993-01-01

    Only insufficient statistical data for epidemiologic analysis and calculations of socioeconomic costs are available in Switzerland. The total number of fractures of the proximal femur per year has nearly doubled in the 10 years from 1980 to 1990, climbing from 5500 to 9800 cases. A number of 15,000 cases is foreseen for the year 2020. In 85% of the cases the patients are older than 65 years. The global annual incidence is estimated to be 145/100,000, the partial incidence for the population of more than 65 years being 825/100,000. The mean hospitalization is 30 days. The total number of hospital days per year climbed from 200,000 to 300,000 in ten years, thus increasing the number of required beds by 50%. The mean costs for primary hospitalization is estimated to 15,000.-Swiss francs per case in 1990 and 146 Million francs globally per annum, i.e. the double of the amount in 1980. In the statistics of the National Accident Insurance Company the mean global economic costs for a fracture of the proximal femur in the active population is 57,000.-Swiss francs approximately and 72,000.-francs for patients of more than 45 years of age. Only roughly 20% of the costs are caused by medical treatment, whereas pensions, per diems and other compensations produce 80% of the costs. The mortality for patients over 65 varies from 2-7% during the primary hospitalization and rises up to 30% after 1 to 2 years after the accident. The relationship between the duration of acute hospitalization and rehabilitation is essential for planning. The evaluation of the chances for a successful rehabilitation is very important, the general medical conditions of the patients before the accident being the main determinant factor. A mean hospitalization of 3 weeks in a surgical unit and 6 to 7 weeks in a rehabilitation hospital seems to be realistic. Appropriate criteria for the selection of patients amenable to successful rehabilitation are essential. The question of the social outcome of these

  11. 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

  12. Internal fixators: a safe option for managing distal femur fractures?

    PubMed Central

    Batista, Bruno Bellaguarda; Salim, Rodrigo; Paccola, Cleber Antonio Jansen; Kfuri, Mauricio

    2014-01-01

    OBJECTIVE: Evaluate safety and reliability of internal fixator for the treatment of intra-articular and periarticular distal femur fractures. METHODS: Retrospective data evaluation of 28 patients with 29 fractures fixed with internal fixator was performed. There was a predominance of male patients (53.5%), with 52% of open wound fractures, 76% of AO33C type fractures, and a mean follow up of 21.3 months. Time of fracture healing, mechanical axis deviation, rate of infection and postoperative complications were registered. RESULTS: Healing rate was 93% in this sample, with an average time of 5.5 months. Twenty-seven percent of patients ended up with mechanical axis deviation, mostly resulting from poor primary intra-operative reduction. There were two cases of implant loosening; two implant breakage, and three patients presented stiff knee. No case of infection was observed. Healing rate in this study was comparable with current literature; there was a high degree of angular deviation, especially in the coronal plane. CONCLUSION: Internal fixators are a breakthrough in the treatment of knee fractures, but its use does not preclude application of principles of anatomical articular reduction and mechanical axis restoration. Level of Evidence II, Retrospective Study. PMID:25061424

  13. Allograft selection for distal femur through cutting contour registration.

    PubMed

    Qiu, Lei; Zhang, Yu; Zhang, Qing; Xu, Lihui; Niu, Xiaohui; Zhang, Li

    2016-12-01

    Allograft reconstruction is an acceptable procedure for the recovery of normal anatomy after the bone tumor resection. During the past few years, several automated methods have been proposed to select the best anatomically matching allograft from the virtual donor bone bank. The surface-based automated method uses the contralateral healthy bone to obtain the normal surface shape of the diseased bone, which could achieve good matching of the defect and the selected allograft. However, the surface-based method focuses on the matching of the whole bone so that the matching of the contact surface between the allograft and the recipient bone may not be optimal. To deal with the above problem, we propose a cutting contour based method for the allograft selection. Cutting contour from the recipient bone could reflect the structural information of the defect and is seldom influenced by tumor. Thus the cutting contour can be used as the matching template to find the optimal alignment of the recipient bone and the allograft. The proposed method is validated using the data of distal femurs where bone transplantation is commonly performed. Experimental results show that the proposed method generally outperforms the surface-based method within modest extra time. Overall, our contour-based method is an effective complementary technique for allograft selection in the virtual bone bank.

  14. 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.

  15. Measurement of elastic wave dispersion on human femur tissue

    NASA Astrophysics Data System (ADS)

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

    2014-03-01

    Cortical bone is one of the most complex heterogeneous media exhibiting strong wave dispersion. In such media when a burst of energy goes into the formation of elastic waves the different modes tend to separate according to the velocities of the frequency components as usually occurs in waveguides. In this study human femur specimens were subjected to elastic wave measurements. The main objective of the study is using broadband acoustic emission sensors to measure parameters like wave velocity dispersion and attenuation. Additionally, waveform parameters like the duration, rise time and average frequency, are also examined relatively to the propagation distance as a preparation for acoustic emission monitoring during fracture. To do so, four sensors were placed at adjacent positions on the surface of the cortical bone in order to record the transient response after pencil lead break excitation. The results are compared to similar measurements on a bulk metal piece which does not exhibit heterogeneity at the scale of the propagating wave lengths. It is shown 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.

  16. Accidental Bolt Gun Injury to Femur - A Case Report

    PubMed Central

    Kattimani, Ravi Prasad; Shetty, Sanath; Mirza, Humayun

    2016-01-01

    Introduction: Bolt gun or slaughterer’s guns are used in meat industry for “humane killing” of animals. Injuries caused by bolt gun are rare, reported exclusively from central European countries. We report a case of 28 year old male, who accidentally shot himself with a bolt gun to his right thigh. Case Report: A 28 years old male presented to our Accident and Emergency department after accidental injury to his right thigh with bolt gun. He had an entry wound measuring 2 cm in length and 1 cm in breadth over anterior aspect of lower one third of thigh at lower and sustained Grade II compound fracture of right femur shaft at distal one third. The wound was treated with multiple debridements, negative pressure wound therapy and intravenous antibiotics based on culture and sensitivity. Conclusion: Bolt gun or slaughterer’s guns are weapons used in meat industry for slaughtering animals. Wounds inflicted by bolt guns have specific morphological feature, distinctive from wounds made by other kinds of hand firearms. Most of the time wound will be infected at presentation. Lesions caused by these weapons are likely to have a more serious character than is to be expected from the size of the entrance wound. The mainstay of treatment is liberal wound exploration, multiple debridement’s and intra venous antibiotics based on culture reports to treat infection and prevent morbidity. PMID:28164044

  17. 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.

  18. Development and Validation of Statistical Models of Femur Geometry for Use with Parametric Finite Element Models.

    PubMed

    Klein, Katelyn F; Hu, Jingwen; Reed, Matthew P; Hoff, Carrie N; Rupp, Jonathan D

    2015-10-01

    Statistical models were developed that predict male and female femur geometry as functions of age, body mass index (BMI), and femur length as part of an effort to develop lower-extremity finite element models with geometries that are parametric with subject characteristics. The process for developing these models involved extracting femur geometry from clinical CT scans of 62 men and 36 women, fitting a template finite element femur mesh to the surface geometry of each patient, and then programmatically determining thickness at each nodal location. Principal component analysis was then performed on the thickness and geometry nodal coordinates, and linear regression models were developed to predict principal component scores as functions of age, BMI, and femur length. The average absolute errors in male and female external surface geometry model predictions were 4.57 and 4.23 mm, and the average absolute errors in male and female thickness model predictions were 1.67 and 1.74 mm. The average error in midshaft cortical bone areas between the predicted geometries and the patient geometries was 4.4%. The average error in cortical bone area between the predicted geometries and a validation set of cadaver femur geometries across 5 shaft locations was 2.9%.

  19. Cancellous impaction grafting in the human femur: histological and radiographic observations in 6 autopsy femurs and 8 biopsies.

    PubMed

    Linder, L

    2000-12-01

    6 whole postmortem femurs and 8 femoral biopsies were studied histologically, 3 months to 8 years after cancellous impaction grafting with a cemented stem for aseptic loosening. All stems were stable. Radiographs showed cortical healing in 5 cases, trabecular remodelling in 1, and trabecular incorporation in 9. There was a radiolucent line in 1 case. The histology varied. There was always a viable cortical shell around the grafted area. 1 patient showed complete bony restitution. The others still had varying amounts of remaining graft in the neo-medullary cavity, even after 8 years. The graft particles were usually embedded in dense fibrous tissue, thus forming a supporting composite tissue capable of carrying load. There was no time-dependent deterioration in the histological appearance. Radiographically, cortical healing and trabecular remodeling corresponded to viable bone. The lack of a radiolucent line said little about the viability of the tissue closest to the cement. The radiographs did not detect thin soft tissue membranes. Radiographic criteria used to assess primary total joint replacement do not necessarily apply to impaction grafting, and radiographic changes should be interpreted cautiously, especially as regards tissue viability.

  20. The effect of the dimensions of the distal femur and proximal tibia joint surfaces on the development of knee osteoarthritis.

    PubMed

    Işik, Derya; Işik, Çetin; Apaydin, Nihal; Üstü, Yusuf; Uğurlu, Mahmut; Bozkurt, Murat

    2015-07-01

    The aim of this study was to determine whether the dimensions of the distal femur and proximal tibia joint surfaces affect the etiology of knee osteoarthritis (OA). The study comprised the records of 1,324 patients who had been admitted to hospital with knee pain. Anterioposterior (AP) and lateral radiographs of the knee were taken. Using the Kellgren-Lawrence Scale, the patient group comprised Stages 2, 3, and 4 radiographs and the controls comprised Stages 0 and 1 radiographs. Four lengths were measured for each patient in both groups: femur mediolateral (femur ML), tibia mediolateral (tibia ML), femur anteroposterior (femur AP), and tibia anteroposterior (tibia AP). Osteophytes were not included in the measurements in the patient group. All the measurements were repeated by two researchers at two different times. The groups were compared in terms of these measurements and the correlations between them. The mean femur ML length was significantly greater in the patient group than the control group (P = 0.032) and the mean femur AP length was significantly less (P = 0.037). In addition, the difference between the femur ML and AP lengths was significantly high in the patient group (P < 0.001). The difference between the tibia and femur ML lengths was significantly high in the patient group (P < 0.001) and the difference between the tibia and femur AP lengths was higher in the control group (P = 0.001). A longer femur ML and a shorter femur AP, together with a greater difference between these two lengths and a greater difference between the tibia ML and femur ML lengths, could be a risk factor for developing knee OA. More extensive anatomical and biomechanical studies in the future will enable these results to be corroborated.

  1. 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.

  2. The shifting trajectory of growth in femur length during gestation.

    PubMed

    Bjørnerem, Ashild; Johnsen, Synnøve L; Nguyen, Tuan V; Kiserud, Torvid; Seeman, Ego

    2010-05-01

    Bone size is a determinant of bone strength and tracks in its percentile of origin during childhood and adolescence. We hypothesized that the ranking of an individual's femur length (FL) is established in early gestation and tracks thereafter. Fetal FL was measured serially using 2D ultrasound in 625 Norwegian fetuses. Tracking was assessed using Pearson correlation, a generalized estimating equation model, and by calculating the proportion of fetuses whose FL remained within the same quartile. Baseline FL Z-score (weeks 10 to 19) and later measurements correlated, but more weakly as gestation advanced: r = 0.59 (weeks 20 to 26); r = 0.45 (weeks 27 to 33); and r = 0.32 (weeks 34 to 39) (p < 0.001). Tracking within the same quartile throughout gestation occurred in 13% of fetuses. Of the 87% deviating, 21% returned to the quartile of origin, so 34% began and ended in the same quartile, 38% deviated by one quartile, and 28% deviated by two or more quartiles by the end of gestation. A standard deviation higher baseline FL Z-score, placental weight (150 g), maternal height (5 cm), and weight (10 kg), was associated with a 0.25, 0.15, 0.10, and 0.05 SD higher FL Z-score at the end of gestation, respectively (p ranging from <0.001 to 0.02). Tracking within the same percentile throughout the whole of gestation, as suggest by growth charts, is uncommon. Deviation from tracking is more common and is the result of changes in growth velocity within and between fetuses and is partly influenced by maternal, fetal, and placental factors.

  3. Bone Mineral Density, Mechanical, Microstructural Properties and Mineral Content of the Femur in Growing Rats Fed with Cactus Opuntia ficus indica (L.) Mill. (Cactaceae) Cladodes as Calcium Source in Diet

    PubMed Central

    Hernández-Becerra, Ezequiel; Gutiérrez-Cortez, Elsa; Del Real, Alicia; Rojas-Molina, Alejandra; Rodríguez-García, Mario; Rubio, Efraín; Quintero-García, Michelle; Rojas-Molina, Isela

    2017-01-01

    Mechanical, microstructural properties, mineral content and bone mineral density (BMD) of the femur were evaluated in growing rats fed with Opuntia ficus indica (L.) Mill. (Cactaceae) cladodes at different maturity stages as calcium source. Male weanling rats were fed with cladodes at early maturity stage (25 and 60 days of age, belonging to groups N-60 and N-200, respectively) and cladodes at late maturity stage (100 and 135 days of age, belonging to groups N-400 and N-600, respectively) for 6 weeks. Additionally, a control group fed with calcium carbonate as calcium source was included for comparative purposes. All diets were fitted to the same calcium content (5 g/kg diet). The failure load of femurs was significantly lower (p ≤ 0.05) in groups N-60 and N-200 in comparison to N-400, N-600 and control groups. The cortical width (Ct.Wi) and trabecular thickness (Tb.Th) of the femurs in control and N-600 groups were significantly higher (p ≤ 0.05) than Ct.Wi and Tb.Th of femurs in groups N-60 and N-200. Trabecular separation of the femurs in N-60 and N-200 groups showed the highest values compared with all experimental groups. The highest calcium content in the femurs were observed in control, N-600 and N-400 groups; whereas the lowest phosphorus content in the bones were detected in N-200, N-600 and N-400 groups. Finally, the BMD in all experimental groups increased with age; nevertheless, the highest values were observed in N-600 and control groups during pubertal and adolescence stages. The results derived from this research demonstrate, for the first time, that the calcium found in Opuntia ficus indica cladodes is actually bioavailable and capable of improving mineral density and mechanical and microstructural properties of the bones. These findings suggest that the consumption of cladodes at late maturity stage within the diet might have a beneficial impact on bone health. PMID:28165410

  4. Femur performed better than tibia in autologous transplantation during hemipelvis reconstruction

    PubMed Central

    2014-01-01

    Background Pelvic reconstruction after hemipelvectomy can greatly improve the weight-bearing stability of the supporting skeleton and improve patients’ quality of life. Although an autograft can be used to reconstruct pelvic defects, the most suitable choice of autograft, i.e., the use of either femur or tibia, has not been determined. We aimed to analyze the mechanical stresses of a pelvic ring reconstructed using femur or tibia after hemipelvectomy using finite element (FE) analysis. Methods FE models of normal and reconstructed pelvis were established based on computed tomography images, and the stress distributions were analyzed under physiological loading from 0 to 500 N in both intact and restored pelvic models using femur or tibia. Results The vertical displacement of the intact pelvis was less than that of reconstructed pelvis, but there was no significant difference between the two reconstructed models. In FE analysis, the stress distribution of the intact pelvic model was bilaterally symmetric and the maximum stresses were located at the sacroiliac joint, arcuate line, ischiatic ramus, and ischial tuberosity. The maximum stress in each part of the reconstructed pelvis greatly exceeded that of the intact model. The maximum von Mises stress of the femur was 13.9 MPa, and that of the tibia was 6.41 MPa. However, the stress distribution was different in the two types of reconstructed pelvises. The tibial reconstruction model induced concentrated stress on the tibia shaft making it more vulnerable to fracture. The maximum stress on the femur was concentrated on the connections between the femur and the screws. Conclusions From a biomechanical point of view, the reconstruction of hemipelvic defects with femur is a better choice. PMID:24387189

  5. 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

  6. A method for accounting for test fixture compliance when estimating proximal femur stiffness.

    PubMed

    Rossman, Timothy; Dragomir-Daescu, Dan

    2016-09-06

    Fracture testing of cadaveric femora to obtain strength and stiffness information is an active area of research in developing tools for diagnostic prediction of bone strength. These measurements are often used in the estimation and validation of companion finite element models constructed from the femora CT scan data, therefore, the accuracy of the data is of paramount importance. However, experimental stiffness calculated from force-displacement data has largely been ignored by most researchers due to inherent error in the differential displacement measurement obtained when not accounting for testing apparatus compliance. However, having such information is necessary for validation of computational models. Even in the few cases when fixture compliance was considered the measurements showed large lab-to-lab variation due to lack of standardization in fixture design. We examined the compliance of our in-house designed cadaveric femur test fixture to determine the errors we could expect when calculating stiffness from the collected experimental force-displacement data and determined the stiffness of the test fixture to be more than 10 times the stiffness of the stiffest femur in a sample of 44 femora. When correcting the apparent femur stiffness derived from the original data, we found that the largest stiffness was underestimated by about 10%. The study confirmed that considering test fixture compliance is a necessary step in improving the accuracy of fracture test data for characterizing femur stiffness, and highlighted the need for test fixture design standardization for proximal femur fracture testing.

  7. Variation between femurs as measured by dual energy X-ray absorptiometry (DEXA).

    PubMed

    Hall, M L; Heavens, J; Ell, P J

    1991-01-01

    It is commonly assumed that there is minimal variation between the hips in an individual, but is densitometry of one femur representative of the other? We performed bone mineral density (BMD) measurements of both hips using a Hologic QDR 1000 densitometer. There were 110 patients, all of whom were right handed, and three main groups of subjects: (1) normal volunteers (n = 36); (2) subjects with known hip pathology (n = 36); (3) subjects with medical conditions not affecting the hip (n = 38). The mean age of the subjects was 46 (21-87) years and a standard analysis protocol was followed in all patients. The coefficient of variation (COV) for femurs was 0.9-3%, depending upon the region studied and the BMD. The left femur had a greater BMD 48% of the time and there were variable differences between femurs in each group studied. While the greatest differences were found in people with unilateral hip pathology, all groups had mean differences greater than the COV. It may be acceptable to study only one hip, but the large variation between femurs in individuals should be borne in mind when interpreting data.

  8. 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.

  9. Percutaneous cementoplasty for painful osteolytic distal femur metastases: a case report.

    PubMed

    Lei, Mingxing; Liu, Yaosheng; Yang, Shaoxing; Jiang, Weigang; Cao, Yuncen; Liu, Shubin

    2016-01-01

    Percutaneous cementoplasty has been shown to immediately restore the mechanical stability of affected bones, prevent further risk of bone fractures, and allow immediate weight bearing. It is emerging as one of the most promising procedures for patients with painful bone metastasis who are unsuitable for surgery or who show resistance to radiotherapy and/or analgesic therapies. This study aimed at describing the procedure, indications, and benefits of percutaneous cementoplasty for painful osteolytic distal femur metastases. We report the case of a painful metastatic lesion in the left distal femur secondary to non-small-cell lung cancer in a 58-year-old woman. The patient underwent percutaneous cementoplasty and experienced effective pain relief and recovery of knee function postoperatively. In addition, no perioperative complication was observed. Percutaneous cementoplasty for osteolytic distal femur metastases offers effective pain relief and restores impaired knee function. Although this method may be a safe option, larger samples of retrospective or prospective confirmation are warranted.

  10. Percutaneous cementoplasty for painful osteolytic distal femur metastases: a case report

    PubMed Central

    Lei, Mingxing; Liu, Yaosheng; Yang, Shaoxing; Jiang, Weigang; Cao, Yuncen; Liu, Shubin

    2016-01-01

    Percutaneous cementoplasty has been shown to immediately restore the mechanical stability of affected bones, prevent further risk of bone fractures, and allow immediate weight bearing. It is emerging as one of the most promising procedures for patients with painful bone metastasis who are unsuitable for surgery or who show resistance to radiotherapy and/or analgesic therapies. This study aimed at describing the procedure, indications, and benefits of percutaneous cementoplasty for painful osteolytic distal femur metastases. We report the case of a painful metastatic lesion in the left distal femur secondary to non-small-cell lung cancer in a 58-year-old woman. The patient underwent percutaneous cementoplasty and experienced effective pain relief and recovery of knee function postoperatively. In addition, no perioperative complication was observed. Percutaneous cementoplasty for osteolytic distal femur metastases offers effective pain relief and restores impaired knee function. Although this method may be a safe option, larger samples of retrospective or prospective confirmation are warranted. PMID:27799817

  11. 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

  12. 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

  13. [Growth prognosis after para-epiphyseal tangential epiphysial injuries of the lower extremity exemplified by the distal femur: outcome after injuries of epiphyses of the distal femur].

    PubMed

    Weinberg, A M; Castellani, C; Werner, C; Mayr, J

    2002-01-01

    Fractures of the distal end of the femur are rare. Premature partial closure of the physis may occur after metaphyseal fractures. After epiphyseal fractures it has a high incidence of occurrence. The cause of physeal arrest is not known. Stimulation of the physes ends in leg length discrepancy and was seen in 50% of all cases. Spontaneous correction of an axis deviation is possible after antecurvation up to an age of 5 years. But this should be only accepted during therapy of metaphyseal fractures of the distal femur. Side-to-Side deviations remodel in all cases. Aim of therapy in distal epiphyseal fractures should be an anatomical reduction and a definitive retention. Screw osteosynthesis seems to have an advantage.

  14. 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.

  15. Segmentierung des Femurs aus MRT-Daten mit Shape-Based Level-Sets

    NASA Astrophysics Data System (ADS)

    Dekomien, Claudia; Busch, Martin; Teske, Wolfram; Winter, Susanne

    Inhalt dieser Arbeit ist die Segmentierung des Femurs aus MRT-Datensätzen mit einem Shape-based Level-Set-Ansatz. Der Algorithmus besteht aus zwei Phasen, der Modellerstellung und der Segmentierungsphase. In der Segmentierungsphase wurde ein kantenbasiertes und ein auf Intensitäten basierendes Optimierungskriterium mit einander kombiniert. Für eine lokale Verbesserung des Ergebnisses wurde zusätzlich ein Laplacian Level-Set-Verfahren angewendet. Der Femur konnte mit diesem Ansatz in drei verschiedenen MRT-Sequenzen und einem Fusionsdatensatz gut segmentiert werden.

  16. Not all secondary bone tumours are secondaries. Concurrent metastatic breast carcinoma and chondrosarcoma of the femur.

    PubMed

    Nath, Preethy; Sankey, Elizabeth; Murray, Elisabeth; Kurup, Harish

    2015-04-09

    We present a case of metastatic adenocarcinoma of the breast in a patient who sustained a pathological fracture of the distal femur. Histology of the distal femur lesion excised at the time of endoprosthetic replacement confirmed this to be a primary chondrosarcoma. We have reviewed the literature and identified previously documented cases of concurrent breast carcinoma and chondrosarcoma of bone. A high index of suspicion is warranted and the diagnosis must be first confirmed before rushing to internal fixation (therapeutic or prophylactic) assuming them to be secondary bone lesions from the known primary cancer even in patients with multiple metastases.

  17. 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...

  18. 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.

  19. A fracture risk assessment model of the femur in children with osteogenesis imperfecta (OI) during gait.

    PubMed

    Fritz, Jessica M; Guan, Yabo; Wang, Mei; Smith, Peter A; Harris, Gerald F

    2009-11-01

    Osteogenesis imperfecta (OI) is a heritable bone fragility disorder characterized by skeletal deformities and increased bone fragility. There is currently no established clinical method for quantifying fracture risk in OI patients. This study begins the development of a patient-specific model for femur fracture risk assessment and prediction based on individuals' gait analysis data, bone geometry from imaging and material properties from nanoindentation (Young's modulus=19 GPa, Poisson's ratio=0.3). Finite element models of the femur were developed to assess fracture risk of the femur in a pediatric patient with OI type I. Kinetic data from clinical gait analysis was used to prescribe loading conditions on the femoral head and condyles along with muscle forces on the bone's surface. von Mises stresses were analyzed against a fracture strength of 115 MPa. The patient with OI whose femur was modeled showed no risk of femoral fracture during normal gait. The highest stress levels occurred during the mid-stance and loading responses phases of gait. The location of high stress migrated throughout the femoral diaphysis across the gait cycle. Maximum femoral stress levels occurred during the gait cycle phases associated with the highest loading. The fracture risk (fracture strength/von Mises stress), however, was low. This study provides a relevant method for combining functional activity, material property and analytical methods to improve patient monitoring.

  20. Anesthetic management in a patient with osteogenesis imperfecta for rush nail removal in femur

    PubMed Central

    Gupta, Divanshu; Purohit, Alaka

    2016-01-01

    Osteogenesis imperfecta (OI) is a rare genetically inherited syndrome involving connective tissues, resulting in anatomic and physiologic abnormalities, which results in any form of anesthesia, a challenging task. We hereby report a case of OI type I presented with distinctively blue sclera, hearing loss, kyphoscoliosis, and mild pulmonary restrictive disease who underwent rush nail removal in the femur. PMID:27746572

  1. Biomechanical characterisation of osteosyntheses for proximal femur fractures: helical blade versus screw.

    PubMed

    Al-Munajjed, Amir A; Hammer, Joachim; Mayr, Edgar; Nerlich, Michael; Lenich, Andreas

    2008-01-01

    Proximal femur fractures are of main concern for elderly and especially osteoporotic patients. Despite advanced implant modifications and surgical techniques, serious mechanical complication rates between 4-18% are found in conventional osteosyntheses of proximal femur fractures. Clinical complications such as the rotation of the femoral head and the cut-out phenomenon of the fracture fixation bolt are often diagnosed during post-operative treatments. Therefore, efforts in new intramedulary techniques focus on the load bearing characteristics of the implant by developing new geometries to improve the implant-tissue interface. The objective of this investigation was to analyse the osteosynthesis/femur head interaction of two commonly used osteosyntheses, one with a helical blade and the other one with a screw design under different loading conditions. For the comparative investigation the helical blade of the Proximal Femur Nail Antirotation was investigated versus the screw system of the Dynamic Hip Screw. After implantation in a femoral head the loads for rotational overwinding of the implants were analysed. Pull-out forces with suppressed rotation were investigated with analysis of the influence of the previous overwinding. All investigations were performed on human femoral heads taken of patients with average age of 70.3+/-11.8. The bone mineral densities of the human specimens were detected by QCT-scans (average BMD: 338.9+/- 61.3$\\frac[\\mathit[mg

  2. Cryptococcal osteomyelitis of the femur: a case report and review of literature.

    PubMed

    Zainal, A I; Wong, S L; Pan, K L; Wong, O L; Tzar, M N

    2011-08-01

    Fungal osteomyelitis is a rare opportunistic infection. It exhibits some clinical and radiological similarities to several other bone pathologies. A diagnostic delay may result in significant increase in morbidity. We report a case of a 37-year-old man with underlying hypogammaglobulinaemia presented with isolated cryptococcal osteomyelitis of the femur.

  3. 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

    2016-02-29

    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.

  4. 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

  5. Bone morphology in 46 BXD recombinant inbred strains and femur-tibia correlation.

    PubMed

    Zhang, Yueying; Huang, Jinsong; Jiao, Yan; David, Valentin; Kocak, Mehmet; Roan, Esra; Di'Angelo, Denis; Lu, Lu; Hasty, Karen A; Gu, Weikuan

    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.

  6. Polymicrobial Chronic Infection Including Acinetobacter Baumannii in a Plated Segmental Defect in the Rat Femur

    DTIC Science & Technology

    2008-01-01

    Including Acinetobacter baumannii in a Plated Segmental Defect in the Rat Femur PRINCIPAL INVESTIGATOR: Dean T. Tsukayama, MD...FEB 2007 - 31 DEC 2007 4. TITLE AND SUBTITLE Polymicrobial Chronic Infection Including Acinetobacter baumannii 5a. CONTRACT NUMBER in a Plated...bone isolate of Acinetobacter baumannii exhibited very little osteolytic involvement when used alone in the model. Qualitative cultures indicated very

  7. 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

  8. Numerical simulation of stress amplification induced by crack interaction in human femur bone

    NASA Astrophysics Data System (ADS)

    Alia, Noor; Daud, Ruslizam; Ramli, Mohammad Fadzli; Azman, Wan Zuki; Faizal, Ahmad; Aisyah, Siti

    2015-05-01

    This research is about numerical simulation using a computational method which study on stress amplification induced by crack interaction in human femur bone. Cracks in human femur bone usually occur because of large load or stress applied on it. Usually, the fracture takes longer time to heal itself. At present, the crack interaction is still not well understood due to bone complexity. Thus, brittle fracture behavior of bone may be underestimated and inaccurate. This study aims to investigate the geometrical effect of double co-planar edge cracks on stress intensity factor (K) in femur bone. This research focuses to analyze the amplification effect on the fracture behavior of double co-planar edge cracks, where numerical model is developed using computational method. The concept of fracture mechanics and finite element method (FEM) are used to solve the interacting cracks problems using linear elastic fracture mechanics (LEFM) theory. As a result, this study has shown the identification of the crack interaction limit (CIL) and crack unification limit (CUL) exist in the human femur bone model developed. In future research, several improvements will be made such as varying the load, applying thickness on the model and also use different theory or method in calculating the stress intensity factor (K).

  9. Immediate hip spica casting for femur fractures in pediatric patients. A review of 175 patients.

    PubMed

    Infante, A F; Albert, M C; Jennings, W B; Lehner, J T

    2000-07-01

    Immediate closed reduction and application of a well-molded hip spica cast is a safe and effective treatment option for closed, isolated femur fractures in children who weigh between 10 and 100 pounds. Between 1988 and 1996, 190 immediate hip spica casts were placed on children with isolated femoral shaft fractures who weight between 10 and 100 pounds. Fifteen patients were lost to followup leaving 175 children who were evaluated and followed up for at least 2 years after the hip spica cast was removed (range 2-10 years). The femur fractures were reduced closed and placed in a 1 1/2 hip spica cast in the emergency room with the patient under conscious sedation or in the operating room with the patient under general anesthesia. All of the children returned home within 24 hours of the procedure. All 175 femur fractures united within 8 weeks. The only complication was a refracture in a 25 pound child who fell 1 week after the cast was removed. No significant residual angular deformities were present in any of the children at last followup. None of the children required external shoe lifts, epiphysiodesis, antibiotics, irrigation and debridements, or limb lengthening procedures for leg length inequalities. The authors think that immediate closed reduction and placement of a well-molded hip spica cast is a safe and reliable treatment option for isolated, closed femur fractures in children from birth to 10 years of age who weigh less than 80 pounds.

  10. Multiple vibration displacements at multiple vibration frequencies stress impact on human femur computational analysis.

    PubMed

    Ezenwa, Bertram; Yeoh, Han Teik

    2011-01-01

    Whole-body vibration training using single-frequency methods has been reported to improve bone mineral density. However, the intensities can exceed safe levels and have drawn unfavorable comments from subjects. In a previous article, whole-body vibration training using multiple vibration displacements at multiple vibration frequencies (MVDMVF) was reported. This article presents the computational simulation evaluation of stress dispersion on a femur with and without the MVDMVF input. A model of bone femur was developed from a computed tomography image of the lower limb with Mimics software from Materialise (Plymouth, Michigan). We analyzed the mesh model in COMSOL Multiphysics (COMSOL, Inc; Burlington, Massachusetts) with and without MVDMVF input, with constraints and load applied to the femur model. We compared the results with published joint stresses during walking, jogging, and stair-climbing and descending and with standard vibration exposure limits. Results showed stress levels on the femur are significantly higher with MVDMVF input than without. The stress levels were within the published levels during walking and stair-climbing and descending but below the stress levels during jogging. Our computational results demonstrate that MVDMVF generates stress level equivalent to the level during walking and stair-climbing. This evidence suggests that MVDMVF is safe for prolonged use in subjects with osteoporosis who ambulate independently.

  11. 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.

  12. A Validated Open-Source Multisolver Fourth-Generation Composite Femur Model.

    PubMed

    MacLeod, Alisdair R; Rose, Hannah; Gill, Harinderjit S

    2016-12-01

    Synthetic biomechanical test specimens are frequently used for preclinical evaluation of implant performance, often in combination with numerical modeling, such as finite-element (FE) analysis. Commercial and freely available FE packages are widely used with three FE packages in particular gaining popularity: abaqus (Dassault Systèmes, Johnston, RI), ansys (ANSYS, Inc., Canonsburg, PA), and febio (University of Utah, Salt Lake City, UT). To the best of our knowledge, no study has yet made a comparison of these three commonly used solvers. Additionally, despite the femur being the most extensively studied bone in the body, no freely available validated model exists. The primary aim of the study was primarily to conduct a comparison of mesh convergence and strain prediction between the three solvers (abaqus, ansys, and febio) and to provide validated open-source models of a fourth-generation composite femur for use with all the three FE packages. Second, we evaluated the geometric variability around the femoral neck region of the composite femurs. Experimental testing was conducted using fourth-generation Sawbones® composite femurs instrumented with strain gauges at four locations. A generic FE model and four specimen-specific FE models were created from CT scans. The study found that the three solvers produced excellent agreement, with strain predictions being within an average of 3.0% for all the solvers (r2 > 0.99) and 1.4% for the two commercial codes. The average of the root mean squared error against the experimental results was 134.5% (r2 = 0.29) for the generic model and 13.8% (r2 = 0.96) for the specimen-specific models. It was found that composite femurs had variations in cortical thickness around the neck of the femur of up to 48.4%. For the first time, an experimentally validated, finite-element model of the femur is presented for use in three solvers. This model is freely available online along with all the supporting validation data.

  13. The effect of simulated metastatic lesions on the biomechanical behavior of the proximal femur.

    PubMed

    Benca, Emir; Reisinger, Andreas; Patsch, Janina M; Hirtler, Lena; Synek, Alexander; Stenicka, Sandra; Windhager, Reinhard; Mayr, Winfried; Pahr, Dieter H

    2017-02-27

    Pathologic fractures of femora in patients with metastatic cancer are associated with high morbidity and mortality. Prediction of impending fractures is based on unspecific clinical criteria or past clinician's experience, which leads to underestimation or overtreatment. The aim of this study was to investigate the effect of the site of metastatic lesions on biomechanical behavior of the proximal femur. Sixteen pairs of human femora were scanned with quantitative computed tomography (QCT) to asses bone mineral density. One femur of each pair remained intact while a defined lesion was reamed out in either the superolateral or inferomedial portion of the femoral neck of the contralateral femur. All femora were loaded in a mechanical test set-up mimicking one-legged stance and stiffness, failure load, and fracture location were determined. In the biomechanical experiments the superolateral lesion and the inferomedial lesion caused a stiffness reduction of 19% and 66%, respectively. The average failure load was 40% and 75% lower for specimens with the superolateral (4.53 ± 1.56 kN) and inferomedial (1.89 ± 1.73 kN) lesions, respectively, compared to intact specimens (7.66 ± 3.34 kN). Lesions in the femoral neck led to reduction in both stiffness and failure load of the proximal femur. Further, the site of the lesion had a large effect on the magnitude of the reduction in biomechanical properties. The presented data emphasize the importance of differentiating between locations of the lesion in pathologic fracture prediction of the metastatic femur and underline the insufficient accuracy of current predictive guidelines. This article is protected by copyright. All rights reserved.

  14. A comparative approach to computer aided design model of a dog femur.

    PubMed

    Turamanlar, O; Verim, O; Karabulut, A

    2016-01-01

    Computer assisted technologies offer new opportunities in medical imaging and rapid prototyping in biomechanical engineering. Three dimensional (3D) modelling of soft tissues and bones are becoming more important. The accuracy of the analysis in modelling processes depends on the outline of the tissues derived from medical images. The aim of this study is the evaluation of the accuracy of 3D models of a dog femur derived from computed tomography data by using point cloud method and boundary line method on several modelling software. Solidworks, Rapidform and 3DSMax software were used to create 3D models and outcomes were evaluated statistically. The most accurate 3D prototype of the dog femur was created with stereolithography method using rapid prototype device. Furthermore, the linearity of the volumes of models was investigated between software and the constructed models. The difference between the software and real models manifests the sensitivity of the software and the devices used in this manner.

  15. Grade 3C open femur fractures with vascular repair in adults.

    PubMed

    Balci, Halil I; Saglam, Yavuz; Tunali, Onur; Akgul, Turgut; Aksoy, Murat; Dikici, Fatih

    2015-06-01

    Grade 3C open femur fractures are challenging injuries with higher rates of complications. This is a retrospective review of grade 3C open femur fractures with vascular repair between 2002 and 2012. Outcomes included initial MESS score, additional injuries, duration of operation, complications, secondary operations or amputations, and social life implications. Thirty-one of 39 total patients were selected for revascularization and fracture fixation based on soft tissue injury and MESS score. The intra-operative approach included temporary arterial shunt replacement, orthopedic fixation, arterial reconstruction venous and/or nerve repair and routine fasciotomies. An external fixation and reverse saphenous vein graft was used in a majority of the patients (respectively; 93.5%, 90.3%). The mean follow up was 5.4 years (range 2.2-10). The decision to amputate versus salvage should be left up to patients and their care teams after discussing options and future possibilities rather than using a scoring system.

  16. 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

  17. [Effect of prosthesis shaft coating on postoperative load bearing of the femur].

    PubMed

    Baroud, G; Willmann, G; Kreissig, R

    1998-01-01

    Stems and cups for total hip replacement (THR) must be coated with hydroxyapatite (HA), which enhances the osseo-integration of the implant. The aim of the present report was to investigate the basic influence of coating on the biomechanical situation, for example, the mechanical stress in the femur and at the femur-implant interface. Using the finite element method, three types of stems for THR were investigated: non-coated, completely HA-coated, and proximally HA-coated. All three stems were of the same design, and had identical material properties. In addition, all other conditions were identical. The results show that, in terms of the nature of the coating, the HA-coated stem is biomechanical superior to the non-coated stem, and the proximally coated stem is superior to the completely coated stem.

  18. 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

  19. 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.

  20. Desmoplastic fibroma in the proximal femur: A case report with long-term follow-up

    PubMed Central

    GONG, YU-BAO; QU, LI-MEI; QI, XIN; LIU, JIAN-GUO

    2015-01-01

    Desmoplastic fibroma of the bone is an extremely rare primary benign tumor. The present study reports a case of desmoplastic fibroma of the bone with the longest published follow-up. A 21-year-old female presented to The First Hospital of Jilin University (Changchun, Jilin, China) with thigh pain. Radiography demonstrated a lytic expansile lesion in the proximal femur. Curettage was performed, followed by use of an allogeneic graft. One month later, the patient suffered a pathological fracture and was treated with an open reduction and internal fixation. There was no recurrence of the tumor over a 28-year follow-up period. In conclusion, desmoplastic fibroma in the proximal femur is rare and an intralesional resection is strongly recommended to prevent recurrence. The disease may be misdiagnosed as a bone cyst, so the diagnosis should be confirmed with a histological examination. PMID:26622872

  1. The femur of Orrorin tugenensis exhibits morphometric affinities with both Miocene apes and later hominins.

    PubMed

    Almécija, Sergio; Tallman, Melissa; Alba, David M; Pina, Marta; Moyà-Solà, Salvador; Jungers, William L

    2013-01-01

    Orrorin tugenensis (Kenya, ca. 6 Ma) is one of the earliest putative hominins. Its proximal femur, BAR 1002'00, was originally described as being very human-like, although later multivariate analyses showed an australopith pattern. However, some of its traits (for example, laterally protruding greater trochanter, medially oriented lesser trochanter and presence of third trochanter) are also present in earlier Miocene apes. Here, we use geometric morphometrics to reassess the morphological affinities of BAR 1002'00 within a large sample of anthropoids (including fossil apes and hominins) and reconstruct hominoid proximal femur evolution using squared-change parsimony. Our results indicate that both hominin and modern great ape femora evolved in different directions from a primitive morphology represented by some fossil apes. Orrorin appears intermediate between Miocene apes and australopiths in shape space. This evidence is consistent with femoral shape similarities in extant great apes being derived and homoplastic and has profound implications for understanding the origins of human bipedalism.

  2. Early result of hemiarthroplasty in elderly patients with fracture neck of femur

    PubMed Central

    Daniel, Mue; Mohammed, Salihu; Francis, Awonusi; William, Yongu; Joseph, Kortor; Cornilius, Elachi

    2015-01-01

    Background: Fractured neck of femur is a frequent and severe injury in elderly patients with consequent high morbidity and mortality. Hemiarthroplasty is an established treatment modality for displaced intracapsular femoral neck fractures in elderly patients above 60 years. This study analysed the early functional outcome and complications of Austin Moore endoprosthesis in elderly patients above 60 years with fractured neck of femur. Materials and Methods: Retrospective data were obtained over a 5 year period from January 2007 to December 2012. Thirty-five elderly patients of 60 years and above with displaced intracapsular fracture neck of femur treated with hemiarthroplasty using Austin Moore endoprosthesis were included. Data were analysed using SPSS version 21. Results: A total of 35 patients were involved. The age-range was 60-90 years with mean age of 69.7 ± 7 years. The predominant mechanism of injury was trivial falls in 18 (66.7%) patients. The commonest complication was pressure sore in 2 (5.7%) patients, followed by surgical site infection in 1 (2.9%) patient and periprosthetic fracture in 1 (2.9%) patients. Early post-operative mortality was 2.9%. Post-operative hip functional status according to Postel and Merle d Aubigne revealed that majority (66.6%) of patients had satisfactory hip function. Conclusion: Functional outcome of Austin Moore in elderly patients above 60 years with fracture neck of femur was satisfactory in most of the cases with minimal morbidity. Careful patient selection for hemiarthroplasty is vital and may decrease the incidence of complications and ameliorate the outcomes in the treatment of intracapsular femoral neck fractures. PMID:25657497

  3. A new technique of endoprosthetic replacement for osteosarcoma of proximal femur with intra-articular extension

    PubMed Central

    Oragui, E.; Nannaparaju, M.; Sri-Ram, K.; Khan, W.; Hashemi-Nejad, A.; Skinner, J.

    2012-01-01

    INTRODUCTION Osteosarcoma is the most common primary malignant tumour of bone and commonly involved sites are the distal femur, proximal tibia, and humerus. Osteosarcoma of proximal femur usually arises at the metaphysis and articular cartilage acts as a relative barrier to tumour spread, with extension into the hip joint being extremely rare. PRESENTATION OF CASE A previously fit and well sixteen-year-old male presented with a 2 month history of right hip pain and a limp. Plain radiographs and magnetic resonance imaging (MRI) showed an expansile lesion in the right femoral neck, extending 16 cm distally from the proximal femoral articular surface through the intertrochanteric region into the upper right femoral shaft. There was also clear evidence of intra-articular extension into the acetabulum. DISCUSSION Endoprosthetic replacement following resection is a good treatment option for proximal femoral tumours due to the low complication rate and achievement of good postoperative function. However, treatment of a proximal femoral lesion with intra-articular involvement by prosthetic reconstruction is challenging. We report a patient who presented with osteosarcoma of the proximal femur extending into the hip joint and describe the technique of en-bloc extra-articular resection of the acetabulum and proximal femur with reconstruction using a custom made prosthesis. CONCLUSION We conclude that extra-articular resection and endoprosthetic reconstruction using a coned hemi-pelvic implant with fluted stem and a modular femoral implant is a useful treatment option in the management of a proximal femoral lesion involving the hip-joint. It allows adequate tumour clearance and stable reconstruction for rapid post-operative recovery with early mobilisation. PMID:23147775

  4. Which Implant Is Best After Failed Treatment for Pathologic Femur Fractures?

    DTIC Science & Technology

    2012-01-01

    Gustafson P. Surgery for metastatic lesions of the femur: good outcome after 245 operations in 216 patients . Injury. 2008;39:404–410. 12. Potter BK...and patient -specific variables; however, its durability must generally match the patient’s estimated life expectancy. Failures do occur, however, it...is unclear which implants are associated with greater risk of failure. Questions/Purposes We evaluated patients with femoral metastases in whom

  5. Outcome of Titanium Elastic Intramedullary Nail in the Treatment of Shaft of Femur Fracture in Children.

    PubMed

    Khan, J A; Singh, G P; Pandey, A

    2015-01-01

    Background Femoral-shaft fractures are among the most common fractures of the lower extremity in children. There are several different options for treating femoral-shaft fractures in children. Elastic stable intramedullary nailing (ESIN) has become the standard treatment for fractures of shaft of femur in children for reasons including mini-invasive surgery, no need for casting, early mobilization and discharge as well as growing concerns toward cost-effectiveness. Objective To demonstrate the effectiveness of intramedullary fixation of fracture shaft of femur in skeletally immature children using the titanium elastic intramedullary nails. Method Forty children who underwent fixation with titanium intramedullary nails because of fracture of shaft of femur (Winquist and Hansen type 1 and 2) were reviewed. There were 60% male and 40% female patients and mean follow-up was six months. Time of union, deformity at fracture site, limb length discrepancy, knee range of motion and complications were assessed. Result Average age of the patients was 5.17 years (range 3 to 10). All patients achieved complete healing at a mean 12.8 weeks (range 10 to 20 weeks). Average limb length discrepancy was -0.16 cm (range -1.0 to 1.1 cm) average knee range of motion was 137.55 degrees (range 118 to 152 degrees). Complications were recorded in 13 (31.7%) patients and included: Five malunion which did not show any deformity or functional impairment and eight superficial wound infections which were healed after removal of nail. All patients were active as their pre injury levels at six months follow up. Conclusion Elastic stable intramedullary nailing is the method of choice for the simple pediatrics fracture shaft of femur, as it is minimally invasive and shows good functional and cosmetic results. It allows short hospital stay and quick recovery from pain and is cast-free.

  6. Loading mechanics of the femur in tiger salamanders (Ambystoma tigrinum) during terrestrial locomotion.

    PubMed

    Sheffield, K Megan; Blob, Richard W

    2011-08-01

    Salamanders are often used as representatives of the basal tetrapod body plan in functional studies, but little is known about the loads experienced by their limb bones during locomotion. Although salamanders' slow walking speeds might lead to low locomotor forces and limb bone stresses similar to those of non-avian reptiles, their highly sprawled posture combined with relatively small limb bones could produce elevated limb bone stresses closer to those of avian and mammalian species. This study evaluates the loads on the femur of the tiger salamander (Ambystoma tigrinum) during terrestrial locomotion using three-dimensional measurements of the ground reaction force (GRF) and hindlimb kinematics, as well as anatomical measurements of the femur and hindlimb muscles. At peak stress (29.8 ± 2.0% stance), the net GRF magnitude averaged 0.42 body weights and was directed nearly vertically for the middle 20-40% of the contact interval, essentially perpendicular to the femur. Although torsional shear stresses were significant (4.1 ± 0.3 MPa), bending stresses experienced by the femur were low compared with other vertebrate lineages (tensile: 14.9 ± 0.8 MPa; compressive: -18.9 ± 1.0 MPa), and mechanical property tests indicated yield strengths that were fairly standard for tetrapods (157.1 ± 3.7 MPa). Femoral bending safety factors (10.5) were considerably higher than values typical for birds and mammals, and closer to the elevated values calculated for reptilian species. These results suggest that high limb bone safety factors may have an ancient evolutionary history, though the underlying cause of high safety factors (e.g. low limb bone loads, high bone strength or a combination of the two) may vary among lineages.

  7. 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.

  8. 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

  9. Spontaneous bilateral fracture neck of femur secondary to vitamin D deficiency: a case report

    PubMed Central

    Desai, Mihir; Nadkarni, Sambprasad

    2015-01-01

    Summary We report a case of a patient who presented with inability to walk for 2 days which was acute in onset, with no history or preceeding trauma. On examination it was found to have stable vitals. Both lower limbs were in the flexed, abducted & externally rotated attitude, with no sensory motor deficit. Radiological investigations revealing osteoporosis and bilateral fracture neck of femur and blood investigations indicated severe vitamin D deficiency. PMID:26811714

  10. Influence of the upper femur and pelvic geometry on the risk and type of hip fractures.

    PubMed

    Partanen, J; Jämsä, T; Jalovaara, P

    2001-08-01

    The geometry of the upper femur has been reported to associate with the hip fracture risk in postmenopausal women. However, these associations seem to be partly conflicting, probably because of differences in measurement setup. Here, we compared the upper femur and pelvic geometries of 70 hip fracture patients (46 cervical and 24 trochanteric fractures) and 40 age-adjusted controls based on plain anteroposterior radiographs, eliminating the possible sources of inaccuracy as far as possible by using a standardized patient position and calibrated dimension measurements by digital image analysis. The femoral neck/shaft angle (NSA) was larger in the fracture patients compared with the controls (p < 0.001). The fracture group had thinner cortices in the upper femur than the controls (p < 0.001). The femoral shaft diameter (FSD; p < 0.001), trochanter width (TW; p < 0.01), and the pelvic dimensions, that is, the smallest outer pelvic diameter (SOPD; p < 0.01) and the largest inner pelvic diameter (LIPD; p < 0.05) were smaller in the fracture group. Comparing the fracture types, we found NSA larger in the cervical hip fracture patients than in the patients with a trochanteric fracture (p < 0.01). The femoral neck/shaft cortex ratio was lower and the FSD was smaller in the cervical hip fracture group (p < 0.05). Acetabular width (AW) was greater and the SOPD was wider in the cervical fracture patients (p < 0.01). We concluded that the upper femur and pelvic dimensions as defined from calibrated and position-standardized plain radiographs are useful in the evaluation of hip fracture risk and fracture type.

  11. Plate fixation of periprosthetic femur fractures: What happens to the cement mantle?

    PubMed

    Konstantinidis, Lukas; Schmidt, Benjamin; Bernstein, Anke; Hirschmüller, Anja; Schröter, Steffen; Südkamp, Norbert Paul; Helwig, Peter

    2017-02-01

    Osteosynthesis of periprosthetic femur fractures by screw fixation around the implanted prosthetic stem is currently regarded as the biomechanically superior option compared with cerclage. The aim of this biomechanical study was damage analysis of the cement mantle after revision screw insertion. A prosthetic stem (Bicontact) was implanted in 20 cadaveric femora in cemented technique. A locking compression plate (Synthes) was then applied to the lateral femur at the level of the prosthetic stem. The method of plate fixation to the femur was assigned randomly to three groups: bicortical non-locking screws, monocortical locking screws, and bicortical locking screws. This was followed by applying a fluctuating axial load (2100 N, 0.5 Hz) for 20,000 cycles. After testing, macroscopic and microscopic evaluations of the cement mantle were conducted. Cracks formed in the cement mantle in 14% of the 80 screw holes. The type of screw (bicortical or monocortical; locking or non-locking) had no significant effect on the number of cracks (p = 0.52). The relationship between manifestation of crack damage and cement mantle thickness was not significant (p = 0.36), whereas the relationship between crack formation and screw position was significant (p = 0.019). Those screws whose circumference was only partially within the cement mantle yielded a significantly lower number of cracks compared with screws positioned completely within the cement mantle or even touching the prosthetic stem. In order to reduce the incidence of crack formation in the cement mantle during plate osteosynthesis of periprosthetic femur fractures, the screws should not be either placed within the cement mantle or make direct contact with the stem.

  12. 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

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

    PubMed

    Zheng, Kai; Yu, Xiuchun; Xu, Songfeng; Xu, Ming

    2015-04-01

    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.

  14. Integrated remodeling-to-fracture finite element model of human proximal femur behavior.

    PubMed

    Hambli, Ridha; Lespessailles, Eric; Benhamou, Claude-Laurent

    2013-01-01

    The purpose of this work was to develop an integrated remodeling-to-fracture finite element model allowing for the combined simulation of (i) simulation of a human proximal femur remodeling under a given boundary conditions, (ii) followed by the simulation of its fracture behavior (force-displacement curve and fracture pattern) under quasi-static load. The combination of remodeling and fracture simulation into one unified model consists in considering that the femur properties resulting from the remodeling simulation correspond to the initial state for the fracture prediction. The remodeling model is based on phenomenological one based on a coupled strain and fatigue damage stimulus. The fracture model is based on continuum damage mechanics in order to predict the progressive fracturing process which allows to predict the fracture pattern and the complete force-displacement curve under quasi-static load. To prevent mesh-dependence that generally affects the damage propagation rate, regularization technique was applied in the current work. To investigate the potential of the proposed unified remodeling-to-fracture model, we performed remodeling simulations on a 3D proximal femur model for a duration of 365 days under five different daily loading conditions followed by a side fall fracture simulation reproducing previously published experimental tests (de Bakker et al. (2009), case C, male, 72 years old). We show here that the implementation of an integrated remodeling-to-fracture model provides more realistic prediction strategy to assess the bone remodeling effects on the fracture risk of bone.

  15. 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.

  16. [Zinc deficiency on pathological changes of femur epiphyseal growth plate in rats].

    PubMed

    Zhang, Yuehong; Cheng, Yiyong; Hong, Yan; Li, Shutian

    2003-01-01

    To study zinc deficiency on pathological changes of femur epiphyseal growth plate in rats thirty Wistar rats were randomly divided into three groups: zinc-deficient group (Zd), control group (Ctr), and pair-fed group (Zp) to study the effects of zinc deficiency on femur epiphyseal growth plate of rats and the mechanism involved. After 8 weeks feeding, the histomorphology of right femur indicated that chondrocytes in the epiphyseal growth plate of Zd group were generally ill-organized and mis-shaped. The number of chondrocytes decreased. Trabecular bone in the epiphyseal of Zd group were also ill-organized, scarce and slim. The cavities of marrow in Zd animals were significantly larger than those of Ctr and Zp. The volume of trabecular bone, the mean trabecular plate density of Zd rats were significantly decreased, but their mean trabecular plate space was significantly increased. In addition, the Zd animals had significantly lower concentration of osteocalcin and growth hormone in sera. The above results suggested that zinc deficiency impaired proliferation and differentiation of chondrocytes and balance between osteoblast and osteoclast function by reduce growth hormone levels in sera. The lack of zinc in diet resulted in disorder of bone molding and ultrastructure.

  17. 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.

  18. Comparing discriminant analysis and neural network for the determination of sex using femur head measurements.

    PubMed

    Alunni, Véronique; Jardin, Philippe du; Nogueira, Luisa; Buchet, Luc; Quatrehomme, Gérald

    2015-08-01

    The measurement of the femoral head is usually considered an interesting variable for the sex determination of skeletal remains. To date, there are few published reference measurements of the femoral head in a modern European population for the purpose of sex determination. In this study, 116 femurs from 58 individuals of the South of France (Nice Bone Collection, Nice, France) were studied. Three measurements of the femoral head were taken: the vertical head diameter (VHD), the transversal head diameter (THD) and the head circumference (HC). The results show that: (i) there is no statistical difference between the right and left femurs for each of the three measurements (VHD, THD and HC). Therefore we arbitrarily chose to use the measures from the right femurs (N=58) to pursue our experiments; (ii) the measurements of the femoral head are similar to those of contemporary American populations; (iii) the dimensions of the femoral head place the measurements of the French population somewhere between Germany or Croatia, and Spain; (iv) there is no significant secular trend (in contrast with the femoral neck diameter); (v) the femoral head measurement as a single variable is useful for sex determination: a 96.5% rate of accuracy was obtained using THD and HC measurements with the artificial neural network; and a 94.8% rate of accuracy using VHD, both with the discriminant analysis and the neural network.

  19. Towards automatic measurement of anteversion and neck-shaft angles in human femurs using CT images.

    PubMed

    Casciaro, Mariano E; Craiem, Damian

    2014-01-01

    Automatic assessment of human femur morphology may provide useful clinical information with regard to hip and knee surgery, prosthesis design and management of hip instability. To this end, neck-shaft and anteversion angles are usually used. We propose a full automatic method to estimate these angles in human femurs. Multislice CT images from 18 dried bones were analysed. The algorithm fits 3D cylinders to different regions of the bone to estimate the angles. A manual segmentation and a conventional angle assessment were used for validation. We found anteversion angle as 20 ± 7° and neck-shaft angle as 130 ± 9°. Mean distances from femur surface to cylinders were 5.5 ± 0.6, 3.5 ± 0.6 and 2.4 ± 0.4 mm for condyles, diaphysis and neck regions, respectively. Automatic and conventional angles were positively correlated (r(2)>0.85). Manual and automatic segmentations did not differ. The method was fast and 100% reproducible. A robust in vivo segmentation algorithm should be integrated to advance towards a clinically compliant methodology.

  20. 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.

  1. Anthropometric measurements of the human distal femur: a study of the adult Malay population.

    PubMed

    Hussain, Fitdriyah; Abdul Kadir, Mohammed Rafiq; Zulkifly, Ahmad Hafiz; Sa'at, Azlin; Aziz, Azian Abd; Hossain, Golam; Kamarul, T; Syahrom, Ardiyansyah

    2013-01-01

    The distal femurs of 100 subjects (50 men, 50 women) from the Malay population aged between 19 and 38 years were scanned to measure the anterior-posterior (AP) and medial-lateral (ML) width. The mean AP values were 64.02 ± 3.38 mm and 57.33 ± 3.26 mm for men and women, respectively, and the mean ML values were 74.91 ± 3.52 mm and 64.53 ± 3.07 mm. We compared our data to that published previously for the Chinese and Indian populations. It was found that the Malay population had smaller distal femur than that of the Chinese but was larger than that of the Indian population (P < 0.05). In conclusion, although it is well established that Asians have a smaller distal femur size than that of the Western population, the variations in different Asian ethnicities may need to be considered when designing the appropriate knee implant.

  2. 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

  3. 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.

  4. Blood flow changes to the proximal femur during total hip arthroplasty

    PubMed Central

    Hupel, Thomas M.; Schemitsch, Emil H.; Aksenov, Sergei A.; Waddell, James P.

    2000-01-01

    Objective To determine the changes in perfusion to the proximal femur that occur during cemented and uncemented total hip arthroplasty (THA). Design Case series. Setting A single tertiary-care centre. Patients Twenty-two consecutive patients. Those who had undergone previous hip surgery or received systemic corticosteroid therapy were excluded. Intervention Cemented (11 procedures) or uncemented (12 procedures) THA. Main outcome measure Changes in blood flow at the level of the proximal femur, measured with laser Doppler flowmetry at 4 different times during THA. Results In both the cemented and the uncemented procedure overall proximal femoral blood flow was reduced (p = 0.002, p = 0.008, respectively). A greater reduction in overall proximal femoral perfusion was seen in the cemented group compared with the uncemented group (p = 0.004). This greater reduction in perfusion was seen primarily in the proximal femoral diaphysis (p = 0.004). Conclusion The extensive canal preparation involved with the cemented procedure or the introduction of bone cement under pressure into the femoral canal may contribute to the greater reduction in perfusion to the proximal femur. PMID:11045094

  5. 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.

  6. 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.

  7. Treatment of femoral subtrochanteric fractures with proximal lateral femur locking plates

    PubMed Central

    Hu, Sun-jun; Zhang, Shi-min; Yu, Guang-rong

    2012-01-01

    OBJECTIVE: To study the outcome of subtrochanteric hip fractures treated with proximal lateral femur locking plate. METHOD: We retrospectively reviewed the clinical results of 48 cases of femoral subtrochanteric fractures treated with proximal lateral femur locking plates from January 2008 to May 2010. The progress of fracture healing, as well as the occurrence of complications, was recorded. The function of the hip joint was evaluated by the Harris social index and the Parker and Palmer mobility score one year after the operation. RESULT: 45 patients were followed up until fracture union or a revision surgery. Among the 45 patients, 43 patients obtained fracture union without further intervention. Thirty-eight fractures healed with no loss of position at 1-year follow-up. There were no cases of hip screw cutting through the femoral head. The mean score of the Harris social index was 86.5±9.8 (73~95). The mean Parker and Palmer mobility score was 7.4±2.1 (3~9). CONCLUSION: The proximal lateral femur locking plate is the kind of stable and effective internal fixation for treating subtrochanteric hip fractures which has the advantage of stable fixation especially for the lateral femoral wall fracture. Level of Evidence IV, Case Series. PMID:24453626

  8. 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.

  9. 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.

  10. Femur length, body mass, and stature estimates of Orrorin tugenensis, a 6 Ma hominid from Kenya.

    PubMed

    Nakatsukasa, Masato; Pickford, Martin; Egi, Naoko; Senut, Brigitte

    2007-07-01

    To understand the palaeobiology of extinct hominids it is useful to estimate their body mass and stature. Although many species of early hominid are poorly preserved, it is occasionally possible to calculate these characteristics by comparison with different extant groups, by use of regression analysis. Calculated body masses and stature determined using these models can then be compared. This approach has been applied to 6 Ma hominid femoral remains from the Tugen Hills, Kenya, attributed to Orrorin tugenensis. It is suggested that the best-preserved young adult individual probably weighed approximately 35-50 kg. Another fragmentary femur results in larger estimates of body mass, indicative of individual variation. The length of the femur of the young adult individual was estimated, by using anthropoid-based regression, to be a minimum of 298 mm. Because whole-femur proportions for Orrorin are unknown, this prediction is conservative and should be revised when additional specimens become available. When this predicted value was used for regression analysis of bonobos and humans it was estimated to be 1.1-1.2 m tall. This value should, however, be viewed as a lower limit.

  11. 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

  12. Three-dimensional conformal intensity-modulated radiation therapy of left femur foci does not damage the sciatic nerve

    PubMed Central

    Xu, Wanlong; Zhao, Xibin; Wang, Qing; Sun, Jungang; Xu, Jiangbo; Zhou, Wenzheng; Wang, Hao; Yan, Shigui; Yuan, Hong

    2014-01-01

    During radiotherapy to kill femoral hydatid tapeworms, the sciatic nerve surrounding the focus can be easily damaged by the treatment. Thus, it is very important to evaluate the effects of radiotherapy on the surrounding nervous tissue. In the present study, we used three-dimensional, conformal, intensity-modulated radiation therapy to treat bilateral femoral hydatid disease in Meriones meridiani. The focus of the hydatid disease on the left femur was subjected to radiotherapy (40 Gy) for 14 days, and the right femur received sham irradiation. Hematoxylin-eosin staining, electron microscopy, and terminal deoxynucleotidyl transferase-dUTP nick end labeling assays on the left femurs showed that the left sciatic nerve cell structure was normal, with no obvious apoptosis after radiation. Trypan blue staining demonstrated that the overall protoscolex structure in bone parasitized with Echinococcus granulosus disappeared in the left femur of the animals after treatment. The mortality of the protoscolex was higher in the left side than in the right side. The succinate dehydrogenase activity in the protoscolex in bone parasitized with Echinococcus granulosus was lower in the left femur than in the right femur. These results suggest that three-dimensional conformal intensity-modulated radiation therapy achieves good therapeutic effects on the secondary bone in hydatid disease in Meriones meridiani without damaging the morphology or function of the sciatic nerve. PMID:25422645

  13. 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

  14. Linear densitometry and digital image processing of proximal femur radiographs: implications for archaeological and forensic anthropology.

    PubMed

    Macchiarelli, R; Bondioli, L

    1994-01-01

    Age- and sex-related patterns of proximal femur trabecular bone loss have previously been used to establish radiographic reference standards for estimating age at death for human skeletal remains. Such standards are of interest to both anthropologists and forensic scientists. However, osteopenia as a physiological phenomenon is dependent on numerous genetic, environmental, and cultural factors. Thus, while general age- and sex-related trends can be clearly observed for trabecular bone loss, such patterns also demonstrate marked variation among individuals of both sexes at all ages. Moreover, clinical evidence shows that rates of bone loss are not steady but episodic, and that radiographically "normal" (i.e., young adult) patterns of trabecular bone architecture can also exist in femora of older individuals, particularly within samples of African origin. In this study, adult proximal femur radiographs were used to explore patterns of age- and sex-related proximal femur cancellous bone involution among a sample of 66 African-American individuals from the Terry collection (33 males and 33 females), ranging in age from 19 to 71 years. The proximal femur radiographs of these subjects were analyzed by digital image processing (DIP), and the results were compared to those obtained by laser linear densitometric analyses (LDA) previously performed on the same series (Macchiarelli et al., 1987). Results of LDA and DIP analyses indicate (a) more pronounced bone density decrease in females; (b) sex- and site-specific structural patterns of proximal femur trabecular bone loss; (c) a high level of individual variability, in which predicted age deviated from real age by as much as 22.26 (males) and 30.78 years (females); (d) a moderate linear correlation with age for all the variables analyzed; and (e) an average discrepancy between known age and predicted age (measured by root mean squared residual values) of 10.34 (males) and 12.71 years (females) for the most satisfactory DIP

  15. Dynamic hip screw versus proximal femur locking compression plate in intertrochanteric femur fractures (AO 31A1 and 31A2): A prospective randomized study

    PubMed Central

    Agrawal, Prabhat; Gaba, Sahil; Das, Saubhik; Singh, Ranjit; Kumar, Arvind; Yadav, Gajanand

    2017-01-01

    Introduction: Intertrochanteric fractures are common in elderly population and pose a significant financial burden to the society. Anatomically contoured proximal femur locking compression plate (PFLCP) is the latest addition in the surgeons’ armamentarium to deal with these fractures. It creates an angular stable construct, which will theoretically lessen the risk of failure by screw cut-out and varus collapse, the common mode of DHS failure. We compared DHS with PFLCP in AO type 31A1 and 31A2 intertrochanteric fractures. Materials and Methods: A randomized prospective study was carried out between June 2011 and June 2013. 26 cases each of DHS and PFLCP were included. Results: Functional and radiological outcome was similar in both groups. Conclusion: Both DHS and PFLCP are good choices for stable intertrochanteric fractures, and both lead to excellent functional outcomes, but non-union might be more common with PFLCP.

  16. 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

  17. Clinical and Radiological Comparison of Femur and Fibular Allografts for the Treatment of Cervical Degenerative Disc Diseases

    PubMed Central

    Oh, Hyeong-Seok; Shim, Chan Shik; Lee, Sang-Ho

    2013-01-01

    Objective This consecutive retrospective study was designed to analyze and to compare the efficacy and outcomes of anterior cervical discectomy and fusion (ACDF) using a fibular and femur allograft with anterior cervical plating. Methods A total of 88 consecutive patients suffering from cervical degenerative disc disease (DDD) who were treated with ACDF from September 2007 to August 2010 were enrolled in this study. Thirty-seven patients (58 segments) underwent anterior interbody fusion with a femur allograft, and 51 patients (64 segments) were treated with a fibular allograft. The mean follow-up period was 16.0 (range, 12-25) months in the femur group and 19.5 (range, 14-39) months in the fibular group. Cage fracture and breakage, subsidence rate, fusion rate, segmental angle and height and disc height were assessed by using radiography. Clinical outcomes were assessed using a visual analog scale and neck disability index. Results At 12 months postoperatively, cage fracture and breakage had occurred in 3.4% (2/58) and 7.4% (4/58) of the patients in the femur group, respectively, and 21.9% (14/64) and 31.3% (20/64) of the patients in the fibular group, respectively (p<0.05). Subsidence was noted in 43.1% (25/58) of the femur group and in 50.5% (32/64) of the fibular group. No difference in improvements in the clinical outcome between the two groups was observed. Conclusion The femur allograft showed good results in subsidence and radiologic parameters, and sustained the original cage shape more effectively than the fibular allograft. The present study suggests that the femur allograft may be a good choice as a fusion substitute for the treatment of cervical DDD. PMID:23439721

  18. 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.

  19. 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.

  20. Proximal femur elastic behaviour is the same in impact and constant displacement rate fall simulation.

    PubMed

    Gilchrist, S; Nishiyama, K K; de Bakker, P; Guy, P; Boyd, S K; Oxland, T; Cripton, P A

    2014-11-28

    Understanding proximal femur fracture may yield new targets for fracture prevention screening and treatment. The goal of this study was to characterize force-displacement and failure behaviours in the proximal femur between displacement control and impact loading fall simulations. Twenty-one human proximal femurs were tested in two ways, first to a sub-failure load at a constant displacement rate, then to fracture in an impact fall simulator. Comparisons of sub-failure energy and stiffness were made between the tests at the same compressive force. Additionally, the impact failure tests were compared with previous, constant displacement rate failure tests (at 2 and 100mm/s) in terms of energy, yield force, and stiffness. Loading and displacement rates were characterized and related to specimen stiffness in the impact tests. No differences were observed between the sub-failure constant displacement and impact tests in the aforementioned metrics. Comparisons between failure tests showed that the impact group had the lowest absorbed energy, 24% lower maximum force and 160% higher stiffness than the 100mm/s group (p<0.01 for all), but suffered from low statistical power to differentiate the donor age and specimen BMD. Loading and displacement rates for the specimens tested using impact varied during each test and between specimens and did not show appreciable viscoelasticity. These results indicate that constant displacement rate testing may help understand sub-failure mechanical behaviour, but may not elucidate failure behaviours. The differences between the impact and constant displacement rate fall simulations have important ramifications for interpreting the results of previous experiments.

  1. Deformities in conservatively treated closed fractures of the shaft of the femur in children.

    PubMed

    Puttaswamaiah, Ravindra; Chandran, Prakash; Sen, Ramesh; Kataria, Sudha; Gill, Shivender Singh

    2006-04-01

    We present the outcome of non-operative management of fractures of the shaft of the femur in children. Thirty children with non-operatively managed unilateral fractures of the shaft of the femur were studied. The mean age was 6.5 years (range: 1.2 to 12). Axial, angular and rotational malunion were assessed clinically and radiologically by plain films and computed tomography (CT). All children had shortening of the fractured limb with a mean shortening of 1.8 cm (range: 0.5 to 3.5). A significant level of shortening was seen in children over 7 years. In the sagittal plane, all had anterior angulation ranging from 4 degrees to 31 degrees (mean: 17.8 degrees) and in the coronal plane, lateral angulation (varus) was seen in 90% (27 patients) with a mean angle of 8.9 degrees. Rotational malunion ranged from -43 degrees to +43 degrees (mean: 9.5 degrees), 30% had rotational malunion of > 20 degrees compared to the uninjured side; 73% had internal rotation malunion and 27% had external rotation malunion. We conclude that non-operative management of fractures of the shaft of the femur in children often results in malunion at the fracture, particularly in the older age group and in comminuted fractures. Perhaps a longer follow-up might have shown lower levels of malunion. Frequent monitoring of fracture position may reduce the occurrence of deformity. It may be appropriate to consider reduction and operative stabilisation of such fractures whenever neces-

  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.

  3. 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

  4. 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.

  5. Salter Harris Fractures of the Distal Femur: Learning Points From Two Cases Compared.

    PubMed

    McKenna, Sean M; Hamilton, Steven W; Barker, Simon L

    2013-01-01

    Salter Harris-type injuries of the distal femur should be treated as a dislocation of the knee and therefore as a medical emergency. Senior medical staff should be involved early, ankle-brachial index ratio should be measured in all patients and the clinician should have a high index of suspicion for a vascular injury. Ideally reduction, stabilization, and vascular repair, if necessary, should be carried out within 6 hours of the initial event. There should be a low threshold for fasciotomies. These 2 cases demonstrate the importance of having a high index of suspicion for vascular injury and the need for continued reassessment.

  6. 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

  7. Structural Analysis and Optimization of the Support Device Used for a Proximal Fracture of the Femur

    DTIC Science & Technology

    2008-12-01

    L bend for valgus curvature. The end caps on both the short and long nail are offered in three sizes: standard, +5mm and +10mm. Both nails are...of the iliac crest [3]. Once the incision is made, a cannulated curved awl is used to open the medullary canal. When reaming the medullary canal...forces produce a bending moment on the proximal end of the femur. By simulating this load, the bone and gamma nail are tested to the limits. The

  8. Bone induction using demineralized bone in the rabbit femur: a long-term study.

    PubMed

    Concannon, M J; Boschert, M T; Puckett, C L

    1997-06-01

    While traditional bone grafting is the standard for replacement of segmental bony defects, alternative options (avoiding morbidity of autologous grafts) are attractive and continue to be sought. This study attempted to determine whether demineralized bone powder could be used reliably to replace a significant bony deficit at a weight-bearing site. The long-term functional characteristics of this induced bone were analyzed to determine whether it maintained its strength and shape and reacted normally to physiologic stress over an extended period of time (12 months). In 55 New Zealand White rabbits, a 1-cm length of femur was removed (approximately 20 percent of the total length of the rabbit femur). The femur was then reconstructed with a titanium mandibular plate, leaving the gap intact. In 38 of the animals, this gap was filled with demineralized bone powder in an attempt to induce bone to form across the defect. In group 1 (n = 23), the mandibular plate remained in place for the duration of the study (12 months). In group 2 (n = 15), the plate was removed 8 weeks after placement of the demineralized bone powder, and the animals were followed for an additional 12 months. In group 3 (n = 10), nothing was placed within the bony gap. In group 4 (n = 7), the gap was repaired with autologous bone graft. All the animals that received demineralized bone powder completely filled the osteotomy gap with new bone within 6 to 8 weeks after implantation. None of control group 3 formed bone across the gap (p < 0.001). Eighty-six percent of control group 4 (autologous bone graft) successfully formed bone across the osteotomy gap. In addition, 90 percent of control group 3 had hardware failure within 8 weeks after surgery compared with 0 percent (0 of 38) of the group that received demineralized bone powder (p < 0.001). In group 1, analysis after 12 months revealed that the bone formed ultimately became thin and easily fractured, most likely because of shielding from stress

  9. Physical therapy in the postoperative of proximal femur fracture in elderly. Literature review

    PubMed Central

    Carneiro, Mariana Barquet; Alves, Débora Pinheiro Lédio; Mercadante, Marcelo Tomanik

    2013-01-01

    The proximal femoral fracture in the elderly is a serious public health problem. Surgical treatment of this fracture is used to reduce morbidity, together with postoperative physical therapy. The objective was to conduct a systematic review of physical therapy protocols in postoperative for fractures of the proximal femur in elderly. We selected randomized controlled trials in elderly in the past 10 years, in Portuguese and English. There were 14 articles in the literature. Physical therapy has an important role in functional recovery of the elderly. Level of Evidence I, Systematic Review RCTs (Study results were homogenous). PMID:24453665

  10. [Indications for usage of oncological prostheses in the treatment of proximal femur methastases].

    PubMed

    Nazar, Jerzy; Nowakowski, Andrzej; Michalski, Paweł; Jaszczak, Tomasz; Bartochowski, Łukasz

    2008-01-01

    In this paper we present indications for usage of oncological prosthesis in the treatment of metastases in proximal femur. According to our experience, based on clinical material of 78 patients treated between year 1997 and 2007 in Spine Surgery, Onclological Orthopaedics and Taumatology Clinic, University of Medical Sciences in Poznan, the indications are: massive bone loss, second surgery in the same place, damage of articular surface, small possibility of stable union, threatening patological fracture. At the appropriately selected group of patients application of onclological prosthesis lets for restoring the function of the limb, reducing or bearing pain complaints or removing the entire methastasis.

  11. 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.

  12. Arthroscopic Excision of an Intraarticular Osteoid Osteoma in the Distal Femur

    PubMed Central

    Kang, Suk; Kim, Young Sung; Lee, Ho Min; Lee, Min Young

    2016-01-01

    An intraarticular osteoid osteoma of the knee is uncommon, and its treatment is challenging. The authors present a case of arthroscopic excision of an intraarticular osteoid osteoma in the distal femur, which was accessible through the knee joint. After confirming the nidus of the osteoid osteoma by computed tomography, the lesion was completely removed arthroscopically. The patient reported complete pain relief immediately after surgery. This case demonstrates that intraarticular osteoid osteomas in the knee joint can be treated by arthroscopic excision and that good results can be obtained. PMID:27904732

  13. Arthroscopic Excision of an Intraarticular Osteoid Osteoma in the Distal Femur.

    PubMed

    Kang, Suk; Kim, Young Sung; Lee, Ho Min; Lee, Min Young; Kim, Jong Pil

    2016-12-01

    An intraarticular osteoid osteoma of the knee is uncommon, and its treatment is challenging. The authors present a case of arthroscopic excision of an intraarticular osteoid osteoma in the distal femur, which was accessible through the knee joint. After confirming the nidus of the osteoid osteoma by computed tomography, the lesion was completely removed arthroscopically. The patient reported complete pain relief immediately after surgery. This case demonstrates that intraarticular osteoid osteomas in the knee joint can be treated by arthroscopic excision and that good results can be obtained.

  14. Long bone florid reactive periostitis ossificans: a case in the distal femur mimicking osteosarcoma.

    PubMed

    Azorín, Daniel; López-Pino, Miguel A; González-Mediero, Imelda; Epeldegui, Tomás; López-Barea, Fernando

    2008-11-01

    Florid reactive periostitis ossificans is a well-known benign lesion classically described in hands and feet which histopathological features can lead to a misdiagnosis of osteosarcoma. To the best of our knowledge, there is only one previous report of this lesion in a long bone. In this study we report a case of florid reactive periostitis ossificans located in the distal metaphysis of the left femur that histologically mimicked an osteosarcoma and discuss the differential diagnosis between these two entities to warn about a diagnostic pitfall.

  15. Comparison of Percutaneous Cementoplasty with and Without Interventional Internal Fixation for Impending Malignant Pathological Fracture of the Proximal Femur

    SciTech Connect

    Tian, Qing-Hua He, Cheng-Jian Wu, Chun-Gen Li, Yong-Dong Gu, Yi-Feng Wang, Tao Xiao, Quan-Ping Li, Ming-Hua

    2016-01-15

    PurposeTo compare the efficacy of percutaneous cementoplasty (PCP) with and without interventional internal fixation (IIF) on malignant impending pathological fracture of proximal femur.MethodsA total of 40 patients with malignant impending pathological fracture of proximal femur were selected for PCP and IIF (n = 19, group A) or PCP alone (n = 21, group B) in this non-randomized prospective study. Bone puncture needles were inserted into the proximal femur, followed by sequential installation of the modified trocar inner needles through the puncture needle sheath. Then, 15–45 ml cement was injected into the femur lesion.ResultsThe overall excellent and good pain relief rate during follow-ups were significantly higher in group A than that in group B (89 vs. 57 %, P = 0.034). The average change of VAS, ODI, KPS, and EFES in group A were significantly higher than those in group B at 1-, 3-, 6-month, 1-year (P < 0.05). Meanwhile, The stability of the treated femur was significantly higher in group A than that in group B (P < 0.05).ConclusionPCP and IIF were not only a safe and effective procedure, but resulted in greater pain relief, bone consolidation, and also reduced the risk of fracture than the currently recommended approach of PCP done on malignant proximal femoral tumor.

  16. Early Alterations in Bone Characteristics of Type I Diabetic Rat Femur: A Fourier Transform Infrared (FT-IR) Imaging Study.

    PubMed

    Bozkurt, Ozlem; Bilgin, Mehmet Dincer; Evis, Zafer; Pleshko, Nancy; Severcan, Feride

    2016-12-01

    Alterations in microstructure and mineral features can affect the mechanical and chemical properties of bones and their capacity to resist mechanical forces. Controversial results on diabetic bone mineral content have been reported and little is known about the structural alterations in collagen, maturation of apatite crystals, and carbonate content in diabetic bone. This current study is the first to report the mineral and organic properties of cortical, trabecular, and growth plate regions of diabetic rat femurs using Fourier transform infrared (FT-IR) microspectroscopy and the Vickers microhardness test. Femurs of type I diabetic rats were embedded into polymethylmethacrylate blocks, which were used for FT-IR imaging and microhardness studies. A lower mineral content and microhardness, a higher carbonate content especially labile type carbonate content, and an increase in size and maturation of hydroxyapatite crystals were observed in diabetic femurs, which indicate that diabetes has detrimental effects on bone just like osteoporosis. There was a decrease in the level of collagen maturity in diabetic femurs, implying a decrease in bone collagen quality that may contribute to the decrease in tensile strength and bone fragility. Taken together, the findings revealed alterations in structure and composition of mineral and matrix components, and an altered quality and mechanical strength of rat femurs in an early stage of type I diabetes. The results contribute to the knowledge of structure-function relationship of mineral and matrix components in diabetic bone disorder and can further be used for diagnostic or therapeutic purposes.

  17. Neck of femur fracture fixation in a bilateral amputee: an uncommon condition requiring an improvised fracture table positioning technique.

    PubMed

    Berg, Andrew James; Bhatia, Chandra

    2014-02-21

    While neck of femur fractures are common it is rare to see this injury in a bilateral leg amputee. Special consideration needs to be given to the management of these patients. We report the case of a 58-year-old man with bilateral leg amputation who presented to the emergency department with left hip pain following a fall. A fracture of the left neck of femur with extension into the femoral shaft was diagnosed. Internal fixation was planned with a dynamic hip screw. Standard fracture table setup, which allows for traction of the fractured limb and positioning of the contralateral limb such that anteroposterior and lateral X-rays can be obtained, was not possible in this case due to the amputations. We highlight considerations that need to be made in positioning a bilateral amputee for neck of femur fracture fixation and also highlight an improvised technique that can be utilised by other surgeons.

  18. Analysis on the results from percutaneous extensor osteotomy of the distal femur in patients with amyoplasia☆☆☆

    PubMed Central

    Moreira, Marcus Vinicius; Rimoldi, André Casari; Aoki, Solange

    2014-01-01

    Objective to review the medical files of 19 patients with a diagnosis of amyoplasia, who underwent percutaneous extensor osteotomy of the distal femur to correct deformities in whom the knees were fixed in flexion. Methods we analyzed 37 osteotomy procedures on 35 knees that presented an initial deformity in which the knees were fixed in flexion at 33.8°. All of these knees underwent percutaneous extensor osteotomy of the distal femur and were followed up for a mean period of 73.7 months. Results we observed recurrence of the deformity in 29 osteotomy cases, i.e. in 78.4% of them. The mean recurrence velocity of the deformity was 0.69°/month. Conclusion percutaneous extensor osteotomy of the distal femur provided sufficient correction of deformities in which the knee was fixed in flexion in these amyoplasia cases, but there was a significant degree of recurrence among the patients analyzed. PMID:26229825

  19. 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

  20. 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

  1. 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

  2. Computational study of Wolff's law with trabecular architecture in the human proximal femur using topology optimization.

    PubMed

    Jang, In Gwun; Kim, Il Yong

    2008-08-07

    In the field of bone adaptation, it is believed that the morphology of bone is affected by its mechanical loads, and bone has self-optimizing capability; this phenomenon is well known as Wolff's law of the transformation of bone. In this paper, we simulated trabecular bone adaptation in the human proximal femur using topology optimization and quantitatively investigated the validity of Wolff's law. Topology optimization iteratively distributes material in a design domain producing optimal layout or configuration, and it has been widely and successfully used in many engineering fields. We used a two-dimensional micro-FE model with 50 microm pixel resolution to represent the full trabecular architecture in the proximal femur, and performed topology optimization to study the trabecular morphological changes under three loading cases in daily activities. The simulation results were compared to the actual trabecular architecture in previous experimental studies. We discovered that there are strong similarities in trabecular patterns between the computational results and observed data in the literature. The results showed that the strain energy distribution of the trabecular architecture became more uniform during the optimization; from the viewpoint of structural topology optimization, this bone morphology may be considered as an optimal structure. We also showed that the non-orthogonal intersections were constructed to support daily activity loadings in the sense of optimization, as opposed to Wolff's drawing.

  3. 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.

  4. 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.

  5. Evaluation of Decalcification Techniques for Rat Femurs Using HE and Immunohistochemical Staining.

    PubMed

    Liu, Haixia; Zhu, Ruyuan; Liu, Chenyue; Ma, Rufeng; Wang, Lili; Chen, Beibei; Li, Lin; Niu, Jianzhao; Zhao, Dandan; Mo, Fangfang; Fu, Min; Brömme, Dieter; Zhang, Dongwei; Gao, Sihua

    2017-01-01

    Aim. In routine histopathology, decalcification is an essential step for mineralized tissues. The purpose of this study is to evaluate the effects of different decalcification solutions on the morphological and antigenicity preservation in Sprague Dawley (SD) rat femurs. Materials and Methods. Four different decalcification solutions were employed to remove the mineral substances from rat femurs, including 10% neutral buffered EDTA, 3% nitric acid, 5% nitric acid, and 8% hydrochloric acid/formic acid. Shaking and low temperature were used to process the samples. The stainings of hematoxylin-eosin (HE) and immunohistochemical (IHC) were employed to evaluate the bone morphology and antigenicity. Key Findings. Different decalcification solutions may affect the quality of morphology and the staining of paraffin-embedded sections in pathological examinations. Among four decalcifying solutions, 3% nitric acid is the best decalcifying agent for HE staining. 10% neutral buffered EDTA and 5% nitric acid are the preferred decalcifying agents for IHC staining. Significance. The current study investigated the effects of different decalcifying agents on the preservation of the bone structure and antigenicity, which will help to develop suitable protocols for the analyses of the bony tissue.

  6. 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

  7. Evaluation of Decalcification Techniques for Rat Femurs Using HE and Immunohistochemical Staining

    PubMed Central

    Liu, Haixia; Zhu, Ruyuan; Liu, Chenyue; Ma, Rufeng; Wang, Lili; Chen, Beibei; Li, Lin; Niu, Jianzhao; Mo, Fangfang; Fu, Min; Brömme, Dieter

    2017-01-01

    Aim. In routine histopathology, decalcification is an essential step for mineralized tissues. The purpose of this study is to evaluate the effects of different decalcification solutions on the morphological and antigenicity preservation in Sprague Dawley (SD) rat femurs. Materials and Methods. Four different decalcification solutions were employed to remove the mineral substances from rat femurs, including 10% neutral buffered EDTA, 3% nitric acid, 5% nitric acid, and 8% hydrochloric acid/formic acid. Shaking and low temperature were used to process the samples. The stainings of hematoxylin-eosin (HE) and immunohistochemical (IHC) were employed to evaluate the bone morphology and antigenicity. Key Findings. Different decalcification solutions may affect the quality of morphology and the staining of paraffin-embedded sections in pathological examinations. Among four decalcifying solutions, 3% nitric acid is the best decalcifying agent for HE staining. 10% neutral buffered EDTA and 5% nitric acid are the preferred decalcifying agents for IHC staining. Significance. The current study investigated the effects of different decalcifying agents on the preservation of the bone structure and antigenicity, which will help to develop suitable protocols for the analyses of the bony tissue. PMID:28246608

  8. Effects of chronic lead exposure on bone mineral properties in femurs of growing rats.

    PubMed

    Álvarez-Lloret, Pedro; Lee, Ching Ming; Conti, María Inés; Terrizzi, Antonela Romina; González-López, Santiago; Martínez, María Pilar

    2017-02-15

    Lead exposure has been associated with several defective skeletal growth processes and bone mineral alterations. The aim of the present study is to make a more detailed description of the toxic effects of lead intoxication on bone intrinsic material properties as mineral composition, morphology and microstructural characteristics. For this purpose, Wistar rats were exposed (n=12) to 1000ppm lead acetate in drinking water for 90days while control group (n=8) were treated with sodium acetate. Femurs were examined using inductively coupled plasma optical emission spectrometry (ICP-OES), Attenuated Total Reflection Fourier transform infrared spectroscopy (ATR-FTIR), X-ray diffraction (XRD), and micro-Computed Tomography (μCT). Results showed that femur from the lead-exposed rats had higher carbonate content in bone mineral and (Ca(2+)+Mg(2+)+ Na(+))/P ratio values, although no variations were observed in crystal maturity and crystallite size. From morphological analyses, lead exposure rats showed a decreased in trabecular bone surface and distribution while trabecular thickness and cortical area increased. These overall effects indicate a similar mechanism of bone maturation normally associated to age-related processes. These responses are correlated with the adverse actions induced by lead on the processes regulating bone turnover mechanism. This information may explain the osteoporosis diseases associated to lead intoxication as well as the risk of fracture observed in populations exposed to this toxicant.

  9. 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

  10. Sodium tungstate alleviates biomechanical properties of diabetic rat femur via modulation of oxidative stress.

    PubMed

    Donmez, Baris O; Ozturk, Nihal; Sarikanat, Mehmet; Oguz, Nurettin; Sari, Ramazan; Ozdemir, Semir

    2014-01-01

    Diabetes mellitus leads to bone disorders such as osteopenia and osteoporosis that can increase fracture risk. On the other hand, sodium tungstate is an inorganic compound which exerts anti-diabetic activity in experimental studies due to its suggested insulin-mimetic or antioxidant activity. Therefore this study was designed to investigate the effect of tungstate on bone quality in diabetic rat femurs. The rats were divided into four groups: Control (C), tungstate-treated control (C+Tung), diabetes (STZ-D) and tungstate-treated diabetes (STZ-D+Tung). Diabetes mellitus was induced by single injection of streptozotocin (50 mg/kg). The treated rats received 150 mg/kg/day of sodium tungstate for 12 weeks. Sodium tungstate achieved a little (17%) but significant reduction on blood glucose levels, while it didn't recover the reduced body weights of diabetic rats. In addition, impaired bone mechanical quality was reversed, despite the unchanged mineral density. Sodium tungstate administration significantly lowered the 2-thiobarbituric acid reactive substances and restored the activity of tissue antioxidant enzymes such as glutathione peroxidase, catalase and superoxide dismutase in diabetic rats. On the other hand, glutathione levels didn't change in either case. These findings indicate that tungstate can improve the reduced mechanical quality of diabetic rat femurs due probably to reduction of reactive oxygen species and modulation of antioxidant enzymes as well as reduction in blood glucose levels.

  11. Surgical treatment of skeletal metastatic lesions of the proximal femur: endoprosthesis or reconstruction nail?

    PubMed

    Wedin, R; Bauer, H C F

    2005-12-01

    We report positive and negative factors associated with the most commonly-used methods of reconstruction after pathological fracture of the proximal femur. The study was based on 142 patients treated surgically for 146 metastatic lesions between 1996 and 2003. The local rate of failure was 10.3% (15 of 146). Of 37 operations involving osteosynthetic devices, six failed (16.2%) compared with nine (8.3%) in 109 operations involving endoprostheses. Of nine cases of prosthetic failure, four were due to periprosthetic fractures and three to recurrent dislocation. In the osteosynthesis group, three (13.6%) of 22 reconstruction nails failed. The two-year risk of re-operation after any type of osteosynthesis was 0.35 compared with 0.18 after any type of endoprosthetic reconstruction (p = 0.07). Endoprosthetic reconstructions are preferable to the use of reconstruction nails and other osteosynthetic devices for the treatment of metastatic lesions in the proximal third of the femur.

  12. Comparative Study of Bipolar Hemiarthroplasty for Femur Neck Fractures Treated with Cemented versus Cementless Stem

    PubMed Central

    Choi, Jung-Yun; Kim, Joo-Hyung

    2016-01-01

    Purpose To compare and analyze clinical and radiologic outcomes of cemented versus cementless bipolar hemiarthroplasty for treatment of femur neck fractures. Materials and Methods A total of 180 patients aged 65 years and over older who underwent bipolar hemiarthroplasty for treatment of displaced femur neck fractures (Garden stage III, IV) from March 2009 to February 2014 were included in this study. Among the 180 patients, 115 were treated with cemented stems and 65 patients with cementless stems. Clinical outcomes assessed were: i) postoperative ambulatory status, ii) inguinal and thigh pain, and iii) complications. The radiologic outcome was femoral stem subsidence measured using postoperative simple X-ray. Results The cemented group had significantly lower occurrence of complications (postoperative infection, P=0.04) compared to the cementless group. There was no significant difference in postoperative ambulatory status, inguinal and thigh pain, and femoral stem subsidence. Conclusion For patients undergoing bipolar hemiarthroplasty, other than complications, there was no statistically significant difference in clinical or radiologic outcomes in our study. Selective use of cemented stem in bipolar hemiarthroplasty may be a desirable treatment method for patients with poor bone quality and higher risk of infections. PMID:28097110

  13. Effect of chromium on vertebrae, femur and calvaria of adult male rats.

    PubMed

    Sankaramanivel, S; Jeyapriya, R; Hemalatha, D; Djody, S; Arunakaran, J; Srinivasan, N

    2006-06-01

    Alloys of chromium have a long history of success in the surgical treatment of many orthopaedic defects. Nonetheless, prostheses loosening are commonly found around arthoplasties due to corrosion of metals. On this basis, it is hypothesized that chromium accumulation interferes with remodeling of bone. The present study aims to analyse the toxic effects of chromium on bone phosphatases in various regions of the bone in rats. Rats were treated with chromium intraperitoneally (0.5 mg/kg) in the form of potassium dichromate for 5 days. The accumulation of chromium is approximately 5.2-fold in the vertebrae, 8.9-fold in the femur and 8.7-fold in the calvaria, when compared to control. Chromium administration significantly reduced the activity of enzymes, eg, alkaline phosphatase (ALP) and tartrate-resistant acid phosphatase (TRAP). The study revealed a significant increase in the concentration of calcium, altered bone formation rate and bone morphology in the femur, vertebrae and calvaria. The interesting findings of the current study suggest altered bone turnover.

  14. Pathological fracture of the femur in a patient with Paget's disease of bone: a case report.

    PubMed

    Petrescu, Pompiliu HoraŢiu; Izvernariu, Dragoş Andrei; Iancu, Cătălina; Dinu, Gabriel Ovidiu; Berceanu-Văduva, Marcel Mihai; Crişan, Dan; Iacob, Mihaela; Bucur, Venera Margareta; RăuŢia, Ion Călin; Prejbeanu, Ion Radu; Dema, Sorin; DuŢă, Ciprian Constantin

    2016-01-01

    Paget's disease of bone is a benign disease characterized by exaggerated remodeling of the bone matrix after osteoclast-mediated bone destruction. Its etiology is still unknown, despite the fact that it was discovered and described in 1877, but genetic factors and environmental triggers were shown to play their part in the pathogenesis of the disease. The main clinical presentations of the disease are related to bone pain and deformities. Radiological diagnosis is the main detection tool, though many monostotic Paget's disease cases may remain undiagnosed. We present the case of an 81-year-old male patient admitted to the Clinic of Orthopedics, Emergency County Hospital, Timisoara, Romania, with intense pain and deformity of the upper left thigh. Radiological examination performed shows a complete fracture of the upper third diaphysis of the left femur with suggestive signs for Paget's disease of the bone therefore a biopsy was taken and the patient was treated by surgical realignment with favorable evolution. He was discharged 13 days after surgery. The biopsy of the bone revealed extensive bone remodeling with numerous osteoclasts and extensive bone matrix deposition, unevenly stained and unevenly mineralized and reverse cement lines, which are consistent with the diagnosis of Paget's disease of the bone. Histomorphometric analysis show intense matrix deposition with a highly active remodeling process. Computed tomography (CT) scans were performed three years later and show the extension of the disease into the lower half of the left femur.

  15. Evaluating accuracy of structural geometry by DXA methods with an anthropometric proximal femur phantom.

    PubMed

    Khoo, B C C; Beck, T J; Brown, K; Price, R I

    2013-09-01

    DXA-derived bone structural geometry has been reported extensively but lacks an accuracy standard. In this study, we describe a novel anthropometric structural geometry phantom that simulates the proximal femur for use in assessing accuracy of geometry measurements by DXA or other X-ray methods. The phantom consists of seven different interchangeable neck modules with geometries that span the range of dimensions in an adult human proximal femur, including those representing osteoporosis. Ten repeated hip scans of each neck module using two current DXA scanner models were performed without repositioning. After scanner specific calibration, hip structure analysis was used to derive structural geometry. Scanner performance was similar for the two manufacturers. DXA-derived HSA geometric measurements were highly correlated with values derived directly from phantom geometry and position; R² between DXA and phantom measures were greater than 94% for all parameters, while precision error ranged between 0.3 and 3.9%. Despite high R² there were some systematic geometry errors for both scanners that were small for outer diameter, but increasing with complexity of geometrical parameter; e.g. buckling ratio. In summary, the anthropometric phantom and its fabrication concept were shown to be appropriate for evaluating proximal femoral structural geometry in two different DXA systems.

  16. 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

    2015-10-15

    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.

  17. The importance of femur/acetabulum cartilage in the biomechanics of the intact hip: experimental and numerical assessment.

    PubMed

    Duarte, R J; Ramos, A; Completo, A; Relvas, C; Simões, J A

    2015-01-01

    Experimental studies have been made to study and validate the biomechanics of the pair femur/acetabulum considering both structures without the presence of cartilage. The main goal of this study was to validate a numerical model of the intact hip. Numerical and experimental models of the hip joint were developed with respect to the anatomical restrictions. Both iliac and femur bones were replicated based on composite replicas. Additionally, a thin layer of silicon rubber was used for the cartilage. A three-dimensional finite element model was developed and the boundary conditions of the models were applied according to the natural physiological constrains of the joint. The loads used in both models were used just for comparison purposes. The biomechanical behaviour of the models was assessed considering the maximum and minimum principal bone strains and von Mises stress. We analysed specific biomechanical parameters in the interior of the acetabular cavity and on femur's surface head to determine the role of the cartilage of the hip joint within the load transfer mechanism. The results of the study show that the stress observed in acetabular cavity was 8.3 to 9.2 MPa. When the cartilage is considered in the joint model, the absolute values of the maximum and minimum peak strains on the femur's head surface decrease simultaneously, and the strains are more uniformly distributed on both femur and iliac surfaces. With cartilage, the cortex strains increase in the medial side of the femur. We prove that finite element models of the intact hip joint can faithfully reproduce experimental models with a small difference of 7%.

  18. Biomechanical stress maps of an artificial femur obtained using a new infrared thermography technique validated by strain gages.

    PubMed

    Shah, Suraj; Bougherara, Habiba; Schemitsch, Emil H; Zdero, Rad

    2012-12-01

    Femurs are the heaviest, longest, and strongest long bones in the human body and are routinely subjected to cyclic forces. Strain gages are commonly employed to experimentally validate finite element models of the femur in order to generate 3D stresses, yet there is little information on a relatively new infrared (IR) thermography technique now available for biomechanics applications. In this study, IR thermography validated with strain gages was used to measure the principal stresses in the artificial femur model from Sawbones (Vashon, WA, USA) increasingly being used for biomechanical research. The femur was instrumented with rosette strain gages and mechanically tested using average axial cyclic forces of 1500 N, 1800 N, and 2100 N, representing 3 times body weight for a 50 kg, 60 kg, and 70 kg person. The femur was oriented at 7° of adduction to simulate the single-legged stance phase of walking. Stress maps were also obtained using an IR thermography camera. Results showed good agreement of IR thermography vs. strain gage data with a correlation of R(2)=0.99 and a slope=1.08 for the straight line of best fit. IR thermography detected the highest principal stresses on the superior-posterior side of the neck, which yielded compressive values of -91.2 MPa (at 1500 N), -96.0 MPa (at 1800 N), and -103.5 MPa (at 2100 N). There was excellent correlation between IR thermography principal stress vs. axial cyclic force at 6 locations on the femur on the lateral (R(2)=0.89-0.99), anterior (R(2)=0.87-0.99), and posterior (R(2)=0.81-0.99) sides. This study shows IR thermography's potential for future biomechanical applications.

  19. Resection of parosteal osteosarcoma of the distal part of the femur: an original reconstruction technique with cement and plate.

    PubMed

    Pezzillo, F; Maccauro, G; Nizegorodcew, T; Rossi, B; Gosheger, G

    2008-01-01

    Parosteal osteosarcoma is a low-grade malignant bone tumor arising from the distal femur and tibia. Wide resection of a parosteal osteosarcoma usually prevents local recurrence. In literature, hemicortical resections of low-grade malignant bone tumors and allograft reconstruction are described. We describe a new method of resection and reconstruction of parosteal osteosarcoma located in the popliteal paraosseous space of the distal part of the femur using cement and plate (LISS-SYNTHES) through dual medial and lateral incisions. The patient did not present infections and fractures and the functional results were good. After one year, no metastases developed and there were no local recurrences.

  20. Resection of Parosteal Osteosarcoma of the Distal Part of the Femur: An Original Reconstruction Technique with Cement and Plate

    PubMed Central

    Pezzillo, F.; Maccauro, G.; Nizegorodcew, T.; Rossi, B.; Gosheger, G.

    2008-01-01

    Parosteal osteosarcoma is a low-grade malignant bone tumor arising from the distal femur and tibia. Wide resection of a parosteal osteosarcoma usually prevents local recurrence. In literature, hemicortical resections of low-grade malignant bone tumors and allograft reconstruction are described. We describe a new method of resection and reconstruction of parosteal osteosarcoma located in the popliteal paraosseous space of the distal part of the femur using cement and plate (LISS-SYNTHES) through dual medial and lateral incisions. The patient did not present infections and fractures and the functional results were good. After one year, no metastases developed and there were no local recurrences. PMID:18949052

  1. ‘Pseudotumour’ invading the proximal femur with normal metal ions following metal on metal hip resurfacing

    PubMed Central

    Krishnan, Harry; Sugand, Kapil; Ali, Ibrahim; Smith, Jay

    2015-01-01

    A 75-year-old woman who had undergone hybrid metal-on-metal hip resurfacing 8 years earlier underwent revision arthroplasty because of hip, groin and lateral thigh pain. The main differential was aseptic loosening; however, serum cobalt and chromium levels were normal. Multiple imaging modalities revealed a periprosthetic, cystic soft tissue mass adjacent to the proximal femur. A large ‘pseudotumour’ with proximal femoral invasion was found at revision arthroplasty. We report the first finding of a ‘pseudotumour’ invading the proximal femur with normal metal ions following metal on metal hip resurfacing. PMID:25670783

  2. Correction of severe post-traumatic deformities in the distal femur by distraction osteogenesis using Taylor Spatial Frame: a case report.

    PubMed

    Nakase, T; Ohzono, K; Shimizu, N; Yoshikawa, H

    2006-01-01

    A case of deformity and shortening after post-traumatic growth arrest treated using the Taylor Spatial Frame (Smith & Nephew, Tennessee, USA) is presented. This is the first report showing the application of the frame for post-traumatic deformity in the distal femur, and successful outcomes promise utilization of the frame even for correction of severe deformity in the distal femur.

  3. [Finite element analysis (FEA) for the structure capacity of proximal femur during falling--(I) FEA model and the failure criteria for the bone].

    PubMed

    Fan, Lixia; Wang, Eric

    2006-10-01

    Femur fracture from falls is considered one of the most serious types of the elderly. FEA has proved to be an extremely useful tool in the structure analysis of the proximal femur. In this paper, a FEA model of proximal femur is introduced, and Hoffman failure criteria are built based on the experimental strength data for both cortical bone and trabecular bone of the femur from some references. The FEA model and the failure criteria are verified using other researcher's experimental results. The predicted trabecular failure load was only 0.5% lower than the experimental data and cortical failure load was 4.2% higher than the experimental result. This result shows that our FEA model, combined with the Hoffman criterion for both cortical bone and trabecular bone, can effectively predict the structural capacity of the femur during falling.

  4. 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.

  5. 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

  6. 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

  7. 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.

  8. One-Piece Zirconia Ceramic versus Titanium Implants in the Jaw and Femur of a Sheep Model: A Pilot Study

    PubMed Central

    De Silva, R. K.; Zafar, S.

    2016-01-01

    Reports have documented titanium (Ti) hypersensitivity after dental implant treatment. Alternative materials have been suggested including zirconia (Zr) ceramics, which have shown predictable osseointegration in animal studies and appear free of immune responses. The aim of the research was to investigate the bone-to-implant contact (BIC) of one-piece Zr, compared with one-piece Ti implants, placed in the jaws and femurs of domestic sheep. Ten New Zealand mixed breed sheep were used. A One-piece prototype Ti (control) and one Zr (test) implant were placed in the mandible, and one of each implant (Ti and Zr) was placed into the femoral epicondyle of each animal. The femur implants were submerged and unloaded; the mandibular implants were placed using a one-stage transgingival protocol and were nonsubmerged. After a healing period of 12 weeks, %BIC was measured. The overall survival rate for mandibular and femur implants combined was 87.5%. %BIC was higher for Zr implants versus Ti implants in the femur (85.5%, versus 78.9%) (p = 0.002). Zirconia implants in the mandible showed comparable %BIC to titanium implants (72.2%, versus 60.3%) (p = 0.087). High failure rate of both Zr and Ti one-piece implants in the jaw could be attributed to the one-piece design and surface characteristics of the implant that could have influenced osseointegration. Further clinical trials are recommended to evaluate the performance of zirconia implants under loading conditions. PMID:28058261

  9. The 5-year survival following the marginal resection of a primary leiomyosarcoma of the distal femur and a stump fracture.

    PubMed

    Plath, J; Gurk, S; Strophal, G; Johnson, M; Jansson, V

    2001-09-01

    In this case, we present a 5-year follow-up of a 3-fault-affected primary leiomyosarcoma of the distal femur (spontaneous fracture treated by osteosynthesis; marginal resection; stump fracture after adequate trauma) with an extended local recurrence but without metastasis.

  10. Nonunion of a pertrochanteric femur fracture due to a low-velocity gunshot.

    PubMed

    Evanson, Brian J; Mullis, Brian H; Anglen, Jeffrey O

    2011-01-01

    The treatment of nonunions often can be a complex and challenging venture. This case report details the treatment of a young patient's pertrochanteric femoral nonunion due to a low-velocity gunshot. Fracture fixation and union were attempted with various implants, including a sliding hip screw, blade plate, and proximal femoral locking plate; however, all eventually failed. Successful union ultimately was obtained only after use of a cephalomedullary nail. There have been few reports in the literature on the failure of proximal femoral locking plates in the treatment of pertrochanteric femur fractures, though much has been published regarding the sliding hip screw and blade plate. Multiple options for use in nonunion surgery were used and discussed in this case, such as autogenous bone graft, bone morphogenic protein, and implantable bone stimulators.

  11. 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

  12. Effects of a sliding plate on morphology of the epiphyseal plate in goat distal femur.

    PubMed

    Lin, Da-sheng; Lian, Ke-jian; Hong, Jia-yuan; Ding, Zhen-qi; Zhai, Wen-liang

    2012-01-01

    The aim of this study was to observe the effects of a sliding plate on the morphology of the epiphyseal plate in goat distal femur. Eighteen premature female goats were divided randomly into sliding plate, regular plate and control groups. Radiographic analysis and histological staining were performed to evaluate the development of epiphyseal plate at 4 and 8 weeks after surgery. In the sliding plate group, the plate extended accordingly as the epiphyseal plate grows, and the epiphyseal morphology was kept essential normal. However, the phenomenon of the epiphyseal growth retardation and premature closure were very common in the regular plate group. In addition, the sliding plate group exhibited more normal histologic features and Safranin O staining compared to the regular plate group. Our results suggest that the sliding plate can provide reliable internal fixation of epiphyseal fracture without inhibiting epiphyseal growth.

  13. [Stress fracture of the femur: a rare complication of sickle cell disease].

    PubMed

    Bahebeck, J; Ngowe Ngowe, M; Monny Lobe, M; Sosso, M; Hoffmeyer, P

    2002-12-01

    A 24-year-old patient with homozygous sickle cell disease developed a stress fracture of the femur. Successive x-rays demonstrated defective ossification and a spontaneous unicortical fracture with no notion of trauma or stressful activities (e.g. sports) followed six months later by a bicortical fracture with displacement and periosteal reaction leading to the diagnosis of stress fracture. This type of fracture has not been reported previously in sickle cell disease. The patient was treated with centromedullary nailing. The follow-up was uneventful. Bone healing was achieved at three months. The patient was pain free and could walk without crutches. Stress fracture is a potential diagnosis in homozygous sickle cell disease patients with defective ossification who present spontaneous pain even when plain x-rays do not visualize an overt fracture. Computed tomography or magnetic resonance imaging should be performed when available. Conventional treatment with nailing provides successful cure with good functional outcome.

  14. An animal model for open femur fracture and osteomyelitis: Part I.

    PubMed

    Lindsey, Brock A; Clovis, Nina B; Smith, E Suzanne; Salihu, Sydha; Hubbard, David F

    2010-01-01

    Infection is an everyday problem in orthopaedics and is quite common in open fracture management. To study this process and provide a basis to prevent infection, we developed a model that includes trauma (blunt fracture in the fashion of Bonnarens and Einhorn), surgical stabilization (standardized intramedullary K-wire fixation), and infection (Staphylococcus aureus inoculum). In this two-part study, we found that 10(2) colony-forming units of inoculum produced an optimal infection rate of 90-100%, which substantially challenged the immune system without overwhelming sepsis. We hypothesized that, in traumatic fractures, there is a specific immunological response that may lead to an increased rate of infection. In Part 2, we demonstrated immunosuppression (decreased Interleukin-12 levels) at days 6, 10, and 12 after fracture fixation versus nonfractured control groups (p < 0.05). This study describes a rat model of femur factures with osteomyelitis that allows investigation of posttraumatic immunosuppression.

  15. Differences by sex and handedness in right and left femur bone mineral densities.

    PubMed

    Sahin, Ali; Dane, Senol; Seven, Bedri; Akar, Sedat; Yildirim, Serap

    2009-12-01

    Left-handedness was reported to be a risk factor for accident-related injuries, head injuries, traumatic brain injuries, sport-related injuries, and bone breaks and fractures. As decreased bone mineral density is a good marker of bone fractures, the femoral bone mineral densities of normal left-handed university students were compared with those of right-handed students. Hand preference of 66 men and 47 women was assessed using the Edinburgh Handedness Inventory. Measures of bone mineral density with a Hologic QDR-4500W (S/N 48403) densitometer showed bone mineral densities of both right and left proximal femur regions were higher in right-handed than in left-handed students. These results are consistent with the claim that left-handed participants had higher trauma and injury risk. Also, these results may explain the sex-related differences by handedness for susceptibility in accident-related injuries such as bone fractures.

  16. Bioglass as a carrier for reindeer bone protein extract in the healing of rat femur defect.

    PubMed

    Tölli, Hanna; Kujala, Sauli; Levonen, Katri; Jämsä, Timo; Jalovaara, Pekka

    2010-05-01

    Bioactive glasses have been developed as scaffolds for bone tissue engineering but combination with reindeer bone protein extract has not been evaluated. We investigated the effects of bone protein extract implants (5-40 mg dosages) with bioglass (BG) carrier on the healing of rat femur defects. Bioglass implants and untreated defects served as controls. All doses of extract increased bone formation compared with the control groups, and bone union was enhanced with doses of 10 mg or more. In comparison with untreated defect, mean cross-sectional bone area at the defect site was greater when implants with BG + 15 mg of extract or bioglass alone were used, bone density at the defect site was higher in all bioglass groups with and without bone extract, and the BG + 15 mg extract dosage marginally increased bone torsional stiffness in mechanical testing. Bioglass performed well as a carrier candidate for reindeer bone protein extract.

  17. 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.

  18. Management of simultaneous bilateral neck of femur fractures in an elderly patient.

    PubMed

    McGoldrick, Niall P; Dodds, Michael K; Green, Connor; Synnott, Keith

    2013-09-01

    Simultaneous bilateral neck of femur fracture is rare. There have been few reports of such a condition in the literature. This uncommon pattern of injury has been associated with high-energy trauma, underlying bone disease, and seizure disorders. We describe our experience of such a condition involving an elderly patient with significant cardiovascular comorbidity. The operative approach involved single-stage repair of both the involved joints. Bilateral uncemented hemi-arthroplasty was performed using a single tray of sterile surgical instruments and 2 sterile drapes. We report a satisfactory outcome. Uncemented arthroplasty should be considered in such a case so as to minimize the risk of a possible bone cement implantation syndrome.

  19. Neck of Femur Fracture in a Patient with a Chronic Osteomyelitis of the Ipsilateral Foot

    PubMed Central

    Döring, Anne-Carolin; Vochteloo, Anne J. H.; van Doorn, Kees; Huis in 't Veld, Rianne M. H. A.

    2016-01-01

    This case report describes a successful two-stage treatment in a 75-year-old male with a displaced neck of femur fracture, also suffering from an active chronic osteomyelitis of the ipsilateral calcaneus. In our case, a below-knee amputation was performed first, followed by total hip arthroplasty two weeks later. At 15-month follow-up, full recovery of the prefracture level of activities of daily living without significant impairment was obtained. Only a few cases of total hip arthroplasty in amputees have been published, but the indication for surgery was mainly traumatic or advanced osteoarthritis. Treating patients with this type of comorbidities is challenging; therapeutic dilemmas can be major. The management in cases like these requires a thorough evaluation and a clear surgical and medical treatment plan, preferably conducted by a multidisciplinary orthogeriatric team. PMID:27843662

  20. Pathological fracture after migration of cement used to treat distal femur physeal arrest.

    PubMed

    Shea, Kevin G; Rab, George T; Dufurrena, Magen

    2009-07-01

    Treatment of physeal arrest with bar removal and placement of interposition materials in young patients has been shown to restore physeal growth. Among the various materials that have been used to prevent early reformation of the physeal bar (fat, silastic, cartilage), Peterson recommended the use of Cranioplast, as this material can prevent bar reformation, and it is radiolucent because it does not contain barium. Peterson suggested steps be taken to prevent migration of the Cranioplast, as migration of the interposition material might allow for reformation of the physeal bar. Although Peterson had not observed cement migration leading to pathologic fracture, he felt that this was a potential concern. We describe the case of cement migration from the epiphysis into the diaphysis, leading to a pathological femur fracture. Despite migration of the Cranioplast, the physeal bridge did not reform, and the patient had nearly normal growth 7 years after the initial physeal arrest procedure.

  1. Effects of a Sliding Plate on Morphology of the Epiphyseal Plate in Goat Distal Femur

    PubMed Central

    LIN, Da-sheng; LIAN, Ke-jian; HONG, Jia-yuan; DING, Zhen-qi; ZHAI, Wen-liang

    2012-01-01

    The aim of this study was to observe the effects of a sliding plate on the morphology of the epiphyseal plate in goat distal femur. Eighteen premature female goats were divided randomly into sliding plate, regular plate and control groups. Radiographic analysis and histological staining were performed to evaluate the development of epiphyseal plate at 4 and 8 weeks after surgery. In the sliding plate group, the plate extended accordingly as the epiphyseal plate grows, and the epiphyseal morphology was kept essential normal. However, the phenomenon of the epiphyseal growth retardation and premature closure were very common in the regular plate group. In addition, the sliding plate group exhibited more normal histologic features and Safranin O staining compared to the regular plate group. Our results suggest that the sliding plate can provide reliable internal fixation of epiphyseal fracture without inhibiting epiphyseal growth. PMID:22359485

  2. Relationship between socioeconomic status and mortality after femur fracture in a Korean population aged 65 years and older

    PubMed Central

    Shin, Jaeyong; Choi, Young; Lee, Sang Gyu; Kim, Woorim; Park, Eun-Cheol; Kim, Tae Hyun

    2016-01-01

    Abstract Femur fracture is an emerging public health concern in aging societies, owing to the substantially high morbidity and mortality. Because the recent increase in femur fracture incidence in Asian populations is comparable to that in the West, it is necessary to investigate the association between socioeconomic status (SES) and mortality after femur fracture in developed Asian societies. Data were obtained from the National Health Insurance Claims Database. During 2002 to 2013, femur fractures were newly diagnosed in 5441 patients among 1025,340 enrollees. Multiple logistic regression and the Cox proportional model were used to investigate the associations between individual SES and probability of surgery and mortality after femur fracture. Of 5441 patients, 1928 (35.4%) received surgery. Patients with low (odds ratio [OR] = 0.87, 95% confidence interval [CI]: 0.75–0.99) and middle (OR = 0.85, 95% CI: 0.74–0.98) income were less likely to undergo surgery than high-income patients. Patients with low (hazard ratio [HR] = 1.12, 95% CI: 1.01–1.24) and middle (HR = 1.20, 95% CI: 1.08–1.33) income had a higher HR for mortality. This difference was more prominent in patients who underwent surgery (low income: HR = 1.07, 95% CI: 0.94–1.21; middle income: HR = 1.18, 95% CI: 1.04–1.33) than in patients with conservative treatment (low income: HR = 1.24, 95% CI: 1.04–1.49; middle income: HR = 1.30, 95% CI: 1.08–1.56). Femur-fracture patients with low SES are less likely to receive surgery for and more likely to die after femur fracture. The difference in mortality risk remained even when only the patients who received surgery were considered, suggesting that we need to consider support measures for these deprived patients. PMID:27930508

  3. Biomechanics and structural adaptations of the rat femur after hindlimb suspension and treadmill running.

    PubMed

    Shimano, M M; Volpon, J B

    2009-04-01

    We microscopically and mechanically evaluated the femurs of rats subjected to hindlimb unloading (tail suspension) followed by treadmill training. Female Wistar rats were randomly divided into five groups containing 12-14 rats: control I (118 days old), control II (139 days old), suspended (tail suspension for 28 days), suspended-released (released for 21 days after 28 days of suspension), and suspended-trained (trained for 21 days after 28 days of suspension). We measured bone resistance by bending-compression mechanical tests of the entire proximal half of the femur and three-point bending tests of diaphyseal cortical bone. We determined bone microstructure by tetracycline labeling of trabecular and cortical bone. We found that tail suspension weakened bone (ultimate load = 86.3 +/- 13.5 N, tenacity modulus = 0.027 +/- 0.011 MPa.m vs ultimate load = 101.5 +/- 10.5 N, tenacity modulus = 0.019 +/- 0.006 MPa.m in control I animals). The tenacity modulus for suspended and released animals was 0.023 +/- 0.010 MPa.m vs 0.046 +/- 0.018 MPa.m for trained animals and 0.035 +/- 0.010 MPa.m for control animals. These data indicate that normal activity and training resulted in recovered bone resistance, but suspended-released rats presented femoral head flattening and earlier closure of the growth plate. Microscopically, we found that suspension inhibited new bone subperiosteal and endosteal formation. The bone disuse atrophy secondary to hypoactivity in rats can be reversed by an early regime of exercising, which is more advantageous than ordinary cage activities alone.

  4. The effect of alendronate treatment on cortical thickness of the proximal femur in postmenopausal women

    PubMed Central

    Mobini, Maryam; Dehghan, Leyla; Yosefi, Gholamali; Mohammadpour, Alireza; Abdi, Rohollah

    2016-01-01

    Background: Bisphosphonates (BPs) are used extensively for managing the osteoporosis. There are some controversies on atypical fractures of femur that associated with increase in cortical thickness (CT) and BPs’ use. In this study, the effects of alendronate consumption were studied on femoral CT as a predictor for atypical fracture. Methods: Forty nine post-menopausal women aged 50-70 years with osteopenia-osteoporosis who were treated with alendronate 70 mg/week for at least one year were compared to 49 controls for CT in subtrochanteric region of femur by hip dual-energy X-ray absorptiometry (DXA) scans and hip Xray. CT and its ratio were measured at 3.5 and 4.0 cm below the tip of the greater trochanter (GT) and 0.5 cm below lesser trochanter (LT) in DXA and at 9.5 and 10.5 cm of GT and 1 cm of LT in Xray. Results: In this study, 98 women participated whose mean age and age at menopause were 60 (17±5.6) and 49 (40±2.7) years, respectively. Duration of BP consumption in alendronate group was 1.76±1.38 (1-10) years. No difference was seen in the mean of CT and its ratio between the alendronate and control groups in BMD scan or X-ray. The best correlation between two imaging modalities was in cortical ratio in 3.5 cm of GT in BMD scan and 9.5 cm of GT in X-ray. Conclusion: Alendronate treatment did not appear to increase femoral CT throughout the detection limits of BMD scan or X-ray. PMID:27390698

  5. Stature estimation from the femur and tibia in Black South African sub-adults.

    PubMed

    Brits, Desiré M; Bidmos, Mubarak A; Manger, Paul R

    2017-01-01

    Stature estimation can play a role in the positive identification of unknown individuals and as such it is routinely assessed during the examination of adult remains. Unfortunately, this is not a standard procedure when dealing with sub-adult remains due to the general lack of standard procedures for the estimation of sub-adult stature. The aim of this study was therefore to derive regression equations for the estimation of stature in black South African sub-adults. Fifty nine black South African sub-adult males and females, aged 10-17 years, voluntarily participated in the study by undergoing a full body Magnetic Resonance Imaging (MRI) scan. Living stature was measured with a stadiometer and the maximum and diaphyseal lengths of the femur and tibia were measured from the MRI scans using the image processing software OsiriX. Pearson's correlation coefficients and linear least square regression analyses were used to assess the correlations between living stature and the measurements and to generate sub-adult stature estimation equations for males, females and a combined sex sample. Measurements of the femur, tibia and the combined measures thereof showed strong statistically significant positive correlations with living stature, while the obtained regression equations were characterized by low standard error of estimates. The strong correlations and low standard error of estimates are comparable to stature estimation models reported for Black South African adults and therefore these variables can be considered good estimators of sub-adult stature which will contribute valuable information to the biological profile of unidentified sub-adult skeletal remains.

  6. 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.

  7. 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.

  8. 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

  9. Proximal Cadaveric Femur Preparation for Fracture Strength Testing and Quantitative CT-based Finite Element Analysis.

    PubMed

    Dragomir-Daescu, Dan; Rezaei, Asghar; Uthamaraj, Susheil; Rossman, Timothy; Bronk, James T; Bolander, Mark; Lambert, Vincent; McEligot, Sean; Entwistle, Rachel; Giambini, Hugo; Jasiuk, Iwona; Yaszemski, Michael J; Lu, Lichun

    2017-03-11

    Cadaveric fracture testing is routinely used to understand factors that affect proximal femur strength. Because ex vivo biological tissues are prone to lose their mechanical properties over time, specimen preparation for experimental testing must be performed carefully to obtain reliable results that represent in vivo conditions. For that reason, we designed a protocol and a set of fixtures to prepare the femoral specimens such that their mechanical properties experienced minimal changes. The femora were kept in a frozen state except during preparation steps and mechanical testing. The relevant clinical measures of total hip and femoral neck bone mineral density (BMD) were obtained with a clinical dual X-ray absorptiometry (DXA) bone densitometer, and the 3D geometry and distribution of bone mineral were obtained using CT with a calibration phantom for quantitative estimations based on the greyscale values. Any possible bone disease, fracture, or the presence of implants or artifacts affecting the bone structure, was ruled out with X-ray scans. For preparation, all bones were carefully cleaned of excess soft tissue, and were cut and potted at the internal rotation angle of interest. A cutting fixture allowed the distal end of the bone to be cut off leaving the proximal femur at a desired length. To allow positioning of the femoral neck at prescribed angles during later CT scanning and mechanical testing, the proximal femoral shafts were potted in polymethylmethacrylate (PMMA) using a fixture designed specifically for desired orientations. The data collected from our experiments were then used for validation of quantitative computed tomography (QCT)-based finite element analysis (FEA), as described in a different protocol. In this manuscript, we present the protocol for the precise bone preparation for mechanical testing and subsequent QCT/FEA modeling. The current protocol was successfully applied to prepare about 200 cadaveric femora over a 6-year time period.

  10. 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

  11. Femur, tibia and fibula bone templates to estimate subject-specific knee ligament attachment site locations.

    PubMed

    Pillet, Hélène; Bergamini, Elena; Rochcongar, Goulven; Camomilla, Valentina; Thoreux, Patricia; Rouch, Philippe; Cappozzo, Aurelio; Skalli, Wafa

    2016-10-03

    In-vivo estimates of the positions of knee ligament attachment sites are crucial for subject-specific knee modelling. The present study provides template digital models of femur, tibia and fibula that embed the positions of centroids of the origins and insertions of cruciate and collateral ligaments, along with information on their dispersion related to inter-individual variability. By using a shape transformation procedure of choice, these templates can be made to match anatomical information measured on a subject under analysis. Generic bone digital models of the femur, tibia and fibula were first chosen as bone templates. Ligament attachment areas were accurately identified through dissection on the bones of 11 knee specimens, and marked using radio opaque paint. Digital models of these bones embedding the positions of the centroids of the identified ligament attachment areas were thereafter obtained using medical imaging techniques. These centroids were mapped onto the relevant bone template, thus obtaining a cloud of 11 points for each attachment site, and descriptive statistics of the position of these points were thereafter determined. Dispersion of these positions, essentially due to inter-individual variability, was below 6mm for all attachment areas. The accuracy with which subject-specific ligament attachment site positions may be estimated using the bone template models provided in this paper was also assessed using the above-mentioned 11 specimens data set, and a leave-one-out cross validation approach. Average accuracy was found to be 3.3±1.5mm and 5.8±2.9mm for femoral and tibial/fibular attachment sites, respectively.

  12. 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

  13. PTH(1-34) and zoledronic acid have differing longitudinal effects on juvenile mouse femur strength and morphology.

    PubMed

    Bartlow, Christopher M; Oest, Megan E; Mann, Kenneth A; Zimmerman, Nicholas D; Butt, Bilal B; Damron, Timothy A

    2016-09-21

    Treatment of secondary pediatric osteoporosis-particularly that due to chronic diseases, immobilization, and necessary medical treatments-is currently limited by a poor understanding of the long-term efficacy and safety of skeletal metabolism modifying drugs. This study aimed to characterize longitudinal effects of representative anabolic (parathyroid hormone, PTH) and anti-catabolic (zoledronic acid, ZA) drugs on skeletal morphology, mechanical strength, and growth in juvenile mice. BALB/cJ mice aged 4 weeks were given PTH(1-34) or vehicle (control) daily for 8 weeks, or 4 weekly doses of ZA, and evaluated at time points 0-26 weeks after treatment initiation. There were no enduring differences in body length or mass between treatment groups. ZA increased femur size as early as week 0, including increased distal femur bone volume and diaphyseal cross-sectional area, persisting through week 26. PTH treatment only transiently increased bone size, including distal femur volume at weeks 4-12. ZA decreased diaphyseal cortical tissue mineral density (TMD) at 12-26 weeks versus controls; PTH decreased TMD only at 2 weeks (vs. controls). ZA increased bending strength at 0-12 weeks and flexural strength at week 4 (vs. controls), but decreased flexural strength and modulus at week 26. PTH treatment increased bending strength only at 4 weeks, and did not affect flexural strength. Overall, ZA rapidly and persistently increased femur strength and size, but compromised bone material quality long-term. In healthy juvenile mice, limited-duration PTH treatment did not exert a strong anabolic effect, and had no adverse effects on femur strength, morphology, or growth. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.

  14. 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.

  15. 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.

  16. 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…

  17. 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

  18. An Unexpected Complication of Residual Fibular Strut Graft While Performing A Press fit Hemiarthroplasty for A Secondary Nonunion Fracture Neck of the Femur

    PubMed Central

    Huda, Najmul; Julfiqar; Pant, Ajay; Aslam, M

    2015-01-01

    Introduction: Perioperative complications are well known during partial and total hip arthroplasty. One of the common categories of these complications is an intraoperative fractures of the proximal femur. Here we discuss a case of perforation of posteromedial cortex of the proximal femur, while doing a press fit modular bipolar hemiarthroplasty, in a young adult with secondary nonunion of the femoral neck fracture. The cause of this proximal femur perforation was residual fibular strut graft that, redirected the femoral stem into undesirable direction. This complication of residual fibular strut graft has not been disscussed much in the orthopedic literature previously. Case Report: A press fit modular bipolar hiparthroplasty was performed in a young adult male with nonunion fracture neck of the femur secondary to initial fixation using 6.5mm cannulated hip screws and nonvascularized free fibular strut grafting. Failure to completely remove the fibular strut from the proximal femur lead to difficult negotiation of the femoral stem into the femoral canal and ultimately a perforation in the proximal femur at the level of the lesser trochanter. A revision procedure was done to completely remove the residual fibular graft, and then a fresh press fit modular bipolar hemiarthroplasty was done. Conclusion: Complete removal of fibular strut graft should be done, while performing hip arthroplasty in patients with failed fibular grafting for fracture neck of the femur. PMID:27299067

  19. Ultrasound study of the motion of the residual femur within a trans-femoral socket during daily living activities other than gait.

    PubMed

    Convery, P; Murray, K D

    2001-12-01

    This study analyses the residual femur motion of a single amputee within a transfemoral socket during a series of daily living activities. Two simultaneously transmitting, socket mounted transducers were connected to two ultrasound scanners. Displacement measurements of the ultrasound image of the femur were video recorded and measured on "paused" playback. Abduction/adduction and flexion/extension of the residual femur within the socket at any instant during these activities were estimated, knowing the relative positions of the two transducers and the position of the residual femur on the ultrasound image. Consistent motion patterns of the residual femur within the trans-femoral socket were noted throughout each monitored daily living activity of the single amputee studied. Convery and Murray (2000) reported that during level walking, relative to the socket, the residual femur extends 6 degrees and abducts 9 degrees by mid-stance while flexing 6 degrees and adducting 2 degrees by toe-off. Uphill/downhill, turning to the right and stepping up/down altered this reported pattern of femoral motion by approximately 1 degree. During the standing activity from a seated position the femur initially flexed 4 degrees before moving to 7 degrees extension, while simultaneously adducting 6 degrees. During the sitting activity from a standing position the femur moved from 7 degrees extension and 6 degrees adduction to 3 degrees flexion and 1 degree abduction. The activity of single prosthetic support to double support introduced only minor femoral motion whereas during the activity of prosthetic suspension the femur flexed 8 degrees while simultaneously adducting 9 degrees. Additional studies of more amputees are required to validate the motion patterns presented in this investigation.

  20. Identify fracture-critical regions inside the proximal femur using statistical parametric mapping

    PubMed Central

    Li, Wenjun; Kornak, John; Harris, Tamara; Keyak, Joyce; Li, Caixia; Lu, Ying; Cheng, Xiaoguang; Lang, Thomas

    2009-01-01

    We identified regions inside the proximal femur that are most strongly associated with hip fracture. Bone densitometry based on such fracture-critical regions showed improved power in discriminating fracture patients from controls. Introduction Hip fractures typically occur in lateral falls, with focal mechanical failure of the sub-volumes of tissue in which the applied stress exceeds the strength. In this study, we describe a new methodology to identify proximal femoral tissue elements with highest association with hip fracture. We hypothesize that bone mineral density (BMD) measured in such sub-volumes discriminates hip fracture risk better than BMD in standard anatomic regions such as the femoral neck and trochanter. Materials and Methods We employed inter-subject registration to transform hip QCT images of 37 patients with hip fractures and 38 age-matched controls into a voxel-based statistical atlas. Within voxels, we performed t-tests between the two groups to identify the regions which differed most. We then randomly divided the 75 scans into a training set and a test set. From the training set, we derived a fracture-driven region of interest (ROI) based on association with fracture. In the test set, we measured BMD in this ROI to determine fracture discrimination efficacy using ROC analysis. Additionally, we compared the BMD distribution differences between the 29 patients with neck fractures and the 8 patients with trochanteric fractures. Results By evaluating fracture discrimination power based on ROC analysis, the fracture-driven ROI had an AUC (area under curve) of 0.92, while anatomic ROIs (including the entire proximal femur, the femoral neck, trochanter and their cortical and trabecular compartments) had AUC values between 0.78 and 0.87. We also observed that the neck fracture patients had lower BMD (p=0.014) in a small region near the femoral neck and the femoral head, and patients with trochanteric fractures had lower BMD in trochanteric regions

  1. Revising Australian Pristomerus (Hymenoptera, Ichneumonidae, Cremastinae): species with a tooth on the hind femur.

    PubMed

    Klopfstein, Seraina

    2016-09-15

    The Australian insect fauna is among the least-well studied in the world, and conservative estimates state that 75% of the species still await description. In the more species-rich groups, this percentage might be even larger, which is certainly the case in parasitoid wasps which have received very little attention by taxonomists. The genus Pristomerus of the family Ichneumonidae is distributed worldwide, with most species found in the tropics. Its members attack concealed larvae of small Lepidoptera, and several species are used in biocontrol. Five species have been reported from Australia, all of them endemic, but many more undescribed species are present in various collections.        I here revise Australian Pristomerus, focussing on the species that bear a tooth on the ventral side of the hind femur. Twenty-two species are recorded, 19 of which are described as new: Pristomerus australiensis n. sp., P. bertschmanni n. sp., P. callitrinus n. sp., P. dundeei n. sp., P. flavicephalus n. sp., P. fourecksensis n. sp., P. gracilis n. sp., P. kakaduensis n. sp., P. laetus n. sp., P. luculentus n. sp., P. lunatus n. sp., P. mangiferus n. sp., P. merus n. sp., P. nedkellyi n. sp., P. pellicius n. sp., P. periculosus n. sp., P. stellatus n. sp., P. tenebrosus n. sp., and P. venustus n. sp. A dichotomous key and an online interactive key to the known Australian species with a tooth on the hind femur are provided, including photographs of all the species.        The origin of the considerable number of Australian Pristomerus species remains unclear. They might represent Southern relict elements with affinities to South American taxa, or their ancestors might have immigrated from the Paleotropics in more recent times; this question can only be solved with a dated phylogeny of the genus. However, support for a Palaeotropic origin of at least a good portion of the taxa comes from their current distribution, as the Australian Pristomerus are found to be most

  2. Computed tomographic evaluation of the proximal femur: A predictive classification in displaced femoral neck fracture management

    PubMed Central

    Magu, Narender Kumar; Magu, Sarita; Rohilla, Rajesh Kumar; Batra, Amit; Jaipuria, Abhishek; Singh, Amanpreet

    2014-01-01

    Background: Femoral neck fracture is truly an enigma due to the high incidence of avascular necrosis and nonunion. Different methods have been described to determine the size of the femoral head fragment, as a small head has been said to be associated with poor outcome and nonunion due to inadequate implant purchase in the proximal fragment. These methods were two dimensional and were affected by radiography techniques, therefore did not determine true head size. Computed tomography (CT) is an important option to measure true head size as images can be obtained in three dimensions. Henceforth, we subjected patients to CT scan of hip in cases with displaced fracture neck of femur. The study aims to define the term small head or inadequate size femoral head” objectively for its prognostic significance. Materials and Methods: 70 cases of displaced femoral neck fractures underwent CT scan preoperatively for proximal femoral geometric measurements of both hips. Dual energy X-ray absorptiometry scan was done in all cases. Patients were treated with either intertrochanteric osteotomy or lag screw osteosynthesis based on the size of the head fragment on plain radiographs. Results: The average femoral head fragment volume was 57 cu cm (range 28.3-84.91 cu cm; standard deviation 14 cu cm). Proximal fragment volume of >43 cu cm was termed adequate size (type I) and of ≤43 cu cm as small femoral head (type II). Fractures which united (n = 54) had a relatively large average head size (59 cu cm) when compared to fractures that did not (n = 16), which had a small average head size (49 cu cm) and this difference was statistically significant. In type I fractures union rate was comparable in both osteotomy and lag screw groups (P > 0.05). Lag screw fixation failed invariably, while osteotomy showed good results in type II fractures (P < 0.05). Conclusion: Computed tomography scan of the proximal femur is advisable for measuring true size of head fragment. An objective

  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. 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.

  5. Minimally-invasive internal fixation of extra-articular distal femur fractures using a locking plate: tricks of the trade.

    PubMed

    Ehlinger, M; Adam, P; Abane, L; Arlettaz, Y; Bonnomet, F

    2011-04-01

    Fractures of the distal femur are rare and occur in two distinct population categories: young patients after high energy traumas and elderly patients who fall from their full height, and often carry severe co-morbidities making especially difficult to manage theses complex injuries. In elderly patients the potential complications are numerous including infection, non-union and frequent function deterioration. We present a technique of minimally invasive internal fixation of the distal extra-articular femur using a locking plate and present the tricks of the trade to obtain successful reduction and achieve union. The hardware used includes plate fixation with a large fragment locking screw. This minimally invasive surgery combines stability of the internal fixation device with the principles of closed surgery, allowing early mobilization and immediate weight bearing to warrant good functional recovery.

  6. Endomedullary radiofrequency ablation of metastatic lesion of the right femur 5 years after primary breast carcinoma: a case report.

    PubMed

    Majerović, Mate; Augustin, Goran; Jelincić, Zeljko; Buković, Damir; Burcar, Ivan; Smud, Dubravko; Kekez, Tihomir; Kinda, Emil; Matosević, Petar; Turcić, Josip

    2008-12-01

    Metastatic tumors of the long bones usually present with severe pain refractory to analgesic therapy. Pathologic fractures of the bone may lead to the significant decrease of patient's quality of life and necessitate further surgical therapy. We present 66 year old female with metastatic left breast carcinoma (T2N0M0) diagnosed 5 years before presentation of the metastatic lesion of the right femur causing severe pain in the middle of the right upper leg. Pain persisted after palliative irradiation therapy. We performed radiofrequency ablation of the metastatic lesion of the right femur using R.I.TA. Medical System Generator. This resulted in total necrosis of the tumor mass that caused osteolysis of the internal part of the femoral cortex. First three months after RFA procedure, the pain and tenderness were absent and normal daily activities were performed without restrictions.

  7. Pathologic fracture of the femur due to endometrial adenocarcinoma metastasis in a female pet rabbit (Oryctolagus cuniculi).

    PubMed

    Haist, Verena; Hirschfeld, Simon Gonzales; Mallig, Carolin; Fehr, Michael; Baumgärtner, Wolfgang

    2010-01-01

    This case report describes the clinical, pathomorphological and histopathological findings in a 12-year-old female pet rabbit with a pathologic fracture of the femur due to a metastasising endometrial adenocarcinoma. The animal was presented due to a history of right hindlimb lameness and inappetence. A fracture of the right femur with adjacent lyric bone lesions was detected by clinical and X-ray examination. Necropsy and histopathology revealed an endometrial adenocarcinoma with metastasis to the right femoral bone, resulting in the pathologic fracture. In both locations, tumour cells were immunohistochemically positive for pan-cytokeratin. Additionally, the animal suffered from an Encephalitozoon cuniculi infection which manifested itself in a multifocal granulomatous encephalitis and bilateral chronic inflammatory lesions in the kidneys.The report shows that in case of bone fractures in female pet rabbits the possibility of a pathologic fracture due to metastasising endometrial adenocarcinoma has to be considered.

  8. Loss of distal femur combined with popliteal artery occlusion: reconstructive arthroplasty using modular segmental endoprosthesis: a case report.

    PubMed

    Kang, Shin-Taeg; Hwang, Chan-Ha; Kim, Bo-Hyeon; Sung, Byung-Yoon

    2009-04-01

    Severe injury to the knee and the surrounding area is frequently associated with injury to ligaments of the knee joint and structures in the popliteal fossa. This case involved a popliteal artery occlusion, severe bone loss of distal femur, loss of collateral ligaments, and extensor mechanism destruction of the knee. Initially, prompt recognition and correction of associated popliteal artery injury are important for good results after treatment. After successful revascularization, treatment for severe bone loss of distal femur and injury of the knee joint must be followed. We treated this case by delayed reconstruction using modular segmental endoprosthesis after revascularization of the popliteal artery. This allowed early ambulation. At 36 months after surgery, the patient had good circulation of the lower limb and was ambulating independently.

  9. Coping – Late Side Effects

    Cancer.gov

    Cancer treatment can cause late side effects that may not show up for months or years after treatment. These late effects may include heart and lung problems, bone loss, eye and hearing changes, lymphedema, and other problems

  10. Defining the medial-lateral axis of an anatomical femur coordinate system using freehand 3D ultrasound imaging.

    PubMed

    Passmore, Elyse; Sangeux, Morgan

    2016-03-01

    Hip rotation from gait analysis informs clinical decisions regarding correction of femoral torsional deformities. However, it is among the least repeatable due to discrepancies in determining the medial-lateral axis of the femur. Conventional or functional calibration methods may be used to define the axis but there is no benchmark to evaluate these methods. Freehand 3D ultrasound, the coupling of ultrasound with 3D motion capture, may provide such a benchmark. We measured the accuracy in vitro and repeatability in vivo of determining the femur condylar axis from freehand 3D ultrasound. The condylar axis provided the reference medial-lateral axis of the femur and was used to evaluate one conventional method and three functional calibration methods, applied to three calibration movements. Ten healthy subjects (20 limbs) underwent 3D gait analysis and freehand 3D ultrasound. The functional calibration methods were a transformation technique, a geometrical method and a method that minimises variance of knee varus-valgus kinematics (DynaKAD). The conventional method used markers over the femoral epicondyles. The condylar axis determined by 3D ultrasound showed good accuracy in vitro, 1.6° (SD: 0.3°) and good repeatability in vivo, 0.2° (RSMD: 2.3°). The DynaKAD method applied to the walking calibration movement determined the medial-lateral axis closest to the ultrasound reference. The average angular difference in the transverse plane was 3.1° (SD: 6.1°). Freehand 3D ultrasound offers an accurate, non-invasive and relatively fast method to locate the medial-lateral axis of the femur for gait analysis.

  11. Cherubism associated with neurofibromatosis type 1, and multiple osteolytic lesions of both femurs: a previously undescribed association of findings.

    PubMed

    Martínez-Tello, Francisco J; Manjón-Luengo, Palmira; Martin-Pérez, Manuel; Montes-Moreno, Santiago

    2005-12-01

    We present a patient with neurofibromatosis type 1, with the clinical, radiological and histological features of cherubism mandibular lesions, and multiple osteolytic, geographic lesions in both femurs, consistent with multiple non-ossifying fibromas. We have been unable to find a similar case in the world literature. We discuss our findings in relationship with a number of syndromes that present clinical, radiological or pathological similarities.

  12. Sex Specific Association of Physical Activity on Proximal Femur BMD in 9 to 10 Year-Old Children

    PubMed Central

    Cardadeiro, Graça; Baptista, Fátima; Ornelas, Rui; Janz, Kathleen F.; Sardinha, Luís B.

    2012-01-01

    The results of physical activity (PA) intervention studies suggest that adaptation to mechanical loading at the femoral neck (FN) is weaker in girls than in boys. Less is known about gender differences associated with non-targeted PA levels at the FN or other clinically relevant regions of the proximal femur. Understanding sex-specific relationships between proximal femur sensitivity and mechanical loading during non-targeted PA is critical to planning appropriate public health interventions. We examined sex-specific associations between non-target PA and bone mineral density (BMD) of three sub-regions of the proximal femur in pre- and early-pubertal boys and girls. BMD at the FN, trochanter (TR) and intertrochanter (IT) regions, and lean mass of the whole body were assessed using dual-energy x-ray absorptiometry in 161 girls (age: 9.7±0.3 yrs) and 164 boys (age: 9.7±0.3 yrs). PA was measured using accelerometry. Multiple linear regression analyses (adjusted for body height, total lean mass and pubertal status) revealed that vigorous PA explained 3–5% of the variability in BMD at all three sub-regions in boys. In girls, vigorous PA explained 4% of the variability in IT BMD and 6% in TR BMD. PA did not contribute to the variance in FN BMD in girls. An additional 10 minutes per day of vigorous PA would be expected to result in a ∼1% higher FN, TR, and IT BMD in boys (p<0.05) and a ∼2% higher IT and TR BMD in girls. In conclusion, vigorous PA can be expected to contribute positively to bone health outcomes for boys and girls. However, the association of vigorous PA to sub-regions of the proximal femur varies by sex, such that girlś associations are heterogeneous and the lowest at the FN, but stronger at the TR and the IT, when compared to boys. PMID:23209801

  13. Three-dimensional image registration of MR proximal femur images for the analysis of trabecular bone parameters

    PubMed Central

    Blumenfeld, Janet; Studholme, Colin; Carballido-Gamio, Julio; Carpenter, Dana; Link, Thomas M.; Majumdar, Sharmila

    2008-01-01

    This study investigated the feasibility of automatic image registration of MR high-spatial resolution proximal femur trabecular bone images as well as the effects of gray-level interpolation and volume of interest (VOI) misalignment on MR-derived trabecular bone structure parameters. For six subjects in a short-term study, a baseline scan and a follow-up scan of the proximal femur were acquired on the same day. For ten subjects in a long-term study, a follow-up scan of the proximal femur was acquired 1 year after the baseline. An automatic image registration technique, based on mutual information, utilized a baseline and a follow-up scan to compute transform parameters that aligned the two images. In the short-term study, these parameters were subsequently used to transform the follow-up image with three different gray-level interpolators. Nearest-neighbor interpolation and B-spline approximation did not significantly alter bone parameters, while linear interpolation significantly modified bone parameters (p<0.01). Improvement in image alignment due to the automatic registration for the long-term and short-term study was determined by inspecting difference images and 3D renderings. This work demonstrates the first application of automatic registration, without prior segmentation, of high-spatial resolution trabecular bone MR images of the proximal femur. Additionally, inherent heterogeneity in trabecular bone structure and imprecise positioning of the VOI along the slice (anterior–posterior) direction resulted in significant changes in bone parameters (p<0.01). Results suggest that automatic mutual information registration using B-spline approximation or nearest neighbor gray-level interpolation to transform the final image ensures VOI alignment between baseline and follow-up images and does not compromise the integrity of MR-derived trabecular bone parameters used in this study. PMID:18975709

  14. Complex AO type C3 distal femur fractures: Results after fixation with a lateral locked plate using modified swashbuckler approach

    PubMed Central

    Agrawal, Anuj; Kiyawat, Vivek

    2017-01-01

    Background: Complex AO type C3 fractures of the distal femur are challenging injuries, fraught with complications such as malunion and stiffness. We prospectively evaluated a consecutive series of patients with complex AO type C3 distal femur fractures to determine the clinicoradiological outcome after fixation with a single locked plate using modified swashbuckler approach. Materials and Methods: 12 patients with C3 type distal femur fractures treated with a lateral locked plate, using a modified swashbuckler approach, were included in the study. The extraarticular component was managed either by compression plating or bridge plating (transarticular approach and retrograde plate osteosynthesis) depending on the fracture pattern. Primary bone grafting was not done in any case. The clinical outcome at 1 year was determined using the Knee Society Score (KSS). The presence of any secondary osteoarthritis in the knee joint was noted at final followup. Results: All fractures united at a mean of 14.3 ± 4.7 weeks (range 6–26 weeks). There were no significant complications such as nonunion, deep infection, and implant failure. One of the patients underwent secondary bone grafting at 3 months. The mean range of motion of the knee was 120° ± 14.8° (range 105°–150°). Seven patients had excellent, three patients had good and two patients had a fair outcome according to the KSS at 1 year. At a mean followup of 17.6 months, three patients showed radiological evidence of secondary osteoarthritis of the knee joint. However, only one of these patients was symptomatic. Conclusion: The results of complex C3 type distal femur fractures, fixed with a single lateral locked plate using a modified swashbuckler approach, are encouraging, with a majority of patients achieving good to excellent outcome at 1 year. PMID:28216747

  15. “Push back” technique: A simple method to remove broken drill bit from the proximal femur

    PubMed Central

    Chouhan, Devendra K; Sharma, Siddhartha

    2015-01-01

    Broken drill bits can be difficult to remove from the proximal femur and may necessitate additional surgical exploration or special instrumentation. We present a simple technique to remove a broken drill bit that does not require any special instrumentation and can be accomplished through the existing incision. This technique is useful for those cases where the length of the broken drill bit is greater than the diameter of the bone. PMID:26601067

  16. Ultrasound backscatter measurements of intact human proximal femurs--relationships of ultrasound parameters with tissue structure and mineral density.

    PubMed

    Malo, M K H; Töyräs, J; Karjalainen, J P; Isaksson, H; Riekkinen, O; Jurvelin, J S

    2014-07-01

    Ultrasound reflection and backscatter parameters are related to the mechanical and structural properties of bone in vitro. However, the potential of ultrasound reflection and backscatter measurements has not been tested with intact human proximal femurs ex vivo. We hypothesize that ultrasound backscatter can be measured from intact femurs and that the measured backscattered signal is associated with cadaver age, bone mineral density (BMD) and trabecular bone microstructure. In this study, human femoral bones of 16 male cadavers (47.0±16.1 years, range: 21-77 years) were investigated using pulse-echo ultrasound measurements at the femoral neck in the antero-posterior direction and at the trochanter major in the anteroposterior and lateromedial directions. Recently introduced ultrasound backscatter parameters, independent of cortical thickness, e.g., time slope of apparent integrated backscatter (TSAB) and mean of the backscatter difference technique (MBD) were obtained and compared with the structural properties of trabecular bone samples, extracted from the locations of ultrasound measurements. Moreover, more conventional backscatter parameters, e.g., apparent integrated backscatter (AIB) and frequency slope of apparent integrated backscatter (FSAB) were analyzed. Bone mineral density of the intact femurs was evaluated using dual energy X-ray absorptiometry (DXA). AIB and MDB measured from the femoral neck correlated significantly (p<0.01) with the neck BMD (R2=0.44 and 0.45), cadaver age (R2=0.61 and 0.41) and several structural parameters, e.g., bone volume fraction (R2=0.33 and 0.39, p<0.05 and p<0.01), respectively. To conclude, ultrasound backscatter parameters, measured from intact proximal femurs, are significantly related (p<0.05) to structural properties and mineral density of trabecular bone.

  17. Partial long-stem resection Austin-Moore hip endoprosthesis in the treatment of metastases to the proximal femur.

    PubMed

    Chrobok, Adam; Spindel, Jerzy; Mrozek, Tomasz; Miszczyk, Leszek; Koczy, Bogdan; Tomasik, Patryk; Matysiakiewicz, Jacek

    2005-12-30

    Background. The proximal femur is a frequent location of bone metastases, and pathological fractures in this area are common. A pathological fracture and/or pain associated with bone destruction are indications for surgery. Among many methods of surgical treatment, partial resection and subsequent arthroplasty appears to be the most efficient. The low cost of the implant and the relatively simple surgical technique incline us to apply long-stem (305mm) partial Austin-Moore hip prosthesis in these cases. Material and methods. Between June 2003 and February 2005 we operated 31 patients (10 men and 21 women) for pathological fracture or proximal femur metastasis. The average age of these patients was 63.8 years. The most common primary neoplasmatic focus among the women was breast cancer (17 cases, 80%), and among the men, clarocellular renal cancer (3 cases, 34%). Results. In most cases - 21 patients (67%) - we achieved excellent or good outcome according to the Merle d'Aubigne Functional Test, as well as reasonable pain relief. Endoprosthesis dislocation occurred in 2 cases and early postoperative death in 2 other cases. Conclusions. Surgical treatment is needed in cases of actual or impending pathological fracture of the proximal femur. Resection arthroplasty is the method of choice in bone metastases to proximal femur. This procedure is well tolerated by patients. The use of long-stem partial Austin-Moore hip prosthesis appears to be a good alternative to costly modular implants, while its long stem protects the femoral shaft against fractures in cases where additional metastatic lesions are found there.

  18. 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

  19. Usefulness of PET/CT for diagnosis of periosteal chondrosarcoma of the femur: A case report.

    PubMed

    Morimoto, Shota; Futani, Hiroyuki; Tsuchiyama, Konan; Fukunaga, Satoru; Tsukamoto, Yoshitane; Yoshiya, Shinichi

    2014-06-01

    Periosteal chondrosarcoma is an extremely rare low-grade malignant cartilaginous tumor arising from the external bone surface. Diagnosis of periosteal chondrosarcomas may be challenging, since this condition closely resembles periosteal chondromas. It has been reported that positron emission tomography (PET) is useful in distinguishing benign from malignant cartilaginous tumors using a maximum standardized uptake value (SUVmax) cut-off of 2.0 or 2.3. This report presents the case of a 40-year-old female with an 18-month history of a tender mass in the left distal femur. Radiological findings demonstrated periosteal buttressing. Magnetic resonance imaging (MRI) revealed a chondrogenic tumor of 3 cm in size developing from the external bone surface. It was difficult to differentiate periosteal chondrosarcoma from periosteal chondroma on the basis of size and the radiological and MRI findings. PET/computed tomography (CT) revealed abnormal linear uptake with an SUVmax of 2.7, indicating a malignant tumor. A diagnosis of periosteal chondrosarcoma was made, and wide resection was performed. Tumor histology was consistent with grade II chondrosarcoma. PET/CT is thus useful in differentiating periosteal chondrosarcoma from periosteal chondroma.

  20. Atypical Femur Fractures in Patients Treated with Bisphosphonates: Identification, Management, and Prevention

    PubMed Central

    Bubbear, Judith Sarah

    2016-01-01

    Osteoporosis is a common condition with significant health care costs. First-line therapy is with bisphosphonates, which have proven anti-fracture efficacy. Around 10 years after the introduction of bisphosphonates reports began to be published of atypical femoral fractures (AFFs) that may be associated with this therapy. These fractures are associated with significant morbidity although lower mortality than the more common osteoporotic neck-of-femur fractures. A case definition has been described to allow identification of this class of fracture. Further work has established a high relative risk of AFFs in patients treated with bisphosphonates, but a low absolute risk in comparison to that of osteoporotic fractures. Proposed pathological mechanisms include low bone turnover states leading to stress/insufficiency fractures. Clinicians should be aware of the risk of AFFs and in particular the high rate of prodromal thigh/groin pain that warrants investigation in a patient receiving a bisphosphonate. If an incomplete fracture is diagnosed then bisphosphonate therapy needs to be stopped and prophylactic surgery may be considered. Due to these rare side effects patients on bisphosphonates require regular review, and this is particularly advised after 5 years of oral or 3 years of intravenous therapy. PMID:27824547

  1. 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

  2. Water uptake and swelling in single trabeculæ from human femur head

    PubMed Central

    Marinozzi, Franco; Bini, Fabiano; Marinozzi, Andrea

    2014-01-01

    The swelling of air-dried single trabeculae from human femur heads was obtained by complete immersion in water and the dimensional changes of the samples were measured over time. The experimental results were analyzed under the viewpoint of the diffusion through a porous material. The dimensional changes of the single trabeculae were 0.26 ± 0.15 percent (length), 0.45 ± 0.25 percent (width) and 1.86 ± 0.97 percent (thickness). The diffusion coefficients were then calculated from the swelling recorded over time and a value of (4.12 ± 0.8) x 10−10(m2s−1) (mean ± standard deviation) was found.   Since the dimensional variations of the specimens is due to the swelling of the collagen bone matrix, this technique could offer new insights for (1) a selective characterization of bone microstructure at the collagen matrix level and (2) the dynamics of diffusion through bone tissue. PMID:24553097

  3. Morphology and locomotor adaptations of the bovid femur in relation to habitat.

    PubMed

    Kappelman, J

    1988-10-01

    Extant bovids inhabit a wide diversity of environments that range from forest to savanna and display locomotor patterns that are habitat specific. I report here on an investigation of the linkage between these locomotor patterns and habitat based on a study of the morphology of the bovid femur. Femoral head shape, shaft dimensions, and knee structure are examined and support a statistically significant separation of the different morphological complexes present in bovids from forest, broken cover, and savanna habitats. Morphological differences are primarily related to locomotor patterns as reflected in the degree of cursoriality displayed by bovids in different habitats. Cursorial bovids from savanna environments have laterally expanded femoral heads that act to limit the degree of abduction and axial rotation at the hip, and elliptically shaped distal femora that increase the moment arm of the extensor muscles that cross the knee. Forest bovids have spherically shaped femoral heads. This morphology permits a much higher degree of abduction and axial rotation at the hip and appears to provide greater maneuverability in a vegetationally complex habitat. Bovids living in broken cover environments that fall between the extremes of closed canopy forest and savanna display an intermediate set of femoral characters. This approach to the relationship between habitat and locomotion offers a potentially powerful means with which to examine the interplay between structural form and function in bovid evolution.

  4. MRI appearances of the femur following bone graft harvesting using the Reamer-Irrigator-Aspirator.

    PubMed

    Rankine, James J; Hodgson, Richard J; Tan, Hiang B; Cox, George; Giannoudis, Peter V

    2015-12-01

    The reamer-irrigator-aspirator is increasingly being used to harvest autologous bone graft from the femur. The purpose of this study was to investigate the extent of neo-vascularisation and new bone formation that occurs within the medulla following the procedure, and determine if new bone formation would potentially allow a repeat bone harvest in those individuals subsequently requiring further bone graft. Eleven patients who had undergone femoral bone harvest were examined with MRI. The nature of the tissue within the medulla and the extent of neo-vascularisation were assessed. MRI was performed between 3 months and 28 months following bone graft harvest, mean 14 months. Intense vascularisation of the endostial cortical surface and neo-vascularisation of the haematoma within the canal occurred as soon as 3 months following bone harvest. From as early as 14 months the tissue was replaced by normal intramedullary bone. The formation of new bone within the medullary canal gives the potential for a repeat reaming, should further bone graft be required at a later date.

  5. Fracture prediction for the proximal femur using finite element models: Part II--Nonlinear analysis.

    PubMed

    Lotz, J C; Cheal, E J; Hayes, W C

    1991-11-01

    In Part I we reported the results of linear finite element models of the proximal femur generated using geometric and constitutive data collected with quantitative computed tomography. These models demonstrated excellent agreement with in vitro studies when used to predict ultimate failure loads. In Part II, we report our extension of those finite element models to include nonlinear behavior of the trabecular and cortical bone. A highly nonlinear material law, originally designed for representing concrete, was used for trabecular bone, while a bilinear material law was used for cortical bone. We found excellent agreement between the model predictions and in vitro fracture data for both the onset of bone yielding and bone fracture. For bone yielding, the model predictions were within 2 percent for a load which simulated one-legged stance and 1 percent for a load which simulated a fall. For bone fracture, the model predictions were within 1 percent and 17 percent, respectively. The models also demonstrated different fracture mechanisms for the two different loading configurations. For one-legged stance, failure within the primary compressive trabeculae at the subcapital region occurred first, leading to load transfer and, ultimately, failure of the surrounding cortical shell. However, for a fall, failure of the cortical and trabecular bone occurred simultaneously within the intertrochanteric region. These results support our previous findings that the strength of the subcapital region is primarily due to trabecular bone whereas the strength of the intertrochanteric region is primarily due to cortical bone.

  6. Desmoplastic (collagenous) fibroma of the femur: A case report and review of the literature

    PubMed Central

    GAO, SONGTAO; CAI, QIQING; YAO, WEITAO; WANG, JIAQIANG; ZHANG, PENG; WANG, XIN

    2013-01-01

    Desmoplastic fibroma is a rare, benign soft-tissue tumor composed of spindled and stellate-shaped cells that are embedded in a dense collagenous stroma. Clinically, desmoplastic fibroma presents as a firm, mobile, slow-growing mass that is located in the subcutaneous tissue or near the deep aspect of the skeletal muscles. The present study describes the case of a 66-year-old female who presented with an inactive, firm, slightly tender mass in the lower medial segment of the right femur. An open biopsy was performed and the result of the pathological examination indicated a desmoplastic fibroma. The patient underwent a radical resection of the tumor and the accompanying bone, which was then reimplanted using devitalized tumor bone, self-ilium graft and homologous allograft bone transplantation, with an internal fixation by locking the compression plate. This was followed by a reconstruction of the anterior and posterior cruciate ligaments and the lateral and medial collateral ligaments. There was no evidence of local recurrence at five years post-surgery. PMID:24179509

  7. Sex estimation with the total area of the proximal femur: A densitometric approach.

    PubMed

    Curate, Francisco; Albuquerque, Anabela; Ferreira, Izilda; Cunha, Eugénia

    2017-03-08

    The estimation of sex is a central step to establish the biological profile of an anonymous skeletal individual. Imaging techniques, including bone densitometry, have been used to evaluate sex in remains incompletely skeletonized. In this paper, we present a technique for sex estimation using the total area (TA) of the proximal femur, a two-dimensional areal measurement determined through densitometry. TA was acquired from a training sample (112 females; 112 males) from the Coimbra Identified Skeletal Collection (University of Coimbra, Portugal). Logistic regression (LR), linear discriminant analysis (LDA), reduce error pruning trees (REPTree), and classification and regression trees (CART) were employed in order to obtain models that could predict sex in unidentified skeletal remains. Under cross-validation, the proposed models correctly estimated sex in 90.2-92.0% of cases (bias ranging from 1.8% to 4.5%). The models were evaluated in an independent test sample (30 females; 30 males) from the 21st Century Identified Skeletal Collection (University of Coimbra, Portugal), with a sex allocation accuracy ranging from 90.0% to 91.7% (bias from 3.3% to 10.0%). Overall, data mining classifiers, especially the REPTree, performed better than the traditional classifiers (LR and LDA), maximizing overall accuracy and minimizing bias. This study emphasizes the significant value of bone densitometry to estimate sex in cadaveric remains in diverse states of preservation and completeness, even human remains with soft tissues.

  8. Radiological and Histopathological Outcome of Giant Cell Tumor of Femur with Denosumab Treatment: A Case Report

    PubMed Central

    Krishnakumar, R.; Jojo, Annie

    2016-01-01

    Giant Cell Tumour of Bone (GCTB) is a benign but locally aggressive osteolytic skeletal neoplasm of young adults consisting of giant cells expressing RANK (Receptor Activator of Nuclear Factor-κB) and mesenchymal spindle-like stromal cells expressing RANKL (RANK ligand). The interaction of these cells leads to bone resorption. Recently, the RANKL inhibitor, denosumab, has demonstrated activity against giant-cell tumours. The current article reports a case of a Giant cell tumour of left distal femur with pathological fracture. A 34-year-old male patient presented with history of on and off dull aching pain in the left knee for 4 months followed by a history of trivial fall. He sustained a closed injury in the left knee, following which he was unable to bear weight and developed pain and swelling in left knee. Conventional radiographs and Computerized tomography (CT) was done which showed the presence of a left distal femoral osteolytic lesion and a histological analysis of a biopsy specimen confirmed the diagnosis of GCTB. The patient was treated with neoadjuvant denosumab therapy which resulted in successful downstaging of the tumour followed by extended curettage of the lesion with high speed burr and argon laser cautery. The post-curettage microscopic examination revealed the absence of osteoclast-type giant cells. PMID:28208958

  9. 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.

  10. 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

  11. Synthesis and characterization of bovine femur bone hydroxyapatite containing silver nanoparticles for the biomedical applications

    NASA Astrophysics Data System (ADS)

    Nirmala, R.; Sheikh, Faheem A.; Kanjwal, Muzafar A.; Lee, John Hwa; Park, Soo-Jin; Navamathavan, R.; Kim, Hak Yong

    2011-05-01

    Bovine femur bone hydroxyapatite (HA) containing silver (Ag) nanoparticles was synthesized by thermal decomposition method and subsequent reduction of silver nitrate with N, N-dimethylformamide (DMF) in the presence of poly(vinylacetate) (PVAc). The structural, morphological, and chemical properties of the HA-Ag nanoparticles were characterized using X-ray diffraction (XRD), scanning electron microscopy (SEM), field-emission scanning electron microscopy (FE-SEM), transmission electron microscopy (TEM), and X-ray photoelectron spectroscopy (XPS). TEM images showed that the Ag nanoparticles with size ranging from 8 to 20 nm and were arranged at the periphery of HA crystals. Bactericidal activity of HA-Ag with different concentration of Ag nanoparticles immobilized on the surface of HA was investigated against gram-positive Staphylococcus aureus ( S. aureus, non-MRSA), Methicillin resistant S. aureus (MRSA) and gram-negative Escherichia coli ( E. coli) by the disc diffusion susceptibility test. The HA-Ag nanoparticles showed that broad spectrum activity against non-MRSA, MRSA, and E. coli bacterial strains.

  12. Functional Outcome of Conservatively Treated Bilateral Neck of Femur Fracture in an Elderly: A Case Report

    PubMed Central

    2016-01-01

    Bilateral Neck of Femur (NOF) fractures is relatively rare. Surgery, either osteosynthesis or hemireplacement arthroplasty, is the mainstay of treatment. Significant complications are known to occur in such cases. In this case report, we present the functional outcome of a conservatively treated bilateral NOF fracture at one year, in a 93-year-old man. Our patient, a 93-year-old gentleman, sustained right side NOF fracture in May 2014 and left side NOF fracture in May 2015, both after trivial fall. He did not give consent for surgery considering high operative risk. Now, at one year follow-up he has no true or apparent limb length discrepancy. He is ambulant with walker, self reliant for toilet care and other personal needs. Harris hip score is 75.80 and 69.65 after 1 year from right and left NOF fracture respectively. In view of high mortality after surgery for NOF fracture in high risk patients or unavailability of resources, conservative treatment for bilateral NOF fracture can achieve satisfactory functional outcome in selected patients. PMID:28208960

  13. Aneurysmal Bone Cyst of the Proximal Femur and Its Management - A Case Report

    PubMed Central

    Kapoor, Chirag; Shah, Malkesh; Soni, Rishit; Patwa, Jagdish; Golwala, Paresh

    2017-01-01

    Aneurysmal bone cyst (ABC) is a benign, expansile, non-neoplastic lesion of the bone, characterized by channels of blood and spaces that are separated by fibrous septae. Giant ABC is an uncommon condition and can be difficult to handle because of the destructive effect of the cyst on the bones and the compressive effect on the nearby structures, especially in weight-bearing bones of the body. We report a case of a giant aneurysmal bone cyst in the proximal femur of a six-year-old child, which was treated with a sclerosing agent and ender's nail fixation first. There was recurrence after 13 months. It was then curetted out extensively, the cavity was filled with bone graft, and fixation with a dynamic hip screw (DHS) was done. At 19 months follow-up, the lesion had subsided and patient was walking pain-free without any deformity. We suggest this method of treatment to be worthwhile for ABC at this site and at this age. PMID:28265527

  14. Advances in the surgical treatment of fragility fractures of the upper femur

    PubMed Central

    Muncibì, Francesco; Petrai, Veronica; Nistri, Lorenzo; Civinini, Roberto; Innocenti, Massimo

    2009-01-01

    Fragility fractures typically occur in elderly patients. They are related to osteoporosis, because of the weakening of the bone structure, and are the result of low-energy injuries and often involve the metaphyseal segments of bone. The fracture of the upper extremity of the femur are one of the most typical of the elderly patients. They may be intracapsular (femoral neck fractures) or extracapsular (intertrochanteric fractures). Each kind of fracture can be treated in several ways: the intracapsular fracture can be treated with screws, unipolar or bipolar hemiarthroplasty or even with total arthroplasty. The extracapsular fractures instead can be treated with sliding hip screw, intramedullary nail, femoral neck screws, helical blade or primary arthroplasty. What must be remembered is that osteoporotic bone has distinct morphologic characteristics that influence its biomechanical properties and therefore the choices and techniques for internal fixation. Therefore only a complete understanding of the biology of the osteoporotic bone will lead to a good quality of the treatment of the fragility fractures. PMID:22461246

  15. 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.

  16. Early experience about Anteversa® plate for lateral femur fractures

    PubMed Central

    Bonicoli, Enrico; Andreani, Lorenzo; Piolanti, Nicola; Dolfi, Lorenzo; Lisanti, Michele

    2012-01-01

    Summary Introduction The hip fractures appear to be a real epidemic problem, especially in the western world, due primarily to higher average age. The social and economical impact is considerable with a continue social and health costs up-rising. The female-male ratio is approximately 8:1. Purpose The purpose of this report is to present a system of osteosynthesis for fractures of the lateral femoral neck. This system is a plate developed by INTRAUMA O'nil®, 3-hole plate with an 130° angle of valgus and 7° of anteversion. Materials and methods At the I Orthopedic Department at the University of Pisa from January 2009 to February 2012 were treated 52 fractures of the femur neck side with this system. All patients undergone to a clinical and X-ray evaluation according to the AO classification: 14 31-A1, 7 31-A2, 4 31-A3. Results The mean follow-up was 10 months, in all cases we did not have cut-outs with a TAD average of 23 mm. Conclusions This system offers the possibility to perform surgery quickly with low risk of cut-out thanks to 7° of anteversion. Ensures optimal fixation to the femoral shaft and an equitable distribution of forces, eliminating the risk of breakage of the implant and loosening of the screws. PMID:23289036

  17. 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

  18. Alterations in trabecular bone microarchitecture in the ovine spine and distal femur following ovariectomy.

    PubMed

    Kreipke, Tyler C; Rivera, Nicole C; Garrison, Jacqueline G; Easley, Jeremiah T; Turner, A Simon; Niebur, Glen L

    2014-06-03

    Osteoporosis is a bone disease resulting in increased fracture risk as a result of alterations in both 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 for evaluating potential treatments of this disease. Large animals, such as the ovariectomized sheep, have been used as models 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 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 architectural changes stabilize after the first year.

  19. Fractured neck of femur below long spinopelvic fixation for Charcot spine: a case report

    PubMed Central

    2013-01-01

    Introduction We present a case of a patient with a previously undescribed complication: intertrochanteric femoral neck insufficiency fracture after long-segment instrumented spinopelvic fusion to the ilium for Charcot spine. Case presentation A 42-year-old Caucasian man with post-traumatic complete T6 paraplegia presented to our institution after developing Charcot spinal arthropathy at L3 and L4 and symptoms of autonomic dysreflexia 21 years after his original spinal cord injury. Multiple anterior and posterior surgeries were required to eventually achieve stabilization of his thoracolumbar spine to his pelvis and resolution of symptoms. The most distal fixation point was two iliac wing screws bilaterally. At 10 weeks after the final spinal surgery and after posterior spinal bony consolidation had occurred, he sustained an intertrochanteric femoral neck fracture, distal to the iliac fixation, whilst bending forward in his wheelchair. His proximal femoral fracture was internally fixed with an intramedullary device. Conclusions Spinal Charcot’s arthropathy is a rare condition that may occur in patients with post-traumatic spinal cord injury. Although associated with high risk of complications, circumferential instrumented fusion in Charcot spine can restore spinal stability. Insufficiency fractures of the proximal femur are possible complications of long spinopelvic fusions. PMID:24378187

  20. Increasing shape modelling accuracy by adjusting for subject positioning: an application to the analysis of radiographic proximal femur symmetry using data from the Osteoarthritis Initiative.

    PubMed

    Lindner, C; Wallis, G A; Cootes, T F

    2014-04-01

    In total hip arthroplasty, the shape of the contra-lateral femur frequently serves as a template for preoperative planning. Previous research on contra-lateral femoral symmetry has been based on conventional hip geometric measurements (which reduce shape to a series of linear measurements) and did not take the effect of subject positioning on radiographic femur shape into account. The aim of this study was to analyse proximal femur symmetry based on statistical shape models (SSMs) which quantify global femoral shape while also adjusting for differences in subject positioning during image acquisition. We applied our recently developed fully automatic shape model matching (FASMM) system to automatically segment the proximal femur from AP pelvic radiographs to generate SSMs of the proximal femurs of 1258 Caucasian females (mean age: 61.3 SD=9.0). We used a combined SSM (capturing the left and right femurs) to identify and adjust for shape variation attributable to subject positioning as well as a single SSM (including all femurs as left femurs) to analyse proximal femur symmetry. We also calculated conventional hip geometric measurements (head diameter, neck width, shaft width and neck-shaft angle) using the output of the FASMM system. The combined SSM revealed two modes that were clearly attributable to subject positioning. The average difference (mean point-to-curve distance) between left and right femur shape was 1.0mm before and 0.8mm after adjusting for these two modes. The automatic calculation of conventional hip geometric measurements after adjustment gave an average absolute percent asymmetry of within 3.1% and an average absolute difference of within 1.1mm or 2.9° for all measurements. We conclude that (i) for Caucasian females the global shape of the right and left proximal femurs is symmetric without isolated locations of asymmetry; (ii) a combined left-right SSM can be used to adjust for radiographic shape variation due to subject positioning; and (iii

  1. Fully automatic segmentation of femurs with medullary canal definition in high and in low resolution CT scans.

    PubMed

    Almeida, Diogo F; Ruben, Rui B; Folgado, João; Fernandes, Paulo R; Audenaert, Emmanuel; Verhegghe, Benedict; De Beule, Matthieu

    2016-12-01

    Femur segmentation can be an important tool in orthopedic surgical planning. However, in order to overcome the need of an experienced user with extensive knowledge on the techniques, segmentation should be fully automatic. In this paper a new fully automatic femur segmentation method for CT images is presented. This method is also able to define automatically the medullary canal and performs well even in low resolution CT scans. Fully automatic femoral segmentation was performed adapting a template mesh of the femoral volume to medical images. In order to achieve this, an adaptation of the active shape model (ASM) technique based on the statistical shape model (SSM) and local appearance model (LAM) of the femur with a novel initialization method was used, to drive the template mesh deformation in order to fit the in-image femoral shape in a time effective approach. With the proposed method a 98% convergence rate was achieved. For high resolution CT images group the average error is less than 1mm. For the low resolution image group the results are also accurate and the average error is less than 1.5mm. The proposed segmentation pipeline is accurate, robust and completely user free. The method is robust to patient orientation, image artifacts and poorly defined edges. The results excelled even in CT images with a significant slice thickness, i.e., above 5mm. Medullary canal segmentation increases the geometric information that can be used in orthopedic surgical planning or in finite element analysis.

  2. Validated finite element models of the proximal femur using two-dimensional projected geometry and bone density.

    PubMed

    Op Den Buijs, Jorn; Dragomir-Daescu, Dan

    2011-11-01

    Two-dimensional finite element models of cadaveric femoral stiffness were developed to study their suitability as surrogates of bone stiffness and strength, using two-dimensional representations of femoral geometry and bone mineral density distributions. If successfully validated, such methods could be clinically applied to estimate patient bone stiffness and strength using simpler and less costly radiographs. Two-dimensional femur images were derived by projection of quantitative computed tomography scans of 22 human cadaveric femurs. The same femurs were fractured in a fall on the hip configuration. Femoral stiffness and fracture load were measured, and high speed video was recorded. Digital image correlation analysis was used to calculate the strain distribution from the high speed video recordings. Two-dimensional projection images were segmented and meshed with second-order triangular elements for finite element analysis. Elastic moduli of the finite elements were calculated based on the projected mineral density values inside the elements. The mapping of projection density values to elastic modulus was obtained using optimal parameter identification in a set of nine of the 22 specimens, and validated on the remaining 13 specimens. Finite element calculated proximal stiffness and strength correlated much better with experimental data than areal bone mineral density alone. In addition, finite element calculated strain distributions compared very well with strains obtained from digital image processing of the high speed video recordings, further validating the two-dimensional projected subject-specific finite element models.

  3. Design and Development of Potential Tissue Engineering Scaffolds from Structurally Different Longitudinal Parts of a Bovine-Femur

    PubMed Central

    Pramanik, Sumit; Pingguan-Murphy, Belinda; Cho, Jongman; Osman, Noor Azuan Abu

    2014-01-01

    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. PMID:25068570

  4. 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

  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.

  6. 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

  7. Direct evidence of trophic interactions among apex predators in the Late Triassic of western North America.

    PubMed

    Drumheller, Stephanie K; Stocker, Michelle R; Nesbitt, Sterling J

    2014-11-01

    Hypotheses of feeding behaviors and community structure are testable with rare direct evidence of trophic interactions in the fossil record (e.g., bite marks). We present evidence of four predation, scavenging, and/or interspecific fighting events involving two large paracrocodylomorphs (='rauisuchians') from the Upper Triassic Chinle Formation (∼220-210 Ma). The larger femur preserves a rare history of interactions with multiple actors prior to and after death of this ∼8-9-m individual. A large embedded tooth crown and punctures, all of which display reaction tissue formed through healing, record evidence of a failed attack on this individual. The second paracrocodylomorph femur exhibits four unhealed bite marks, indicating the animal either did not survive the attack or was scavenged soon after death. The combination of character states observed (e.g., morphology of the embedded tooth, 'D'-shaped punctures, evidence of bicarination of the marking teeth, spacing of potentially serial marks) indicates that large phytosaurs were actors in both cases. Our analysis of these specimens demonstrates phytosaurs targeted large paracrocodylomorphs in these Late Triassic ecosystems. Previous distinctions between 'aquatic' and 'terrestrial' Late Triassic trophic structures were overly simplistic and built upon mistaken paleoecological assumptions; we show they were intimately connected at the highest trophic levels. Our data also support that size cannot be the sole factor in determining trophic status. Furthermore, these marks provide an opportunity to start exploring the seemingly unbalanced terrestrial ecosystems from the Late Triassic of North America, in which large carnivores far outnumber herbivores in terms of both abundance and diversity.

  8. 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

  9. 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

  10. Arthroscopically Assisted Evacuation of Brodie’s Abscess of Distal Femur

    PubMed Central

    Manandhar, Rajeev R; Lakhey, Shisir; Rijal, Kiran P

    2017-01-01

    Brodie’s abscess is a type of subacute osteomyelitis. Opinions differ as to whether treatment should be surgical or medical for these classic lesions. Failure of symptoms to resolve after six weeks of antibiotics or worsening of the condition during treatment should be followed by surgical treatment. Clinical signs of subperiosteal pus or synovitis indicate that the subacute infection has transformed into an acute component, and it must be drained surgically. Surgical treatment is comprised of evacuation and curettage for small lesions and evacuation, packing with cancellous bone chips, for large cavities. When clinical signs of synovitis are present, with a possibility of pus within a joint, arthrotomy is performed. Arthroscopically assisted evacuation of Brodie’s abscess from the distal femur has never been reported in the literature. We report a case of a 23-year-old female who presented with pain and swelling over the left knee for four months. There was diffuse swelling in the knee; tenderness was present over medial femoral condyle and range of motion (ROM) of the knee was five to 45 degrees at the time of presentation. X-ray and magnetic resonance imaging (MRI) revealed Brodie’s abscess on the lateral aspect of the medial femoral condyle. The patient was treated with the evacuation of pus and curettage of the cavity using an arthroscope. After two weeks, the patient had mild pain with knee ROM from zero to 45 degrees, and at the one-month follow-up, the knee ROM improved to zero to 90 degrees. At the two-year follow-up, the patient had no pain, with knee ROM from zero to 120 degrees. PMID:28168137

  11. 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.

  12. 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.

  13. Enhanced recovery after surgery: An opportunity to improve fractured neck of femur management

    PubMed Central

    Wainwright, TW; Middleton, RG

    2016-01-01

    Introduction Approximately 67,000 hip fractures occurred in England, Wales and Northern Ireland in 2014, and annual hospital costs for fracture are around £1.1 billion. We review the potential scope for improving length of stay (LOS). Methods Hospital Episode Statistics data on non-elective admissions to 137 hospital trusts between November 2013 and October 2015 with a primary diagnosis of fractured neck of femur were analysed. The primary outcome was superspell LOS, which is the total LOS for all related spells for a single patient during an episode of care. Secondary outcomes were discharge to home, readmission at 28 days and in-hospital mortality. Results The mean observed LOS was 22.1±3.8 days (range 12.3-33.7 days). The range for case mix-adjusted expected LOS was 21.5-24.4 days. On average, 6.7±1.5% (range 3.6%-10.9%) of patients died while in hospital, at a relative risk of in-hospital mortality of 28.2-182.9. A mean of 12.3±3.2% (range 3.9% to 23.0%) of patients were readmitted at 28 days, at a relative relative risk of 34.8-203.2. Conclusions The wide range of observed LOS in our study is unlikely to be due to the case mix, as the case mix-adjusted range of LOS is less than 3 days, but rather due to local processes and pathways. There is therefore considerable scope for quality and efficiency of care improvements in our hospitals. We propose this could be best achieved if clinicians experienced in enhanced recovery focused on FNOF pathways. PMID:27376444

  14. Comparative Study of Surgical Management of Fracture Neck of Femur with Cemented Versus Uncemented Bipolar Hemiarthroplasty

    PubMed Central

    Niranjan, M

    2017-01-01

    Introduction There is evidence for use of cemented hemiarthroplasty resulting in greater anchoring and lesser peri prosthetic fracture. However, this procedure results in more haemodynamic instability and cardiopulmonary complications termed as ‘cement reaction’ or bone cement implantation syndrome. There has been a heightened interest among surgeons to compare cemented and uncemented hemiarthroplasty for fracture neck of femur. Aim To compare cemented and uncemented hemiarthroplasty in terms of blood loss during the procedure, post-operative complications, mortality, functional recovery and long term clinical outcome. Materials and Methods In a prospective study spanning 8 years from January 2006 to January 2014 in a tertiary care hospital, 52 cases of fracture of neck were selected. Twenty four patients underwent cemented and 28 patients underwent uncemented hemiarthroplasty. Mean follow up duration was 59.3 months. Harris Hip Score evaluation was done at each follow up. Radiological evaluation was done at each follow up for calcar length and periprosthetic fractures. Results Mean age of patients was 70 years. Harris Hip scores at 3, 6 and 12 months did not show statistically significant differences. Periprosthetic osteolysis or loosening was not seen in the present study. No complications noted in uncemented hemiarthroplasty. Four patients who had cemented hemiarthroplasty had infections. No mortality occurred during admission and within 12 months after surgery. Conclusion No significant difference was noted between the cemented and uncemented hemiarthroplasty procedures on long term follow up in terms of functionality. No re-operations and no mortality reported. Cemented hemiarthroplasty had more blood loss and minimal post-operative complications. PMID:28384949

  15. 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

  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. 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

  18. 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.

  19. 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.

  20. Never too late.

    PubMed

    1996-11-01

    Motivated by the belief that education has been central to Japan's economic success, Japan International Cooperation Agency (JICA) promotes universal access to quality basic education. In developing countries, school children rarely learn science through experiments. A new JICA training course, the Science Experiment in Primary Education, involved teacher trainers from Bangladesh, Myanmar, Pakistan, and Sri Lanka. Physics, chemistry, biology, geology, and astronomy experiments that require simple, inexpensive materials were taught. Another JICA project in Satkhira, Bangladesh, sought to raise the economic status of women enrolled in a dressmaking program through a year-long evening literacy class at three sites. Elementary school diplomas (available with proof to a local teacher of basic literacy and minimal arithmetic skills) are required in Bangladesh to apply for nongovernmental organization-initiated vocational schools and loans to start businesses in areas such as dressmaking, agriculture, and livestock raising. By late 1993, the female literacy program had expanded to 18 villages.

  1. Three-dimensional image registration of MR proximal femur images for the analysis of trabecular bone parameters

    NASA Astrophysics Data System (ADS)

    Blumenfeld, Janet; Studholme, Colin; Carballido-Gamio, Julio; Link, Thomas M.; Majumdar, Sharmila

    2008-03-01

    This study investigated the feasibility of automatic image registration of MR high-spatial resolution proximal femur trabecular bone images as well as the effects of gray-level interpolation and volume of interest (VOI) misalignment on MR-derived trabecular bone structure parameters. For six subjects, a baseline scan and a follow-up scan of the proximal femur were acquired on the same day. An automatic image registration technique, based on mutual information, utilized a baseline and a follow-up scan to compute transform parameters that aligned the two images. These parameters were subsequently used to transform the follow-up image with three different gray-level interpolators. Nearest neighbor interpolation and b-spline approximation did not significantly alter bone parameters, while linear interpolation significantly modified bone parameters (p<0.01). Improvement in image alignment due to the automatic registration was determined by visually inspecting difference images and 3D renderings. This work demonstrates the first application of automatic registration, without prior segmentation, of high-spatial resolution trabecular bone MR images of the proximal femur. Additionally, effects due to imprecise analysis volume alignment are investigated. Inherent heterogeneity in trabecular bone structure and imprecise positioning of the VOI along the slice (A/P) direction resulted in significant changes in bone parameters (p<0.01). Results suggest that automatic mutual information registration using nearest-neighbor gray-level interpolation to transform the final image ensures VOI alignment between baseline and follow-up images and does not compromise the integrity of MR-derived trabecular bone parameters.

  2. A novel model for ectopic, chronic, intravital multiphoton imaging of bone marrow vasculature and architecture in split femurs

    PubMed Central

    Bălan, Mirela; Kiefer, Friedemann

    2015-01-01

    Creating a model for intravital visualization of femoral bone marrow, a major site of hematopoiesis in adult mammalian organisms, poses a serious challenge, in that it needs to overcome bone opacity and the inaccessibility of marrow. Furthermore, meaningful analysis of bone marrow developmental and differentiation processes requires the repetitive observation of the same site over long periods of time, which we refer to as chronic imaging. To surmount these issues, we developed a chronic intravital imaging model that allows the observation of split femurs, ectopically transplanted into a dorsal skinfold chamber of a host mouse. Repeated, long term observations are facilitated by multiphoton microscopy, an imaging technique that combines superior imaging capacity at greater tissue depth with low phototoxicity. The transplanted, ectopic femur was stabilized by its sterile environment and rapidly connected to the host vasculature, allowing further development and observation of extended processes. After optimizing transplant age and grafting procedure, we observed the development of new woven bone and maturation of secondary ossification centers in the transplanted femurs, preceded by the sprouting of a sinusoidal-like vascular network, which was almost entirely composed of femoral endothelial cells. After two weeks, the transplant was still populated with stromal and haematopoietic cells belonging both to donor and host. Over this time frame, the transplant partially retained myeloid progenitor cells with single and multi-lineage differentiation capacity. In summary, our model allowed repeated intravital imaging of bone marrow angiogenesis and hematopoiesis. It represents a promising starting point for the development of improved chronic optical imaging models for femoral bone marrow. PMID:28243515

  3. 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.

  4. Orthopedic Multidimensional Prognostic Index (Ortho-MPI) in the elderly with hip or neck femur fracture: a pilot study.

    PubMed

    Vitale, Elsa; Notarnicola, Angela; Tafuri, Silvio; Vicenti, Giovanni; Cassano, Maria; Moretti, Biagio

    2014-01-01

    The Orthopedic Multidimensional Prognostic Index (Ortho-MPI) was performed and validated in order to ameliorate the decision-making process as regards the elderly with hip or neck femur fractures. A retrospective study was performed. 95 patients 65 years old and over with a diagnosis of hip or femur fracture were enrolled. A standardized comprehensive orthopedic geriatric assessment was performed. It included information on: depressive symptoms, functional and instrumental activities of daily living, cognitive and nutritional status, laboratory tests, risk of pressure sore, comorbidities and comorbidity. The Ortho-MPI was calculated. After six months their initial assessment, patients were recalled in order to know if they live too or not. The survival condition was associated to the prognostic capacity calculated by the Ortho-MPI. Results showed that higher Ortho-MPI Index value was associated with higher six months-later mortality. In an unvaried analysis model the Ortho-MPI index was associated with death event of the elderly patients enrolled (OR=1.05; 95% CI, 1.01-1.10; z=2.27; p=0.023). This association was also validated by considering different ages between participants (OR=1.05; 95% CI, 1.004-1.11; z=2.13; p=0.033). Furthermore, each specific index considered in the total Ortho-MPI was associated with the death event of the elderly patients. In conclusion it was shown that the Ortho-MPI Index could be used to predict outcome in the elderly with hip or femur fracture.

  5. Late, Late-Onset Group B Streptococcus Cellulitis With Bacteremia.

    PubMed

    Yokouchi, Yukako; Katsumori, Hiroshi; Koike, Yuji

    2016-01-01

    Group B streptococcus (GBS) infection remains a leading cause of serious neonatal and early infantile infection. As the infection often presents with nonspecific symptoms, and is associated with underlying bacteremia, prompt investigation and treatment is required. We report a case of late, late-onset GBS infection with bacteremia in a 94-day-old boy experiencing cellulitis of the left hand. Although late-onset disease or late, late-onset disease has been reported to be common among infants with underlying conditions such as premature birth, immunocompromised status, trauma, or among those using medical devices, no such underlying medical condition predisposed this infant to invasive GBS infection. Recent reports including the present case underscore the risk of GBS infection among previously healthy infants beyond the neonatal period. Thus, clinicians should especially be aware of unusual presentations of GBS invasive disease with bacteremia.

  6. Episomal plasmid-based generation of induced pluripotent stem cells from fetal femur-derived human mesenchymal stromal cells.

    PubMed

    Megges, Matthias; Oreffo, Richard O C; Adjaye, James

    2016-01-01

    Human bone mesenchymal stromal cells derived from fetal femur 55 days post-conception were reprogrammed to induced pluripotent stem cells using episomal plasmid-based expression of OCT4, SOX2, NANOG, LIN28, SV40LT, KLF4 and c-MYC and supplemented with the following pathway inhibitors - TGFβ receptor inhibitor (A-83-01), MEK inhibitor (PD325901), GSK3β inhibitor (CHIR99021) and ROCK inhibitor (HA-100). Successful induction of pluripotency in two iPS-cell lines was demonstrated in vitro and by the Pluritest.

  7. CT analysis of the upper end of the femur: the asterisk sign and ischaemic bone necrosis of the femoral head.

    PubMed

    Dihlmann, W

    1982-01-01

    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 disease of the femoral head.

  8. Collar-type osteophyte of the femur in young adults: is it a harbinger of intra-articular osteoid osteoma?

    PubMed

    Sanal, Hatice Tuba; Bozkurt, Yalcin

    2013-09-01

    Variable clinical and radiological findings for intra-articular osteoid osteoma (OO) of the hip joint make its diagnosis difficult. Because radiographs commonly do not identify the nidus, MR imaging becomes the second line of study. However, because the appearance varies, findings on MR images can be confusing. We found "collar type osteophyte" of the femur i.e. an osteophyte rim around the femoral neck, to be a conspicuous finding of intra-articular OO. Here, this feature will be emphasized and intra-articular OOs will be discussed, with a review of the literature.

  9. Unusual Femur Stress Fractures in Children With Osteogenesis Imperfecta and Intramedullary Rods on Long-term Intravenous Pamidronate Therapy.

    PubMed

    Hegazy, Abdelsalam; Kenawey, Mohamed; Sochett, Etienne; Tile, Lianne; Cheung, Angela M; Howard, Andrew W

    2016-01-01

    In this report, we describe 6 children with osteogenesis imperfecta with unusual stress femoral fractures. All children were on long-term cyclic pamidronate treatment. All fractures occurred without trauma or with minimal trauma and were located in the subtrochanteric or the diaphyseal regions of the femur over preexisting intramedullary rods. These fractures have very similar features to the reported minimal trauma atypical femoral fractures in adults on long-term bisphosphonate treatment. These fractures raise concerns about the role of prolonged remodeling suppression and microdamage accumulation and the risk of increased bone fragility.

  10. 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

  11. Comparative evaluation of femoral nerve block and intravenous fentanyl for positioning during spinal anaesthesia in surgery of femur fracture

    PubMed Central

    Jadon, Ashok; Kedia, Sunil Kumar; Dixit, Shreya; Chakraborty, Swastika

    2014-01-01

    Background: Spinal anaesthesia is the preferred technique to fix fracture of the femur. Extreme pain does not allow ideal positioning for this procedure. Intravenous fentanyl and femoral nerve block are commonly used techniques to reduce the pain during position for spinal anaesthesia however; results are conflicting regarding superiority of femoral nerve block over intravenous fentanyl. Aims: We conducted this study to compare the analgesic effect provided by femoral nerve block (FNB) and intra- venous (IV) fentanyl prior to positioning for central neuraxial block in patients undergoing surgery for femur fracture. Patients and Methods: In this randomized prospective study 60 patients scheduled for fracture femur operation under spinal were included. Patients were distributed in two groups through computer generated random numbers table; Femoral nerve block group (FNB) and Intravenous fentanyl group (FENT). In FNB group patients received FNB guided by a peripheral nerve stimulator (Stimuplex; B Braun, Melsungen, AG) 5 minutes prior to positioning. 20mL, 1.5% lidocaine with adrenaline (1:200,000) was injected incrementally after a negative aspiration test. Patients in the fentanyl group received injection fentanyl 1 μg/kg IV 5 mins prior to positioning. Spinal block was performed and pain scores before and during positioning were recorded. Statistical analysis was done with Sigmaplot version-10 computer software. Student t-test was applied to compare the means and P < 0.05 was taken as significant. Results: VAS during positioning in group FNB: 0.57 ± 0.31 versus FENT 2.53 ± 1.61 (P = 0.0020). Time to perform spinal anesthesia in group FNB: 15.33 ± 1.64 min versus FENT 19.56 ± 3.09 min (P = 0.000049). Quality of patient positioning for spinal anesthesia in group FNB 2.67± 0.606 versus FENT 1.967 ± 0.85 (P = 0.000027). Patient acceptance was less in group FENT (P = 0.000031). Conclusion: Femoral nerve block provides better analgesia, patient satisfaction and

  12. 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

  13. Biomechanical analysis of the cephalomedullary nail versus the trochanteric stabilizing plate for unstable intertrochanteric femur fractures.

    PubMed

    Walmsley, David; Nicayenzi, Bruce; Kuzyk, Paul Rt; Machin, Alan; Bougherara, Habiba; Schemitsch, Emil H; Zdero, Radovan

    2016-10-26

    Unstable intertrochanteric fractures are commonly treated with a cephalomedullary nail due to high failure rates with a sliding hip screw. The Omega3 Trochanteric Stabilizing Plate is a relatively new device that functions like a modified sliding hip screw with a proximal extension; however, its mechanical properties have not been evaluated. This study biomechanically compared a cephalomedullary nail, that is, Gamma3 Nail against the Omega3 plate. Unstable intertrochanteric fractures were created in 24 artificial femurs. Experimental groups were as follows: Nail (i.e. Gamma3 Nail) (n = 8), Plate A (i.e. Omega3 plate with four distal non-locking screws and no proximal locking screws) (n = 8), Plate B (i.e. Plate A plus five proximal locking screws) (n = 8), Plate C (i.e. Omega3 plate with three distal locking screws and no proximal locking screws) (n = 8), and Plate D (i.e. Plate C plus five proximal locking screws) (n = 8). All specimens were stiffness tested, while the Nail and Plate D groups were also strength tested. For lateral bending, Plate B was less stiff than the Nail (p = 0.001) and Plate A (p = 0.009). For torsion, Plate A was less stiff than Plate D (p = 0.020). For axial compression, the Nail was less stiff than Plate A (p = 0.036) and Plate B (p = 0.008). Axial strength for the Nail (5014 ± 308 N) was 66% higher than the Plate D construct (2940 ± 411 N) (p < 0.001). All Nails failed by partial or complete cutout through the femoral head and neck, but Plate D failed by varus collapse and deformation of the lag screw. When the cephalomedullary nail is clinically contra-indicated, this study supports the use of the Omega3 plate, since it had similar stiffness in three test modes to the Gamma3 Nail, but had lower strength. Stability of Omega3 plate constructs was not improved with locked fixation proximally or distally.

  14. Trabecular orientation in the human femur and tibia and the relationship with lower-limb alignment for patients with osteoarthritis of the knee.

    PubMed

    Sampath, Shameem A; Lewis, Sandra; Fosco, Matteo; Tigani, Domenico

    2015-04-13

    Wolff׳s Law suggests that the orientation of trabeculae in human bone changes in response to altered loading patterns. The aim of this study was to investigate trabecular orientation in both the femur and tibia and to compare this with the mechanical axis of the leg. The study involved analysis of radiographs from patients with osteoarthritis of the knee (n=91). For each patient, the trabecular orientation in both the distal femur and proximal tibia was measured from a standard anteroposterior radiograph of the knee and the mechanical axis of the leg was calculated from a long leg view taken while weight bearing. There was a significant correlation between the mechanical axis and the trabecular orientation in each of the regions considered in the femur (r=-0.41, -0.30, 0.52, and 0.23) and tibia (r=-0.27 and 0.31). Multiple regression analysis, with mechanical axis as the dependent variable, produced an R(2) of 0.62. Greater trabecular anisotropy (i.e. greater alignment) was observed in the medial femur and tibia compared to the lateral side (p<0.01). The results give an insight into the trabecular changes that may take place during development of osteoarthritis and following surgery. In particular, we propose that the orientation of the trabeculae in both the distal femur and proximal tibia will reflect the angle of mechanical loading through the knee.

  15. 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.

  16. On the use of knee functional calibration to determine the medio-lateral axis of the femur in gait analysis: Comparison with EOS biplanar radiographs as reference.

    PubMed

    Sauret, Christophe; Pillet, Hélène; Skalli, Wafa; Sangeux, Morgan

    2016-10-01

    Accurate calibration of the medio-lateral axis of the femur is crucial for clinical decision making based on gait analysis. This study proposes a protocol utilizing biplanar radiographs to provide a reference medio-lateral axis based on the anatomy of the femur. The biplanar radiographs allowed 3D modelling of the bones of the lower limbs and the markers used for motion capture, in the standing posture. A comprehensive analysis was performed and results from biplanar radiographs were reliable for 3D marker localization (±0.35mm) and for 3D localization of the anatomical landmarks (±1mm), leading to a precision of 1° for the orientation of the condylar axis of the femur and a 95% confidence interval of ±3° after registration with motion capture data. The anatomical condylar axis was compared to a conventional, marker-based, axis and three functional calibration techniques (axis transformation, geometric axis fit and DynaKAD). Results for the conventional method show an average difference with the condylar axis of 15° (SD: 6°). Results indicate DynaKAD functional axis was the closest to the anatomical condylar axis, mean: 1° (SD: 5°) when applied to passive knee flexion movement. However, the range of the results exceeded 15° for all methods. Hence, the use of biplanar radiographs, or an alternative imaging technique, may be required to locate the medio-lateral axis of the femur reliably prior to clinical decision making for femur derotational osteotomies.

  17. 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.

  18. Illusory Late Heavy Bombardments

    PubMed Central

    Boehnke, Patrick; Harrison, T. Mark

    2016-01-01

    The Late Heavy Bombardment (LHB), a hypothesized impact spike at ∼3.9 Ga, is one of the major scientific concepts to emerge from Apollo-era lunar exploration. A significant portion of the evidence for the existence of the LHB comes from histograms of 40Ar/39Ar “plateau” ages (i.e., regions selected on the basis of apparent isochroneity). However, due to lunar magmatism and overprinting from subsequent impact events, virtually all Apollo-era samples show evidence for 40Ar/39Ar age spectrum disturbances, leaving open the possibility that partial 40Ar* resetting could bias interpretation of bombardment histories due to plateaus yielding misleadingly young ages. We examine this possibility through a physical model of 40Ar* diffusion in Apollo samples and test the uniqueness of the impact histories obtained by inverting plateau age histograms. Our results show that plateau histograms tend to yield age peaks, even in those cases where the input impact curve did not contain such a spike, in part due to the episodic nature of lunar crust or parent body formation. Restated, monotonically declining impact histories yield apparent age peaks that could be misinterpreted as LHB-type events. We further conclude that the assignment of apparent 40Ar/39Ar plateau ages bears an undesirably high degree of subjectivity. When compounded by inappropriate interpretations of histograms constructed from plateau ages, interpretation of apparent, but illusory, impact spikes is likely. PMID:27621460

  19. Illusory Late Heavy Bombardments.

    PubMed

    Boehnke, Patrick; Harrison, T Mark

    2016-09-27

    The Late Heavy Bombardment (LHB), a hypothesized impact spike at ∼3.9 Ga, is one of the major scientific concepts to emerge from Apollo-era lunar exploration. A significant portion of the evidence for the existence of the LHB comes from histograms of (40)Ar/(39)Ar "plateau" ages (i.e., regions selected on the basis of apparent isochroneity). However, due to lunar magmatism and overprinting from subsequent impact events, virtually all Apollo-era samples show evidence for (40)Ar/(39)Ar age spectrum disturbances, leaving open the possibility that partial (40)Ar* resetting could bias interpretation of bombardment histories due to plateaus yielding misleadingly young ages. We examine this possibility through a physical model of (40)Ar* diffusion in Apollo samples and test the uniqueness of the impact histories obtained by inverting plateau age histograms. Our results show that plateau histograms tend to yield age peaks, even in those cases where the input impact curve did not contain such a spike, in part due to the episodic nature of lunar crust or parent body formation. Restated, monotonically declining impact histories yield apparent age peaks that could be misinterpreted as LHB-type events. We further conclude that the assignment of apparent (40)Ar/(39)Ar plateau ages bears an undesirably high degree of subjectivity. When compounded by inappropriate interpretations of histograms constructed from plateau ages, interpretation of apparent, but illusory, impact spikes is likely.

  20. Managing the chronically late patient.

    PubMed

    Baum, Neil

    2014-01-01

    Every practice has patients who are chronically late. This wrecks havoc with your schedule and makes you less productive. Patients can be trained to respect your time and arrive in the office on time. This article discusses several approaches to managing the chronically late patient.

  1. Anxiety disorders in late life.

    PubMed Central

    Flint, A. J.

    1999-01-01

    OBJECTIVE: To review the epidemiology, clinical characteristics, and treatment of anxiety disorders in late life. QUALITY OF EVIDENCE: Epidemiologic and comorbidity data are derived from well designed random-sample community surveys. There are virtually no controlled data specific to treatment of anxiety in the elderly. Guidelines for treating anxiety disorders in late life, therefore, must be extrapolated from results of randomized controlled trials conducted in younger patients. MAIN MESSAGE: Generalized anxiety disorder and agoraphobia account for most cases of anxiety disorder in late life. Late-onset generalized anxiety is usually associated with depressive illness and, in this situation, the primary pharmacologic treatment is antidepressant medication. Most elderly people with agoraphobia do not give a history of panic attacks; exposure therapy is the preferred treatment for agoraphobia without panic. CONCLUSIONS: Physicians need to make more use of antidepressant medication and behavioural therapy and less use of benzodiazepines in treating anxiety disorders in late life. PMID:10587775

  2. Late-life attachment.

    PubMed

    Freitas, Mélanie; Rahioui, Hassan

    2017-03-01

    Old age is likely to cause a crisis in one's life because of the vulnerabilities it brings up, acting as stressful elements disrupting the elder's feeling of security. It leads to the activation of what is called his attachment system, consisting in attachment styles and interpersonal emotional regulation strategies. To recover a higher sense of safety, the elder would refer to his attachment figures, that is to say closed people paying attention to him, showing towards him availability and consideration. However older adults particularly see their tolerance threshold lowered, regarding an accumulation of losses (true or symbolic) and stressful events within their lifetime. In a psychological and organic exhaustion phenomenon, the risk is to wear out the interpersonal emotional regulation strategies. These are as much vulnerabilities that may increase psychiatric decompensation, including depression. To resolve the tension of this period and to found a necessary secure feeling, the elder will have to redesign the attachment links previously settled and proceed to adjustments to this new context. The need of relational closeness comes back in the elders' attachment behaviour, counting on attachment figures not only to help their loneliness or dependency, but essentially to support them in a narcissist and affective way. That is why attachment theory enlightens the late life period, such as the new challenges older adults have to face. Many studies recognize its value in understanding the transition to old age, but without proposing conceptualization. We aim first to focus on attachment conception to say how much it is relevant with elderly, and then to describe specific terms of attachment within this population in order to better understand those patients. To finish, we must think about new therapeutic proposals taking into consideration the attachment perspective for a better understanding of old age transition.

  3. An unusual case of simultaneous bilateral neck of femur fracture following electrocution injury-A case report and review of literature

    PubMed Central

    Nekkanti, Supreeth; Vijay, C; Theja, JS Sujana; RaviShankar, R; Raj, Sumit

    2016-01-01

    Introduction: Simultaneous bilateral fractures of the neck of femur is rare. Hypocalcemia, epilepsy, osteoporosis and electrical injuries are known to cause similar injuries. Case Report: We report a case of a 43-year-old male who sustained an electrical shock injury following which he fell from a height of around 4 feet. Radiological studies confirmed bilateral transcervical neck of femur fracture. Laboratory investigations revealed the patient had extremely low levels of vitamin D (11.1ng/ml). Patient was treated with three 6.5 mm cannulated cancellous screws on each side. Patient had good functional outcome at the end of one year. Conclusion: We report this case as a rare etiological combination of hypovitaminosis D and electrical injury causing bilateral neck of femur fracture. Such injuries should be diagnosed at the earliest and goal of treatment should be to preserve both the hip joints. Early management would avoid potential complications like non-union and avascular necrosis. PMID:28116275

  4. 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.

  5. 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.

  6. 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

    2016-05-03

    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.

  7. Exploring the Use of Non-Image-Based Ultrasound to Detect the Position of the Residual Femur within a Stump

    PubMed Central

    Chong, Sook-Yee; Röhrle, Oliver

    2016-01-01

    A satisfactorily fitted socket interacts dynamically with the stump in order to support body weight, transmit load effectively, enhance dynamic stability, and enable the control and stabilization of the residual limb. The internal dynamics occurring within a socket is important in determining optimal fit. Many measurement and imaging techniques, such as X-rays, have been utilized to investigate the movement of the residual femur within the stump during gait. However, due to associated health risks and costs, none of the current techniques have been extended to clinical prosthetics. The use of B-mode ultrasound has been suggested as a safe and cheap alternative, and has been utilized in previous studies to monitor the motion of the femur. However, the need to create a duplicate socket and time-consuming analysis of the images were obstacles to the system being applied clinically. This study aims to gauge the effectiveness of a non-image based ultrasound system. Here, we determined errors expected from the measurements. Accuracy errors of 2.9 mm to 8.4 mm and reproducibility measurements within a standard deviation of 3.9 mm are reported. We also estimated errors up to 14.4 mm in in-vivo measurements. We think there is potential in developing this technique, and we hope to reduce some technical difficulties such that it can, one day, be easily incorporated into prosthetic fitting. PMID:27764120

  8. Bone regeneration in a massive rat femur defect through endochondral ossification achieved with chondrogenically differentiated MSCs in a degradable scaffold.

    PubMed

    Harada, Noriko; Watanabe, Yoshinobu; Sato, Kenji; Abe, Satoshi; Yamanaka, Katsuyuki; Sakai, Yuhiro; Kaneko, Tadashi; Matsushita, Takashi

    2014-09-01

    Mesenchymal stem cells (MSCs) are multipotent cells capable of proliferating and differentiating into several lineages. In regenerative medicine, their potential as a resource for tissue-replacement therapy is receiving much attention. However, transplanting MSCs to repair larger bone defects in animal models has so far proved disappointing. Here we report on the healing of both critical-sized (5 mm) and massive (15 mm) full-thickness femur defects in rats by implanting a uniquely fabricated PLGA scaffold seeded with MSCs pre-differentiated in vitro into cartilage-forming chondrocytes (MSC-DCs). This strategy closely mimics endochondral ossification, the process by which long bones develop in nature. It is thought that because the transplanted MSC-DCs induced natural bone formation, the defect size was not critical to the outcome. Crucially, after 8 weeks the mean biomechanical strength of femora with the massive 15 mm implant reached 75% that of a normal rat femur, while in the case of 5 mm implants there was no significant difference. Successful healing was also highly reproducible, with bone union occurring in all treated animals examined radiologically 8 or 16 weeks after surgery.

  9. Perioperative Application of a Serum Protein Solution (Biseko(®)) After Proximal Femur Fracture of Elder Patients.

    PubMed

    Maier, Marcus; Reinert, Mark; Lehnert, Mark; Bauer, Clemens; Marzi, Ingo

    2007-08-01

    Fractures of the proximal femur are frequently seen in elderly people and will increase due to the demographic development of most industrialized countries. Early operation of dislocated fractures with either osteosynthesis or hemiprothesis has become a standard treatment for this type of injury. The high co-morbidity often leads to secondary complications like infections still resulting in a perioperative mortality rate of 11%. The perioperative infusion regime might influence the postoperative inflammatory response. Therefore Biseko(®), a serum protein solution, was compared to albumin and crystalloid infusion (Elomel). A total of 45 patients with proximal femur fractures were randomly assigned to either of the groups and received 500 ml of the infusion on 3 days starting from the day of operation. The Biseko(®) group showed significantly lower CRP levels, less infections and antibiotic treatment as well as a better clinical outcome referring to the TISS28 and APACHE Score. Concerning IL-6, IL-8, IL-10 and serum leukocytes no significant differences were observed. The result shows a beneficial influence of the serum protein solution Biseko(®) concerning the number of perioperative complications. The design of this study and the small number of patients does not yet allow any conclusion concerning the effectiveness of this treatment.

  10. Femur morphometry, densitometry, geometry and mechanical properties in young pigs fed a diet free of inorganic phosphorus and supplemented with phytase.

    PubMed

    Skiba, Grzegorz; Sobol, Monika; Raj, Stanisława

    2017-02-01

    The study investigated in piglets the effect of replacing dietary inorganic P by addition of microbial phytase and its impact on performance, nutrient digestibility and on the geometrical characteristics and mineralisation of the femur. Sixteen pigs on day 58 of age were divided into two groups and fed either a diet free of additional inorganic phosphorus (P) and supplemented with phytase (Diet LP, 4.23 g total P/kg diet) or a diet with a mineral source of P and not supplemented with phytase (Diet SP, 5.38 g total P/kg diet). Performance data and the apparent total tract digestibility of nutrients were estimated between days 58 and 114, and 72 and 86 of age, respectively. On day 114 of age, the pigs were slaughtered, the femur was dissected and the mineral content and mineral density, maximum strength and maximum elastic strength, cortical wall thickness, cross-sectional area and cortical index were analysed. The growth performance and digestibility of nutrient fractions (with exception of P) did not differ between treatment groups. The P-digestibility was significantly higher in Group LP. The femur of pigs in Group LP had significantly greater cortical wall thickness, cortical index, bone mineral content, bone mineral density, maximum strength and maximum elastic strength than Group SP. Femur maximum strength and maximum elastic strength were correlated with cortical wall thickness and cortical index. Resulting from the different supply of digestible P, the femur geometrical, densitometric and mechanical properties of Group LP were better than those of Group SP. The mechanical properties of the femur of pigs depended more on its geometrical characteristics than on the degree of its mineralisation.

  11. Theoretical effects of fully ductile versus fully brittle behaviors of bone tissue on the strength of the human proximal femur and vertebral body.

    PubMed

    Nawathe, Shashank; Yang, Haisheng; Fields, Aaron J; Bouxsein, Mary L; Keaveny, Tony M

    2015-05-01

    The influence of the ductility of bone tissue on whole-bone strength represents a fundamental issue of multi-scale biomechanics. To gain insight, we performed a computational study of 16 human proximal femurs and 12 T9 vertebral bodies, comparing the whole-bone strength for the two hypothetical bounding cases of fully brittle versus fully ductile tissue-level failure behaviors, all other factors, including tissue-level elastic modulus and yield stress, held fixed. For each bone, a finite element model was generated (60-82 μm element size; up to 120 million elements) and was virtually loaded in habitual (stance for femur, compression for vertebra) and non-habitual (sideways fall, only for femur) loading modes. Using a geometrically and materially non-linear model, the tissue was assumed to be either fully brittle or fully ductile. We found that, under habitual loading, changing the tissue behavior from fully ductile to fully brittle reduced whole-bone strength by 38.3±2.4% (mean±SD) and 39.4±1.9% for the femur and vertebra, respectively (p=0.39 for site difference). These reductions were remarkably uniform across bones, but (for the femur) were greater for non-habitual (57.1±4.7%) than habitual loading (p<0.001). At overall structural failure, there was 5-10-fold less failed tissue for the fully brittle than fully ductile cases. These theoretical results suggest that the whole-bone strength of the proximal femur and vertebra can vary substantially between fully brittle and fully ductile tissue-level behaviors, an effect that is relatively insensitive to bone morphology but greater for non-habitual loading.

  12. 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.

  13. Iatrogenic Pseudo-aneurysm of Profunda Femoris Artery Following Fixation of Intertrochanteric Femur Fracture – A Case Report and Review of Literature

    PubMed Central

    Aggarwal, Rishi Anil; Purohit, Shaligram; Bandagi, Gokul; Marathe, Nandan

    2016-01-01

    The Profunda Femoris is a common site for arterial pseudo-aneurysms and these have been described in literature following fractures as well as orthopaedic procedures of the femur and hip region. These are an uncommon complication and a high index of suspicion is required for correct diagnosis and prompt management. We present a case of pseudo-aneurysm of the Profunda Femoris in an operated case of Intertrochanteric femur fracture with acute presentation. The case was managed successfully by angiographic coil embolization. PMID:27134957

  14. 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

  15. EVALUATION OF PRESENTATION OF SIGNS AND SYMPTOMS OF FEMOROACETABULAR IMPINGEMENT AFTER EPIPHYSIOLYSIS OF THE PROXIMAL FEMUR.

    PubMed

    Krüger, Fábio Peng; de Britto, Paulo Sérgio Gérzon; Neto, Lauro Machado; Schwartsmann, Carlos Roberto

    2011-01-01

    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.

  16. 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 ...

  17. Vaginal bleeding in late pregnancy

    MedlinePlus

    ... this page: //medlineplus.gov/ency/patientinstructions/000627.htm Vaginal bleeding in late pregnancy To use the sharing ... JavaScript. One out of 10 women will have vaginal bleeding during their 3rd trimester. At times, it ...

  18. 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.

  19. 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

  20. Intramedullary and total femur replacement in revision arthroplasty as a last limb-saving option: is there any benefit from the less invasive intramedullary replacement?

    PubMed

    Hoell, S; Butschek, S; Gosheger, G; Dedy, N; Dieckmann, R; Henrichs, M; Daniilidis, K; Hardes, J

    2011-11-01

    There has been a substantial increase in the number of hip and knee prostheses implanted in recent years, with a consequent increase in the number of revisions required. Total femur replacement (TFR) following destruction of the entire femur, usually after several previous revision operations, is a rare procedure but is the only way of avoiding amputation. Intramedullary femur replacement (IFR) with preservation of the femoral diaphysis is a modification of TFR. Between 1999 and 2010, 27 patients with non-oncological conditions underwent surgery in our department with either IFR (n = 15) or TFR (n = 12) and were included in this study retrospectively. The aim of the study was to assess the indications, complications and outcomes of IFR and TFR in revision cases. The mean follow-up period was 31.3 months (6 to 90). Complications developed in 37% of cases, 33% in the IFR group and 4% in the TFR group. Despite a trend towards a slightly better functional outcome compared with TFR, the indication for intramedullary femur replacement should be established on a very strict basis in view of the procedure's much higher complication rate.

  1. Effects of rhBMP-2 on cortical strut allograft healing to the femur in revision total hip arthroplasties: an experimental study

    PubMed Central

    Wu, Li-Dong; Yu, Hua-Chen

    2006-01-01

    We have studied the effects of recombinant human bone morphogenetic protein-2 (rhBMP-2) on cortical strut allograft healing and remodelling in revision hip arthroplasty. Thirty adult New Zealand rabbits underwent bilateral onlay allograft strut procedures to the femur using wires. The left femur (experimental side) received the rhBMP-2 device (1.0-mg rhBMP-2/gelatin composites) interposed between the allograft and host bone, while the right side was grafted with an allograft strut as the control. The femurs and implants were retrieved at 4, 6, and 8 weeks postoperatively. The healing of cortical strut grafts to the femur was enhanced dramatically by the addition of the rhBMP-2 device in radiographic examination, contact radiographic examination, non-decalcification sections, fluorescence tag, and computer-aided image analysis. The remodelling of cortical strut allograft was also accelerated. The new bone formation ratio and radiographic scores of the experimental side were also much higher than the control side at all times. Strut healing with the rhBMP-2 device at 4 weeks postoperatively was superior to the healing in control sides at 8 weeks. Our findings showed that the rhBMP-2 device improved and accelerated the course of cortical strut allograft healing and remodelling with host bone. PMID:17123081

  2. 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.

  3. The effect of an intramedullary implant with a static magnetic field on the healing of the osteotomised rabbit femur.

    PubMed

    Aydin, Nuri; Bezer, Murat

    2011-01-01

    Static magnetic fields are a type of electromagnetic fields used in clinical practice. To ascertain what effect a static magnetic intramedullary device implanted in the rabbit femur had on fracture healing, 20 male New Zealand white rabbits with magnetic/nonmagnetic intramedullary implants were examined histologically, radiologically and for bone mineral density. Three groups were constituted according to the poles of the magnets. During surgery the intramedullary device was driven into the medulla. A femoral osteotomy was created with a mini Gigli wire at the centre point of the rod. Radiographs were obtained at the second and fourth weeks. Histological examination and bone mineral density were evaluated at the fourth week. The results of this study verified that an intramedullary implant with a static magnetic field improves bone healing in the first two weeks radiologically and that the configuration difference in magnetic poles has an effect on bone quality. Static magnetic fields have minor effects on bone mineral density values.

  4. Are albumin and total lymphocyte count significant and reliable predictors of mortality in fractured neck of femur patients?

    PubMed

    Kumar, Vishwajeet; Alva, Avinash; Akkena, Sudheer; Jones, Morgan; Murphy, Philip N; Clough, Tim

    2014-10-01

    Hip fractures are a significant cause of mortality and morbidity in the elderly. It is important to identify factors that predict an increased mortality following hip fracture. The aim of this study was to identify significant predictors of mortality at 6 and 12 months following hip fractures. Three hundred patients above the age of 65 were identified who were admitted in to the hospital with fracture neck of femur. Two hundred and seventy-four patients were operated and were included into the study. Variables collected were age, gender, significant comorbidities, admission albumin level and admission total lymphocyte count (TLC). Admission time and subsequent time to surgery were also analysed. Our study showed that albumin and TLC were found to be the only clearly significant mortality predictors at 12 months and a delay of up to 4 days to surgery does not significantly increase the mortality at 12 months.

  5. Femur-bending properties as influenced by gravity. IV - Limits after high and low weight-bearing

    NASA Technical Reports Server (NTRS)

    Wunder, C. C.; Tipton, C. M.; Cook, K. M.

    1980-01-01

    Gravity enhances femur growth as measured in terms of strength, but shows little or even a growth-retarding effect in terms of relative brittleness, defined as the inverse of ultimate or tolerable strain. Chronic weightlessness was simulated by harness suspension or by extrapolation of results from 3-g centrifugation. Experimental results from 45 male, white rats (34-520 d old) were compared to 72 control or baseline rats (28-520 d old) with correction for age and size differences. After suspension, the youngest rats showed subnormal tolerable strains. Combined results, however, although predicting 19 + or 1% below normal strength, after a week of weightlessness, predicted less effect (1 + or - 4%) for the tolerable strain.

  6. Mapping the strain distribution on the proximal femur with titanium and flexible-stemmed implants using digital image correlation.

    PubMed

    Tayton, E; Evans, S; O'Doherty, D

    2010-08-01

    We implanted titanium and carbon fibre-reinforced plastic (CFRP) femoral prostheses of the same dimensions into five prosthetic femora. An abductor jig was attached and a 1 kN load applied. This was repeated with five control femora. Digital image correlation was used to give a detailed two-dimensional strain map of the medial cortex of the proximal femur. Both implants caused stress shielding around the calcar. Distally, the titanium implant showed stress shielding, whereas the CFRP prosthesis did not produce a strain pattern which was statistically different from the controls. There was a reduction in strain beyond the tip of both the implants. This investigation indicates that use of the CFRP stem should avoid stress shielding in total hip replacement.

  7. 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.

  8. 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

  9. A case report of pycnodysostosis with atypical femur fracture diagnosed by next-generation sequencing of candidate genes

    PubMed Central

    Song, Hyung Keun; Sohn, Young Bae; Choi, Yong Jun; Chung, Yoon-Sok; Jang, Ja-Hyun

    2017-01-01

    Abstract Rationale: Pycnodysostosis is a rare autosomal recessive skeletal dysplasia characterized by short stature, craniofacial dysmorphism, acro-osteolysis, osteosclerosis, and brittle bone with poor healing. Pycnodysostosis results from the deficient activity of cathepsin K, a lysosomal cysteine protease that is encoded by CTSK. Patient concerns: We report a Korean adult patient with pycnodysostosis and atypical femur fracture whose diagnosis was confirmed by next-generation sequencing (NGS) of candidate genes. A 41-year-old female patient was presented with a left femur fracture after falling down. Underlying sclerotic bone disease was suspected as a radiographic skeletal survey showed thickened cortical bones, and the total body bone density was increased (T score was 5.3, and Z score was 4.9). Diagnoses: We performed candidate gene sequencing of various sclerotic bone diseases for the differential molecular diagnosis of underlying sclerosing bone disease. Two heterozygous variants of CTSK were detected. One was a frameshift variant in exon 5, c.426delT (p.Phe142Leufs∗19), which was previously reported, and the other was a novel missense variant in exon 6, c.755G>A (p.Ser252Asn). Sanger sequencing of CTSK confirmed the 2 heterozygous variants and thus the patient was diagnosed with pycnodysostosis. Interventions: The patient had emergency surgery for subtrochantic femoral fracture. Outcomes: After 4 months of surgery, the patient had almost a full range of hip and knee movements and radiographs show the substantial bridging callus across the fracture. Lessons: Candidate gene sequencing could be a useful diagnostic tool for the genetically heterogeneous skeletal dysplasia group, especially in cases with a mild or atypical clinical phenotype. PMID:28328823

  10. 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.

  11. Reconsideration of the Effects of Age on Proximal Femur Structure: Implications for Joint Replacement and Hip Fracture

    PubMed Central

    Khoo, B. C. C.; Brown, J. K.; Prince, R. L.

    2016-01-01

    Objectives In recent years quantitative computed tomography (QCT) has allowed precise non-invasive, three dimensional, in vivo measurement of hip structure in large numbers of individuals. The effects of ageing on proximal femur structure are reported and implications for the prevention of hip prosthesis loosening and hip fracture considered. Design, Setting and Participants An observational cross-sectional study of proximal femur QCT in 719 unselected female European descent aged 20 to 89 years recruited from US and Australian populations. Main Outcomes Measures QCT scans were obtained using software that separates cortical and cancellous bone by a thresholding technique. Voxel based mineral volume and mass was computed for the integral (external), cancellous and cortical compartments of 1 mm wide sections through the femoral neck (FN), trochanter (TR) and intertrochanter (IT) regions. Results Over the adult life span total integral volumes at the FN, TR and IT sites expand linearly by between 18 and 37% at the same time as bone mass decreased by 22 to 25% resulting in massive reductions in true volumetric BMD (vBMD) of 40 to 50%. Cancellous volume expansion was larger at 65 to 79% at the three sites. Between the ages of 65 and 75 the average increase in cancellous volume at the IT site was 3.74 cm3 (12.1%). Voxel determined FN cortical volume decreased linearly by 43%, as did cortical bone mass so that vBMD did not change substantially. TR and IT cortical volumes decreased 54 and 28% respectively, small reductions in TR and IT cortical vBMD also occurred. Conclusions Large endosteal expansion in the area in which hip replacement stem placement occurs may contribute to loosening. Regarding the propensity to hip fracture, periosteal expansion contributes to increased resistance to bending but cortical thinning contributes to loss of bone to resistance to bending forces. Understanding individual hip structure may contribute to individualisation of risk and

  12. Effects of diet-induced obesity and voluntary wheel running on the microstructure of the murine distal femur

    PubMed Central

    2011-01-01

    Background Obesity and osteoporosis, two possibly related conditions, are rapidly expanding health concerns in modern society. Both of them are associated with sedentary life style and nutrition. To investigate the effects of diet-induced obesity and voluntary physical activity we used high resolution micro-computed tomography (μCT) together with peripheral quantitative computed tomography (pQCT) to examine the microstructure of the distal femoral metaphysis in mice. Methods Forty 7-week-old male C57BL/6J mice were assigned to 4 groups: control (C), control + running (CR), high-fat diet (HF), and high-fat diet + running (HFR). After a 21-week intervention, all the mice were sacrificed and the left femur dissected for pQCT and μCT measurements. Results The mice fed the high-fat diet showed a significant weight gain (over 70% for HF and 60% for HFR), with increased epididymal fat pad mass and impaired insulin sensitivity. These obese mice had significantly higher trabecular connectivity density, volume, number, thickness, area and mass, and smaller trabecular separation. At the whole bone level, they had larger bone circumference and cross-sectional area and higher density-weighted maximal, minimal, and polar moments of inertia. Voluntary wheel running decreased all the cortical bone parameters, but increased the trabecular mineral density, and decreased the pattern factor and structure model index towards a more plate-like structure. Conclusions The results suggest that in mice the femur adapts to obesity by improving bone strength both at the whole bone and micro-structural level. Adaptation to running exercise manifests itself in increased trabecular density and improved 3D structure, but in a limited overall bone growth PMID:21241467

  13. Finite-element analysis of the effect of basic hip movements on the mechanical stimulus within a proximal femur.

    PubMed

    Tovar-López, Francisco Javier; Domínguez-Hernández, Víctor Manuel; Diez-García, María Del Pilar; Araujo-Monsalvo, Víctor Manuel

    2014-07-01

    Osteoporosis is a serious and multifactorial disease. The number of people affected with osteoporosis is increasing due to the lengthening of life expectancy. Currently, unlike the genetic, nutritional and hormonal factors that have been the focus of most studies of osteoporosis, mechanical stimuli that potentially can produce an increase in bone strength have not been well studied. Studies suggest that the relationship between the health of the bone and mechanical stimuli occurs through bone adaptive remodeling, which is activated by means of the shear stress transmitted by the interstitial fluid flow. The present work consists of a finite element analysis of a femur to simulate the basic movements of the hip (flexion, extension, abduction, and adduction) to compare the shear stresses in a common zone of fracture and in the critical mechanical strength zones of the femoral head. A comparison of the distribution and magnitude of the shear stresses was performed to estimate the movement that could induce a more rapid adaptive bone remodeling. This study is the first step in the development of a physical therapy for a preventive rehabilitation that helps to prevent patients with low bone mineral density to avoid suffering osteoporosis hip fractures. The finite element model was constructed using a free-access three-dimensional standardized femur obtained from the Instituti Ortopedici Rizzoli, Bologna, Italy. The mechanical properties and the muscular forces were obtained from a specialized bibliography. We conclude that the movements that exhibit a higher mean value and a good shear stress distribution in the femoral neck are hip extension and abduction.

  14. Relationship between number of spleen colonies and /sup 125/IdUrd incorporation into spleen and femur

    SciTech Connect

    Inoue, T.; Bullis, J.E.; Cronkite, E.P.; Hubner, G.E.

    1983-01-01

    Graded numbers of bone marrow (BM) cells were injected into fatally irradiated mice. Eight days later the mice were given 3.0 ..mu..Ci (1 Ci = 3.7 x 10/sup 10/Bq) of /sup 125/IdUrd to label proliferating cells in the spleen and BM. On day 9 the mice were killed and the spleens and femurs were removed for splenic colony assay and measurement of radioactivity in the spleen and femurs. The number of splenic colonies shows a linear relationship with dose of marrow cells injected from 10/sup 4/ to 10/sup 5/ cells. The slope of the curve of spleen colonies versus number of cells injected is <1, implying that the fraction seeded in spleen decreases with number of cells injected. Above 10/sup 5/ and below 10/sup 4/ there is a striking departure from the simple linearity. Below 2 x 10/sup 3/ cells injected, the logarithm of the observed colony yield is linear with logarithm of the number of cells injected. Poisson calculation of the average number of pluripotent stem cells that should be present with numbers of marrow cells injected below 2 x 10/sup 3/ followed closely the actual observations. The data show that there is no detectible proliferation in the BM until the dose of marrow cells exceeds 3.5 x 10/sup 4/ cells. Induction of cells into cycle increases the seeding into the BM, and thymidine cytocide drastically reduces seeding in the BM, leading us to conclude that the BM is repopulated almost exclusively by stem cells in DNA synthesis.

  15. 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.

  16. 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.

  17. 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

  18. Complicated grief in late life

    PubMed Central

    Miller, Mark D.

    2012-01-01

    Complicated grief (CG) is a syndrome that affects 10% to 20% of grievers regardless of age, although proportionally more will face the death of loved ones in late life, CG is characterized by preoccupying and disabling symptoms that can persist for decades such as an inability to accept the death, intense yearning or avoidance, frequent reveries, deep sadness, crying, somatic distress, social withdrawal, and suicidal ideation. This syndrome is distinct from major depression and post-traumatic stress disorder, but CG maybe comorbid with each. This communication will focus on the impact of CG in late life (over age 60) and will include a case vignette for illustrating complicated grief therapy. PMID:22754292

  19. 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.

  20. 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

  1. 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…

  2. Individual density-elasticity relationships improve accuracy of subject-specific finite element models of human femurs.

    PubMed

    Eberle, Sebastian; Göttlinger, Michael; Augat, Peter

    2013-09-03

    In a previous study on subject-specific finite-element-models, we found that appropriate density-elasticity relationships to compute the mechanical behavior of femurs seem to be subject-specific. The purpose of this study was to test the hypothesis that the predictive error of a cohort of subject-specific finite element-models is lower with subject-specific density-elasticity relationships than with a cohort-specific density-elasticity relationship. Finite-element-analysis and inverse optimization based on response surface methodology were employed to test the hypothesis. Subject-specific FE-models of 17 human femurs and corresponding experimental data from biomechanical tests were taken from a previous study. A power function for the relation between radiological bone density and elastic modulus was set up with the optimization variables a and b: E(MPa)=aρqCT(b)(gK2HPO4/cm(3)). The goal of the optimization was to minimize the root-mean-square error in percent (RMSE%) between computational and experimental results. A Wilcoxon test (p=0.05) was performed on all absolute relative errors between the two groups (subject-specific functions vs. cohort-specific function). The subject-specific functions resulted in a 6% lower overall prediction error and a 6% lower RMSE% than the cohort-specific function (p<0.001). The determined subject-specific relations were mostly linear, with variable a ranging from 9307 to 15673 and variable b ranging from 0.68 to 1.40. For the cohort-specific relation, the following power law was obtained: E(MPa)=12486ρqCT(1.16)(gK2HPO4/cm(3)). We conclude that individual density-elasticity relationships improve the accuracy of subject-specific finite element models. Future subject-specific finite-element-analyses of bones should include the individuality of the elastic properties by a stochastic density-elasticity relationship with mean and standard deviation of a and b.

  3. Comparison of proximal femur and vertebral body strength improvements in the FREEDOM trial using an alternative finite element methodology.

    PubMed

    Zysset, Philippe; Pahr, Dieter; Engelke, Klaus; Genant, Harry K; McClung, Michael R; Kendler, David L; Recknor, Christopher; Kinzl, Michael; Schwiedrzik, Jakob; Museyko, Oleg; Wang, Andrea; Libanati, Cesar

    2015-12-01

    Denosumab reduced the incidence of new fractures in postmenopausal women with osteoporosis by 68% at the spine and 40% at the hip over 36 months compared with placebo in the FREEDOM study. This efficacy was supported by improvements from baseline in vertebral (18.2%) strength in axial compression and femoral (8.6%) strength in sideways fall configuration at 36 months, estimated in Newtons by an established voxel-based finite element (FE) methodology. Since FE analyses rely on the choice of meshes, material properties, and boundary conditions, the aim of this study was to independently confirm and compare the effects of denosumab on vertebral and femoral strength during the FREEDOM trial using an alternative smooth FE methodology. Unlike the previous FE study, effects on femoral strength in physiological stance configuration were also examined. QCT data for the proximal femur and two lumbar vertebrae were analyzed by smooth FE methodology at baseline, 12, 24, and 36 months for 51 treated (denosumab) and 47 control (placebo) subjects. QCT images were segmented and converted into smooth FE models to compute bone strength. L1 and L2 vertebral bodies were virtually loaded in axial compression and the proximal femora in both fall and stance configurations. Denosumab increased vertebral body strength by 10.8%, 14.0%, and 17.4% from baseline at 12, 24, and 36 months, respectively (p<0.0001). Denosumab also increased femoral strength in the fall configuration by 4.3%, 5.1%, and 7.2% from baseline at 12, 24, and 36 months, respectively (p<0.0001). Similar improvements were observed in the stance configuration with increases of 4.2%, 5.2%, and 5.2% from baseline (p≤0.0007). Differences between the increasing strengths with denosumab and the decreasing strengths with placebo were significant starting at 12 months (vertebral and femoral fall) or 24 months (femoral stance). Using an alternative smooth FE methodology, we confirmed the significant improvements in vertebral body

  4. Late colonization of Easter Island.

    PubMed

    Hunt, Terry L; Lipo, Carl P

    2006-03-17

    Easter Island (Rapa Nui) provides a model of human-induced environmental degradation. A reliable chronology is central to understanding the cultural, ecological, and demographic processes involved. Radiocarbon dates for the earliest stratigraphic layers at Anakena, Easter Island, and analysis of previous radiocarbon dates imply that the island was colonized late, about 1200 A.D. Substantial ecological impacts and major cultural investments in monumental architecture and statuary thus began soon after initial settlement.

  5. Monomelic amyotrophy with late progression.

    PubMed

    Rowin, J; Meriggioli, M N; Cochran, E J

    2001-04-01

    Monomelic amyotrophy is a sporadic juvenile-onset disease that presents with gradual onset of weakness and atrophy in the hand muscles unilaterally. Generally, this disease is considered a 'benign' and non-progressive motor neuron disease, which stabilizes within five years of onset. We discuss a case that illustrates that monomelic amyotrophy may rarely exhibit late clinical progression to the lower extremities after a prolonged period of disease stability.

  6. Three-dimensional micro-level computational study of Wolff's law via trabecular bone remodeling in the human proximal femur using design space topology optimization.

    PubMed

    Boyle, Christopher; Kim, Il Yong

    2011-03-15

    The law of bone remodeling, commonly referred to as Wolff's Law, asserts that the internal trabecular bone adapts to external loadings, reorienting with the principal stress trajectories to maximize mechanical efficiency creating a naturally optimum structure. The goal of the current study was to utilize an advanced structural optimization algorithm, called design