Effects of Ibuprofen and Resistance Training on Bone and Muscle: A Randomized Controlled Trial in Older Women.

PubMed

Duff, Whitney R D; Chilibeck, Philip D; Candow, Darren G; Gordon, Julianne J; Mason, Riley S; Taylor-Gjevre, Regina; Nair, Bindu; Szafron, Michael; Baxter-Jones, Adam; Zello, Gordon A; Kontulainen, Saija A

2017-04-01

Resistance training with ibuprofen supplementation may improve musculoskeletal health in postmenopausal women. The study purpose was to determine the efficacy of resistance training and ibuprofen supplementation on bone and muscle properties in postmenopausal women. Participants (n = 90, 65.3 ± 4.9 yr) were randomly assigned to: supervised resistance training or stretching (placebo-exercise) with postexercise ibuprofen (400 mg) or placebo supplementation for 3 d·wk (9 months). Baseline and postintervention measurements included distal and shaft scans of the forearm and lower leg using peripheral quantitative computed tomography. Distal site outcomes included cross-sectional area, content, and density for total and trabecular bone, as well as estimated bone strength in compression. Shaft site outcomes included total bone area; cortical bone area, content, and density; estimated bone strength in torsion; and muscle area and density. Exercise-supplement-time interactions for total bone content at the distal radius (P = 0.009) and cortical density at the radius shaft (P = 0.038) were significant. Resistance training with ibuprofen decreased total bone content (-1.5%) at the distal radius in comparison to the resistance training (0.6%; P = 0.032) and ibuprofen alone (0.5%; P = 0.050). Change in cortical density at the radius shaft differed between the stretching with placebo and ibuprofen supplementation groups (-1.8% vs 1.1%; P = 0.050). Resistance training preserved muscle density in the lower leg more so than stretching (-3.1% vs -5.4%; P = 0.015). Ibuprofen consumed immediately after resistance training had a deleterious effect on bone mineral content at the distal radius, whereas resistance training or ibuprofen supplementation individually prevented bone loss. Resistance training prevented muscle density decline in the lower leg.

Effects of cast-mediated immobilization on bone mineral mass at various sites in adolescents with lower-extremity fracture.

PubMed

Ceroni, Dimitri; Martin, Xavier; Delhumeau, Cécile; Rizzoli, René; Kaelin, André; Farpour-Lambert, Nathalie

2012-02-01

Leg or ankle fractures occur commonly in the pediatric population and are primarily treated with closed reduction and cast immobilization. The most predictable consequences of immobilization and subsequent weight-bearing restriction are loss of bone mineral mass, substantial muscle atrophy, and functional limitations. The purposes of this study were to determine if lower-limb fractures in adolescents are associated with abnormal bone mineral density or content at the time of fracture, and to quantify bone mineral loss at various sites due to cast-mediated immobilization and limited weight-bearing. We recruited fifty adolescents aged ten to sixteen years who had undergone cast immobilization for a leg or ankle fracture. Dual x-ray absorptiometry scans of the total body, lumbar spine, hip, leg, and calcaneus were performed at the time of fracture and at cast removal. Patients with a fracture were paired with healthy controls according to sex and age. Values at baseline and at cast removal, or at equivalent time intervals in the control group, were compared between groups and between the injured and uninjured legs of the adolescents with the fracture. At the time of fracture, there were no observed differences in the bone mineral density or bone mineral content Z-scores of the total body or the lumbar spine, or in the bone mineral density Z-scores of the calcaneus, between the injured and healthy subjects. At cast removal, bone mineral parameters on the injured side were significantly lower than those on the uninjured side in the injured group. Differences ranged from -5.8% to -31.7% for bone mineral density and from -5.2% to -19.4% for bone mineral content. During the cast period, the injured adolescents had a significant decrease of bone mineral density at the hip, greater trochanter, calcaneus, and total lower limb as compared with the healthy controls. Lower-limb fractures are not related to osteopenia in adolescents at the time of fracture. However, osteopenia does develop in the injured limb during cast immobilization for fracture treatment. Further investigation is required to determine if the bone mineral mass will return to normal or if a permanent decrease is to be expected, which may constitute a hypothetical risk of sustaining a second fracture.

Recovery of decreased bone mineral mass after lower-limb fractures in adolescents.

PubMed

Ceroni, Dimitri; Martin, Xavier E; Delhumeau, Cécile; Farpour-Lambert, Nathalie J; De Coulon, Geraldo; Dubois-Ferrière, Victor; Rizzoli, René

2013-06-05

Loss of bone mineral mass, muscle atrophy, and functional limitations are predictable consequences of immobilization and subsequent weight-bearing restriction due to leg or ankle fractures. The aim of this study was to prospectively determine whether decreased bone mineral mass following lower-limb fractures recovers at follow-up durations of six and eighteen months in adolescents. In the present study, we included fifty adolescents who underwent cast immobilization for a leg or ankle fracture. Dual x-ray absorptiometry scans of four different sites (total hip, femoral neck, entire lower limb, and calcaneus) were performed at the time of the fracture, at cast removal, and at follow-ups of six and eighteen months. Patients with fractures were paired with healthy controls according to sex, age, and ethnicity. Dual x-ray absorptiometry values were compared between groups and between injured and non-injured legs in adolescents with fractures. Among those with fractures, lower-limb bone mineral variables were significantly lower at the injured side compared with the non-injured side at cast removal, with differences ranging from 6.2% to 31.7% (p < 0.0001). Similarly, injured adolescents had significantly lower bone mineral values at the level of the injured lower limb compared with healthy controls (p < 0.0001). At the six-month follow-up, there were still significant residual differences between injured and non-injured legs in adolescents with fractures (p < 0.0001). However, a significant residual difference between healthy controls and injured adolescents was present only for femoral neck bone mineral density (p = 0.011). At the eighteen-month follow-up, no significant difference was observed at any lower-limb site. Bone mineral loss following a fracture of the lower limb in adolescents is highly significant and affects the lower limb both proximal to and distal to the fracture site. In contrast to observations in adults, a rapid bone mass reversal occurs with full bone recovery by eighteen months. Prognostic Level I. See Instructions for Authors for a complete description of levels of evidence.

Incubation lighting schedules and their interaction with matched or mismatched post hatch lighting schedules: Effects on broiler bone development and leg health at slaughter age.

PubMed

van der Pol, Carla W; van Roovert-Reijrink, Inge A M; Aalbers, Gerald; Kemp, Bas; van den Brand, Henry

2017-10-01

The incidence of leg pathologies in broiler chickens with a developmental origin may be decreased by stimulating embryonic bone development through lighting schedules during incubation, but this may depend on post hatch lighting conditions. Aim was to investigate how lighting schedules during incubation and their interactions with matched or mismatched lighting schedules post hatch affected bone development and leg health at slaughter age. In a 3×2 factorial designed experiment, eggs were incubated under continuous cool white LED light (Inc 24L ), 16h of light, 8h of darkness (Inc 16L:8D ), or continuous darkness (Inc 24D ) from set till hatch. After hatch, broilers were housed under continuous light (PH 24L , to match Inc 24L and Inc 24D ) or 16h of light, 8h of darkness (PH 16L:8D , to match Inc 16L:8D ). Gait scores were determined on D21, D28, and D34. After slaughter on D35, legs were scored for varus-valgus deformities, rotated tibia, tibial dyschondroplasia, bacterial chondronecrosis with osteomyelitis (BCO), epiphyseolysis, and epiphyseal plate abnormalities from 1=absent to 4=severe. Femur and tibia dimensions and mineral density were determined. Inc 24L led to more epiphyseal plate abnormalities than Inc 16L:8D or Inc 24D . Inc 24D led to more BCO than Inc 16L:8D . Gait scores on D21, D28, and D34, and bone dimensions did not differ between treatments. Inc 24L led to higher femur mineral density than Inc 24D with Inc 16L:8D intermediate. Providing a chicken with a matched post hatch lighting schedule did not affect most measurements of bone development and health. It can be concluded that a circadian incubation lighting schedule may improve leg health in broilers. Copyright © 2017 Elsevier Ltd. All rights reserved.

Subacute reconstruction of lower leg and foot defects due to high velocity-high energy injuries caused by gunshots, missiles, and land mines.

PubMed

Celiköz, Bahattin; Sengezer, Mustafa; Işik, Selçuk; Türegün, Murat; Deveci, Mustafa; Duman, Haluk; Acikel, Cengiz; Nişanci, Mustafa; Oztürk, Serdar

2005-01-01

The present study reviews 215 male patients suffering high velocity-high energy injuries of the lower leg or foot caused by war weapons such as missiles, gunshots, and land mines. They were treated in the Department of Plastic and Reconstructive Surgery at Gulhane Military Medical Academy (Ankara, Turkey) between November 1993-January 2001. Severe soft-tissue defects requiring flap coverage and associated open bone fractures that were treated 7-21 days (mean, 9.6 days) after the injury were included in the study. Twenty-three of 226 extremities (10.2%) underwent primary below-knee amputation. The number of debridements prior to definitive treatment was between 1-3 (mean, 1.9). Gustilo type III open tibia fractures accompanied 104 of 126 soft-tissue defects of the lower leg. Sixty-four bone defects accompanied 83 soft-tissue defects of the feet. Eighteen local pedicled muscle flaps and 208 free muscle flaps (latissimus dorsi, rectus abdominis, and gracilis) were used in soft-tissue coverage of 209 defects. Overall, the free muscle flap success rate was 91.3%. Bone defects were restored with 106 bone grafts, 25 free fibula flaps, and 14 distraction osteogenesis procedures. Osseous and soft-tissue defects were reconstructed simultaneously at the first definitive treatment in 94% of cases. The mean follow-up after definitive treatment was 25 (range, 9-47) months. The average full weight-bearing times for lower leg and feet injuries were 8.4 months and 4 months, respectively. Early, aggressive, and serial debridement of osseous and soft tissue, early restoration of bone and soft-tissue defects at the same stage, intensive rehabilitation, and patient education were the key points in the management of high velocity-high energy injuries of the lower leg and foot. copyright 2005 Wiley-Liss, Inc.

Hot-boning enhances cook yield of boneless skinless chicken thighs.

PubMed

Zhuang, H; Bowker, B C; Buhr, R J; Brambila, G Sanchez

2014-06-01

Three experiments were conducted to evaluate the effects of postmortem deboning time on cook yield of boneless skinless chicken thighs. In experiment 1, chicken thigh meat was deboned at 0.75 (hot-bone), 2, and 24 h postmortem (PM) and trimmed to obtain mainly iliotibialis muscle. Samples were cooked directly from a frozen state. Cook yield of the muscle was significantly influenced by PM deboning time. Hot-boned thighs exhibited a 7% greater cook yield than the samples deboned at 24 h. In experiment 2, boneless skinless chicken thighs were deboned at 0.3, 2, and 24 h PM and cooked directly from a fresh, never-frozen state at 24 h PM. Cook yield of the hot-boned thighs was significantly higher than those of the 2 and 24 h deboned samples, which did not differ from each other. In experiment 3, whole legs (thigh + drumstick) were cut from the carcass backbone at 0.3 (hot-cut), 2, and 24 h PM. Thighs were separated from the legs (drumsticks) at either the same time the whole legs were removed from the carcasses or at 24 h PM. Intact thighs (bone in) were cooked fresh at 24 h PM. Color of fresh thigh muscles, cook yield, and Warner-Bratzler shear force of cooked samples were measured. Cook yield of the thighs cut from the backbone before chilling was significantly higher than those cut from the carcasses at 2 and 24 h PM, which did not differ from each other. The PM time at which intact thighs were separated from the leg (drumstick) did not influence cook yield. These results demonstrate that postmortem deboning time can significantly affect cook yield of boneless skinless chicken thigh products. Deboning chicken thighs after chilling reduces the cook yield. Differences in the cook yield of thighs may also result from the removal of whole chicken legs from the carcass backbone. Poultry Science Association Inc.

Pelvis x-ray

MedlinePlus

X-ray - pelvis ... Tumors Degenerative conditions of bones in the hips, pelvis, and upper legs ... hip joint Tumors of the bones of the pelvis Sacroiliitis (inflammation of the area where the sacrum ...

Lateral traction

MedlinePlus

... treat or reduce any joint dislocation or bone fracture by applying tension to the leg or arm with weights and pulleys to realign the bone. For example, it may be used to help line up a broken bone while it heals. Traction as a treatment involves the amount of ...

Noninvasive Raman spectroscopy of rat tibiae: approach to in vivo assessment of bone quality

PubMed Central

Okagbare, Paul I.; Begun, Dana; Tecklenburg, Mary; Awonusi, Ayorinde; Goldstein, Steven A.

2012-01-01

Abstract. We report on in vivo noninvasive Raman spectroscopy of rat tibiae using robust fiber-optic Raman probes and holders designed for transcutaneous Raman measurements in small animals. The configuration allows placement of multiple fibers around a rat leg, maintaining contact with the skin. Bone Raman data are presented for three regions of the rat tibia diaphysis with different thicknesses of overlying soft tissue. The ability to perform in vivo noninvasive Raman measurement and evaluation of subtle changes in bone composition is demonstrated with rat leg phantoms in which the tibia has carbonated hydroxylapatite, with different carbonate contents. Our data provide proof of the principle that small changes in bone composition can be monitored through soft tissue at anatomical sites of interest in biomedical studies. PMID:23085899

Noninvasive Raman spectroscopy of rat tibiae: approach to in vivo assessment of bone quality.

PubMed

Okagbare, Paul I; Begun, Dana; Tecklenburg, Mary; Awonusi, Ayorinde; Goldstein, Steven A; Morris, Michael D

2012-09-01

We report on in vivo noninvasive Raman spectroscopy of rat tibiae using robust fiber-optic Raman probes and holders designed for transcutaneous Raman measurements in small animals. The configuration allows placement of multiple fibers around a rat leg, maintaining contact with the skin. Bone Raman data are presented for three regions of the rat tibia diaphysis with different thicknesses of overlying soft tissue. The ability to perform in vivo noninvasive Raman measurement and evaluation of subtle changes in bone composition is demonstrated with rat leg phantoms in which the tibia has carbonated hydroxylapatite, with different carbonate contents. Our data provide proof of the principle that small changes in bone composition can be monitored through soft tissue at anatomical sites of interest in biomedical studies.

Mathematical simulations of photon interactions using Monte Carlo analysis to evaluate the uncertainty associated with in vivo K X-ray fluorescence measurements of stable lead in bone

NASA Astrophysics Data System (ADS)

Lodwick, Camille J.

This research utilized Monte Carlo N-Particle version 4C (MCNP4C) to simulate K X-ray fluorescent (K XRF) measurements of stable lead in bone. Simulations were performed to investigate the effects that overlying tissue thickness, bone-calcium content, and shape of the calibration standard have on detector response in XRF measurements at the human tibia. Additional simulations of a knee phantom considered uncertainty associated with rotation about the patella during XRF measurements. Simulations tallied the distribution of energy deposited in a high-purity germanium detector originating from collimated 88 keV 109Cd photons in backscatter geometry. Benchmark measurements were performed on simple and anthropometric XRF calibration phantoms of the human leg and knee developed at the University of Cincinnati with materials proven to exhibit radiological characteristics equivalent to human tissue and bone. Initial benchmark comparisons revealed that MCNP4C limits coherent scatter of photons to six inverse angstroms of momentum transfer and a Modified MCNP4C was developed to circumvent the limitation. Subsequent benchmark measurements demonstrated that Modified MCNP4C adequately models photon interactions associated with in vivo K XRF of lead in bone. Further simulations of a simple leg geometry possessing tissue thicknesses from 0 to 10 mm revealed increasing overlying tissue thickness from 5 to 10 mm reduced predicted lead concentrations an average 1.15% per 1 mm increase in tissue thickness (p < 0.0001). An anthropometric leg phantom was mathematically defined in MCNP to more accurately reflect the human form. A simulated one percent increase in calcium content (by mass) of the anthropometric leg phantom's cortical bone demonstrated to significantly reduce the K XRF normalized ratio by 4.5% (p < 0.0001). Comparison of the simple and anthropometric calibration phantoms also suggested that cylindrical calibration standards can underestimate lead content of a human leg up to 4%. The patellar bone structure in which the fluorescent photons originate was found to vary dramatically with measurement angle. The relative contribution of lead signal from the patella declined from 65% to 27% when rotated 30°. However, rotation of the source-detector about the patella from 0 to 45° demonstrated no significant effect on the net K XRF response at the knee.

Shin Splints

MedlinePlus

Shin splints Overview The term "shin splints" refers to pain along the shin bone (tibia) — the large bone in the front of your lower leg. Shin splints are common in runners, dancers and military recruits. ...

A morphometric study of bone surfaces and skin reactions after stimulation with static magnetic fields in rats

DOE Office of Scientific and Technical Information (OSTI.GOV)

Linder-Aronson, S.; Lindskog, S.

1991-01-01

The present investigation was undertaken to measure any bone surface changes after stimulation with orthodontic magnets and, furthermore, to examine the soft tissue in immediate contact with the magnets. Both distal parts of the tibial hind legs in six groups of young rats were fitted with devices holding two orthodontic magnets in the experimental legs and similar devices without magnets in the control legs. The animals were killed after 2, 3, and 4 weeks. Morphometric evaluation showed significant increases in resorbing areas after 3 and 4 weeks. Similarly, a reduction was evident in the number of epithelial cells under themore » areas where the magnets had been applied. These findings indicate that the stimulation of bone resorption in the present study may have been caused by inhibition of the bone-lining osteoblasts. This proposition is supported by the apparent inhibitory effect of the magnetic fields on epithelial recycling that was seen as a reduced thickness of the epithelium under the magnets. Consequently, static magnetic fields should be used with care in orthodontic practice until a more complete understanding of their mechanism of action has been established.« less

A morphometric study of bone surfaces and skin reactions after stimulation with static magnetic fields in rats.

PubMed

Linder-Aronson, S; Lindskog, S

1991-01-01

The present investigation was undertaken to measure any bone surface changes after stimulation with orthodontic magnets and, furthermore, to examine the soft tissue in immediate contact with the magnets. Both distal parts of the tibial hind legs in six groups of young rats were fitted with devices holding two orthodontic magnets in the experimental legs and similar devices without magnets in the control legs. The animals were killed after 2, 3, and 4 weeks. Morphometric evaluation showed significant increases in resorbing areas after 3 and 4 weeks. Similarly, a reduction was evident in the number of epithelial cells under the areas where the magnets had been applied. These findings indicate that the stimulation of bone resorption in the present study may have been caused by inhibition of the bone-lining osteoblasts. This proposition is supported by the apparent inhibitory effect of the magnetic fields on epithelial recycling that was seen as a reduced thickness of the epithelium under the magnets. Consequently, static magnetic fields should be used with care in orthodontic practice until a more complete understanding of their mechanism of action has been established.

Fast Facts on Osteogenesis Imperfecta

MedlinePlus

... bone) and short femur (upper leg bone) Coxa vera is common (the acutely angled femur head affects ... Fax: 301-947-0456 Internet: www.oif.org E-mail: bonelink@oif.org The National Institutes of ...

Leg size and muscle functions associated with leg compliance

NASA Technical Reports Server (NTRS)

Convertino, Victor A.; Doerr, Donald F.; Flores, Jose F.; Hoffler, G. Wyckliffe; Buchanan, Paul

1988-01-01

The relationship between the leg compliance and factors related to the size of leg muscle and to physical fitness was investigated in ten healthy subjects. Vascular compliance of the leg, as determined by a mercury strain gauge, was found to be not significantly correlated with any variables associated with physical fitness per se (e.g., peak O2 uptake, calf strength, age, body weight, or body composition. On the other hand, leg compliance correlated with the calf cross-sectional area (CSA) and the calculated calf volume, with the CSA of calf muscle being the most dominant contributing factor (while fat and bone were poor predicators). It is suggested that leg compliance can be lowered by increasing calf muscle mass, thus providing structural support to limit the expansion of leg veins.

Handball Practice Enhances Bone Mass in Specific Sites Among Prepubescent Boys.

PubMed

Missawi, Kawther; Zouch, Mohamed; Chakroun, Yosra; Chaari, Hamada; Tabka, Zouhair; Bouajina, Elyès

2016-01-01

This investigation's purpose is to focus on the effects of practicing handball for at least 2 yr on bone acquisition among prepubescent boys. One hundred prepubescent boys aged 10.68 ± 0.85 yr were divided into 2 groups: 50 handball players (HP group) and 50 controls (C group). Bone mineral density (BMD), bone mineral content (BMC), and bone area (BA) were evaluated by using dual-photon X-ray absorptiometry on the whole body, lumbar spine (L2-L4), legs, arms, femoral necks, hips and radiuses. Results showed greater values of BMD in both right and left femoral neck and total hip in handball players than in controls. In addition, handball players had higher values of legs and right total hip BMC than controls without any obvious variation of BA measurement in all sites between groups. All results of the paired t-test displayed an obviously marked variation of bone mass parameters between the left and right sides in the trained group without any marked variation among controls. Data showed an increased BMD of the supporting sites between the left and the right leg among handball players. However, "BMC" results exhibited higher values in the right than in the left total hip, and in the right total radius than in the left correspondent site. In addition, differences in the "BA" measurements were observed in the left total hip and in the right arm. Specific bone sites are markedly stimulated by handball training in prepubescent boys. Copyright © 2016 International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

Development of finite element model for customized prostheses design for patient with pelvic bone tumor.

PubMed

Iqbal, Taimoor; Shi, Lei; Wang, Ling; Liu, Yaxiong; Li, Dichen; Qin, Mian; Jin, Zhongmin

2017-06-01

The aim of this study was to design a hemi-pelvic prosthesis for a patient affected by pelvic sarcoma. To investigate the biomechanical functionality of the pelvis reconstructed with designed custom-made prosthesis, a patient-specific finite element model of whole pelvis with primary ligaments inclusive was constructed based on the computed tomography images of the patient. Then, a finite element analysis was performed to calculate and compare the stress distribution between the normal and implanted pelvis models when undergoing three different static conditions-both-leg standing, single-leg standing for the healthy and the affected one. No significant differences were observed in the stresses between the normal and reconstructed pelvis for both-leg standing, but 20%-40% larger stresses were predicted for the peak stress of the single-leg standing (affected side). Moreover, two- to threefold of peak stresses were predicted within the prostheses compared to that of the normal pelvis especially for single-leg standing case, however, still below the allowable fatigue limitation. The study on the load transmission functionality of prosthesis indicated that it is crucial to carry out finite element analysis for functional evaluation of the designed customized prostheses before three-dimensional printing manufacturing, allowing better understanding of the possible peak stresses within the bone as well as the implants for safety precaution. The finite element model can be equally applicable to other bone tumor model for biomechanical studying.

Cross-sectional properties of the lower limb long bones in the Middle Pleistocene Sima de los Huesos sample (Sierra de Atapuerca, Spain).

PubMed

Rodríguez, Laura; Carretero, José Miguel; García-González, Rebeca; Arsuaga, Juan Luis

2018-04-01

The recovery to date of three complete and five partial femora, seven complete tibiae, and four complete fibulae from the Atapuerca Sima de los Huesos site provides an opportunity to analyze the biomechanical cross-sectional properties in this Middle Pleistocene population and to compare them with those of other fossil hominins and recent modern humans. We have performed direct comparisons of the cross-sectional geometric parameters and reduced major axis (RMA) regression lines among different samples. We have determined that Atapuerca Sima de los Huesos (SH) fossils have significantly thicker cortices than those of recent modern humans for the three leg bones at all diaphyseal levels, except that of the femur at 35% of biomechanical length. The SH bones are similar to those of Neandertals and Middle Pleistocene humans and different from Homo sapiens in their diaphyseal cross-sectional shape and strength parameters. When standardized by estimated body size, both the SH and Neandertal leg bones have in general greater strength than those of H. sapiens from the early modern (EMH), Upper Paleolithic (UP), and recent populations (RH). The Sima de los Huesos human leg bones have, in general terms, an ancestral pattern similar to that of Pleistocene humans and differing from H. sapiens. Copyright © 2017 Elsevier Ltd. All rights reserved.

Discriminant musculo-skeletal leg characteristics between sprint and endurance elite Caucasian runners.

PubMed

Bex, T; Iannaccone, F; Stautemas, J; Baguet, A; De Beule, M; Verhegghe, B; Aerts, P; De Clercq, D; Derave, W

2017-03-01

Excellence in either sprinting or endurance running requires specific musculo-skeletal characteristics of the legs. This study aims to investigate the morphology of the leg of sprinters and endurance runners of Caucasian ethnicity. Eight male sprinters and 11 male endurance runners volunteered to participate in this cross-sectional study. They underwent magnetic resonance imaging and after data collection, digital reconstruction was done to calculate muscle volumes and bone lengths. Sprinters have a higher total upper leg volume compared to endurance runners (7340 vs 6265 cm 3 ). Specifically, the rectus femoris, vastus lateralis, and hamstrings showed significantly higher muscle volumes in the sprint group. For the lower leg, only a higher muscle volume was found in the gastrocnemius lateralis for the sprinters. No differences were found in muscle volume distribution, center of mass in the different muscles, or relative bone lengths. There was a significant positive correlation between ratio hamstrings/quadriceps volume and best running performance in the sprint group. Sprinters and endurance runners of Caucasian ethnicity showed the greatest distinctions in muscle volumes, rather than in muscle distributions or skeletal measures. Sprinters show higher volumes in mainly the proximal and lateral leg muscles than endurance runners. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Common Leg Injuries of Long-Distance Runners

PubMed Central

Gallo, Robert A.; Plakke, Michael; Silvis, Matthew L.

2012-01-01

Context Long-distance running (greater than 3000 m) is often recommended to maintain a healthy lifestyle. Running injury rates increase significantly when weekly mileage extends beyond 40 miles cumulatively. With the development of running analysis and other diagnostic tests, injuries to the leg secondary to bone, musculotendinous, and vascular causes can be diagnosed and successfully managed. Evidence Acquisition Searches used the terms running, injuries, lower extremity, leg, medial tibial stress syndrome, compartment syndrome, stress fractures, popliteal artery entrapment, gastrocnemius soleus tears, and Achilles tendinopathy. Sources included Medline, Google Scholar, and Ovid from 1970 through January 2012. Results Tibial stress fractures and medial tibial stress syndrome can sometimes be prevented and/or treated by correcting biomechanical abnormalities. Exertional compartment syndrome and popliteal artery entrapment syndrome are caused by anatomic abnormalities and are difficult to treat without surgical correction. Conclusion Leg pain due to bone, musculotendinous, and vascular causes is common among long-distance runners. Knowledge of the underlying biomechanical and/or anatomic abnormality is necessary to successfully treat these conditions. PMID:24179587

Diversity of activity participation determines bone mineral content in the lower limbs of pre-pubertal children with developmental coordination disorder.

PubMed

Fong, S S M; Vackova, D; Choi, A W M; Cheng, Y T Y; Yam, T T T; Guo, X

2018-04-01

This study examined the relationships between activity participation and bone mineralization in children with developmental coordination disorder. Limited participation in physical, recreational, social, and skill-based and self-improvement activities contributed to lower bone mineral content. For improved bone health, these children should participate in a variety of activities, not only physical activities. Limited activity participation in children with developmental coordination disorder (DCD) may have a negative impact on bone mineral accrual. The objectives of this study were to compare bone mineralization and activity participation patterns of pre-pubertal children with DCD and those with typical development, and to determine the association between activity participation patterns and bone mineralization in children with DCD. Fifty-two children with DCD (mean age = 7.51 years) and 61 children with typical development (mean age = 7.22 years) participated in the study. Appendicular and total body (less head) bone mineral content (BMC) and bone mineral density (BMD) were evaluated by a whole-body dual-energy X-ray absorptiometry scan. Activity participation patterns were assessed using the Children's Assessment of Participation and Enjoyment (CAPE) questionnaire. Children with DCD had lower appendicular and total body BMCs and BMDs than children with typical development overall (p < 0.05). They also had lower CAPE total activity and physical activity diversity scores (p < 0.05). After accounting for the effects of age, sex, height, lean mass, and fat mass, the total activity diversity score remained independently associated with leg BMC in children with DCD, explaining 5.1% of the variance (p = 0.030). However, the physical activity diversity score was no longer associated with leg BMC (p = 0.090). Diversity of activity participation and bone mineralization were lower in pre-pubertal children with DCD. Decreased total activity participation diversity was a contributing factor to lower BMC in the legs of children with DCD.

Sublingual testosterone replacement improves muscle mass and strength, decreases bone resorption, and increases bone formation markers in hypogonadal men--a clinical research center study.

PubMed

Wang, C; Eyre, D R; Clark, R; Kleinberg, D; Newman, C; Iranmanesh, A; Veldhuis, J; Dudley, R E; Berman, N; Davidson, T; Barstow, T J; Sinow, R; Alexander, G; Swerdloff, R S

1996-10-01

To study the effects of androgen replacement therapy on muscle mass and strength and bone turnover markers in hypogonadal men, we administered sublingual testosterone (T) cyclodextrin (SLT; 5 mg, three times daily) to 67 hypogonadal men (baseline serum T, < 8.4 nmol/L) recruited from 4 centers in the U.S.: Torrance (n = 34), Durham (n = 12), New York (n = 9), and Salem (n = 12). Subjects who had received prior T therapy were withdrawn from injections for at least 6 weeks and from oral therapy for 4 weeks. Body composition, muscle strength, and serum and urinary bone turnover markers were measured before and after 6 months of SLT. We have shown previously that this regimen for 60 days will maintain adequate serum T levels and restore sexual function. Total body (P = 0.0104) and lean body mass (P = 0.007) increased with SLT treatment in the 34 subjects in whom body composition was assessed. There was no significant change in total body fat or percent fat. The increase in lean body mass was mainly in the legs; the right leg lean mass increased from 8.9 +/- 0.3 kg at 0 months to 9.2 +/- 0.3 kg at 6 months (P = 0.0008). This increase in leg lean mass was associated with increased leg muscle strength, assessed by leg press (0 months, 139.0 +/- 4.0 kg; 6 months, 147.7 +/- 4.2 kg; P = 0.0038). SLT replacement in hypogonadal men led to small, but significant, decreases in serum Ca (P = 0.0029) and the urinary calcium/creatinine ratio (P = 0.0066), which were associated with increases in serum PTH (P = 0.0001). At baseline, the urinary type I collagen-cross linked N-telopeptides/creatinine ratio [75.6 +/- 7.9 nmol bone collagen equivalents (BCE/mmol] was twice the normal adult male mean (41.0 +/- 3.6 nmol BCE/mmol) and was significantly decreased in response to SLT treatment at 6 months (68.2 +/- 7.7 nmol BCE/mmol; P = 0.0304) without significant changes in urinary creatinine. Serum skeletal alkaline phosphatase did not change. In addition, SLT replacement caused significant increases in serum osteocalcin (P = 0.0001) and type I procollagen (P = 0.0012). Bone mineral density did not change during the 6 months of SLT treatment. We conclude that SLT replacement therapy resulted in increases in lean muscle mass and muscle strength. Like estrogen replacement in hypogonadal postmenopausal females, androgen replacement therapy led to decreased bone resorption and urinary calcium excretion. Moreover, androgen replacement therapy may have the additional benefit of increasing bone formation. A longer term study for several years duration would be necessary to demonstrate whether these changes in bone turnover marker levels will result in increased bone mineral density decreased fracture risks, and reduced frailty in hypogonadal men.

Osteomyelitis as the only manifestation of late latent syphilis: case report and literature review.

PubMed

Liu, Z-Y; Zhang, Y; Qiu, K-F; Du, S-X

2011-06-01

Bone infection, particularly of the skull and the long bones of the legs and arms, despite being a common characteristic of tertiary stage syphilis and congenital syphilis in the past, is seldom encountered clinically due to effective antibiotic therapy. We report a case of a 62-year-old man who presented with one-month acute pain in the left leg. Treponema pallidum particle agglutination test was positive, and radiography showed a pathological fracture of the left tibiofibula. Surgical debridement and biopsy of the bone marrow were performed and a pathological diagnosis of syphilis osteomyelitis was entertained. The patient's symptoms resolved completely after a six-week course of penicillin. We identified 17 previously published cases of bone lesions of syphilis, eight of which had syphilitic osteomyelitis, seven were syphilitic osteitis and two had syphilitic periostitis. We suggest that bone lesions such as osteomyelitis caused by syphilis can be the only manifestation of late latent syphilis.

Development of a Three-Dimensional (3D) Printed Biodegradable Cage to Convert Morselized Corticocancellous Bone Chips into a Structured Cortical Bone Graft.

PubMed

Chou, Ying-Chao; Lee, Demei; Chang, Tzu-Min; Hsu, Yung-Heng; Yu, Yi-Hsun; Liu, Shih-Jung; Ueng, Steve Wen-Neng

2016-04-20

This study aimed to develop a new biodegradable polymeric cage to convert corticocancellous bone chips into a structured strut graft for treating segmental bone defects. A total of 24 adult New Zealand white rabbits underwent a left femoral segmental bone defect creation. Twelve rabbits in group A underwent three-dimensional (3D) printed cage insertion, corticocancellous chips implantation, and Kirschner-wire (K-wire) fixation, while the other 12 rabbits in group B received bone chips implantation and K-wire fixation only. All rabbits received a one-week activity assessment and the initial image study at postoperative 1 week. The final image study was repeated at postoperative 12 or 24 weeks before the rabbit scarification procedure on schedule. After the animals were sacrificed, both femurs of all the rabbits were prepared for leg length ratios and 3-point bending tests. The rabbits in group A showed an increase of activities during the first week postoperatively and decreased anterior cortical disruptions in the postoperative image assessments. Additionally, higher leg length ratios and 3-point bending strengths demonstrated improved final bony ingrowths within the bone defects for rabbits in group A. In conclusion, through this bone graft converting technique, orthopedic surgeons can treat segmental bone defects by using bone chips but with imitate characters of structured cortical bone graft.

Development of a Three-Dimensional (3D) Printed Biodegradable Cage to Convert Morselized Corticocancellous Bone Chips into a Structured Cortical Bone Graft

PubMed Central

Chou, Ying-Chao; Lee, Demei; Chang, Tzu-Min; Hsu, Yung-Heng; Yu, Yi-Hsun; Liu, Shih-Jung; Ueng, Steve Wen-Neng

2016-01-01

This study aimed to develop a new biodegradable polymeric cage to convert corticocancellous bone chips into a structured strut graft for treating segmental bone defects. A total of 24 adult New Zealand white rabbits underwent a left femoral segmental bone defect creation. Twelve rabbits in group A underwent three-dimensional (3D) printed cage insertion, corticocancellous chips implantation, and Kirschner-wire (K-wire) fixation, while the other 12 rabbits in group B received bone chips implantation and K-wire fixation only. All rabbits received a one-week activity assessment and the initial image study at postoperative 1 week. The final image study was repeated at postoperative 12 or 24 weeks before the rabbit scarification procedure on schedule. After the animals were sacrificed, both femurs of all the rabbits were prepared for leg length ratios and 3-point bending tests. The rabbits in group A showed an increase of activities during the first week postoperatively and decreased anterior cortical disruptions in the postoperative image assessments. Additionally, higher leg length ratios and 3-point bending strengths demonstrated improved final bony ingrowths within the bone defects for rabbits in group A. In conclusion, through this bone graft converting technique, orthopedic surgeons can treat segmental bone defects by using bone chips but with imitate characters of structured cortical bone graft. PMID:27104525

Air University Athletic Programs and Related Sport Injuries: What You Should Know

DTIC Science & Technology

1984-04-01

runners most frequently sustain shin splints , knee pain, muscle soreness, hamstring strain and low back pain. More experienced * runners, along with long...failed. SHIN SPLINTS p.. Definition An overuse syndrome affecting the muscles, tendons and bone covering of the front, lower two-thirds of the leg(s...These tissues become inflamed and swollen producing pain along the inner lower two-thirds of the leg(s). Causes Four primary causes of shin splints

Correlation between broiler lameness and anatomical measurements of bone using radiographical projections with assessments of consistency across and within radiographs.

PubMed

Toscano, M J; Nasr, M A F; Hothersall, B

2013-09-01

Lameness represents a major welfare and production issue in the poultry industry with a recent survey estimating 27% of birds lame and 3% unable to walk by 40 d of age. A variety of factors may induce lameness and are typically grouped into 2 broad classes on the basis of being infectious or skeletal in nature with the latter accounting for the majority of cases. The current work sought to build upon a large body of literature assessing the anatomical properties of bone in lame birds. Our specific objectives sought to identify relationships between relevant anatomical properties of the tibia and metatarsus using digital quantification from radiographs of legs and a measure of walking difficulty. Resulting output was statistically analyzed to assess 1) observer reliability for consistency in placing the leg during the radiograph procedure and quantification of the various measures within a radiograph, 2) the relationship between the various measurements of anatomical bone properties and sex, bird mass, and gait score, and 3) the relationship between each measurement and leg symmetry. Our anatomical bone measures were found to be reliable (intra-rater and test-retest reliabilities < 0.75) within radiograph for all measures and 8 of the 10 measures across radiographs. Several measures of bone properties in the tibia correlated to difficulty walking as measured by gait score (P < 0.05), indicating greater angulations with increasing lameness. Of the measures that manifested a gait score × bird mass interaction, heavier birds appeared to exhibit less angulation with increasing difficulty walking with lighter birds the opposite. These interactions suggest possibilities for influencing effects of activity or feed intake on bone mineralization with the bone angulation observed. Our efforts agree with that of others and indicate that angulation of the tibia may be related to lameness, though subsequent efforts involving comprehensive measures of bird activity, growth rates, and internal bone structure will be needed if the validity of the measures are to be accepted.

Tibial Geometry in Individuals with Neurofibromatosis Type 1 without Anterolateral Bowing of the Lower Leg Using Peripheral Quantitative Computed Tomography

PubMed Central

Stevenson, David A.; Viskochil, David H.; Carey, John C.; Slater, Hillarie; Murray, Mary; Sheng, Xiaoming; D’Astous, Jacques; Hanson, Heather; Schorry, Elizabeth; Moyer-Mileur, Laurie J.

2008-01-01

Introduction Lower leg bowing with tibial pseudarthrosis is associated with neurofibromatosis type 1 (NF1). The objective of the study is to determine if the geometry of the lower limb in individuals with neurofibromatosis type 1 (NF1) differs from controls, and to characterize the osseous components of the tibia in NF1. Methods Peripheral quantitative computed tomography (pQCT) of the lower limb was performed (90 individuals with NF1 without tibial and/or fibular dysplasia: 474 healthy individuals without NF1). Subjects were 4–18 years of age. Individuals with NF1 were compared to controls using an analysis-of-covariance with a fixed set of covariates (age, weight, height, Tanner stage, and gender). Results Using pQCT, NF1 individuals without bowing of the lower leg have smaller periosteal circumferences (p<0.0001), smaller cortical area (p<0.0001), and decreased tibial cortical and trabecular bone mineral content (BMC) (p<0.0001) compared to controls. Discussion Individuals with NF1 have a different geometry of the lower leg compared to healthy controls suggesting that NF1 haploinsufficiency impacts bone homeostasis although not resulting in overt anterolateral bowing of the lower leg. PMID:19118659

Impact of intra- and extra-osseous soft tissue composition on changes in bone mineral density with weight loss and regain.

PubMed

Bosy-Westphal, Anja; Later, Wiebke; Schautz, Britta; Lagerpusch, Merit; Goele, Kristin; Heller, Martin; Glüer, Claus-C; Müller, Manfred J

2011-07-01

Recent studies report a significant gain in bone mineral density (BMD) after diet-induced weight loss. This might be explained by a measurement artefact. We therefore investigated the impact of intra- and extra-osseous soft tissue composition on bone measurements by dual X-ray absorptiometry (DXA) in a longitudinal study of diet-induced weight loss and regain in 55 women and 17 men (19-46 years, BMI 28.2-46.8 kg/m(2)). Total and regional BMD were measured before and after 12.7 ± 2.2 week diet-induced weight loss and 6 months after significant weight regain (≥30%). Hydration of fat free mass (FFM) was assessed by a 3-compartment model. Skeletal muscle (SM) mass, extra-osseous adipose tissue, and bone marrow were measured by whole body magnetic resonance imaging (MRI). Mean weight loss was -9.2 ± 4.4 kg (P < 0.001) and was followed by weight regain in a subgroup of 24 subjects (+6.3 ± 2.9 kg; P < 0.001). With weight loss, bone marrow and extra-osseous adipose tissue decreased whereas BMD increased at the total body, lumbar spine, and the legs (women only) but decreased at the pelvis (men only, all P < 0.05). The decrease in BMD(pelvis) correlated with the loss in visceral adipose tissue (VAT) (P < 0.05). Increases in BMD(legs) were reversed after weight regain and inversely correlated with BMD(legs) decreases. No other associations between changes in BMD and intra- or extra-osseous soft tissue composition were found. In conclusion, changes in extra-osseous soft tissue composition had a minor contribution to changes in BMD with weight loss and decreases in bone marrow adipose tissue (BMAT) were not related to changes in BMD.

Study of bone mineral metabolism. [during body immobilization, bed rest, and space flight

NASA Technical Reports Server (NTRS)

Palmer, H. E.

1975-01-01

The use of Sr-85 as an indicator of the skeletal location and relative amount of bone demineralization which occurs during immobilization of the body or body parts, bed-rest or space flight was studied. The bone mineral replacement which occurs after immobilization was measured rather than the bone loss which occurs during immobilization. In a study with two adult beagle dogs, the Sr-85 uptake in a leg which had been immobilized for two months was 400 percent higher than the uptake in the legs in regular use. This increased uptake probably resulted from only a few percent loss in bone mineral and indicates that losses less than one percent can be easily detected and located. The sensitivity, simplicity, and low radiation dose associated with the use of this method indicates that it should receive consideration for use on humans in bed-rest and space flight studies. Methods for measuring changes in total body nitrogen and in assisting the Johnson Space Center in calibrating a whole body counter for total body potassium measurements were also investigated.

Scaling in Theropod Dinosaurs: Femoral Bone Strength and Locomotion

ERIC Educational Resources Information Center

Lee, Scott

2015-01-01

In our first article on scaling in theropod dinosaurs, the longitudinal stress in the leg bones due to supporting the weight of the animal was studied and found not to control the dimensions of the femur. As a continuation of our study of elasticity in dinosaur bones, we now examine the transverse stress in the femur due to locomotion and find…

THE EFFECT OF THE GROWTH HORMONE FROM THE ANTERIOR LOBE OF THE PITUITARY ON BONE UNDER CONDITIONS OF IRRADIATION (in Russian)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ivanova, E.A.

1963-05-21

Young rats 3 to 4 days old were given an x-ray dose of 1000 r on the left hind leg. A daily dose of 200 gamma of growth hormone obtained from the pituitary of a bull was administered, until the animals were killed on the 36th, 41st, and 44th days after the irradiation. The length of the tibia in the left and right legs was determined by x rays. In the irradiated animals, the ratio of the length of the left tibia to the right tibia was about 0.50, and the introduction of growth hormone into the rat had onlymore » a slight effect on tibial growth. The bones were then fixed in a Zenkerformalin fluid, and cytological studies were carried out. These studies show that irradiation of the extremity of a four-day rat with an x-ray dose of 2000 r resulted in deep disturbances in the cartilage bone with subsequent arrest in the development of the bone. The introduction of growth hormone ameliorated the changes in bone structure, but did not result in normal bone development. (TTT)« less

Time-Dependent Effects of Chlorhexidine Soaks on Grossly Contaminated Bone

DTIC Science & Technology

2012-10-01

decontaminate . Methods: Fifty four bone segments were harvested from fresh frozen porcine legs. Each specimen was dropped onto a Mueller Hinton medium that was...P, 0.0001) and no difference between the 2%CHLand 4%CHLgroups. Conclusions: This study provides new data supporting the use of CHL to decontaminate ...bone may expedite the process of biofilm formation.1,6,7 Therefore, grossly contaminated bone seg- ments should be decontaminated with effective

Investigate methods for measuring muscle and bone mass changes in astronauts and animals which occur during space flight

NASA Technical Reports Server (NTRS)

Palmer, H. E.

1977-01-01

Sodium-22 is being used as a tracer for bone mineral metabolism studies. Dogs are being grown from puppies to adulthood on a diet containing a constant level of sodium-22 in order to uniformly tag the entire skeleton with a long lived radionuclide. This study is still in progress and the dogs are still growing. Potassium-40 measurements were made on people, who are replacing muscle mass lost due to leg injuries, in a second study. It appears that potassium-40 measurements provide an accurate and convenient method for determining relative changes in the muscle content of the leg.

Simulated bone remodeling around two types of osseointegrated implants for direct fixation of upper-leg prostheses.

PubMed

Tomaszewski, P K; Verdonschot, N; Bulstra, S K; Rietman, J S; Verkerke, G J

2012-11-01

Direct attachment of an upper leg prosthesis to the skeletal system by a percutaneous implant is an alternative solution to the traditional socket fixation. In this study, we investigated long-term periprosthetic bone changes around two types of fixation implants using two different initial conditions, namely immediate post-amputation implantation and the conventional implantation after considerable time of socket prosthesis use. We questioned the difference in bone modeling response the implants provoked and if it could lead to premature bone fracture. Generic CT-based finite element models of an intact femoral bone and amputated bone implanted with models of two existing direct-fixation implants, the OPRA system (Integrum AB) and the ISP Endo/Exo prosthesis (ESKA Implants AG) were created for this study. Adaptive bone-remodeling simulations used the heel-strike and toe-off loads from a normal walking cycle. The bone loss caused by prolonged use of socket prosthesis had more severe effects on the ultimate bone quality than adaptation induced by the direct-fixation implants. Both implants showed considerable bone remodeling; the titanium screw implant (OPRA system) provoked more bone loss than the porous coated CoCrMo stem (ISP implant). The chance of the peri-prosthetic bone fracture remained higher for the post-socket case as compared to the direct amputation cases. In conclusion, both direct-fixation implants lead to considerable bone loss and bone loss is more severe after a prolonged period of post-socket use. Hence, from a biomechanical perspective it is better to limit the post-socket time and to re-design direct fixation devices to reduce bone loss and the probability of peri-prosthetic bone fractures. Copyright © 2012 Elsevier Ltd. All rights reserved.

Associations between variants of bone morphogenetic protein 7 gene and growth traits in chickens.

PubMed

Wang, Yan; Guo, Fuyou; Qu, Hao; Luo, Chenglong; Wang, Jie; Shu, Dingming

2018-04-18

1. Enhancing bone strength to solve leg disorders in poultry has become an important goal in broiler production. 2. Bone morphogenetic protein 7 (BMP7), a member of the BMP family, represents an attractive therapeutic target for bone regeneration in humans and plays critical roles in skeletal development. 3. The objective of this study was to investigate the relationship between BMP7 gene expression, single nucleotide polymorphisms (SNPs) and growth traits in chickens. Here, a SNP (c.1995T>C) in the chicken (Gallus gallus) BMP7 gene was identified, that was associated with growth and carcass traits. 4. Genotyping revealed that the T allele occurred more frequently in breeds with high growth rates, whereas the C allele was predominant in those with low growth rates. The expression level of BMP7 in the thigh bone of birds with the TT genotype was significantly higher than in those with the CC genotype at 21, 42 and 91 days of age. 5. These findings suggest that selecting the birds with the TT genotype of SNP c.1995T>C could improve bone growth, could reduce leg disorders in fast-growing birds. The SNP c.1995T>C may serve as a selective marker for improving bone growth and increasing the consistency of body weights in poultry breeding.

Combat sports practice favors bone mineral density among adolescent male athletes.

PubMed

Nasri, Raouf; Hassen Zrour, Saoussen; Rebai, Haithem; Neffeti, Fadoua; Najjar, Mohamed Fadhel; Bergaoui, Naceur; Mejdoub, Hafedh; Tabka, Zouhair

2015-01-01

The aim of this study was to determine the impact of combat sports practice on bone mineral density (BMD) and to analyze the relationship between bone parameters and anthropometric measurements, bone markers, and activity index (AI). In other words, to detect the most important determinant of BMD in the adolescent period among combat sports athletes. Fifty athletes engaged in combat sports, mean age 17.1±0.2 yr, were compared with 30 sedentary subjects who were matched for age, height, and pubertal stage. For all subjects, the whole-body BMD, lumbar spine BMD (L2-L4), and BMD in the pelvis, arms, and legs was measured by dual-energy X-ray absorptiometry, and anthropometric measurements were evaluated. Daily calcium intake, bone resorption, and formation markers were measured. BMD measurements were greater in the combat sports athletes than in the sedentary group (p<0.01). Weight, body mass index, and lean body mass were significantly correlated with BMD in different sites. Daily calcium consumption lower than daily calcium intake recommended in both athletes and sedentary group. AI was strongly correlated with all BMD measurements particularly with the whole body, legs, and arms. Negative correlations were observed between bone markers and BMD in different sites. The common major predictor of BMD measurements was AI (p<0.0001). AI associated to lean body mass determined whole-body BMD until 74%. AI explained both BMD in arms and L2-L4 at 25%. AI associated to height can account for 63% of the variance in BMD legs. These observations suggested that the best model predicting BMD in different sites among adolescent combat sports athletes was the AI. Children and adolescents should be encouraged to participate in combat sports to maximize their bone accrual. Copyright © 2015 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

[Analysis of the results of bone healing in femurs lengthened by the gradual distraction method in children and adolescents].

PubMed

Jochymek, J; Skvaril, J; Ondrus, S

2009-10-01

Treatment of leg length inequality via lengthening of the shorter extremity is an infrequent orthopedic procedure due to the requirement of special distraction devices and possible serious complications. Essential qualitative changes in operative technique development are associated with the name of G. A. Ilizarov, who paved the way for the autoregenerate gradual distraction method in the 1950s. In the years 1990 through 2007 a total of 67 patients underwent femur lengthening via gradual distraction using various types of external fixators at the Department of Pediatric Surgery, Orthopedics, and Traumatology, Faculty Hospital in Brno. The quality of bone healing was monitored and a number of parameters followed and statistically evaluated using regularly scheduled X-ray examinations. In 13 cases we had to remove the external fixator following the distraction phase, perform an osteosynthesis via a splint and fill the distraction gap via spongioplasty. The bone healing was satisfactory in the remaining 54 patients and the lengthened bone required no other fixation method. The analysis showed statistically significant deceleration in bone healing following distraction in female patients over 12 years of age, and in boys over 14 years of age. Lack of periosteal callus five weeks after surgery always signified serious problems in further healing. Severe complications were recorded in 11 cases during the distraction phase, and in 12 cases after the removal of the distraction apparatus. Our results fully correspond with the data and experience of others cited authors. In addition our study showed deceleration in bone healing in girls over 12 years and in boys over 14 years of age and serious problem in healing when is lack of periostal callus five weeks after surgery. The aim of this report was to present the results of our study of distraction gap bone healing using the gradual lengthening approach. Key words: leg lengthening, gradual distraction, external fixation, leg discrepancy, complication.

Modeling the benefits of an artificial gravity countermeasure coupled with exercise and vibration

NASA Astrophysics Data System (ADS)

Goel, Rahul; Kaderka, Justin; Newman, Dava

2012-01-01

The current, system-specific countermeasures to space deconditioning have limited success with the musculoskeletal system in long duration missions. Artificial gravity (AG) that is produced by short radius centrifugation has been hypothesized as an effective countermeasure because it reintroduces an acceleration field in space; however, AG alone might not be enough stimuli to preserve the musculoskeletal system. A novel combination of AG coupled with one-legged squats on a vibrating platform may preserve muscle and bone in the lower limbs to a greater extent than the current exercise paradigm. The benefits of the proposed countermeasure have been analyzed through the development of a simulation platform. Ground reaction force data and motion data were collected using a motion capture system while performing one-legged and two-legged squats in 1-G. The motion was modeled in OpenSim, an open-source software, and inverse dynamics were applied in order to determine the muscle and reaction forces of lower limb joints. Vibration stimulus was modeled by adding a 20 Hz sinusoidal force of 0.5 body weight to the force plate data. From the numerical model in a 1-G acceleration field, muscle forces for quadriceps femoris, plantar flexors and glutei increased substantially for one-legged squats with vibration compared to one- or two-legged squats without vibration. Additionally, joint reaction forces for one-legged squats with vibration also increased significantly compared to two-legged squats with or without vibration. Higher muscle forces and joint reaction forces might help to stimulate muscle activation and bone modeling and thus might reduce musculoskeletal deconditioning. These results indicate that the proposed countermeasure might surpass the performance of the current space countermeasures and should be further studied as a method of mitigating musculoskeletal deconditioning.

Early Conversion of External Fixation to Interlocked Nailing in Open Fractures of Both Bone Leg Assisted with Vacuum Closure (VAC) - Final Outcome

PubMed Central

Raj, Manish; Kumar, Sunil; Singh, Pulkesh; Kumar, Dinesh; Singh, Jasveer; Deep, Akash

2016-01-01

Introduction Management of compound grade III fractures of both bone leg includes external stabilization for long period, followed by various soft tissue coverage procedures. Primary interlocking of tibia had been also done with variable results. External fixation for long time without any bone loss often leads to infected nonunion, loss of reduction, pin tract infection and failure of fixation, primary interlocking in compound grade III fractures had shown high medullary infection rate. We managed all cases of compound grade III A/B fractures with primary external fixation, simultaneous wound management using vacuum assisted closure (VAC) followed by early conversion to interlocking within 2 weeks of fixator application. Aim To determine the effectiveness of vacuum assisted closure (VAC) for the early conversion of external fixator to definitive interlocking in open fractures of the both bone leg. Materials and Methods In current study we selected 84 cases of compound grade IIIA/B diaphyseal fractures of both bone leg during period of May 2010 to September 2013. We managed these cases by immediate debridement and application of external fixation followed by repeated debridement, application of vacuum assisted closure (VAC) and conversion to interlocking within two weeks. Results Out of 84 cases union was achieved in 80(95%) of cases with definitive tibial interlocking. Excellent to good result were obtained in 77(91.8%) of cases and fair to poor result seen in rest of 7(8.2%) of cases according to modified Ketenjian’s criteria. 5 out of these 7 poor result group cases were from Compound Grade III B group to start with. Deep infection rate in our series were 7% i.e. total 6 cases and 4 out of these were from compound Grade III B group to start with. Conclusion Vacuum assisted closure (VAC) give a good help for rapid closure of the wound and help in early conversion to definitive intramedullary nailing. Reamed nail could well be used in compound grade IIIA/B fractures without increasing the risk of infection. It gives better stability to fracture site and lessen the risk of implant failure. PMID:27042541

Sagittal plane bending moments acting on the lower leg during running.

PubMed

Haris Phuah, Affendi; Schache, Anthony G; Crossley, Kay M; Wrigley, Tim V; Creaby, Mark W

2010-02-01

Sagittal bending moments acting on the lower leg during running may play a role in tibial stress fracture development. The purpose of this study was to evaluate these moments at nine equidistant points along the length of the lower leg (10% point-90% point) during running. Kinematic and ground reaction force data were collected for 20 male runners, who each performed 10 running trials. Inverse dynamics and musculoskeletal modelling techniques were used to estimate sagittal bending moments due to reaction forces and muscle contraction. The muscle moment was typically positive during stance, except at the most proximal location (10% point) on the lower leg. The reaction moment was predominantly negative throughout stance and greater in magnitude than the muscle moment. Hence, the net sagittal bending moment acting on the lower leg was principally negative (indicating tensile loads on the posterior tibia). Peak moments typically occurred around mid-stance, and were greater in magnitude at the distal, compared with proximal, lower leg. For example, the peak reaction moment at the most distal point was -9.61+ or - 2.07%Bw.Ht., and -2.73 + or - 1.18%Bw.Ht. at the most proximal point. These data suggest that tensile loads on the posterior tibia are likely to be higher toward the distal end of the bone. This finding may explain the higher incidence of stress fracture in the distal aspect of the tibia, observed by some authors. Stress fracture susceptibility will also be influenced by bone strength and this should also be accounted for in future studies. Copyright 2009 Elsevier B.V. All rights reserved.

Management of fibular hemimelia using the Ilizarov method at Siriraj Hospital in Thailand.

PubMed

Unprasert, Prangthong; Kaewpornsawan, Kamolporn; Chotigavanichaya, Chatupon; Eamsobhana, Perajit

2014-09-01

Fibular hemimelia is one of the most common congenital longitudinal bone deficiencies. Previous treatment protocols called for amputation of the deficient limb; while others made attempts to save the limb. The objective of treatment is to restore function and achieve patient satisfaction. The authors evaluated the outcomes of the Ilizarov technique for the treatment of leg-length discrepancy and bone associated deformities in patients with fibular hemimelia. The present study also evaluated and assessed complications, knee and ankle function, and patient satisfaction with the treatment. Nine patients with fibular hemimelia who underwent tibial lengthening using the Ilizarov method were reviewed in the present study. Initial condition data, including age, gender type offibular hemimelia, initial limb-length discrepancy, predicted limb-length discrepancy, and the data were collected and analyzed. Activity level, patient satisfaction, complications, and residual leg-length discrepancy were assessed at the end of treatment. According to Achterman and Kalamchi classification, there were 4 patients with Type IA, 3 patients with Type IB, and 2 patients with Type II. In Type IA, the affected leg-length discrepancy and mean age at the initial treatment were 3.25 cm and 7.75 years, respectively. In type IB, the affected leg-length discrepancy and mean age at the initial treatment were 5.83 cm and 4.3 years, respectively. In Type II, the affected leg-length discrepancy and mean age at the initial treatment were 5.5 cm and 5 years, respectively. The mean follow-up was 5 years (range: 7-10). The mean lengthening was 7.52 cm (range: 4-13). The lengthening index was 1.28 mo/cm. The mean residual leg-length discrepancy was 0.94 cm. There was ankle joint stiffness and mild equinous foot in type II cases, but patients could walk well without gait aid. No patients were experiencing pain by the end of treatment. All patients expressed satisfaction with this technique. The Ilizarov technique for bone lengthening of the tibia has shown satisfactory results in the treatment of all types of congenital fibular hemimelia and should be considered an attractive alternative to amputation, as measureable functional improvement can be expected.

[Multiple sites extrapodal actinomycetoma: Favorable outcome to treatment with a combination of cotrimoxazole and NSAI].

PubMed

Diallo, B; Barro-Traoré, F; Bamba, S; Sanou-Lamien, A; Traoré, S S; Andonaba, J-B; Konaté, I; Niamba, P; Traoré, A; Guiguemdé, T R

2015-12-01

Mycetoma is a bacteriological or fungal infectious disease affecting the skin and/or soft tissues, which can be complicated by bone involvement. The most common feature is a tumor of the foot, but extrapodal localizations have been described. We report one case of a 47-year-old man who presented with tumefaction of a leg with multiple skin fistulae. Histopathological examination permitted to confirm the diagnosis of actinomycetoma and TDM showed the degree of bone and soft tissues involvement. Our case was characterized by the very inflammatory aspect of the tumor, its localization to the leg without foot involvement, the modest functional signs compared to the importance of radiological bone involvements, the deep destruction of the fibula while the tibia was apparently intact and the good response to treatment. In spite of its characteristic features, diagnosis of mycetoma is still late in our country, often with bone and/or articular spread. Priority may be given to measures for reduction of mycetoma diagnosis lateness. Copyright © 2015. Published by Elsevier Masson SAS.

Muscular Maximal Strength Indices and Bone Variables in a Group of Elderly Women.

PubMed

Nasr, Riad; Al Rassy, Nathalie; Watelain, Eric; Matta, Joseph; Frenn, Fabienne; Rizkallah, Maroun; Maalouf, Ghassan; El Khoury, César; Berro, Abdel-Jalil; El Hage, Rawad

2018-03-22

The aim of the present study was to explore the relations between muscular maximal strength indices and bone parameters (bone mineral density [BMD], hip geometry indices, and trabecular bone score [TBS]) in a group of elderly women. This study included 35 healthy elderly women whose ages range between 65 and 75 yr (68.1 ± 3.1 yr). BMD (in gram per square centimeter) was determined for each individual by dual-energy X-ray absorptiometry at the whole body, lumbar spine (L1-L4), total hip (TH), and femoral neck (FN). L1-L4 TBS and hip geometry indices were also evaluated by dual-energy X-ray absorptiometry. Maximal muscle strength of bench press (1-repetition maximum [RM] bench press), maximal muscle strength of leg press (1-RM leg press), and handgrip were measured using validated methods. 1-RM bench press was positively correlated to TH BMD (r = 0.40; p < 0.05), FN BMD (r = 0.41; p < 0.05), FN section modulus (r = 0.33; p < 0.05), and FN cross-sectional moment of inertia (r = 0.35; p < 0.05). 1-RM leg press was positively correlated to TH BMD (r = 0.50; p < 0.01), FN BMD (r = 0.35; p < 0.05), FN cross-sectional area (r = 0.38; p < 0.05), and TBS (r = 0.37; p < 0.05). Handgrip was correlated only to FN cross-sectional moment of inertia (r = 0.43; p < 0.01). This study suggests that 1-RM bench press and 1-RM leg press are positive determinants of BMD in elderly women. Copyright © 2018 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

Case 24: Stress Fracture of the Tibia

DTIC Science & Technology

2008-03-01

extremity weight bearing bones. Most often this micro trauma is found in military recruits and athletes taking part in running activities. A...application of force most commonly related to running and jumping results in micro trauma to the cortical bone. The weight bearing bones of the lower...year old active duty U.S Army combat soldier deployed to Iraq. He had had progressive pain over his lower right leg that radiated to his knee joint

Effects of whole-body vibration exercise on bone mineral content and density in thermally injured children.

PubMed

Edionwe, Joel; Hess, Cameron; Fernandez-Rio, Javier; Herndon, David N; Andersen, Clark R; Klein, Gordon L; Suman, Oscar E; Amonette, William E

2016-05-01

Loss of bone mass, muscle mass, and strength leads to significant disability in severely burned children. We assessed the effects of exercise combined with whole-body vibration (WBV) on bone mass, lean mass (LM), and muscle strength in children recovering from burns. Nineteen burned children (≥30% total body surface area [TBSA] burns) were randomly assigned to a 6-week exercise regimen either alone (EX; n=10) or in combination with a 6-week WBV training regimen (EX+WBV; n=9). WBV was performed concurrent to the exercise regimen for 5days/week on a vibrating platform. Dual-energy X-ray absorptiometry quantified bone mineral content (BMC), bone mineral density (BMD), and LM; knee extension strength was assessed using isokinetic dynamometry before and after training. Alpha was set at p<0.05. Both groups were similar in age, height, weight, TBSA burned, and length of hospitalization. Whole-body LM increased in the EX group (p=0.041) and trended toward an increase in the EX+WBV group (p=0.055). On the other hand, there were decreases in leg BMC for both groups (EX, p=0.011; EX+WBV, p=0.047), and in leg BMD for only the EX group (EX, p<0.001; EX+WBV, p=0.26). Truncal BMC decreased in only the EX group (EX, p=0.009; EX+WBV, p=0.61), while BMD decreased in both groups (EX, p<0.001; EX+WBV group, p<0.001). Leg strength increased over time in the EX group (p<0.001) and the EX+WBV group (p<0.001; between-group p=0.31). Exercise in combination with WBV may help attenuate regional bone loss in children recovering from burns. Studies are needed to determine the optimal magnitude, frequency, and duration of the vibration protocol, with attention to minimizing any potential interference with wound healing and graft closure. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Prevalence of rickets-like bone deformities in rural Gambian children.

PubMed

Jones, Helen L; Jammeh, Lamin; Owens, Stephen; Fulford, Anthony J; Moore, Sophie E; Pettifor, John M; Prentice, Ann

2015-08-01

The aim of this study was to estimate the burden of childhood rickets-like bone deformity in a rural region of West Africa where rickets has been reported in association with a low calcium intake. A population-based survey of children aged 0.5-17.9 years living in the province of West Kiang, The Gambia was conducted in 2007. 6221 children, 92% of those recorded in a recent census, were screened for physical signs of rickets by a trained survey team with clinical referral of suspected cases. Several objective measures were tested as potential screening tools. The prevalence of bone deformity in children <18.0 years was 3.3%. The prevalence was greater in males (M = 4.3%, F = 2.3%, p < 0.001) and in children <5.0 years (5.7%, M = 8.3%, F = 2.9%). Knock-knee was more common (58%) than bow-leg (31%) or windswept deformity (9%). Of the 196 examined clinically, 36 were confirmed to have a deformity outside normal variation (47% knock-knee, 53% bow-leg), resulting in more conservative prevalence estimates of bone deformity: 0.6% for children <18.0 years (M = 0.9%, F = 0.2%), 1.5% for children < 5.0 years (M = 2.3%, F = 0.6%). Three of these children (9% of those with clinically-confirmed deformity, 0.05% of those screened) had active rickets on X-ray at the time of medical examination. This emphasises the difficulties in comparing prevalence estimates of rickets-like bone deformities from population surveys and clinic-based studies. Interpopliteal distance showed promise as an objective screening measure for bow-leg deformity. In conclusion, this population survey in a rural region of West Africa with a low calcium diet has demonstrated a significant burden of rickets-like bone deformity, whether based on physical signs under survey conditions or after clinical examination, especially in boys < 5.0 years. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Effects of soccer vs swim training on bone formation in sedentary middle-aged women.

PubMed

Mohr, Magni; Helge, Eva W; Petersen, Liljan F; Lindenskov, Annika; Weihe, Pál; Mortensen, Jann; Jørgensen, Niklas R; Krustrup, Peter

2015-12-01

The present study examined the effects of 15 weeks of soccer training and two different swimming training protocols on bone turnover in sedentary middle-aged women. Eighty-three premenopausal mildly hypertensive women [age: 45 ± 6 (± SD) years, height: 165 ± 6 cm, weight: 80.0 ± 14.1 kg, body fat: 42.6 ± 5.7 %, systolic blood pressure/diastolic blood pressure: 138 ± 6/85 ± 3 mmHg] were randomized into soccer training (SOC, n = 21), high-intensity intermittent swimming (HS, n = 21), moderate-intensity swimming (MS, n = 21) intervention groups, and a control group (C, n = 20). The training groups completed three sessions per week for 15 weeks. DXA scans were performed and resting blood samples were drawn pre- and post-intervention. In SOC, plasma osteocalcin, procollagen type I N propeptide and C-terminal telopeptide increased (P < 0.05) by 37 ± 15, 52 ± 23 and 42 ± 18 %, respectively, with no changes in MS, HS and C. The intervention-induced increase in SOC was larger (P < 0.05) than in MS, HS and C. In SOC, leg BMC increased (P < 0.05) by 3.1 ± 4.5 %, with a larger increase in SOC than in C. Femoral shaft and trochanter bone mineral density (BMD) increased (P < 0.05) by 1.7 ± 1.9 and 2.4 ± 2.9 %, respectively, in SOC, with a greater (P < 0.05) change in SOC than in MS and C, whereas total body and total leg BMD did not change in any of the groups. In conclusion, 15 weeks of soccer training with sedentary middle-aged women caused marked increases in bone turnover markers, with concomitant increases in leg bone mass. No changes in bone formation and resorption markers were seen after prolonged submaximal or high-intensity intermittent swimming training. Thus, soccer training appears to provide a powerful osteogenic stimulus in middle-aged women.

Effects of Whole-Body Vibration Exercise on Bone Mineral Content and Density in Thermally Injured Children

PubMed Central

Edionwe, Joel; Hess, Cameron; Fernandez-Rio, Javier; Herndon, David N.; Andersen, Clark R.; Klein, Gordon L.; Suman, Oscar E.; Amonette, William E.

2015-01-01

Background Loss of bone mass, muscle mass, and strength leads to significant disability in severely burned children. We assessed the effects of exercise combined with whole-body vibration (WBV) on bone mass, lean mass (LM), and muscle strength in children recovering from burns. Methods Nineteen burned children (≥30% total body surface area [TBSA] burns) were randomly assigned to a 6-week exercise regimen either alone (EX; n = 10) or in combination with a 6-week WBV training regimen (EX+WBV; n = 9). WBV was performed concurrent to the exercise regimen for 5 days/week on a vibrating platform. Dual-energy X-ray absorptiometry quantified bone mineral content (BMC), bone mineral density (BMD) and LM; knee extension strength was assessed using isokinetic dynamometry before and after training. Alpha was set at p < 0.05. Results Both groups were similar in age, height, weight, TBSA burned, and length of hospitalization. Whole-body LM increased in the EX group (p = 0.041) and trended toward an increase in the EX+WBV group (p = 0.055). On the other hand, there were decreases in leg BMC for both groups (EX, p = 0.011; EX+WBV, p = 0.047), and in leg BMD for only the EX group (EX, p < 0.001; EX+WBV, p = 0.26). Truncal BMC decreased in only the EX group (EX, p = 0.009; EX+WBV, p = 0.61), while BMD decreased in both groups (EX, p < 0.001; EX+WBV group, p < 0.001). Leg strength increased over time in the EX group (p < 0.001) and the EX+WBV group (p < 0.001; between-group P = 0.31). Conclusions Exercise in combination with WBV may help attenuate regional bone loss in children recovering from burns. Studies are needed to determine the optimal magnitude, frequency, and duration of the vibration protocol, with attention to minimizing any potential interference with wound healing and graft closure. PMID:26796240

Radiating leg pain and positive straight leg raising in spondylolysis in children.

PubMed

Halperin, N; Copeliovitch, L; Schachner, E

1983-09-01

Three children presented with low back pain radiating to the leg and with spasm of the hamstring and paravertebral muscles. Since the pain could not be ascribed to trauma, it was necessary to exclude the presence of infection or tumors. All the signs--localization of the pain, tenderness on one side of the back, X-ray film findings of unilateral or bilateral spondylolysis, and localized positive bone scan--pointed to spondylolysis as the cause of pain. All three children exhibited symptoms resembling those found in the facet syndrome described by Mooney and Robertson.

The Relationship Between Lower Limb Bone and Muscle in Military Recruits, Response to Physical Training, and Influence of Smoking Status

PubMed Central

Puthucheary, Zudin; Kordi, Mehdi; Rawal, Jai; Eleftheriou, Kyriacos I.; Payne, John; Montgomery, Hugh E.

2015-01-01

The relationship between bone and skeletal muscle mass may be affected by physical training. No studies have prospectively examined the bone and skeletal muscle responses to a short controlled exercise-training programme. We hypothesised that a short exercise-training period would affect muscle and bone mass together. Methods: Femoral bone and Rectus femoris Volumes (RFVOL) were determined by magnetic resonance imaging in 215 healthy army recruits, and bone mineral density (BMD) by Dual X-Ray Absorptiometry (DXA) and repeated after 12 weeks of regulated physical training. Results: Pre-training, RFVOL was smaller in smokers than non-smokers (100.9 ± 20.2 vs. 108.7 ± 24.5, p = 0.018; 96.2 ± 16.9 vs. 104.8 ± 21.3, p = 0.002 for dominant/non-dominant limbs), although increases in RFVOL with training (of 14.2 ± 14.5% and 13.2 ± 15.6%] respectively, p < 0.001) were independent of prior smoking status. Pre-training RFVOL was related to bone cortical volume (r2 = 0.21 and 0.30, p < 0.001 for dominant and non-dominant legs), and specifically to periosteal (r2 = 0.21 and 0.23, p < 0.001) volume. Pre-training dominant RFVOL was independently associated with Total Hip BMD (p < 0.001). Training-related increases in RFVOL and bone volumes were related. Whilst smokers demonstrated lower muscle mass than non-smokers, differences were abolished with training. Training-related increases in muscle mass were related to increases in periosteal bone volume in both dominant and non-dominant legs. PMID:25792356

Practice of martial arts and bone mineral density in adolescents of both sexes

PubMed Central

Ito, Igor Hideki; Mantovani, Alessandra Madia; Agostinete, Ricardo Ribeiro; Costa, Paulo; Zanuto, Edner Fernando; Christofaro, Diego Giulliano Destro; Ribeiro, Luis Pedro; Fernandes, Rômulo Araújo

2016-01-01

Abstract Objective: The purpose of this study was to analyze the relationship between martial arts practice (judo, karate and kung-fu) and bone mineral density in adolescents. Methods: The study was composed of 138 (48 martial arts practitioners and 90 non-practitioners) adolescents of both sexes, with an average age of 12.6 years. Bone mineral density was measured using Dual-Energy X-ray Absorptiometry in arms, legs, spine, trunk, pelvis and total. Weekly training load and previous time of engagement in the sport modality were reported by the coach. Partial correlation tested the association between weekly training load and bone mineral density, controlled by sex, chronological age, previous practice and somatic maturation. Analysis of covariance was used to compare bone mineral density values according to control and martial arts groups, controlled by sex, chronological age, previous practice and somatic maturation. Significant relationships between bone mineral density and muscle mass were inserted into a multivariate model and the slopes of the models were compared using the Student t test (control versus martial art). Results: Adolescents engaged in judo practice presented higher values of bone mineral density than the control individuals (p-value=0.042; Medium Effect size [Eta-squared=0.063]), while the relationship between quantity of weekly training and bone mineral density was significant among adolescents engaged in judo (arms [r=0.308] and legs [r=0.223]) and kung-fu (arms [r=0.248] and spine [r=0.228]). Conclusions: Different modalities of martial arts are related to higher bone mineral density in different body regions among adolescents. PMID:27017002

Scaling in Theropod Dinosaurs: Femoral Bone Strength and Locomotion

NASA Astrophysics Data System (ADS)

Lee, Scott

2015-02-01

In our first article1 on scaling in theropod dinosaurs, the longitudinal stress in the leg bones due to supporting the weight of the animal was studied and found not to control the dimensions of the femur. As a continuation of our study of elasticity in dinosaur bones, we now examine the transverse stress in the femur due to locomotion and find that this effect is important for the geometry of the bone. We find that larger theropods (including Tyrannosaurus rex) were less athletic than smaller theropods.

Soccer helps build strong bones during growth: a systematic review and meta-analysis.

PubMed

Lozano-Berges, Gabriel; Matute-Llorente, Ángel; González-Agüero, Alejandro; Gómez-Bruton, Alejandro; Gómez-Cabello, Alba; Vicente-Rodríguez, Germán; Casajús, José A

2018-03-01

The aim of this study was to analyze the effects of soccer practice on bone in male and female children and adolescents. MEDLINE, PubMed, SPORTDiscus and Web of Science databases were searched for scientific articles published up to and including October 2016. Twenty-seven studies were included in this systematic review (13 in the meta-analysis). The meta-analysis was performed by using OpenMeta[Analyst] software. It is well documented that soccer practice during childhood provides positive effects on bone mineral content (BMC) and density (BMD) compared to sedentary behaviors and other sports, such as tennis, weightlifting, or swimming. Furthermore, soccer players present higher BMC and BMD in most weight-bearing sites such as the whole body, lumbar spine, hip, and legs. Moreover, bone differences were minimized between groups during prepuberty. Therefore, the maturity status should be considered when evaluating bone. According to meta-analysis results, soccer practice was positively associated with whole-body BMD either in males (mean difference 0.061; 95%CI, 0.042-0.079) or in females (mean difference 0.063; 95%CI, 0.026-0.099). Soccer may be considered a sport that positively affects bone mass during growth. Pubertal soccer players presented increased bone mass compared to controls or other athletes; however, these bone differences are minimized during the prepubertal stage. What is known: • It has been described that childhood and adolescence are important periods for bone mass and structure. • Previous studies have demonstrated that soccer participation improves bone mass in male and female children and adolescents. What is new: • The differences between soccer players and controls are more marked during puberty than prepuberty. • Weight-bearing sites such as lumbar spine, hip, femoral neck, trochanter, intertrochanteric region and both legs are particularly sensitive to soccer actions.

Bone Mineral Content and Density Among Female NCAA Division I Athletes Across the Competitive Season and Over a Multi-Year Time Frame.

PubMed

Stanforth, Dixie; Lu, Tao; Stults-Kolehmainen, Matthew A; Crim, Brittany N; Stanforth, Philip R

2016-10-01

Stanforth, D, Lu, T, Stults-Kolehmainen, MA, Crim, BN, and Stanforth, PR. Bone mineral content and density among female NCAA Division I athletes across the competitive season and over a multi-year time frame. J Strength Cond Res 30(10): 2828-2838, 2016-Longitudinal and cross-sectional bone mineral content (BMC) and bone mineral density (BMD) comparisons were made among impact and nonimpact sports. Female collegiate athletes, 18-23 years of age, from basketball (BB; n = 38), soccer (SOC; n = 47), swimming (SW; n = 52), track sprinters and jumpers (TR; n = 49), and volleyball (VB; n = 26) had BMC/BMD measures preseason and postseason over 3 years. Control groups of 85 college females, 18-24 years of age, who completed 2 tests 1-3 years apart and of 170 college females, 18-20 years of age, were used for the longitudinal and cross-sectional analyses, respectively. A restricted maximum likelihood linear mixed model regression analysis with a compound symmetric heterogeneous variance-covariance matrix structure was used for all analyses (p ≤ 0.05). Increases from year-1 preseason to year-3 postseason included the following: total BMC (3.3%), total BMD (1.4%), and spine BMD (4.5%) for BB; total BMC (1.5%) and leg BMD (1.2%) for SOC; arm (1.8%), leg (1.9%), and total BMD (5.7%) for SW; total BMC (2.0%), arm (1.7%), leg (2.3%), pelvis (3.4%), spine (6.0%), and total BMD (2.3%) for TR; and arm (4.1%), leg (2.0%), pelvis (2.0%), spine (2.0%), and total BMD (2.7%) for VB. Comparisons among sports determined that BB had higher BMC and BMD values than all other sports for all variables except spine and total BMD; BB, SOC, TR, and VB had higher total BMC (11-29%), leg BMD (13-20%), and total BMD (9-15%) than SW and CON, and there were few differences among SOC, TR, and VB. In conclusion, small, significant increases in many BMC and BMD measures occur during female athlete's collegiate careers. The BMC and BMD differences between impact and nonimpact sports are large compared with smaller differences within impact sports.

A prospective study on MRI findings and prognostic factors in athletes with MTSS.

PubMed

Moen, M H; Schmikli, S L; Weir, A; Steeneken, V; Stapper, G; de Slegte, R; Tol, J L; Backx, F J G

2014-02-01

In medial tibial stress syndrome (MTSS) bone marrow and periosteal edema of the tibia on the magnetic resonance imaging (MRI) is frequently reported. The relationship between these MRI findings and recovery has not been previously studied. This prospective study describes MRI findings of 52 athletes with MTSS. Baseline characteristics were recorded and recovery was related to these parameters and MRI findings to examine for prognostic factors. Results showed that 43.5% of the symptomatic legs showed bone marrow or periosteal edema. Absence of periosteal and bone marrow edema on MRI was associated with longer recovery (P = 0.033 and P = 0.013). A clinical scoring system for sports activity (SARS score) was significantly higher in the presence of bone marrow edema (P = 0.027). When clinical scoring systems (SARS score and the Lower Extremity Functional Scale) were combined in a model, time to recovery could be predicted substantially (explaining 54% of variance, P = 0.006). In conclusion, in athletes with MTSS, bone marrow or periosteal edema is seen on MRI in 43,5% of the symptomatic legs. Furthermore, periosteal and bone marrow edema on MRI and clinical scoring systems are prognostic factors. Future studies should focus on MRI findings in symptomatic MTSS and compare these with a matched control group. © 2012 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Factors affecting bone mineral mass loss after lower-limb fractures in a pediatric population.

PubMed

Ceroni, Dimitri; Martin, Xavier; Kherad, Omar; Salvo, Davide; Dubois-Ferrière, Victor

2015-06-01

The purpose of this study was to assess the effects of the durations of cast immobilization and non-weight-bearing periods, and decreases in vigorous physical activity (VPA) on bone mineral parameters in a pediatric population treated for a lower-limb fracture. Fifty children and teenagers who had undergone a cast-mediated immobilization for a leg or ankle fracture were prospectively recruited. The durations of cast immobilization and non-weight-bearing periods were recorded for each participant. Dual-energy x-ray absorptiometry scans were performed at the time of fracture treatment (baseline) and at cast removal. Physical activity during cast immobilization was assessed using accelerometers. A strong negative correlation was found between the total duration of cast immobilization and decreases in both calcaneal bone mineral density (BMD) (r=-0.497) and total lower-limb bone mineral content (BMC) (r=-0.405). A strong negative correlation was also noted between the durations of the non-weight-bearing periods and alterations in calcaneal BMD (r=-0.420). No apparent correlations were found between lower BMD and BMC and decreased VPA. Bone mineral loss was correlated to the total duration of cast immobilization for all measurement sites on the affected leg, whereas it was only correlated to the durations of non-weight-bearing periods for calcaneal BMD and total lower-limb BMC. However, no correlations were noted between bone mineral loss and decreased VPA.

Muscle size, quality, and body composition: characteristics of division I cross-country runners.

PubMed

Roelofs, Erica J; Smith-Ryan, Abbie E; Melvin, Malia N; Wingfield, Hailee L; Trexler, Eric T; Walker, Nina

2015-02-01

The primary purpose of this study was to identify the relationship between muscle cross-sectional area (mCSA), echo intensity (EI), and body composition of Division I cross-country runners. The secondary purpose was to examine differences in these variables in athletes stratified based on stress-fracture (SFx) history. Thirty-six athletes were stratified based on sex and SFx history. A panoramic scan vastus lateralis was performed using a GE Logiq-e B-mode ultrasound. Echo intensity and mCSA were determined from the scan using a grayscale imaging software (ImageJ). Body composition measures were determined using dual-energy x-ray absorptiometry. For females, mCSA was significantly correlated with left leg lean mass (LM; R = 0.54) and EI (R = -0.57). Lean mass was significantly correlated with bone mineral density (BMD; R = 0.58) and bone mineral content (BMC; R = 0.56), whereas BMC was also correlated with leg LM (R = 0.72). For males, mCSA was significantly correlated with leg LM (R = 0.66), BMD (R = 0.50), and BMC (R = 0.54). Leg LM was significantly correlated with BMD (R = 0.53) and BMC (R = 0.77). Personal best times for males were significantly correlated with fat mass (R = 0.489) and %fat (R = 0.556) for the 10- and 5-km races, respectively. Female and male athletes with a history of SFx were not significantly different across any variables when compared with athletes with no history. These correlations suggest that more muscle mass may associate with higher BMD and BMC for stronger bone structure. Modifications in training strategies to include heavy resistance training and plyometrics may be advantageous for preventing risk factors associated with SFx reoccurrence.

Modeling of the pliant surfaces of the thigh and leg during gait

NASA Astrophysics Data System (ADS)

Ball, Kevin A.; Pierrynowski, Michael R.

1998-05-01

Rigid Body Modeling, a 6 degree of freedom (DOF) method, provides state of the art human movement analysis, but with one critical limitation; it assumes segment rigidity. A non- rigid 12 DOF method, Pliant Surface Modeling (PSM) was developed to model the simultaneous pliant characteristics (scaling and shearing) of the human body's soft tissues. For validation, bone pins were surgically inserted into the tibia and femur of three volunteers. Infrared markers (44) were placed upon the thigh, leg, and bone pin surfaces. Two synchronized OPTOTRAK/3020TM cameras (Northern Digital Inc., Waterloo, ON) were used to record 120 seconds of treadmill gait per subject. In comparison to the 'gold standard' bone pin rotational results, PSM located the tibia, femur and tibiofemoral joint with root mean square (RMS) errors of 2.4 degrees, 4.0 degrees and 4.6 degrees, respectively. These performances met or exceeded (P less than .01) the current state of the art for surface data, Rigid Surface Modeling. The thigh's measured surface experienced uniform repeatable changes in scale: 40% mediolateral, 5% anterioposterior, 5% superioinferior, and planar shears of: 25 degrees transverse, 15 degrees sagittal, 5 degrees frontal. With the brief exception of push-off, the lower leg demonstrated much greater rigidity: less than 5% scaling and less than 5 degrees shearing. Thus, PSM offers superior 'rigid' estimates of knee motion with the ability to quantify 'pliant' surface changes.

Intoeing

MedlinePlus

... the leg bone between the knee and the ankle). Parents usually notice internal tibial torsion about the ... Exercise and Fitness Exercise Basics Sports Safety Injury Rehabilitation Emotional Well-Being Mental Health Sex and Birth ...

End-stage kidney disease

MedlinePlus

... Sleep problems Swelling of the feet and hands ( edema ) Vomiting , often in the morning ... legs syndrome Stroke , seizures , and dementia Swelling and edema Weakening of the bones and fractures related to ...

Muscle-driven finite element simulation of human foot movements.

PubMed

Spyrou, L A; Aravas, N

2012-01-01

This paper describes a finite element scheme for realistic muscle-driven simulation of human foot movements. The scheme is used to simulate human ankle plantar flexion. A three-dimensional anatomically detailed finite element model of human foot and lower leg is developed and the idea of generating natural foot movement based entirely on the contraction of the plantar flexor muscles is used. The bones, ligaments, articular cartilage, muscles, tendons, as well as the rest soft tissues of human foot and lower leg are included in the model. A realistic three-dimensional continuum constitutive model that describes the biomechanical behaviour of muscles and tendons is used. Both the active and passive properties of muscle tissue are accounted for. The materials for bones and ligaments are considered as homogeneous, isotropic and linearly elastic, whereas the articular cartilage and the rest soft tissues (mainly fat) are defined as hyperelastic materials. The model is used to estimate muscle tissue deformations as well as stresses and strains that develop in the lower leg muscles during plantar flexion of the ankle. Stresses and strains that develop in Achilles tendon during such a movement are also investigated.

Report of a man with heterotopic ossification of the legs.

PubMed

García-Arpa, Mónica; Flores-Terry, Miguel A; Franco-Muñoz, Monserrat; Villasanti-Rivas, Natalia; González-Ruiz, Lucía; Banegas-Illescas, M Eugenia

2018-05-21

Heterotopic ossification is an uncommon disorder that consists of deposition of ectopic bone outside the extraskeletal tissues. In the skin, it can be primary, in association with genetic syndromes, or be secondary to different disorders. The latter include subcutaneous ossification of the legs in chronic venousinsufficiency, an infrequent and unrecognized complication. We report the case of a patient with subcutaneous ossification of both legs secondary to venous insufficiency and review the literature. Copyright © 2018 Sociedad Española de Reumatologña y Colegio Mexicano de Reumatologña. Publicado por Elsevier España, S.L.U. All rights reserved.

Shin-splints: common exercise-related syndromes affecting the lower leg.

PubMed

Williamson, B L; Arthur, C H C

2014-01-01

Lower leg pain is a common complaint of athletically active individuals, often limiting physical activities. As such, the group of lower leg conditions related to athletic pursuits and physical exercise confer considerable operational implications for the military. Whilst acute injuries to the lower limb are commonly encountered and are clearly of significance, this article focuses instead on chronic conditions related to physical activity. These include insults to bone such as stress fractures and medial tibial stress syndrome, and those related to the soft tissues such as chronic exertional compartment syndrome. In this article we will examine the presentation and management of these conditions.

Quantitative in vivo assessment of bone microarchitecture in the human knee using HR-pQCT.

PubMed

Kroker, Andres; Zhu, Ying; Manske, Sarah L; Barber, Rhamona; Mohtadi, Nicholas; Boyd, Steven K

2017-04-01

High-resolution peripheral quantitative computed tomography (HR-pQCT) is a novel imaging modality capable of visualizing bone microarchitecture in vivo at human peripheral sites such as the distal radius and distal tibia. This research has extended the technology to provide a non-invasive assessment of bone microarchitecture at the human knee by establishing new hardware, imaging protocols and data analysis. A custom leg holder was developed to stabilize a human knee centrally within a second generation HR-pQCT field of view. Five participants with anterior cruciate ligament reconstructions had their knee joint imaged in a continuous scan of 6cm axially. The nominal isotropic voxel size was 60.7μm. Bone mineral density and microarchitecture were assessed within the weight-bearing regions of medial and lateral compartments of the knee at three depths from the weight-bearing articular bone surface, including both the cortical and trabecular bone regions. Scan duration was approximately 18min per knee and produced 5GB of projection data and 10GB of reconstructed image data (2304×2304 image matrix, 1008 slices). Motion during the scan was minimized by the leg holder and was similar in magnitude as a scan of the distal tibia. Bone mineral density and microarchitectural parameters were assessed for 16 volumes of interest in the tibiofemoral joint. This is a new non-invasive in vivo assessment tool for bone microarchitecture in the human knee that provides an opportunity to gain insight into normal, injured and surgically reconstructed human knee bone architecture in cross-sectional or longitudinal studies. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

Quantifying Bone–relevant Activity and its Relation to Bone Strength in Girls

PubMed Central

Farr, Joshua N.; Lee, Vinson R.; Blew, Robert M.; Lohman, Timothy G.; Going, Scott B.

2011-01-01

Physical activity (PA) is critical for maximizing bone development during growth. However, there is no consensus on how well existing PA measurement tools predict bone strength. PURPOSE Compare four methods of quantifying physical activity (PA) (pedometer, 3-day physical activity recall (3DPAR), bone-specific physical activity questionnaire (BPAQ), and past year physical activity questionnaire (PYPAQ)), in young girls and evaluate their ability to predict indices of bone strength. METHODS 329 girls aged 8–13 years completed a pedometer assessment, the 3DPAR, the BPAQ, and a modified PYPAQ. Peripheral quantitative computed tomography (pQCT) was used to assess bone strength index (BSI) at metaphyseal (4% distal femur and tibia) sites and strength-strain index (SSI) at diaphyseal (femur = 20%, tibia = 66%) sites of the non-dominant leg. Correlations and hierarchical multiple regression were used to assess relationships among PA measures and indices of bone strength. RESULTS After adjustment for maturity, correlations between PA measures and indices of bone strength were positive, although low (r = 0.01–0.20). Regression models that included covariates (maturity, body mass, leg length, and ethnicity) and PA variables showed that PYPAQ score was significantly (P < 0.05) associated with BSI and SSI at all sites and explained more variance in BSI and SSI than any other PA measure. Pedometer steps were significantly (P < 0.05) associated with metaphyseal femur and tibia BSI and 3DPAR score was significantly (P < 0.05) associated with metaphyseal femur BSI. BPAQ score was not significantly (P > 0.05) associated with BSI or SSI at any sites. CONCLUSION A modified PYPAQ that accounts for the duration, frequency, and load of PA predicted indices of bone strength better than other PA measures. PMID:20631644

[Practice of martial arts and bone mineral density in adolescents of both sexes].

PubMed

Ito, Igor Hideki; Mantovani, Alessandra Madia; Agostinete, Ricardo Ribeiro; Costa Junior, Paulo; Zanuto, Edner Fernando; Christofaro, Diego Giulliano Destro; Ribeiro, Luis Pedro; Fernandes, Rômulo Araújo

2016-06-01

The purpose of this study was to analyze the relationship between martial arts practice (judo, karate and kung-fu) and bone mineral density in adolescents. The study was composed of 138 (48 martial arts practitioners and 90 non-practitioners) adolescents of both sexes, with an average age of 12.6 years. Bone mineral density was measured using Dual-Energy X-ray Absorptiometry in arms, legs, spine, trunk, pelvis and total. Weekly training load and previous time of engagement in the sport modality were reported by the coach. Partial correlation tested the association between weekly training load and bone mineral density, controlled by sex, chronological age, previous practice and somatic maturation. Analysis of covariance was used to compare bone mineral density values according to control and martial arts groups, controlled by sex, chronological age, previous practice and somatic maturation. Significant relationships between bone mineral density and muscle mass were inserted into a multivariate model and the slopes of the models were compared using the Student t test (control versus martial art). Adolescents engaged in judo practice presented higher values of bone mineral density than the control individuals (p-value=0.042; Medium Effect size [Eta-squared=0.063]), while the relationship between quantity of weekly training and bone mineral density was significant among adolescents engaged in judo (arms [r=0.308] and legs [r=0.223]) and kung-fu (arms [r=0.248] and spine [r=0.228]). Different modalities of martial arts are related to higher bone mineral density in different body regions among adolescents. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

Influence of wholesale lamb marketing options and merchandising styles on retail yield and fabrication time.

PubMed

Lorenzen, C L; Martin, A M; Griffin, D B; Dockerty, T R; Walter, J P; Johnson, H K; Savell, J W

1997-01-01

Lamb carcasses (n = 94) from five packing plants, selected to vary in weight class and fat thickness, were used to determine retail yield and labor requirements of wholesale lamb fabrication. Carcasses were allotted randomly according to weight class to be fabricated as whole carcasses (n = 20), three-piece boxes (n = 22), or subprimals (n = 52). Processing times (seconds) were recorded and wholesale and retail weights (kilograms) were obtained to calculate retail yield. Subprimals were fabricated into bone-in retail cuts or boneless or semi-boneless retail cuts. Retail yield for subprimal lamb legs decreased from 85.3 +/- .6% for bone-in to 68.0 +/- .7% for a completely boneless retail product. Correspondingly, processing times increased from 126.1 +/- 5.4 s to 542.0 +/- 19.2 s for bone-in and boneless legs, respectively. For all subprimals, retail yield percentage tended to decrease and total processing time increase as cuts were fabricated to boneless or semi-boneless end points compared with a bone-in end point. Percentage retail yield did not differ (P > .05) among whole carcass, three-piece box, and subprimal marketing methods. Total processing time was shorter for subprimals (P < .05) than for the other two marketing methods.

Three-stage treatment protocol for recalcitrant distal femoral nonunion.

PubMed

Ma, Ching-Hou; Chiu, Yen-Chun; Tu, Yuan-Kun; Yen, Cheng-Yo; Wu, Chin-Hsien

2017-04-01

In this study, we proposed a three-stage treatment protocol for recalcitrant distal femoral nonunion and aimed to analyze the clinical results. We retrospective reviewed 12 consecutive patients with recalcitrant distal femoral nonunion undergoing our three-stage treatment protocol from January 2010 to December 2014 in our institute. The three-stage treatment protocol comprised debridement of the nonunion site, lengthening to eliminate leg length discrepancy, deformity correction, stabilization with a locked plate, filling of the defect with cement spacer for inducing membrane formation, and bone reconstruction using a cancellous bone autograft (Masquelet technique) or free vascularized fibular bone graft. The bone union time, wound complication, lower limbs alignment, amount of lengthening, knee range of motion, and functional outcomes were evaluated. Osseous union with angular deformity <5° and leg length discrepancy <1 cm were achieved in all the patients. The average amount of lengthening was 5.88 cm (range 3.5-12 cm). Excellent or good outcomes were obtained in 9 patients. Although the current study involved only a small number of patients and the intervention comprised three stages, we believe that such a protocol may be a valuable alternative for the treatment of recalcitrant distal femoral nonunion.

An unusual case of calcineurine inhibitor pain syndrome.

PubMed

Nickavar, Azar; Mehrazma, Mitra; Hallaji, Farideh

2014-09-01

Cyclosporine induced pain syndrome (CIPS) is a newly diagnosed complication of calcineurine inhibitors, mainly observed in solid organ and hematopoetic transplantations. The present case is a male child with steroid resistant nephrotic syndrome on low therapeutic level cyclosporine treatment. He presented with intractable and debilitating leg pain, with no reported history of previous injury or trauma. The pain was reluctant to antimicrobial and sedative treatment. MRI revealed bone marrow and soft tissue edema in the mid shaft of patient's right leg. Inspite of unusual manifestations, CIPS was suggested and cyclosporine discontinued. However, the pain did not improve and was resistant to calcium blocker. Subsequently, core decompression was performed as an unusual treatment of CIPS, revealing normal bone morphology. The pain improved rapidly and the patient was discharged a few days later.

An Unexpected Complication of Bone Marrow Aspiration and Trephine Biopsy: Arteriovenous Fistula

PubMed Central

Berber, Ilhami; Erkurt, Mehmet Ali; Kuku, Irfan; Kaya, Emin; Kutlu, Ramazan; Koroglu, Mustafa; Yigit, Ali; Unlu, Serkan

2014-01-01

Objective To report a case of arteriovenous fistula (AVF) following bone marrow aspiration and trephine biopsy. Clinical Presentation and Intervention A 76-year-old man was diagnosed with acute myeloblastic leukemia. Pain and hematoma were detected in his left leg and hip 4 days after bone marrow aspiration and trephine biopsy. A pelvic arteriography was performed, and a diagnosis of AVF was made. Conclusion This case shows that clinicians should be aware of AVF, especially in cases with refractory bleeding after bone marrow aspiration and trephine biopsy despite normal blood coagulation parameters. PMID:24481007

Building a bone μCT images atlas for micro-architecture recognition

NASA Astrophysics Data System (ADS)

Freuchet, E.; Recur, B.; Guédon, Jp.; Kingston, A.; Autrusseau, F.; Amouriq, Y.

2015-03-01

Trabecular bone and its micro-architecture are of prime importance for health. Changes of bone micro-architecture are linked to different pathological situations like osteoporosis and begin now to be understood. In a previous paper, we started to investigate the relationships between bone and vessels and we also proposed to build a Bone Atlas. This study describes how to proceed for the elaboration and use of such an atlas. Here, we restricted the Atlas to legs (tibia, femur) of rats in order to work with well known geometry of the bone micro-architecture. From only 6 acquired bone, 132 trabecular bone volumes were generated using simple mathematical morphology tools. The variety and veracity of the created micro-architecture volumes is presented in this paper. Medical application and final goal would be to determinate bone micro-architecture with some angulated radiographs (3 or 4) and to easily diagnose the bone status (healthy, pathological or healing bone...).

Evaluation of the magnitude of hip joint deformation in subjects with avascular necrosis of the hip joint during walking with and without Scottish Rite orthosis.

PubMed

Karimi, Mohammad Taghi; Mohammadi, Ali; Ebrahimi, Mohammad Hossein; McGarry, Anthony

2017-02-01

The femoral head in subjects with leg calve perthes disease (LCPD) is generally considerably deformed. It is debatable whether this deformation is due to an increase in applied loads, a decrease in bone mineral density or a change in containment of articular surfaces. The aim of this study was to determine the influence of these factors on deformation of the femoral head. Two subjects with LCPD participated in this study. Subject motion and the forces applied on the affected leg were recorded using a motion analysis system (Qualsis TM ) and a Kistler force plate. OpenSim software was used to determine joint contact force of the hip joint whilst walking with and without a Scottish Rite orthosis. 3D Models of hip joints of both subjects were produced by Mimics software. The deformation of femoral bone was determined by Abaqus. Mean values of the force applied on the leg increased while walking with the orthosis. There was no difference between bone mineral density (BMD) of the femoral bone of normal and LCPD sides (p-value>0.05) and no difference between hip joint contact force of normal and LCPD sides. Hip joint containment appeared to decrease follow the use of the orthosis. It can be concluded that the deformation of femoral head in LCPD may not be due to change in BMD or applied load. Although the Scottish Rite orthosis is used mostly to increase hip joint containment, it appears to reduce hip joint contact area. It is recommended that a similar study is conducted using a higher number of subjects. Copyright © 2016 IPEM. All rights reserved.

Medial tibial pain: a dynamic contrast-enhanced MRI study.

PubMed

Mattila, K T; Komu, M E; Dahlström, S; Koskinen, S K; Heikkilä, J

1999-09-01

The purpose of this study was to compare the sensitivity of different magnetic resonance imaging (MRI) sequences to depict periosteal edema in patients with medial tibial pain. Additionally, we evaluated the ability of dynamic contrast-enhanced imaging (DCES) to depict possible temporal alterations in muscular perfusion within compartments of the leg. Fifteen patients with medial tibial pain were examined with MRI. T1-, T2-weighted, proton density axial images and dynamic and static phase post-contrast images were compared in ability to depict periosteal edema. STIR was used in seven cases to depict bone marrow edema. Images were analyzed to detect signs of compartment edema. Region-of-interest measurements in compartments were performed during DCES and compared with controls. In detecting periosteal edema, post-contrast T1-weighted images were better than spin echo T2-weighted and proton density images or STIR images, but STIR depicted the bone marrow edema best. DCES best demonstrated the gradually enhancing periostitis. Four subjects with severe periosteal edema had visually detectable pathologic enhancement during DCES in the deep posterior compartment of the leg. Percentage enhancement in the deep posterior compartment of the leg was greater in patients than in controls. The fast enhancement phase in the deep posterior compartment began slightly slower in patients than in controls, but it continued longer. We believe that periosteal edema in bone stress reaction can cause impairment of venous flow in the deep posterior compartment. MRI can depict both these conditions. In patients with medial tibial pain, MR imaging protocol should include axial STIR images (to depict bone pathology) with T1-weighted axial pre and post-contrast images, and dynamic contrast enhanced imaging to show periosteal edema and abnormal contrast enhancement within a compartment.

A quantification strategy for missing bone mass in case of osteolytic bone lesions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fränzle, Andrea, E-mail: a.fraenzle@dkfz.de; Giske, Kristina; Bretschi, Maren

Purpose: Most of the patients who died of breast cancer have developed bone metastases. To understand the pathogenesis of bone metastases and to analyze treatment response of different bone remodeling therapies, preclinical animal models are examined. In breast cancer, bone metastases are often bone destructive. To assess treatment response of bone remodeling therapies, the volumes of these lesions have to be determined during the therapy process. The manual delineation of missing structures, especially if large parts are missing, is very time-consuming and not reproducible. Reproducibility is highly important to have comparable results during the therapy process. Therefore, a computerized approachmore » is needed. Also for the preclinical research, a reproducible measurement of the lesions is essential. Here, the authors present an automated segmentation method for the measurement of missing bone mass in a preclinical rat model with bone metastases in the hind leg bones based on 3D CT scans. Methods: The affected bone structure is compared to a healthy model. Since in this preclinical rat trial the metastasis only occurs on the right hind legs, which is assured by using vessel clips, the authors use the left body side as a healthy model. The left femur is segmented with a statistical shape model which is initialised using the automatically segmented medullary cavity. The left tibia and fibula are segmented using volume growing starting at the tibia medullary cavity and stopping at the femur boundary. Masked images of both segmentations are mirrored along the median plane and transferred manually to the position of the affected bone by rigid registration. Affected bone and healthy model are compared based on their gray values. If the gray value of a voxel indicates bone mass in the healthy model and no bone in the affected bone, this voxel is considered to be osteolytic. Results: The lesion segmentations complete the missing bone structures in a reasonable way. The mean ratiov{sub r}/v{sub m} of the reconstructed bone volume v{sub r} and the healthy model bone volume v{sub m} is 1.07, which indicates a good reconstruction of the modified bone. Conclusions: The qualitative and quantitative comparison of manual and semi-automated segmentation results have shown that comparing a modified bone structure with a healthy model can be used to identify and measure missing bone mass in a reproducible way.« less

Venogram - leg

MedlinePlus

... through the body to form an image on film. Structures that are dense (such as bone) will ... Guidelines Viewers & Players MedlinePlus Connect for EHRs For Developers U.S. National Library of Medicine 8600 Rockville Pike, ...

High femoral bone mineral content and density in male football (soccer) players.

PubMed

Calbet, J A; Dorado, C; Díaz-Herrera, P; Rodríguez-Rodríguez, L P

2001-10-01

This investigation examined the effect that long-term football (soccer) participation may have on areal bone mineral density (BMD) and bone mineral content (BMC) in male football players. Dual energy x-ray absorptiometry (DXA) scans were obtained in 33 recreational male football players active in football for the last 12 yr and 19 nonactive subjects from the same population. Both groups had comparable age (23 +/- 4 yr vs 24 +/- 3 yr), body mass (73 +/- 7 kg vs 72 +/- 11 kg), height (176 +/- 5 cm vs 176 +/- 8 cm), and calcium intake (23 +/- 10 mg.kg(-1).d(-1) vs 20 +/- 11 mg.kg(-1).d(-1) (mean +/- SD). The football players showed 8% greater total lean mass (P < 0.001), 13% greater whole-body BMC (P < 0.001), and 5 units lower percentage body fat (P < 0.001) than control subjects. Lumbar spine (L2-L4) BMC and BMD were 13% and 10% higher, respectively, in the football players than in the control subjects (P < 0.05). Furthermore, football players displayed higher femoral neck BMC (24%, 18%, 23%, and 24% for the femoral neck, intertrochanteric, greater trochanter, and Ward's triangle subregions, respectively, P < 0.05) and BMD (21%, 19%, 21%, and 27%, respectively, P < 0.05) than controls. BMC in the whole leg was 16-17% greater in the football players, mainly because of enhanced BMD (9-10%) but also because of bone hypertrophy, since the area occupied by the osseous pixels was 7% higher (867 +/- 63 cm2 vs 814 +/- 26 cm2, P < 0.05). Leg muscle mass was 11% higher in the football players than in the control subjects (20,635 +/- 2,073 g vs 18,331 +/- 2,301 g, P < 0.001). No differences were found between the legs in either groups for BMC, BMD, and muscle mass. Left leg muscle mass was correlated with femoral neck BMC and BMD (P < 0.001), as well as with lumbar spine (L2-L4) BMC and BMD (P < 0.001). Long-term football participation, starting at prepubertal age, is associated with markedly increased BMC and BMD at the femoral neck and lumbar spine regions.

75 FR 42770 - Notice of Inventory Completion: Denver Museum of Nature & Science, Denver, CO

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-22

... collected), one child of indeterminate sex, and two adults of indeterminate sex. Most of these individuals...), A533.5C (CUI 31), and A533.6A (CUI 32)). Remains include one child, which was reportedly found with... right arm bone of an adult of indeterminate sex (AC.2874; CUI 35) and two leg bones of an adult of...

Prevalence of rickets-like bone deformities in rural Gambian children

PubMed Central

Jones, Helen L.; Jammeh, Lamin; Owens, Stephen; Fulford, Anthony J.; Moore, Sophie E.; Pettifor, John M.; Prentice, Ann

2015-01-01

The aim of this study was to estimate the burden of childhood rickets-like bone deformity in a rural region of West Africa where rickets has been reported in association with a low calcium intake. A population-based survey of children aged 0.5–17.9 years living in the province of West Kiang, The Gambia was conducted in 2007. 6221 children, 92% of those recorded in a recent census, were screened for physical signs of rickets by a trained survey team with clinical referral of suspected cases. Several objective measures were tested as potential screening tools. The prevalence of bone deformity in children < 18.0 years was 3.3%. The prevalence was greater in males (M = 4.3%, F = 2.3%, p < 0.001) and in children < 5.0 years (5.7%, M = 8.3%, F = 2.9%). Knock-knee was more common (58%) than bow-leg (31%) or windswept deformity (9%). Of the 196 examined clinically, 36 were confirmed to have a deformity outside normal variation (47% knock-knee, 53% bow-leg), resulting in more conservative prevalence estimates of bone deformity: 0.6% for children < 18.0 years (M = 0.9%, F = 0.2%), 1.5% for children < 5.0 years (M = 2.3%, F = 0.6%). Three of these children (9% of those with clinically-confirmed deformity, 0.05% of those screened) had active rickets on X-ray at the time of medical examination. This emphasises the difficulties in comparing prevalence estimates of rickets-like bone deformities from population surveys and clinic-based studies. Interpopliteal distance showed promise as an objective screening measure for bow-leg deformity. In conclusion, this population survey in a rural region of West Africa with a low calcium diet has demonstrated a significant burden of rickets-like bone deformity, whether based on physical signs under survey conditions or after clinical examination, especially in boys < 5.0 years. PMID:25871880

Profiles of musculoskeletal development in limbs of college Olympic weightlifters and wrestlers.

PubMed

Kanehisa, H; Fukunaga, T

1999-04-01

To investigate the event-related profiles of musculoskeletal development in weight-categorized athletes, we measured the cross-sectional areas (CSA) of bone and muscle in the forearm, upper arm, lower leg and thigh, using a B-mode ultrasound apparatus, in college Olympic weightlifters (OWL, n = 19) and wrestlers (WR, n = 17) and untrained men (UM, n = 24), whose body masses were within the range from 55 kg to 78 kg. Both bone and muscle CSA at all sites were significantly correlated to the two-thirds power of fat-free mass (FFM(2/3)) with correlation coefficients of 0.430-40.741 (P < 0.05) and 0.608-0.718 (P < 0.05), respectively. Moreover, there were significant correlations between bone and muscle CSA at all sites (r = 0.664-0.829, P < 0.05). Even when bone and muscle CSA were expressed relative value to FFM(2/3), both OWL and WR showed significantly greater values than UM at all sites except for the lower leg. Furthermore, the comparison of the lean (bone + muscle) CSA ratio from site to site indicated a higher distribution of lean tissues in the upper extremities in OWL and WR compared to UM. While there was no significant difference between the two athlete groups in FFM(2/3), OWL showed significantly larger values than WR in the bone CSA of the upper arm and thigh and in the muscle CSA of the lower leg and thigh. However, lean CSA ratios of the upper extremities to the lower ones were significantly higher in WR than in OWL. Thus, the present results indicated that, compared to UM, OWL and WR had a greater lean tissue CSA in limbs, especially in the upper extremities, even when the difference in FFM was normalized. Moreover, the relative distribution of lean tissues in limbs differed between the two weight-categorized athletes in spite of there being no difference in FFM, which may be attributable to their own training regimens and/or competition style.

Ectopic bone formation cannot occur by hydroxyapatite/β-tricalcium phosphate bioceramics in green fluorescent protein chimeric mice

NASA Astrophysics Data System (ADS)

Cheng, Lijia; Duan, Xin; Xiang, Zhou; Shi, Yujun; Lu, Xiaofeng; Ye, Feng; Bu, Hong

2012-12-01

Many studies have shown that calcium phosphate ceramics (CP) have osteoconductive and osteoinductive properties; however, the exact mechanism of bone induction has not yet been reported. This study was performed to investigate if destroying immunological function will influence osteogenesis, to explain the mechanism which is unclear. In this study, twenty C57BL/6 mice were divided into two groups (n = 10), in group 1, a hydroxyapatite/β-tricalcium phosphate (HA/β-TCP) ceramic was implanted into both the left and right leg muscles of each mouse; in group 2, ten mice experienced lethal irradiation, then were injected bone marrow (BM) cells from green fluorescent protein (GFP) transgenic mice by tail veil, after bone marrow transplantation (BMT), heart, liver, spleen, lung, kidney, and muscle were harvested for biological analysis, after the GFP chimera model was established successfully, the same HA/β-TCP ceramic was implanted into both leg muscles of each mouse immediately after irradiation. 45 and 90 days after implantation, the ceramics of the two groups were harvested to perform with hematoxylin and eosin (HE) and immunohistochemistry (IHC) staining; the results showed that there was no bone formation in group 2, while new bone tissues were detected in group 1. Our findings suggest that the BM cell from GFP transgenic mice is a good biomarker and it could set a good platform for chimera model; it also shows that BM cell is one of cell resources of bone induction, and destruction of immune function will impede osteoinduction by CP. Overall, our results may shed light on clear mechanism study of bone induction in the future.

Regional, but not total, body composition changes in overweight and obese adults consuming a higher protein, energy-restricted diet are sex specific.

PubMed

Tang, Minghua; Leidy, Heather J; Campbell, Wayne W

2013-08-01

Secondary analyses of data from 2 studies were used to assess the effects of protein intake and sex on diet-induced changes in body composition. The primary hypothesis was that the changes of body composition via energy restriction (ie, lean body mass [LBM], fat mass [FM], and bone) would be sex and diet specific. For 12 weeks, 43 male (study 1) and 45 female (study 2) overweight and obese adults consumed an energy-deficit diet (750 kcal/d less than energy needs) containing either 0.8 (normal protein [NP], 21 men and 23 women) or 1.4 g protein∙kg(-1)∙d(-1) (high protein [HP], 22 men and 22 women). Body composition measurements were performed at preintervention and postintervention. Over time, all research participants lost weight, LBM, and FM. Independent of protein intake, the men lost more LBM in the trunk (-0.9 vs -0.5 kg) and less in the legs (-1.5 vs -1.1 kg) compared with the women (P < .05). Independent of sex, the HP group lost less LBM in the trunk and legs than the NP group. These sex and protein intake responses resulted in the NP men losing the most LBM in the legs and the NP women losing the most LBM in the trunk. Over time, men lost more FM (-5.0 vs -3.9 kg) from the trunk and less from legs (-1.7 vs -2.1 kg) than women (P < .05), which resulted in a greater decrease of the android-to-gynoid fat ratio for the men. Protein intake did not influence these sex-specific responses or have any independent effects on changes in FM. In addition, protein intake did not influence bone mineral density responses over time; bone mineral density was reduced in women, but not in men. These findings indicate that higher protein intake during weight loss promotes the retention of LBM in both the trunk and legs despite the sex-specific changes in these body regions. Copyright © 2013 Elsevier Inc. All rights reserved.

Movement of the sacroiliac joint during the Active Straight Leg Raise test in patients with long-lasting severe sacroiliac joint pain.

PubMed

Kibsgård, Thomas J; Röhrl, Stephan M; Røise, Olav; Sturesson, Bengt; Stuge, Britt

2017-08-01

The Active Straight Leg Raise is a functional test used in the assessment of pelvic girdle pain, and has shown to have good validity, reliability and responsiveness. The Active Straight Leg Raise is considered to examine the patients' ability to transfer load through the pelvis. It has been hypothesized that patients with pelvic girdle pain lack the ability to stabilize the pelvic girdle, probably due to instability or increased movement of the sacroiliac joint. This study examines the movement of the sacroiliac joints during the Active Straight Leg Raise in patients with pelvic girdle pain. Tantalum markers were inserted in the dorsal sacrum and ilium of 12 patients with long-lasting pelvic girdle pain scheduled for sacroiliac joint fusion surgery. Two to three weeks later movement of the sacroiliac joints during the Active Straight Leg Raise was measured with radiostereometric analysis. Small movements were detected. There was larger movement of the sacroiliac joint of the rested leg's sacroiliac joint compared to the lifted leg's side. A mean backward rotation of 0.8° and inward tilt of 0.3° were seen in the rested leg's sacroiliac joint. The movements of the sacroiliac joints during the Active Straight Leg Raise are small. There was a small backward rotation of the innominate bone relative to sacrum on the rested leg's side. Our findings contradict an earlier understanding that a forward rotation of the lifted leg's innominate occur while performing the Active Straight Leg Raise. Copyright © 2017. Published by Elsevier Ltd.

Orthopedic pathology of the lower extremities: scintigraphic evaluation in the thigh, knee, and leg.

PubMed

Etchebehere, E C; Etchebehere, M; Gamba, R; Belangero, W; Camargo, E E

1998-01-01

Radionuclide imaging (RI) of the osseous and nonosseous structures of the thigh, knee, and leg provide important diagnostic and prognostic information upon which the orthopedic surgeon can base treatment planning and management decisions. 99mTc-MDP scintigraphy is essential in overuse injuries such as stress fractures and shin splints. RI is important in assessing complications of trauma. It is the only imaging modality able to assess the magnitude of physeal stimulus caused by femoral fractures and to predict a favorable or unfavorable outcome of leg length by semiquantitative analysis; SPECT imaging can detect and locate decreased metabolism associated with posttraumatic closure of the physeal plate to predict growth arrest and deformities. Three-phase bone imaging (TPBI) is essential to differentiate hypervascular from avascular nonunions and follow delayed union. In osteonecrosis of the knee, bone scintigraphy precedes radiography changes even in stage l of the disease. 99mTc-MDP and 99mTc-HIG imaging are powerful tools in determining the outcomes of osteoarthritis and rheumatoid arthritis, respectively. Bone scintigraphy can also detect chronic ligament and acute and chronic meniscal lesions. The combined use of TPBI, gallium-67 citrate imaging, and indium-111 or 99mTc-HMPAO labeled leukocytes is important to diagnose and differentiate acute from chronic osteomyelitis, and to detect infected knee prostheses. Thallium-201 chloride imaging and 99mTc-sestamibi imaging have an important role in the assessment of tumor response to chemotherapy and in the quantification of tumor viability.

The use of dual-energy X-ray absorptiometry to estimate the dissected composition of lamb carcasses.

PubMed

Mercier, J; Pomar, C; Marcoux, M; Goulet, F; Thériault, M; Castonguay, F W

2006-06-01

A total of 140 male and female Dorset and Suffolk lambs were slaughtered according to four live weight classes (36-39kg, 41-44kg, 46-49kg and 51-54kg). Total tissue, fat and lean masses, and bone mineral content measured by dual-energy X-ray absorptiometry (DXA) were used to predict dissected tissue weights. The DXA total weights accurately predict half-carcasses and primal cuts weights (shoulder, leg, loin and flank) (R(2)>0.99, CVe<1.3%). The prediction of the half-carcass dissected fat percentage is weaker (R(2)=0.77, CVe=10.4%). Fatness prediction accuracy is equivalent for the shoulder, leg and loin (R(2) between 0.68 and 0.78, CVe between 10% and 13%). The R(2) obtained when predicting dissected lean content from DXA variables is 0.93 for the half-carcass and higher than 0.83 for all cuts other than flank (CVe are between 3.5% and 6.5%, except for the flank, which is 9.1%). The prediction of bone weight using the bone mineral content is not very accurate for the half-carcass, shoulder and leg (R(2): 0.48, 0.47 and 0.43; CVe: 10.2%, 12.0% and 11.6%, respectively). The situation improves, however, for the loin (R(2)=0.70, CVe=10.7%). In conclusion, DXA is an effective technology for predicting total weight and the amount of lean and fat in lamb carcasses and their primal cuts.

Allometry in dinosaurs and mammals

NASA Astrophysics Data System (ADS)

Lee, Scott

2015-03-01

The proportions of the leg bones change as the size of an animal becomes larger since the mass of the animal increases at a faster rate than the cross-sectional area of its leg bones. For the case of elastic similarity (in which the longitudinal stress in the legs remains constant in animals of all sizes), the diameter d and length L of the femur should be related as d = A L3/2. For geometric similarity (in which all dimensions are scaled by the same factor), d = A L. For animals with femora longer than 20 cm, we find the power law relationship to be d = A Lb with b = 1.13 +/- 0.06 for extant mammals (the largest mammal being Loxodonta africana with a 1.00-m-long femur) and b = 1.18 +/- 0.02 for dinosaurs (the largest dinosaur being Brachiosaurus brancai with a 2.03-m-long femur). These data show that extinct dinosaurs and extant animals scale in the same basic manner. The large sauropods (with femora twice as long as found in elephants) scale in a manner consistent with extrapolation of the scaling shown by extant mammals. These results argue that extinct dinosaurs moved in a manner very similar to extant mammals.

p53 Regulates Bone Differentiation and Osteosarcoma Formation | Center for Cancer Research

Cancer.gov

Osteosarcoma is an uncommon cancer that usually begins in the large bones of the arm or leg, but is the second leading cause of cancer-related death in children and young adults. The tumor suppressor protein, p53, appears to be an important player in osteosarcomagenesis in part because these cancers are one of the most common to develop in patients with Li-Fraumeni syndrome,

Atrophic femoral nonunion with bone loss: treatment with monorail transport: a case report.

PubMed

Gay, David M; Voss, Frank R

2004-08-01

Nonunions are an uncommon outcome of femoral fractures. Atrophic nonunions with a leg length discrepancy secondary to bone loss are often the most difficult to treat, and the treatment options are limited. We present a case that uses concomitant monolateral external fixation and intramedullary nailing to heal a nonunion and perform a simultaneous 7-cm lengthening procedure in a 33-year-old female.

Slow Recovery of Weight Bearing After Stabilization of Long-Bone Fractures Using Elastic Stable Intramedullary Nails in Children

PubMed Central

Lardelli, Patrizia; Frech-Dörfler, Martina; Holland-Cunz, Stefan; Mayr, Johannes

2016-01-01

Abstract Stabilization of diaphyseal long-bone fractures using elastic stable intramedullary nails (ESIN) in children promises early mobilization and rapid resumption of full weight bearing. We evaluated the duration of postoperative functional rehabilitation after ESIN, measured by the time from stabilization until first partial weight bearing, full weight bearing, and resumption of school sports. Fifty children with unstable, displaced fractures of the femur or lower leg treated with ESIN between 2002 and 2012 were included in this retrospective analysis. We classified fractures according to the pediatric comprehensive classification of fractures (PCCF). Thirty-five children sustained a femur fracture, and 15 children had a fracture of the lower leg or tibia. The surgeons in charge applied an additional plaster cast in 7 of 15 children who suffered a lower leg fracture. The postoperative time interval until full weight bearing in the group of children who had suffered transverse or short oblique femur fractures was significantly shorter (median: 4.4 weeks; range: 0.1–9.1 weeks) than that in the group who had sustained more complex fracture patterns (median: 6.8 weeks; range: 2.9–13.9 weeks; P = 0.04). Similarly, transverse and short oblique lower leg and tibia fractures required less time until full weight bearing (median: 4.1 weeks; range 2.7–6.0 weeks) than complex lower leg fractures (median: 6.1 weeks; range: 1.3–12.9 weeks; P = 0.04). ESIN proved fairly effective in restoring full weight bearing in transverse or short oblique fractures of the lower extremities but was less effective in complex fractures. PMID:26986106

Slow Recovery of Weight Bearing After Stabilization of Long-Bone Fractures Using Elastic Stable Intramedullary Nails in Children.

PubMed

Lardelli, Patrizia; Frech-Dörfler, Martina; Holland-Cunz, Stefan; Mayr, Johannes

2016-03-01

Stabilization of diaphyseal long-bone fractures using elastic stable intramedullary nails (ESIN) in children promises early mobilization and rapid resumption of full weight bearing. We evaluated the duration of postoperative functional rehabilitation after ESIN, measured by the time from stabilization until first partial weight bearing, full weight bearing, and resumption of school sports. Fifty children with unstable, displaced fractures of the femur or lower leg treated with ESIN between 2002 and 2012 were included in this retrospective analysis. We classified fractures according to the pediatric comprehensive classification of fractures (PCCF). Thirty-five children sustained a femur fracture, and 15 children had a fracture of the lower leg or tibia. The surgeons in charge applied an additional plaster cast in 7 of 15 children who suffered a lower leg fracture. The postoperative time interval until full weight bearing in the group of children who had suffered transverse or short oblique femur fractures was significantly shorter (median: 4.4 weeks; range: 0.1-9.1 weeks) than that in the group who had sustained more complex fracture patterns (median: 6.8 weeks; range: 2.9-13.9 weeks; P = 0.04). Similarly, transverse and short oblique lower leg and tibia fractures required less time until full weight bearing (median: 4.1 weeks; range 2.7-6.0 weeks) than complex lower leg fractures (median: 6.1 weeks; range: 1.3-12.9 weeks; P = 0.04). ESIN proved fairly effective in restoring full weight bearing in transverse or short oblique fractures of the lower extremities but was less effective in complex fractures.

Eyes, bones and teeth in the 16th century Statute law of Rijeka.

PubMed

Milovic, Dorde; Milovic Karic, Grozdana

2008-01-01

The 16th century statute law or the town of Rijeka treats the eye in two ways. First, it stipulates a severe punishment for deliberate "eye-plucking". Second, for those who commit this crime, it specifies "eye-plucking" as a corporeal punishment (following the eye-for-an-eye principle).The 1530 Statute of Rijeka also pays considerable attention to the bones. Bone breaking by means of intentional or unintentional blow was fined 25 libras (pounds) for the following bones: thighbone, forearm and hand bones, lower leg bone, and foot bone. A fine of 10 libras applied for all other intentional or unintentional bone breaking by a blow. Legal protection of teeth involved a fine of five libras for each of the teeth blown out, and half the fine for a broken tooth. Both fines applied whether the offence was done on purpose or not.

Whole-body 3D kinematics of bird take-off: key role of the legs to propel the trunk

NASA Astrophysics Data System (ADS)

Provini, Pauline; Abourachid, Anick

2018-02-01

Previous studies showed that birds primarily use their hindlimbs to propel themselves into the air in order to take-off. Yet, it remains unclear how the different parts of their musculoskeletal system move to produce the necessary acceleration. To quantify the relative motions of the bones during the terrestrial phase of take-off, we used biplanar fluoroscopy in two species of birds, diamond dove ( Geopelia cuneata) and zebra finch ( Taeniopygia guttata). We obtained a detailed 3D kinematics analysis of the head, the trunk and the three long bones of the left leg. We found that the entire body assisted the production of the needed forces to take-off, during two distinct but complementary phases. The first one, a relatively slow preparatory phase, started with a movement of the head and an alignment of the different groups of bones with the future take-off direction. It was associated with a pitch down of the trunk and a flexion of the ankle, of the hip and, to a lesser extent, of the knee. This crouching movement could contribute to the loading of the leg muscles and store elastic energy that could be released in the propulsive phase of take-off, during the extension of the leg joints. Combined with the fact that the head, together with the trunk, produced a forward momentum, the entire body assisted the production of the needed forces to take-off. The second phase was faster with mostly horizontal forward and vertical upward translation motions, synchronous to an extension of the entire lower articulated musculoskeletal system. It led to the propulsion of the bird in the air with a fundamental role of the hip and ankle joints to move the trunk upward and forward. Take-off kinematics were similar in both studied species, with a more pronounced crouching movement in diamond dove, which can be related to a large body mass compared to zebra finch.

Fatigue characteristics and biocompatability of a totally implantable bone growth stimulator in ponies.

PubMed

Collier, M A; Lowe, J E; Rendano, V T

1985-01-01

Materials fatigue and gross biocompatability of an implantable bone growth stimulator (BGS) were assessed in a 6-month trial using 6 ponies. The forelegs of each pony were implanted with a BGS; the right leg implant had the cathode and cathode lead preconnected by the manufacturer, and the left leg implant was connected at surgery. Evaluation was by radiographic and clinical examination at the beginning and end of the experimental period. Six of the 12 cathode leads (50%) and 7 of the 12 cathodes (58%) were broken at 6 months. All of the implanted preconnected cathode and insulated cathode leads and 33.3% of the surgically connected cathodes and insulated cathode leads were connected at the titanium connector socket at 6 months. This BGS may exhibit wire fatigue greater than 50% of the time when used in the distal extremity of the horse.

Caffey disease in neonatal period: the importance of the family!

PubMed

Prior, Ana Rita; Moldovan, Oana; Azevedo, António; Moniz, Carlos

2012-10-09

A male newborn was apparently well until his second day of life, when increased irritability and a swelling in his right leg were noted. He was rooming-in with his mother since birth. On examination, a mass on the anterior surface of the right leg was noticed. The mass was firm, elongated, ill-defined, unmovable and painful at palpation. No overlying skin changes were seen. The newborn had a family history of neonatal bone swelling with resolution before the age of 2. Subsequent images showed hyperostosis in the diaphysis of the right tibia. After exclusion of other conditions such as trauma, osteomyelitis and congenital syphilis, the involvement of the tibial diaphysis, sparing the epiphyses and the benign course of the disease in family history, were indicative of Caffey disease. The genetic study confirmed this diagnosis. Caffey disease, although rare, should not be overlooked in the diagnostic approach to childhood bone swelling.

The specific scintigraphic pattern of "shin splints in the lower leg": concise communication.

PubMed

Holder, L E; Michael, R H

1984-08-01

The clinical entity, "shin splints," is now being recognized, and more specifically characterized by the findings of exercise-induced pain and tenderness to palpation along the posterior medial border of the tibia. In this prospective study, ten patients with this syndrome were evaluated using three-phase bone scintigrams, and a specific scintigraphic pattern was determined. Radionuclide angiograms and blood-pool images were all normal. On delayed images, tibial lesions involved the posterior cortex, were longitudinally oriented, were long, involving one third of the length of the bone, and often showed varying tracer uptake along that length. Obtaining both lateral and medial views was crucial. The location of activity suggested that this entity is related to the soleus muscle. These scintigraphic findings can be used to differentiate shin splints from stress fractures or other conditions causing pain in the lower leg in athletes.

Caffey disease in neonatal period: the importance of the family!

PubMed Central

Prior, Ana Rita; Moldovan, Oana; Azevedo, António; Moniz, Carlos

2012-01-01

A male newborn was apparently well until his second day of life, when increased irritability and a swelling in his right leg were noted. He was rooming-in with his mother since birth. On examination, a mass on the anterior surface of the right leg was noticed. The mass was firm, elongated, ill-defined, unmovable and painful at palpation. No overlying skin changes were seen. The newborn had a family history of neonatal bone swelling with resolution before the age of 2. Subsequent images showed hyperostosis in the diaphysis of the right tibia. After exclusion of other conditions such as trauma, osteomyelitis and congenital syphilis, the involvement of the tibial diaphysis, sparing the epiphyses and the benign course of the disease in family history, were indicative of Caffey disease. The genetic study confirmed this diagnosis. Caffey disease, although rare, should not be overlooked in the diagnostic approach to childhood bone swelling. PMID:23047998

Clinical evaluation of an allogeneic bone matrix containing viable osteogenic cells in patients undergoing one- and two-level posterolateral lumbar arthrodesis with decompressive laminectomy.

PubMed

Musante, David B; Firtha, Michael E; Atkinson, Brent L; Hahn, Rebekah; Ryaby, James T; Linovitz, Raymond J

2016-05-27

Trinity Evolution® cellular bone allograft (TE) possesses the osteogenic, osteoinductive, and osteoconductive elements essential for bone healing. The purpose of this study is to evaluate the radiographic and clinical outcomes when TE is used as a graft extender in combination with locally derived bone in one- and two-level instrumented lumbar posterolateral arthrodeses. In this retrospective evaluation, a consecutive series of subject charts that had posterolateral arthrodesis with TE and a 12-month radiographic follow-up were evaluated. All subjects were diagnosed with degenerative disc disease, radiculopathy, stenosis, and decreased disc height. At 2 weeks and at 3 and 12 months, plain radiographs were performed and the subject's back and leg pain (VAS) was recorded. An evaluation of fusion status was performed at 12 months. The population consisted of 43 subjects and 47 arthrodeses. At 12 months, a fusion rate of 90.7 % of subjects and 89.4 % of surgical levels was observed. High-risk subjects (e.g., diabetes, tobacco use, etc.) had fusion rates comparable to normal patients. Compared with the preoperative leg or back pain level, the postoperative pain levels were significantly (p < 0.0001) improved at every time point. There were no adverse events attributable to TE. Fusion rates using TE were higher than or comparable to fusion rates with autologous iliac crest bone graft that have been reported in the recent literature for posterolateral fusion procedures, and TE fusion rates were not adversely affected by several high-risk patient factors. The positive results provide confidence that TE can safely replace autologous iliac crest bone graft when used as a bone graft extender in combination with locally derived bone in the setting of posterolateral lumbar arthrodesis in patients with or without risk factors for compromised bone healing. Because of the retrospective nature of this study, the trial was not registered.

Computational Evaluation of the Effects of Bone Ingrowth on Bone Resorptive Remodeling after a Cementless Total Hip Arthroplasty

NASA Astrophysics Data System (ADS)

Jung, Duk-Young; Kang, Yu-Bong; Tsutsumi, Sadami; Nakai, Ryusuke; Ikeuchi, Ken; Sekel, Ron

In this study, we simulated a wide cortex separation from a cementless hip prosthesis using the bone resorption remodeling method that is based on the generation of high compressive stress around the distal cortical bone. Thereafter, we estimated the effect on late migration quantities of the hip prosthesis produced by the interface state arising from bone ingrowth. This was accomplished using cortical bone remodeling over a long period of time. Two-dimensional natural hip and implanted hip FEM models were constructed with each of the following interface statements between the bone and prosthesis: (1) non-fixation, (2) proximal 1/3, (3) proximal 2/3 and (4) full-fixation. The fixation interfaces in the fully and partially porous coated regions were rigidly fixed by bony ingrowth. The non-fixation model was constructed as a critical situation, with the fibrous or bony tissue not integrated at all into the implant surface. The daily load history was generated using the three loading cases of a one-legged stance as well as abduction and adduction motions. With the natural hip and one-legged stance, the peak compressive principal stresses were found to be under the criteria value for causing bone resorption, while no implant movement occurred. The migration magnitude of the stem of the proximal 1/3 fixation model with adduction motion was much higher, reaching 6%, 11%and 21%greater than those of the non-fixation, proximal 2/3 fixation and all-fixation models, respectively. The full-fixation model showed the lowest compressive principal stress and implant movement. Thus, we concluded that the late loosening and subsequent movement of the stem in the long term could be estimated with the cortical bone remodeling method based on a high compressive stress at the bone-implant interface. The change caused at the bone-prosthesis interface by bony or fibrous tissue ingrowth constituted the major factor in determining the extent of cortical bone resorption occurring with clinical loosening and subsequent implant movement.

Locomotor variation and bending regimes of capuchin limb bones.

PubMed

Demes, Brigitte; Carlson, Kristian J

2009-08-01

Primates are very versatile in their modes of progression, yet laboratory studies typically capture only a small segment of this variation. In vivo bone strain studies in particular have been commonly constrained to linear locomotion on flat substrates, conveying the potentially biased impression of stereotypic long bone loading patterns. We here present substrate reaction forces (SRF) and limb postures for capuchin monkeys moving on a flat substrate ("terrestrial"), on an elevated pole ("arboreal"), and performing turns. The angle between the SRF vector and longitudinal axes of the forearm or leg is taken as a proxy for the bending moment experienced by these limb segments. In both frontal and sagittal planes, SRF vectors and distal limb segments are not aligned, but form discrepant angles; that is, forces act on lever arms and exert bending moments. The positions of the SRF vectors suggest bending around oblique axes of these limb segments. Overall, the leg is exposed to greater moments than the forearm. Simulated arboreal locomotion and turns introduce variation in the discrepancy angles, thus confirming that expanding the range of locomotor behaviors studied will reveal variation in long bone loading patterns that is likely characteristic of natural locomotor repertoires. "Arboreal" locomotion, even on a linear noncompliant branch, is characterized by greater variability of force directions and discrepancy angles than "terrestrial" locomotion (significant for the forearm only), partially confirming the notion that life in trees is associated with greater variation in long bone loading. Directional changes broaden the range of external bending moments even further.

A finite element model of the foot and ankle for automotive impact applications.

PubMed

Shin, Jaeho; Yue, Neng; Untaroiu, Costin D

2012-12-01

A finite element (FE) model of the foot and leg was developed to improve understanding of injury mechanisms of the ankle and subtalar joints during vehicle collisions and to aid in the design of injury countermeasures. The FE model was developed based on the reconstructed geometry of a male volunteer close to the anthropometry of a 50th percentile male and a commercial anatomical database. While the forefoot bones were defined as rigid bodies connected by ligament models, the surrounding bones of the ankle and subtalar joints and the leg bones were modeled as deformable structures. The material and structural properties were selected based on a synthesis of current knowledge of the constitutive models for each tissue. The whole foot and leg model was validated in different loading conditions including forefoot impact, axial rotation, dorsiflexion, and combined loadings. Overall results obtained in the model validation indicated improved biofidelity relative to previous FE models. The developed model was used to investigate the injury tolerance of the ankle joint under brake pedal loading for internally and externally rotated feet. Ligament failures were predicted as the main source of injury in this loading condition. A 12% variation of failure moment was observed in the range of axial foot rotations (±15°). The most vulnerable position was the internally rotated (15°) posture among three different foot positions. Furthermore, the present foot and ankle model will be coupled together with other body region FE models into the state-of-art human FE model to be used in the field of automotive safety.

Effects of focal vibration on bone mineral density and motor performance of postmenopausal osteoporotic women.

PubMed

Brunetti, O; Botti, F M; Brunetti, A; Biscarini, A; Scarponi, A M; Filippi, G M; Pettorossi, V E

2015-01-01

This randomized double blind controlled study is aimed at determining the effect of repeated vibratory stimuli focally applied to the contracted quadriceps muscles (repeated muscle vibration=rMV) on bone mineral density, leg power and balance of postmenopausal osteoporotic women. The study has been conducted on 40 voluntary postmenopausal osteoporotic women, randomised at 2 groups for rMV treatment and for control. The treatment group underwent rMV (100Hz, 300-500 μm; three applications per day, each lasting 10-minutes, for 3 consecutive days) applied to voluntary contracted quadriceps (VC=vibrated and contracted group). The control group, received a sham stimulation on contracted quadriceps (NV=non vibrated group). Bone mineral density T-score of proximal femur of the participants, was evaluated in two weeks before and 360 days after intervention; body balance and explosive leg power were measured 1 day before, 30 days and 360 days after treatment. VC group T-score at one year didn't change significantly relative to baseline values (pretreatment: -2.61±0.11, post-treatment -2.62±0.13); conversely in NV subjects T-score decreased significantly from -2.64 ± 0.15 SD down to -2.99 ± 0.28 SD. A significant improvement of balance and explosive leg power was observed only in VC group at 30 and 360 days after the intervention. We conclude that rMV is a safe, short-lasting and non-invasive treatment that can significantly and persistently improve muscle performance and can effectively counteract progressive demineralisation in postmenopausal and osteoporotic women.

Long-bone fractures in persons with spinal cord injury.

PubMed

Frotzler, A; Cheikh-Sarraf, B; Pourtehrani, M; Krebs, J; Lippuner, K

2015-09-01

Retrospective data analysis. To document fracture characteristics, management and related complications in individuals with traumatic spinal cord injury (SCI). Rehabilitation centre for SCI individuals. Patients' records were reviewed. Patients with traumatic SCI and extremity fractures that had occurred after SCI were included. Patient characteristics, fractured bone, fracture localisation, severity and management (operative/conservative), and fracture-related complications were extracted. A total of 156 long-bone fractures in 107 SCI patients (34 women and 73 men) were identified. The majority of patients were paraplegics (77.6%) and classified as American Spinal Injury Association Impairment Scale A (86.0%). Only the lower extremities were affected, whereby the femur (60.9% of all fractures) was fractured more frequently than the lower leg (39.1%). A total of 70 patients (65.4%) had one fracture, whereas 37 patients (34.6%) had two or more fractures. Simple or extraarticular fractures were most common (75.0%). Overall, 130 (83.3%) fractures were managed operatively. Approximately half of the femur fractures (48.2%) were treated with locking compression plates. In the lower leg, fractures were mainly managed with external fixation (48.8%). Conservative fracture management was applied in 16.7% of the cases and consisted of braces or a well-padded soft cast. Fracture-associated complications were present in 13.5% of the cases but did not differ significantly between operative (13.1%) and conservative (15.4%) fracture management. SCI was associated with simple or extraarticular fractures of the distal femur and the lower leg. Fractures were mainly managed operatively with a low complication rate.

Follow-up of bone lesions in an experimental multiple myeloma mouse model: description of an in vivo technique using radiography dedicated for mammography.

PubMed Central

Vanderkerken, K.; Goes, E.; De Raeve, H.; Radl, J.; Van Camp, B.

1996-01-01

The evolution of bone lesions in transplantable C57BL/KaLwRjj 5T mouse myeloma (MM) has been followed in vivo. Mice were anaesthetised and a radiograph of the pelvis and hind legs was performed by a radiograph dedicated for mammography. This is the first description of an in vivo technique under experimental conditions whereby the development of bone lesions owing to the MM growth was demonstrated. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 6 PMID:8664113

Diverse bone scan abnormalitites in "shin splints".

PubMed

Spencer, R P; Levinson, E D; Baldwin, R D; Sziklas, J J; Witek, J T; Rosenberg, R

1979-12-01

Four young patients who presented with pain over the anterior compartment of the legs, gave a recent athletic history suggesting stress fractures. Although radiographs were initially normal in all four cases, the bone scintigrams were positive. The individual findings, however, were quite different. In one there was a single focal area of increased radioactivity in each of the tibias; the second patient had uneven uptake of radiotracer and several foci of accumulation in the fibulas; the third showed diffuse linear tibial uptake suggesting periosteal lesions; and the fourth case revealed uptake in the lateral malleolus and in bones of the foot.

Do sporting activities convey benefits to bone mass throughout the skeleton?

PubMed

Nevill, Alan; Holder, Roger; Stewart, Arthur

2004-07-01

It is well known that sport and exercise play an important role in stimulating site-specific bone mineral density (BMD). However, what is less well understood is how these benefits dissipate throughout the body. Hence, the aim of the present study was to compare the BMD (recorded at nine sites throughout the skeleton) of 106 male athletes (from nine sports) with that of 15 male non-exercising age-matched controls. Given that BMD is known to increase with body mass and peak with age, multivariate and univariate analyses of covariance were performed to compare the BMD of the nine sports groups with controls (at all sites) using body mass and age as covariates. Our results confirmed a greater adjusted BMD in the arms of the upper-body athletes, the right arm of racket players and the legs of runners (compared with controls), supporting the site-specific nature (i.e. specific to the externally loaded site) of the bone remodelling response (all P <0.01). However, evidence that bone mass acquisition is not just site-specific comes from the results of the rugby players, strength athletes, triathletes and racket players. The rugby players' adjusted BMD was the greatest of all sports groups and greater than controls at all nine sites (all P <0.01), with differences ranging from 8% greater in the left arm to 21% in the lumbar spine. Similarly, the strength athletes' adjusted BMD was superior to that of controls at all sites (P <0.05) except the legs. The adjusted BMD of the triathletes was significantly greater than that of the controls in both the arms and the legs as well as the thoracic and lumbar spine. The racket players not only had significantly greater right arm BMD compared with the controls but also a greater BMD of the lumbar spine, the pelvis and legs. In contrast, the low-strain, low-impact activities of keep-fit, cycling and rowing failed to benefit BMD compared with the age-matched controls. These results suggest that sporting activities involving high impact, physical contact and/or rotational forces or strains are likely to convey significant benefits not only to the loaded sites, but also to other unloaded peripheral and axial sites throughout the skeleton.

The relationship between objectively assessed physical activity and bone health in older adults differs by sex and is mediated by lean mass.

PubMed

McMillan, L B; Aitken, D; Ebeling, P; Jones, G; Scott, D

2018-03-12

Relationships between objectively assessed free-living physical activity (PA) and changes in bone health over time are poorly understood in older adults. This study suggests these relationships are sex-specific and that body composition may influence the mechanical loading benefits of PA. To investigate associations of objectively assessed PA and bone health in community-dwelling older adults. This secondary analysis of a subset of the Tasmanian Older Adult Cohort study included participants with PA assessed utilising ActiGraph GT1M accelerometers over 7 days (N = 209 participants, 53% female; mean ± SD age 64.5 ± 7.2 years). Steps/day and PA intensity were estimated via established thresholds. Bone mineral content (BMC) was acquired at the total hip, lumbar spine, legs and whole body by DXA at baseline and approximately 2.2 years later. Relationships between PA and BMC were assessed by multivariable linear regression analyses adjusted for age, smoking status, height and total lean mass. Men with above-median total hip BMC completed significantly less steps per day, but there was no significant difference in PA intensity compared with those with below-median BMC. There were no significant differences in PA in women stratified by median BMC. In women, steps/day were positively associated with leg BMC (B = 0.178; P = 0.017), and sedentary behaviour was negatively associated with leg BMC (- 0.165; 0.016) at baseline. After adjustment for confounders including lean mass and height, higher sedentary behaviour at baseline was associated with declines in femoral neck BMC (- 0.286; 0.011) but also with increases in pelvic BMC (0.246; 0.030) in men and increases in total hip BMC (0.215; 0.032) in women, over 2.2 years. No other significant longitudinal associations were observed after adjustment for body composition. Associations of accelerometer-determined sedentary behaviour and PA with bone health in older adults differ by sex and anatomical site and are mediated by body composition.

Perches and elevated platforms in commercial broiler farms: use and effect on walking ability, incidence of tibial dyschondroplasia and bone mineral content.

PubMed

Kaukonen, E; Norring, M; Valros, A

2017-05-01

Modern fast-growing broilers spend excessive periods resting and their activity further decreases with age. Inactivity has been suggested to increase impaired gait and the incidence of leg disorders. Tibial dyschondroplasia (TD) is a common leg pathology in broilers. A more complex environment might facilitate more activity and improve leg health. Perches or elevated platforms bring variety to broilers' environment and could motivate more locomotion. This study examined the impact of perches and elevated platforms on walking ability, the occurrence of TD and level of bone ash and mineral contents. The investigation was performed on four commercial broiler farms throughout six consecutive batches with platforms and four to five with perches. On each farm at least two separate houses were included, enabling the comparison of furnished flocks to control flocks during each batch. Plastic slats with ramp access elevated by 30 cm or wooden perches of 10 and 30 cm height were offered in the furnished house. Farmers recorded the platform and perch usage twice a week with a five-point scale. Gait was scored before slaughter on a six-point scale according to the Welfare Quality® assessment protocol for poultry. The severity of TD was determined using a four-point scale on farm from all birds gait scored as 3 and at slaughter from 200 birds/flock. Farmers estimated 50% to 100% of the platforms to be occupied in all flocks throughout the entire growing period. Only single birds were perching, thus perch structures were constantly evaluated to be empty. Due to the low use, the perch-equipped houses were excluded when analysing bone content, walking ability and TD. On average, 30% of the tested birds exhibited gait score ⩾3. Younger scoring age resulted in a lower mean gait score and a lower percentage of scores 3 and 4 to 5. Overall, 2.3% of the birds examined at slaughter and 3.5% of the birds with gait score 3 were affected by TD. Leg health was better in birds with access to platforms: mean gait score, the percentage of birds scoring 3, and TD percentage and severity were lower in birds in platform-equipped houses. Elevated structures such as platforms, offering additional possibilities for locomotion to broilers seem to improve their leg health.

[Penetrating injury of the lungs and multiple injuries of lower extremities caused by aircraft bombs splinters].

PubMed

Golubović, Zoran; Stanić, Vojkan; Trenkić, Srbobran; Stojiljković, Predrag; Stevanović, Goran; Lesić, Aleksandar; Golubović, Ivan; Milić, Dragan; Visnjić, Aleksandar; Najman, Stevo

2010-08-01

Injuries caused by aircraft bombs cause severe damages to the human body. They are characterized by massive destruction of injured tissues and organs, primary contamination by polymorph bacterial flora and modified reactivity of the body. Upon being wounded by aircraft bombs projectiles a victim simultaneously sustains severe damages of many organs and organ systems due to the fact that a large number of projectiles at the same time injure the chest, stomach, head and extremities. We presented a patient, 41 years of age, injured by aircraft bomb with hemo-pneumothorax and destruction of the bone and soft tissue structures of the foot, as well as the treatment result of such heavy injuries. After receiving thoracocentesis and short reanimation, the patient underwent surgical procedure. The team performed thoracotomy, primary treatment of the wound and atypical resection of the left lung. Thoracic drains were placed. The wounds on the lower leg and feet were treated primarily. Due to massive destruction of bone tissue of the right foot by cluster bomb splinters, and impossibility of reconstruction of the foot, guillotine amputation of the right lower leg was performed. Twelve days after the wounding caused by cluster bomb splinters, soft tissue of the left lower leg was covered by Tirsch free transplant and the defect in the area of the left foot was covered by dorsalis pedis flap. The transplant and flap were accepted and the donor sites were epithelized. Twenty-six days following the wounding reamputation was performed and amputation stump of the right lower leg was closed. The patient was given a lower leg prosthesis with which he could move. Upon being wounded by aircraft bomb splinters, the injured person sustains severe wounds of multiple organs and organ systems due to simultaneous injuries caused by a large number of projectiles. It is necessary to take care of the vital organs first because they directly threaten the life of the wounded patient. Despite adequate surgical treatment of war wounds of the feet, because of massive defect of bone and soft tissue, amputation may be the only rational solution of the treatment. The resection of the lung may be succesfull method for the severe destruction of the lung.

Strontium administration in young chickens improves bone volume and architecture but does not enhance bone structural and material strength.

PubMed

Shahnazari, M; Lang, D H; Fosmire, G J; Sharkey, N A; Mitchell, A D; Leach, R M

2007-03-01

Genetic selection for rapid body growth in broiler chickens has resulted in adverse effects on the skeletal system exemplified by a higher rate of cortical fractures in leg bones. Strontium (Sr) has been reported to have beneficial effects on bone formation and strength. We supplemented the diet of 300-day-old chicks with increasing dosages of Sr (0%, 0.12%, or 0.24%) to study the capacity of the element to improve bone quality and mechanical integrity. Treatment with Sr increased cortical bone volume and reduced bone porosity as measured by micro-computed tomography. The higher level of Sr significantly reduced bone Ca content (34.7%) relative to controls (37.2%), suggesting that Sr replaced some of the Ca in bone. Material properties determined by the three-point bending test showed that bone in the Sr-treated groups withstood greater deformation prior to fracture. Load to failure and ultimate stress were similar across groups. Our results indicate that Sr treatment in rapidly growing chickens induced positive effects on bone volume but did not improve the breaking strength of long bones.

A Comparison of the Physiology and Mechanics of Exercise in LBNP and Upright Gait

NASA Technical Reports Server (NTRS)

Boda, W. L.; Watenpaugh, D. E.; Ballard, R. E.; Chang, D.; Looft-Wilson, R.; Hargens, A. R.

1996-01-01

Bone, muscular strength, aerobic capacity, and normal fluid pressure gradients within the body are lost during bed rest and spaceflight. Lower Body Negative Pressure (LBNP) exercise may create musculoskeletal and cardiovascular strains equal to a greater than those experienced on Earth and elucidate some of the mechanisms for maintaining bone integrity. LBNP exercise simulates gravity during supine posture by using negative pressure to pull subjects inward against a treadmill generating footward forces and increasing transmural pressures. Footward forces are generated which equal the product of the pressure differential and the cross-sectional area of the LBNP waist seal. Subjects lie supine within the chamber with their legs suspended from one another via cuffs, bungee cords, and pulleys, such that each leg acts as a counterweight to the other leg during the gait cycle. The subjects then walk or run on a treadmill which is positioned vertically within the chamber. Supine orientation allows only footward force production due to the negative pressure within the chamber. The purpose of this study was to determine if the kinematics, kinetics, and metabolic rate during supine walking and slow running on a vertical treadmill within LBNP are similar to those on a treadmill in 1-g environment in an upright posture.

Acceleration of tendon-bone healing of anterior cruciate ligament graft using intermittent negative pressure in rabbits.

PubMed

Sun, Zhengming; Wang, Xiaoqing; Ling, Ming; Wang, Wei; Chang, Yanhai; Yang, Guang; Dong, Xianghui; Wu, Shixun; Wu, Xueyuan; Yang, Bo; Chen, Ming

2017-04-18

The purpose of this study was to test effects of negative pressure on tendon-bone healing after reconstruction of anterior cruciate ligament (ACL) in rabbits. Hind legs of 24 New Zealand White rabbits were randomly selected as negative pressure group and the contralateral hind legs as control. Reconstruction of the ACL was done. Joints of the negative pressure side were placed with drainage tubes connecting the micro-negative pressure aspirator. Control side was placed with ordinary drainage tubes. Drainage tubes on both sides were removed at the same time 5 days after operation. After 6 weeks, joint fluid was drawn to detect the expression levels of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α); at the same time, femur-ligament-tibia complex was obtained to determine tendon graft tension and to observe the histomorphology, blood vessels of the tendon-bone interface, and expression of vascular endothelial growth factor (VEGF). The maximum load breakage of tendon graft was significantly greater in the negative pressure group than in the control group (P < 0.05). Histological studies of the tendon-bone interface found that there was more new bone formation containing chondroid cells and aligned connective tissue in the negative pressure group than in the control group. Expression of VEGF was higher in the negative pressure group than in the control group (P < 0.01). Content of IL-1β and TNF-α in synovial fluid is lower in the negative pressure group than in the control group (P < 0.01). Intermittent negative pressure plays an active role in tendon-bone healing and creeping substitution of ACL reconstruction in the rabbits.

Extended healing validation of an artificial tendon to connect the quadriceps muscle to the Tibia: 180-day study.

PubMed

Melvin, Alan J; Litsky, Alan S; Mayerson, Joel L; Stringer, Keith; Juncosa-Melvin, Natalia

2012-07-01

Whenever a tendon or its bone insertion is disrupted or removed, existing surgical techniques provide a temporary connection or scaffolding to promote healing, but the interface of living to non-living materials soon breaks down under the stress of these applications, if it must bear the load more than acutely. Patients are thus disabled whose prostheses, defect size, or mere anatomy limit the availability or outcomes of such treatments. Our group developed the OrthoCoupler™ device to join skeletal muscle to prosthetic or natural structures without this interface breakdown. In this study, the goat knee extensor mechanism (quadriceps tendon, patella, and patellar tendon) was removed from the right hind limb in 16 goats. The device connected the quadriceps muscle to a stainless steel bone plate on the tibia. Mechanical testing and histology specimens were collected from each operated leg and contralateral unoperated control legs at 180 days. Maximum forces in the operated leg (vs. unoperated) were 1,400 ± 93 N (vs. 1,179 ± 61 N), linear stiffnesses were 33 ± 3 N/mm (vs. 37 ± 4 N/mm), and elongations at failure were 92.1 ± 5.3 mm (vs. 68.4 ± 3.8 mm; mean ± SEM). Higher maximum forces (p = 0.02) and elongations at failure (p=0.008) of legs with the device versus unoperated controls were significant; linear stiffnesses were not (p=0.3). We believe this technology will yield improved procedures for clinical challenges in orthopedic oncology, revision arthroplasty, tendon transfer, and tendon injury reconstruction. Copyright © 2011 Orthopaedic Research Society.

Benefits of Ilizarov automated bone distraction for nerves and articular cartilage in experimental leg lengthening.

PubMed

Shchudlo, Nathalia; Varsegova, Tatyana; Stupina, Tatyana; Shchudlo, Michael; Saifutdinov, Marat; Yemanov, Andrey

2017-09-18

To determine peculiarities of tissue responses to manual and automated Ilizarov bone distraction in nerves and articular cartilage. Twenty-nine dogs were divided in two experimental groups: Group M - leg lengthening with manual distraction (1 mm/d in 4 steps), Group A - automated distraction (1 mm/d in 60 steps) and intact group. Animals were euthanized at the end of distraction, at 30 th day of fixation in apparatus and 30 d after the fixator removal. M-responses in gastrocnemius and tibialis anterior muscles were recorded, numerical histology of peroneal and tibialis nerves and knee cartilage semi-thin sections, scanning electron microscopy and X-ray electron probe microanalysis were performed. Better restoration of M-response amplitudes in leg muscles was noted in A-group. Fibrosis of epineurium with adipocytes loss in peroneal nerve, subperineurial edema and fibrosis of endoneurium in some fascicles of both nerves were noted only in M-group, shares of nerve fibers with atrophic and degenerative changes were bigger in M-group than in A-group. At the end of experiment morphometric parameters of nerve fibers in peroneal nerve were comparable with intact nerve only in A-group. Quantitative parameters of articular cartilage (thickness, volumetric densities of chondrocytes, percentages of isogenic clusters and empty cellular lacunas, contents of sulfur and calcium) were badly changed in M-group and less changed in A-group. Automated Ilizarov distraction is more safe method of orthopedic leg lengthening than manual distraction in points of nervous fibers survival and articular cartilage arthrotic changes.

Benefits of Ilizarov automated bone distraction for nerves and articular cartilage in experimental leg lengthening

PubMed Central

Shchudlo, Nathalia; Varsegova, Tatyana; Stupina, Tatyana; Shchudlo, Michael; Saifutdinov, Marat; Yemanov, Andrey

2017-01-01

AIM To determine peculiarities of tissue responses to manual and automated Ilizarov bone distraction in nerves and articular cartilage. METHODS Twenty-nine dogs were divided in two experimental groups: Group M - leg lengthening with manual distraction (1 mm/d in 4 steps), Group A - automated distraction (1 mm/d in 60 steps) and intact group. Animals were euthanized at the end of distraction, at 30th day of fixation in apparatus and 30 d after the fixator removal. M-responses in gastrocnemius and tibialis anterior muscles were recorded, numerical histology of peroneal and tibialis nerves and knee cartilage semi-thin sections, scanning electron microscopy and X-ray electron probe microanalysis were performed. RESULTS Better restoration of M-response amplitudes in leg muscles was noted in A-group. Fibrosis of epineurium with adipocytes loss in peroneal nerve, subperineurial edema and fibrosis of endoneurium in some fascicles of both nerves were noted only in M-group, shares of nerve fibers with atrophic and degenerative changes were bigger in M-group than in A-group. At the end of experiment morphometric parameters of nerve fibers in peroneal nerve were comparable with intact nerve only in A-group. Quantitative parameters of articular cartilage (thickness, volumetric densities of chondrocytes, percentages of isogenic clusters and empty cellular lacunas, contents of sulfur and calcium) were badly changed in M-group and less changed in A-group. CONCLUSION Automated Ilizarov distraction is more safe method of orthopedic leg lengthening than manual distraction in points of nervous fibers survival and articular cartilage arthrotic changes. PMID:28979852

Bone strength and muscle properties in postmenopausal women with and without a recent distal radius fracture.

PubMed

Crockett, K; Arnold, C M; Farthing, J P; Chilibeck, P D; Johnston, J D; Bath, B; Baxter-Jones, A D G; Kontulainen, S A

2015-10-01

Distal radius (wrist) fracture (DRF) in women over age 50 years is an early sign of bone fragility. Women with a recent DRF compared to women without DRF demonstrated lower bone strength, muscle density, and strength, but no difference in dual-energy x-ray absorptiometry (DXA) measures, suggesting DXA alone may not be a sufficient predictor for DRF risk. The objective of this study was to investigate differences in bone and muscle properties between women with and without a recent DRF. One hundred sixty-six postmenopausal women (50-78 years) were recruited. Participants were excluded if they had taken bone-altering medications in the past 6 months or had medical conditions that severely affected daily living or the upper extremity. Seventy-seven age-matched women with a fracture in the past 6-24 months (Fx, n = 32) and without fracture (NFx, n = 45) were measured for bone and muscle properties using the nondominant (NFx) or non-fractured limb (Fx). Peripheral quantitative computed tomography (pQCT) was used to estimate bone strength in compression (BSIc) at the distal radius and tibia, bone strength in torsion (SSIp) at the shaft sites, muscle density, and area at the forearm and lower leg. Areal bone mineral density at the ultradistal forearm, spine, and femoral neck was measured by DXA. Grip strength and the 30-s chair stand test were used as estimates of upper and lower extremity muscle strength. Limb-specific between-group differences were compared using multivariate analysis of variance (MANOVA). There was a significant group difference (p < 0.05) for the forearm and lower leg, with the Fx group demonstrating 16 and 19% lower BSIc, 3 and 6% lower muscle density, and 20 and 21% lower muscle strength at the upper and lower extremities, respectively. There were no differences between groups for DXA measures. Women with recent DRF had lower pQCT-derived estimated bone strength at the distal radius and tibia and lower muscle density and strength at both extremities.

[Fractures of the lower extremities in childhood : Part 2: lower leg and ankle fractures].

PubMed

Voth, M; Kremer, L; Marzi, I

2017-11-01

The treatment of pediatric patients in trauma surgery is a special situation in every aspect. For deciding on the correct treatment of fractures of the lower leg and ankle joint, various parameters, such as residual growth rate, skeletal age and height of the patient are decisive. The differences between fractures in children and adolescents are the open epiphyseal plate and the resulting residual growth. The bones of young children have a higher healing tendency and a greater potential for correction than in adolescents. Especially in the lower leg and the ankle joint, the potential for correction is decisive for the healing of fractures and for possible development of growth disorders. The limits of tolerance concerning axial malalignments and the expected spontaneous potential for correction must play an essential role for further treatment with conservative or operative therapy. This article deals with the special features of pediatric fractures of the lower leg and ankle joint.

Maintenance of exercise-induced benefits in physical functioning and bone among elderly women.

PubMed

Karinkanta, S; Heinonen, A; Sievänen, H; Uusi-Rasi, K; Fogelholm, M; Kannus, P

2009-04-01

This study showed that about a half of the exercise-induced gain in dynamic balance and bone strength was maintained one year after cessation of the supervised high-intensity training of home-dwelling elderly women. However, to maintain exercise-induced gains in lower limb muscle force and physical functioning, continued training seems necessary. Maintenance of exercise-induced benefits in physical functioning and bone structure was assessed one year after cessation of 12-month randomized controlled exercise intervention. Originally 149 healthy women 70-78 years of age participated in the 12-month exercise RCT and 120 (81%) of them completed the follow-up study. Self-rated physical functioning, dynamic balance, leg extensor force, and bone structure were assessed. During the intervention, exercise increased dynamic balance by 7% in the combination resistance and balance-jumping training group (COMB). At the follow-up, a 4% (95% CI: 1-8%) gain compared with the controls was still seen, while the exercise-induced isometric leg extension force and self-rated physical functioning benefits had disappeared. During the intervention, at least twice a week trained COMB subjects obtained a significant 2% benefit in tibial shaft bone strength index compared to the controls. A half of this benefit seemed to be maintained at the follow-up. Exercise-induced benefits in dynamic balance and rigidity in the tibial shaft may partly be maintained one year after cessation of a supervised 12-month multi-component training in initially healthy elderly women. However, to maintain the achieved gains in muscle force and physical functioning, continued training seems necessary.

"Shin splint" syndrome and tibial stress fracture in the same patient diagnosed by means of (99m)Tc-HMDP SPECT/CT.

PubMed

Vicente, Justo Serrano; Grande, Maria Luz Domínguez; Torre, Jose Rafael Infante; Madrid, Juan Ignacio Rayo; Barquero, Carmen Durán; Bernardo, Lucía García; Sánchez, Román Sánchez

2013-04-01

We show a patient who presented leg pain triggered by intense exercise. The most likely diagnosis was a possible tibial stress fracture or a "shin splint" syndrome (soleus enthesopathy). We performed a bone scintigraphy including SPECT/CT that revealed the presence of the two concomitant pathologies. SPECT/CT identified the hot spot superimposed with bone lesion in the tibial stress fracture and only remodeling activity without evidence of cortical lesions in the enthesopathy processes.

Material Parameter Sensitivity of Predicted Injury in the Lower Leg

DTIC Science & Technology

2015-06-01

in a region of the structure that experienced the largest strains due to geometric or structural features, e.g., a sharp curve or point. The specific...Annals of Biomedical Engineering. 2012;40(12):2519–2531. 23. Iwamoto M, Omori K, Kimpara H, Nakahira Y, Tamura A, Watanabe I, Miki K, Hasegawa J...cortical layer; the void space between the inner scaled bone and the original outer bone was considered the cortical shell. Thus, a sharp interface exists

Diverse bone scan abnormalities in shin splints

DOE Office of Scientific and Technical Information (OSTI.GOV)

Spencer, R.P.; Levinson, E.D.; Baldwin, R.D.

1979-12-01

Four young patients who presented with pain over the anterior compartment of the legs, gave a recent athletic history suggesting stress fractures. Although radiographs were initially normal in all four cases, the bone scintigrams were positive. The individual findings, however, were quite different. In one there was a single focal area of increased radioactivity in each of the tibias; the second patient had uneven uptake of radiotracer and several foci of accumulation in the fibulas; the third showed diffuse linear tibial uptake suggesting periosteal lesions; and the fourth case revealed uptake in the lateral malleolus and in bones of themore » foot.« less

Effectiveness of various isometric exercises at improving bone strength in cortical regions prone to distal tibial stress fractures.

PubMed

Florio, C S

2018-06-01

A computational model was used to compare the local bone strengthening effectiveness of various isometric exercises that may reduce the likelihood of distal tibial stress fractures. The developed model predicts local endosteal and periosteal cortical accretion and resorption based on relative local and global measures of the tibial stress state and its surface variation. Using a multisegment 3-dimensional leg model, tibia shape adaptations due to 33 combinations of hip, knee, and ankle joint angles and the direction of a single or sequential series of generated isometric resultant forces were predicted. The maximum stress at a common fracture-prone region in each optimized geometry was compared under likely stress fracture-inducing midstance jogging conditions. No direct correlations were found between stress reductions over an initially uniform circular hollow cylindrical geometry under these critical design conditions and the exercise-based sets of active muscles, joint angles, or individual muscle force and local stress magnitudes. Additionally, typically favorable increases in cross-sectional geometric measures did not guarantee stress decreases at these locations. Instead, tibial stress distributions under the exercise conditions best predicted strengthening ability. Exercises producing larger anterior distal stresses created optimized tibia shapes that better resisted the high midstance jogging bending stresses. Bent leg configurations generating anteriorly directed or inferiorly directed resultant forces created favorable adaptations. None of the studied loads produced by a straight leg was significantly advantageous. These predictions and the insight gained can provide preliminary guidance in the screening and development of targeted bone strengthening techniques for those susceptible to distal tibial stress fractures. Copyright © 2018 John Wiley & Sons, Ltd.

Broiler embryo bone development is influenced by incubator temperature, oxygen concentration and eggshell conductance at the plateau stage in oxygen consumption.

PubMed

Oviedo-Rondón, E O; Small, J; Wineland, M J; Christensen, V L; Mozdziak, P S; Koci, M D; Funderburk, S V L; Ort, D T; Mann, K M

2008-11-01

1. Four experiments were conducted to evaluate the effects of temperature (TEM) and oxygen (O(2)) concentrations during the last 4 d of incubation on bone development. Fertile eggs from two strains were obtained that either exhibited Low or High eggshell conductance (G). 2. Four experimental cabinets provided either four TEM (36, 37, 38 or 39 degrees C) or four O(2) concentrations (17, 19, 21 or 23% O(2)). Data were analysed as a 2 x 2 factorial design. In the fourth experiment, two temperatures (36 and 39 degrees C), two O(2) concentrations (17 and 23%) and the same Low and High G strains were evaluated in a 2 x 2 x 2 factorial design. 3. Body weights (BW) and residual yolks were obtained, both legs were dissected. Femur, tibia and shank weights, length and thickness were recorded. Relative asymmetry (RA) of each leg section was calculated. 4. The results indicated that elevated TEM during incubation increased RA between the two legs, mainly in the Low G strain. Chickens at the lowest O(2) concentrations had lighter and shorter tibias, lighter shanks, and increased RA of femur length compared to chickens in the 23% O(2). In the fourth experiment no interactions were observed between O(2) and TEM. High TEM depressed BW of Low G broilers, but no significant effect of treatments was observed on BW of High G broilers. Nevertheless, the high TEM or low O(2) independently caused reduced femur and tibia weights and length, shank length and thickness, and both low O(2) and high TEM together increased RA in shank weight. 5. These results suggest that late incubation conditions affect long bone development in broilers.

Negative Pressure Wound Therapy (NPWT) to Treat Complex Defect of the Leg after Electrical Burn.

PubMed

Tevanov, Iulia; Enescu, Dan M; Bălănescu, Radu; Sterian, G; Ulici, Alexandru

2016-01-01

Negative pressure wound therapy is a non-invasive treatment that uses under atmospheric pressure to increase blood supply to the wound, stimulating the formation of granulation tissue, angiogenesis, proliferation of fibroblasts and endothelial cells. Negative pressure therapy has also the ability to decrease the bacterial load, reduce swelling and decrease exudate while maintaining a moist environment that facilitates healing. Our patient, a 17 year old male, suffered major third and fourth-degree high voltage electrical burns on 60% of the body surface, in November 2011. After the excision of the necrotic tissue (muscles and tendons), the lower extremity of the right leg- the tibial bone, the fibula, external and internal malleoli became exposed circularly. The soft-tissue defect was partially covered by using an internal twin muscle flap and free split skin. Then, a cross leg flap technique has been used, partially covering the defect with a contralateral thigh flap. Surface swab cultures were positive for Pseudomonas aeruginosa. In October 2013 the patient was transferred to our department. The clinical examination of the right leg showed that the tibial bone had been exposed on an area of 15/3 cm in the lower half. The peroneal malleolus had also been exposed. The resection of the devitalized, exposed tibia and the avivement of the wound edges were performed. Then the NPWT was started and performed by intermittent suction. Local cleansing, soft-tissue avivement and dressing changes were performed twice a week for 6 weeks. After six weeks of NPWT and eleven dressing changes under general anaesthesia, the wounds were ready for skin grafting. Granulation tissue was formed, covering the entire surface of both the tibia bone and the peroneal malleolus. Both receptor beds were covered with free skin graft harvested from the ipsilateral thigh. The mechanical suture of the skin grafts was performed and the grafts were covered with damp dressing. By using the NPWT it was possible to cover major chronic soft tissue defects, thus avoiding the amputation of the member. Celsius.

[Tibiocalcaneal arthrodesis using retrograde insertion of a compression nail].

PubMed

Bölderl, A; Dallapozza, C; Wille, M

2011-12-01

OPERATION GOAL: Arthrodesis of the upper and lower ankle joint because of problematic bone positioning or failed arthrodesis. Osteosynthesis procedure using a retrograde compression nail. To achieve stable, fully weight-bearing osteosynthesis for early, pain-free mobilization. Rearthrodesis because of failure of the conventional arthrodesis technique and development of osteoarthritis of the lower ankle joint. Painful osteoarthritis of the upper ankle joint because of inadequate perfusion or a major bone defect because of sclerosis or necrosis. Primary arthrodesis because of facture of the lower leg (pilon tibial) with joint involvement and preexisting osteoarthritis. Acute osteitis/osteomyelitis, sclerosis in the marrow of the distal tibia, malalignment of the distal tibial shaft and local soft tissue inflammation. Preparation of the articular surface of the upper and lower ankle for arthrodesis using a transfibular approach. If necessary, correction of bone defects with iliac crest spongiosa. Stabile osteosynthesis by retrograde insertion of a compression nail. A split lower leg cast on the 2nd postoperative day, mobilization of the patient with underarm crutches with floor contact for 2 weeks, then with application of a lower leg walking cast for 8 weeks with partial weight-bearing for 4 weeks and full weight-bearing for the last 4 weeks of cast fixation. X-ray controls immediately postoperatively, then after 6 and 12 weeks. From 2006 to 2008, 12 patients (7 men, 5 women; mean age 59 years) with various indications were treated with retrograde insertion of a compression nail. All patients were routinely controlled radiologically and clinically after 2, 4, 8 and 12 weeks. Follow-up was carried out at 6, 12 and 24 months. All arthrodeses showed osseous consolidation 16 weeks postoperatively. Ten patients were able to use full weight-bearing without pain after 12 weeks. Two patients reported experiencing pain after walking for 2 h. In total three complications occurred: one hindfoot healed with varus malalignment; one patient fell, fracturing the lower leg above the nail; one distal locking screw loosened.

[Pedicle flap transfer combined with external fixator to treat leg open fracture with soft tissue defect].

PubMed

Luo, Zhongchun; Lou, Hua; Jiang, Junwei; Song, Chunlin; Gong, Min; Wang, Yongcai

2008-08-01

To investigate the clinical results of treating leg open fracture with soft tissue defect by pedicle flap transfer in combination with external fixator. From May 2004 to June 2007, 12 cases of leg open fracture with soft tissue defect, 9 males and 3 females aged 18-75 years, were treated. Among them, 8 cases were caused by traffic accidents, 2 crush, 1 falling and 1 mechanical accident. According to the Gustilo Classification, there were 2 cases of type II, 5 of type IIIA and 5 of type IIIB. There were 2 cases of upper-tibia fracture, 3 of middle-tibia and 7 of middle-lower. The sizes of soft tissue defect ranged from 5 cm x 3 cm to 22 cm x 10 cm.The sizes of exposed bone ranged from 3 cm x 2 cm to 6 cm x 3 cm. The course of the disease was 1-12 hours. Fracture fixation was reached by external fixators or external fixators and limited internal fixation with Kirschner wire. The wounds with exposed tendons and bones were repaired by ipsilateral local rotation flap, sural neurocutaneous flap and saphenous nerve flap. The size of selected flap ranged from 5 cm x 4 cm to 18 cm x 12 cm. Granulation wounds were repaired by skin grafting or direct suture. All patients were followed up for 6 months to 2 years. All patients survived, among whom 2 with the wound edge infection and 1 with the distal necrosis were cured by changing the dressing, 8 with pin hole infection were treated by taking out the external fixator, 1 with nonunion received fracture healing after bone graft in comminuted fracture of lower tibia, 2 suffered delayed union in middle-lower tibia fracture. The ROM of ankle in 3 cases was mildly poor with surpass-joint fixation, with plantar extension of 0-10 degrees and plantar flexion of 10-30 degrees, while the others had plantar extension of 10-20 degrees and plantar flexion of 30-50 degrees. The method of pedicle flap transfer combined with external fixator is safe and effective for the leg open fracture with soft tissue defect.

Effects of incubator temperature and oxygen concentration during the plateau stage of oxygen consumption on Turkey embryo long bone development.

PubMed

Oviedo-Rondón, E O; Small, J; Wineland, M J; Christensen, V L; Grimes, J L; Funderburk, S V L; Ort, D T; Mann, K M

2008-08-01

Temperature (TEM) and O(2) concentrations during the plateau stage of oxygen consumption are known to affect yolk utilization, tissue development, and thyroid metabolism in turkey embryos. Three experiments were conducted to evaluate these incubation effects on long bone development. Fertile eggs of Nicholas turkeys were used. In each trial, standard incubation conditions were used to 24 d, when the eggs containing viable embryos were randomly divided into 4 groups. Four experimental cabinets provided 4 TEM (36, 37, 38, or 39 degrees C) or 4 O(2) concentrations (17, 19, 21, or 23% O(2)). In the third experiment, 2 temperatures (36 and 39 degrees C) and 2 O(2) concentrations (17 and 23%) were evaluated in a 2 x 2 factorial design. Body and residual yolk weights were obtained. Both legs were dissected, and shanks, femur, and tibia weights, length, and thickness were recorded. Relative asymmetry of each leg section was calculated. Chondrocyte density was evaluated in slides stained with hematoxylin and eosin. Immunofluorescence was used to evaluate the presence of collagen type X and transforming growth factor beta. Hot TEM caused reduction of tibia weights and increase of shank weight when compared with cool TEM. The lengths of femur, tibia, and shanks were reduced by 39 degrees C. The relative asymmetry of leg weights were increased at 38 and 39 degrees C. Poult body and part weights were not affected by O(2) concentrations, but poults on 23% O(2) had bigger shanks and heavier tibias than the ones on 17% O(2). High TEM depressed the fluorescence of collagen type X and transforming growth factor beta. The O(2) concentrations did not consistently affect the immunofluorescence of these proteins. The chondrocyte density was affected by TEM and O(2) in resting and hypertrophic zones. In the third experiment, high TEM depressed BW, leg muscle weights, and shank length. Low O(2) reduced tibia and shanks as a proportion of the whole body. We concluded that incubation conditions affect long bone development in turkeys.

Numerical simulation of hemorrhage in human injury

NASA Astrophysics Data System (ADS)

Chong, Kwitae; Jiang, Chenfanfu; Santhanam, Anand; Benharash, Peyman; Teran, Joseph; Eldredge, Jeff

2015-11-01

Smoothed Particle Hydrodynamics (SPH) is adapted to simulate hemorrhage in the injured human body. As a Lagrangian fluid simulation, SPH uses fluid particles as computational elements and thus mass conservation is trivially satisfied. In order to ensure anatomical fidelity, a three-dimensional reconstruction of a portion of the human body -here, demonstrated on the lower leg- is sampled as skin, bone and internal tissue particles from the CT scan image of an actual patient. The injured geometry is then generated by simulation of ballistic projectiles passing through the anatomical model with the Material Point Method (MPM) and injured vessel segments are identified. From each such injured segment, SPH is used to simulate bleeding, with inflow boundary condition obtained from a coupled 1-d vascular tree model. Blood particles interact with impermeable bone and skin particles through the Navier-Stokes equations and with permeable internal tissue particles through the Brinkman equations. The SPH results are rendered in post-processing for improved visual fidelity. The overall simulation strategy is demonstrated on several injury scenarios in the lower leg.

Shin splints: MR appearance in a preliminary study.

PubMed

Anderson, M W; Ugalde, V; Batt, M; Gacayan, J

1997-07-01

To investigate the magnetic resonance (MR) imaging appearance of activity-related lower leg pain (shin splints syndrome) and evaluate the relative involvement of bone and soft tissues. Nineteen patients with activity-related lower leg pain and tenderness on palpation along the posteromedial tibia (shin splints) underwent clinical examination and MR imaging. Five also underwent plain radiography. MR findings were compared with patient demographics, clinical findings, and plain radiographs when available. Four MR patterns were identified: normal appearance (n = 7), periosteal fluid only (n = 5), abnormal marrow signal intensity (n = 5), and stress fracture (n = 2). Increased symptom duration correlated strongly with a normal MR image (P = .002). Plain radiographs appeared normal in all five patients for whom they were available. Patients with acute shin splints have a spectrum of MR findings, which suggests this clinical entity is part of a continuum of stress response in bone. The strong association between chronic symptoms and a normal-appearing MR image implies that this modality has less utility in these patients.

Ash content of bones in the pigtail monkey, Macaca nemestrina.

NASA Technical Reports Server (NTRS)

Vose, G. P.; Roach, T. L.

1972-01-01

Ash analyses of skeletons of four adult primates, Macaca nemestrina, revealed some similarities and some marked contrasts when compared with published data on human skeletal ash. The skull in both Macaca nemestrina and man has the highest ash content of all bones in the skeleton. While the bones of the arms of humans have an ash content nearly identical to that of the legs (0.3% difference), in Macaca nemestrina the humeri and radii contain 5.4% more ash than the femora and tibiae. Similarly in Macaca nemestrina the bones of the hands contain 3.5% more ash than the bones of the feet, while in humans the same bones agree within 0.3% implying that adaptive use function is a factor in bone ash concentration. The ribs of Macaca nemestrina showed an unexpectedly high ash content in comparison with those of humans. In contrast with the relatively constant ash content throughout the vertebrae in humans, a conspicuous decrease axially was noted in Macaca nemestrina.

Automatic bone detection and soft tissue aware ultrasound-CT registration for computer-aided orthopedic surgery.

PubMed

Wein, Wolfgang; Karamalis, Athanasios; Baumgartner, Adrian; Navab, Nassir

2015-06-01

The transfer of preoperative CT data into the tracking system coordinates within an operating room is of high interest for computer-aided orthopedic surgery. In this work, we introduce a solution for intra-operative ultrasound-CT registration of bones. We have developed methods for fully automatic real-time bone detection in ultrasound images and global automatic registration to CT. The bone detection algorithm uses a novel bone-specific feature descriptor and was thoroughly evaluated on both in-vivo and ex-vivo data. A global optimization strategy aligns the bone surface, followed by a soft tissue aware intensity-based registration to provide higher local registration accuracy. We evaluated the system on femur, tibia and fibula anatomy in a cadaver study with human legs, where magnetically tracked bone markers were implanted to yield ground truth information. An overall median system error of 3.7 mm was achieved on 11 datasets. Global and fully automatic registration of bones aquired with ultrasound to CT is feasible, with bone detection and tracking operating in real time for immediate feedback to the surgeon.

Effect of office-based brief high-impact exercise on bone mineral density in healthy premenopausal women: the Sendai Bone Health Concept Study.

PubMed

Niu, Kaijun; Ahola, Riikka; Guo, Hui; Korpelainen, Raija; Uchimaru, Jin; Vainionpää, Aki; Sato, Kyoko; Sakai, Aiko; Salo, Sinikka; Kishimoto, Koshi; Itoi, Eiji; Komatsu, Shoko; Jämsä, Timo; Nagatomi, Ryoichi

2010-09-01

Although there is ample evidence supporting the effectiveness of physical activity in the prevention and treatment of osteoporosis, there are no previous studies to examine the effect of office-based brief high-impact exercise (HIE) on bone mineral density (BMD) in healthy premenopausal women. This study evaluated the effects of office-based HIE on BMD in healthy premenopausal Japanese women. Ninety-one healthy premenopausal women were randomized to receive stretching exercise (SE) or HIE (stretching, along with up to 5 × 10 vertical and versatile jumps) for 12 months. The BMD of the lumbar spine and proximal femur was measured using dual-energy X-ray absorptiometry. Several cardiovascular risk factors and leg strength also were assessed. An accelerometer-based recorder was used to measure daily impact loading in four 1-week samples. The progression of the HIE program was ensured by the accelerometer. Thirty-three women (71.7%) in the SE group and 34 (75.6%) in the HIE group completed the study. There was a significant difference in the change in the femoral neck BMD between the groups in favor of the HIE group [0.6% (95% CI: -0.4, 1.7) vs. -1.0% (95% CI: -2.2, 0.2)]. Adiponectin, LDL, HDL, and the leg strength of participants in both the groups improved during the intervention. These finding suggested that office-based brief HIE can be recommended for premenopausal women for preventing bone mineral loss.

Leg Muscle Usage Effects on Tibial Elasticity During Running

DTIC Science & Technology

2006-01-01

stress, such a strike mechanics and surface incline, also modulate bone elasticity during running. Because these modulators may operate on the tibia via...prototypical forefoot runner. We have obtained a video showing well-defined forefoot -running without coaching and have developed a short training video for

Three-phase radionuclide bone imaging in sports medicine

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rupani, H.D.; Holder, L.E.; Espinola, D.A.

Three-phase radionuclide bone (TPB) imaging was performed on 238 patients with sports-related injuries. A wide variety of lesions was encountered, but the most frequent lesions seen were stress fractures of the lower part of the leg at the junction of the middle and distal thirds of the posterior tibial cortex (42 of 79 lesions). There were no differences in the type, location, or distribution of lesions between males and females or between competitive and noncompetitive athletes. In 110 cases, bone stress lesions were often diagnosed when radiographs were normal, whereas subacute or chronic soft-tissue abnormalities had few specific scintigraphic features.more » TPB imaging provides significant early diagnostic information about bone stress lesions. Normal examination results (53 cases) exclude underlying osseous pathologic conditions.« less

Association of regional body composition with bone mineral density in HIV-infected and HIV-uninfected women: women's interagency HIV study.

PubMed

Sharma, Anjali; Tian, Fang; Yin, Michael T; Keller, Marla J; Cohen, Mardge; Tien, Phyllis C

2012-12-01

To understand how regional body composition affects bone mineral density (BMD) in HIV-infected and HIV-uninfected women. Dual energy x-ray absorptiometry was used to measure regional lean and fat mass and BMD at lumbar spine (LS), total hip (TH), and femoral neck (FN) in 318 HIV-infected and 122 HIV-uninfected Women's Interagency HIV Study participants at baseline and 2 and 5 years later. Total lean and fat mass were measured using bioimpedance analysis. Multivariate marginal linear regression models assessed the association of HIV status and body composition on BMD change. Compared with HIV-uninfected women, HIV-infected women were older (44 vs. 37 years), more likely to be Hepatitis C virus-infected (32% vs. 14%), and postmenopausal (26% vs. 3%) and had lower baseline total fat mass, trunk fat, and leg fat. In multivariate models, increased total lean mass was independently associated with increased BMD at LS, TH, and FN, and total fat mass was associated with increased BMD at TH and FN (all P < 0.05). When total fat was replaced in multivariate models with trunk fat and leg fat, increased trunk fat (and not leg fat) was associated with increased TH and FN BMD (P < 0.001). Total fat and lean mass are strong independent predictors of TH and FN BMD, and lean mass was associated with greater LS BMD. Regardless of HIV status, greater trunk fat (and not leg fat) was associated with increased TH and FN BMD, suggesting that weight-bearing fat may be a more important predictor of BMD in the hip.

Early-phase musculoskeletal adaptations to different levels of eccentric resistance after 8 weeks of lower body training.

PubMed

English, Kirk L; Loehr, James A; Lee, Stuart M C; Smith, Scott M

2014-11-01

Eccentric muscle actions are important to the development of muscle mass and strength and may affect bone mineral density (BMD). This study's purpose was to determine the relative effectiveness of five different eccentric:concentric load ratios to increase musculoskeletal parameters during early adaptations to resistance training. Forty male subjects performed a supine leg press and calf press training program 3 days week(-1) for 8 weeks. Subjects were matched for pre-training leg press 1-repetition maximum strength (1-RM) and randomly assigned to one of five training groups. Concentric training load (% 1-RM) was constant across groups, but within groups, eccentric load was 0, 33, 66, 100, or 138% of concentric load. Muscle mass (dual energy X-ray absorptiometry; DXA), strength (1-RM), and BMD (DXA) were measured pre- and post-training. Markers of bone metabolism were assessed pre-, mid- and post-training. The increase in leg press 1-RM in the 138% group (20 ± 4%) was significantly greater (P < 0.05) than the 0% (8 ± 3%), 33% (8 ± 5%) and 66% (8 ± 4%) groups, but not the 100% group (13 ± 6 %; P = 0.15). All groups, except the 0% group, increased calf press 1-RM (P < 0.05). Leg lean mass and greater trochanter BMD were increased only in the 138% group (P < 0.05). Early-phase adaptations to eccentric overload training include increases in muscle mass and site-specific increases in BMD and muscle strength which are not present or are less with traditional and eccentric underload training. Eccentric overload provides a robust musculoskeletal stimulus that may benefit bedridden patients, individuals recovering from injury or illness, and astronauts during spaceflight.

Carcass conformation and cut composition of Creole goat from Guadeloupe.

PubMed

Liméa, Léticia; Bocage, Bruno; Arquet, Rémy; Mahieu, Maurice; Alexandre, Gisele

2010-03-01

Carcass data base of 164 Creole male goats was used in order to provide factual data on the carcass conformation. Standardised procedures of carcass measuring and cutting were followed. The European official grid of light lamb is implemented for meat goat in the French West Indies and included five levels. Weights of carcass, cuts and tissues, quality scores and linear measurements were analysed. Feeding system, age at slaughter and weight were taken into account for statistical analysis. There were significant differences among carcass conformation classes (CC) for many traits except for the fat score, leg length and compactness ratio (carcass width on length): 2.2, 34.5 cm and 0.30 on average, respectively. The values of chilled carcass weight and yield and the carcass linear measurements steadily increased until conformation class 4 or 5: 6.7 to 11.2 kg, 49% to 55% and 52.4 to 58.0 cm carcass length. For the weights of carcass cuts, significant differences appeared between two groups: classes 1 and 2 vs. classes 3, 4 and 5. Regardless of the carcass weight, the distribution of prime cuts remained similar. The indices calculated on a weight basis (kg/cm), either for the carcass or the leg, increased significantly (P<0.01): with 54% and 63% difference between the two extreme classes, respectively. The muscle, bone and fat proportions in the shoulder did not vary between CC with 0.72, 0.22 and 0.06, respectively. Corresponding traits in leg were 0.74, 0.23 and 0.03; the last two were different (P<0.05) from class 1 to class 5. The muscle/bone ratios calculated either in shoulder or in leg ranged from 3.1 to 3.6 (P>0.05).

Differences in distal lower extremity tissue masses and mass ratios exist in athletes of sports involving repetitive impacts.

PubMed

Schinkel-Ivy, Alison; Burkhart, Timothy A; Andrews, David M

2014-01-01

This study aimed to examine the effects of sex and sport on the tissue composition of the distal lower extremity of varsity athletes, in sports that involve repetitive-impact loading patterns. Fat mass, lean mass, bone mineral content and wobbling mass were predicted for the leg and leg + foot segments of varsity basketball, cross-country, soccer and volleyball athletes. The absolute masses were normalised to body mass, and also expressed relative to each other as ratios. Females and males differed on most normalised tissue masses and ratios by 11-101%. Characteristic differences were found in the normalised tissue masses across sports, with the lowest and highest values displayed by cross-country and volleyball (female)/basketball (male) athletes, respectively. Conversely, cross-country athletes had the highest wobbling mass:bone mineral content and lean mass:bone mineral content ratios for females by 10% and 16%, respectively. The differences between sports may be explained in part by different impact loading patterns characteristic of each sport. Tissue mass ratio differences between sports may suggest that the ratios of soft to rigid tissues are optimised by the body in response to typical loading patterns, and may therefore be useful in investigations of distal lower extremity injury mechanisms in athletes.

An MRI-based leg model used to simulate biomechanical phenomena during cuff algometry: a finite element study.

PubMed

Manafi-Khanian, Bahram; Arendt-Nielsen, Lars; Graven-Nielsen, Thomas

2016-03-01

Cuff pressure stimulation is applicable for assessing deep-tissue pain sensitivity by exciting a variety of deep-tissue nociceptors. In this study, the relative transfer of biomechanical stresses and strains from the cuff via the skin to the muscle and the somatic tissue layers around bones were investigated. Cuff pressure was applied on the lower leg at three different stimulation intensities (mild pressure to pain). Three-dimensional finite element models including bones and three different layers of deep tissues were developed based on magnetic resonance images (MRI). The skin indentation maps at mild pressure, pain threshold, and intense painful stimulations were extracted from MRI and applied to the model. The mean stress under the cuff position around tibia was 4.6, 4.9 and around fibula 14.8, 16.4 times greater than mean stress of muscle surface in the same section at pain threshold and intense painful stimulations, respectively. At the same stimulation intensities, the mean strains around tibia were 36.4, 42.3 % and around fibula 32.9, 35.0 %, respectively, of mean strain on the muscle surface. Assuming strain as the ideal stimulus for nociceptors the results suggest that cuff algometry is less capable to challenge the nociceptors of tissues around bones as compared to more superficially located muscles.

Age, gender, and race/ethnic differences in total body and subregional bone density1

PubMed Central

Looker, Anne C; Melton, L. Joseph; Harris, Tamara; Borrud, Lori; Shepherd, John; McGowan, Joan

2011-01-01

Introduction Total body dual-energy x-ray absorptiometry (DXA) data offer the opportunity to compare bone density of demographic groups across the entire skeleton. Methods The present study uses total body DXA data (Hologic QDR 4500A, Hologic Inc, Bedford MA) from the National Health and Nutrition Examination Survey (NHANES) 1999–2004 to examine bone mineral density (BMD) of the total body and selected skeletal subregions in a wide age range of adult men and women from three race/ethnic groups. Total body, lumbar spine, pelvis, right leg, and left arm BMD and lean mass from 13,091 adults age 20 years and older were used. The subregions were chosen to represent sites with different degrees of weight bearing. Results Mean BMD varied in expected ways for some demographic characteristics (men>women and non-Hispanic blacks>non-Hispanic whites) but not others (non-Hispanic whites>Mexican Americans). Differences in age patterns in BMD also emerged for some characteristics (sex) but not others (race/ethnicity). Differences in cross-sectional age patterns in BMD and lean mass by degree of weight-bearing in older adults were observed for the pelvis, leg and arm. Conclusion This information may be useful for generating hypotheses about age, race, and sex differences in fracture risk in the population. PMID:19048179

Optimum frequency of exercise for bone health: randomised controlled trial of a high-impact unilateral intervention.

PubMed

Bailey, Christine A; Brooke-Wavell, Katherine

2010-04-01

Exercise can increase bone strength, but to be effective in reducing fracture risk, exercise must be feasible enough to be adopted into daily life and influence potentially vulnerable skeletal sites such as the superolateral cortex of the femoral neck, where thinning is associated with increased fracture risk. Brief, high-impact exercise increases femoral neck bone density but the optimal frequency of such exercise and the location of bone accrual is unknown. This study thus examined (1) the effectiveness of different weekly frequencies of exercise on femoral neck BMD and (2) whether BMD change differed between hip sites using a high-impact, unilateral intervention. Healthy premenopausal women were randomly assigned to exercise 0, 2, 4, or 7 days/week for 6 months. The exercise intervention incorporated 50 multidirectional hops on one randomly selected leg. BMD was measured by DXA at baseline and after 6 months of exercise. Changes in the exercise leg were compared between groups using ANCOVA, with change in the control leg and baseline BMD as covariates. RM-MANOVA was conducted to determine whether bone changes from exercise differed between hip sites. 61 women (age 33.6+/-11.1 years) completed the intervention. Compliance amongst exercisers was 86.7+/-10.6%. Peak ground reaction forces during exercise increased from 2.5 to 2.8 times body weight. The change in femoral neck BMD in the exercise limb (adjusted for change in the control limb and baseline BMD) differed between groups (p=0.015), being -0.3% (-1.2 to 0.6), 0.0% (-1.0 to 1.0), 0.9% (-0.1 to 2.0) and 1.8% (0.8 to 2.8) in those exercising 0, 2, 4 and 7 days per week, respectively. When BMD changes at upper neck, lower neck and trochanter were compared using RM-MANOVA, a significant exercise effect was observed (p=0.048), but this did not differ significantly between sites (p=0.439) despite greatest mean increases at the upper femoral neck. Brief, daily hopping exercises increased femoral neck BMD in premenopausal women but less frequent exercise was not effective. Brief high-impact exercise may have a role in reducing hip fragility, but may need to be performed frequently for optimal response. Copyright 2009 Elsevier Inc. All rights reserved.

Effects of vertical and side-alternating vibration training on fall risk factors and bone turnover in older people at risk of falls.

PubMed

Corrie, Heather; Brooke-Wavell, Katherine; Mansfield, Neil J; Cowley, Alison; Morris, Robert; Masud, Tahir

2015-01-01

whole-body vibration training may improve neuromuscular function, falls risk and bone density, but previous studies have had conflicting findings. this study aimed to evaluate the influence of vertical vibration (VV) and side-alternating vibration (SV) on musculoskeletal health in older people at risk of falls. single-blind, randomised, controlled trial comparing vibration training to sham vibration (Sham) in addition to usual care. participants were 61 older people (37 women and 24 men), aged 80.2 + 6.5 years, referred to an outpatient falls prevention service. participants were randomly assigned to VV, SV or Sham in addition to the usual falls prevention programme. Participants were requested to attend three vibration sessions per week for 12 weeks, with sessions increasing to six, 1 min bouts of vibration. Falls risk factors and neuromuscular tests were assessed, and blood samples collected for determination of bone turnover, at baseline and following the intervention. chair stand time, timed-up-and-go time, fear of falling, NEADL index and postural sway with eyes open improved in the Sham group. There were significantly greater gains in leg power in the VV than in the Sham group and in bone formation in SV and VV compared with the Sham group. Conversely, body sway improved less in the VV than in the Sham group. Changes in falls risk factors did not differ between the groups. whole-body vibration increased leg power and bone formation, but it did not provide any additional benefits to balance or fall risk factors beyond a falls prevention programme in older people at risk of falls. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF).

PubMed

Joeris, Alexander; Lutz, Nicolas; Blumenthal, Andrea; Slongo, Theddy; Audigé, Laurent

2017-04-01

Background and purpose - To achieve a common understanding when dealing with long bone fractures in children, the AO Pediatric Comprehensive Classification of Long Bone Fractures (AO PCCF) was introduced in 2007. As part of its final validation, we present the most relevant fracture patterns in the lower extremities of a representative population of children classified according to the PCCF. Patients and methods - We included patients up to the age of 17 who were diagnosed with 1 or more long bone fractures between January 2009 and December 2011 at either of 2 tertiary care university hospitals in Switzerland. Patient charts were retrospectively reviewed. Results - More lower extremity fractures occurred in boys (62%, n = 341). Of 548 fractured long bones in the lower extremity, 25% involved the femur and 75% the lower leg. The older the patients, the more combined fractures of the tibia and fibula were sustained (adolescents: 50%, 61 of 123). Salter-Harris (SH) fracture patterns represented 66% of single epiphyseal fractures (83 of 126). Overall, 74 of the 83 SH patterns occurred in the distal epiphysis. Of all the metaphyseal fractures, 74 of 79 were classified as incomplete or complete. Complete oblique spiral fractures accounted for 57% of diaphyseal fractures (120 of 211). Of all fractures, 7% (40 of 548) were classified in the category "other", including 29 fractures that were identified as toddler's fractures. 5 combined lower leg fractures were reported in the proximal metaphysis, 40 in the diaphysis, 26 in the distal metaphysis, and 8 in the distal epiphysis. Interpretation - The PCCF allows classification of lower extremity fracture patterns in the clinical setting. Re-introduction of a specific code for toddler's fractures in the PCCF should be considered.

The AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF)

PubMed Central

Joeris, Alexander; Lutz, Nicolas; Blumenthal, Andrea; Slongo, Theddy; Audigé, Laurent

2017-01-01

Background and purpose To achieve a common understanding when dealing with long bone fractures in children, the AO Pediatric Comprehensive Classification of Long Bone Fractures (AO PCCF) was introduced in 2007. As part of its final validation, we present the most relevant fracture patterns in the lower extremities of a representative population of children classified according to the PCCF. Patients and methods We included patients up to the age of 17 who were diagnosed with 1 or more long bone fractures between January 2009 and December 2011 at either of 2 tertiary care university hospitals in Switzerland. Patient charts were retrospectively reviewed. Results More lower extremity fractures occurred in boys (62%, n = 341). Of 548 fractured long bones in the lower extremity, 25% involved the femur and 75% the lower leg. The older the patients, the more combined fractures of the tibia and fibula were sustained (adolescents: 50%, 61 of 123). Salter-Harris (SH) fracture patterns represented 66% of single epiphyseal fractures (83 of 126). Overall, 74 of the 83 SH patterns occurred in the distal epiphysis. Of all the metaphyseal fractures, 74 of 79 were classified as incomplete or complete. Complete oblique spiral fractures accounted for 57% of diaphyseal fractures (120 of 211). Of all fractures, 7% (40 of 548) were classified in the category "other", including 29 fractures that were identified as toddler’s fractures. 5 combined lower leg fractures were reported in the proximal metaphysis, 40 in the diaphysis, 26 in the distal metaphysis, and 8 in the distal epiphysis. Interpretation The PCCF allows classification of lower extremity fracture patterns in the clinical setting. Re-introduction of a specific code for toddler’s fractures in the PCCF should be considered. PMID:27882811

INDIRECT EFFECT OF X-RADIATION ON BONE GROWTH IN RATS

DOE Office of Scientific and Technical Information (OSTI.GOV)

Conard, R.A.

1962-12-21

Effects of 200 to 600 r of x irradiation on tibial bone growth in groups of weanling male rats were studied by in vivo measurement of tibial bone growth in serial radiographs. By comparison of growth rates in shielded with unshielded legs, direct and indirect effects of radiation were demonstrated, both roughly dose dependent, but with the indirect effect being about twice that of the direct effect. Pair-feeding experiments showed that about 70% of the indirect effect was due to radiation-induced lowered food consumption. By partial-body shielding experiments, using pnir-fed controls, it was shown that the abdomen may be themore » site of a non-nutritional abscopal effect. (auth)« less

Bone transport osteogenesis for reconstruction of a bone defect in the tibiotarsus of a yellow-naped Amazon parrot (Amazona ochrocephala auropalliata).

PubMed

Johnston, Matthew S; Thode, Henry P; Ehrhart, Nicole P

2008-03-01

A yellow-naped Amazon parrot (Amazona ochrocephala auropalliata) was presented 5 months after a traumatic fracture of its left tibiotarsus. Fixation of the simple, closed, mid-diaphyseal fracture was originally with an intramedullary pin and external coaptation with a modified Robert-Jones bandage. During the subsequent 5 months, the bone became osteopenic, and the middle third of the tibiotarsus exhibited probable avascular necrosis. After various fixation attempts failed, the parrot was fitted with a ring fixator device, and bone transport osteogenesis was attempted. Within 7 weeks, the left tibiotarsus had regrown to full length, but the docking site at the proximal fracture line had not healed. After 2 more surgeries to debride bone ends to stimulate healing, the leg in this parrot became functional. This is the first reported clinical use of bone transport osteogenesis in a pet bird. Materials and techniques were applied successfully to this parrot, which suggests that bone transport osteogenesis deserves further study for the repair of large bone defects in birds.

Tibial dyschondroplasia associated proteomic changes in chicken growth plate cartilage

USDA-ARS?s Scientific Manuscript database

Tibial dyschondroplasia (TD) is a poultry leg problem that affects the proximal growth plate of tibia preventing its transition to bone. To understand the disease-induced proteomic changes we compared the protein extracts of cartilage from normal and TD- affected growth plates. TD was induced by fe...

Association of physical activity and physical performance with tibial cartilage volume and bone area in young adults.

PubMed

Antony, Benny; Venn, Alison; Cicuttini, Flavia; March, Lyn; Blizzard, Leigh; Dwyer, Terence; Cross, Marita; Jones, Graeme; Ding, Changhai

2015-10-26

Physical activity has been recommended to patients with knee osteoarthritis for improving their symptoms. However, it is still controversial if physical activity has effects on joint structures including cartilage volume. The aim of this study was to describe the associations between physical activity and performance measured 5 years prior and tibial cartilage volume and bone area in young adults. Subjects broadly representative of the Australian population (n = 328, aged 31-41 years, female 47.3 %) were selected from the Childhood Determinants of Adult Health study. They underwent T1-weighted fat-suppressed magnetic resonance imaging (MRI) scans of their knees. Tibial bone area and cartilage volume were measured from MRI. Physical activity (measured using long international physical activity questionnaire (IPAQ)) and performance measures (long jump, leg muscle strength, physical work capacity (PWC170)) were measured 5 years prior. In multivariable analyses, total physical activity (min/week) (β: 0.30 mm(3), 95 % CI: 0.13,0.47), vigorous (β: 0.54 mm(3), 95 % CI: 0.13,0.94), moderate (β: 0.34 mm(3), 95 % CI: 0.01,0.67), walking (β: 0.40 mm(3), 95 % CI: 0.07,0.72) and IPAQ category (β: 182.9 mm(3), 95 % CI: 51.8,314.0) were positively associated with total tibial cartilage volume but not tibial bone area. PWC170, long jump and leg muscle strength were positively and significantly associated with both total tibial cartilage volume and total tibial bone area; and the associations with tibial cartilage volume decreased in magnitude but remained significant for PWC170 and long jump after further adjustment for tibial bone area. While tibial bone area is affected only by physical performance, total tibial cartilage volume can be influenced by both physical activity and performance in younger adults. The clinical significance suggests a beneficial effect for cartilage but the bone area association was restricted to performance suggesting other factors rather than physical activity may be important.

Ulcer osteoma and periosteal reactions to chronic leg ulcers.

PubMed

Karasick, D; Schweitzer, M E; Deely, D M

1997-01-01

The purpose of this study was to describe the types of periosteal reaction seen in response to long-standing leg ulcers and to differentiate the types associated with osteomyelitis. Over a 10-year span, we retrospectively evaluated the radiographs of 20 patients with lower leg soft-tissue ulceration and adjacent periosteal bone reaction of the tibia or fibula. Two of us evaluated the location and appearance of periosteal reaction, and one of us evaluated the patients' medical records for evidence of peripheral vascular disease, systemic illnesses, and osteomyelitis. Twelve patients had organized periosteal reactions that resulted in the appearance of ulcer osteoma. None of these patients subsequently developed osteomyelitis. Eight patients had interrupted lamellar nodular periosteal reactions; six of the eight patients had superimposed osteomyelitis. Our study showed two types of periosteal response to chronic leg ulcers: a solid organized type that over time formed an ulcer osteoma and a lamellar nodular type that was often associated with osteomyelitis. Both types of ulcers were seen in patients with peripheral vascular disease, IV drug abuse, sickle cell disease, and neurologic impairment.

A rationale for treating leg length discrepancy using photodynamic therapy

NASA Astrophysics Data System (ADS)

Bisland, Stuart K.; Johnson, Crystal; Diab, Mohammed; Wilson, Brian C.; Burch, Shane

2005-09-01

This study investigates the use of photodynamic therapy (PDT) in regulating bone development with a view to its potential role in treating Juvenile leg length discrepancy (LLD). Transgenic mice expressing the luciferase firefly gene upon activation of a promoter sequence specific to the vascular endothelial growth factor (VEGF) gene were subject to benzoporphyrin derivative monoacid (BPD-MA)-mediated PDT in the right, tibial epiphyseal growth plate at the age of 3 weeks. BPD-MA was administered intracardially (2mg/kg) followed 10 mins later by a laser light (690 +/- 5 nm) at a range of doses (5-27J, 50 mW output) delivered either as a single or repeat regimen (x2-3). Contra-lateral legs served as no-light controls. Further controls included animals that received light treatment in the absence of photosensitizer or no treatment. Mice were imaged for VEGF related bioluminescence (photons/sec/steradian) at t= 0, 24, 48, 72 h and 1-4 weeks post PDT. FaxitronTM x-ray images provided accurate assessment of bone morphometry. Upon sacrifice, the tibia and femur of the treated and untreated limbs were harvested, imaged and measured again and prepared for histology. A number of animals were sacrificed at 24 h post PDT to allow immunohistochemical staining for CD31, VEGF and hypoxia-inducible factor (HIF-1 alpha) within the bone. PDT-treated (10 J, x2) mice displayed enhanced bioluminescence at the treatment site (and ear nick) for up to 4 weeks post treatment while control mice were bioluminescent at the ear-nick site only. Repeat regimens provided greater shortening of the limb than the corresponding single treatment. PDT-treated limbs were shorter by 3-4 mm on average as compared to the contra lateral and light only controls (10 J, x2). Immunohistochemistry confirmed the enhanced expression VEGF and CD31 at 4 weeks post-treatment although no increase in HIF-1α was evident at either 24 h or 4 weeks post PDT treatment. Results confirm the utility of PDT to provide localized effects on bone development that may be applicable to other related skeletal deformities.

Scaling in Theropod Dinosaurs: Femoral Bone Strength and Locomotion II

NASA Astrophysics Data System (ADS)

Lee, Scott

2015-03-01

In the second paper1 of this series, the effect of transverse femoral stresses due to locomotion in theropod dinosaurs of different sizes was examined for the case of an unchanging leg geometry. Students are invariably thrilled to learn about theropod dinosaurs, and this activity applies the concepts of torque and stress to the issue of theropod locomotion. In this paper, our model calculation of Ref. 1 is extended to incorporate the fact that larger animals run with straighter legs. As in Ref. 1, students use geometric data for the femora of theropod dinosaurs to analyze their locomotion abilities. This can either be an in-class activity or given as a homework problem. Larger theropods are found to be less athletic in their movements than smaller theropods since the stresses in the femora of large theropods are closer to breaking their legs than smaller theropods.

Clinical effects of leg length discrepancy through ground and joint reaction force responses: A review

NASA Astrophysics Data System (ADS)

Zabri, S. W. K. Ali; Basaruddin, K. S.; Salleh, A. F.; Rusli, W. M. R.; Daud, R.

2017-09-01

Leg length discrepancy (LLD) is caused either due to functional disorder or shortening of bone structure. This disorder could contribute to the significant effects on body weight distribution and lumbar scoliosis at the certain extend. Ground reaction force and joint reaction force are the parameters that can be used to analyze the responses in weight distribution and kinetics changes on the body joints, respectively. Hence, the purpose of this paper is to review the studies that focus on the clinical effects of LLD to the lower limb and spine through ground and joint reaction force responses that could lead to the orthopedics disorder.

Island osteoperiosteal flap vitality when isolated from basal bone by silicone interposition: an experimental study in rabbit tibia.

PubMed

Laviv, Amir; Ringeman, Jason; Debecco, Meir; Jensen, Ole T; Casap, Nardy

2014-01-01

This study sought to confirm, through histologic evaluation, the vitality and viability of the island osteoperiosteal flap (i-flap) in a rabbit tibia model. In four rabbits, an osteotomy was performed on the tibial aspect of the right leg. A bone flap was raised, but the periosteal attachment was kept intact. The free-floating i-flap was separated from the rest of the bone by a silicone sheet. The rabbits were to be sacrificed after 1, 2, 4, and 8 weeks and histologic samples examined. All surgeries were accomplished successfully; however, three animals showed fractured tibiae within a few days after surgery and were sacrificed immediately after the fractures were discovered. The fourth rabbit was sacrificed at 4 weeks. Histologic specimens showed vital new bone in the i-flap area and signs of remodeling in the transition zone and the original basal bone. The i-flap remained vital. This suggests potential for use in bone augmentation strategies, particularly for the alveolar split procedure.

Pelvic movement strategies and leg extension power in patients with end-stage medial compartment knee osteoarthritis: a cross-sectional study.

PubMed

Kierkegaard, Signe; Jørgensen, Peter Bo; Dalgas, Ulrik; Søballe, Kjeld; Mechlenburg, Inger

2015-09-01

During movement tasks, patients with medial compartment knee osteoarthritis use compensatory strategies to minimise the joint load of the affected leg. Movement strategies of the knees and trunk have been investigated, but less is known about movement strategies of the pelvis during advancing functional tasks, and how these strategies are associated with leg extension power. The aim of the study was to investigate pelvic movement strategies and leg extension power in patients with end-stage medial compartment knee osteoarthritis compared with controls. 57 patients (mean age 65.6 years) scheduled for medial uni-compartmental knee arthroplasty, and 29 age and gender matched controls were included in this cross-sectional study. Leg extension power was tested with the Nottingham Leg Extension Power-Rig. Pelvic range of motion was derived from an inertia-based measurement unit placed over the sacrum bone during walking, stair climbing and stepping. Patients had lower leg extension power than controls (20-39 %, P < 0.01) and used greater pelvic range of motion during stair and step ascending and descending (P ≤ 0.03, except for pelvic range of motion in the frontal plane during ascending, P > 0.06). Furthermore, an inverse association (coefficient: -0.03 to -0.04; R (2) = 13-22 %) between leg extension power and pelvic range of motion during stair and step descending was found in the patients. Compared to controls, patients with medial compartment knee osteoarthritis use greater pelvic movements during advanced functional performance tests, particularly when these involve descending tasks. Further studies should investigate if it is possible to alter these movement strategies by an intervention aimed at increasing strength and power for the patients.

Bone growth and bone development in the presence of implants or after induced leg-lengthening studied using the Oxford Scanning Proton Microprobe

NASA Astrophysics Data System (ADS)

Pålsgård, Eva; Johansson, Carina; Li, Gang; Grime, Geoff W.; Triffitt, J. T.

1997-07-01

To respond to varying environmental demands the bone tissue in the body is under continual reconstruction throughout life. It is known that metallic elements are important for maintaining normal bone structure, but their roles are not well understood. More information about the effects of metal excess or deficiency is needed to help in the development of metallic bone implants and to improve the treatment of bone fractures and defects. The Oxford Scanning Proton Microprobe (SPM) is being applied in two studies involving metal ions in bone: (1) bone regrowth and bonding to titanium bone implants may be influenced by diffusion of Ti ions into the bone. We are using microPIXE to determine the metal ion content of bone developing in contact with implants of pure Nb, Ti and Ti alloys. (2) Bone lengthening as a surgical procedure is induced by fracturing the bone and allowing it to heal with a small gap between the fractured ends created by the use of external fixators. The gap can be slowly increased during the healing process to stimulate the production of new bone. The enzymes and other constituents of the developing bone need certain metals for their function. Using experimental animals we have studied the concentrations of the metals and whether a deficiency of trace metals limits the optimum rate of bone lengthening.

Associations of components of sarcopenic obesity with bone health and balance in older adults.

PubMed

Scott, David; Shore-Lorenti, Catherine; McMillan, Lachlan; Mesinovic, Jakub; Clark, Ross A; Hayes, Alan; Sanders, Kerrie M; Duque, Gustavo; Ebeling, Peter R

To determine characteristics of sarcopenic obesity that are independently associated with bone health and balance in older adults. Cross-sectional study of 168 community-dwelling older adults (mean age 67.7 ± 8.4 years; 55% women). Appendicular lean mass (ALM), whole-body areal BMD (aBMD) and body fat percentage were assessed by dual-energy X-ray absorptiometry. Peripheral quantitative computed tomography assessed muscle density and cortical volumetric BMD (vBMD), area, thickness, and strength-strain index (SSI) at 66% tibial length. Hand grip strength (dynamometry) and balance path length (computerised posturography) were assessed. Obesity was defined as high body fat percentage. Greater lower-leg muscle density was associated with lower balance path length in men (r = -0.36; P < .01) and women (r = -0.40; P = < .01). Obese participants by body fat percentage did not differ to non-obese on bone indices, although a trend towards lower cortical vBMD was observed in obese compared with non-obese men (1041.4 ± 39.8 vs 1058.8 ± 36.1 mg/cm 3 ; P = .051). In multivariable models, ALM was positively associated with all bone parameters in obese women, and with whole-body aBMD, proximal tibial cortical area and SSI in non-obese women, and both non-obese and obese men (all P < .05). Lower-leg muscle density was also positively associated with cortical vBMD (B = 2.91; 95% CI 0.02, 5.80) and area (2.70; 0.06, 5.33) in obese women. Amongst components of sarcopenic obesity, higher ALM is a consistent independent predictor of better bone health. Low muscle density may also compromise bone health and balance. Interventions which improve muscle mass and composition may lower fracture risk in sarcopenic obesity. Copyright © 2017 Elsevier B.V. All rights reserved.

Grebe dysplasia - prenatal diagnosis based on rendered 3-D ultrasound images of fetal limbs.

PubMed

Goncalves, Luis F; Berger, Julie A; Macknis, Jacqueline K; Bauer, Samuel T; Bloom, David A

2017-01-01

Grebe dysplasia is a rare skeletal dysplasia characterized by severe acromesomelic shortening of the long bones in a proximal to distal gradient of severity, with bones of the hands and feet more severely affected than those of the forearms and legs, which in turn are more severely affected than the humeri and femora. In addition, the bones of the lower extremities tend to be more severely affected than the bones of the upper extremities. Despite the severe skeletal deformities, the condition is not lethal and surviving individuals can have normal intelligence. Herein we report a case of Grebe dysplasia diagnosed at 20 weeks of gestation. Rendered 3-D ultrasound images of the fetal limbs, particularly of the characteristic tiny and globular-looking fingers and toes, were instrumental in accurately characterizing the phenotype prenatally.

Prenatal nutritional manipulation by in ovo enrichment influences bone structure, composition, and mechanical properties.

PubMed

Yair, R; Shahar, R; Uni, Z

2013-06-01

The objective of this study was to examine the effect of embryonic nutritional enrichment on the development and properties of broiler leg bones (tibia and femur) from the prenatal period until maturity. To accomplish the objective, 300 eggs were divided into 2 groups: a noninjected group (control) and a group injected in ovo with a solution containing minerals, vitamins, and carbohydrates (enriched). Tibia and femur from both legs were harvested from chicks on embryonic days 19 (E19) and 21 (E21) and d 3, 7, 14, 28, and 54 posthatch (n = 8). The bones were mechanically tested (stiffness, maximal load, and work to fracture) and scanned in a micro-computed tomography (μCT) scanner to examine the structural properties of the cortical [cortical area, medullary area, cortical thickness, and maximal moment of inertia (Imax)] and trabecular (bone volume percent, trabecular thickness, and trabecular number) areas. To examine bone mineralization, bone mineral density (BMD) of the cortical area was obtained from the μCT scans, and bones were analyzed for the ash and mineral content. The results showed improved mechanical properties of the enriched group between E19 and d 3 and on d 14 (P < 0.05). Differences in cortical morphology were noted between E19 and d 14 as the enriched group had greater medullary area on E19 (femur), reduced medullary area on E21 (both bones), greater femoral cortical area on d 3, and greater Imax of both bones on d 14 (P < 0.05). The major differences in bone trabecular architecture were that the enriched group had greater bone volume percent and trabecular thickness in the tibia on d 7 and the femur on d 28 (P < 0.05). The pattern of mineralization between E19 and d 54 showed improved mineralization in the enriched group on E19 whereas on d 3 and 7, the control group showed a mineralization advantage, and on d 28 and 54, the enriched group showed again greater mineralization (P < 0.05). In summary, this study demonstrated that in ovo enrichment affects multiple bone properties pre- and postnatally and showed that avian embryos are a good model for studying the effect of embryonic nutrition on natal and postnatal development. Most importantly, the enrichment led to improved mechanical properties until d 14 (roughly third of the lifespan of the bird), a big advantage for the young broiler. Additionally, the improved mineralization and trabecular architecture on d 28 and 54 indicate a potential long-term effect of altering embryonic nutrition.

Age, gender, and race/ethnic differences in total body and subregional bone density.

PubMed

Looker, A C; Melton, L J; Harris, T; Borrud, L; Shepherd, J; McGowan, J

2009-07-01

Total body bone density of adults from National Health and Nutrition Examination Survey (NHANES) 1999-2004 differed as expected for some groups (men>women and blacks>whites) but not others (whites>Mexican Americans). Cross-sectional age patterns in bone mineral density (BMD) of older adults differed at skeletal sites that varied by degree of weight-bearing. Total body dual-energy X-ray absorptiometry (DXA) data offer the opportunity to compare bone density of demographic groups across the entire skeleton. The present study uses total body DXA data (Hologic QDR 4500A, Hologic, Bedford MA, USA) from the NHANES 1999-2004 to examine BMD of the total body and selected skeletal subregions in a wide age range of adult men and women from three race/ethnic groups. Total body, lumbar spine, pelvis, right leg, and left arm BMD and lean mass from 13,091 adults aged 20 years and older were used. The subregions were chosen to represent sites with different degrees of weight-bearing. Mean BMD varied in expected ways for some demographic characteristics (men>women and non-Hispanic blacks>non-Hispanic whites) but not others (non-Hispanic whites>Mexican Americans). Differences in age patterns in BMD also emerged for some characteristics (sex) but not others (race/ethnicity). Differences in cross-sectional age patterns in BMD and lean mass by degree of weight-bearing in older adults were observed for the pelvis, leg, and arm. This information may be useful for generating hypotheses about age, race, and sex differences in fracture risk in the population.

Three-dimensional printing as a technology supporting the treatment of lower limb deformity and shortening with the Ilizarov method.

PubMed

Morasiewicz, Piotr; Burzyńska, Karolina; Orzechowski, Wiktor; Dragan, Szymon Łukasz; Dragan, Szymon Feliks; Filipiak, Jarosław

2018-04-20

Treatment of multiplanar deformities, especially in younger children, requires construction of a complex Ilizarov fixator, frequently with small dimensions. The aim of this study is to verify clinical application of a3D-printed bone model in treatment with the Ilizarov method. The study involved a 6-year-old child in whom clinical and radiological examination revealed multiplanar deformity of the right leg. Then, 3D models of individual bones were printed by means of additive manufacturing and were used as a scaffold to install the Ilizarov apparatus. To compare the expected and factual axial correction and lengthening, we measured spatial orientation of bone fragments three times. The factual axial correction and lengthening were determined with a photometric technique. Ilizarov fixator with a configuration developed using a 3D model of the treated bone was mounted on the patient's leg. Corticotomy was carried out at the proximal metaphysis of the right tibia, along with osteotomy of the right talus. The treatment resulted in a 3.5-cm lengthening of the limb and a 7° correction of valgus angle. The values of actual lengthening and axial correction were 4.1% lower than the expected values of these parameters. Orthopedists should consider differences between the expected and actual lengthening and axial correction in planning treatment with the Ilizarov method. Three-dimensional printing is a useful technology that can be used to support treatment with the Ilizarov method. Copyright © 2018 IPEM. Published by Elsevier Ltd. All rights reserved.

Analytical Prediction of Lower Leg Injury in a Vehicular Mine Blast Event

DTIC Science & Technology

2010-01-01

the spring constant of the tibia is nearly arbitrary; the spring constant of the boot assumes a hard ethylene propylene diene monomer ( EPDM ) rubber ...the sole of the boot. The significantly lower spring constant of the EPDM rubber in the sole compared to the bone structures greatly diminished the

Sprint Interval Training Induces A Sexual Dimorphism but does not Improve Peak Bone Mass in Young and Healthy Mice

PubMed Central

Koenen, Kathrin; Knepper, Isabell; Klodt, Madlen; Osterberg, Anja; Stratos, Ioannis; Mittlmeier, Thomas; Histing, Tina; Menger, Michael D.; Vollmar, Brigitte; Bruhn, Sven; Müller-Hilke, Brigitte

2017-01-01

Elevated peak bone mass in early adulthood reduces the risk for osteoporotic fractures at old age. As sports participation has been correlated with elevated peak bone masses, we aimed to establish a training program that would efficiently stimulate bone accrual in healthy young mice. We combined voluntary treadmill running with sprint interval training modalities that were tailored to the individual performance limits and were of either high or intermediate intensity. Adolescent male and female STR/ort mice underwent 8 weeks of training before the hind legs were analyzed for cortical and trabecular bone parameters and biomechanical strength. Sprint interval training led to increased running speeds, confirming an efficient training. However, males and females responded differently. The males improved their running speeds in response to intermediate intensities only and accrued cortical bone at the expense of mechanical strength. High training intensities induced a significant loss of trabecular bone. The female bones showed neither adverse nor beneficial effects in response to either training intensities. Speculations about the failure to improve geometric alongside mechanical bone properties include the possibility that our training lacked sufficient axial loading, that high cardio-vascular strains adversely affect bone growth and that there are physiological limits to bone accrual. PMID:28303909

Radiographic anatomy of the foot and ankle—part 4: the metatarsals.

PubMed

Christman, Robert A

2015-01-01

The normal radiographic anatomy of the foot and ankle, aside from my previous work, has been addressed only superficially or sparingly in the medical literature. This project correlates the detailed radiographic anatomy of the entire adult foot and ankle (two-dimensional) to osteology (three-dimensional). Each bone's position was determined after meticulous examination and correlation to an articulated skeleton relative to the image receptor and direction of the x-ray beam, with correlation to the radiograph for confirmation. Images of each foot and distal leg bone ("front" and "back" perspectives) are presented alongside a corresponding radiographic image for comparison. The normal gross and radiographic anatomy is correlated and described for each radiographic positioning technique. Foundational knowledge is provided that future researchers can use as a baseline ("normal") and that students and practitioners can use for comparison when interpreting radiographs and distinguishing abnormal findings. The results of the original project, owing to its broad scope, have been divided into five parts: the lower leg, the greater tarsus, the lesser tarsus, the metatarsals (the focus of this article), and the phalanges.

Radiographic anatomy of the foot and ankle-part 5. The phalanges.

PubMed

Christman, Robert A

2015-03-01

The normal radiographic anatomy of the foot and ankle, aside from my previous work, has been addressed only superficially or sparingly in the medical literature. This project correlates the detailed radiographic anatomy of the entire adult foot and ankle (two-dimensional) to osteology (three-dimensional). Each bone's position was determined after meticulous examination and correlation to an articulated skeleton relative to the image receptor and direction of the x-ray beam, with correlation to the radiograph for confirmation. Images of each foot and distal leg bone ("front" and "back" perspectives) are presented alongside a corresponding radiographic image for comparison. The normal gross and radiographic anatomy is correlated and described for each radiographic positioning technique. Foundational knowledge is provided that future researchers can use as a baseline ("normal") and that students and practitioners can use for comparison when interpreting radiographs and distinguishing abnormal findings. The results of the original project, owing to its broad scope, have been divided into five parts: the lower leg, the greater tarsus, the lesser tarsus, the metatarsals, and the phalanges (the focus of this article).

Radiographic anatomy of the foot and ankle-part 2: the greater tarsus.

PubMed

Christman, Robert A

2014-01-01

Normal radiographic anatomy of the foot and ankle, aside from my previous work, has been addressed only superficially or sparingly in the medical literature. This project correlates detailed radiographic anatomy of the entire adult foot and ankle (two-dimensional) to osteology (three-dimensional). Each bone's position was determined after meticulous examination and correlation to an articulated skeleton relative to the image receptor and direction of the x-ray beam, with correlation to the radiograph for confirmation. Images of each foot and distal leg bone ("front" and "back" perspectives) are presented alongside a corresponding radiographic image for comparison. The normal gross and radiographic anatomy is correlated and described for each radiographic positioning technique. Foundational knowledge is provided that future researchers can use as a baseline ("normal") and that students and practitioners can use for comparison when interpreting radiographs and distinguishing abnormal findings. The results of the original project, owing to its broad scope, have been divided into five parts: the lower leg, the greater tarsus (the focus of this article), the lesser tarsus, the metatarsals, and the phalanges.

Determination of in vivo mechanical properties of long bones from their impedance response curves

NASA Technical Reports Server (NTRS)

Borders, S. G.

1981-01-01

A mathematical model consisting of a uniform, linear, visco-elastic, Euler-Bernoulli beam to represent the ulna or tibia of the vibrating forearm or leg system is developed. The skin and tissue compressed between the probe and bone is represented by a spring in series with the beam. The remaining skin and tissue surrounding the bone is represented by a visco-elastic foundation with mass. An extensive parametric study is carried out to determine the effect of each parameter of the mathematical model on its impedance response. A system identification algorithm is developed and programmed on a digital computer to determine the parametric values of the model which best simulate the data obtained from an impedance test.

Free flap reconstructions of tibial fractures complicated after internal fixation.

PubMed

Nieminen, H; Kuokkanen, H; Tukiainen, E; Asko-Seljavaara, S

1995-04-01

The cases of 15 patients are presented where microvascular soft-tissue reconstructions became necessary after internal fixation of tibial fractures. Primarily, seven of the fractures were closed. Eleven fractures had originally been treated by open reduction and internal fixation using plates and screws, and four by intramedullary nailing. All of the patients suffered from postoperative complications leading to exposure of the bone or fixation material. The internal fixation material was removed and radical revision of dead and infected tissue was carried out in all cases. Soft tissue reconstruction was performed using a free microvascular muscle flap (11 latissimus dorsi, three rectus abdominis, and one gracilis). In eight cases the nonunion of the fracture indicated external fixation. The microvascular reconstruction was successful in all 15 patients. In one case the recurrence of deep infection finally indicated a below-knee amputation. In another case, chronic infection with fistulation recurred postoperatively. After a mean follow-up of 26 months the soft tissue coverage was good in all the remaining 13 cases. All the fractures united. Microvascular free muscle flap reconstruction of the leg is regarded as a reliable method for salvaging legs with large soft-tissue defects or defects in the distal leg. If after internal fixation of the tibial fracture the osteosynthesis material or fracture is exposed, reconstruction of the soft-tissue can successfully be performed by free flap transfer. By radical revision, external fixation, bone grafting, and a free flap the healing of the fracture can be achieved.

Real-time three-dimensional digital image correlation for biomedical applications

NASA Astrophysics Data System (ADS)

Wu, Rong; Wu, Hua; Arola, Dwayne; Zhang, Dongsheng

2016-10-01

Digital image correlation (DIC) has been successfully applied for evaluating the mechanical behavior of biological tissues. A three-dimensional (3-D) DIC system has been developed and applied to examining the motion of bones in the human foot. To achieve accurate, real-time displacement measurements, an algorithm including matching between sequential images and image pairs has been developed. The system was used to monitor the movement of markers which were attached to a precisely motorized stage. The accuracy of the proposed technique for in-plane and out-of-plane measurements was found to be -0.25% and 1.17%, respectively. Two biomedical applications were presented. In the experiment involving the foot arch, a human cadaver lower leg and foot specimen were subjected to vertical compressive loads up to 700 N at a rate of 10 N/s and the 3-D motions of bones in the foot were monitored in real time. In the experiment involving distal tibio fibular syndesmosis, a human cadaver lower leg and foot specimen were subjected to a monotonic rotational torque up to 5 Nm at a speed of 5 deg per min and the relative displacements of the tibia and fibula were monitored in real time. Results showed that the system could reach a frequency of up to 16 Hz with 6 points measured simultaneously. This technique sheds new lights on measuring 3-D motion of bones in biomechanical studies.

[Role of an interdisciplinary approach in the healing of long bone fractures in patients with osteogenesis imperfecta].

PubMed

Kokavec, M; Novorolský, K; Pribilincová, Z

2008-06-01

The aim of the study was to analyze a group of patients who had undergone multilevel osteotomy of long bones and medication therapy for osteogenesis imperfecta (OI). The group included 14 OI patients (nine girls and five boys) operated on in the years 1996 to 2006, who ranged in age from 3 to 17 years (average, 8.2 years). Due to residual deformation following a fracture of or because of treatment for acute trauma to long bones of the lower extremities, the patients underwent multilevel osteotomy with the use of osteosynthesis (Prevot's rod, six patients; Kirschner's wire, three patients; Küntcher's nail, three patients; Rush's nail, one patient; condylar plate, one patient). A special working and rehabilitation program played an important role in the therapeutic protocol. Four patients treated after 2003 received Pamidronate. Sufficient correction of axil deformity of the legs and equal leg length resulting in gait improvement were achieved in 11 patients. In one patient, osteosynthesis with a condylar plate failed and it was necessary to apply intramedullary elastic fixation. In one patient, tibia vara developed following Küntcher's nail osteosynthesis. In one patient, disunion of bone from osteosynthetic material, with a subsequent supracondylar fracture under the Küntcher's nail, was recorded. Pamidronate administered in pre- and post-operative periods to the four patients treated after 2003 reduced the need for their immobilization from 6 to 3 weeks, which permitted early rehabilitation and, in one patient, first standing and walking at the age of 12 years. The treatment of long bone fractures in OI patients is based on the assumptions that bone healing is not affected and that long immobilization leads to deterioration of osteopenia and to a risk of further fractures. For these reasons, surgical procedures using intramedullary fixation have recently been preferred. Pamidronate administration alleviates pain, improves muscle tonus, reduces the period of immobilization and enhances bone density. The multidisciplinary, rational approach, which involves early surgical intramedullary fixation of fractures with subsequent rehabilitation and Pamidronate administration, is considered to provide a more effective therapy with better results and therefore better quality of life in patients with osteogenesis imperfecta.

A Comparison between the Effects of Aerobic Dance Training on Mini-Trampoline and Hard Wooden Surface on Bone Resorption, Health-Related Physical Fitness, Balance, and Foot Plantar Pressure in Thai Working Women.

PubMed

Sukkeaw, Wittawat; Kritpet, Thanomwong; Bunyaratavej, Narong

2015-09-01

To compare the effects of aerobic dance training on mini-trampoline and hard wooden surface on bone resorption, health-related physical fitness, balance, and foot plantar pressure in Thai working women. Sixty-three volunteered females aged 35-45 years old participated in the study and were divided into 3 groups: A) aerobic dance on mini-trampoline (21 females), B) aerobic dance on hard wooden surface (21 females), and C) control group (21 females). All subjects in the aerobic dance groups wore heart rate monitors during exercise. Aerobic dance worked out 3 times a week, 40 minutes a day for 12 weeks. The intensity was set at 60-80% of the maximum heart rate. The control group engaged in routine physical activity. The collected data were bone formation (N-terminal propeptine of procollagen type I: P1NP) bone resorption (Telopeptide cross linked: β-CrossLaps) health-related physical fitness, balance, and foot plantar pressure. The obtained data from pre- and post trainings were compared and analyzed by paired samples t-test and one way analysis of covariance. The significant difference was at 0.05 level. After the 12-week training, the biochemical bone markers of both mini-trampoline and hard wooden surface aerobic dance training subjects decreased in bone resorption (β-CrossLaps) but increased in boneformation (P1NP). Health-related physical fitness, balance, and foot plantar pressure were not only better when comparing to the pre-test result but also significantly different when comparing to the control group (p < 0.05). The aerobic dance on mini-trampoline showed that leg muscular strength, balance and foot plantar pressure were significantly better than the aerobic dance on hard wooden surface (p < 0.05). The aerobic dance on mini-trampoline and hard wooden surface had positive effects on biochemical bone markers. However, the aerobic dance on mini-trampoline had more leg muscular strength and balance including less foot plantar pressure. It is considered to be an appropriate exercise programs in working women.

Indian girls have higher bone mineral content per unit of lean body than boys through puberty.

PubMed

Khadilkar, Anuradha V; Sanwalka, Neha; Mughal, M Zulf; Chiplonkar, Shashi; Khadilkar, Vaman

2018-05-01

Our aim is to describe changes in the muscle-bone unit assessed as a ratio of bone mineral content (BMC) to lean body mass (LBM) through puberty at total body and various skeletal sites in Indian boys and girls. A cross-sectional study was conducted (888 children, 480 boys, aged 5-17 years) in Pune, India. Pubertal staging was assessed. BMC, LBM and fat percentage at the arms, legs, android, gynoid and total body (less the head) were assessed by dual energy X-ray absorptiometry. The amount of BMC per unit LBM (BMC/LBM) was computed. Changes in mean BMC/LBM at 5 Tanner (pubertal) stages after adjustment for age and fat percentage were calculated. In boys, adjusted BMC/LBM was significantly higher with successive Tanner stages [legs (TS-II vs TS-I), android (TS-III vs TS-II, TS-IV vs TS-III) and gynoid region (TS-III vs TS-II and TS-II vs TS-I) (p < 0.05)]. In girls, adjusted BMC/LBM was significantly higher with successive Tanner stages at total body, legs and gynoid (TS-III vs TS-II; TS-II vs TS-I; TS-V vs TS-IV), arms (TS-I to TS-V) and android regions (TS-V vs TS-IV) (p < 0.05). Boys had significantly higher adjusted BMC/LBM than girls at earlier Tanner stages (TS-I to TS-III), whereas girls had significantly higher adjusted BMC/LBM than boys at later Tanner stages (TS-IV, TS-V) (p < 0.05). Indian boys and girls showed higher total and regional body, and age- and fat percentage-adjusted BMC/LBM with successive pubertal stages. Girls had higher BMC/LBM than boys which may possibly act as a reservoir for later demands of pregnancy and lactation.

New method of fixation of in-bone implanted prosthesis

PubMed Central

Pitkin, Mark; Cassidy, Charles; Muppavarapu, Raghuveer; Raymond, James; Shevtsov, Maxim; Galibin, Oleg; Rousselle, Serge D.

2013-01-01

This article presents results on the effectiveness of a new version of the titanium porous composite skin and bone integrated pylon (SBIP). The SBIP is designed for direct skeletal attachment of limb prostheses and was evaluated in a pre-clinical study with three rabbits. In accordance with the study protocol, a new version of the pylon (SBIP-3) was implanted into the hind leg residuum of three rabbits. The SBIP-3 has side fins that are designed to improve the bond between the bone and pylon. The fins are positioned inside two slots precut in the bone walls; their length can be adjusted to match the thickness of the bone walls. After 13 (animal 1) or 26 wk (animals 2 and 3), the animals were sacrificed and samples collected for histopathological analysis. The space between the fins and the bone into which they were fit was filled with fibro-vascular tissue and woven bone. No substantial inflammation was found. We suggest that if further studies substantiate the present results, the proposed method can become an alternative to the established technique of implanting prostheses into the medullar canal of the hosting bone. PMID:24013918

A Comparative Finite-Element Analysis of Bone Failure and Load Transfer of Osseointegrated Prostheses Fixations

PubMed Central

Tomaszewski, P. K.; Verdonschot, N.; Bulstra, S. K.

2010-01-01

An alternative solution to conventional stump–socket prosthetic limb attachment is offered by direct skeletal fixation. This study aimed to assess two percutaneous trans-femoral implants, the OPRA system (Integrum AB, Göteborg, Sweden), and the ISP Endo/Exo prosthesis (ESKA Implants AG, Lübeck, Germany) on bone failure and stem–bone interface mechanics both early post-operative (before bony ingrowth) and after full bone ingrowth. Moreover, mechanical consequences of implantation of those implants in terms of changed loading pattern within the bone and potential consequences on long-term bone remodeling were studied using finite-element models that represent the intact femur and implants fitted in amputated femora. Two experimentally measured loads from the normal walking cycle were applied. The analyses revealed that implantation of percutaneous prostheses had considerable effects on stress and strain energy density levels in bone. This was not only caused by the implant itself, but also by changed loading conditions in the amputated leg. The ISP design promoted slightly more physiological strain energy distribution (favoring long-term bone maintenance), but the OPRA design generated lower bone stresses (reducing bone fracture risk). The safety factor against mechanical failure of the two percutaneous designs was relatively low, which could be improved by design optimization of the implants. PMID:20309731

Computational Models of Exercise on the Advanced Resistance Exercise Device (ARED)

NASA Technical Reports Server (NTRS)

Newby, Nate; Caldwell, Erin; Scott-Pandorf, Melissa; Peters,Brian; Fincke, Renita; DeWitt, John; Poutz-Snyder, Lori

2011-01-01

Muscle and bone loss remain a concern for crew returning from space flight. The advanced resistance exercise device (ARED) is used for on-orbit resistance exercise to help mitigate these losses. However, characterization of how the ARED loads the body in microgravity has yet to be determined. Computational models allow us to analyze ARED exercise in both 1G and 0G environments. To this end, biomechanical models of the squat, single-leg squat, and deadlift exercise on the ARED have been developed to further investigate bone and muscle forces resulting from the exercises.

[Bone sequestration in alpacas in Germany - A practice report with 12 cases].

PubMed

Kobera, Ralph; Wagner, Henrik

2018-04-01

Bone sequestration is relatively unknown in New-world camelids in Germany and is frequently wrongly addressed as neoplasia by veterinary practitioners. This clinical case report describes diagnosis and treatment for bone sequestration in alpacas based on 12 cases. The main symptom of the presented alpacas was moderate to severe lameness in one limb. Some of the patients had been treated with nonsteroidal anti-inflammatory drugs by the referring veterinarian. In eight alpacas, palpation of the swelling in the affected leg was painful and in five animals, exudation was observed. Radiographic imaging led to a correct diagnosis in all of the cases. Following surgical removal of the bone sequestrum, the lameness was already noticeably improved by the third postoperative day. In all patients, healing was achieved without any complications. These results show that bone sequestration in alpacas can be treated successfully by timely surgery. This is the first case report on this topic in alpacas in Germany. Schattauer GmbH.

[Multiple myeloma with significant multifocal osteolysis in a dog without a detectible gammopathy].

PubMed

Souchon, F; Koch, A; Sohns, A

2013-01-01

Description of a variant of multiple myeloma in a dog lacking the gammopathy normally associated with this type of neoplasm. A Border Collie mongrel was presented with symptoms of progressive hind-leg weakness, lethargy and tiredness, which had started to appear 6 weeks previously. Radiographic examination showed small osteolytic areas in the spinal column, but also diffuse small areas of increased opacity as well as evidence of decreased bone density in the pelvis and of both femoral necks. Moderate regenerative anaemia, hypogammopathy and hypercalcaemia were diagnosed. Computed tomography scans displayed multifocal osteolysis and bone destruction in the skull, spinal column, scapulae, proximal humeri, pelvis and femoral necks. H&E staining of the biopsies showed bone destruction and monomorphic plasmacyotid cell populations, causing infiltrative bone marrow lesions and osteolysis. In many areas neoplastic plasma cell infiltration of the bone marrow was 70% and in some areas reached 100%. The diagnosis was non-secretory multiple myeloma without apparent secretion of paraproteins into the blood.

Identification tibia and fibula bone fracture location using scanline algorithm

NASA Astrophysics Data System (ADS)

Muchtar, M. A.; Simanjuntak, S. E.; Rahmat, R. F.; Mawengkang, H.; Zarlis, M.; Sitompul, O. S.; Winanto, I. D.; Andayani, U.; Syahputra, M. F.; Siregar, I.; Nasution, T. H.

2018-03-01

Fracture is a condition that there is a damage in the continuity of the bone, usually caused by stress, trauma or weak bones. The tibia and fibula are two separated-long bones in the lower leg, closely linked at the knee and ankle. Tibia/fibula fracture often happen when there is too much force applied to the bone that it can withstand. One of the way to identify the location of tibia/fibula fracture is to read X-ray image manually. Visual examination requires more time and allows for errors in identification due to the noise in image. In addition, reading X-ray needs highlighting background to make the objects in X-ray image appear more clearly. Therefore, a method is required to help radiologist to identify the location of tibia/fibula fracture. We propose some image-processing techniques for processing cruris image and Scan line algorithm for the identification of fracture location. The result shows that our proposed method is able to identify it and reach up to 87.5% of accuracy.

Bone marrow metastasis of malignant melanoma in childhood arising within a congenital melanocytic nevus.

PubMed

Volejnikova, Jana; Bajciova, Viera; Sulovska, Lucie; Geierova, Marie; Buriankova, Eva; Jarosova, Marie; Hajduch, Marian; Sterba, Jaroslav; Mihal, Vladimir

2016-09-01

Malignant melanoma in childhood is infrequent and can arise within congenital melanocytic nevi. Spread of malignant melanoma to the bone marrow, especially in children, is extremely rare. Reported is a case of a 5-year-old boy with a congenital large melanocytic nevus of the head and neck who presented with a short history of low back and leg pain, fever and cervical lymphadenopathy. Despite regular follow-up by a dermatologist and plastic surgeon and repeatedly negative histology of previous partial excisions, diffuse bone marrow infiltration with malignant melanoma was diagnosed. The primary site was identified in the post-excision area. The disease progressed rapidly on ipilimumab immunotherapy and led to death at four months from the diagnosis. Surveillance is indispensable in children with a predisposition to melanoma and nonspecific symptoms such as bone pain, gait impairment or cytopenia, should always be taken into account.

Computational modeling to predict mechanical function of joints: application to the lower leg with simulation of two cadaver studies.

PubMed

Liacouras, Peter C; Wayne, Jennifer S

2007-12-01

Computational models of musculoskeletal joints and limbs can provide useful information about joint mechanics. Validated models can be used as predictive devices for understanding joint function and serve as clinical tools for predicting the outcome of surgical procedures. A new computational modeling approach was developed for simulating joint kinematics that are dictated by bone/joint anatomy, ligamentous constraints, and applied loading. Three-dimensional computational models of the lower leg were created to illustrate the application of this new approach. Model development began with generating three-dimensional surfaces of each bone from CT images and then importing into the three-dimensional solid modeling software SOLIDWORKS and motion simulation package COSMOSMOTION. Through SOLIDWORKS and COSMOSMOTION, each bone surface file was filled to create a solid object and positioned necessary components added, and simulations executed. Three-dimensional contacts were added to inhibit intersection of the bones during motion. Ligaments were represented as linear springs. Model predictions were then validated by comparison to two different cadaver studies, syndesmotic injury and repair and ankle inversion following ligament transection. The syndesmotic injury model was able to predict tibial rotation, fibular rotation, and anterior/posterior displacement. In the inversion simulation, calcaneofibular ligament extension and angles of inversion compared well. Some experimental data proved harder to simulate accurately, due to certain software limitations and lack of complete experimental data. Other parameters that could not be easily obtained experimentally can be predicted and analyzed by the computational simulations. In the syndesmotic injury study, the force generated in the tibionavicular and calcaneofibular ligaments reduced with the insertion of the staple, indicating how this repair technique changes joint function. After transection of the calcaneofibular ligament in the inversion stability study, a major increase in force was seen in several of the ligaments on the lateral aspect of the foot and ankle, indicating the recruitment of other structures to permit function after injury. Overall, the computational models were able to predict joint kinematics of the lower leg with particular focus on the ankle complex. This same approach can be taken to create models of other limb segments such as the elbow and wrist. Additional parameters can be calculated in the models that are not easily obtained experimentally such as ligament forces, force transmission across joints, and three-dimensional movement of all bones. Muscle activation can be incorporated in the model through the action of applied forces within the software for future studies.

Should congruence between intra- and interspecific ecomorphological relationships be expected? A case study with the great tit, Parus major

PubMed Central

Moreno, E.; Barbosa, A.; Carrascal, L. M.

1997-01-01

We studied the relationship between leg morphology and posture while feeding in a population of great tits (Parus major) under controlled conditions to investigate to what extent morphology and ecology are linked at the individual level. From predictions generated at the interspecific level within the genus Parus (Moreno and Carrascal 1993), we tested whether intra- and interspecific ecomorphological relationships are consistent. Within our population, neither leg bone lengths nor leg muscle morphology were related to the feeding posture of individuals. However, differences in body weight were correlated with inter-individual differences in time spent hanging. These results demonstrate that the association between intra- and interspecific ecomorphological relationships is not uniform. We argue that, at the intraspecific level, body weight overrides the significance of other traits that have a functional meaning at the interspecific level (i.e. leg segment lengths, muscular morphology), due to isometric variation of morphological traits (muscular and skeletal) with body mass. Thus, the discrepancy between the ecomorphological associations at intra- and interspecific levels is the result of a problem of scale (morphological changes in evolutionary time and isometric variation of morphological traits with body mass in ecological time).

A system for evaluation and exercise-conditioning of paralyzed leg muscles.

PubMed

Gruner, J A; Glaser, R M; Feinberg, S D; Collins, S R; Nussbaum, N S

1983-07-01

The purpose of this project was to develop instrumentation and protocols in which electrical stimulation is used to induce exercise in paralyzed quadriceps muscles strength and endurance evaluation and conditioning. A computer-controlled electrical stimulation system, using surface electrodes, automatically regulates the bouts of leg extension exercise. Load weights attached just above the ankles can be progressively increased over a number of training sessions in such a manner that a measure of the fitness of the legs can be obtained. With three exercise sessions per week for 9 weeks, the strength and endurance of the quadriceps muscles of two paraplegic and four quadriplegic subjects were gradually and safely increased. During exercise at a means load weight of 5.4 kg, means heart rate did not rise above rest, whereas systolic blood pressure increased about 20 mm Hg, and skin temperature above the active muscles increased about 1.75 degrees C. Such exercise conditioning appears to be safe and may provide important health benefits, including improved fitness of the muscles and bones, better circulation in the paralyzed limbs, and enhanced self-image. Conditioned electrically stimulated paralyzed leg muscles may be used for locomotion in conjunction with special vehicles.

Unusually large solitary unicameral bone cyst: case report.

PubMed

Singh, Sandeep; Dhammi, Ish Kumar; Arora, Anil; Kumar, Sudhir

2003-01-01

A 15-year-old boy presented with complaints of pain and swelling of the right leg. Radiography revealed a large lytic lesion involving the proximal half of the tibia. The patient was taken to surgery, where the cavity was curetted and packed with allogeneic bone graft. Tissue was sent for histopathological evaluation. The patient was kept in an above-knee cast for 4 months, after which partial weight-bearing was allowed. The histopathological diagnosis was a unicameral bone cyst. A radiograph at 1 year showed incorporation of the graft, but a small part of the cavity was still visible and there was a persistent discharge. The patient was again subjected to allogeneic bone grafting in the remaining cavity. At 3.5 years of follow-up now, the patient is walking unsupported, there is no pain, and the radiograph shows complete obliteration of the cavity. Unicameral bone cysts are usually a few centimeters in size. To the best of our knowledge, a unicameral bone cyst of such a large size has never been reported in the literature.

Strategies for Managing Massive Defects of the Foot in High-Energy Combat Injuries of the Lower Extremity

DTIC Science & Technology

2010-01-01

infection, or avascular necrosis is extremely difficult. Tibiocalcaneal fusion typically leaves a patient with a leg length discrepancy unless large bone...fractures. J Orthop Trauma 2004;18(5):265–70. 37. Dennison MG, Pool RD, Simonis RB, et al. Tibiocalcaneal fusion for avascular necrosis of the talus

Scaling in Theropod Dinosaurs: Femoral Bone Strength and Locomotion II

ERIC Educational Resources Information Center

Lee, Scott

2015-01-01

In the second paper of this series, the effect of transverse femoral stresses due to locomotion in theropod dinosaurs of different sizes was examined for the case of an unchanging leg geometry. Students are invariably thrilled to learn about theropod dinosaurs, and this activity applies the concepts of torque and stress to the issue of theropod…

Frequency and Associated Factors of Bone Fractures in Russians: The Ural Eye and Medical Study.

PubMed

Bikbov, Mukharram M; Fayzrakhmanov, Rinat R; Kazakbaeva, Gyulli M; Zainullin, Rinat M; Salavatova, Venera F; Gilmanshin, Timur R; Arslangareeva, Inga I; Nikitin, Nikolai A; Panda-Jonas, Songhomitra; Mukhamadieva, Svetlana R; Yakupova, Dilya F; Khikmatullin, Renat I; Aminev, Said K; Nuriev, Ildar F; Zaynetdinov, Artur F; Uzianbaeva, Yulia V; Jonas, Jost B

2018-05-10

With information about frequency of bone fractures in Russia mostly missing, we assessed the frequency of previous bone fractures in a Russian population. The population-based study Ural Eye and Medical Study included 5899 (80.5%) out of 7328 eligible individuals (mean age: 59.0 ± 10.7 years; range: 40-94 years). The history of previous bone fractures was assessed in a standardized interview for 5397 (91.5%) individuals. Mean frequency of any previous bone fracture was 1650/5397 (30.6%; 95% confidence interval (CI): 29, 3, 31.8). In multivariate analysis, higher frequency of bone fractures was associated with male sex (P < 0.001; odds ratio (OR): 1.67; 95% CI: 1.41, 2.00), urban region (P < 0.001; OR: 1.45; 95% CI: 1.23, 1.72), higher prevalence of vigorous activity during leisure (P < 0.001; OR: 1.42; 95% CI: 1.20, 1.68), current smoking (P = 0.001; OR: 1.46; 95% CI: 1.16, 1.82) and higher prevalence of cardiovascular disease (P = 0.007; OR: 1.29; 95% CI: 1.07, 1.56), low blood pressure episodes with hospital admission (P = 0.001; OR: 2.08; 95% CI: 1.37, 3.16), tumbling (P < 0.001; OR: 2.58; 95% CI: 1.37, 3.16) and thoracic spine pain (P < 0.001; OR: 1.43; 95% CI: 1.18, 1.73). In women, menopause (P < 0.001; OR: 2.17; 95% CI: 1.47, 3.22) was additionally associated. The most common single-bone fractures involved leg and knee (229/5397; 4.2%), hand in general (n = 169; 3.1%) or hand wrist only (n = 97; 1.8%), arm (n = 94; 1.7%) and ankle (n = 67; 1.2%). Severe fractures included spine (n = 35; 0.6%), os sacrum (n = 10; 0.2%), skull (n = 6; 0.1%), pelvis (n = 5; 0.1%) and hip (n = 22; 0.4%). Most frequent combined fractures included as most important part the leg (n = 90; 1.7%), spine (n = 18; 0.3%), and hip (n = 18; 0.3). These data give hints on the epidemiology of bone fractures in Russia.

Numerical modeling anti-personnel blast mines coupled to a deformable leg structure

NASA Astrophysics Data System (ADS)

Cronin, Duane; Worswick, Mike; Williams, Kevin; Bourget, Daniel; Pageau, Gilles

2001-06-01

The development of improved landmine protective footwear requires an understanding of the physics and damage mechanisms associated with a close proximity blast event. Numerical models have been developed to model surrogate mines buried in soil using the Arbitrary Lagrangian Eulerian (ALE) technique to model the explosive and surrounding air, while the soil is modeled as a deformable Lagrangian solid. The advantage of the ALE model is the ability to model large deformations, such as the expanding gases of a high explosive. This model has been validated using the available experimental data [1]. The effect of varying depth of burial and soil conditions has been investigated with these numerical models and compares favorably to data in the literature. The surrogate landmine model has been coupled to a numerical model of a Simplified Lower Leg (SLL), which is designed to mimic the response and failure mechanisms of a human leg. The SLL consists of a bone and tissue simulant arranged as concentric cylinders. A new strain-rate dependant hyperelastic material model for the tissue simulant, ballistic gelatin, has been developed to model the tissue simulant response. The polymeric bone simulant material has been characterized and implemented as a strain-rate dependent material in the numerical model. The numerical model results agree with the measured response of the SLL during experimental blast tests [2]. The numerical model results are used to explain the experimental data. These models predict that, for a surface or sub-surface buried anti-personnel mine, the coupling between the mine and SLL is an important effect. In addition, the soil properties have a significant effect on the load transmitted to the leg. [1] Bergeron, D., Walker, R. and Coffey, C., 1998, “Detonation of 100-Gram Anti-Personnel Mine Surrogate Charges in Sand”, Report number SR 668, Defence Research Establishment Suffield, Canada. [2] Bourget, D., Williams, K., Pageau, G., and Cronin, D., “AP Mine Blast Effects on Surrogate Lower Leg”, Military Aspects of Ballistics and Shock, MABS 16, 2000.

Intra-operative digital imaging: assuring the alignment of components when undertaking total hip arthroplasty.

PubMed

Hambright, D; Hellman, M; Barrack, R

2018-01-01

The aims of this study were to examine the rate at which the positioning of the acetabular component, leg length discrepancy and femoral offset are outside an acceptable range in total hip arthroplasties (THAs) which either do or do not involve the use of intra-operative digital imaging. A retrospective case-control study was undertaken with 50 patients before and 50 patients after the integration of an intra-operative digital imaging system in THA. The demographics of the two groups were comparable for body mass index, age, laterality and the indication for surgery. The digital imaging group had more men than the group without. Surgical data and radiographic parameters, including the inclination and anteversion of the acetabular component, leg length discrepancy, and the difference in femoral offset compared with the contralateral hip were collected and compared, as well as the incidence of altering the position of a component based on the intra-operative image. Digital imaging took a mean of five minutes (2.3 to 14.6) to perform. Intra-operative changes with the use of digital imaging were made for 43 patients (86%), most commonly to adjust leg length and femoral offset. There was a decrease in the incidence of outliers when using intra-operative imaging compared with not using it in regard to leg length discrepancy (20% versus 52%, p = 0.001) and femoral offset inequality (18% versus 44%, p = 0.004). There was also a difference in the incidence of outliers in acetabular inclination (0% versus 7%, p = 0.023) and version (0% versus 4%, p = 0.114) compared with historical results of a high-volume surgeon at the same centre. The use of intra-operative digital imaging in THA improves the accuracy of the positioning of the components at THA without adding a substantial amount of time to the operation. Cite this article: Bone Joint J 2018;100B(1 Supple A):36-43. ©2018 The British Editorial Society of Bone & Joint Surgery.

Muscle function in Turner syndrome: normal force but decreased power.

PubMed

Soucek, Ondrej; Lebl, Jan; Matyskova, Jana; Snajderova, Marta; Kolouskova, Stanislava; Pruhova, Stepanka; Hlavka, Zdenek; Sumnik, Zdenek

2015-02-01

Although hypogonadism and SHOX gene haploinsufficiency likely cause the decreased bone mineral density and increased fracture rate associated with Turner syndrome (TS), the exact mechanism remains unclear. We tested the hypothesis that muscle dysfunction in patients with TS contributes to increased fracture risk. The secondary aim was to determine whether menarche, hormone therapy duration, positive fracture history and genotype influence muscle function parameters in patients with TS. A cross-sectional study was conducted in a single university hospital referral centre between March 2012 and October 2013. Sixty patients with TS (mean age of 13·7 ± 4·5 years) were compared to the control group of 432 healthy girls. A Leonardo Mechanograph(®) Ground Reaction Force Platform was used to assess muscle force (Fmax ) by the multiple one-legged hopping test and muscle power (Pmax ) by the single two-legged jump test. While the Fmax was normal (mean weight-specific Z-score of 0·11 ± 0·77, P = 0·27), the Pmax was decreased in patients with TS (Z-score of -0·93 ± 1·5, P < 0·001) compared with healthy controls. The muscle function parameters were not significantly influenced by menarcheal stage, hormone therapy duration, fracture history or genotype (linear regression adjusted for age, weight and height; P > 0·05 for all). Fmax , a principal determinant of bone strength, is normal in patients with TS. Previously described changes in bone quality and structure in TS are thus not likely related to inadequate mechanical loading but rather represent a primary bone deficit. A decreased Pmax indicates impaired muscle coordination in patients with TS. © 2014 John Wiley & Sons Ltd.

Sci-Fri PM: Radiation Therapy, Planning, Imaging, and Special Techniques - 07: Transitioning from extended-distance total body irradiation to optimized VMAT total marrow irradiation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cherpak, Amanda; Chytyk-Praznik, Krista; Yewondwos

2016-08-15

Purpose: TMI targets only the bone marrow, with the intent of sparing normal tissues. The NSCC has recently implemented a TMI protocol which includes VMAT fields to treat the bone marrow from head to mid-thigh and extended SSD POP fields to treat the lower legs. This work describes the commissioning and initial clinical results of the first reported VMAT TMI treatments in Canada. Methods: Detailed CT simulation, imaging, planning and treatment procedures were developed by a multi-disciplinary team. Patients have 1 cm of bolus over the lower legs and 0.5 cm of bolus around the lower arms. The PTV includesmore » all bone, except mandible, facial bones and hands, with the objective of V(12 Gy) > 90%. Detailed analysis of the influence of field overlap was performed to determine optimal field placement and image-guidance tolerances. Results: PTV coverage was achieved for all cases as V(12 Gy) ranged from 90.4–96.3%. The minimum dose to the PTV, D(99%), ranged from 91.4–97.87% and V(90%Rx=10.8 Gy) ranged from 99.1–100.0%. The lungs, liver and heart had an average D{sub mean} of (7.8±0.3)Gy/(65±2)%, (7.6±0.7)Gy/(63±5)%, and (6.8±0.4)Gy/(56±4)% respectively. Conclusions: Commissioning required input and collaboration from all team members. Transitioning from TBI to TMI requires additional time for contouring, treatment planning, QA, and treatment. Patient benefit can however be seen in the quality of OAR sparing.« less

Accelerated functional recovery after skeletal muscle ischemia-reperfusion injury using freshly isolated bone marrow cells.

PubMed

Corona, Benjamin T; Rathbone, Christopher R

2014-05-01

Relatively little information exists regarding the usefulness of bone marrow-derived cells for skeletal muscle ischemia-reperfusion injury (I/R), especially when compared with I/R that occurs in other tissues. The objectives of this study were to evaluate the ability of freshly isolated bone marrow cells to home to injured skeletal muscle and to determine their effects on muscle regeneration. Freshly isolated lineage-depleted bone marrow cells (Lin(-) BMCs) were injected intravenously 2 d after I/R. Bioluminescent imaging was used to evaluate cell localization for up to 28 d after injury. Muscle function, the percentage of fibers with centrally located nuclei, and the capillary-to-fiber ratio were evaluated 14 d after delivery of either saline (Saline) or saline containing Lin(-) BMCs (Lin(-) BMCs). Bioluminescence was higher in the injured leg than the contralateral control leg for up to 7 d after injection (P < 0.05) suggestive of cell homing to the injured skeletal muscle. Fourteen days after injury, there was a significant improvement in maximal tetanic torque (40% versus 22% deficit; P < 0.05), a faster rate of force production (+dP/dt) (123.6 versus 94.5 Nmm/S; P < 0.05), and a reduction in the percentage of fibers containing centrally located nuclei (40 versus 17%; P < 0.05), but no change in the capillary-to-fiber ratio in the Lin(-) BMC as compared with the Saline group. The homing of freshly isolated BMCs to injured skeletal muscle after I/R is associated with an increase in functional outcomes. Published by Elsevier Inc.

Associations between bone mineral density, grip strength, and lead body burden in older men.

PubMed

Khalil, Naila; Faulkner, Kimberly A; Greenspan, Susan L; Cauley, Jane A

2014-01-01

To study the association between blood lead concentration (BPb) and bone mineral density (BMD), physical function, and cognitive function in noninstitutionalized community-dwelling older men. Cross-sectional study. University of Pittsburgh clinic, Pittsburgh, Pennsylvania. Non-Hispanic Caucasian men aged 65 and older (N = 445) recruited as a subset of a prospective cohort for the Osteoporotic Fractures in Men Study. BPb was measured in 2007/08. From 2007 to 2009, BMD (g/cm(2)) was measured using dual-energy X-ray absorptiometry. At the same time, physical performance was measured using five tests: grip strength, leg extension power, walking speed, narrow-walk pace, and chair stands. Cognitive performance was assessed using the modified Mini-Mental State Examination and the Trail-Making Test Part B. Participants were categorized into quartiles of BPb. Multivariate regression analysis was used to evaluate the independent relationship between BPb, BMD, and cognitive and physical function. Mean BPb ± standard deviation was 2.25 ± 1.20 μg/dL (median 2 μg/dL, range 1-10 μg/dL). In multivariate-adjusted models, men in higher BPb quartiles had lower BMD at femoral neck and total hip (P-trend < .001 for both). Men with higher BPb had lower age-adjusted score for grip strength (P-trend < .001), although this association was not significant in multivariate-adjusted models (P-trend < .15). BPb was not associated with lumbar spine BMD, cognition, leg extension power, walking speed, narrow-walk pace, or chair stands. Environmental lead exposure may adversely affect bone health in older men. These findings support consideration of environmental exposure in age-associated bone fragility. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

Comparing immunocompetent and immunodeficient mice as animal models for bone tissue engineering.

PubMed

Zhang, Y; Li, X; Chihara, T; Mizoguchi, T; Hori, A; Udagawa, N; Nakamura, H; Hasegawa, H; Taguchi, A; Shinohara, A; Kagami, H

2015-07-01

To understand the differences and similarities between immunocompetent and immunodeficient mice as ectopic transplantation animal models for bone tissue engineering. Osteogenic cells from mouse leg bones were cultured, seeded on β-TCP granules, and transplanted onto the backs of either immunocompetent or immunodeficient nude mice. At 1, 2, 4, and 8 weeks postoperatively, samples were harvested and evaluated by hematoxylin-eosin staining, tartrate-resistant acid phosphatase (TRAP) staining, and immunohistochemical staining and quantitative PCR. In immunocompetent mice, inflammatory cell infiltration was evident at 1 week postoperatively and relatively higher expression of TNF-α and IL-4 was observed. In immunodeficient mice, new bone area and the number of TRAP-positive cells were larger at 4 weeks than in immunocompetent mice. The volume of new bone area in immunodeficient mice was reduced by 8 weeks. Bone regeneration was feasible in immunocompetent mice. However, some differences were observed between immunocompetent and immunodeficient mice in the bone regeneration process possibly due to different cytokine expression, which should be considered when utilizing in vivo animal models. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Body composition and cross-sectional areas of limb lean tissues in Olympic weight lifters.

PubMed

Kanehisa, H; Ikegawa, S; Fukunaga, T

1998-10-01

The cross-sectional area (CSAs) of bone and muscle tissues in the forearm, upper arm, lower leg, and thigh and body composition were determined by B-mode ultrasound and underwater weighing methods, respectively for 56 college Olympic weight lifters and 28 age-matched non-athletes to investigate the magnitude of musculoskeletal development in the strength-trained athletes belonging to the weight-classified sports event. The average value of fat-free mass (FFM) for the weight lifters ranked 12.6 kg above the regression line of FFM on stature for untrained subjects. In the weight lifters, however, the percentage of fat mass to body mass was also highly correlated to body mass index. Bone and muscle CSAs in every site were significantly larger in the weight lifter than in the untrained subjects with relative differences of 22 to 58% and 17 to 56%, respectively. Moreover, as a result of regression analysis for the mixed data from weight lifters and untrained subjects, significant correlation was found between bone and muscle CSAs in every site (r = 0.620 to 0.791, P < 0.05). The differences in lean (bone + muscle) CSA were still significant in all sites except for the lower leg even when the difference in body size was statistically controlled. The comparisons between the weight lifters and untrained subjects on the lean CSA ratios of site to site and muscle CSA ratios of flexors to extensors indicated that the weight lifters had achieved a high relative distribution of lean tissues in the arms and a dominant development in elbow and knee extensors. Thus, the present results suggested that participation in weight lifting exercises for a long period could increase bone CSA as well as muscle CSA, and induce in the participants a noticeable enlargement in given sites and muscle groups responsible for performing the Olympic lifts.

Body composition and bone mineral density of national football league players.

PubMed

Dengel, Donald R; Bosch, Tyler A; Burruss, T Pepper; Fielding, Kurt A; Engel, Bryan E; Weir, Nate L; Weston, Todd D

2014-01-01

The purpose of the present study was to examine the body composition of National Football League (NFL) players before the start of the regular season. Four hundred eleven NFL players were measured for height, weight and lean, fat, and bone mass using dual-energy x-ray absorptiometry (DXA). Subjects were categorized by their offensive or defensive position for comparison. On average, positions that mirror each other (i.e., offensive lineman [OL] vs. defensive lineman [DL]) have very similar body composition. Although OL had more fat mass than DL, they were similar in total and upper and lower lean mass. Linebackers (LB) and running backs (RB) were similar for all measures of fat and lean mass. Tight ends were unique in that they were similar to RB and LB on measures of fat mass; however, they had greater lean mass than both RB and LB and upper-body lean mass that was similar to OL. Quarterbacks and punters/kickers were similar in fat and lean masses. All positions had normal levels of bone mineral density. The DXA allowed us to measure differences in lean mass between arms and legs for symmetry assessments. Although most individuals had similar totals of lean mass in each leg and or arms, there were outliers who may be at risk for injury. The data presented demonstrate not only differences in total body composition, but also show regional body composition differences that may provide positional templates.

[Phytoestrogens role in bone functional structure protection in the ovariectomized rat].

PubMed

Mihalache, Gr; Mihalache, Gr D; Indrei, L L; Indrei, Anca; Hegsted, Maren

2002-01-01

Effects of soy protein diet on bone formation and density were evaluated in ovariectomized rats as a model for postmenopausal women. Twenty-seven 9-month-old rats were assigned to 3 treatment groups for the 9-week study: sham-surgery (Sh, n = 9); ovariectomy (Ovx, n = 9); ovariectomy + soy diet (OvxS, n = 9). Rats had free access to an AIN-93 M diet or AIN-93 M diet with 7% soy protein concentration and water. At sacrifice, rear legs were removed, and the right femur and tibia were cleaned manually. Serum alkaline phosphatase, a marker of bone formation, was measured colorimetrically. Bone density was measured using Archimedes' Principle. Alkaline phosphatase activity was greater in OvxS (114 +/- 19 U/L) and Ovx (128 +/- 26 U/L) compared to Sh (110 +/- 22 U/L). Femur bone density was greater for OvxS (1.520 +/- 0.02 g/cc) compared to Ovx (1.510 +/- 0.017 g/cc), but not to Sh (1532 +/- 0.025 g/cc). Tibia bone density was greater for OvxS (1.560 +/- 0.019 g/cc) compared to Ovx (1.553 +/- 0.015 g/cc), but not to Sh (1566 +/- 0.03 g/cc). In conclusion soy protein diet increased the rate of bone formation and bone density in some bones, suggesting that may help prevent bone loss in postmenopausal women.

Effects Of Exercise During Prolonged Bed Rest

NASA Technical Reports Server (NTRS)

Arnaud, S.; Berry, P; Cohen, M.; Danelis, J.; Deroshia, C.; Greenleaf, J.; Harris, B.; Keil, L.; Bernauer, E.; Bond, M.;

[Tibia reconstruction using cross-leg pedicled fibular flaps: report of two cases].

PubMed

Molski, M

2000-01-01

The paper presents the results of treatment of two children with cross-leg pedicle fibular flaps. A boy (10 years old) was operated because of an extensive defect of the proximal tibial shaft (15 cm) and soft tissue deficit due to osteosarcoma. He had been previously operated several times: tumor resection with chemiotherapy, bone reconstruction using allografts and two other procedures because of inflammatory complications. The second case was a 9-year old girl who underwent an extensive excision of congenital pseudoarthrosis of the tibia due to neurofibroma and reconstruction of the further fragment of the tibia. Vascularized fibula was nailed deep into the tibial shaft, beyond the previously implanted metal elements. This allowed to maintain a correct axis of the limb, a firm stabilization of the transplant and probably evoked a quick periosteal reaction of the tibia. Plaster of Paris was used to immobilize the limb. Postoperative course showed no complications. The flap pedicle was cut off after 3-4 weeks. Progressive bone healing followed by bony hypertrophy was observed after 8 weeks. The children were able to fully load the operated extremities and ambulate without crutches (the boys 12 months post-surgery and the girl 6 months post-surgery).

Effect of radioactive iodine-induced hypothyroidism on longitudinal bone growth during puberty in immature female rats.

PubMed

Choi, Hyeonhae; Ryu, Ki-Young; Roh, Jaesook; Bae, Jaeman

2018-05-22

Thyroid cancer in children, the most common endocrine malignancy, shows aggressive behavior and has a high recurrence rate after surgical ablation. Radioactive iodine (RAI) treatment is the most effective primary modality for medical ablation of juvenile thyroid cancer, and leads to intentional hypothyroidism. Although several negative impacts of hypothyroidism have been reported in children in response to other antithyroid agents, the combined effects of RAI exposure and hypothyroidism, on growing bones specifically, are unknown. In this study, we investigated the effect of RAI-induced hypothyroidism on the long bones during the pubertal growth spurt using immature female rats. Female Sprague-Dawley rats were randomly divided into a control group, and an RAI-treated group fed with RAI (0.37 MBq/g body weight) twice via gavage. After 4 weeks, we observed a significantly-reduced serum free thyroxine level in the RAI group. The latter group also displayed decreased body weight gain compared to the control. In addition, the lengths of long bones, such as the leg bones and vertebral column, as well as bone mineral content, were reduced in the RAI-treated animals. Our results confirm the negative impacts of RAI-induced thyroid deficiency during puberty on longitudinal bone growth and bone mineralization.

Parental smoking during pregnancy shortens offspring's legs.

PubMed

Żądzińska, E; Kozieł, S; Borowska-Strugińska, B; Rosset, I; Sitek, A; Lorkiewicz, W

2016-12-01

One of the most severe detrimental environmental factors acting during pregnancy is foetal smoke exposure. The aim of this study was to assess the effect of maternal, paternal and parental smoking during pregnancy on relative leg length in 7- to 10-year-old children. The research conducted in the years 2001-2002 included 978 term-born children, 348 boys and 630 girls, at the age of 7-10 years. Information concerning the birth weight of a child was obtained from the health records of the women. Information about the mother's and the father's smoking habits during pregnancy and about the mothers' education level was obtained from a questionnaire. The influence of parental smoking on relative leg length, controlled for age, sex, birth weight and the mother's education, as a proxy measure of socioeconomic status, and controlled for an interaction between sex and birth weight, was assessed by an analysis of covariance, where relative leg length was the dependent variable, smoking and sex were the independent variables, and birth weight as well as the mother's education were the covariates. Three separate analyses were run for the three models of smoking habits during pregnancy: the mother's smoking, the father's smoking and both parents' smoking. Only both parents' smoking showed a significant effect on relative leg length of offspring. It is probable that foetal hypoxia caused by carbon monoxide contained in smoke decelerated the growth of the long bones of foetuses. Copyright © 2016 Elsevier GmbH. All rights reserved.

Multimodal noninvasive monitoring of soft tissue wound healing.

PubMed

Bodo, Michael; Settle, Timothy; Royal, Joseph; Lombardini, Eric; Sawyer, Evelyn; Rothwell, Stephen W

2013-12-01

Here we report results of non-invasive measurements of indirect markers of soft tissue healing of traumatic wounds in an observational swine study and describe the quantification of analog physiological signals. The primary purpose of the study was to measure bone healing of fractures with four different wound treatments. A second purpose was to quantify soft tissue wound healing by measuring the following indirect markers: (1) tissue oxygenation, (2) fluid content, and (3) blood flow, which were all measured by non-invasive modalities, measured with available devices. Tissue oxygenation was measured by near infrared spectroscopy; fluid content was measured by bipolar bio-impedance; and blood flow was measured by Doppler ultrasound. Immediately after comminuted femur fractures were produced in the right hind legs of thirty anesthetized female Yorkshire swine, one of four wound treatments was instilled into each wound. The four wound treatments were as follows: salmon fibrinogen/thrombin-n = 8; commercial bone filler matrix-n = 7; bovine collagen-n = 8; porcine fibrinogen/thrombin-n = 7. Fractures were stabilized with an external fixation device. Immediately following wound treatments, measurements were made of tissue oxygenation, fluid content and blood flow; these measurements were repeated weekly for 3 weeks after surgery. Analog signals of each modality were recorded on both the wounded (right) hind leg and the healthy (left) hind leg, for comparison purposes. Data were processed off-line. The mean values of 10-s periods were calculated for right-left leg comparison. ANOVA was applied for statistical analysis. Results of the bone healing studies are published separately (Rothwell et al. in J Spec Oper Med 13:7-18, 2013). For soft tissue wounds, healing did not differ significantly among the four wound treatments; however, regional oxygenation of wounds treated with salmon fibrinogen/thrombin showed slightly different time trends. Further studies are needed to establish standards for healthy wound healing and for detection of pathological alterations such as infection. Non-invasive measurement and quantification of indirect markers of soft tissue wound healing support the goals and principles of evidence-based medicine and show potential as easy to administer tools for clinicians and battlefield medical personnel to apply when procedures such as the PET scan are not available or affordable. The method we developed for storing analog physiological signals could be used for maintaining electronic health records, by incorporating vital signs such as ECG and EEG, etc.

Bone stress: a radionuclide imaging perspective. [/sup 99m/Tc-pyrophosphate

DOE Office of Scientific and Technical Information (OSTI.GOV)

Roub, L.W.; Gumerman, L.W.; Hanley, E.N. Jr.

Thirty-five college athletes with lower leg pain underwent radiography and radionuclide studies to rule out a stress fracture. Their asymptomatic extremities and 13 pain-free athletes served as controls. Four main patterns were observed: (a) sharply marginated scintigraphic abnormalities and positive radiographs; (b) sharply marginated scintigraphic abnormalities and negatives radiographs; (c) ill-defined scintigraphic abnormalities and negative radiographs; and (d) negative radionuclide images and negative radiographs. Since the patients with the first two patterns were otherwise identical medically, the authors feel that this scintigraphic appearance is characterisic of bone stress in the appropriate clinical setting, regardless of the radiographic findings. A schemamore » is proposed to explain the occurrence of positive radionuclide images and negative radiographs in the same patient, using a broad conceptual approach to the problem of bone stress.« less

[Problems and complications of leg lengthening with the Wagner apparatus].

PubMed

Herzog, R; Hefti, F

1992-06-01

Since 1971, we have performed 189 leg lengthening procedures using the Wagner method at our institution. The results obtained in the first 26 cases (1971-1973) showed a high complication rate, which led us to reconsider the indications for this procedure. In the present paper, we analyze the results of 37 leg lengthening procedures carried out in 32 patients during the last 10 years (1981-1990) in the children's unit of the orthopedic department of the University of Basle. We found a complication rate of 78%, and in 46% of cases there was more than one major complication. We did not distinguish between "complications" and "problems", because such distinctions are of little importance to the patient. The average age at the time of surgery was 14.8 years, and the average increase in length was 4.3 (2.2-9.2) cm. For each 1 cm of lengthening, an average of 21 days in hospital and 64 days of reduced weight-bearing were needed. Our conclusion is that the Wagner method makes it possible to attain the goal of leg lengthening, but the second step cannot reduce the length of stay in hospital or the length of time the patient needs the help of crutches. Bone remodeling is disturbed. Our preliminary experience with the Ilizarov method is more encouraging.

An interesting case of peripheral vascular disease, vascular reperfusion, and subsequent development of pain due to Paget's disease of bone.

PubMed

Kwun, Sunna; Tucci, Joseph R

2013-01-01

To present a case of Paget's disease of bone that was unmasked after vascular reperfusion. In this case study, we review the presentation, evaluation, diagnosis, and management of a patient with Paget's disease and peripheral vascular disease. A 79-year-old-woman with a history of coronary artery heart disease and recent finding of a T5 compression fracture was hospitalized for evaluation of right lower extremity claudication. Angiography demonstrated a focal complete occlusion of the distal right femoral and popliteal arteries. A self-expanding stent was placed in the distal femoral and popliteal arteries. Approximately 48 hours after the procedure, the patient developed severe, right lower leg pain. On endocrine evaluation, the patient was found to have clinical signs suggesting Paget's disease of bone, which was subsequently confirmed by imaging. This patient's development of severe pain following reperfusion of distal femoral and popliteal arteries is in keeping with the known and aforementioned hypervascularity of pagetic bone. The finding of increased warmth over an area of skeletal deformation should always raise the possibility of Paget's disease of bone.

Melorheostosis – Case Report of Rare Disease

PubMed Central

Kumar, Rakesh; Sankhala, S.S.; Bijarnia, Isha

2014-01-01

Introduction: Melorheostosis(synonyms: candle bone disease, melting wax syndrome, Leri disease) is a rare chronic bone disorder, first described in 1922 by Leri and Joanny. Men and women are equally affected, and no hereditary features have been discovered. Onset is insidious, and most common symptom is pain. Most common part of bone is diaphysis of the long bone of lower limb rarely the axial skeleton. Classical radiological appearance of ’flowing hyperosteosis’ resembling hardened wax that has dripped down the side of a candle. Case Report: A 35 years old woman presented with left leg pain with mild swelling and limitation of knee movement. On examination non tender bony heard swelling, hyperpigmented and restriction of knee movement present. Plain radiographs showed extensive, dense, undulating or irregular cortical hyperostosis, resembling candle wax, extending along the length of bone. Pamidronate as well asanalgesic were given to the patient. Physiotherepy started for the deformity. Conclusion: Routine laboratory findings usually are normal. The exact cause remain unclear. There is no definite treatment available for this disease. Only symptomatic treatment improve the condition of the patients, more fruitful result obtain with pamidronate and physiotherapy. PMID:27298954

p53 Regulates Bone Differentiation and Osteosarcoma Formation | Center for Cancer Research

Cancer.gov

Osteosarcoma is an uncommon cancer that usually begins in the large bones of the arm or leg, but is the second leading cause of cancer-related death in children and young adults. The tumor suppressor protein, p53, appears to be an important player in osteosarcomagenesis in part because these cancers are one of the most common to develop in patients with Li-Fraumeni syndrome, which is caused by an inherited mutation in p53. However, the precise role of p53 in osteosarcoma development has not been established. To begin investigating its importance to the formation of normal bone and osteosarcomas, Jing Huang, Ph.D., of CCR’s Laboratory of Cancer Biology and Genetics, and his colleagues, isolated bone marrow-derived mesenchymal stem cells (BMSCs) from p53 wild type (WT) and knock out (KO) mice using a recently validated approach. Because BMSCs are one of the cells-of-origin of osteosarcoma, they serve as a useful model system. BMSCs contain a subset of multipotent stem cells that can differentiate into several cell types, including osteoblasts, and are important mediators of bone homeostasis.

Bone loss during long term space flight is prevented by the application of a short term impulsive mechanical stimulus

NASA Astrophysics Data System (ADS)

Goodship, A. E.; Cunningham, J. L.; Oganov, V.; Darling, J.; Miles, A. W.; Owen, G. W.

In long term space flight, the mechanical forces applied to the skeleton are substantially reduced and are altered in character. This reduced skeletal loading results in a reduction in bone mass. Exercise techmques currently used in space can maintain muscle mass but the mechanical stimulus provided by this exercise does not prevent bone loss. By applying an external impulsive load for a short period each day, which is intended to mimic the heel strike transient, to the lower limb of an astronaut during a long term space flight (5 months), this study tests the hypothesis that the bone cells can be activated by an appropriate external mechanical stimulus to maintain bone mass throughout prolonged periods of weightlessness. A mechanical loading device was developed to produce a loading of the os-calcis similar to that observed during the heel strike transient. The device is activated by the astronaut to provide a transient load to the heel of one leg whilst providing an equivalent exercising load to the other leg. During the EUROMIR95 mission on the MIR space station, an astronaut used this device for a short period daily throughout the duration of the mission. Pre- and post-flight measurements of bone mineral density (BMD) of the os-calcis and femoral neck of the astronaut were made to determine the efficacy of the device in preventing loss of bone mineral during the mission. On the os-calcis which received the mechanical stimulus, BMD was maintained throughout the period of the flight, while it was reduced by up to 7% on the os-calcis which received no stimulus. Post-flight, BMD in both the stimulated and non-stimulated os-calcis reduces, the extent of this reduction however is less in the stimulated os-calcis. For the femoral neck, the mechanical Stimulation does not produce a positive effect. On the os-calcis which received the mechanical stimulus, BMD was maintained throughout the period of the flight, while it was reduced by up to 7% on the os-calcis which received no stimulus. Post-flight, BMD in both the stimulated and non-stimulated os-calcis reduces, the extent of this reduction however is less in the stimulated os-calcis. For the femoral neck, the mechanical stimulation does not produce a positive effect.

Sclerostin antibody inhibits skeletal deterioration in mice exposed to partial weight-bearing

NASA Astrophysics Data System (ADS)

Spatz, J. M.; Ellman, R.; Cloutier, A. M.; Louis, L.; van Vliet, M.; Dwyer, D.; Stolina, M.; Ke, H. Z.; Bouxsein, M. L.

2017-02-01

Whereas much is known regarding the musculoskeletal responses to full unloading, little is known about the physiological effects and response to pharmacological agents in partial unloading (e.g. Moon and Mars) environments. To address this, we used a previously developed ground-based model of partial weight-bearing (PWB) that allows chronic exposure to reduced weight-bearing in mice to determine the effects of murine sclerostin antibody (SclAbII) on bone microstructure and strength across different levels of mechanical unloading. We hypothesize that treatment with SclAbII would improve bone mass, microarchitecture and strength in all loading conditions, but that there would be a greater skeletal response in the normally loaded mice than in partially unloaded mice suggesting the importance of combined countermeasures for exploration-class long duration spaceflight missions. Eleven-week-old female mice were assigned to one of four loading groups: normal weight-bearing controls (CON) or weight-bearing at 20% (PWB20), 40% (PWB40) or 70% (PWB70) of normal. Mice in each group received either SclAbII (25 mg/kg) or vehicle (VEH) via twice weekly subcutaneous injection for 3 weeks. In partially-unloaded VEH-treated groups, leg BMD decreased -5 to -10% in a load-dependent manner. SclAbII treatment completely inhibited bone deterioration due to PWB, with bone properties in SclAbII-treated groups being equal to or greater than those of CON, VEH-treated mice. SclAbII treatment increased leg BMD from +14 to +18% in the PWB groups and 30 ± 3% in CON (p < 0.0001 for all). Trabecular bone volume, assessed by μCT at the distal femur, was lower in all partially unloaded VEH-treated groups vs. CON-VEH (p < 0.05), and was 2-3 fold higher in SclAbII-treated groups (p < 0.001). Midshaft femoral strength was also significantly higher in SclAbII vs. VEH-groups in all-loading conditions. These results suggest that greater weight bearing leads to greater benefits of SclAbII on bone mass, particularly in the trabecular compartment. Altogether, these results demonstrate the efficacy of sclerostin antibody therapy in preventing astronaut bone loss during terrestrial solar system exploration.

Sclerostin antibody inhibits skeletal deterioration in mice exposed to partial weight-bearing.

PubMed

Spatz, J M; Ellman, R; Cloutier, A M; Louis, L; van Vliet, M; Dwyer, D; Stolina, M; Ke, H Z; Bouxsein, M L

2017-02-01

Whereas much is known regarding the musculoskeletal responses to full unloading, little is known about the physiological effects and response to pharmacological agents in partial unloading (e.g. Moon and Mars) environments. To address this, we used a previously developed ground-based model of partial weight-bearing (PWB) that allows chronic exposure to reduced weight-bearing in mice to determine the effects of murine sclerostin antibody (SclAbII) on bone microstructure and strength across different levels of mechanical unloading. We hypothesize that treatment with SclAbII would improve bone mass, microarchitecture and strength in all loading conditions, but that there would be a greater skeletal response in the normally loaded mice than in partially unloaded mice suggesting the importance of combined countermeasures for exploration-class long duration spaceflight missions. Eleven-week-old female mice were assigned to one of four loading groups: normal weight-bearing controls (CON) or weight-bearing at 20% (PWB20), 40% (PWB40) or 70% (PWB70) of normal. Mice in each group received either SclAbII (25mg/kg) or vehicle (VEH) via twice weekly subcutaneous injection for 3 weeks. In partially-unloaded VEH-treated groups, leg BMD decreased -5 to -10% in a load-dependent manner. SclAbII treatment completely inhibited bone deterioration due to PWB, with bone properties in SclAbII-treated groups being equal to or greater than those of CON, VEH-treated mice. SclAbII treatment increased leg BMD from +14 to +18% in the PWB groups and 30 ± 3% in CON (p< 0.0001 for all). Trabecular bone volume, assessed by μCT at the distal femur, was lower in all partially unloaded VEH-treated groups vs. CON-VEH (p< 0.05), and was 2-3 fold higher in SclAbII-treated groups (p< 0.001). Midshaft femoral strength was also significantly higher in SclAbII vs. VEH-groups in all-loading conditions. These results suggest that greater weight bearing leads to greater benefits of SclAbII on bone mass, particularly in the trabecular compartment. Altogether, these results demonstrate the efficacy of sclerostin antibody therapy in preventing astronaut bone loss during terrestrial solar system exploration. Copyright © 2017 The Committee on Space Research (COSPAR). Published by Elsevier Ltd. All rights reserved.

Os tibiale externum or sesamoid in the tendon of tibialis posterior.

PubMed

Bareither, D J; Muehleman, C M; Feldman, N J

1995-01-01

From a total of 165 foot and lower leg cadaveric specimens, 38 specimens were selected by palpation of the region of the tuberosity of the navicular for the possible presence of an accessory bone. Specimens were radiographed and dissected to reveal the presence of an accessory bone and its relationship to the tibialis posterior tendon. Nineteen of the specimens exhibited hypertrophy of the tibialis posterior tendon and 19 specimens exhibited an accessory bone. Specimens exhibiting an accessory bone were divided into two categories. In one group, the accessory bone was located in the tibialis posterior tendon prior to its division and was separated from the tuberosity by at least 3 mm. In the other group, the accessory bone was located in the main segment of the tibialis posterior tendon, connected to the tuberosity of the navicular by fibrous tissue, and, in some cases, exhibited a central cavity between the accessory bone and tuberosity. The accessory bone of specimens in the first group was considered to be a sesamoid in the tibialis posterior tendon and the accessory bone in the second group was an ossicle considered to be the os tibiale externum. Linking the os tibiale externum to the tibiale component of the primitive tetrapod foot rather than to the prehallux component eliminates the use of the term "prehallux" as an alternative name for this ossicle.

Low dose PTH improves metaphyseal bone healing more when muscles are paralyzed.

PubMed

Sandberg, Olof; Macias, Brandon R; Aspenberg, Per

2014-06-01

Stimulation of bone formation by PTH is related to mechanosensitivity. The response to PTH treatment in intact bone could therefore be blunted by unloading. We studied the effects of mechanical loading on the response to PTH treatment in bone healing. Most fractures occur in the metaphyses, therefor we used a model for metaphyseal bone injury. One hind leg of 20 male SD rats was unloaded via intramuscular botulinum toxin injections. Two weeks later, the proximal unloaded tibia had lost 78% of its trabecular contents. At this time-point, the rats received bilateral proximal tibiae screw implants. Ten of the 20 rats were given daily injections of 5 μg/kg PTH (1-34). After two weeks of healing, screw fixation was measured by pull-out, and microCT of the distal femur cancellous compartment was performed. Pull-out force provided an estimate for cancellous bone formation after trauma. PTH more than doubled the pull-out force in the unloaded limbs (from 14 to 30 N), but increased it by less than half in the loaded ones (from 30 to 44 N). In relative terms, PTH had a stronger effect on pull-out force in unloaded bone than in loaded bone (p=0.03). The results suggest that PTH treatment for stimulation of bone healing does not require simultaneous mechanical stimulation. Copyright © 2014 Elsevier Inc. All rights reserved.

Treatment of open tibial shaft fracture with soft tissue and bone defect caused by aircraft bomb--case report.

PubMed

Golubović, Zoran; Vidić, Goran; Trenkić, Srbobran; Vukasinović, Zoran; Lesić, Aleksandar; Stojiljković, Predrag; Stevanović, Goran; Golubović, Ivan; Visnjić, Aleksandar; Najman, Stevo

2010-01-01

Aircraft bombs can cause severe orthopaedic injuries. Tibia shaft fractures caused by aircraft bombs are mostly comminuted and followed by bone defects, which makes the healing process extremely difficult and prone to numerous complications. The goal of this paper is to present the method of treatment and the end results of treatment of a serious open tibial fracture with soft and bone tissue defects resulting from aircraft bomb shrapnel wounds. A 26-year-old patient presented with a tibial fracture as the result of a cluster bomb shrapnel wound. He was treated applying the method of external bone fixation done two days after wounding, as well as of early coverage of the lower leg soft tissue defects done on the tenth day after the external fixation of the fracture. The external fixator was removed after five months, whereas the treatment was continued by means of functional plaster cast for another two months. The final functional result was good. Radical wound debridement, external bone fixation of the fracture, and early reconstruction of any soft tissue and bone defects are the main elements of the treatment of serious fractures.

Esophageal squamous cell carcinoma with dural and bone marrow metastases.

PubMed

Chen, Yen-Hao; Huang, Cheng-Hua

2014-09-21

Patients with esophageal squamous cell carcinoma generally present at an advanced stage at the time of diagnosis. The most common sites of visceral metastasis are the lung, liver and bone, but brain and bone marrow involvement is exceedingly rare. Herein, we report a 62-year-old man with a 4-wk history of progressive low back pain with radiation to bilateral lower legs, dysphagia and body weight loss. Esophageal squamous cell carcinoma with regional lymph node, liver and bone metastases was diagnosed. He underwent concurrent chemoradiotherapy and got a partial response. Four months later, he complained of headache, diplopia and severe hearing impairment in the left ear. There was no evidence for bacterial, fungal, tuberculous infection or neoplastic infiltration. Magnetic resonance imaging of the brain demonstrated thickening and enhancement of bilateral pachymeninges and multiple enhancing masses in bilateral skull. Dural metastasis was diagnosed and he received whole brain irradiation. In addition, laboratory examination revealed severe thrombocytopenia and leucopenia, and bone marrow study confirmed the diagnosis of metastatic squamous cell carcinoma. This is the first described case of esophageal squamous cell carcinoma with dural and bone marrow metastases. We also discuss the pathogenesis of unusual metastatic diseases and differential diagnosis of pachymeningeal thickening.

Goal-directed ultrasound in the detection of long-bone fractures

NASA Technical Reports Server (NTRS)

Marshburn, Thomas H.; Legome, Eric; Sargsyan, Ashot; Li, Shannon Melton James; Noble, Vicki A.; Dulchavsky, Scott A.; Sims, Carrie; Robinson, David

2004-01-01

BACKGROUND: New portable ultrasound (US) systems are capable of detecting fractures in the remote setting. However, the accuracy of ultrasound by physicians with minimal ultrasound training is unknown. METHODS: After one hour of standardized training, physicians with minimal US experience clinically evaluated patients presenting with pain and trauma to the upper arm or leg. The investigators then performed a long-bone US evaluation, recording their impression of fracture presence or absence. Results of the examination were compared with routine plain or computer aided radiography (CT). RESULTS: 58 patients were examined. The sensitivity and specificity of US were 92.9% and 83.3%, and of the physical examination were 78.6% and 90.0%, respectively. US provided improved sensitivity with less specificity compared with physical examination in the detection of fractures in long bones. CONCLUSION: Ultrasound scans by minimally trained clinicians may be used to rule out a long-bone fracture in patients with a medium to low probability of fracture.

Muscle changes can account for bone loss after botulinum toxin injection.

PubMed

Manske, Sarah L; Boyd, Steven K; Zernicke, Ronald F

2010-12-01

Studies to date have assumed that botulinum toxin type A (BTX) affects bone indirectly, through its action on muscle. We hypothesized that BTX has no discernable effect on bone morphometry, independent of its effect on muscle. Therefore, we investigated whether BTX had an additional effect on bone when combined with tenotomy compared to tenotomy in isolation. Female BALB/c mice (n = 73) underwent one of the following procedures in the left leg: BTX injection and Achilles tenotomy (BTX-TEN), BTX injection and sham surgery (BTX-sham), Achilles tenotomy (TEN), or sham surgery (sham). BTX groups were injected with 20 μL of BTX (1 U/100 g) in the posterior lower hindlimb. At 4 weeks, muscle cross-sectional area (MCSA) and tibial bone morphometry were assessed using micro-CT. Each treatment, other than sham, resulted in significant muscle and bone loss (P < 0.05). BTX-TEN experienced the greatest muscle loss (23-45% lower than other groups) and bone loss (20-30% lower bone volume fraction than other groups). BTX-sham had significantly lower MCSA and bone volume fraction than TEN and sham. After adjusting for differences in MCSA, there were no significant between-group differences in bone properties. We found that BTX injection resulted in more adverse muscle and bone effects than tenotomy and that effects were amplified when the procedures were combined. However, between-group differences in bone could be accounted for by MCSA. We conclude that any independent effect of BTX on bone morphometry is likely small or negligible compared with the effect on muscle.

Knee arthrodesis with a press-fit modular intramedullary nail without bone-on-bone fusion after an infected revision TKA.

PubMed

Iacono, Francesco; Bruni, Danilo; Lo Presti, Mirco; Raspugli, Giovanni; Bondi, Alice; Sharma, Bharat; Marcacci, Maurilio

2012-10-01

Knee arthrodesis can be an effective treatment after an infected revision Total Knee Arthroplasty (TKA). The main hypothesis of this study is that a two-stage arthrodesis of the knee using a press-fit, modular intramedullary nail and antibiotic loaded cement, to fill the residual gap between the bone surfaces, prevents an excessive limb shortening, providing satisfactory clinical and functional results even without direct bone-on-bone fusion. The study included 22 patients who underwent knee arthrodesis between 2004 and 2009 because of recurrent infection following revision-TKA (R-TKA). Clinical and functional evaluations were performed using the Visual Analogue Scale (VAS) and the Lequesne Algofunctional Score. A postoperative clinical and radiographical evaluation of the residual limb-length discrepancy was conducted by three independent observers. VAS and LAS results showed a significant improvement with respect to the preoperative condition. The mean leg length discrepancy was less than 1cm. There were three recurrent infections that needed further surgical treatment. This study demonstrated that reinfection after Revision of total knee Arthroplasty can be effectively treated with arthrodesis using a modular intramedullary nail, along with an antibiotic loaded cement spacer and that satisfactory results can be obtained without direct bone-on-bone fusion. Published by Elsevier B.V.

Associations of muscle force, power, cross-sectional muscle area and bone geometry in older UK men.

PubMed

Zengin, Ayse; Pye, Stephen R; Cook, Michael J; Adams, Judith E; Rawer, Rainer; Wu, Frederick C W; O'Neill, Terence W; Ward, Kate A

2017-08-01

Ageing is associated with sarcopenia, osteoporosis, and increased fall risk, all of which contribute to increased fracture risk. Mechanically, bone strength adapts in response to forces created by muscle contractions. Adaptations can be through changes in bone size, geometry, and bending strength. Muscle mass is often used as a surrogate for muscle force; however, force can be increased without changes in muscle mass. Increased fall risk with ageing has been associated with a decline in muscle power-which is a measure of mobility. The aims of this study were as follows: (i) to investigate the relationship between muscle parameters in the upper and lower limbs with age in UK men and the influence of ethnicity on these relationships; (ii) to examine the relationships between jump force/grip strength/cross-sectional muscle area (CSMA) with bone outcomes at the radius and tibia. White European, Black Afro-Caribbean, and South Asian men aged 40-79 years were recruited from Manchester, UK. Cortical bone mineral content, cross-sectional area, cortical area, cross-sectional moment of inertia, and CSMA were measured at the diaphysis of the radius and tibia using peripheral quantitative computed tomography. Lower limb jump force and power were measured from a single two-legged jump performed on a ground-reaction force platform. Grip strength was measured using a dynamometer. Associations between muscle and bone outcomes was determined using linear regression with adjustments for age, height, weight, and ethnicity. Three hundred and one men were recruited. Jump force was negatively associated with age; for every 10 year increase in age, there was a 4% reduction in jump force (P < 0.0001). There was a significant age-ethnicity interaction for jump power (P = 0.039); after adjustments, this was attenuated (P = 0.088). For every 10 year increase in age, grip strength decreased by 11%. Jump force was positively associated with tibial bone outcomes: a 1 standard deviation greater jump force was associated with significantly higher cortical bone mineral content 3.1%, cross-sectional area 4.2%, cortical area 3.4%, and cross-sectional moment of inertia 6.8% (all P < 0.001). Cross-sectional muscle area of the lower leg was not associated with tibial bone outcomes. Both grip strength and CSMA of the arm were positively associated, to a similar extent, with radius diaphyseal bone outcomes. Jump force and power are negatively associated with age in UK men. In the lower limb, the measurement of jump force is more strongly related to bone outcomes than CSMA. It is important to consider jump force and power when understanding the aetiology of bone loss and mobility in ageing men. © 2017 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society on Sarcopenia, Cachexia and Wasting Disorders.

Mechanical response tissue analyzer for estimating bone strength

NASA Technical Reports Server (NTRS)

Arnaud, Sara B.; Steele, Charles; Mauriello, Anthony

1991-01-01

One of the major concerns for extended space flight is weakness of the long bones of the legs, composed primarily of cortical bone, that functions to provide mechanical support. The strength of cortical bone is due to its complex structure, described simplistically as cylinders of parallel osteons composed of layers of mineralized collagen. The reduced mechanical stresses during space flight or immobilization of bone on Earth reduces the mineral content, and changes the components of its matrix and structure so that its strength is reduced. Currently, the established clinical measures of bone strength are indirect. The measures are based on determinations of mineral density by means of radiography, photon absorptiometry, and quantitative computer tomography. While the mineral content of bone is essential to its strength, there is growing awareness of the limitations of the measurement as the sole predictor of fracture risk in metabolic bone diseases, especially limitations of the measurement as the sole predictor of fracture risk in metabolic bone diseases, especially osteoporosis. Other experimental methods in clinical trials that more directly evaluate the physical properties of bone, and do not require exposure to radiation, include ultrasound, acoustic emission, and low-frequency mechanical vibration. The last method can be considered a direct measure of the functional capacity of a long bone since it quantifies the mechanical response to a stimulus delivered directly to the bone. A low frequency vibration induces a response (impedance) curve with a minimum at the resonant frequency, that a few investigators use for the evaluation of the bone. An alternative approach, the method under consideration, is to use the response curve as the basis for determination of the bone bending stiffness EI (E is the intrinsic material property and I is the cross-sectional moment of inertia) and mass, fundamental mechanical properties of bone.

Limb saving surgery for Ewing's sarcoma of the distal tibia: a case report.

PubMed

Mizoshiri, Naoki; Shirai, Toshiharu; Terauchi, Ryu; Tsuchida, Shinji; Mori, Yuki; Katsuyama, Yusei; Hayashi, Daichi; Oka, Yoshinobu; Kubo, Toshikazu

2018-05-02

Ewing's sarcoma is a primary malignant tumor of bone occurring mostly in childhood. Few effective reconstruction techniques are available after wide resection of Ewing's sarcoma at the distal end of the tibia. Reconstruction after wide resection is especially difficult in children, as it is necessary to consider the growth and activity of the lower limbs. A 12-year-old Japanese boy had presented with right lower leg pain at age 8 years. Imaging examination showed a bone tumor accompanied by a large extra-skeletal mass in the distal part of his tibia. The tumor was histologically diagnosed as Ewing's sarcoma. The patient received chemotherapy, followed by wide resection. Reconstruction consisted of a bone transport method involving external fixation of Taylor Spatial Frame. To prevent infection after surgery, the external fixation pin was coated with iodine. One year after surgery, the patient showed poor consolidation of bone, so iliac bone transplantation was performed on the extended bones and docking site of the distal tibia. After 20 months, tibia formation was good. Three years after surgery, there was no evidence of tumor recurrence or metastases; bone fusion was good, and he was able to run. The bone transport method is an effective surgical method of reconstruction after wide resection of a bone tumor at the distal end of the tibia, if a pin can be inserted into the distal bone fragment. Coating external fixation pins with iodine may prevent postoperative infection.

Mediolateral force distribution at the knee joint shifts across activities and is driven by tibiofemoral alignment.

PubMed

Kutzner, I; Bender, A; Dymke, J; Duda, G; von Roth, P; Bergmann, G

2017-06-01

Tibiofemoral alignment is important to determine the rate of progression of osteoarthritis and implant survival after total knee arthroplasty (TKA). Normally, surgeons aim for neutral tibiofemoral alignment following TKA, but this has been questioned in recent years. The aim of this study was to evaluate whether varus or valgus alignment indeed leads to increased medial or lateral tibiofemoral forces during static and dynamic weight-bearing activities. Tibiofemoral contact forces and moments were measured in nine patients with instrumented knee implants. Medial force ratios were analysed during nine daily activities, including activities with single-limb support (e.g. walking) and double-limb support (e.g. knee bend). Hip-knee-ankle angles in the frontal plane were analysed using full-leg coronal radiographs. The medial force ratio strongly correlated with the tibiofemoral alignment in the static condition of one-legged stance (R² = 0.88) and dynamic single-limb loading (R² = 0.59) with varus malalignment leading to increased medial force ratios of up to 88%. In contrast, the correlation between leg alignment and magnitude of medial compartment force was much less pronounced. A lateral shift of force occurred during activities with double-limb support and higher knee flexion angles. The medial force ratio depends on both the tibiofemoral alignment and the nature of the activity involved. It cannot be generalised to a single value. Higher medial ratios during single-limb loading are associated with varus malalignment in TKA. The current trend towards a 'constitutional varus' after joint replacement, in terms of overall tibiofemoral alignment, should be considered carefully with respect to the increased medial force ratio. Cite this article: Bone Joint J 2017;99-B:779-87. ©2017 The British Editorial Society of Bone & Joint Surgery.

The beneficial effects of aerobic and concurrent training on metabolic profile and body composition after detraining: a 1-year follow-up in postmenopausal women.

PubMed

Rossi, F E; Diniz, T A; Neves, L M; Fortaleza, A C S; Gerosa-Neto, J; Inoue, D S; Buonani, C; Cholewa, J M; Lira, F S; Freitas, I F

2017-05-01

Aerobic and concurrent training (CT, aerobic and strength training) improves body composition and metabolic profile; however, it is not known whether these positive outcomes acquired after aerobic or CT are maintained long term (⩾6 months) after program interruption in postmenopausal women. This study investigated the changes in total and appendicular body composition, bone mineral density and metabolic profile following 16 weeks of aerobic or CT, and through 6 months and 1 year of detraining in postmenopausal women. In total, 60 postmenopausal women were divided into the following groups: aerobic (AT), aerobic plus strength training (CT) and control group (CG), and 31 participants were assessed for the 1 year follow-up. Body composition and bone mineral density were evaluated by dual-energy X-ray absorptiometry (DXA), and total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triacylglycerol, glucose, insulin, leptin, adiponectin and plasminogen activator inhibitor-1 (PAI-1) were assessed. There were main effects of time for arm fat mass, arm lean mass and trunk lean mass (P<0.05). There was a statistical difference between AT and CG for leg fat mass and percentage of fat (P<0.05). After 6 months of detraining, leg lean mass decreased in relation to post-intervention, and there was a statistically significant interaction for total and appendicular lean mass (P<0.05). There were differences between CT and CG in glucose and between AT and CG in glucose and triacylglycerol (P<0.05). A duration of 16 weeks of aerobic or CT improved total and appendicular body composition and metabolic profile but after 6 months of detraining, leg lean mass returned to the values obtained pre-training in CT.

Lumbar Gout Tophus Mimicking Epidural Abscess with Magnetic Resonance Imaging, Bone, and Gallium Scans

PubMed Central

Vicente, Justo Serrano; Gómez, Alejandro Lorente; Moreno, Rafael Lorente; Torre, Jose Rafael Infante; Bernardo, Lucía García; Madrid, Juan Ignacio Rayo

2018-01-01

Gout is a common metabolic disorder, typically diagnosed in peripheral joints. Tophaceous deposits in lumbar spine are a very rare condition with very few cases reported in literature. The following is a case report of a 52-year-old patient with low back pain, left leg pain, and numbness. Serum uric acid level was in normal range. magnetic resonance imaging, bone scan, and gallium-67 images suggested an inflammatory-infectious process focus at L4. After a decompressive laminectomy at L4–L5 level, histological examination showed a chalky material with extensive deposition of amorphous gouty material surrounded by macrophages and foreign-body giant cells (tophaceous deposits). PMID:29643682

Lumbar Gout Tophus Mimicking Epidural Abscess with Magnetic Resonance Imaging, Bone, and Gallium Scans.

PubMed

Vicente, Justo Serrano; Gómez, Alejandro Lorente; Moreno, Rafael Lorente; Torre, Jose Rafael Infante; Bernardo, Lucía García; Madrid, Juan Ignacio Rayo

2018-01-01

Gout is a common metabolic disorder, typically diagnosed in peripheral joints. Tophaceous deposits in lumbar spine are a very rare condition with very few cases reported in literature. The following is a case report of a 52-year-old patient with low back pain, left leg pain, and numbness. Serum uric acid level was in normal range. magnetic resonance imaging, bone scan, and gallium-67 images suggested an inflammatory-infectious process focus at L4. After a decompressive laminectomy at L4-L5 level, histological examination showed a chalky material with extensive deposition of amorphous gouty material surrounded by macrophages and foreign-body giant cells (tophaceous deposits).

Automatic joint alignment measurements in pre- and post-operative long leg standing radiographs.

PubMed

Goossen, A; Weber, G M; Dries, S P M

2012-01-01

For diagnosis or treatment assessment of knee joint osteoarthritis it is required to measure bone morphometry from radiographic images. We propose a method for automatic measurement of joint alignment from pre-operative as well as post-operative radiographs. In a two step approach we first detect and segment any implants or other artificial objects within the image. We exploit physical characteristics and avoid prior shape information to cope with the vast amount of implant types. Subsequently, we exploit the implant delineations to adapt the initialization and adaptation phase of a dedicated bone segmentation scheme using deformable template models. Implant and bone contours are fused to derive the final joint segmentation and thus the alignment measurements. We evaluated our method on clinical long leg radiographs and compared both the initialization rate, corresponding to the number of images successfully processed by the proposed algorithm, and the accuracy of the alignment measurement. Ground truth has been generated by an experienced orthopedic surgeon. For comparison a second reader reevaluated the measurements. Experiments on two sets of 70 and 120 digital radiographs show that 92% of the joints could be processed automatically and the derived measurements of the automatic method are comparable to a human reader for pre-operative as well as post-operative images with a typical error of 0.7° and correlations of r = 0.82 to r = 0.99 with the ground truth. The proposed method allows deriving objective measures of joint alignment from clinical radiographs. Its accuracy and precision are on par with a human reader for all evaluated measurements.

Oral administration of undenatured native chicken type II collagen (UC-II) diminished deterioration of articular cartilage in a rat model of osteoarthritis (OA).

PubMed

Bagi, C M; Berryman, E R; Teo, S; Lane, N E

2017-12-01

The aim of this study was to determine the ability of undenatured native chicken type II collagen (UC-II) to prevent excessive articular cartilage deterioration in a rat model of osteoarthritis (OA). Twenty male rats were subjected to partial medial meniscectomy tear (PMMT) surgery to induce OA. Immediately after the surgery 10 rats received vehicle and another 10 rats oral daily dose of UC-II at 0.66 mg/kg for a period of 8 weeks. In addition 10 naïve rats were used as an intact control and another 10 rats received sham surgery. Study endpoints included a weight-bearing capacity of front and hind legs, serum biomarkers of bone and cartilage metabolism, analyses of subchondral and cancellous bone at the tibial epiphysis and metaphysis, and cartilage pathology at the medial tibial plateau using histological methods. PMMT surgery produced moderate OA at the medial tibial plateau. Specifically, the deterioration of articular cartilage negatively impacted the weight bearing capacity of the operated limb. Immediate treatment with the UC-II preserved the weight-bearing capacity of the injured leg, preserved integrity of the cancellous bone at tibial metaphysis and limited the excessive osteophyte formation and deterioration of articular cartilage. Study results demonstrate that a clinically relevant daily dose of UC-II when applied immediately after injury can improve the mechanical function of the injured knee and prevent excessive deterioration of articular cartilage. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Effects of different levels of vitamin premix in finisher diets on performance, immuno-competence and meat lipid oxidation of chickens fed on corn-soybean meal.

PubMed

Moravej, Hoseein; Alahyari-Shahrasb, Majid; Kiani, Ali; Bagherirad, Mona; Shivazad, Mahmood

2013-01-01

The present study was carried out to examine the effects of a vitamin premix (VP) reduction or withdrawal from finisher diet (29-43 days) on performance, immuno-competence, and characteristics of leg bones and meat lipid oxidation of chickens fed on corn-soybean meal based diet. A total of 900 male broiler chickens (Ross 308) were allocated to five treatment groups (0, 33%, 66%, 100% and 133% VP), with nine replicates per treatment group. At 29 and 36 days of ages, four birds from each replicate were injected with sheep red blood cells (SRBC). The cell-mediated immunity was determined via phytohemagglutinin (PHA) and 1-chloro 2-4-dinitrobenzen (DNCB) at 34 and 42 days of ages. At 33, 38 and 43 days of age, 42 days of ages, and two birds of each replicate were slaughtered and bone parameters measured. The oxidative stability was evaluated by thiobarbituric acid reactive substances (TBARS) on the thigh samples that were stored for 90 day at -80 ˚C. The results showed that reduction or withdrawal of VP from diets at different time points of the finisher period did not affect performance, immunocompetence and characteristics of leg bones. Results of TBARS showed that lipid peroxidation of the treatment without VP was significantly higher than of the other treatments when slaughtered at 43 days of age. Finally, the results of this study demonstrated that it is not possible to reduce the VP in finisher broilers' diets without negative effects on meat quality during the time of freezing.

Greater association of peak neuromuscular performance with cortical bone geometry, bone mass and bone strength than bone density: A study in 417 older women.

PubMed

Belavý, Daniel L; Armbrecht, Gabriele; Blenk, Tilo; Bock, Oliver; Börst, Hendrikje; Kocakaya, Emine; Luhn, Franziska; Rantalainen, Timo; Rawer, Rainer; Tomasius, Frederike; Willnecker, Johannes; Felsenberg, Dieter

2016-02-01

We evaluated which aspects of neuromuscular performance are associated with bone mass, density, strength and geometry. 417 women aged 60-94years were examined. Countermovement jump, sit-to-stand test, grip strength, forearm and calf muscle cross-sectional area, areal bone mineral content and density (aBMC and aBMD) at the hip and lumbar spine via dual X-ray absorptiometry, and measures of volumetric vBMC and vBMD, bone geometry and section modulus at 4% and 66% of radius length and 4%, 38% and 66% of tibia length via peripheral quantitative computed tomography were performed. The first principal component of the neuromuscular variables was calculated to generate a summary neuromuscular variable. Percentage of total variance in bone parameters explained by the neuromuscular parameters was calculated. Step-wise regression was also performed. At all pQCT bone sites (radius, ulna, tibia, fibula), a greater percentage of total variance in measures of bone mass, cortical geometry and/or bone strength was explained by peak neuromuscular performance than for vBMD. Sit-to-stand performance did not relate strongly to bone parameters. No obvious differential in the explanatory power of neuromuscular performance was seen for DXA aBMC versus aBMD. In step-wise regression, bone mass, cortical morphology, and/or strength remained significant in relation to the first principal component of the neuromuscular variables. In no case was vBMD positively related to neuromuscular performance in the final step-wise regression models. Peak neuromuscular performance has a stronger relationship with leg and forearm bone mass and cortical geometry as well as proximal forearm section modulus than with vBMD. Copyright © 2015 Elsevier Inc. All rights reserved.

Decreased Hip, Lower Leg, and Humeral Fractures but Increased Forearm Fractures in Highly Active Individuals.

PubMed

Stattin, Karl; Hållmarker, Ulf; Ärnlöv, Johan; James, Stefan; Michaëlsson, Karl; Byberg, Liisa

2018-06-22

It is not known how physical exercise affects the risk of different types of fractures, especially in highly active individuals. To investigate this association, we studied a cohort of 118,204 men and 71,757 women who from 1991 to 2009 participated in Vasaloppet, a long-distance cross-country skiing race in Sweden, and 505,194 nonparticipants frequency-matched on sex, age, and county of residence from the Swedish population. Participants ranged from recreational exercisers to world-class skiers. Race participation, distance of race run, number of races participated in, and finishing time were used as proxies for physical exercise. Incident fractures from 1991 to 2010 were obtained from national Swedish registers. Over a median follow-up of 8.9 years, 53,175 fractures of any type, 2929 hip, 3107 proximal humerus, 11,875 lower leg, 11,733 forearm, and 2391 vertebral fractures occurred. In a Cox proportional hazard regression analysis using time-updated exposure and covariate information, participation in the race was associated with an increased risk of any type of fracture (hazard ratio [HR], 1.02; 95% CI, 1.00 to 1.05); forearm fractures had an HR, 1.11 with a 95% CI, 1.06 to 1.15. There was a lower risk of hip (HR, 0.75; 95% CI, 0.67 to 0.83), proximal humerus (HR, 0.90; 95% CI, 0.82 to 0.98), and lower leg fractures (HR, 0.93; 95% CI, 0.89 to 0.97), whereas the HR of vertebral fracture was 0.97 with a 95% CI, 0.88 to 1.07. Among participants, the risk of fracture was similar irrespective of race distance and number of races run. Participants close to the median finishing time had a lower risk of fracture compared with faster and slower participants. In summary, high levels of physical exercise were associated with a slightly higher risk of fractures of any type, including forearm fractures, but a lower risk of hip, proximal humerus, and lower leg fractures. © 2018 American Society for Bone and Mineral Research. © 2018 American Society for Bone and Mineral Research.

FE6 during Sprint Ultrasound Scans

NASA Image and Video Library

2013-11-22

ISS038-E-007119 (21 Nov. 2013) --- Japan Aerospace Exploration Agency astronaut Koichi Wakata, Expedition 38 flight engineer, wears ultrasound gear around his legs while performing the Integrated Resistance and Aerobic Training Study (Sprint) experiment in the Columbus laboratory of the International Space Station. Sprint evaluates the use of high intensity, low volume exercise training to minimize loss of muscle, bone, and cardiovascular function in station crew members during long-duration missions.

Leg Muscle Usage Effects on Tibial Elasticity during Running

DTIC Science & Technology

2007-01-01

such a strike mechanics and surface incline, also modulate bone elasticity during running. Because these modulators may operate on the tibia via...co- Investigators (PS) as a prototypical forefoot runner. We have obtained a video showing 6 well-defined forefoot -running without coaching and...completion for 8 subjects. • Baseline data for 3 subjects who started but did not complete study. • Development of training video for forefoot running

Tantalum coating of porous carbon scaffold supplemented with autologous bone marrow stromal stem cells for bone regeneration in vitro and in vivo.

PubMed

Wei, Xiaowei; Zhao, Dewei; Wang, Benjie; Wang, Wei; Kang, Kai; Xie, Hui; Liu, Baoyi; Zhang, Xiuzhi; Zhang, Jinsong; Yang, Zhenming

2016-03-01

Porous tantalum metal with low elastic modulus is similar to cancellous bone. Reticulated vitreous carbon (RVC) can provide three-dimensional pore structure and serves as the ideal scaffold of tantalum coating. In this study, the biocompatibility of domestic porous tantalum was first successfully tested with bone marrow stromal stem cells (BMSCs) in vitro and for bone tissue repair in vivo. We evaluated cytotoxicity of RVC scaffold and tantalum coating using BMSCs. The morphology, adhesion, and proliferation of BMSCs were observed via laser scanning confocal microscope and scanning electron microscopy. In addition, porous tantalum rods with or without autologous BMSCs were implanted on hind legs in dogs, respectively. The osteogenic potential was observed by hard tissue slice examination. At three weeks and six weeks following implantation, new osteoblasts and new bone were observed at the tantalum-host bone interface and pores. At 12 weeks postporous tantalum with autologous BMSCs implantation, regenerated trabecular equivalent to mature bone was found in the pore of tantalum rods. Our results suggested that domestic porous tantalum had excellent biocompatibility and could promote new bone formation in vivo. Meanwhile, the osteogenesis of porous tantalum associated with autologous BMSCs was more excellent than only tantalum implantation. Future clinical studies are warranted to verify the clinical efficacy of combined implantation of this domestic porous tantalum associated with autologous BMSCs implantation and compare their efficacy with conventional autologous bone grafting carrying blood vessel in patients needing bone repairing. © 2016 by the Society for Experimental Biology and Medicine.

Tantalum coating of porous carbon scaffold supplemented with autologous bone marrow stromal stem cells for bone regeneration in vitro and in vivo

PubMed Central

Wei, Xiaowei; Wang, Benjie; Wang, Wei; Kang, Kai; Xie, Hui; Liu, Baoyi; Zhang, Xiuzhi; Zhang, Jinsong; Yang, Zhenming

2016-01-01

Porous tantalum metal with low elastic modulus is similar to cancellous bone. Reticulated vitreous carbon (RVC) can provide three-dimensional pore structure and serves as the ideal scaffold of tantalum coating. In this study, the biocompatibility of domestic porous tantalum was first successfully tested with bone marrow stromal stem cells (BMSCs) in vitro and for bone tissue repair in vivo. We evaluated cytotoxicity of RVC scaffold and tantalum coating using BMSCs. The morphology, adhesion, and proliferation of BMSCs were observed via laser scanning confocal microscope and scanning electron microscopy. In addition, porous tantalum rods with or without autologous BMSCs were implanted on hind legs in dogs, respectively. The osteogenic potential was observed by hard tissue slice examination. At three weeks and six weeks following implantation, new osteoblasts and new bone were observed at the tantalum–host bone interface and pores. At 12 weeks postporous tantalum with autologous BMSCs implantation, regenerated trabecular equivalent to mature bone was found in the pore of tantalum rods. Our results suggested that domestic porous tantalum had excellent biocompatibility and could promote new bone formation in vivo. Meanwhile, the osteogenesis of porous tantalum associated with autologous BMSCs was more excellent than only tantalum implantation. Future clinical studies are warranted to verify the clinical efficacy of combined implantation of this domestic porous tantalum associated with autologous BMSCs implantation and compare their efficacy with conventional autologous bone grafting carrying blood vessel in patients needing bone repairing. PMID:26843518

Physical performance in relation to body composition and bone mineral density in healthy, overweight, and obese postmenopausal women.

PubMed

Shin, Hyehyung; Liu, Pei-Yang; Panton, Lynn B; Ilich, Jasminka Z

2014-01-01

Diminished physical performance can be detrimental among the older adults, causing falls and subsequent fractures, loss of independence, and increased morbidity and mortality rates. Therefore, it is important to maintain functional ability from the early onset of aging. The purpose of this study was to investigate the relationship between physical performance measures and body composition (bone, fat, and lean mass) in healthy, overweight and obese, early postmenopausal white women. A total of 97 participants aged 56.0 (4.4) years (mean (SD)) with body mass index of 31.0 (4.6) kg/m(2) were included. Weight and height were recorded and 3 days of dietary records and physical activity were collected. Dual-energy x-ray absorptiometry measurements for body composition and bone mineral density were performed. Fasting blood samples were used for serum 25-hydroxy vitamin D (25OHD) analysis. Measures of physical performance included handgrip strength, 8-meter walking speed, one-leg-stance time, 8-foot Timed Get-Up-and-Go Test, and chair sit-to-stand test. Results showed that higher lean mass was related to better physical performance on items assessing body strength, including handgrip (r ranged from 0.22 to 0.25, P < .05) while higher body fat was related to the poorer physical performance in each of the assessed measures. Bone mineral density of the forearm was positively related to the handgrip strength (r = 0.207, P < .05). In regression analyses (controlled for age, weight, height, serum 25OHD status, calcium intake, physical activity, and smoking), fat mass of the lower extremities was inversely related to walking speed, one-leg-stance time, and Get-Up-and-Go measures, all crucial for mobility (r(2) = 0.13-0.23, P < .05). Overall, higher fat and lower lean mass was related to poorer physical performance, while forearm bone mineral density was related to the handgrip strength only. Further investigation may be beneficial for a better understanding of how body composition may prevent decline in physical performance among overweight/obese, mid-age, and older women.

Osteosarcopenic obesity is associated with reduced handgrip strength, walking abilities, and balance in postmenopausal women.

PubMed

Ilich, J Z; Inglis, J E; Kelly, O J; McGee, D L

2015-11-01

We determined the prevalence of osteosarcopenic obesity (loss of bone and muscle coexistent with increased adiposity) in overweight/obese postmenopausal women and compared their functionality to obese-only women. Results showed that osteosarcopenic obese women were outperformed by obese-only women in handgrip strength and walking/balance abilities indicating their higher risk for mobility impairments. Osteosarcopenic obesity (OSO) is a recently defined triad of osteopenia/osteoporosis, sarcopenia, and adiposity. We identified women with OSO in overweight/obese postmenopausal women and evaluated their functionality comparing them with obese-only (OB) women. Additionally, women with osteopenic/osteoporotic obesity (OO), but no sarcopenia, and those with sarcopenic obesity (SO), but no osteopenia/osteoporosis, were identified and compared. We hypothesized that OSO women will have the lowest scores for each of the functionality measures. Participants (n = 258; % body fat ≥35) were assessed using a Lunar iDXA instrument for bone and body composition. Sarcopenia was determined from negative residuals of linear regression modeled on appendicular lean mass, height, and body fat, using 20th percentile as a cutoff. Participants with T-scores of L1-L4 vertebrae and/or total femur <-1, but without sarcopenia, were identified as OO (n = 99) and those with normal T-scores, but with sarcopenia, as SO (n = 28). OSO (n = 32) included women with both osteopenia/osteoporosis and sarcopenia, while those with normal bone and no sarcopenia were classified as OB (n = 99). Functionality measures such as handgrip strength, normal/brisk walking speed, and right/left leg stance were evaluated and compared among groups. Women with OSO presented with the lowest handgrip scores, slowest normal and brisk walking speed, and shortest time for each leg stance, but these results were statistically significantly different only from the OB group. These findings indicate a poorer functionality in women presenting with OSO, particularly compared to OB women, increasing the risk for bone fractures and immobility from the combined decline in bone and muscle mass, and increased fat mass.

Vascular endothelial growth factor/bone morphogenetic protein-2 bone marrow combined modification of the mesenchymal stem cells to repair the avascular necrosis of the femoral head

PubMed Central

Ma, Xiao-Wei; Cui, Da-Ping; Zhao, De-Wei

2015-01-01

Vascular endothelial cell growth factor (VEGF) combined with bone morphogenetic protein (BMP) was used to repair avascular necrosis of the femoral head, which can maintain the osteogenic phenotype of seed cells, and effectively secrete VEGF and BMP-2, and effectively promote blood vessel regeneration and contribute to formation and revascularization of tissue engineered bone tissues. To observe the therapeutic effect on the treatment of avascular necrosis of the femoral head by using bone marrow mesenchymal stem cells (BMSCs) modified by VEGF-165 and BMP-2 in vitro. The models were avascular necrosis of femoral head of rabbits on right leg. There groups were single core decompression group, core decompression + BMSCs group, core decompression + VEGF-165/BMP-2 transfect BMSCs group. Necrotic bone was cleared out under arthroscope. Arthroscopic observation demonstrated that necrotic bone was cleared out in each group, and fresh blood flowed out. Histomorphology determination showed that blood vessel number and new bone area in the repair region were significantly greater at various time points following transplantation in the core decompression + VEGF-165/BMP-2 transfect BMSCs group compared with single core decompression group and core decompression + BMSCs group (P < 0.05). These suggested that VEGF-165/BMP-2 gene transfection strengthened osteogenic effects of BMSCs, elevated number and quality of new bones and accelerated the repair of osteonecrosis of the femoral head. PMID:26629044

A Meta-Analysis of Experiments Linking Incubation Conditions with Subsequent Leg Weakness in Broiler Chickens

PubMed Central

Groves, Peter J.; Muir, Wendy I.

2014-01-01

A series of incubation and broiler growth studies were conducted using one strain of broiler chicken (fast feathering dam line) observing incubation effects on femoral bone ash % at hatch and the ability of the bird to remain standing at 6 weeks of age (Latency-To-Lie). Egg shell temperatures during incubation were consistently recorded. Parsimonious models were developed across eight studies using stepwise multiple linear regression of egg shell temperatures over 3-day periods and both bone ash at hatch and Latency-To-Lie. A model for bone ash at hatch explained 70% of the variation in this factor and revealed an association with lower egg shell temperatures during days 4–6 and 13–15 and higher egg shell temperatures during days 16–18 of incubation. Bone ash at hatch and subsequent Latency-To-Lie were positively correlated (r = 0.57, P<0.05). A model described 66% of the variation Latency-To-Lie showing significant association of the interaction of femoral ash at hatch and lower average egg shell temperatures over the first 15 days of incubation. Lower egg shell temperature in the early to mid incubation process (days 1–15) and higher egg shell temperatures at a later stage (days 16–18) will both tend to delay the hatch time of incubating eggs. Incubation profiles that resulted in later hatching chicks produced birds which could remain standing for a longer time at 6 weeks of age. This supports a contention that the effects of incubation observed in many studies may in fact relate more to earlier hatching and longer sojourn of the hatched chick in the final stage incubator. The implication of these outcomes are that the optimum egg shell temperature during incubation for broiler leg strength development may be lower than that regarded as ideal (37.8°C) for maximum hatchability and chick growth. PMID:25054636

A meta-analysis of experiments linking incubation conditions with subsequent leg weakness in broiler chickens.

PubMed

Groves, Peter J; Muir, Wendy I

2014-01-01

A series of incubation and broiler growth studies were conducted using one strain of broiler chicken (fast feathering dam line) observing incubation effects on femoral bone ash % at hatch and the ability of the bird to remain standing at 6 weeks of age (Latency-To-Lie). Egg shell temperatures during incubation were consistently recorded. Parsimonious models were developed across eight studies using stepwise multiple linear regression of egg shell temperatures over 3-day periods and both bone ash at hatch and Latency-To-Lie. A model for bone ash at hatch explained 70% of the variation in this factor and revealed an association with lower egg shell temperatures during days 4-6 and 13-15 and higher egg shell temperatures during days 16-18 of incubation. Bone ash at hatch and subsequent Latency-To-Lie were positively correlated (r = 0.57, P<0.05). A model described 66% of the variation Latency-To-Lie showing significant association of the interaction of femoral ash at hatch and lower average egg shell temperatures over the first 15 days of incubation. Lower egg shell temperature in the early to mid incubation process (days 1-15) and higher egg shell temperatures at a later stage (days 16-18) will both tend to delay the hatch time of incubating eggs. Incubation profiles that resulted in later hatching chicks produced birds which could remain standing for a longer time at 6 weeks of age. This supports a contention that the effects of incubation observed in many studies may in fact relate more to earlier hatching and longer sojourn of the hatched chick in the final stage incubator. The implication of these outcomes are that the optimum egg shell temperature during incubation for broiler leg strength development may be lower than that regarded as ideal (37.8°C) for maximum hatchability and chick growth.

Arthroscopic single-bundle anterior cruciate ligament reconstruction with six-strand hamstring tendon allograft versus bone-patellar tendon-bone allograft.

PubMed

Dai, Chengliang; Wang, Fei; Wang, Xiaomeng; Wang, Ruipeng; Wang, Shengjie; Tang, Shiyu

2016-09-01

The aim of this study was to compare the clinical outcomes of arthroscopic single-bundle anterior cruciate ligament (ACL) reconstruction with six-strand hamstring tendon (HT) allograft versus bone-patellar tendon-bone (BPTB) allograft. The prospective randomized controlled trial was included 129 patients. Sixty-nine patients received reconstruction with six-strand HT allografts (HT group), whereas 60 patients with BPTB allografts (BPTB group). Outcome assessment included re-rupture findings, International Knee Documentation Committee (IKDC) scores, Lysholm scores, KT-1000 arthrometer, Lachman test, pivot-shift test, range of motion (ROM) and single-leg hop test. At a mean follow-up of 52 months, 113 patients (HT group, 61 patients; BPTB group, 52 patients) completed a minimum 4-year follow-up. Four patients in HT group and six in BPTB group experienced ACL re-rupture (6.2 vs. 10.3 %) and received revision surgery. Significant between-group differences were observed in KT-1000 outcomes and pivot-shift test 1 (1.2 ± 1.5 vs. 1.8 ± 1.3, p = 0.025; positive rate 6.5 vs. 18.9 %, p = 0.036), 2 (1.1 ± 1.4 vs. 1.6 ± 1.2, p = 0.044; 8.1 vs. 20.7 %, p = 0.039), 4 (1.1 ± 1.5 vs. 1.7 ± 1.4, p = 0.031; 9.7 vs. 25 %, p = 0.012) years postoperatively. The outcomes between the two groups were comparable in terms of IKDC scores, Lysholm scores, Lachman test, ROM and single-leg hop test. Six-strand HT allograft achieved superior anteroposterior and rotational stability after single-bundle ACL reconstruction. It is a reasonable graft substitute for ACL reconstruction. II.

Growth hormone treatment of growth failure secondary to total body irradiation and bone marrow transplantation.

PubMed Central

Papadimitriou, A; Urena, M; Hamill, G; Stanhope, R; Leiper, A D

1991-01-01

Growth hormone was given to 13 children (nine boys, four girls) with acute leukaemia who had undergone treatment with cyclophosphamide and total body irradiation before bone marrow transplantation. Mean age at total body irradiation and bone marrow transplantation was 9.0 years (range 3.7-15.8). Endocrinological investigation was carried out at a mean of 2.0 years (range 0.4-4.0) after bone marrow transplantation. Peak serum growth hormone responses to hypoglycaemia were less than 10.0 micrograms/l (less than 20.0 mU/l) in 10, 10.5 micrograms/l (21.0 mU/l) in one, greater than 16.0 micrograms/l (greater than 32.0 mU/l) in two patients. Mean age of the patients at the start of growth hormone treatment was 12.2 years (range 5.8-18.2). The mean time between total body irradiation and bone marrow transplantation and the start of growth hormone treatment was 3.2 years (range, 1.1-5.0). Height velocity SD score (SD) increased from a mean pretreatment value of -1.27 (0.65) to + 0.22 (0.81) in the first year, +0.16 (1.11) in the second year, and +0.42 (0.71) in the third year of treatment. Height SD score (SD) changed only slightly from -1.52 (0.42) to -1.50 (0.47) in the first year, to -1.50 (0.46) in the second year, and -1.74 (0.92) in the third year. Measurement of segmental proportions showed no significant increase in subischial leg length from -0.87 (0.67) to -0.63 (0.65) in the first year, to -0.58 (0.70) in the second year, and -0.80 (1.14) in the third year of treatment. Our data indicate that children who have undergone total body irradiation and bone marrow transplantation respond to treatment with growth hormone in either of two dose regimens, with an increase in height velocity that is adequate to restore a normal growth rate but not to 'catch up', and that total body irradiation impairs not only spinal but also leg growth, possibly by a direct effect of irradiation on the epiphyses and soft tissues. PMID:2053788

Essential and toxic metals in animal bone broths

PubMed Central

Hsu, Der-jen; Lee, Chia-wei; Tsai, Wei-choung; Chien, Yeh-chung

2017-01-01

ABSTRACT Background: This investigation examines the extraction of metals from animal bones into broth, and assesses whether bone broths are good sources of essential metals and the risks associated with the consumption of toxic metals. Method:Three sets of controlled experiments were performed to study the factors (cooking time, acidity, bone type and animal species) that influence metal extractions. Three types of animal bone broth-based foods were also tested. Results: Reducing the broth pH from 8.38 to 5.32 significantly (p < 0.05) increased Ca and Mg extraction by factors of 17.4 and 15.3, respectively. A long cooking time, > 8 h, yielded significantly higher (p < 0.05) Ca and Mg extraction than shorter cooking times. The extraction characteristics of metals, particularly Ca, Mg, Cu and Al, from the leg and rib bones differed. The between-species variations in extraction were larger than those of within-species. Conclusions:The Ca and Mg levels in home-made or commercial broth/soup were found not to exceed low tenths of milligram per serving, or <5% of the daily recommended levels. The risks that are associated with the ingestion of heavy metals such as Pb and Cd in broth are minimal because the levels were in the ranges of a few μg per serving. PMID:28804437

Professional football (soccer) players have a markedly greater skeletal mineral content, density and size than age- and BMI-matched controls.

PubMed

Wittich, A; Mautalen, C A; Oliveri, M B; Bagur, A; Somoza, F; Rotemberg, E

1998-08-01

The total skeletal bone mineral content (BMC), bone mineral density (BMD), bone size, and body composition were measured by dual-energy x-ray absorptiometry (DXA) in all professional male football players of a 1st division team (n = 24) and age- and BMI-matched (n = 22) controls (less than 3 hours of recreational sport activities per week). Average (+/- 1 SD) age of the athletes was 22.6 +/- 2.5 years. Intensive training is conducted during 48 weeks a year for 20-22 hours/week. The length of the registered playing career before the study was 8.2 +/- 2.7 years. Total skeleton BMC was 18.0% (P < 0.001) greater in the football players. The difference resulted from the sum of 5.2% (P < 0.02) increment of bone size and 12.3% (P < 0.001) increment of BMD. The analysis of skeletal subareas revealed that the difference of the BMC and BMD was greater at the level of the pelvis and legs compared with the arms or trunk. The BMC and BMD of the head was equal for both groups. Also, the bone size of the legs and pelvis was significantly greater for the players compared with controls; there was no difference at the level of the arms or head. Within the group of football players the increment of total skeleton BMD was similar in the young players, with less than 7 years of practice (age 20.6 +/- 0.9 years) compared with relative older players (age 24.6 +/- 1.9) with more than 7 years of practice. Lean body mass was significantly greater in the players (63.3 +/- 4.0 kg) compared with the controls (56.7 +/- 3.6, P < 0.001) whereas fat mass was markedly lower (9.4 +/- 2.9 kg versus 14.9 +/- 6.3 kg), P < 0.002). The BMD of the controls was significantly correlated to total weight, height, and lean mass whereas the BMD of the players was only correlated to muscle mass. The calcium intake from dairy products was similar in both groups. The range of calcium intake was wide among the players (184-2519 mg/day) but it was not significantly correlated to BMD (r = 0.03). In conclusion, male professional football players develop a significant increment of BMC as a result of increased bone size and density. This is already present at the end of the second decade and maintained at least to the end of the third decade in active players. As in other high impact loading sports, the effect on area is specific involving mainly the pelvis and legs. The increment was totally unrelated to the calcium intake from dairy products. The fate of the increased BMC after intensive training is discontinued should be assessed. However, if the findings of the present cross-sectional study are supported by detailed longitudinal investigations, the presently reported observations might be important for the prevention of future osteoporotic fractures.

Secreted Wnt Signaling Inhibitors in Disuse-Induced Bone Loss

DTIC Science & Technology

2014-07-01

goal, we proposed to in‐ duce disuse (using Botox‐induced paralysis of the quadriceps,  hamstrings , and soleus) in one hindlimb of a se‐ ries of mice...muscle paralysis of the lower limb via botulinum toxin (Botox; 20 U/kg) injec on into the  quadriceps,  hamstrings , triceps surae, and leg extensor...kg) injec on into the quadriceps,  hamstrings , tri‐ ceps surae, and leg extensor compartment of the right lower limb.   The le  lower limb was

Functional Adaptation of the Calcaneus in Historical Foot Binding.

PubMed

Reznikov, Natalie; Phillips, Carina; Cooke, Martyn; Garbout, Amin; Ahmed, Farah; Stevens, Molly M

2017-09-01

The normal structure of human feet is optimized for shock dampening during walking and running. Foot binding was a historical practice in China aimed at restricting the growth of female feet for aesthetic reasons. In a bound foot the shock-dampening function normally facilitated by the foot arches is withdrawn, resulting in the foot functioning as a rigid extension of the lower leg. An interesting question inspiring this study regards the nature of adaptation of the heel bone to this nonphysiological function using the parameters of cancellous bone anisotropy and 3D fabric topology and a novel intertrabecular angle (ITA) analysis. We found that the trabecular microarchitecture of the normal heel bone, but not of the bound foot, adapts to function by increased anisotropy and preferred orientation of trabeculae. The anisotropic texture in the normal heel bone consistently follows the physiological stress trajectories. However, in the bound foot heel bone the characteristic anisotropy pattern fails to develop, reflecting the lack of a normal biomechanical input. Moreover, the basic topological blueprint of cancellous bone investigated by the ITA method is nearly invariant in both normal and bound foot. These findings suggest that the anisotropic cancellous bone texture is an acquired characteristic that reflects recurrent loading conditions; conversely, an inadequate biomechanical input precludes the formation of anisotropic texture. This opens a long-sought-after possibility to reconstruct bone function from its form. The conserved topological parameters characterize the generic 3D fabric of cancellous bone, which is to a large extent independent of its adaptation to recurrent loading and perhaps determines the mechanical competence of trabecular bone regardless of its functional adaptation. © 2017 American Society for Bone and Mineral Research. © 2017 American Society for Bone and Mineral Research.

MINERAL METABOLISM OF FRACTURES OF THE TIBIA IN MAN STUDIED WITH EXTERNAL COUNTING OF Sr$sup 8$$sup 5$

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wendberg, B.

1961-01-01

A study was made of 51 adult patients with tibial fractures by external counting with scintillation detectors over the thighs, knees, and tibias during a 14-day period after intravenous injection of 25 to 50 mu c Sr/sup 85/. The pattern of activity curves recorded over the fractured leg compared to those recorded over the control leg varied significantly with the age of the fracture (2 days to 9 yr). Increased uptake of Sr/sup 85/ was observed in all cases. The activity ratio fracture/control tibia obtained 14 days after injection rose during the 1st months after fracture to reach a peakmore » value 6 to 8 months after fracture. The mean 14-day fracture/ control ratios obtained 5 to 10 months after fracture was 15.5 plus or minus 7.2; then it dropped. Even 6 to 9 yr after fracture the counting rate over the fracture was higher than that over the intact tibia. No differences in activity uptake were observed between normally healing fractures and fractures showing delayed or nonunion. Activity curves obtained over the thigh, knee, and tibia of the fractured and intact legs 1 to l4 days after injection of Sr/sup 85/ could be simulated on the basis of a 2-compartment model for the kinetics of Sr in the body. Based on this kinetic analysis the externally recorded Sr/sup 85/ activity values may be interpreted as follows: The activity ratios fractured/intact leg obtained during early intervals after injection are mainly related to differences in the size of the exchangeable mineral spaces under the detector. The 14-day activity ratio of 2 anatomically comparable locations may be used as a relative index of the difference in the accretion rate (rate of irreversible deposition of bone mineral) in these locations, but is somewhat lower than the absolute dfference in the accretion rate. The bone salt laid down in the fracture callus is derived from the body fluids. The accretion rate in the fracture region is increased within a week of the fracture. It rapidly increases during the first months after fracture to reach a peak value at 6 to 8 months after fracture. The accretion rate in the entire fractured leg is increased some months after fracture. The traumatic osteopenia is caused by increased resorption and not by decreased accretion. (H.H.D.)« less

Cerebral fat embolism syndrome after long bone fracture due to gunshot injury.

PubMed

Duran, Latif; Kayhan, Servet; Kati, Celal; Akdemir, Hizir Ufuk; Balci, Kemal; Yavuz, Yucel

2014-03-01

Cerebral fat embolism syndrome is a lethal complication of long-bone fractures and clinically manifasted with respiratory distress, altered mental status, and petechial rash. We presented a 20-year-old male admitted with gun-shot wounds to his left leg. Twenty-four hours after the event, he had generalized tonic clonic seizures, decorticate posture and a Glascow Coma Scale of seven with localization of painful stimuli. Subsequent magnetic resonance imaging of the brain showed a star-field pattern defining multiple lesions of restricted diffusion. On a 4-week follow-up, he had returned to normal neurological function. Despite the severity of the neurological condition upon initial presentation, the case cerebral fat embolism illustrates that, cerebral dysfunction associated with cerebral fat embolism illustrates reversible.

Osteoinduction by Ca-P biomaterials implanted into the muscles of mice*

PubMed Central

Yang, Rui-na; Ye, Feng; Cheng, Li-jia; Wang, Jin-jing; Lu, Xiao-feng; Shi, Yu-jun; Fan, Hong-song; Zhang, Xing-dong; Bu, Hong

2011-01-01

The osteoinduction of porous biphasic calcium phosphate ceramics (BCP) has been widely reported and documented, but little research has been performed on rodent animals, e.g., mice. In this study, we report osteoinduction in a mouse model. Thirty mice were divided into two groups. BCP materials (Sample A) and control ceramics (Sample B) were implanted into the leg muscle, respectively. Five mice in each group were killed at 15, 30, and 45 d after surgery. Sample A and Sample B were harvested and used for hematoxylin and eosin (HE) staining, immunohistochemistry (IHC) staining, and Alizarin Red S staining to check bone formation in the biomaterials. Histological analysis showed that no bone tissue was formed 15 d after implantation (0/5) in either of the two groups. Newly-formed bone tissues were observed in Sample A at 30 d (5/5) and 45 d (5/5) after implantation; the average amounts of newly-formed bone tissues were approximately 5.2% and 8.6%, respectively. However, we did not see any bone tissue in Sample B until 45 d after implantation. Bone-related molecular makers such as bone morphogenesis protein-2 (BMP-2), collagen type I, and osteopontin were detected by IHC staining in Sample A 30 d after implantation. In addition, the newly-formed bone was also confirmed by Alizarin Red S staining. Because this is the report of osteoinduction in the rodent animal on which all the biotechnologies were available, our results may contribute to further mechanism research. PMID:21726066

Successful correction of tibial bone deformity through multiple surgical procedures, liquid nitrogen-pretreated bone tumor autograft, three-dimensional external fixation, and internal fixation in a patient with primary osteosarcoma: a case report.

PubMed

Takeuchi, Akihiko; Yamamoto, Norio; Shirai, Toshiharu; Nishida, Hideji; Hayashi, Katsuhiro; Watanabe, Koji; Miwa, Shinji; Tsuchiya, Hiroyuki

2015-12-07

In a previous report, we described a method of reconstruction using tumor-bearing autograft treated by liquid nitrogen for malignant bone tumor. Here we present the first case of bone deformity correction following a tumor-bearing frozen autograft via three-dimensional computerized reconstruction after multiple surgeries. A 16-year-old female student presented with pain in the left lower leg and was diagnosed with a low-grade central tibial osteosarcoma. Surgical bone reconstruction was performed using a tumor-bearing frozen autograft. Bone union was achieved at 7 months after the first surgical procedure. However, local tumor recurrence and lung metastases occurred 2 years later, at which time a second surgical procedure was performed. Five years later, the patient developed a 19° varus deformity and underwent a third surgical procedure, during which an osteotomy was performed using the Taylor Spatial Frame three-dimensional external fixation technique. A fourth corrective surgical procedure was performed in which internal fixation was achieved with a locking plate. Two years later, and 10 years after the initial diagnosis of tibial osteosarcoma, the bone deformity was completely corrected, and the patient's limb function was good. We present the first report in which a bone deformity due to a primary osteosarcoma was corrected using a tumor-bearing frozen autograft, followed by multiple corrective surgical procedures that included osteotomy, three-dimensional external fixation, and internal fixation.

Lower extremity finite element model for crash simulation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schauer, D.A.; Perfect, S.A.

1996-03-01

A lower extremity model has been developed to study occupant injury mechanisms of the major bones and ligamentous soft tissues resulting from vehicle collisions. The model is based on anatomically correct digitized bone surfaces of the pelvis, femur, patella and the tibia. Many muscles, tendons and ligaments were incrementally added to the basic bone model. We have simulated two types of occupant loading that occur in a crash environment using a non-linear large deformation finite element code. The modeling approach assumed that the leg was passive during its response to the excitation, that is, no active muscular contraction and thereforemore » no active change in limb stiffness. The approach recognized that the most important contributions of the muscles to the lower extremity response are their ability to define and modify the impedance of the limb. When nonlinear material behavior in a component of the leg model was deemed important to response, a nonlinear constitutive model was incorporated. The accuracy of these assumptions can be verified only through a review of analysis results and careful comparison with test data. As currently defined, the model meets the objective for which it was created. Much work remains to be done, both from modeling and analysis perspectives, before the model can be considered complete. The model implements a modeling philosophy that can accurately capture both kinematic and kinetic response of the lower limb. We have demonstrated that the lower extremity model is a valuable tool for understanding the injury processes and mechanisms. We are now in a position to extend the computer simulation to investigate the clinical fracture patterns observed in actual crashes. Additional experience with this model will enable us to make a statement on what measures are needed to significantly reduce lower extremity injuries in vehicle crashes. 6 refs.« less

Grip strength is a predictor of bone mineral density among adolescent combat sport athletes.

PubMed

Nasri, Raouf; Hassen Zrour, Saoussen; Rebai, Haithem; Fadhel Najjar, Mohamed; Neffeti, Fadoua; Bergaoui, Naceur; Mejdoub, Hafedh; Tabka, Zouhair

2013-01-01

The aim of this study was firstly to investigate the correlation between bone parameters and grip strength (GS) in hands, explosive legs power (ELP), and hormonal parameters; second, to identify the most determinant variables of bone mineral density (BMD) among adolescent combat sport athletes. Fifty combat sport athletes aged 17.1 ± 0.2 year were compared with 30 sedentary subjects matched for age, height, and pubertal stage. For all subjects, the BMD in deferent sites associated with anthropometric parameters were measured by dual-energy X-ray absorptiometry. The growth hormone (GH) and testosterone (TESTO) concentrations were tested. The GS in dominant (GSDA) and nondominant arms (GSNDA) and ELP were evaluated. All BMD measured were greater in athletes than in sedentary group (p<0.01). The GS and ELP showed higher values in athletes than in sedentary group (p<0.01). The BMD in all sites were correlated with weight, but without correlation with height. The GSNDA and ELP were significantly correlated with BMD of both spine and legs. The GH was correlated with the BMD of whole body and spine (p<0.05). The TESTO was only correlated with BMD of the arms (p<0.01). The best predictor of BMD measurements is GSNDA. This study has proved the osteogenic effect of combat sports practice, especially judo and karate kyokushinkai. Therefore, children and adolescent should be encouraged to participate in combat sport. Moreover, it suggested that the best model predicting BMD in different sites among adolescent combat sports athletes was the GSNDA. Copyright © 2013 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

Reconstruction with distraction osteogenesis for juxta-articular nonunions with bone loss.

PubMed

Kabata, Tamon; Tsuchiya, Hiroyuki; Sakurakichi, Keisuke; Yamashiro, Teruhisa; Watanabe, Koji; Tomita, Kasuro

2005-06-01

Nonunions of a juxta-articular lesion with bone loss, which represent a challenging therapeutic problem, were treated using external fixation and distraction osteogenesis. Seven juxta-articular nonunions (five septic and two aseptic) were treated. The location of the nonunion was the distal femur in four patients, the proximal tibia in one patient, and the distal tibia in two patients. All of them were located within 5 cm from the affected joints. Preoperative limb shortening was present in six cases, averaging 2.9 cm (range, 1-7 cm). The reconstructive procedure consisted of refreshment of the nonunion site, deformity correction, stabilization by external fixation, and lengthening to eliminate leg length discrepancy or to fill the defect. Shortening-distraction was applied to six patients and bone transport to one patient for reconstruction. Intramedullary nailing to reduce the duration of external fixation was simultaneously performed in two cases. All the patients had at least 1 year of follow-up evaluation. Osseous union without angular deformity or leg length discrepancy greater than 1 cm was achieved in all patients. The mean amount of lengthening was 5.8 cm (range, 2.2-10.0 cm). The mean external fixation period was 219 days (range, 98-317 days), and the mean external fixation index was 34.4 days/cm (range, 24.5-47.6 days/cm). All patients reported excellent pain reduction. There were no recurrences of infection in five patients with prior history of osteomyelitis. The functional results were categorized as excellent in two, good in three, and fair in two. Despite the length of postoperative external fixation, distraction osteogenesis can be a valuable alternative for the treatment of juxta-articular nonunions.

The role of body mass index, insulin, and adiponectin in the relation between fat distribution and bone mineral density.

PubMed

Zillikens, M Carola; Uitterlinden, André G; van Leeuwen, Johannes P T M; Berends, Anne L; Henneman, Peter; van Dijk, Ko Willems; Oostra, Ben A; van Duijn, Cornelia M; Pols, Huibert A P; Rivadeneira, Fernando

2010-02-01

Despite the positive association between body mass index (BMI) and bone mineral density (BMD) and content (BMC), the role of fat distribution in BMD/BMC remains unclear. We examined relationships between BMD/BMC and various measurements of fat distribution and studied the role of BMI, insulin, and adiponectin in these relations. Using a cross-sectional investigation of 2631 participants from the Erasmus Rucphen Family study, we studied associations between BMD (using dual-energy X-ray absorptiometry (DXA]) at the hip, lumbar spine, total body (BMD and BMC), and fat distribution by the waist-to-hip ratio (WHR), waist-to-thigh ratio (WTR), and DXA-based trunk-to-leg fat ratio and android-to-gynoid fat ratio. Analyses were stratified by gender and median age (48.0 years in women and 49.2 years in men) and were performed with and without adjustment for BMI, fasting insulin, and adiponectin. Using linear regression (adjusting for age, height, smoking, and use of alcohol), most relationships between fat distribution and BMD and BMC were positive, except for WTR. After BMI adjustment, most correlations were negative except for trunk-to-leg fat ratio in both genders. No consistent influence of age or menopausal status was found. Insulin and adiponectin levels did not explain either positive or negative associations. In conclusion, positive associations between android fat distribution and BMD/BMC are explained by higher BMI but not by higher insulin and/or lower adiponectin levels. Inverse associations after adjustment for BMI suggest that android fat deposition as measured by the WHR, WTR, and DXA-based android-to-gynoid fat ratio is not beneficial and possibly even deleterious for bone.

Quantification of Sodium (Na) in Bone with in Vivo Neutron Activation Analysis (IVNAA) and Its Implications on Na Retention Studies

NASA Astrophysics Data System (ADS)

Coyne, Mychaela

The locations of Na storage and its exchange mechanisms in different tissues in the body are not well known. This information is important for understanding the impact of Na intake, absorption, and retention on human health, especially on the risk of developing chronic diseases like hypertension. In order to non-invasively quantify Na in bone, a compact deuterium-deuterium (DD) neutron generator-based IVNAA system was developed for use in Na nutrition studies. This thesis will first discuss the optimization of the system using MCNP to maximize the thermal neutron flux inside the irradiation cave while limiting radiation exposure to the hand and the whole body. With optimized assembly in place, an animal study was conducted to investigate the storage and exchange of Na in the body. The right posterior legs of two live pigs, one on a low Na diet and one on a high Na diet, were irradiated inside the customized assembly and then measured with a 100% high efficiency high purity germanium detector (HPGe). The results show that the difference in concentration between the pigs on high vs low Na diets was distinguishable with the system. Analysis also shows rapid exchange of Na in the leg during the first 2 hour measurements (with an exchange decay time of 1.3 hours) while the exchange was minimal at the second and third 2 hour measurements, taken 7 and 21 hours post irradiation. With these results, we conclude there is a non or low exchangeable compartment (likely to be bone) for Na storage and that the DD neutron generator-based IVNAA is a useful method in Na nutrition studies.

Functional Adaptation of the Calcaneus in Historical Foot Binding

PubMed Central

Reznikov, Natalie; Phillips, Carina; Cooke, Martyn; Garbout, Amin; Ahmed, Farah

2017-01-01

ABSTRACT The normal structure of human feet is optimized for shock dampening during walking and running. Foot binding was a historical practice in China aimed at restricting the growth of female feet for aesthetic reasons. In a bound foot the shock‐dampening function normally facilitated by the foot arches is withdrawn, resulting in the foot functioning as a rigid extension of the lower leg. An interesting question inspiring this study regards the nature of adaptation of the heel bone to this nonphysiological function using the parameters of cancellous bone anisotropy and 3D fabric topology and a novel intertrabecular angle (ITA) analysis. We found that the trabecular microarchitecture of the normal heel bone, but not of the bound foot, adapts to function by increased anisotropy and preferred orientation of trabeculae. The anisotropic texture in the normal heel bone consistently follows the physiological stress trajectories. However, in the bound foot heel bone the characteristic anisotropy pattern fails to develop, reflecting the lack of a normal biomechanical input. Moreover, the basic topological blueprint of cancellous bone investigated by the ITA method is nearly invariant in both normal and bound foot. These findings suggest that the anisotropic cancellous bone texture is an acquired characteristic that reflects recurrent loading conditions; conversely, an inadequate biomechanical input precludes the formation of anisotropic texture. This opens a long‐sought‐after possibility to reconstruct bone function from its form. The conserved topological parameters characterize the generic 3D fabric of cancellous bone, which is to a large extent independent of its adaptation to recurrent loading and perhaps determines the mechanical competence of trabecular bone regardless of its functional adaptation. © 2017 The Authors. Journal of Bone and Mineral Research Published by Wiley Periodicals Inc. PMID:28561380

Relation of adrenal-derived steroids with bone maturation, mineral density and geometry in healthy prepubertal and early pubertal boys.

PubMed

Vandewalle, S; Taes, Y; Fiers, T; Toye, K; Van Caenegem, E; Kaufman, J-M; De Schepper, J

2014-12-01

Little is known about the effects of adrenal steroids on skeletal maturation and bone mass acquisition in healthy prepubertal boys. To study whether adrenal-derived steroids within the physiological range are associated with skeletal maturation, areal and volumetric bone mineral density (aBMD and vBMD) and bone geometry in healthy prepubertal and early pubertal boys. 98 healthy prepubertal and early pubertal boys (aged 6-14 y) were studied cross-sectionally. Androstenedione (A) and estrone (E1) were determined by liquid chromatography tandem mass spectrometry and DHEAS was determined by immunoassay. Whole body and lumbar spine aBMD and bone area were determined by dual-energy X-ray absorptiometry. Trabecular (distal site) and cortical (proximal site) vBMD and bone geometry were assessed at the non-dominant forearm and leg using peripheral QCT. Skeletal age was determined by X-ray of the left hand. Adrenal-derived steroids (DHEAS, A and E1) are positively associated with bone age in prepubertal and early pubertal children, independently of age. There are no associations between the adrenal-derived steroids and the studied parameters of bone size (lumbar spine and whole body bone area, trabecular or cortical area at the radius or tibia, periosteal circumference and cortical thickness at the radius or tibia) or BMD (aBMD or vBMD). In healthy prepubertal and early pubertal boys, serum adrenal-derived steroid levels, are associated with skeletal maturation, independently of age, but not with bone size or (v)BMD. Our data suggest that adrenal derived steroids are not implicated in the accretion of bone mass before puberty in boys. Copyright © 2014 Elsevier Inc. All rights reserved.

Lower Trabecular Volumetric BMD at Metaphyseal Regions of Weight-Bearing Bones is Associated With Prior Fracture in Young Girls

PubMed Central

Farr, Joshua N; Tomás, Rita; Chen, Zhao; Lisse, Jeffrey R; Lohman, Timothy G; Going, Scott B

2011-01-01

Understanding the etiology of skeletal fragility during growth is critical for the development of treatments and prevention strategies aimed at reducing the burden of childhood fractures. Thus we evaluated the relationship between prior fracture and bone parameters in young girls. Data from 465 girls aged 8 to 13 years from the Jump-In: Building Better Bones study were analyzed. Bone parameters were assessed at metaphyseal and diaphyseal sites of the nondominant femur and tibia using peripheral quantitative computed tomography (pQCT). Dual-energy X-ray absorptiometry (DXA) was used to assess femur, tibia, lumbar spine, and total body less head bone mineral content. Binary logistic regression was used to evaluate the relationship between prior fracture and bone parameters, controlling for maturity, body mass, leg length, ethnicity, and physical activity. Associations between prior fracture and all DXA and pQCT bone parameters at diaphyseal sites were nonsignificant. In contrast, lower trabecular volumetric BMD (vBMD) at distal metaphyseal sites of the femur and tibia was significantly associated with prior fracture. After adjustment for covariates, every SD decrease in trabecular vBMD at metaphyseal sites of the distal femur and tibia was associated with 1.4 (1.1–1.9) and 1.3 (1.0–1.7) times higher fracture prevalence, respectively. Prior fracture was not associated with metaphyseal bone size (ie, periosteal circumference). In conclusion, fractures in girls are associated with lower trabecular vBMD, but not bone size, at metaphyseal sites of the femur and tibia. Lower trabecular vBMD at metaphyseal sites of long bones may be an early marker of skeletal fragility in girls. © 2011 American Society for Bone and Mineral Research. PMID:20721933

Lower trabecular volumetric BMD at metaphyseal regions of weight-bearing bones is associated with prior fracture in young girls.

PubMed

Farr, Joshua N; Tomás, Rita; Chen, Zhao; Lisse, Jeffrey R; Lohman, Timothy G; Going, Scott B

2011-02-01

Understanding the etiology of skeletal fragility during growth is critical for the development of treatments and prevention strategies aimed at reducing the burden of childhood fractures. Thus we evaluated the relationship between prior fracture and bone parameters in young girls. Data from 465 girls aged 8 to 13 years from the Jump-In: Building Better Bones study were analyzed. Bone parameters were assessed at metaphyseal and diaphyseal sites of the nondominant femur and tibia using peripheral quantitative computed tomography (pQCT). Dual-energy X-ray absorptiometry (DXA) was used to assess femur, tibia, lumbar spine, and total body less head bone mineral content. Binary logistic regression was used to evaluate the relationship between prior fracture and bone parameters, controlling for maturity, body mass, leg length, ethnicity, and physical activity. Associations between prior fracture and all DXA and pQCT bone parameters at diaphyseal sites were nonsignificant. In contrast, lower trabecular volumetric BMD (vBMD) at distal metaphyseal sites of the femur and tibia was significantly associated with prior fracture. After adjustment for covariates, every SD decrease in trabecular vBMD at metaphyseal sites of the distal femur and tibia was associated with 1.4 (1.1-1.9) and 1.3 (1.0-1.7) times higher fracture prevalence, respectively. Prior fracture was not associated with metaphyseal bone size (ie, periosteal circumference). In conclusion, fractures in girls are associated with lower trabecular vBMD, but not bone size, at metaphyseal sites of the femur and tibia. Lower trabecular vBMD at metaphyseal sites of long bones may be an early marker of skeletal fragility in girls. Copyright © 2011 American Society for Bone and Mineral Research.

[Tenotomy of carpal and digital flexor tendons for correction of congenital neuromyodysplasia in a calf].

PubMed

Sohrt, J T; Heppelmann, M; Rehage, J; Staszyk, C

2013-01-01

In a 7-day-old heifer calf, a bilateral flexural deformity of the forelimbs involving the digital flexor tendons, the suspensory ligament and the ulnar and radial carpal flexor tendons was diagnosed. After 2 weeks of conservative treatment consisting of manual stretching of the legs and the application of splints and wooden blocks, which were glued to the soles and extended beyond the tip of the claws, the right forelimb could be extended sufficiently to allow weight bearing, whereas the left forelimb could be passively extended to only approximately 120°. Therefore, tenotomy of the ulnar carpal flexor tendon, the digital flexor tendons and the suspensory ligament was carried out in the left leg. A support bandage was then applied to the leg for 8 weeks, after which the carpus and fetlock could be completely extended passively. Flexural deformity of the carpus caused by contracture of the carpal flexor tendons was treated by means of a tenotomy of the ulnar carpal flexor tendon proximal to the accessory carpal bone, which allowed preservation of the carpal tunnel and avoided the risk of iatrogenic damage to nerves and the carpal joint capsule.

Deboning broiler chicken legs and wings by dislocation of articular cartilage followed by stripping periosteum.

PubMed

Nakano, T; Ozimek, L; Betti, M

2012-11-01

The yield of deboned meat is an important economic factor affecting the profit of the meat industry. This study was undertaken to determine whether the yield of boneless meat from broiler chicken leg (thigh and drumstick) and wing (drumette and winglet) is improved by introducing a new deboning method consisting of articular cartilage dislocation followed by stripping periosteum. A total of 44 broiler chicken carcasses were used in the deboning experiment. Right and left legs or wings from the first 22 carcasses were assigned to the new and ordinary hand deboning methods, respectively. For the remaining 22 carcasses, right and left legs or wings were assigned to the ordinary and new methods, respectively. The weight of residue, composed of bone and small amounts of cartilage and noncartilaginous tissues obtained after deboning, was then compared between the right and left legs or wings to see the difference between the 2 methods. The removal of tibia, fibula, humerus, radius, or ulna resulted in formation of a hollow in boneless meat obtained. There was no difference (P > 0.05) between the right and left legs or wings in the weight of residue obtained after deboning as expected. The weight of residue was less (P < 0.05) with the new method compared with the ordinary method in all chicken parts examined. The difference of residue weight between the 2 methods accounted for 10, 12, 14, and 21% of the weight of residue obtained by the ordinary method in thigh, drumstick, drumette, and winglet, respectively. The new method may be useful to deboners at home kitchens as well as the poultry meat industry. The present study also showed the development of a secondary ossification center at the proximal end of the carpometacarpus of chickens. This is, to our knowledge, the first report of development of secondary ossification center in chicken wings.

Stature Estimation from Lower Limb Anthropometry using Linear Regression Analysis: A Study on the Malaysian Population.

PubMed

Abu Bakar, S N; Aspalilah, A; AbdelNasser, I; Nurliza, A; Hairuliza, M J; Swarhib, M; Das, S; Mohd Nor, F

2017-01-01

Stature is one of the characteristics that could be used to identify human, besides age, sex and racial affiliation. This is useful when the body found is either dismembered, mutilated or even decomposed, and helps in narrowing down the missing person's identity. The main aim of the present study was to construct regression functions for stature estimation by using lower limb bones in the Malaysian population. The sample comprised 87 adult individuals (81 males, 6 females) aged between 20 to 79 years. The parameters such as thigh length, lower leg length, leg length, foot length, foot height and foot breadth were measured. They were measured by a ruler and measuring tape. Statistical analysis involved independent t-test to analyse the difference between lower limbs in male and female. The Pearson's correlation test was used to analyse correlations between lower limb parameters and stature, and the linear regressions were used to form equations. The paired t-test was used to compare between actual stature and estimated stature by using the equations formed. Using independent t-test, there was a significant difference (p< 0.05) in the measurement between males and females with regard to leg length, thigh length, lower leg length, foot length and foot breadth. The thigh length, leg length and foot length were observed to have strong correlations with stature with p= 0.75, p= 0.81 and p= 0.69, respectively. Linear regressions were formulated for stature estimation. Paired t-test showed no significant difference between actual stature and estimated stature. It is concluded that regression functions can be used to estimate stature to identify skeletal remains in the Malaysia population.

Age dependence of the normal/abnormal difference of bone mineral density in osteoporotic women.

PubMed

Bagur, A; Vega, E; Mautalen, C

1994-09-01

Bone mineral density (BMD) is the major factor in bone strength and in the risk of suffering osteoporotic fractures. The aim of this study was to examine the normal/abnormal difference for antero-posterior (AP) spine, lateral spine, proximal femur and total body BMD to assess if age influences discrimination at three different decades between 50 and 80 years of age. The BMD was determined in 61 control women and 60 osteoporotic women (at least one vertebral wedge fracture readily visible in the lateral X-rays of the thoracic or lumbar spine). Measurements were made by DEXA with a total body scanner. The BMD of the whole group of osteoporotic women was markedly lower than that of age-matched controls at all skeletal areas (P < 0.001) except at the arms where the difference was smaller (P < 0.02). The Z-score (the difference between osteoporotic patients and age-matched control divided by the intrapopulation S.D.) was similar (approximately -1.7) over the AP spine, femoral neck, Ward's triangle, total body and legs. It was significantly lower at the arms (-0.8, P < 0.001), lateral spine (-1.4, P < 0.01) and trochanter (-1.3, P < 0.001) compared with the Z-score of the AP spine. The analysis of the results by decades of age disclosed that the higher Z-score on the 6th and 7th decades corresponded to the AP lumbar spine (approximately -2.0). A high descrimination was also observed for the femoral neck, Ward's triangle and legs while the Z-score of the lateral lumbar spine, total body, trochanter and arms were significantly lower than that of the AP lumbar spine. However on the 8th decade the Z-score of the AP lumbar spine diminished to -1.2 and was only significantly higher than the Z-score of the arms (P < 0.01). The study showed that, in women 50-60 years of age--the period where the majority of studies are made for prevention of osteoporosis, none of the other skeletal areas were superior to the AP spine in discrimination for spinal osteoporosis. Proximal femur and legs densitometry gave lower but not significantly different Z-score than the AP spine, while the remaining areas were significantly inferior to AP spine in separating osteoporotic and normal women.

Accelerated production of dry cured hams.

PubMed

Marriott, N G; Graham, P P; Shaffer, C K; Phelps, S K

1987-01-01

Ten uncured legs from the right side of the sampled pork carcasses (Study A) were vacuum tumbled with the cure adjuncts for 30 min (T) and 10 counterparts from the left side were tumbled 30 min, rested 30 min and tumbled an additional 30 min (TRT). Evaluations were conducted at 40 and 70 days after cure application for color, taste attributes, percentage moisture, percentage salt and NO(3)(-) and NO(2)(-) content. Study B was the same except that 18 legs were boned, tumbled and cured for 40, 56 and 70 days. The TRT samples (Study A) at 40 days sustained less color fading (P < 0.05) during cookery, but no differences (P > 0.05) existed among the uncooked hams. Increased cure time enhanced moisture loss and salt content (Study A) and color retention during cookery (Study B). The TRT samples had increased moisture loss and salt content (Study A). Copyright © 1987. Published by Elsevier Ltd.

Effects of Extremity Armor on Metabolic Cost and Gait Biomechanics

DTIC Science & Technology

2010-05-26

of prosthetics , orthotics, and exercise equipment could benefit from knowing the tipping point at which a mass on the limb begins to effect metabolic...measured. For this, you wear a nose clip and 4 breathe through a rubber mouthpiece and valve , similar to those found in scuba diving 5 equipment. The...32 33 Stress fractures , or breaks of bones in the foot and leg, have been associated with road 34 marching while carrying loads, especially

A semi-automated software tool to study treadmill locomotion in the rat: from experiment videos to statistical gait analysis.

PubMed

Gravel, P; Tremblay, M; Leblond, H; Rossignol, S; de Guise, J A

2010-07-15

A computer-aided method for the tracking of morphological markers in fluoroscopic images of a rat walking on a treadmill is presented and validated. The markers correspond to bone articulations in a hind leg and are used to define the hip, knee, ankle and metatarsophalangeal joints. The method allows a user to identify, using a computer mouse, about 20% of the marker positions in a video and interpolate their trajectories from frame-to-frame. This results in a seven-fold speed improvement in detecting markers. This also eliminates confusion problems due to legs crossing and blurred images. The video images are corrected for geometric distortions from the X-ray camera, wavelet denoised, to preserve the sharpness of minute bone structures, and contrast enhanced. From those images, the marker positions across video frames are extracted, corrected for rat "solid body" motions on the treadmill, and used to compute the positional and angular gait patterns. Robust Bootstrap estimates of those gait patterns and their prediction and confidence bands are finally generated. The gait patterns are invaluable tools to study the locomotion of healthy animals or the complex process of locomotion recovery in animals with injuries. The method could, in principle, be adapted to analyze the locomotion of other animals as long as a fluoroscopic imager and a treadmill are available. Copyright 2010 Elsevier B.V. All rights reserved.

Bone fractures following external beam radiotherapy and limb-preservation surgery for lower extremity soft tissue sarcoma: relationship to irradiated bone length, volume, tumor location and dose.

PubMed

Dickie, Colleen I; Parent, Amy L; Griffin, Anthony M; Fung, Sharon; Chung, Peter W M; Catton, Charles N; Ferguson, Peter C; Wunder, Jay S; Bell, Robert S; Sharpe, Michael B; O'Sullivan, Brian

2009-11-15

To examine the relationship between tumor location, bone dose, and irradiated bone length on the development of radiation-induced fractures for lower extremity soft tissue sarcoma (LE-STS) patients treated with limb-sparing surgery and radiotherapy (RT). Of 691 LE-STS patients treated from 1989 to 2005, 31 patients developed radiation-induced fractures. Analysis was limited to 21 fracture patients (24 fractures) who were matched based on tumor size and location, age, beam arrangement, and mean total cumulative RT dose to a random sample of 53 nonfracture patients and compared for fracture risk factors. Mean dose to bone, RT field size (FS), maximum dose to a 2-cc volume of bone, and volume of bone irradiated to >or=40 Gy (V40) were compared. Fracture site dose was determined by comparing radiographic images and surgical reports to fracture location on the dose distribution. For fracture patients, mean dose to bone was 45 +/- 8 Gy (mean dose at fracture site 59 +/- 7 Gy), mean FS was 37 +/- 8 cm, maximum dose was 64 +/- 7 Gy, and V40 was 76 +/- 17%, compared with 37 +/- 11 Gy, 32 +/- 9 cm, 59 +/- 8 Gy, and 64 +/- 22% for nonfracture patients. Differences in mean, maximum dose, and V40 were statistically significant (p = 0.01, p = 0.02, p = 0.01). Leg fractures were more common above the knee joint. The risk of radiation-induced fracture appears to be reduced if V40 <64%. Fracture incidence was lower when the mean dose to bone was <37 Gy or maximum dose anywhere along the length of bone was <59 Gy. There was a trend toward lower mean FS for nonfracture patients.

Bioactive and biodegradable silica biomaterial for bone regeneration.

PubMed

Wang, Shunfeng; Wang, Xiaohong; Draenert, Florian G; Albert, Olga; Schröder, Heinz C; Mailänder, Volker; Mitov, Gergo; Müller, Werner E G

2014-10-01

Biosilica, a biocompatible, natural inorganic polymer that is formed by an enzymatic, silicatein-mediated reaction in siliceous sponges to build up their inorganic skeleton, has been shown to be morphogenetically active and to induce mineralization of human osteoblast-like cells (SaOS-2) in vitro. In the present study, we prepared beads (microspheres) by encapsulation of β-tricalcium phosphate [β-TCP], either alone (control) or supplemented with silica or silicatein, into the biodegradable copolymer poly(d,l-lactide-co-glycolide) [PLGA]. Under the conditions used, ≈5% β-TCP, ≈9% silica, and 0.32μg/mg of silicatein were entrapped into the PLGA microspheres (diameter≈800μm). Determination of the biocompatibility of the β-TCP microspheres, supplemented with silica or silicatein, revealed no toxicity in the MTT based cell viability assay using SaOS-2 cells. The adherence of SaOS-2 cells to the surface of silica-containing microspheres was higher than for microspheres, containing only β-TCP. In addition, the silica-containing β-TCP microspheres and even more pronounced, a 1:1 mixture of microspheres containing β-TCP and silica, and β-TCP and silicatein, were found to strongly enhance the mineral deposition by SaOS-2 cells. Using these microspheres, first animal experiments with silica/biosilica were performed in female, adult New Zealand White rabbits to study the effect of the inorganic polymer on bone regeneration in vivo. The microspheres were implanted into 5mm thick holes, drilled into the femur of the animals, applying a bilateral comparison study design (3 test groups with 4-8 animals each). The control implant on one of the two hind legs contained microspheres with only β-TCP, while the test implant on the corresponding leg consisted either of microspheres containing β-TCP and silica, or a 1:1 mixture of microspheres, supplemented with β-TCP and silica, and β-TCP and silicatein. The results revealed that tissue/bone sections of silica containing implants and implants, composed of a 1:1 mixture of silica-containing microspheres and silicatein-containing microspheres, show an enhanced regeneration of bone tissue around the microspheres, compared to the control implants containing only β-TCP. The formation of new bone induced by the microspheres is also evident from measurements of the stiffness/reduced Young's modulus of the regenerated bone tissue. The reduced Young's modulus of the regenerating bone tissue around the implants was markedly higher for the silica-containing microspheres (1.1MPa), and even more for the 1:1 mixture of the silica- and silicatein-containing microspheres (1.4MPa), compared to the β-TCP microsphere controls (0.4MPa). We propose that based on their morphogenetic activity on bone-forming cells in vitro and the results of the animal experiments presented here, silica/biosilica-based scaffolds are promising materials for bone repair/regeneration. Copyright © 2014 Elsevier Inc. All rights reserved.

[Chronic bone pain due to raised FGF23 production? The importance of determining phosphate levels].

PubMed

de Jongh, Renate T; Vervloet, Marc G; Bravenboer, Nathalie; Heijboer, Annemieke C; den Heijer, Martin; Lips, Paul

2013-01-01

Hypophosphatemia is an important finding in the evaluation of patients with chronic bone pain. Fibroblast-growth factor 23 (FGF23) plays a role in the differential diagnosis of hypophosphatemia. A 34-year-old man had progressive pain in both shoulders and hips due to hypophosphatemic osteomalacia. He had elevated FGF23 levels, induced by a FGF23-producing tumour in the right acetabulum. Thus, he had tumour-induced hypophosphatemic osteomalacia. A 50-year-old man had had bowed legs and joint pains since his youth due to osteomalacia. Several family members also had osteomalacia. His phosphate concentration was low. Genetic testing revealed a mutation on the PHEX gene which results in high FGF23 levels. Thus, he had X-linked hereditary hypophosphatemic osteomalacia. In patients with bone pain, the measurement of a phosphate concentration is important. In renal phosphate loss, the measurement of FGF23 is an important next step if parathormone concentrations are low or normal.

Stress reactions involving the pars interarticularis in young athletes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jackson, D.W.; Wiltse, L.L.; Dingeman, R.D.

A stress reaction involving the pars interarticularis of the lumbar spine was confirmed in seven young athletes with a positive technetium pyrophosphate bone scan. No pars defects were detectable on their lumbosacral roentgenograms, which included oblique views. The return to normal levels of radioactive uptake on repeat bone scans correlated closely with their clinical course. If the bony reaction is recognized early, it may heal at a subroentgenographic level and prevent the development of lumbar spondylolysis. These early lesions usually show unilateral increased uptake at one lumbar level on the bone scan and, initially, the athlete localizes the pain tomore » the corresponding unilateral lumbar paraspinous area. The ''one-legged hyperextension test'' is positive on the ipsilateral side and aggravates the pain. Treatment consists of avoiding the aggravating activities and resting. The average time for return to pain-free competition was 7.3 months. These developing defects may be the source of considerable prolonged disability in the young athlete, particularly if undiagnosed and untreated.« less

Tissue distribution of mesenchymal stem cell marker Stro-1.

PubMed

Lin, Guiting; Liu, Gang; Banie, Lia; Wang, Guifang; Ning, Hongxiu; Lue, Tom F; Lin, Ching-Shwun

2011-10-01

Stro-1 is the best-known mesenchymal stem cell marker. However, despite its bone marrow origin, its localization in bone marrow has never been demonstrated. By immunofluorescence staining, we show here that ∼ 0.74% of nucleated bone marrow cells expressed Stro-1. We also found that ∼ 8.7% of CD34-expressing cells expressed Stro-1, and more than 20% of Stro-1-expressing cells did not express CD34. In adipose tissue Stro-1 expression was identified in the endothelium of arterioles and capillaries. Stro-1 was also localized in the endothelium of some but not all adipose tissue veins. Endothelial expression of Stro-1 was also identified in blood vessels in penis and in leg muscles, but not in other tested tissues. In these other tissues, Stro-1 was scantly expressed near but not in blood vessels. These variable and endothelial expression patterns of Stro-1 point to a need to re-examine published data that relied on Stro-1 as a mesenchymal stem cell marker.

Osteogenic capacity of nanocrystalline bone cement in a weight-bearing defect at the ovine tibial metaphysis.

PubMed

Harms, Christoph; Helms, Kai; Taschner, Tibor; Stratos, Ioannis; Ignatius, Anita; Gerber, Thomas; Lenz, Solvig; Rammelt, Stefan; Vollmar, Brigitte; Mittlmeier, Thomas

2012-01-01

The synthetic material Nanobone(®) (hydroxyapatite nanocrystallines embedded in a porous silica gel matrix) was examined in vivo using a standardized bone defect model in the ovine tibial metaphysis. A standardized 6 × 12 × 24-mm bone defect was created below the articular surface of the medial tibia condyles on both hind legs of 18 adult sheep. The defect on the right side was filled with Nanobone(®), while the defect on the contralateral side was left empty. The tibial heads of six sheep were analyzed after 6, 12, and 26 weeks each. The histological and radiological analysis of the defect on the control side did not reveal any bone formation after the total of 26 weeks. In contrast, the microcomputed tomography analysis of the defect filled with Nanobone(®) showed a 55%, 72%, and 74% volume fraction of structures with bone density after 6, 12, and 26 weeks, respectively. Quantitative histomorphological analysis after 6, and 12 weeks revealed an osteoneogenesis of 22%, and 36%, respectively. Hematoxylin and eosin sections demonstrated multinucleated giant cells on the surface of the biomaterial and resorption lacunae, indicating osteoclastic resorptive activity. Nanobone(®) appears to be a highly potent bone substitute material with osteoconductive properties in a loaded large animal defect model, supporting the potential use of Nanobone(®) also in humans.

Osteogenic capacity of nanocrystalline bone cement in a weight-bearing defect at the ovine tibial metaphysis

PubMed Central

Harms, Christoph; Helms, Kai; Taschner, Tibor; Stratos, Ioannis; Ignatius, Anita; Gerber, Thomas; Lenz, Solvig; Rammelt, Stefan; Vollmar, Brigitte; Mittlmeier, Thomas

2012-01-01

The synthetic material Nanobone® (hydroxyapatite nanocrystallines embedded in a porous silica gel matrix) was examined in vivo using a standardized bone defect model in the ovine tibial metaphysis. A standardized 6 × 12 × 24-mm bone defect was created below the articular surface of the medial tibia condyles on both hind legs of 18 adult sheep. The defect on the right side was filled with Nanobone®, while the defect on the contralateral side was left empty. The tibial heads of six sheep were analyzed after 6, 12, and 26 weeks each. The histological and radiological analysis of the defect on the control side did not reveal any bone formation after the total of 26 weeks. In contrast, the microcomputed tomography analysis of the defect filled with Nanobone® showed a 55%, 72%, and 74% volume fraction of structures with bone density after 6, 12, and 26 weeks, respectively. Quantitative histomorphological analysis after 6, and 12 weeks revealed an osteoneogenesis of 22%, and 36%, respectively. Hematoxylin and eosin sections demonstrated multinucleated giant cells on the surface of the biomaterial and resorption lacunae, indicating osteoclastic resorptive activity. Nanobone® appears to be a highly potent bone substitute material with osteoconductive properties in a loaded large animal defect model, supporting the potential use of Nanobone® also in humans. PMID:22745551

Effect of age and gender on carcass traits and meat quality of farmed brown hares.

PubMed

Trocino, A; Birolo, M; Dabbou, S; Gratta, F; Rigo, N; Xiccato, G

2018-04-01

A total of 48 sub-adult hares and adult reproducing farmed hares were used to characterize carcass and meat traits according to the age and gender of animals. With respect to carcass traits, when age increased, the carcass weight significantly increased (2022 to 3391 g; P<0.001), but dressing out percentages did not change. The dissectible fat (1.3% to 2.2%; P<0.05) and Longissimus lumborum (LL) proportions (13.5% to 14.5%; P<0.001) and muscle-to-bone ratio of hind legs (5.11 to 6.23; P<0.001) increased, whereas the hind leg proportions decreased (37.3% to 36.3%; P=0.01). As for the meat quality, the pH of hind leg (5.74 to 5.83; P<0.001) and LL (5.53 to 5.69; P<0.001) increased with age, while the L* index decreased in both cuts (42.9 to 34.4 in hind leg; 45.1 to 40.3 in LL; P<0.001). The redness index increased at the hind leg (4.07 to 5.76; P<0.001), while it decreased at LL (3.03 to 1.46; P<0.001). In the case of the hind leg, meat thawing losses decreased (1.58% to 1.02%), and shear force increased (2.97 to 4.02 kg/g). In the case of LL, thawing losses decreased (8.79% to 4.91%; P<0.001) in the adult hares compared with the sub-adult ones. Meat water and protein contents decreased in the hind leg and LL of the adult hares compared with the sub-adult ones, whereas ether extract increased in a restricted range in LL only (0.92% to 1.11%; P<0.001). In the case of the hind leg, the rate of the saturated fatty acids (SFA) decreased (41.0% to 26.7%), and the rate of the polyunsaturated fatty acids (PUFA) increased (34.0% to 45.3%) (P<0.001). In the case of LL, SFA (38.6% to 42.9%) and monounsaturated fatty acids (19.4% to 27.2%) increased, whereas PUFA decreased (42.0% to 30.1%) when the age increased (P<0.001). Gender affected only the slaughter results and carcass traits. In conclusion, farmed hares have favourable slaughter results (high dressing percentage), carcass traits (high hind legs and loins rates), and meat nutritional value (high-protein, low-fat meat). This fact would offer additional commercial opportunities, in addition to restocking, to hare farmers.

[Clinical and physiological evaluation of bone changes among astronauts after long-term space flights

NASA Technical Reports Server (NTRS)

Grigoriev, A. I.; Oganov, V. S.; Bakulin, A. V.; Poliakov, V. V.; Voronin, L. I.; Morgun, V. V.; Shnaider, V. S.; Murashko, L. V.; Novikov, V. E.; LeBlank, A.;

Association of ACTN3 polymorphisms with BMD, and physical fitness of elderly women.

PubMed

Min, Seok-Ki; Lim, Seung-Taek; Kim, Chang-Sun

2016-10-01

[Purpose] Association of ACTN3 polymorphism with bone mineral density and the physical fitness of elderly women is still unclear. Therefore, this study investigated the association between ACTN3 genotype and bone mineral density, and the physical fitness of elderly women. [Subjects and Methods] Sixty-eight elderly women (67.38 ± 3.68 years) were recruited at a Seongbuk-Gu (Seoul, Korea) Medical Service Public Health Center. Measurements of physical fitness included muscle strength, muscle endurance, flexibility, agility, balance and VO 2 max. Bone mineral density (BMD), upper limb muscle mass, lower limb muscle mass, percent body fat and body fat mass for the entire body were measured by dual-energy X-ray absorptiometry and an analyzer. Genotyping for the ACTN3 R577X (rs1815739) polymorphism was performed using the TaqMan approach. [Results] ACTN3 gene distribution of subjects were in the Hardy-Weinberg equilibrium (p=0.694). The relative bone mineral density trunk, pelvis and spine differed significantly among the ACTN3 genotypes. There were no significant differences among bone mineral densities of the head, arms, legs, ribs and total, but the RR genotype tended to be higher than other genotypes. Physical fitness was not significantly different among the ACTN3 genotypes. [Conclusion] These results suggest that ACTN3 gene polymorphisms could be used as one of the genetic determinants of bone mass in elderly women, and in particular, they indicate that individuals with the RR genotype have higher BMD and bone mineral composition.

Bone mineral density and bone size in men with primary osteoporosis and vertebral fractures.

PubMed

Vega, E; Ghiringhelli, G; Mautalen, C; Rey Valzacchi, G; Scaglia, H; Zylberstein, C

1998-05-01

The bone mineral density (BMD) at the lumbar spine, proximal femur, and total skeleton was evaluated in 38 men with primary osteoporosis and vertebral fractures. BMD of the patients was significantly reduced over all skeletal areas compared with controls. The Z-score of the lumbar spine (-2.8 +/- 0.9) was less than that of the other areas (P < 0.001) except the legs (-2.5 +/- 1.1) (p.n.s.) showing that bone loss had a tendency to be greater over the axial skeleton. Vertebral dimensions compared with age-matched controls were as follows: projected L2-L4 area (cm 2): 45.7 +/- 5.6 versus 53.7 +/- 3. 6 (P < 0.001); vertebral width (cm): 4.37 +/- 0.44 versus 4.90 +/- 0. 36 (P < 0.001). Serum biochemical parameters and testosterone levels were similar between osteoporotic and control men. We conclude that men with vertebral osteoporotic fractures have reduced vertebral BMD and vertebral dimensions compared with age-matched controls. Thus, these findings indicate that the achievement of a reduced bone size at the end of the growth period or a failure of periosteal increase during adult life is likely to contribute to the pathogenesis of the vertebral fractures observed in older men.

Cerebral fat embolism syndrome after long bone fracture due to gunshot injury

PubMed Central

Duran, Latif; Kayhan, Servet; Kati, Celal; Akdemir, Hizir Ufuk; Balci, Kemal; Yavuz, Yucel

2014-01-01

Cerebral fat embolism syndrome is a lethal complication of long-bone fractures and clinically manifasted with respiratory distress, altered mental status, and petechial rash. We presented a 20-year-old male admitted with gun-shot wounds to his left leg. Twenty-four hours after the event, he had generalized tonic clonic seizures, decorticate posture and a Glascow Coma Scale of seven with localization of painful stimuli. Subsequent magnetic resonance imaging of the brain showed a star-field pattern defining multiple lesions of restricted diffusion. On a 4-week follow-up, he had returned to normal neurological function. Despite the severity of the neurological condition upon initial presentation, the case cerebral fat embolism illustrates that, cerebral dysfunction associated with cerebral fat embolism illustrates reversible. PMID:24701067

Simultaneous occurrence of a severe Morel-Lavallée lesion and gluteal muscle necrosis as a sequela of transcatheter angiographic embolization following pelvic fracture: a case report.

PubMed

Shimizu, Takayoshi; Matsuda, Shuichi; Sakuragi, Atsushi; Tsukie, Tomio; Kawanabe, Keiichi

2015-03-26

Morel-Lavallée lesions are posttraumatic hemolymphatic collections caused by disruption of the interfascial planes between the subcutaneous soft tissue and muscle. Severe peripelvic Morel-Lavallée lesions have rarely been reported in the literature. By contrast, a number of cases of gluteal muscle necrosis following transcatheter angiographic embolization for pelvic fracture have been reported. Each entity can result in severe infection and sepsis, and the mortality rate in such cases is quite high. However, to date, no previous reports have described a case in which these life-threatening entities occurred simultaneously. A 32-year-old Asian man simultaneously developed severe peripelvic Morel-Lavallée lesions and gluteal muscle necrosis with sepsis following transcatheter angiographic embolization after an unstable pelvic fracture. Extremely large skin and soft tissue defects, which were untreatable with any commonly used flaps, were generated after repeated debridement. In addition, a deep-bone infection was suspected in his left fractured iliac bone, while motor function was almost completely lost in his left leg, possibly as a sequela of transcatheter angiographic embolization. As a result of his condition, a left hemipelvectomy was unavoidable. A pedicled fillet flap from his sacrificed left limb was used for the treatment of the defects and to provide a durable base for a prosthesis. Our patient survived and returned to his previous job 24 months after the surgery wearing a prosthetic left leg. As illustrated by the present case, severe peripelvic Morel-Lavallée lesions and gluteal muscle necrosis following transcatheter angiographic embolization can occur simultaneously after unstable pelvic fractures. Physicians should recognize that these entities can result in life-threatening sepsis and, therefore, should attempt to detect them as early as possible. When hemipelvectomy is unavoidable, a pedicled upper and lower leg in-continuity fillet flap may provide satisfactory outcomes.

The Effects of Age, Adiposity, and Physical Activity on the Risk of Seven Site‐Specific Fractures in Postmenopausal Women

PubMed Central

Lacombe, Jason; Cairns, Benjamin J; Green, Jane; Reeves, Gillian K; Beral, Valerie

2016-01-01

ABSTRACT Risk factors for fracture of the neck of the femur are relatively well established, but those for fracture at other sites are little studied. In this large population study we explore the role of age, body mass index (BMI), and physical activity on the risk of fracture at seven sites in postmenopausal women. As part of the Million Women Study, 1,154,821 postmenopausal UK women with a mean age of 56.0 (SD 4.8) years provided health and lifestyle data at recruitment in 1996 to 2001. All participants were linked to National Health Service (NHS) hospital records for day‐case or overnight admissions with a mean follow‐up of 11 years per woman. Adjusted absolute and relative risks for seven site‐specific incident fractures were calculated using Cox regression models. During follow‐up, 4931 women had a fracture of the humerus; 2926 of the forearm; 15,883 of the wrist; 9887 of the neck of the femur; 1166 of the femur (not neck); 3199 a lower leg fracture; and 10,092 an ankle fracture. Age‐specific incidence rates increased gradually with age for fractures of forearm, lower leg, ankle, and femur (not neck), and steeply with age for fractures of neck of femur, wrist, and humerus. When compared to women with desirable BMI (20.0 to 24.9 kg/m2), higher BMI was associated with a reduced risk of fracture of the neck of femur, forearm, and wrist, but an increased risk of humerus, femur (not neck), lower leg, and ankle fractures (p < 0.001 for all). Strenuous activity was significantly associated with a decreased risk of fracture of the humerus and femur (both neck and remainder of femur) (p < 0.001), but was not significantly associated with lower leg, ankle, wrist, and forearm fractures. Postmenopausal women are at a high lifetime risk of fracture. BMI and physical activity are modifiable risk factors for fracture, but their associations with fracture risk differ substantially across fracture sites. © 2016 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research (ASBMR) PMID:26950269

The Use of 3D Printing Technology in the Ilizarov Method Treatment: Pilot Study.

PubMed

Burzyńska, Karolina; Morasiewicz, Piotr; Filipiak, Jarosław

2016-01-01

Significant developments in additive manufacturing technology have occurred in recent years. 3D printing techniques can also be helpful in the Ilizarov method treatment. The aim of this study was to evaluate the usefulness of 3D printing technology in the Ilizarov method treatment. Physical models of bones used to plan the spatial design of Ilizarov external fixator were manufactured by FDM (Fused Deposition Modeling) spatial printing technology. Bone models were made of poly(L-lactide) (PLA). Printed 3D models of both lower leg bones allow doctors to prepare in advance for the Ilizarov method treatment: detailed consideration of the spatial configuration of the external fixation, experimental assembly of the Ilizarov external fixator onto the physical models of bones prior to surgery, planning individual osteotomy level and Kirschner wires introduction sites. Printed 3D bone models allow for accurate preparation of the Ilizarov apparatus spatially matched to the size of the bones and prospective bone distortion. Employment of the printed 3D models of bone will enable a more precise design of the apparatus, which is especially useful in multiplanar distortion and in the treatment of axis distortion and limb length discrepancy in young children. In the course of planning the use of physical models manufactured with additive technology, attention should be paid to certain technical aspects of model printing that have an impact on the accuracy of mapping of the geometry and physical properties of the model. 3D printing technique is very useful in 3D planning of the Ilizarov method treatment.

The AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF).

PubMed

Audigé, Laurent; Slongo, Theddy; Lutz, Nicolas; Blumenthal, Andrea; Joeris, Alexander

2017-04-01

Background and purpose - The AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF) describes the localization and morphology of fractures, and considers severity in 2 categories: (1) simple, and (2) multifragmentary. We evaluated simple and multifragmentary fractures in a large consecutive cohort of children diagnosed with long bone fractures in Switzerland. Patients and methods - Children and adolescents treated for fractures between 2009 and 2011 at 2 tertiary pediatric surgery hospitals were retrospectively included. Fractures were classified according to the AO PCCF. Severity classes were described according to fracture location, patient age and sex, BMI, and cause of trauma. Results - Of all trauma events, 3% (84 of 2,730) were diagnosed with a multifragmentary fracture. This proportion was age-related: 2% of multifragmentary fractures occurred in school-children and 7% occurred in adolescents. In patients diagnosed with a single fracture only, the highest percentage of multifragmentation occurred in the femur (12%, 15 of 123). In fractured paired radius/ulna bones, multifragmentation occurred in 2% (11 of 687); in fractured paired tibia/fibula bones, it occurred in 21% (24 of 115), particularly in schoolchildren (5 of 18) and adolescents (16 of 40). In a multivariable regression model, age, cause of injury, and bone were found to be relevant prognostic factors of multifragmentation (odds ratio (OR) > 2). Interpretation - Overall, multifragmentation in long bone fractures in children was rare and was mostly observed in adolescents. The femur was mostly affected in single fractures and the lower leg was mostly affected in paired-bone fractures. The clinical relevance of multifragmentation regarding growth and long-term functional recovery remains to be determined.

Bone microvascular flow differs from skin microvascular flow in response to head-down tilt.

PubMed

Howden, Michelle; Siamwala, Jamila H; Hargens, Alan R

2017-10-01

Loss of hydrostatic pressures in microgravity may alter skin and bone microvascular flows in the lower extremities and potentially reduce wound healing and bone fracture repair. The purpose of this study was to determine the rate at which skin and bone microvascular flows respond to head-down tilt (HDT). We hypothesized that microvascular flows in tibial bone and overlying skin would increase at different rates during HDT. Tibial bone and skin microvascular flows were measured simultaneously using photoplethysmography (PPG) in a total of 17 subjects during sitting (control posture), supine, 6° HDT, 15° HDT, and 30° HDT postures in random order. With greater angles of HDT, bone microvascular flow increased significantly, but skin microvascular flow did not change. Tibial bone microvascular flow increased from the sitting control posture (0.77 ± 0.41 V) to supine (1.95 ± 1.01 V, P = 0.001) and from supine posture to 15° HDT (3.74 ± 2.43 V, P = 0.004) and 30° HDT (3.91 ± 2.68 V, P = 0.006). Skin microvascular flow increased from sitting (0.703 ± 0.75 V) to supine (2.19 ± 1.72 V, P = 0.02) but did not change from supine posture to HDT ( P = 1.0). We show for the first time that microcirculatory flows in skin and bone of the leg respond to simulated microgravity at different rates. These altered levels of blood perfusion may affect rates of wound and bone fracture healing in spaceflight. NEW & NOTEWORTHY Our data show that bone microvascular flow increases more than cutaneous blood flow with greater degrees of head-down tilt. A higher level of perfusion in bone may give insight into the bone mineral density loss in lower extremities of astronauts and why similar tissue degradation is not observed in the skin of the same areas. Copyright © 2017 the American Physiological Society.

Soccer increases bone mass in prepubescent boys during growth: a 3-yr longitudinal study.

PubMed

Zouch, Mohamed; Zribi, Anis; Alexandre, Christian; Chaari, Hamada; Frere, Delphine; Tabka, Zouhair; Vico, Laurence

2015-01-01

The aim of this study was to examine the effect of 3-yr soccer practice on bone acquisition in prepubescent boys. We investigated 65 boys (aged 10-13 yr, Tanner stage I) at baseline, among which only 40 boys (Tanner stages II and III) have continued the 3-yr follow-up: 23 soccer players (F) completed 2-5 h of training plus 1 competition game per week and 17 controls (C). Bone mineral density (BMD, g/cm(2)) and bone mineral content (BMC, g) were measured by dual-energy X-ray absorptiometry at different sites. At baseline, BMD was higher in soccer players than in controls in the whole body and legs. In contrast, there was nonsignificant difference BMD in head, femoral neck, arms, and BMC in all measured sites between groups. At 3-yr follow-up, soccer players were found to have higher BMD and BMC at all sites than controls, except for head BMD and BMC and arms BMC in which the difference was nonsignificant between groups. During the 3-yr follow-up, the soccer players were found to gain significantly more in lumbar spine (31.2% ± 2.9% vs 23.9% ± 2.1%; p < 0.05), femoral neck (24.1% ± 1.8% vs 11.4% ± 1.9%; p < 0.001), whole body (16.5% ± 1.4% vs 11.8% ± 1.5%; p < 0.05), and nondominant arm BMD (18.2% ± 1.4% vs 13.6% ± 1.7%; p < 0.05) as well as lumbar spine (62.5% ± 20.1% vs 39.5% ± 20.1%; p < 0.001), femoral neck, (37.7% ± 14.2% vs 28.9% ± 12.8%; p < 0.05) and nondominant arm BMC (68.6% ± 22.9% vs 50.1% ± 22.4%; p < 0.05) than controls. In contrast, soccer players have less %BMD and %BMC changes in the head than controls. A nonsignificant difference was found in legs, dominant arm, head %BMD and %BMC changes, and whole-body %BMC changes between groups. In summary, we suggest that soccer has an osteogenic effect BMD and BMC in loaded sites in pubertal soccer players. The increased bone mass induced by soccer training in the stressed sites was associated to a decreased skull bone mass after 3 yr of follow-up. Copyright © 2015 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

Muscle strength and regional lean body mass influence on mineral bone health in young male adults.

PubMed

Guimarães, Bianca Rosa; Pimenta, Luciana Duarte; Massini, Danilo Alexandre; Dos Santos, Daniel; Siqueira, Leandro Oliveira da Cruz; Simionato, Astor Reis; Dos Santos, Luiz Gustavo Almeida; Neiva, Cassiano Merussi; Pessôa Filho, Dalton Muller

2018-01-01

The relationship between muscle strength and bone mineral content (BMC) and bone mineral density (BMD) is supposed from the assumption of the mechanical stress influence on bone tissue metabolism. However, the direct relationship is not well established in younger men, since the enhancement of force able to produce effective changes in bone health, still needs to be further studied. This study aimed to analyze the influence of muscle strength on BMC and BMD in undergraduate students. Thirty six men (24.9 ± 8.6 y/o) were evaluated for regional and whole-body composition by dual energy X-ray absorptiometry (DXA). One repetition maximum tests (1RM) were assessed on flat bench-press (BP), lat-pull down (LPD), leg-curl (LC), knee extension (KE), and leg-press 45° (LP45) exercises. Linear regression modelled the relationships of BMD and BMC to the regional body composition and 1RM values. Measurements of dispersion and error (R2adj and standard error of estimate (SEE)) were tested, setting ρ at ≤0.05. The BMD mean value for whole-body was 1.12±0.09 g/cm2 and BMC attained 2477.9 ± 379.2 g. The regional lean mass (LM) in upper-limbs (UL) (= 6.80±1.21 kg) was related to BMC and BMD for UL (R2adj = 0.74, p<0.01, SEE = 31.0 g and R2adj = 0.63, SEE = 0.08 g/cm2), and LM in lower-limbs (LL) (= 19.13±2.50 kg) related to BMC and BMD for LL (R2adj = 0.68, p<0,01, SEE = 99.3 g and R2adj = 0.50, SEE = 0.20 g/cm2). The 1RM in BP was related to BMD (R2adj = 0.51, SEE = 0.09 g/cm2), which was the strongest relationship among values of 1RM for men; but, 1RM on LPD was related to BMC (R2adj = 0.47, p<0.01, SEE = 44.6 g), and LC was related to both BMC (R2adj = 0.36, p<0.01, SEE = 142.0 g) and BMD (R2adj = 0.29, p<0.01, SEE = 0.23 g/cm2). Hence, 1RM for multi-joint exercises is relevant to BMC and BMD in young men, strengthening the relationship between force and LM, and suggesting both to parametrizes bone mineral health.

[The monorail system--bone segment transport over unreamed interlocking nails].

PubMed

Oedekoven, G; Jansen, D; Raschke, M; Claudi, B F

1996-11-01

A treatment protocol is demonstrated, consisting of an osteotomy, either proximal or distal, of the bone defect with subsequent segmental transport via an anteromedially (tibia) or laterally (femur) mounted AO external fixation over an unreamed interlocking nail (monorail system). Twenty patients were treated by this method with indications as follows: 13 had a segmental bone defect of the tibia, 3 of the femur. Three patients showed post-traumatic and postinfectious leg-length discrepancies and one was treated for hypertrophic non-union of the femur. Defect distance varied between 5 and 18.5 cm and average time for transport was 19,42 days/ cm for the tibial shaft, 15,93 days/cm for the femur. Two patients developed deep infection, which required change of treatment, removing the monorail system and application of an Ilizarov apparatus. Despite complications using the monorail system, all patients healed and no amputations were required. The monorail system can be used as an alternative to the Ilizarov method under certain criteria of patient selection; these criteria are shown by an algorithm for segmental bone defects without infection, respecting the soft-tissue status with or without neurovascular compromise.

Mineral distribution in rat skeletons after exposure to a microgravity model

NASA Technical Reports Server (NTRS)

Arnaud, Sara B.; Harper, Jennifer S.; Navidi, Meena

1995-01-01

Exposure to space flight models induces changes in the distribution of bone mineral in the human skeleton that has the features of a gravitational gradient. Regional bone mineral measurements with dual energy x-ray absorptiometry (DEXA) in male adults exposed to head-down tilt bed rest for 30 days shown non-significant decrements in the pelvis and legs with 10% increases in the head region. Horizontal bed rest for 17 weeks reveals losses of bone mineral ranging from 2.2 to 10.4% from the lumbar spine to the calcaneus and an increase of 3.4% in the skull. Investigation of this phenomena would be most definitively carried out in an animal model. One candidate is the flight simulation model in the rat which removes body weight from the hind limbs and induces a cephalad fluid shift by suspending the animal by the tail. Weanling rats exposed to this model showed bone mineral to be lower in the hind limbs and higher in the skull after 3 weeks. These finds are similar in older 200 g animals after 2 weeks tail suspension. The purpose of this study was to determine the effect of age on the distribution of skeletal mineral in this model.

Radiographic and Clinical Outcome of Silicate-substituted Calcium Phosphate (Si-CaP) Ceramic Bone Graft in Spinal Fusion Procedures.

PubMed

Alimi, Marjan; Navarro-Ramirez, Rodrigo; Parikh, Karishma; Njoku, Innocent; Hofstetter, Christoph P; Tsiouris, Apostolos J; Härtl, Roger

2017-07-01

Retrospective cohort study. To evaluate the radiographic and clinical outcome of silicate-substituted calcium phosphate (Si-CaP), utilized as a graft substance in spinal fusion procedures. Specific properties of Si-CaP provide the graft with negative surface charge that can result in a positive effect on the osteoblast activity and neovascularization of the bone. This study included those patients who underwent spinal fusion procedures between 2007 and 2011 in which Si-CaP was used as the only bone graft substance. Fusion was evaluated on follow-up CT scans. Clinical outcome was assessed using Oswestry Disability Index, Neck Disability Index, and the visual analogue scale (VAS) for back, leg, neck, and arm pain. A total of 234 patients (516 spinal fusion levels) were studied. Surgical procedures consisted of 57 transforaminal lumbar interbody fusion, 49 anterior cervical discectomy and fusion, 44 extreme lateral interbody fusion, 30 posterior cervical fusions, 19 thoracic fusion surgeries, 17 axial lumbar interbody fusions, 16 combined anterior and posterior cervical fusions, and 2 anterior lumbar interbody fusion. At a mean radiographic follow-up of 14.2±4.3 months, fusion was found to be present in 82.9% of patients and 86.8% of levels. The highest fusion rate was observed in the cervical region. At the latest clinical follow-up of 21.7±14.2 months, all clinical outcome parameters showed significant improvement. The Oswestry Disability Index improved from 45.6 to 13.3 points, Neck Disability Index from 40.6 to 29.3, VAS back from 6.1 to 3.5, VAS leg from 5.6 to 2.4, VAS neck from 4.7 to 2.7, and VAS arm from 4.1 to 1.7. Of 7 cases with secondary surgical procedure at the index level, the indication for surgery was nonunion in 3 patients. Si-CaP is an effective bone graft substitute. At the latest follow-up, favorable radiographic and clinical outcome was observed in the majority of patients. Level-III.

An evaluation of the lamb vision system as a predictor of lamb carcass red meat yield percentage.

PubMed

Brady, A S; Belk, K E; LeValley, S B; Dalsted, N L; Scanga, J A; Tatum, J D; Smith, G C

2003-06-01

An objective method for predicting red meat yield in lamb carcasses is needed to accurately assess true carcass value. This study was performed to evaluate the ability of the lamb vision system (LVS; Research Management Systems USA, Fort Collins, CO) to predict fabrication yields of lamb carcasses. Lamb carcasses (n = 246) were evaluated using LVS and hot carcass weight (HCW), as well as by USDA expert and on-line graders, before fabrication of carcass sides to either bone-in or boneless cuts. On-line whole number, expert whole-number, and expert nearest-tenth USDA yield grades and LVS + HCW estimates accounted for 53, 52, 58, and 60%, respectively, of the observed variability in boneless, saleable meat yields, and accounted for 56, 57, 62, and 62%, respectively, of the variation in bone-in, saleable meat yields. The LVS + HCW system predicted 77, 65, 70, and 87% of the variation in weights of boneless shoulders, racks, loins, and legs, respectively, and 85, 72, 75, and 86% of the variation in weights of bone-in shoulders, racks, loins, and legs, respectively. Addition of longissimus muscle area (REA), adjusted fat thickness (AFT), or both REA and AFT to LVS + HCW models resulted in improved prediction of boneless saleable meat yields by 5, 3, and 5 percentage points, respectively. Bone-in, saleable meat yield estimations were improved in predictive accuracy by 7.7, 6.6, and 10.1 percentage points, and in precision, when REA alone, AFT alone, or both REA and AFT, respectively, were added to the LVS + HCW output models. Use of LVS + HCW to predict boneless red meat yields of lamb carcasses was more accurate than use of current on-line whole-number, expert whole-number, or expert nearest-tenth USDA yield grades. Thus, LVS + HCW output, when used alone or in combination with AFT and/or REA, improved on-line estimation of boneless cut yields from lamb carcasses. The ability of LVS + HCW to predict yields of wholesale cuts suggests that LVS could be used as an objective means for pricing carcasses in a value-based marketing system.

High and odd impact exercise training improved physical function and fall risk factors in community-dwelling older men

PubMed Central

Allison, Sarah J.; Brooke-Wavell, Katherine; Folland, Jonathan

2018-01-01

High impact exercise programmes can improve bone strength, but little is known about whether this type of training further benefits fracture risk by improving physical function in older people. Objectives: This study investigated the influence of high impact exercise on balance, muscle function and morphology in older men. Methods: Fifty, healthy men (65-80 years) were assigned to a 6-month multidirectional hopping programme (TG) and twenty age and physical activity matched volunteers served as controls (CG). Before and after training, muscle function (hop performance, leg press and plantar- and dorsiflexion strength) and physiological determinants (muscle thickness and architecture) as well as balance control (sway path, one leg stance duration) were measured. Resting gastrocnemius medialis (GM) muscle thickness and architecture were assessed using ultrasonography. Results: Significant improvements in hop impulse (+12%), isometric leg-press strength (+4%) and ankle plantarflexion strength (+11%), dorsiflexor strength (+20%) were found in the TG compared to the CG (ANOVA interaction, P<0.05) and unilateral stance time improved over time for TG. GM muscle thickness indicated modest hypertrophy (+4%), but muscle architecture was unchanged. Conclusion: The positive changes in strength and balance after high impact and odd impact training would be expected to improve physical function in older adults. PMID:29504585

Study of body composition in small animals by a multifrequency impedancemeter

NASA Astrophysics Data System (ADS)

Ribbe, E.; Khider, N.; Moreno, M. V.

2010-04-01

Bioimpedance is essentially used today to study the body composition in the human body but not really in small animals. The aim of this paper is to develop a model for body composition in rats to help pharmaceutical labs assessing effects of medicine on rats. We propose a non invasive, rapid and scientific method. With a multifrequency impedancemeter, Z-Métrix® (BioparHom© Company France), resistances and reactances are measured at 55 frequencies for a population of 40 rats (males and females). With our model, derived from Cole-Cole model, resistances of extracellular (Re) and total body (Rinf) compartment are extrapolated. Three methods were applied: posterior to posterior leg, anterior to posterior leg on the left and on the right side. Measurements by CT imaging were performed on the anesthetized population to determine Fat Mass (FM), Lean Body Mass (LBM) and Bone Mineral Content (BMC), as our reference measurements. With electrical data, age, sex and weight, equations are created to calculate FM, LBM and BMC with the three methods. Graphs of correlation, between tissue masses calculated by bioimpedance and obtained with scanner, indicate that measurements with posterior to posterior leg are better. Moreover, there is no significantly difference between tissue masses measured by bioimpedance and with the scanner.

High and odd impact exercise training improved physical function and fall risk factors in community-dwelling older men.

PubMed

Allison, Sarah J; Brooke-Wavell, Katherine; Folland, Jonathan

2018-03-01

High impact exercise programmes can improve bone strength, but little is known about whether this type of training further benefits fracture risk by improving physical function in older people. This study investigated the influence of high impact exercise on balance, muscle function and morphology in older men. Fifty, healthy men (65-80 years) were assigned to a 6-month multidirectional hopping programme (TG) and twenty age and physical activity matched volunteers served as controls (CG). Before and after training, muscle function (hop performance, leg press and plantar- and dorsiflexion strength) and physiological determinants (muscle thickness and architecture) as well as balance control (sway path, one leg stance duration) were measured. Resting gastrocnemius medialis (GM) muscle thickness and architecture were assessed using ultrasonography. Significant improvements in hop impulse (+12%), isometric leg-press strength (+4%) and ankle plantarflexion strength (+11%), dorsiflexor strength (+20%) were found in the TG compared to the CG (ANOVA interaction, P⟨0.05) and unilateral stance time improved over time for TG. GM muscle thickness indicated modest hypertrophy (+4%), but muscle architecture was unchanged. The positive changes in strength and balance after high impact and odd impact training would be expected to improve physical function in older adults.

Combined Hydration and Antibiotics with Lisinopril to Mitigate Acute and Delayed High-dose Radiation Injuries to Multiple Organs.

PubMed

Fish, Brian L; Gao, Feng; Narayanan, Jayashree; Bergom, Carmen; Jacobs, Elizabeth R; Cohen, Eric P; Moulder, John E; Orschell, Christie M; Medhora, Meetha

2016-11-01

The NIAID Radiation and Nuclear Countermeasures Program is developing medical agents to mitigate the acute and delayed effects of radiation that may occur from a radionuclear attack or accident. To date, most such medical countermeasures have been developed for single organ injuries. Angiotensin converting enzyme (ACE) inhibitors have been used to mitigate radiation-induced lung, skin, brain, and renal injuries in rats. ACE inhibitors have also been reported to decrease normal tissue complication in radiation oncology patients. In the current study, the authors have developed a rat partial-body irradiation (leg-out PBI) model with minimal bone marrow sparing (one leg shielded) that results in acute and late injuries to multiple organs. In this model, the ACE inhibitor lisinopril (at ~24 mg m d started orally in the drinking water at 7 d after irradiation and continued to ≥150 d) mitigated late effects in the lungs and kidneys after 12.5-Gy leg-out PBI. Also in this model, a short course of saline hydration and antibiotics mitigated acute radiation syndrome following doses as high as 13 Gy. Combining this supportive care with the lisinopril regimen mitigated overall morbidity for up to 150 d after 13-Gy leg-out PBI. Furthermore, lisinopril was an effective mitigator in the presence of the growth factor G-CSF (100 μg kg d from days 1-14), which is FDA-approved for use in a radionuclear event. In summary, by combining lisinopril (FDA-approved for other indications) with hydration and antibiotics, acute and delayed radiation injuries in multiple organs were mitigated.

Automatic and hierarchical segmentation of the human skeleton in CT images.

PubMed

Fu, Yabo; Liu, Shi; Li, Harold; Yang, Deshan

2017-04-07

Accurate segmentation of each bone of the human skeleton is useful in many medical disciplines. The results of bone segmentation could facilitate bone disease diagnosis and post-treatment assessment, and support planning and image guidance for many treatment modalities including surgery and radiation therapy. As a medium level medical image processing task, accurate bone segmentation can facilitate automatic internal organ segmentation by providing stable structural reference for inter- or intra-patient registration and internal organ localization. Even though bones in CT images can be visually observed with minimal difficulty due to the high image contrast between the bony structures and surrounding soft tissues, automatic and precise segmentation of individual bones is still challenging due to the many limitations of the CT images. The common limitations include low signal-to-noise ratio, insufficient spatial resolution, and indistinguishable image intensity between spongy bones and soft tissues. In this study, a novel and automatic method is proposed to segment all the major individual bones of the human skeleton above the upper legs in CT images based on an articulated skeleton atlas. The reported method is capable of automatically segmenting 62 major bones, including 24 vertebrae and 24 ribs, by traversing a hierarchical anatomical tree and by using both rigid and deformable image registration. The degrees of freedom of femora and humeri are modeled to support patients in different body and limb postures. The segmentation results are evaluated using the Dice coefficient and point-to-surface error (PSE) against manual segmentation results as the ground-truth. The results suggest that the reported method can automatically segment and label the human skeleton into detailed individual bones with high accuracy. The overall average Dice coefficient is 0.90. The average PSEs are 0.41 mm for the mandible, 0.62 mm for cervical vertebrae, 0.92 mm for thoracic vertebrae, and 1.45 mm for pelvis bones.

Automatic and hierarchical segmentation of the human skeleton in CT images

NASA Astrophysics Data System (ADS)

Fu, Yabo; Liu, Shi; Li, H. Harold; Yang, Deshan

2017-04-01

Accurate segmentation of each bone of the human skeleton is useful in many medical disciplines. The results of bone segmentation could facilitate bone disease diagnosis and post-treatment assessment, and support planning and image guidance for many treatment modalities including surgery and radiation therapy. As a medium level medical image processing task, accurate bone segmentation can facilitate automatic internal organ segmentation by providing stable structural reference for inter- or intra-patient registration and internal organ localization. Even though bones in CT images can be visually observed with minimal difficulty due to the high image contrast between the bony structures and surrounding soft tissues, automatic and precise segmentation of individual bones is still challenging due to the many limitations of the CT images. The common limitations include low signal-to-noise ratio, insufficient spatial resolution, and indistinguishable image intensity between spongy bones and soft tissues. In this study, a novel and automatic method is proposed to segment all the major individual bones of the human skeleton above the upper legs in CT images based on an articulated skeleton atlas. The reported method is capable of automatically segmenting 62 major bones, including 24 vertebrae and 24 ribs, by traversing a hierarchical anatomical tree and by using both rigid and deformable image registration. The degrees of freedom of femora and humeri are modeled to support patients in different body and limb postures. The segmentation results are evaluated using the Dice coefficient and point-to-surface error (PSE) against manual segmentation results as the ground-truth. The results suggest that the reported method can automatically segment and label the human skeleton into detailed individual bones with high accuracy. The overall average Dice coefficient is 0.90. The average PSEs are 0.41 mm for the mandible, 0.62 mm for cervical vertebrae, 0.92 mm for thoracic vertebrae, and 1.45 mm for pelvis bones.

Association of ACTN3 polymorphisms with BMD, and physical fitness of elderly women

PubMed Central

Min, Seok-Ki; Lim, Seung-Taek; Kim, Chang-Sun

2016-01-01

[Purpose] Association of ACTN3 polymorphism with bone mineral density and the physical fitness of elderly women is still unclear. Therefore, this study investigated the association between ACTN3 genotype and bone mineral density, and the physical fitness of elderly women. [Subjects and Methods] Sixty-eight elderly women (67.38 ± 3.68 years) were recruited at a Seongbuk-Gu (Seoul, Korea) Medical Service Public Health Center. Measurements of physical fitness included muscle strength, muscle endurance, flexibility, agility, balance and VO2max. Bone mineral density (BMD), upper limb muscle mass, lower limb muscle mass, percent body fat and body fat mass for the entire body were measured by dual-energy X-ray absorptiometry and an analyzer. Genotyping for the ACTN3 R577X (rs1815739) polymorphism was performed using the TaqMan approach. [Results] ACTN3 gene distribution of subjects were in the Hardy-Weinberg equilibrium (p=0.694). The relative bone mineral density trunk, pelvis and spine differed significantly among the ACTN3 genotypes. There were no significant differences among bone mineral densities of the head, arms, legs, ribs and total, but the RR genotype tended to be higher than other genotypes. Physical fitness was not significantly different among the ACTN3 genotypes. [Conclusion] These results suggest that ACTN3 gene polymorphisms could be used as one of the genetic determinants of bone mass in elderly women, and in particular, they indicate that individuals with the RR genotype have higher BMD and bone mineral composition. PMID:27821924

A role for subchondral bone changes in the process of osteoarthritis; a micro-CT study of two canine models.

PubMed

Sniekers, Yvonne H; Intema, Femke; Lafeber, Floris P J G; van Osch, Gerjo J V M; van Leeuwen, Johannes P T M; Weinans, Harrie; Mastbergen, Simon C

2008-02-12

This study evaluates changes in peri-articular bone in two canine models for osteoarthritis: the groove model and the anterior cruciate ligament transection (ACLT) model. Evaluation was performed at 10 and 20 weeks post-surgery and in addition a 3-weeks time point was studied for the groove model. Cartilage was analysed, and architecture of the subchondral plate and trabecular bone of epiphyses was quantified using micro-CT. At 10 and 20 weeks cartilage histology and biochemistry demonstrated characteristic features of osteoarthritis in both models (very mild changes at 3 weeks). The groove model presented osteophytes only at 20 weeks, whereas the ACLT model showed osteophytes already at 10 weeks. Trabecular bone changes in the groove model were small and not consistent. This contrasts the ACLT model in which bone volume fraction was clearly reduced at 10 and 20 weeks (15-20%). However, changes in metaphyseal bone indicate unloading in the ACLT model, not in the groove model. For both models the subchondral plate thickness was strongly reduced (25-40%) and plate porosity was strongly increased (25-85%) at all time points studied. These findings show differential regulation of subchondral trabecular bone in the groove and ACLT model, with mild changes in the groove model and more severe changes in the ACLT model. In the ACLT model, part of these changes may be explained by unloading of the treated leg. In contrast, subchondral plate thinning and increased porosity were very consistent in both models, independent of loading conditions, indicating that this thinning is an early response in the osteoarthritis process.

Bone mineral loss and recovery after 17 weeks of bed rest

NASA Technical Reports Server (NTRS)

Leblanc, A. D.; Schneider, V. S.; Evans, H. J.; Engelbretson, D. A.; Krebs, J. M.; LaBlanc, A. D. (Principal Investigator)

1990-01-01

The purpose of this work was to determine the rate and extent of bone loss and recovery from long-term disuse and in particular from disuse after exposure to weightlessness. For this purpose, bed rest is used to simulate the reduced stress and strain on the skeleton. This study reports on the bone loss and recovery after 17 weeks of continuous bed rest and 6 months of reambulation in six normal male volunteers. Bone regions measured were the lumbar spine, hip, tibia, forearm, calcaneus, total body, and segmental regions from the total-body scan. The total body, lumbar spine, femoral neck, trochanter, tibia, and calcaneus demonstrated significant loss, p less than 0.05. Expressed as the percentage change from baseline, these were 1.4, 3.9, 3.6, 4.6, 2.2, and 10.4, respectively. Although several areas showed positive slopes during reambulation, only the calcaneus was significant (p less than 0.05), with nearly 100% recovery. Segmental analysis of the total-body scans showed significant loss (p less than 0.05) in the lumbar spine, total spine, pelvis, trunk, and legs. During reambulation, the majority of the regions demonstrated positive slopes, although only the pelvis and trunk were significant (p less than 0.05). Potential redistribution of bone mineral was observed: during bed rest the bone mineral increased in the skull of all subjects. The change in total BMD and calcium from calcium balance were significantly (p less than 0.05) correlated, R = 0.88.

Evaluation of bone healing in femurs lengthened via the gradual distraction method.

PubMed

Jochymek, Jiri; Gal, Petr

2007-06-01

Treatment of leg length inequality via lengthening of the shorter extremity is an infrequent orthopedic procedure due to the requirement of special distraction devices and possible serious complications. Essential qualitative changes in operative technique development are associated with the name of G. A. Ilizarov, who paved the way for the autoregenerate gradual distraction method in the 1950s. In the years 1990 through 2006 a total of 57 patients underwent femur lengthening via gradual distraction using various types of external fixators at the Department of Pediatric Surgery, Orthopedics, and Traumatology, Faculty Hospital in Brno. The quality of bone healing was monitored and a number of parameters followed and statistically evaluated using regularly scheduled X-ray examinations. In 11 cases we had to remove the external fixator following the distraction phase, perform an osteosynthesis via a splint and fill the distraction gap via spongioplasty. The bone healing was satisfactory in the remaining 46 patients and the lengthened bone required no other fixation method. The analysis showed statistically significant deceleration in bone healing following distraction in female patients over 12 years of age, and in boys over 14 years of age. Lack of periosteal callus five weeks after surgery always signified serious problems in further healing. Severe complications were recorded in 11 cases during the distraction phase, and in 9 cases after the removal of the distraction apparatus. The aim of this report was to present the results of our study of distraction gap bone healing using the gradual lengthening approach.

[TRANSOSSEOUS OSTEOSYNTHESIS OF LOWER EXTREMITIES BONES FRACTURES AND QUALITY OF LIFE OF PATIENTS IN THE TREATMENT PERIOD].

PubMed

Dyusupov, A; Dyusupov, A; Manarbekov, E; Bukatov, A; Serikbaev, A

2018-02-01

The aim of the study is a comparative analysis of the quality of life in the treatment of fractures of the bones of the lower extremities of various localizations using transosseous and submerged osteosynthesis. We examined 397 patients with injuries of the lower segment of the lower extremity (patellar fractures - 81, multiple bones fractures of the tibia - 84 and fractures of the ankles, accompanied by a dislocation of the foot - 232). Patients were distributed in the subgroups depending on the treatment. The main group was performed using transosseous osteosynthesis, the comparison group - submerged osteosynthesis. The quality of life was examined using a general questionnaire SF-36 and specialized KOOS (with patella fractures) and FOAS (fractures of the bones of the lower leg and ankles). In patients with all localizations of fractures the quality of life was exceeded in the subgroups of the transosseous osteosynthesis group over the parameters of the comparison group. The most significant differences with the use of specialized questionnaires were revealed 6-9 months after trauma with a tendency to leveling to the end of the study (1 year). A more pronounced excess of the quality of life in the main group was seen in fractures of the shin bones. The study of the quality of life allows us to recommend the use of transosseous osteosynthesis for the treatment of lower segment of the lower limb bone fractures.

Recording of Electric Signal Passing Through a Pylon in Direct Skeletal Attachment of Leg Prostheses with Neuromuscular Control

PubMed Central

Pitkin, M.; Cassidy, C.; Muppavarapu, R.; Edell, David

2012-01-01

Direct recordings were made of electrical signals emanating from the muscles in a rabbit’s residuum. The signals were transmitted via wires attached on one end to the muscles, and on the other to an external recording system. The cable was held in a titanium tube inside a pylon that had been transcutaneously implanted into the residuum’s bone. The tube was surrounded by porous titanium cladding to enhance its bond with the bone and with the skin of the residuum. This study was the first known attempt to merge the technology of direct skeletal attachment of limb prostheses with the technology of neuromuscular control of prostheses, providing a safe and reliable passage of the electrical signal from the muscles inside the residuum to the outside recording system. PMID:22345523

Bone transplantation and tissue engineering, part I. Mythology, miracles and fantasy: from Chimera to the Miracle of the Black Leg of Saints Cosmas and Damian and the cock of John Hunter.

PubMed

Hernigou, Philippe

2014-12-01

The replacement of diseased organs and tissues by the healthy ones of others has been a unique milestone in modern medicine. However, even though cloning, member transplantation and regenerative therapies with stem cells are available in the twentieth and twenty-first centuries, one should remember that all these techniques were in the imagination more than 2,000 years ago. For centuries, transplantation remained a theme of mythology, miracle or fantasy and was found only in literature and arts. This first paper explains the concept of tissue transplantation from the period when it was relegated to the imagination to the work of the Scottish surgeon and anatomist, John Hunter, who demonstrated the viability of bone allograft.

In vivo assessment of bone healing following Piezotome® ultrasonic instrumentation.

PubMed

Reside, Jonathan; Everett, Eric; Padilla, Ricardo; Arce, Roger; Miguez, Patricia; Brodala, Nadine; De Kok, Ingeborg; Nares, Salvador

2015-04-01

This pilot study evaluated the molecular, histologic, and radiographic healing of bone to instrumentation with piezoelectric or high speed rotary (R) devices over a 3-week healing period. Fourteen Sprague-Dawley rats (Charles River Laboratories International, Inc., Wilmington, MA, USA) underwent bilateral tibial osteotomies prepared in a randomized split-leg design using Piezotome® (P1) (Satelec Acteon, Merignac, France), Piezotome 2® (P2) (Satelec Acteon), High-speed R instrumentation, or sham surgery (S). At 1 week, an osteogenesis array was used to evaluate differences in gene expression while quantitative analysis assessed percentage bone fill (PBF) and bone mineral density (BMD) in the defect, peripheral, and distant regions at 3 weeks. Qualitative histologic evaluation of healing osteotomies was also performed at 3 weeks. At 1 week, expression of 11 and 18 genes involved in bone healing was significantly (p < .05) lower following P1 and P2 instrumentation, respectively, relative to S whereas 16 and 4 genes were lower relative to R. No differences in PBF or BMD were detected between groups within the osteotomy defect. However, significant differences in PBF (p = .020) and BMD (p = .008) were noted along the peripheral region between P2 and R groups, being R the group with the lowest values. Histologically, smooth osteotomy margins were present following instrumentation using P1 or P2 relative to R. Piezoelectric instrumentation favors preservation of bone adjacent to osteotomies while variations in gene expression suggest differences in healing rates due to surgical modality. Bone instrumented by piezoelectric surgery appears less detrimental to bone healing than high-speed R device. © 2013 Wiley Periodicals, Inc.

[Interposition arthrodesis of the ankle].

PubMed

Vienne, Patrick

2005-10-01

Bony fusion of the ankle in a functionally favorable position for restitution of a painless weight bearing while avoiding a leg length discrepancy. Disabling, painful osteoarthritis of the ankle with extensive bone defect secondary to trauma, infection, or serious deformities such as congenital malformations or diabetic osteoarthropathies. Acute joint infection. Severe arterial occlusive disease of the involved limb. Lateral approach to the distal fibula. Fibular osteotomy 7 cm proximal to the tip of the lateral malleolus and posterior flipping of the distal fibula. Exposure of the ankle. Removal of all articular cartilage and debridement of the bone defect. Determination of the size of the defect and harvesting of a corresponding tricortical bone graft from the iliac crest. Also harvesting of autogenous cancellous bone either from the iliac crest or from the lateral part of the proximal tibia. Insertion of the tricortical bone graft and filling of the remaining defect with cancellous bone. Fixation with three 6.5-mm titanium lag screws. Depending on the extent of the defect additional stabilization of the bone graft with a titanium plate. Fixation of the lateral fibula on talus and tibia with two 3.5-mm titanium screws for additional support. Wound closure in layers. Split below-knee cast with the ankle in neutral position. Between January 2002 and January 2004 this technique was used in five patients with extensive bone defects (four women, one man, average age 57 years [42-77 years]). No intra- or early postoperative complications. The AOFAS (American Orthopedic Foot and Ankle Society) Score was improved from 23 points preoperatively to 76 points postoperatively (average follow-up time of 25 months). Two patients developed a nonunion and underwent a revision with an ankle arthrodesis nail. A valgus malposition after arthrodesis in one patient was corrected with a supramalleolar osteotomy.

Associations of physical activity duration, frequency, and load with volumetric BMD, geometry, and bone strength in young girls

PubMed Central

Farr, Joshua N.; Blew, Robert M.; Lee, Vinson R.; Lohman, Timothy G.; Going, Scott B.

2011-01-01

Purpose This study evaluated the associations of physical activity (PA) duration, frequency, load, and their interaction (total PA score = duration × frequency × load) with volumetric bone mineral density, geometry, and indices of bone strength in young girls. Methods 465 girls (aged 8–13 years) completed a past year physical activity questionnaire (PYPAQ) which inquires about the frequency (days/week) and duration (average minutes/session) of leisure-time PA and sports. Load (peak strain score) values were assigned to each activity based on ground reaction forces. Peripheral quantitative computed tomography was used to assess bone parameters at metaphyseal and diaphyseal sites of the femur and tibia of the non-dominant leg. Results Correlations across all skeletal sites between PA duration, frequency, load and periosteal circumference (PC), bone strength index (BSI), and strength-strain index (SSI) were significant (p ≤ 0.05), although low (0.10–0.17). A 2.7–3.7% greater PC across all skeletal sites was associated with a high compared to a low PYPAQ score. Also, a high PYPAQ score was associated with greater BSI (6.5–8.7%) at metaphyseal sites and SSI (7.5–8.1%) at diaphyseal sites of the femur and tibia. The effect of a low PYPAQ score on bone geometric parameters and strength was greater than a high PYPAQ score. Conclusions PA duration, frequency, and load were all associated with bone geometry and strength, although their independent influences were modest and site specific. Low levels of PA may compromise bone development whereas high levels have only a small benefit over more average levels. PMID:20694457

High-frequency, low-magnitude vibration does not prevent bone loss resulting from muscle disuse in mice following botulinum toxin injection.

PubMed

Manske, Sarah L; Good, Craig A; Zernicke, Ronald F; Boyd, Steven K

2012-01-01

High-frequency, low-magnitude vibration enhances bone formation ostensibly by mimicking normal postural muscle activity. We tested this hypothesis by examining whether daily exposure to low-magnitude vibration (VIB) would maintain bone in a muscle disuse model with botulinum toxin type A (BTX). Female 16-18 wk old BALB/c mice (N = 36) were assigned to BTX-VIB, BTX-SHAM, VIB, or SHAM. BTX mice were injected with BTX (20 µL; 1 U/100 g body mass) into the left hindlimb posterior musculature. All mice were anaesthetized for 20 min/d, 5 d/wk, for 3 wk, and the left leg mounted to a holder. Through the holder, VIB mice received 45 Hz, ± 0.6 g sinusoidal acceleration without weight bearing. SHAM mice received no vibration. At baseline and 3 wk, muscle cross-sectional area (MCSA) and tibial bone properties (epiphysis, metaphysis and diaphysis) were assessed by in vivo micro-CT. Bone volume fraction in the metaphysis decreased 12 ± 9% and 7 ± 6% in BTX-VIB and BTX-SHAM, but increased in the VIB and SHAM. There were no differences in dynamic histomorphometry outcomes between BTX-VIB and BTX nor between VIB and SHAM. Thus, vibration did not prevent bone loss induced by a rapid decline in muscle activity nor produce an anabolic effect in normal mice. The daily loading duration was shorter than would be expected from postural muscle activity, and may have been insufficient to prevent bone loss. Based on the approach used in this study, vibration does not prevent bone loss in the absence of muscle activity induced by BTX.

The AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF)

PubMed Central

Audigé, Laurent; Slongo, Theddy; Lutz, Nicolas; Blumenthal, Andrea; Joeris, Alexander

2017-01-01

Background and purpose The AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF) describes the localization and morphology of fractures, and considers severity in 2 categories: (1) simple, and (2) multifragmentary. We evaluated simple and multifragmentary fractures in a large consecutive cohort of children diagnosed with long bone fractures in Switzerland. Patients and methods Children and adolescents treated for fractures between 2009 and 2011 at 2 tertiary pediatric surgery hospitals were retrospectively included. Fractures were classified according to the AO PCCF. Severity classes were described according to fracture location, patient age and sex, BMI, and cause of trauma. Results Of all trauma events, 3% (84 of 2,730) were diagnosed with a multifragmentary fracture. This proportion was age-related: 2% of multifragmentary fractures occurred in school­children and 7% occurred in adolescents. In patients diagnosed with a single fracture only, the highest percentage of multifragmentation occurred in the femur (12%, 15 of 123). In fractured paired radius/ulna bones, multifragmentation occurred in 2% (11 of 687); in fractured paired tibia/fibula bones, it occurred in 21% (24 of 115), particularly in schoolchildren (5 of 18) and adolescents (16 of 40). In a multivariable regression model, age, cause of injury, and bone were found to be relevant prognostic factors of multifragmentation (odds ratio (OR) > 2). Interpretation Overall, multifragmentation in long bone fractures in children was rare and was mostly observed in adolescents. The femur was mostly affected in single fractures and the lower leg was mostly affected in paired-bone fractures. The clinical relevance of multifragmentation regarding growth and long-term functional recovery remains to be determined. PMID:27882814

Association of age and physical exercise with bodyweight and body composition in Asian Chinese men.

PubMed

Goh, Victor H-H; Tong, Terry Y Y

2010-12-01

The present study sought to examine the association between physical exercise as a lifestyle habit with anthropometric parameters and body composition and aging in men. Intensity of exercise was scored as metabolic equivalent-min/week (MET-min/week) from data of the questionnaire, while anthropometric parameters and body composition were carried out by standard measuring instruments and dual-energy X-ray absorptiometry scanner, respectively. Age was associated with decreases in bodyweight, height, total lean mass and bone mass, but an increase in fat mass. The negative association of lean mass with age was predominantly due to the negative association of lean masses in the legs and arm, while the positive association of fat mass with age was primarily due to the positive association of fat masses in the trunk and abdomen. Exercise of intensity greater than 1000 MET-min/week was significantly associated with higher lean and bone masses and lower fat mass. The increase in lean mass was predominantly in the legs, while the decreases in fat mass were in the trunk and abdomen. The study showed that the high intensity of physical exercise, equivalent to greater than 1000 MET-min/week, is required to effect beneficial changes in the body composition. Hence, results from the study support the importance of promoting a lifestyle habit of exercise of sufficient intensity in order to mitigate the increase risks of sarcopenia and obesity and their attendant ill effects on health in men as they age.

Bald eagle predation on common loon egg

USGS Publications Warehouse

DeStefano, Stephen; McCarthy, Kyle P.; Laskowski, Tom

2010-01-01

The Common Loon (Gavia immer) must defend against many potential egg predators during incubation, including corvids, Herring Gulls (Larus argentatus), raccoons (Procyon lotor), striped skunk (Mephitis mephitis), fisher (Martes pennanti), and mink (Neovison vison) (McIntyre 1988, Evers 2004, McCann et al. 2005). Bald Eagles (Haliaeetus leucocephalus) have been documented as predators of both adult Common Loons and their chicks (Vliestra and Paruk 1997, Paruk et al. 1999, Erlandson et al. 2007, Piper et al. 2008). In Wisconsin, where nesting Bald Eagles are abundant (>1200 nesting pairs, >1 young/pair/year), field biologists observed four instances of eagle predation of eggs in loon nests during the period 2002–2004 (M. Meyer pers. comm.). In addition, four cases of eagle predation of incubating adult loons were inferred from evidence found at the loon nest (dozens of plucked adult loon feathers, no carcass remains) and/or loon leg, neck, and skull bones beneath two active eagle nests, including leg bones containing the bands of the nearby (<25 m) incubating adult loon. However, although loon egg predation has been associated with Bald Eagles, predation events have yet to be described in peer-reviewed literature. Here we describe a photographic observation of predation on a Common Loon egg by an immature Bald Eagle as captured by a nest surveillance video camera on Lake Umbagog, a large lake (32 km2) at Umbagog National Wildlife Refuge (UNWR) in Maine.

Relationship between total and segmental bone mineral density and different domains of physical activity among children and adolescents: cross-sectional study.

PubMed

Diniz, Tiego Aparecido; Agostinete, Ricardo Ribeiro; Costa, Paulo; Saraiva, Bruna Thamyres Ciccotti; Sonvenso, Diego Kanashiro; Freitas, Ismael Forte; Fernandes, Rômulo Araujo; Christofaro, Diego Giulliano Destro

2017-01-01

This study aimed to investigate the relationship between total and segmental bone mineral density (BDM) and physical activity (PA) in different domains (school, leisure and sports) among adolescents and children. Cross-sectional study in the Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP). The study sample consisted of 173 children and adolescents (10.31 ± 1.87 years). The BMDs for the whole body (WB) and the regions of the trunk and legs were measured using dual energy X-ray absorptiometry (DXA). PA was measured using the Baecke questionnaire. A regression model was used to analyze the relationship between all the BMDs and the different domains of PA. 41.5% of the adolescents had high percentages of body fat. Regarding the comparison between physically active and insufficiently active adolescents, there were no statistically significant differences in any BMD variables (P > 0.05). The BMD of the legs showed positive relationships with the total PA (β = 0.009; P = 0.013) and sports PA (β = 0.010; P = 0.049) after insertion of the confounders. Similarly, the WB BMD showed the same relationships (total PA: β = 0.005; P = 0.045; and sports PA: β = 0.008; P = 0.049). No relationship was found between leisure and school PA and any of the BMDs (P > 0.05). The results indicated that practice of sport was related to higher BMD values, independent of sex, age and body fatness.

The relationship between bone mineral density and mammographic density in Korean women: the Healthy Twin study.

PubMed

Sung, Joohon; Song, Yun-Mi; Stone, Jennifer; Lee, Kayoung

2011-09-01

Mammographic density is one of the strong risk factors for breast cancer. A potential mechanism for this association is that cumulative exposure to mammographic density may reflect cumulative exposure to hormones that stimulate cell division in breast stroma and epithelium, which may have corresponding effects on breast cancer development. Bone mineral density (BMD), a marker of lifetime estrogen exposure, has been found to be associated with breast cancer. We examined the association between BMD and mammographic density in a Korean population. Study subjects were 730 Korean women selected from the Healthy Twin study. BMD (g/cm(2)) was measured with dual-energy X-ray absorptiometry. Mammographic density was measured from digital mammograms using a computer-assisted thresholding method. Linear mixed model considering familial correlations and a wide range of covariates was used for analyses. Quantitative genetic analysis was completed using SOLAR. In premenopausal women, positive associations existed between absolute dense area and BMD at ribs, pelvis, and legs, and between percent dense area and BMD at pelvis and legs. However, in postmenopausal women, there was no association between BMD at any site and mammographic density measures. An evaluation of additive genetic cross-trait correlation showed that absolute dense area had a weak-positive additive genetic cross-trait correlation with BMD at ribs and spines after full adjustment of covariates. This finding suggests that the association between mammographic density and breast cancer could, at least in part, be attributable to an estrogen-related hormonal mechanism.

Physeal growth arrest by excessive compression: histological, biochemical, and micro-CT observations in rabbits.

PubMed

Yoo, Won Joon; Cheon, Jung-Eun; Lee, Hye Ran; Cho, Tae-Joon; Choi, In Ho

2011-12-01

Compressive force across the growth plate may cause retardation and even arrest of physeal growth. The purpose of this study was to investigate histologic changes, metabolic changes in terms of glycosaminoglycan (GAG) concentration, and contrast-enhanced micro-computed tomography (CEMCT) findings of physeal cartilage in a rabbit model of physeal damage caused by excessive compression. Compressive forces were applied via external fixators for two weeks to the growth plates of distal femurs and proximal tibiae of right hind-legs in 8-week-old rabbits. Left hind-legs remained intact and were used as controls. Forty-four bone specimens containing growth plates of distal femurs or proximal tibiae were harvested one week (n = 12) and four weeks (n = 32) after surgery, and examined for histologic findings (H&E staining) and GAGs quantification in physeal cartilage. After incubation in an ionic contrast material for 48 hours, specimens were scanned by CEMCT, and the pixel values of physeal cartilage were measured. CEMCT showed a thin, highly attenuated line parallel to the growth plate in compressed specimens harvested at four weeks after surgery, which was found to be transversely connected trabecular bone. In these specimens, GAG content in physeal cartilage was significantly lower, and CEMCT pixel values of physeal cartilage were significantly higher than in the specimens from the contralateral control side. Excessive compressive force applied to growth plates produces altered histologic features and metabolic function in terms of decreased GAG content in physeal cartilage, changes that can be demonstrated by CEMCT.

Minimally invasive locked plating of distal tibia fractures is safe and effective.

PubMed

Ronga, Mario; Longo, Umile Giuseppe; Maffulli, Nicola

2010-04-01

Distal tibial fractures are difficult to manage. Limited soft tissue and poor vascularity impose limitations for traditional plating techniques that require large exposures. The nature of the limitations for traditional plating techniques is intrinsic to the large exposure required to approach distal tibia, a bone characterized by limited soft tissue coverage and poor vascularity. The locking plate (LP) is a new device for treatment of fractures. We assessed the bone union rate, deformity, leg-length discrepancy, ankle range of motion, return to preinjury activities, infection, and complication rate in 21 selected patients who underwent minimally invasive osteosynthesis of closed distal tibia fractures with an LP. According to the AO classification, there were 12 Type A, 5 Type B, and 4 Type C fractures. The minimum followup was 2 years (average, 2.8 years; range, 2-4 years). Two patients were lost to followup. Union was achieved in all but one patient by the 24th postoperative week. Four patients had angular deformity less than 7 degrees . No patient had a leg-length discrepancy more than 1.1 cm. Five patients had ankle range of motion less than 20 degrees compared with the contralateral side. Sixteen patients had not returned to their preinjury sporting or leisure activities. Three patients developed a delayed infection. We judge the LP a reasonable device for treating distal tibia fractures. The level of physical activities appears permanently reduced in most patients. Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Prospective study of periostitis and finger clubbing in primary biliary cirrhosis and other forms of chronic liver disease.

PubMed Central

Epstein, O; Dick, R; Sherlock, S

1981-01-01

The association of finger clubbing and periostitis has been reported in primary biliary cirrhosis and, more rarely, in other forms of chronic liver disease. The prevalence of periostitis and its relationship to finger clubbing is unknown. In this prospective study, we have determined the prevalence of periostitis and finger clubbing in 74 patients with primary biliary cirrhosis and 54 with other forms of chronic liver disease. Clubbing was present in 24% of patients with primary biliary cirrhosis, 29% with HBsAg negative chronic active hepatitis, and 23% in the group of miscellaneous liver diseases. Symmetrical periostitis affecting the tibiae and fibulae occurred in 35% of patients with primary biliary cirrhosis, 29% with chronic, active hepatitis and 40% of patients in the miscellaneous group. The distal radii and ulnae were affected in only eight patients (6%). In primary biliary cirrhosis, the presence of finger clubbing was strongly associated with periostitis (P less than 0.01), but this association was uncommon in other forms of chronic liver disease. In all forms of chronic liver disease periostitis commonly occurs in the absence of finger clubbing. Marked tenderness over the distal leg bones is a reliable sign of underlying periostitis, but this sign is present in only a third of affected patients. This study indicates that periostitis affecting the lower leg bones is common in patients with chronic liver disease, and its presence should be sought whether or not the patient has finger clubbing. Images Fig. 2 PMID:7227854

In healthy elderly postmenopausal women variations in BMD and BMC at various skeletal sites are associated with differences in weight and lean body mass rather than by variations in habitual physical activity, strength or VO2max.

PubMed

Schöffl, I; Kemmler, W; Kladny, B; Vonstengel, S; Kalender, W A; Engelke, K

2008-01-01

The objective of this study was an integrated cross-sectional investigation for answering the question whether differences in bone mineral density in elderly postmenopausal women are associated with differences in habitual physical activity and unspecific exercise levels. Two hundred and ninety nine elderly women (69-/+3 years), without diseases or medication affecting bone metabolism were investigated. The influence of weight, body composition and physical activity on BMD was measured at multiple sites using different techniques (DXA, QCT, and QUS). Physical activity and exercise level were assessed by questionnaire, maximum strength of the legs and aerobic capacity. Variations in physical activity or habitual exercise had no effect on bone. The only significant univariate relation between strength/VO(2)max and BMD/BMC that remained after adjusting for confounding variables was between arm BMD (DXA) and hand-grip strength. The most important variable for explaining BMD was weight and for cortical BMC of the femur (QCT) lean body mass. Weight and lean body mass emerge as predominant predictors of BMD in normal elderly women, whereas the isolated effect of habitual physical activity, unspecific exercise participation, and muscle strength on bone parameters is negligible. Thus, an increase in the amount of habitual physical activity will probably have no beneficial impact on bone.

Investigation of Ballistic Penetration through Tibia Soft Tissue Simulant

NASA Astrophysics Data System (ADS)

Nguyen, Thuy-Tien N.; Masouros, Spyros D.; Tear, Gareth R.; Proud, William G.; Institute of Shock Physics; CentreBlast Injury Studies, Imperial College London, UK Team

2017-06-01

High energy trauma events such as from explosions and ballistic weapons can cause severe damage to the human body. The resulting injuries are very complex and their mechanism is not fully understood. Secondary blast injuries, effectively ballistic traumas, to the extremities are commonly reported, especially to the tibia. The aim of this study is to quantify the effect of parameters such as projectile mass and velocity, and impact location on injury thresholds in the leg. The bones of the leg were set in biofidelic gelatin tissue simulant. A 32-mm-bore gas gun was used to launch a sabot carrying a carbon steel projectile 0.5 to 1.1 g in mass at the sample with speeds of 50 to 300 m/s. Penetration depth and impact velocity were recorded. The effect of different postures - such as standing and non-weight bearing -- on injury were considered. The resulting injuries were scored clinically and their correlation with the various impact parameters was calculated. The project is funded by the Royal British Legion, United Kingdom.

Loading, electromyograph, and motion during exercise

NASA Technical Reports Server (NTRS)

Todd, Beth A.

1993-01-01

A bicycle ergometer system has been developed to determine forces acting in specific muscles and muscle groups for both cycling and isometric exercise. The bicycle has been instrumented with encoders, accelerometers, and load cells. A harnessing system has been developed to keep subjects in place during isometric exercise. EMG data will also be collected with electrodes attached to various muscles on the subject's leg. Data has been collected for static loading and will be collected for cycling in both an earth-based laboratory and on the KC-135. Once the data is analyzed, the forces will be entered into finite element models of bones of the lower extremities. A finite element model of the tibia-fibula has been generated from the experimental subject's MRI data. The linear elastic isoparametric brick elements representing the bones are connected by linear elastic isoparametric shell elements placed at the locations of ligaments. Models will be generated for the calcaneus and the femur. Material properties for the various tissues will be taken from the literature. The experimentally determined muscle forces will be applied to the models to determine the stress distribution which is created in the bones.

Micro-stereotactic frame utilizing bone cement for individual fabrication: an initial investigation of its accuracy

NASA Astrophysics Data System (ADS)

Rau, Thomas S.; Lexow, G. Jakob; Blume, Denise; Kluge, Marcel; Lenarz, Thomas; Majdani, Omid

2017-03-01

A new method for template-guided cochlear implantation surgery is proposed which has been developed to create a minimally invasive access to the inner ear. A first design of the surgical template was drafted, built, and finally tested regarding its accuracy. For individual finalization of the micro-stereotactic frame bone cement is utilized as this well-known and well-established material suggests ease of use as well as high clinical acceptance and enables both sterile and rapid handling. The new concept includes an alignment device, based on a passive hexapod with manually adjustable legs for temporary fixation of the separate parts in the patient-specific pose until the bone cement is spread and finally cured. Additionally, a corresponding evaluation method was developed to determine the accuracy of the microstereotactic frame in some initial experiments. In total 18 samples of the surgical template were fabricated based on previously planned trajectories. The mean positioning error at the target point was 0.30 mm with a standard deviation of 0.25 mm.

Whole-body vibration versus proprioceptive training on postural control in post-menopausal osteopenic women.

PubMed

Stolzenberg, Nils; Belavý, Daniel L; Rawer, Rainer; Felsenberg, Dieter

2013-07-01

To prevent falls in the elderly, especially those with low bone density, is it necessary to maintain muscle coordination and balance. The aim of this study was to examine the effect of classical balance training (BAL) and whole-body vibration training (VIB) on postural control in post-menopausal women with low bone density. Sixty-eight subjects began the study and 57 completed the nine-month intervention program. All subjects performed resistive exercise and were randomized to either the BAL- (N=31) or VIB-group (N=26). The BAL-group performed progressive balance and coordination training and the VIB-group underwent, in total, four minutes of vibration (depending on exercise; 24-26Hz and 4-8mm range) on the Galileo Fitness. Every month, the performance of a single leg stance task on a standard unstable surface (Posturomed) was tested. At baseline and end of the study only, single leg stance, Romberg-stance, semi-tandem-stance and tandem-stance were tested on a ground reaction force platform (Leonardo). The velocity of movement on the Posturomed improved by 28.3 (36.1%) (p<0.001) in the VIB-group and 18.5 (31.5%) (p<0.001) in the BAL-group by the end of the nine-month intervention period, but no differences were seen between the two groups (p=0.45). Balance tests performed on the Leonardo device did not show any significantly different responses between the two groups after nine months (p≥0.09). Strength training combined with either proprioceptive training or whole-body vibration was associated with improvements in some, but not all, measures of postural control in post-menopausal women with low bone density. The current study could not provide evidence for a significantly different impact of whole-body vibration or balance training on postural control. Copyright © 2013 Elsevier B.V. All rights reserved.

Reconstruction of juxta-articular huge defects of distal femur with vascularized fibular bone graft and Ilizarov's distraction osteogenesis.

PubMed

Lai, Davy; Chen, Chuan-Mu; Chiu, Fang-Yao; Chang, Ming-Chau; Chen, Tain-Hsiung

2007-01-01

We evaluate the effect of reconstructing huge defects (mean, 15.8 cm) of the distal femur with Ilizarov's distraction osteogenesis and free twin-barreled vascularized fibular bone graft (TVFG). We retrospectively reviewed a consecutive series of five patients who had cases of distal femoral fractures with huge defects and infection that were treated by the Ilizarov's distraction osteogenesis. After radical debridement, two of the five cases had free TVFG and monolocal distraction osteogenesis, and another two cases had multilocal distraction osteogenesis with knee fusion because of loss of the joint congruity. The other case with floating knee injury had bilocal distraction osteogenesis and a preserved knee joint. The mean defect of distal femur was 15.8 cm (range, 14-18 cm) in length. The mean length of distraction osteogenesis by Ilizarov's apparatus was 8.2 cm. The mean length of TVFG was 8 cm. The average duration from application of Ilizarov's apparatus to achievement of bony union was 10.2 months (range, 8-13 months). At the end of the follow-up, ranges of motion of three knees were 0 to 45 degrees, 0 to 60 degrees, and 0 to 90 degrees. Two cases had knee arthrodesis with bony fusion because of loss of the joint congruity. There were no leg length discrepancies in all five patients. In addition, three patients had pin tract infections and one case had a 10 degree varus deformity of the femur. Juxta-articular huge defect (>10 cm) of distal femur remains a challenge to orthopedic surgeons. Ilizarov's technique provides the capability to maintain stability, eradicate infection, restore leg length, and to perform adjuvant reconstructive procedure easily. In this study, we found that combining Ilizarov's distraction osteogenesis with TVFG results in improved patient outcome for patients with injuries such as supracondylar or intercondylar infected fractures or nonunion of distal femur with huge bone defect.

On reconstructing Giraffa sivalensis, an extinct giraffid from the Siwalik Hills, India

PubMed Central

Mitchell, Graham

2015-01-01

Giraffa sivalensis occurred during the Plio-Pleistocene period and probably represents the terminal species of the genus in Southern Asia. The holotype is an almost perfectly preserved cervical vertebra of disputed anatomical location. Although there is also uncertainty regarding this animal’s size, other specimens that have been assigned to this species include fragments of two humeri, a radius, metacarpi and teeth. Here we estimate neck length, leg length and body mass using interspecific and, unusually, ontogenetic allometry of extant giraffe skeletal parameters. The appropriateness of each equation to estimate body mass was evaluated by calculating the prediction error incurred in both extant giraffes (G. camelopardalis) and okapis (Okapia johnstoni). It followed that the equations with the lowest prediction error in both species were considered robust enough to use in G. sivalensis. The size of G. sivalensis, based on the holotype, is proposed as 400 kg (range 228 kg–575 kg), with a neck length of approximately 147 cm and a height of 390 cm. The molar lengths of tooth specimens considered agree with this size estimate. The humerus was the most appropriate long bone to establish body mass, which estimates a heavier animal of ca 790 kg. The discrepancy with the vertebral body weight estimate might indicate sexual dimorphism. Radial and metacarpal specimens estimate G. sivalensis to be as heavy as extant giraffes. This may indicate that the radius and metacarpus are unsuitable for body mass predictions in Giraffa spp. Alternatively, certain long bones may have belonged to another long legged giraffid that occurred during the same period and locality as G. sivalensis. We have concluded that if sexual dimorphism was present then males would have been about twice the size of females. If sexual dimorphism was not present and all bones were correctly attributed to this species, then G. sivalensis had a slender neck with a relatively stocky body. PMID:26290791

A longitudinal study of bone area, content, density, and strength development at the radius and tibia in children 4-12 years of age exposed to recreational gymnastics.

PubMed

Jackowski, S A; Baxter-Jones, A D G; Gruodyte-Raciene, R; Kontulainen, S A; Erlandson, M C

2015-06-01

This study investigated the long-term relationship between the exposure to childhood recreational gymnastics and bone measures and bone strength parameters at the radius and tibia. It was observed that individuals exposed to recreational gymnastics had significantly greater total bone content and area at the distal radius. No differences were observed at the tibia. This study investigated the relationship between exposure to early childhood recreational gymnastics with bone measures and bone strength development at the radius and tibia. One hundred twenty seven children (59 male, 68 female) involved in either recreational gymnastics (gymnasts) or other recreational sports (non-gymnasts) between 4 and 6 years of age were recruited. Peripheral quantitative computed tomography (pQCT) scans of their distal and shaft sites of the forearm and leg were obtained over 3 years, covering the ages of 4-12 years at study completion. Multilevel random effects models were constructed to assess differences in the development of bone measures and bone strength measures between those exposed and not exposed to gymnastics while controlling for age, limb length, weight, physical activity, muscle area, sex, and hours of training. Once age, limb length, weight, muscle area, physical activity, sex, and hours of training effects were controlled, it was observed that individuals exposed to recreational gymnastics had significantly greater total bone area (18.0 ± 7.5 mm(2)) and total bone content (6.0 ± 3.0 mg/mm) at the distal radius (p < 0.05). This represents an 8-21 % benefit in ToA and 8-15 % benefit to ToC from 4 to 12 years of age. Exposure to recreational gymnastics had no significant effect on bone measures at the radius shaft or at the tibia (p > 0.05). Exposure to early life recreational gymnastics provides skeletal benefits to distal radius bone content and area. Thus, childhood recreational gymnastics exposure may be advantageous to bone development at the wrist.

Relationship of total body fat mass to weight-bearing bone volumetric density, geometry, and strength in young girls

PubMed Central

Farr, Joshua N.; Chen, Zhao; Lisse, Jeffrey R.; Lohman, Timothy G.; Going, Scott B.

2010-01-01

Understanding the influence of total body fat mass (TBFM) on bone during the peri-pubertal years is critical for the development of future interventions aimed at improving bone strength and reducing fracture risk. Thus, we evaluated the relationship of TBFM to volumetric bone mineral density (vBMD), geometry, and strength at metaphyseal and diaphyseal sites of the femur and tibia of young girls. Data from 396 girls aged 8–13 years from the “Jump-In: Building Better Bones” study were analyzed. Bone parameters were assessed using peripheral quantitative computed tomography (pQCT) at the 4% and 20% distal femur and 4% and 66% distal tibia of the non-dominant leg. Bone parameters at the 4% sites included trabecular vBMD, periosteal circumference, and bone strength index (BSI), while at the 20% femur and 66% tibia, parameters included cortical vBMD, periosteal circumference, and strength-strain index (SSI). Multiple linear regression analyses were used to assess associations between bone parameters and TBFM, controlling for muscle cross-sectional area (MCSA). Regression analyses were then repeated with maturity, bone length, physical activity, and ethnicity as additional covariates. Analysis of covariance (ANCOVA) was used to compare bone parameters among tertiles of TBFM. In regression models with TBFM and MCSA, associations between TBFM and bone parameters at all sites were not significant. TBFM explained very little variance in all bone parameters (0.2–2.3%). In contrast, MCSA was strongly related (p < 0.001) to all bone parameters, except cortical vBMD. The addition of maturity, bone length, physical activity, and ethnicity did not alter the relationship between TBFM and bone parameters. With bone parameters expressed relative to total body mass, ANCOVA showed that all outcomes were significantly (p < 0.001) greater in the lowest compared to the middle and highest tertiles of TBFM. Although TBFM is correlated with femur and tibia vBMD, periosteal circumference, and strength in young girls, this relationship is significantly attenuated after adjustment for MCSA. Nevertheless, girls with higher TBFM relative to body mass have markedly diminished vBMD, geometry, and bone strength at metaphyseal and diaphyseal sites of the femur and tibia. PMID:20060079

The Biocompatibility of Degradable Magnesium Interference Screws: An Experimental Study with Sheep

PubMed Central

Thormann, Ulrich; Alt, Volker; Heimann, Lydia; Gasquere, Cyrille; Heiss, Christian; Szalay, Gabor; Franke, Jörg; Schnettler, Reinhard; Lips, Katrin Susanne

2015-01-01

Screws for ligament reconstruction are nowadays mostly made of poly-L-lactide (PLLA). However, magnesium-based biomaterials are gathering increased interest in this research field because of their good mechanical property and osteoanabolic influence on bone metabolism. The aim of this pilot study was to evaluate the biocompatibility of an interference screw for ligament reconstruction made of magnesium alloy W4 by diecasting and milling and using different PEO-coatings with calcium phosphates. PLLA and titanium screws were used as control samples. The screws were implanted in the femur condyle of the hind leg of a merino sheep. The observation period was six and twelve weeks and one year. Histomorphometric, immunohistochemical, immunofluorescence, and molecular biological evaluation were conducted. Further TEM analysis was done. In all magnesium screws a clinically relevant gas formation in the vicinity of the biomaterial was observed. Except for the PLLA and titanium control samples, no screw was fully integrated in the surrounding bone tissue. Regarding the fabrication process, milling seems to produce less gas liberation and has a better influence on bone metabolism than diecasting. Coating by PEO with calcium phosphates could not reduce the initial gas liberation but rather reduced the bone metabolism in the vicinity of the biomaterial. PMID:25717474

Present status of the use of growth hormone in short children with bone diseases (diseases of the skeleton).

PubMed

Kanaka-Gantenbein, C

2001-01-01

Skeletal dysplasias are genetic disorders of bone and cartilage development, mainly characterized by disproportionate short stature. Achondroplasia is the commonest and best described form of skeletal dysplasia, leading to a mean final height of 131+/-5.6 cm for males and 124+/-5.9 cm for females. Growth hormone (GH) has been used in different studies in patients with achondroplasia in order to ameliorate their height, and short term results range from rather positive to moderate. However, disproportionate advancement of bone age has been observed that can compromise the positive effect of such treatment. Furthermore, concern exists about the aggravation of body disproportion necessitating a later leg lengthening procedure in order to achieve proportionate adult stature. In hypochondroplasia, GH treatment seems to give better results when administered at puberty. No data on final height yet exist, however, so that more studies with greater numbers of patients need to be performed before a consensus on GH use in achondroplasia and hypochondroplasia can be reached. Other forms of skeletal dysplasias are quite rare, so that no conclusion on GH use in such patients can be drawn. Finally, in osteogenesis imperfecta, GH administration significantly ameliorates bone density but does not clearly seem to affect final height positively.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Degowin, R.L.; Lass, S.L.

Our studies show that the induction of a chronic inflammatory lesion in the left hind legs of mice by administration of 5000 rad produced distinct abnormalities of the hematopoietic system. A peripheral neutrophilia accompanied reduced numbers of total nucleated cells, stem cells, stromal cells, erythroblasts, and lymphocytes in the unirradiated femoral marrow, and the spleen was enlarged. Mice with these hematopoietic abnormalities promptly succumbed with bone marrow failure to a sublethal dose of total body irradiation (600 rad TB). Acute inflammation associated with a sterile abscess also impaired survival after 600 rad TB. Hematopoietic abnormalities resembling those in mice withmore » inflammation had been reported in mice bearing a solid extramedullary tumor of sarcoma-180. Concomitant studies showed that bone marrow failure and impaired survival after 600 rad TB administered to mice bearing sarcoma-180 occurred at the same time as that in mice with chronic inflammation. We concluded that chronic inflammation or tumor produced similar abnormalities in the bone marrow and spleen that led to markedly impaired survival and death from bone marrow failure after a sublethal dose of total body irradiation. Although the extramedullary hematopoiesis in the enlarged spleen indicated that its microenvironment supported hematopoiesis, whereas that in marrow was reduced, it was insufficient to compensate for a total body deficit of functional stem cells.« less

Finite element analysis of a bone healing model: 1-year follow-up after internal fixation surgery for femoral fracture.

PubMed

Jiang-Jun, Zhou; Min, Zhao; Ya-Bo, Yan; Wei, Lei; Ren-Fa, Lv; Zhi-Yu, Zhu; Rong-Jian, Chen; Wei-Tao, Yu; Cheng-Fei, Du

2014-03-01

Finite element analysis was used to compare preoperative and postoperative stress distribution of a bone healing model of femur fracture, to identify whether broken ends of fractured bone would break or not after fixation dislodgement one year after intramedullary nailing. Method s: Using fast, personalized imaging, bone healing models of femur fracture were constructed based on data from multi-slice spiral computed tomography using Mimics, Geomagic Studio, and Abaqus software packages. The intramedullary pin was removed by Boolean operations before fixation was dislodged. Loads were applied on each model to simulate a person standing on one leg. The von Mises stress distribution, maximum stress, and its location was observed. Results : According to 10 kinds of display groups based on material assignment, the nodes of maximum and minimum von Mises stress were the same before and after dislodgement, and all nodes of maximum von Mises stress were outside the fracture line. The maximum von Mises stress node was situated at the bottom quarter of the femur. The von Mises stress distribution was identical before and after surgery. Conclusion : Fast, personalized model establishment can simulate fixation dislodgement before operation, and personalized finite element analysis was performed to successfully predict whether nail dislodgement would disrupt femur fracture or not.

Derivation and application of a mathematical model for long bone growth.

PubMed

Seetharam, Suneil; Bhatia, Sujata K

2012-01-01

The objective of this work was to develop a mathematical model of long bone growth and to gain insights regarding growth disorders. A cell balance (mass balance of moving cells) assessment was performed on the three regions of the growth plate, to determine the variables (including number of proliferating cells, and division rate of proliferating cells) that influence tibia growth rate. Once this relationship was established, clinical data were used to understand how tibia growth rate and number of proliferating cells change with time. These equations were then inserted into the model to determine how cell division rate changes with time. The model was utilized to determine the influence of growth time, and to measure changes in vitamin C deficiency, Indian hedgehog (IHH) expression, and bone morphogenetic protein-2 (BMP-2) implants on tibia length. According to the model, a 10-month discrepancy in growth time between the two tibias is required to produce clinically significant leg asymmetry. In addition, vitamin C deficiency, IHH overexpression, and BMP-2 implants can all affect tibia length. These bioactive molecules have the greatest effect on tibia growth rate when these perturbations occur early in life for extended periods of time. The results are significant for modeling and predicting the effects of perturbations, including bioactive implants, on long bone growth.

[Tensile strength of bone fixation of hydroxyapatite coated Schanz screws of the Heidelberg External Fixation System (HEFS)--comparative torque measurements in clinical use and in cadaver tibia].

PubMed

Placzek, R; Deuretzbacher, G; Meiss, A L

2002-12-01

It is claimed in the literature that hydroxyapatite(HA)-coated screws of external fixators have superior fixation strength in bone, which is postulated to lead to a substantial decrease in loosening and infection rates. We report on a study of the maximum torque values developed while inserting and removing 30 HA-coated Schanz screws of 8 Heidelberg external fixation systems applied to the tibia to correct leg length differences and axial deformities. The infection rate was determined in accordance with defined criteria, and was found to be about 20% for the HA-coated screws. Screws without infection showed an extraction torque above insertion torque, screws with infection an extraction torque below. A significant correlation (p = 0.05) was seen between infection and decrease in fixation strength (quotient: loosening torque/tightening torque). To exclude the impact of such biological processes as osteointegration and bone remodelling, the clinical results were compared with the torques measured for coated and uncoated Schanz screws in a human cadaveric tibia. A significantly higher fixation strength in bone was found for HA-coated screws in comparison with uncoated screws (p = 0.002). These data warrant a clinical study directly comparing HA-coated and uncoated Schanz screws.

Effects of 16-week high-intensity interval training using upper and lower body ergometers on aerobic fitness and morphological changes in healthy men: a preliminary study

PubMed Central

Osawa, Yusuke; Azuma, Koichiro; Tabata, Shogo; Katsukawa, Fuminori; Ishida, Hiroyuki; Oguma, Yuko; Kawai, Toshihide; Itoh, Hiroshi; Okuda, Shigeo; Matsumoto, Hideo

2014-01-01

It is unclear whether combined leg and arm high-intensity interval training (HIIT) improves fitness and morphological characteristics equal to those of leg-based HIIT programs. The aim of this study was to compare the effects of HIIT using leg-cycling (LC) and arm-cranking (AC) ergometers with an HIIT program using only LC. Effects on aerobic capacity and skeletal muscle were analyzed. Twelve healthy male subjects were assigned into two groups. One performed LC-HIIT (n=7) and the other LC- and AC-HIIT (n=5) twice weekly for 16 weeks. The training programs consisted of eight to 12 sets of >90% VO2 (the oxygen uptake that can be utilized in one minute) peak for 60 seconds with a 60-second active rest period. VO2 peak, watt peak, and heart rate were measured during an LC incremental exercise test. The cross-sectional area (CSA) of trunk and thigh muscles as well as bone-free lean body mass were measured using magnetic resonance imaging and dual-energy X-ray absorptiometry. The watt peak increased from baseline in both the LC (23%±38%; P<0.05) and the LC–AC groups (11%±9%; P<0.05). The CSA of the quadriceps femoris muscles also increased from baseline in both the LC (11%±4%; P<0.05) and the LC–AC groups (5%±5%; P<0.05). In contrast, increases were observed in the CSA of musculus psoas major (9%±11%) and musculus anterolateral abdominal (7%±4%) only in the LC–AC group. These results suggest that a combined LC- and AC-HIIT program improves aerobic capacity and muscle hypertrophy in both leg and trunk muscles. PMID:25395872

Effects of 16-week high-intensity interval training using upper and lower body ergometers on aerobic fitness and morphological changes in healthy men: a preliminary study.

PubMed

Osawa, Yusuke; Azuma, Koichiro; Tabata, Shogo; Katsukawa, Fuminori; Ishida, Hiroyuki; Oguma, Yuko; Kawai, Toshihide; Itoh, Hiroshi; Okuda, Shigeo; Matsumoto, Hideo

2014-01-01

It is unclear whether combined leg and arm high-intensity interval training (HIIT) improves fitness and morphological characteristics equal to those of leg-based HIIT programs. The aim of this study was to compare the effects of HIIT using leg-cycling (LC) and arm-cranking (AC) ergometers with an HIIT program using only LC. Effects on aerobic capacity and skeletal muscle were analyzed. Twelve healthy male subjects were assigned into two groups. One performed LC-HIIT (n=7) and the other LC- and AC-HIIT (n=5) twice weekly for 16 weeks. The training programs consisted of eight to 12 sets of >90% VO2 (the oxygen uptake that can be utilized in one minute) peak for 60 seconds with a 60-second active rest period. VO2 peak, watt peak, and heart rate were measured during an LC incremental exercise test. The cross-sectional area (CSA) of trunk and thigh muscles as well as bone-free lean body mass were measured using magnetic resonance imaging and dual-energy X-ray absorptiometry. The watt peak increased from baseline in both the LC (23%±38%; P<0.05) and the LC-AC groups (11%±9%; P<0.05). The CSA of the quadriceps femoris muscles also increased from baseline in both the LC (11%±4%; P<0.05) and the LC-AC groups (5%±5%; P<0.05). In contrast, increases were observed in the CSA of musculus psoas major (9%±11%) and musculus anterolateral abdominal (7%±4%) only in the LC-AC group. These results suggest that a combined LC- and AC-HIIT program improves aerobic capacity and muscle hypertrophy in both leg and trunk muscles.

Effects of Roughly Focused Extracorporeal Shock Waves Therapy on the Expressions of Bone Morphogenetic Protein-2 and Osteoprotegerin in Osteoporotic Fracture in Rats

PubMed Central

Huang, Hai-Ming; Li, Xiao-Lin; Tu, Shu-Qiang; Chen, Xiao-Feng; Lu, Chang-Chun; Jiang, Liang-Hua

2016-01-01

Background: Roughly focused extracorporeal shock waves therapy (ESWT) is characterized by a wide focal area, a large therapy zone, easy positioning, and less pain during treatment. The purpose of this study was to investigate the effects of roughly focused ESWT on the expression of osteoprotegerin (OPG) and bone morphogenetic protein-2 (BMP-2) in osteoporotic fractures in rats. Methods: Seventy-two female Sprague-Dawley (SD) rats, 3 months old, were divided into sham-operated group (n = 6) and an ovariectomized (OVX) group (n = 66). Sixty OVX SD rats were used as a model of double proximal tibial osteotomy and inner fixation. The osteotomy site in the left tibia was treated with roughly focused ESWT once at an energy density of 0.26 mJ/mm2, 60 doses/min, and 2000 pact quantities. The contralateral right tibia was left untreated and served as a control. Expression of OPG and BMP-2 in the callus of the osteoporotic fracture area was assessed using immunohistochemistry, real-time polymerase chain reaction (PCR), and Western blotting analysis. Results: Bone mineral density (BMD) at the proximal tibia, femur, and L5 spine was significantly reduced after ovariectomy. BMD of proximal tibia was 12.9% less in the OVX group than that in the sham-operated group. Meanwhile, bilateral oophorectomy resulted in a lower trabecular bone volume fraction (BV/TV) in the proximal tibia of the sham-OVX animals. Three months after bilateral oophorectomy, BV/TV was 14.29% of baseline BV/TV in OVX legs versus 45.91% in the sham-OVX legs (P < 0.001). These data showed that the SD rats became a suitable model of osteoporosis, 3 months after they were OVX. Immunohistochemical analysis showed higher levels of BMP-2 and OPG expression in the treatment group than those in the control group. Compared with the contralateral controls, decreased expression of OPG and BMP-2 at 3 days after roughly focused ESWT, followed by a later increase at 7 days, was indicated by real-time PCR and Western blotting analysis. The OPG messenger RNA (mRNA) expression levels peaked at 6 weeks after the shock wave treatment, paired with a much earlier (at 4 weeks) increase of BMP-2, and declined close to normal at 8 weeks. Conclusions: Roughly focused ESWT may promote the expression of OPG and BMP-2 in the osteoporotic fracture area in rats. BMP-2 and OPG may act synergistically and may lead to a significant enhancement of bone formation and remodeling. PMID:27779163

Severe rickets in a young girl caused by celiac disease: the tragedy of delayed diagnosis: a case report.

PubMed

Al-Sharafi, Butheinah A; Al-Imad, Shafiq A; Shamshair, Amani M; Al-Faqeeh, Derhim H

2014-10-08

Celiac disease is a systemic immune mediated disease which usually presents with gastrointestinal symptoms, but it may present with extra gastrointestinal manifestations such as metabolic bone disease and failure to thrive. This may lead to a delay in the diagnosis. We present a 13 year old female from the middle east with an 8 year history of severe rickets causing multiple bone deformities leaving the child crippled with bowing of both of her arms and legs. The patient was also found to have growth failure, anemia and on further workup she was found to have celiac disease. We are presenting this case because it shows a severe case of rickets after malabsorption for many years. Celiac disease should be kept in mind as a cause of rickets in patients not responding to usual forms of treatment or when associated with other manifestations of malabsorption.

Etiologic factors in the development of medial tibial stress syndrome: a review of the literature.

PubMed

Tweed, Jo L; Avil, Steven J; Campbell, Jackie A; Barnes, Mike R

2008-01-01

Medial tibial stress syndrome is a type of exercise-induced leg pain that is common in recreational and competitive athletes. Although various studies have attempted to find the exact pathogenesis of this common condition, it remains unknown. Various theories in literature from 1976 to 2006 were reviewed using key words. Until recently, inflammation of the periosteum due to excessive traction was thought to be the most likely cause of medial tibial stress syndrome. This periostitis has been hypothesized by some authors to be caused by the tearing away of the muscle fibers at the muscle-bone interface, although there are several suggestions as to which, if any, muscle is responsible. Recent studies have supported the view that medial tibial stress syndrome is not an inflammatory process of the periosteum but instead a stress reaction of bone that has become painful.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Safigholi, Habib; Meigooni, A S.; University of Nevada Las Vegas

Purpose: Recently, different applicators are designed for treatment of the skin cancer such as scalp and legs, using Ir-192 HDR Brachytherapy Sources (IR-HDRS), Miniature Electronic Brachytherapy Sources (MEBXS), and External Electron Beam Radiation Therapy (EEBRT). Although, all of these methodologies may deliver the desired radiation dose to the skin, the dose to the underlying bone may become the limiting factor for selection of the optimum treatment technique. In this project the radiation dose delivered to the underlying bone has been evaluated as a function of the radiation source and thickness of the underlying bone. Methods: MC simulations were performed usingmore » MCNP5 code. In these simulations, the mono-energetic and non-divergent photon beams of 30 keV, 50 keV, and 70 keV for MEBXS, 380 keV photons for IR-HDRS, and 6 MeV mono-energetic electron beam for EEBRT were modeled. A 0.5 cm thick soft tissue (0.3 cm skin and 0.2 cm adipose) with underlying 0.5 cm cortical bone followed by 14 cm soft tissue are utilized for simulations. Results: Dose values to bone tissue as a function of beam energy and beam type, for a delivery of 5000 cGy dose to skin, were compared. These results indicate that for delivery of 5000 cGy dose to the skin surface with 30 keV, 50 keV, 70 keV of MEBXS, IR-HDRS, and EEBRT techniques, bone will receive 31750 cGy, 27450 cGy, 18550 cGy, 4875 cGy, and 10450 cGy, respectively. Conclusion: The results of these investigations indicate that, for delivery of the same skin dose, average doses received by the underlying bone are 5.2 and 2.2 times larger with a 50 keV MEBXS and EEBRT techniques than IR-HDRS, respectively.« less

Bilateral diaphyseal bone cysts of the tibia mimicking shin splints in a young professional athlete--a case report and depiction of a less-invasive surgical technique.

PubMed

Toepfer, Andreas; Harrasser, Norbert; Lenze, Ulrich; Liska, Franz; Mühlhofer, Heinrich; von Eisenhart-Rothe, Rüdiger; Banke, Ingo J

2015-08-23

Medial tibial stress syndrome is one of the most common causes of exertional leg pain in runners whereas musculoskeletal tumors and tumor-like lesions are rare encounters in orthopedic sports medicine practice. Unicameral (simple) bone cyst is a well-known tumor-like lesions of the bone typically affecting children and adolescents. Bilateral occurrence is very rare though and has never been reported before in both tibiae. Failing to accurately diagnose a tumorous lesion can entail far-reaching consequences for both patients and physicians. We report the case of large bilateral unicameral bone cysts of the diaphyseal tibiae mimicking medial tibial stress syndrome in a 17-year old professional athlete. This is the first report of symmetric tibial unicameral bone cysts in the literature. The patient complained about persisting shin splint-like symptoms over 5 months despite comprehensive conservative treatment before MRI revealed extensive osteolytic bone lesions in both diaphyseal tibiae. The patient-tailored, less-invasive surgical procedure, allowing the patient to return to his competitive sports level symptom-free 3 months after surgery and to eventually qualify for this years Biathlon Junior World Championships, is outlined briefly. Pathogenesis and various treatment options for this entity will be discussed. This report will help to raise awareness for musculoskeletal tumors as differential diagnosis for therapy-refractory symptoms in young athletes and encourage medical staff involved in sports medicine and athlete support to perform early high quality imaging and initiate sufficient surgical treatment in similar cases. Moreover, our less-invasive surgical procedure aiming for a fast return to sports might be an optimal compromise between traditional open curettage with low risk of recurrence and a soft tissue-saving and bone-sparing minimal-invasive technique.

Calcium Sulphate/Hydroxyapatite Carrier for Bone Formation in the Femoral Neck of Osteoporotic Rats.

PubMed

Sirka, Aurimas; Raina, Deepak Bushan; Isaksson, Hanna; Tanner, K Elizabeth; Smailys, Alfredas; Kumar, Ashok; Tarasevicius, Sarunas; Tägil, Magnus; Lidgren, Lars

2018-06-01

We investigated bone regeneration in the femoral neck canal of osteoporotic rats using a novel animal model. We used a calcium sulphate (CS)/ Hydroxyapatite (HA) carrier to locally deliver a bisphosphonate, zoledronic acid (ZA), with or without added recombinant human bone morphogenic protein-2 (rhBMP-2). Ovariectomized Sprague-Dawley rats of 28 weeks age were used. A 1 mm diameter and 8 mm long defect was created in the femoral neck by drilling from the lateral cortex in the axis of the femoral neck leaving the surrounding cortex intact. Three treatment groups and one control group were used 1) CS/HA alone, 2) CS/HA+ ZA (10 μg) 3) CS/HA+ZA (10 μg)+rhBMP-2 (4 μg) and 4) Empty defect. The bone formation was assessed at 4 weeks post-surgery using in vivo micro computed tomography (micro-CT). At 8 weeks post-surgery, the animals were sacrificed and both defect and contralateral femurs were subjected to micro-CT, mechanical testing and histology. Micro-CT results showed that the combination of CS/HA with ZA or ZA+rhBMP-2 increased the bone formation in the defect when compared to the other groups and to the contralateral hips. Evidence of new dense bone formation in CS/HA+ZA and CS/HA+ZA+rhBMP-2 groups was seen histologically. Mechanical testing results showed no differences in the load to fracture between the treatments in either of the treated or contralateral legs. The CS/HA biomaterial can be used as a carrier for ZA and rhBMP-2 to regenerate bone in the femoral neck canal of osteoporotic rats.

Correlation between μCT imaging, histology and functional capacity of the osteoarthritic knee in the rat model of osteoarthritis.

PubMed

Bagi, Cedo M; Zakur, David E; Berryman, Edwin; Andresen, Catharine J; Wilkie, Dean

2015-08-25

To acquire the most meaningful understanding of human arthritis, it is essential to select the disease model and methodology translatable to human conditions. The primary objective of this study was to evaluate a number of analytic techniques and biomarkers for their ability to accurately gauge bone and cartilage morphology and metabolism in the medial meniscal tear (MMT) model of osteoarthritis (OA). MMT surgery was performed in rats to induce OA. A dynamic weight bearing system (DWB) system was deployed to evaluate the weight-bearing capacity of the front and hind legs in rats. At the end of a 10-week study cartilage pathology was evaluated by micro computed tomography (μCT), contrast enhanced μCT (EPIC μCT) imaging and traditional histology. Bone tissue was evaluated at the tibial metaphysis and epiphysis, including the subchondral bone. Histological techniques and dynamic histomorphometry were used to evaluate cartilage morphology and bone mineralization. The study results showed a negative impact of MMT surgery on the weight-bearing capacity of the operated limb. Surgery caused severe and extensive deterioration of the articular cartilage at the medial tibial plateau, as evidenced by elevated CTX-II in serum, EPIC μCT and histology. Bone analysis by μCT showed thickening of the subchondral bone beneath the damaged cartilage, loss of cancellous bone at the metaphysis and active osteophyte formation. The study emphasizes the need for using various methodologies that complement each other to provide a comprehensive understanding of the pathophysiology of OA at the organ, tissue and cellular levels. Results from this study suggest that use of histology, μCT and EPIC μCT, and functional DWB tests provide powerful combination to fully assess the key aspects of OA and enhance data interpretation.

Normal Bone Microstructure and Density But Worse Physical Function in Older Women Treated with Selective Serotonin Reuptake Inhibitors, a Cross-Sectional Population-Based Study.

PubMed

Larsson, Berit; Mellström, Dan; Johansson, Lisa; Nilsson, Anna G; Lorentzon, Mattias; Sundh, Daniel

2018-05-05

Depression in the elderly is today often treated with selective serotonin reuptake inhibitors (SSRIs) because of their favorable adverse effect profile. However, treatment with SSRIs is associated with increased risk of fractures. Whether this increased risk depends on reduced bone strength or increased fall risk due to reduced physical function is not certain. The aim was therefore to investigate if treatment with SSRIs is associated with impaired bone microstructure, bone density, or physical function in older women. From an ongoing population-based study, 1057 women (77.7 ± 1.5 years) were included. Validated questionnaires were used to assess information regarding medical history, medications, smoking, mental and physical health, and physical activity. Physical function was measured using clinically used tests: timed up and go, walking speed, grip strength, chair stand test, and one leg standing. Bone mineral density (BMD) was measured at the hip and spine with dual-energy X-ray absorptiometry (Hologic Discovery A). Bone geometry and microstructure were measured at the ultradistal and distal (14%) site of radius and tibia using high-resolution peripheral quantitative computed tomography (HR-pQCT; XtremeCT). Treatment with SSRIs was associated with higher BMD at the femoral neck, total hip, and lumbar spine, whereas no associations were found for any HR-pQCT-derived measurements. The use of SSRIs was associated with lower grip strength, walking speed, and fewer chair stand rises. These associations were valid also after adjustments for known risk factors for falls. Treatment with SSRIs was, independently of covariates, associated with worse physical function without any signs of inferior bone geometry and microstructure.

Bone lead (Pb) content at the tibia is associated with thinner distal tibia cortices and lower volumetric bone density in postmenopausal women

PubMed Central

Wong, Andy K.O.; Beattie, Karen A.; Bhargava, Aakash; Cheung, Marco; Webber, Colin E.; Chettle, David R.; Papaioannou, Alexandra; Adachi, Jonathan D.

2016-01-01

Conflicting evidence suggests that bone lead or blood lead may reduce areal bone mineral density (BMD). Little is known about how lead at either compartment affects bone structure. This study examined postmenopausal women (N = 38, mean age 76 ± 8, body mass index (BMI): 26.74 ± 4.26 kg/m2) within the Hamilton cohort of the Canadian Multicentre Osteoporosis Study (CaMos), measuring bone lead at 66% of the non-dominant leg and at the calcaneus using 109Cadmium X-ray fluorescence. Volumetric BMD and structural parameters were obtained from peripheral quantitative computed tomography images (200 μm in-plane resolution, 2.3 ± 0.5 mm slice thickness) of the same 66% site and of the distal 4% site of the tibia length. Blood lead was measured using atomic absorption spectrometry and blood-to-bone lead partition coefficients (PBB, log ratio) were computed. Multivariable linear regression examined each of bone lead at the 66% tibia, calcaneus, blood lead and PBB as related to each of volumetric BMD and structural parameters, adjusting for age and BMI, diabetes or antiresorptive therapy. Regression coefficients were reported along with 95% confidence intervals. Higher amounts of bone lead at the tibia were associated with thinner distal tibia cortices (−0.972 (−1.882, −0.061) per 100 μg Pb/g of bone mineral) and integral volumetric BMD (−3.05 (−6.05, −0.05) per μg Pb/g of bone mineral). A higher PBB was associated with larger trabecular separation (0.115 (0.053, 0.178)), lower trabecular volumetric BMD (−26.83 (−50.37, −3.29)) and trabecular number (−0.08 (−0.14, −0.02)), per 100 μg Pb/g of bone mineral after adjusting for age and BMI, and remained significant while accounting for diabetes or use of antiresorptives. Total lead exposure activities related to bone lead at the calcaneus (8.29 (0.11, 16.48)) and remained significant after age and antiresorptives-adjustment. Lead accumulated in bone can have a mild insult on bone structure; but greater partitioning of lead in blood versus bone revealed more dramatic effects on both microstructure and volumetric BMD. PMID:25986335

Neurologic impairment from ectopic bone in the lumbar canal: a potential complication of off-label PLIF/TLIF use of bone morphogenetic protein-2 (BMP-2).

PubMed

Wong, David A; Kumar, Anant; Jatana, Sanjay; Ghiselli, Gary; Wong, Katherine

2008-01-01

Bone morphogenetic protein-2 (BMP-2) (Infuse) has been approved for use in anterior lumbar fusion in conjunction with an LT cage. However, off-label use is seen with anterior cervical fusion, posterior lumbar interbody fusion (PLIF), and transforaminal lumbar interbody fusion (TLIF). The Federal Food and Drug Administration trial of BMP-2 in a PLIF application was halted because of a high incidence of ectopic bone forming in the neural canal (75%). The authors did not find a correlation between ectopic bone and increased leg pain. They concluded that the ectopic bone was a radiographic phenomenon and not associated with clinical findings. Complications using BMP in the cervical spine have been reported. Heretofore, there has not been a similar warning voiced for use of BMP in a lumbar PLIF or TLIF. The purpose was to report five cases of ectopic bone in the canal associated with PLIF/TLIF off-label use of BMP-2 potentially contributing to abnormal neurologic findings. This is an observational cohort study of patients referred to a tertiary care private medical center. This was a retrospective chart review of patients referred to a tertiary spine institute with complications after surgery where BMP-2 had been used in an off-label PLIF or TLIF application. Patient demographics, operating room (OR) notes from the index BMP surgery, imaging studies, and current clinical status were reviewed. Five cases of ectopic bone in the spinal canal with potential neurologic compromise were identified. It does appear that ectopic bone in the spinal canal associated with BMP-2 use in PLIF or TLIF may contribute to symptomatic neurologic findings in rare cases. Revision surgeries are difficult. This article challenges a previous publication, which concluded that the high incidence of ectopic bone was of no clinical significance. Isolating BMP anteriorly in the disc space using layered barriers of bone graft between the BMP and the annular defect may reduce the incidence of ectopic bone in the spinal canal. Surgeons need to weigh the benefits versus risks of any technology used off label when making treatment decisions with their patients.

Technical requirements for Na¹⁸F PET bone imaging of patients being treated using a Taylor spatial frame.

PubMed

Hatherly, Robert; Brolin, Fredrik; Oldner, Åsa; Sundin, Anders; Lundblad, Henrik; Maguire, Gerald Q; Jonsson, Cathrine; Jacobsson, Hans; Noz, Marilyn E

2014-03-01

Diagnosis of new bone growth in patients with compound tibia fractures or deformities treated using a Taylor spatial frame is difficult with conventional radiography because the frame obstructs the images and creates artifacts. The use of Na(18)F PET studies may help to eliminate this difficulty. Patients were positioned on the pallet of a clinical PET/CT scanner and made as comfortable as possible with their legs immobilized. One bed position covering the site of the fracture, including the Taylor spatial frame, was chosen for the study. A topogram was performed, as well as diagnostic and attenuation correction CT. The patients were given 2 MBq of Na(18)F per kilogram of body weight. A 45-min list-mode acquisition was performed starting at the time of injection, followed by a 5-min static acquisition 60 min after injection. The patients were examined 6 wk after the Taylor spatial frame had been applied and again at 3 mo to assess new bone growth. A list-mode reconstruction sequence of 1 × 1,800 and 1 × 2,700 s, as well as the 5-min static scan, allowed visualization of regional bone turnover. With Na(18)F PET/CT, it was possible to confirm regional bone turnover as a means of visualizing bone remodeling without the interference of artifacts from the Taylor spatial frame. Furthermore, dynamic list-mode acquisition allowed different sequences to be performed, enabling, for example, visualization of tracer transport from blood to the fracture site.

An awake, minimally-invasive, fully-endoscopic surgical technique for treating lumbar radiculopathy secondary to heterotopic foraminal bone formation after a minimally invasive transforaminal lumbar interbody fusion with BMP: technical note

PubMed Central

2018-01-01

One complication associated with recombinant human bone morphogenetic protein (rhBMP-2) use in minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) is heterotopic bone growth at the neural foramen which results in the compression of neural structures. Here we present an awake, minimally invasive surgical approach for treating the radiculopathy that results from this excessive bone growth in the foramen. A 42-year-old male underwent a lumbar 4–sacral 1 MIS-TLIF by another surgeon. He did well in the initial postoperative period, but he began to note right leg pain and numbness in an L5 dermatomal pattern. The pain continued for 2 years despite interventional pain management, and he began to note left foot dorsiflexion weakness. An electromyography (EMG) showed a left L5 radiculopathy and a CT Lumbar spine demonstrated excessive bone growth in the right L4–5 neural foramen. The patient underwent an awake, endoscopic foraminotomy procedure utilizing a blunt tipped manual shaver drill system. The patient’s radicular symptoms improved immediately, and he remained asymptomatic at the 1 year follow up. Heterotopic foraminal bone growth is one potential complication of rhBMP-2 use in the MIS-TLIF procedure. The endoscopic procedure described here is a minimally invasive surgical option that can be performed in an awake patient and is suggested a unique salvage or rescue procedure to be considered for the treatment of this potential rhBMP-2 complication. PMID:29732437

Biomechanical analysis of iliac crest loading following cortico-cancellous bone harvesting.

PubMed

Schmitz, Paul; Cornelius Neumann, Christoph; Neumann, Carsten; Nerlich, Michael; Dendorfer, Sebastian

2018-05-09

Iliac crest bone harvesting is a frequently performed surgical procedure widely used to treat bone defects. The objective of this study is to assess the biomechanical quantities related to risk for pelvic fracture after harvesting an autologous bone graft at the anterior iliac crest. Finite element models with a simulated harvest site (sized 15 × 20 mm, 15 × 35 mm, 30 × 20 mm and 30 × 35 mm) in the iliac wing are created. The relevant loading case is when the ipsilateral leg is lifted off the ground. Musculoskeletal analysis is utilized to compute the muscle and joint forces involved in this motion. These forces are used as boundary conditions for the finite element analyses. Bone tissue stress is analyzed. Critical stress peaks are located between the anterior superior iliac spine (ASIS) and the anterior edge of the harvest site. Irrespective of the graft size, the iliac wing does not show any significant stress peaks with the harvest site being 20 to 25 mm posterior to the ASIS. The harvest area itself inhibits the distribution of the forces applied on the ASIS to extend to the posterior iliac wing. This leads to a lack of stress posterior to the harvest site. A balanced stress distribution with no stress peaks appears when the bone graft is taken below the iliac crest. A harvest site located at least 20 to 25 mm posterior to the ASIS should be preferred to minimize the risk of iliac fatigue fracture.

Exercise-Induced Changes in the Cortical Bone of Growing Mice Are Bone and Gender Specific

PubMed Central

Wallace, Joseph M.; Rajachar, Rupak M.; Allen, Matthew R.; Bloomfield, Susan A.; Robey, Pamela G.; Young, Marian F.; Kohn, David H.

2009-01-01

Fracture risk and mechanical competence of bone are functions of bone mass and tissue quality, which in turn are dependent on the bone’s mechanical environment. Male mice have a greater response to non weight-bearing exercise than females, resulting in larger, stronger bones compared with control animals. The aim of this study was to test the hypothesis that short-term weight-bearing running during growth (21 days starting at 8 weeks of age; 30 minutes/day; 12 meters/minute; 5° incline; 7 days/week) would similarly have a greater impact on cross sectional geometry and mechanical competence in the femora and tibiae of male mice versus females. Based on the orientation of the legs during running and the proximity of the tibia to the point of impact, this response was hypothesized to be greatest in the tibia. Exercise-related changes relative to controls were assayed by four-point bending tests, while volumetric bone mineral density and cross-sectional geometry were also assessed. The response to running was bone and gender-specific, with male tibiae demonstrating the greatest effects. In male tibiae, periosteal perimeter, endocortical perimeter, cortical area, medial-lateral width and bending moment of inertia increased versus control mice suggesting that while growth is occurring in these mice between 8 and 11 weeks of age, exercise accelerated this growth resulting in a greater increase in bone tissue over the 3 weeks of the study. Exercise increased tissue-level strain-to-failure and structural post-yield deformation in the male tibiae, but these post-yield benefits came at the expense of decreased yield deformation, structural and tissue-level yield strength and tissue-level ultimate strength. These results suggest that exercise superimposed upon growth accelerated growth-related increases in tibial cross-sectional dimensions. Exercise also influenced the quality of this forming bone, significantly impacting structural and tissue-level mechanical properties. PMID:17240210

Increases in IGF-1 After Anti-TNF-α Therapy Are Associated With Bone and Muscle Accrual in Pediatric Crohn Disease.

PubMed

DeBoer, Mark D; Lee, Arthur M; Herbert, Kirabo; Long, Jin; Thayu, Meena; Griffin, Lindsay M; Baldassano, Robert N; Denson, Lee A; Zemel, Babette S; Denburg, Michelle R; Herskovitz, Rita; Leonard, Mary B

2018-03-01

Low levels of insulinlike growth factor 1 (IGF-1) in pediatric and adolescent Crohn disease (CD) likely contribute to bone and muscle deficits. Assess changes in IGF-1 levels and associations with bone and muscle accrual following initiation of anti-tumor necrosis factor α (TNF-α) therapy in pediatric and adolescent CD. Participants (n = 75, age 5 to 21 years) with CD were enrolled in a prospective cohort study; 63 completed the 12-month visit. IGF-1 levels at baseline and 10 weeks, as well as dual-energy x-ray absorptiometry (DXA) and tibia peripheral quantitative computed tomography (pQCT) measures of bone and muscle at baseline and 12 months after initiation of anti-TNF-α therapy. Outcomes were expressed as sex-specific z scores. IGF-1 z scores increased from a median (interquartile range) of -1.0 (-1.58 to -0.17) to -0.36 (-1.04 to 0.36) over 10 weeks (P < 0.001). Lesser disease severity and systemic inflammation, as well as greater estradiol z scores (in girls), was significantly associated with greater IGF-1 z scores over time. DXA whole-body bone mineral content, leg lean mass, and total hip and femoral neck bone mineral density (BMD) z scores were low at baseline (P < 0.0001 vs reference data) and increased significantly (P < 0.001) over 12 months. Greater increases in IGF-1 z scores over 10 weeks predicted improvement in DXA bone and muscle outcomes and pQCT trabecular BMD and cortical area. Adjustment for changes in muscle mass markedly attenuated the associations between IGF-1 levels and bone outcomes. Short-term improvements in IGF-1 z scores predicted recovery of bone and muscle outcomes following initiation of anti-TNF-α therapy in pediatric CD. These data suggest that disease effects on growth hormone metabolism contribute to musculoskeletal deficits in CD.

Experience with free fibula transfer with screw fixation as a primary modality of treatment for congenital pseudarthosis of tibia in children - Series of 26 cases

PubMed Central

Kalra, Guru Dayal Singh; Agarwal, Amit

2012-01-01

Background: Congenital pseudarthrosis is one of the greatest challenges of paediatric orthopaedic practice. Treatment options and literature addressing this condition are numerous, reflecting the difficulty in management. We aimed to study the effectiveness of free fibula transfer as a primary modality of treatment in children with this condition in terms of achieving length, union, and normal axis of the involved leg. Materials and Methods: During the period of 2001 to 2010, 26 children with congenital pseudarthrosis of tibia between age group of 2-8 years were evaluated and were reconstructed using contra-lateral free fibula graft, and then patients were followed up for 5 years subsequently. Patients were examined and time of bony union, weight bearing ability and walking without support were noted. Any complication directly or indirectly related to surgery with any complication seen in the due course of follow up of 5 years was also taken care of. Results: In our experience with treatment of congenital pseudarthrosis over a span of 10 years with free fibula transfer, the results have been gratifying with no flap loss. All our patients had UNEVENTFUL post-op recovery. Only 2 patients out of 26 had non-union, for which cancellous bone grafting was done (7.6%). Most of the patients were ambulatory with support by 3-6 months and continued to walk without support after a span of 18-24 months. The incidence of stress fracture in our study over the follow-up period was 4 out of 26 pts (15.3%). None of them had any deformity in the donor leg. Conclusion: When compared to other surgical modalities of treatment of the problem in question, vascularised free fibula transfer has emerged as a real saviour with good patient compliance and less complication rate in our study. It achieves the desired target with no residual deformities and near normal to normal gait with no stigma of bone removal from other leg. PMID:23450675

Opportunities for exercise during pullet rearing, Part II: Long-term effects on bone characteristics of adult laying hens at the end-of-lay.

PubMed

Casey-Trott, T M; Korver, D R; Guerin, M T; Sandilands, V; Torrey, S; Widowski, T M

2017-08-01

Osteoporosis in laying hens has been a production and welfare concern for several decades. The objective of this study was to determine whether differing opportunities for exercise during pullet rearing influences long-term bone quality characteristics in end-of-lay hens. A secondary objective was to assess whether differing opportunities for exercise in adult housing systems alters bone quality characteristics in end-of-lay hens. Four flock replicates of 588 Lohmann Selected Leghorn-Lite pullets were reared in either conventional cages (Conv) or an aviary rearing system (Avi) and placed into conventional cages (CC), 30-bird furnished cages (FC-S), or 60-bird furnished cages (FC-L) for adult housing. Wing and leg bones were collected at the end-of-lay to quantify bone composition and strength using quantitative computed tomography and bone breaking strength (BBS). At the end-of-lay, Avi hens had greater total and cortical cross-sectional area (P < 0.05) for the radius and tibia, greater total bone mineral content of the radius (P < 0.001), and greater tibial cortical bone mineral content (P = 0.029) than the Conv hens; however, total bone mineral density of the radius (P < 0.001) and cortical bone mineral density of the radius and tibia (P < 0.001) were greater in the Conv hens. Hens in the FC-L had greater total bone mineral density for the radius and tibia (P < 0.05) and greater trabecular bone mineral density for the radius (P = 0.027), compared to hens in the FC-S and CC. Total bone mineral content of the tibia (P = 0.030) and cortical bone mineral content of the radius (P = 0.030) and tibia (P = 0.013) were greater in the FC-L compared to the CC. The humerus of Conv hens had greater BBS than the Avi hens (P < 0.001), and the tibiae of FC-L and FC-S hens had greater BBS than CC hens (P = 0.006). Increased opportunities for exercise offered by the aviary rearing system provided improved bone quality characteristics lasting through to the end-of-lay. © The Author 2017. Published by Oxford University Press on behalf of Poultry Science Association.

Effect of surface chemistry on the rate of osseointegration of sintered porous-surfaced Ti-6Al-4V implants.

PubMed

Taché, Alex; Gan, Lu; Deporter, Douglas; Pilliar, Robert M

2004-01-01

The effect of adding a thin sol-gel-formed calcium phosphate (CaP) coating to sintered porous-surfaced titanium alloy (Ti-6Al-4V) implants on rates of initial bone ingrowth was investigated. Control implants (as manufactured) and similar implants with sol-gel CaP coatings were randomly placed in distal femoral rabbit condyles (1 implant/leg). After healing for 6, 9, 12, and 16 days, 8 of 10 rabbits in each time group were assessed for maximum implant pullout force (N) and interface stiffness (N/mm). Selected extracted implants also were examined by secondary electron imaging to characterize affected surfaces. The implants of the remaining 2 rabbits in each group were examined by backscattered scanning electron microscopy (BSEM). Significantly greater pullout forces and interface stiffness were found for CaP-coated implants at 6 and 9 days. At 6 days, BSEM revealed bone ingrowth on CaP-coated implants but not on control implants. Secondary electron imaging and BSEM observations also suggested greater bone ingrowth with CaP-coated porous implants at 9, 12, and 16 days. Sol-gel-formed CaP surface films significantly enhance rates of bone ingrowth into sintered porous-surfaced implants. This surface treatment may have a number of clinical benefits, including shortening the period prior to functional loading of such implants and improving treatment outcomes in situations of poor bone quality and/or quantity. (More than 50 references).

The reverse sural artery fasciomusculocutaneous flap for small lower-limb defects: the use of the gastrocnemius muscle cuff as a plug for small bony defects following debridement of infected/necrotic bone.

PubMed

Al-Qattan, M M

2007-09-01

The reverse sural artery fasciomusculocutaneous flap is a modification of the original fasciocutaneous flap in which a midline gastrocnemius muscle cuff around the buried sural pedicle is included in the flap. This modification was done to improve the blood supply of the distal part of the flap, which is harvested from the upper leg. The aim of this paper is to demonstrate that there is another important advantage of the modified flap: the use of the muscle cuff as a "plug" for small lower limb defects following debridement of infected/necrotic bone. A total of 10 male adult patients with small complex lower-limb defects with underlying bone pathology were treated with the modified flap using the muscle component to fill up the small bony defects. The bony pathology included necrotic exposed bone without evidence of osteomyelitis or wound infection (n = 1), an underlying neglected tibial fracture with wound infection (n = 4), and a sinus at the heel with underlying calcaneal osteomyelitis (n = 5). Primary wound healing of the flap into the defect was noted in all patients. No recurrence of calcaneal osteomyelitis was seen and all tibial fractures united following appropriate orthopedic fixation. It was concluded that the reverse sural artery fasciomusculocutaneous flap is well suited for small complex lower-limb defects with underlying bone pathology.

Is bone mineral density measurement using dual-energy X-ray absorptiometry affected by gamma rays?

PubMed

Xie, Liang-Jun; Li, Jian-Fang; Zeng, Feng-Wei; Jiang, Hang; Cheng, Mu-Hua; Chen, Yi

2013-01-01

The objective of this study was to determine whether the gamma rays emitted from the radionuclide effect bone mineral density (BMD) measurement. Nine subjects (mean age: 56 ± 17.96 yr) scheduled for bone scanning underwent BMD measurement using dual-energy X-ray absorptiometry (DXA) (Hologic/Discovery A) before and 1, 2, and 4 h after injection of technetium-99m-methylene diphosphonate (99mTc-MDP). Ten subjects (mean age: 41 ± 15.47 yr) scheduled for therapy of differentiated thyroid carcinoma with iodine-131 underwent BMD measurement before and 2 h after therapeutic radionuclide administration. All patients were given whole body BMD measurement, including head, arm, ribs, lumbar spine, pelvis, and leg sites. Besides, patients who referred to radioiodine therapy were given total hip and femoral neck BMD measurement as well. No statistically significant changes in BMD values were detected after 99mTc-MDP and iodine-131 administration for all measurement sites (p > 0.05), and individual difference of BMD before and after radionuclide imaging or therapy was less than the least significant change in lumbar spine, total hip, and femoral neck. In conclusion, BMD measurements are not influenced by the gamma rays emitted from technetium-99m and iodine-131. DXA bone densitometry may be performed simultaneously with bone scanning and radioiodine therapy. Copyright © 2013 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

Reliability of upper and lower extremity anthropometric measurements and the effect on tissue mass predictions.

PubMed

Burkhart, Timothy A; Arthurs, Katherine L; Andrews, David M

2008-01-01

Accurate modeling of soft tissue motion effects relative to bone during impact requires knowledge of the mass of soft and rigid tissues in living people. Holmes et al., [2005. Predicting in vivo soft tissue masses of the lower extremity using segment anthropometric measures and DXA. Journal of Applied Biomechanics, 21, 371-382] developed and validated regression equations to predict the individual tissue masses of lower extremity segments of young healthy adults, based on simple anthropometric measurements. However, the reliability of these measurements and the effect on predicted tissue mass estimates from the equations has yet to be determined. In the current study, two measurers were responsible for collecting two sets of unilateral measurements (25 male and 25 female subjects) for the right upper and lower extremities. These included 6 lengths, 6 circumferences, 8 breadths, and 4 skinfold thicknesses. Significant differences were found between measurers and between sexes, but these differences were relatively small in general (75-80% of between-measurer differences were <1cm). Within-measurer measurement differences were smaller and more consistent than those between measurers in most cases. Good to excellent reliability was demonstrated for all measurement types, with intra-class correlation coefficients of 0.79, 0.86, 0.85 and 0.86 for lengths, circumferences, breadth and skinfolds, respectively. Predicted tissue mass magnitudes were moderately affected by the measurement differences. The maximum mean errors between measurers ranged from 3.2% to 24.2% for bone mineral content and fat mass, for the leg and foot, and the leg segments, respectively.

Physical tests for patient selection for bone mineral density measurements in postmenopausal women.

PubMed

Kärkkäinen, Matti; Rikkonen, Toni; Kröger, Heikki; Sirola, Joonas; Tuppurainen, Marjo; Salovaara, Kari; Arokoski, Jari; Jurvelin, Jukka; Honkanen, Risto; Alhava, Esko

2009-04-01

There is a need for cost-effective clinical methods to select women for bone densitometry. The aim of the present study was to determine whether relatively simple and clinically applicable physical tests could be useful in prediction of bone density in postmenopausal women. A total of 606 women (age range 66-71 years) taking part in the population based OSTPRE Fracture Prevention Study were investigated. Spinal and femoral bone mineral density (BMD) was measured by Dual X-ray Absorptiometry (DXA). Physical tests included the standing-on-one-foot (SOOF), grip strength (GS), leg extension strength, ability to squat down, standing 10 s eyes closed, chair rising, regular walk for 10 m and tandem walk for 6 m. All linear regression models were adjusted for age, body mass index, years on hormone therapy, years since menopause, current smoking and use of oral glucocorticoids. The SOOF was associated with lumbar spine BMD (r2=0.16, p=0.004) and the femoral regions (r2 values from 0.17 to 0.23 and p-values all<0.001). The GS was associated with lumbar spine BMD (r2=0.16, p=0.011) and the femoral regions (r2 values from 0.16 to 0.21 and p-values from <0.001 to 0.004). The ability to squat down on the floor was associated with the femoral regions (r2 values from 0.15 to 0.21 and p-values from 0.028 to 0.040). In addition, functional capacity was decreased in women with femoral neck osteoporosis (WHO classification) compared to women with normal or osteopenic BMD: SOOF -39% (p=0.001), GS -18% (p<0.001), leg extension strength -19% (p=0.007) and ability to squat down on the floor -40% (p=0.004). For osteoporosis prediction (ROC analysis) a threshold of a 22 kg in GS would yield a true-positive rate (sensitivity) of about 58% and a true-negative rate (specificity) of 86% (AUC 0.76). We suggest that grip strength could be used in medical decision making to identify those women who would benefit from BMD measurements albeit alone it may not provide accurate enough tool for osteoporosis screening.

[Adapted physical activity in the prevention and therapy of osteoporosis].

PubMed

Bosković, Ksenija; Gava, Branka Protić; Grajić, Mirko; Madić, Dejan; Obradović, Borislav; Todorović, Snezana Tomasević

2013-01-01

Osteoporosis, a disease characterized by the progressive loss of bone tissue, is one of the most common complications of aging. According to some calculations, there were 25% of women and 4% of men older than 50 years with osteoporosis in the world in 2010. It is assumed that the number of patients with osteoporosis will increase by 30% in every 10 years in the 21st century. There are many reasons for that: the world's population is growing older, diet is getting poorer in vitamins and minerals and physical activity is decreasing. THE QUALITY AND QUANTITY OF BONE TISSUE: Developing bones are much more responsive to mechanical loading and physical activity than mature bones. This suggests that training in early childhood may be an important factor in the prevention of osteoporosis in later life. It is important to note that the quality of bone achieved by training at younger age cannot be maintained permanently if it is not supported by physical activity later in life. Adapted physical activity represents physical activity individually tailored according to the psychosomatic capabilities of a person and the goal to be achieved. It can be applied at any age in order to maintain strong bones and reduce the risk of fracture. Adapted physical activity is different for men and women, for different age, as well as for the individuals. Aerobic exercises, which lead to an acceleration of breathing, increased heart rate and mild perspiration, as well as resistance exercises and exercises against resistance done by stretching elastic bands, for hands, legs and torso have been proven to increase bone density and improve bone strength. Coordination and balance exercises are important in an individual workout program. An explanation of the action of adapted physical activity is the basis for the theory of control and modulation of bone loss, muscle strength, coordination and balance. Physical activity is very effective in reducing sclerostin, which is known to inhibit bone formation. In addition, physical training enhances the levels of insulinlike growth factor, which has a very positive effect on bone formation. The aim of adapted physical activity is to improve bone formation in youngsters, to preserve the bone mass in adults and to prevent the bone loss in the elderly thus reducing the risk of falls and resulting fractures; in other words, to minimize the disability caused by fractures and improve the quality of life.

[Stump forming after traumatic foot amputation of a child--description of a new surgical procedure and literature review of lawnmower accidents].

PubMed

Bayer, J; Zajonc, H; Strohm, P C; Vohrer, M; Maier-Lenz, D; Südkamp, N P; Schwering, L

2009-01-01

Amputation injuries in children occur in motor vehicle, farming and, importantly, lawn mower accidents. Treatment of lawn mower related injuries is complicated by gross wound contamination, avascular tissue, soft tissue defects and exposed bone. Many treatment options exist and often an adequate prosthetic supply is needed for rehabilitation. We report on an 8-year old boy who got under a ride-on lawn mower and sustained a subtotal amputation of his right foot. After initial surgery an amputation was subsequently necessary. For this, it had to be taken into account that the traumatic loss of the talus, calcaneus and parts of the cuboid bone would result in a length shortening of the right leg and so far not injured metatarsal and tarsal bones had to be sacrificed. Thus, we aimed to develop a new operation technique to optimize stump length as well as preserve tarsal bones and the possibility of limb growth. In order to achieve this, we performed a new stump forming operation in which we integrated uninjured tarsal and metatarsal bones. First a Lisfranc's amputation was performed and a metatarsal bone was kept aside. The talus, calcaneus as well as the cuboid bone were either completely or almost completely destroyed and were removed. The remaining cuneiform bones were transfixed by a notched metatarsal bone, thus achieving a tarsal arthrodesis, and the cartilages of the proximal joint surfaces were removed. The cartilage of the cranial and caudal navicular as well as the distal tibial joint surface was also removed and an arthrodesis between the distal tibia and the navicular bone was achieved by crossed Kirschner wires. Finally the cuneiform bones were placed inferior to the navicular bone. Further stump coverage was managed by skin and muscle flaps as well as split skin graft. Our patient was discharged on day 34. A fluent gait without crutches as well as sports activities were possible again as early as 6 1/2 months after the injury. Using our stump forming technique we hope to prevent some complications of amputation injuries. Because of the intact epiphysis a bone overgrowth is hopefully prevented and growth potential is preserved and by inclusion of tarsal and metatarsal bones in the stump formation a length discrepancy is minimized. (c) Georg Thieme Verlag KG Stuttgart-New York.

Later Age at Onset of Independent Walking Is Associated With Lower Bone Strength at Fracture-Prone Sites in Older Men.

PubMed

Ireland, Alex; Muthuri, Stella; Rittweger, Joern; Adams, Judith E; Ward, Kate A; Kuh, Diana; Cooper, Rachel

2017-06-01

Later age at onset of independent walking is associated with lower leg bone strength in childhood and adolescence. However, it is unknown whether these associations persist into older age or whether they are evident at axial (central) or upper limb sites. Therefore, we examined walking age obtained at age 2 years and bone outcomes obtained by dual-energy X-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT) scans at ages 60 to 64 years in a nationally representative cohort study of British people, the MRC National Survey of Health and Development. It was hypothesized that later walking age would be associated with lower bone strength at all sites. Later independent walking age was associated with lower height-adjusted hip (standardized regression coefficients with 95% confidence interval [CI] -0.179 [-0.251 to -0.107]), spine (-0.157 [-0.232 to -0.082]), and distal radius (-0.159 [-0.245 to -0.073]) bone mineral content (BMC, indicating bone compressive strength) in men (all p < 0.001). Adjustment for covariates partially attenuated these associations, primarily because of lower lean mass and adolescent sporting ability in later walkers. These associations were also evident for a number of hip geometric parameters (including cross-sectional moment of inertia [CSMI], indicating bone bending/torsional strength) assessed by hip structural analysis (HSA) from DXA scans. Similar height-adjusted associations were also observed in women for several hip, spine, and upper limb outcomes, although adjustment for fat or lean mass led to complete attenuation for most outcomes, with the exception of femoral shaft CSMI and spine bone area (BA). In conclusion, later independent walking age appears to have a lifelong association with bone strength across multiple skeletal sites in men. These effects may result from direct effects of early life loading on bone growth and mediation by adult body composition. Results suggest that late walking age may represent a novel risk factor for subsequent low bone strength. Existing interventions effective in hastening walking age may have positive effects on bone across life. © 2017 The Authors. Journal of Bone and Mineral Research Published by Wiley Periodicals Inc. © 2017 The Authors. Journal of Bone and Mineral Research Published by Wiley Periodicals Inc.

Parathormone--25(OH)-vitamin D axis and bone status in children and adolescents with type 1 diabetes mellitus.

PubMed

Hamed, Enas A; Faddan, Nagla H Abu; Elhafeez, Hebh A Adb; Sayed, Douaa

2011-09-01

Skeletal involvement in patients with type 1 diabetes mellitus (T1DM) has complex pathogenesis and despite numerous researches on this problem, many questions remain unanswered. This study aimed to assess bone status by measurement parathormone (PTH), 25-hydroxy vitamin D [25(OH)D] serum levels in children and adolescents with T1DM and its relation to insulin-like growth factor-1 (IGF-1), disease duration, puberty stage, and metabolic control. This study included 36 children and adolescents with T1DM and 15 apparently healthy controls. Serum levels of 25(OH)D, PTH, IGF-1 measured using enzyme-linked immunosorbent assay (ELISA), while glycosylated hemoglobin (HbA1c), calcium (Ca), inorganic phosphorus (PO(4) ) using autoanalyzer. Bone quality assessed using dual energy X-ray absorptiometry (DEXA). Diabetic patients showed significant increase in PO(4) and PTH levels, while significant decrease in Ca, IGF-1, and 25(OH)D serum levels. As much as 52.8% of patients showed reduced 25(OH)D, and 30.65% showed elevated PTH serum levels. In diabetic patients, abnormal bone status (osteopenia-osteoporosis) found mostly in total body (94.40%) then lumber-spine (88.90%), ribs (88.90%), pelvis (86.10%), thoracic-spine (80.60%), arms (80.60%) and legs (77.80%), while head bones showed no abnormalities. Long diabetic duration had negative; meanwhile PTH, onset age, and puberty age had positive impact on bone status. Children and adolescent with T1DM have abnormal bone status mostly in axial skeleton which may be contributed to impairment of formation of 25(OH)D and IGF-1. Physical activity, calcium and vitamin D supplement seem important in T1DM. Elevated serum PTH level in diabetic patients is not uncommon and its positive correlation with bone status needs further investigations. © 2011 John Wiley & Sons A/S.

An aggressive chondroblastoma of the knee treated with resection arthrodesis and limb lengthening using the Ilizarov technique

PubMed Central

2010-01-01

This case report describes the management of a 15 year old male with a biologically aggressive chondroblastoma of the knee. Following CT, bone scan, angiography and an open biopsy, the diagnosis was confirmed histologically and immunohistochemically. The patient underwent a 13 cm en-bloc excision of the knee, and knee arthrodesis with simultaneous bone transport using an Ilizarov ring fixator. Following 136 days of bone transport, the patient achieved radiological and clinical bony union after a total frame time of 372 days. He then commenced 50% partial weight-bear in a protective knee brace and gradually worked up to full weight-bearing by 4 months. The patient developed superficial pin tract infections around the k-wires on 2 occasions; these settled with a cephalosporin antibiotic spray and local dressings. At 13 years follow-up there are no signs of disease recurrence or failure at the fusion site. The patient is able to fully weight bear and stand independently on the operated leg. Knee arthrodesis with simultaneous limb-lengthening is an effective treatment modality following en-bloc resection of an aggressive chondroblastoma. The case is discussed with reference to the literature. PMID:20667131

In Vivo Caprine Model for Osteomyelitis and Evaluation of Biofilm-Resistant Intramedullary Nails

PubMed Central

Tran, Nhiem; Tran, Phong A.; Jarrell, John D.; Engiles, Julie B.; Thomas, Nathan P.; Young, Matthew D.; Hayda, Roman A.; Born, Christopher T.

2013-01-01

Bone infection remains a formidable challenge to the medical field. The goal of the current study is to evaluate antibacterial coatings in vitro and to develop a large animal model to assess coated bone implants. A novel coating consisting of titanium oxide and siloxane polymer doped with silver was created by metal-organic methods. The coating was tested in vitro using rapid screening techniques to determine compositions which inhibited Staphylococcus aureus growth, while not affecting osteoblast viability. The coating was then applied to intramedullary nails and evaluated in vivo in a caprine model. In this pilot study, a fracture was created in the tibia of the goat, and Staphylococcus aureus was inoculated directly into the bone canal. The fractures were fixed by either coated (treated) or non-coated intramedullary nails (control) for 5 weeks. Clinical observations as well as microbiology, mechanical, radiology, and histology testing were used to compare the animals. The treated goat was able to walk using all four limbs after 5 weeks, while the control was unwilling to bear weight on the fixed leg. These results suggest the antimicrobial potential of the hybrid coating and the feasibility of the goat model for antimicrobial coated intramedullary implant evaluation. PMID:23841085

Magnetic resonance imaging in stress fractures and shin splints.

PubMed

Aoki, Yoshimitsu; Yasuda, Kazunori; Tohyama, Harukazu; Ito, Hirokazu; Minami, Akio

2004-04-01

The purpose of the current study was to determine whether stress fractures and shin splints could be discriminated with MRI in the early phase. Twenty-two athletes, who had pain in the middle or distal part of their leg during or after sports activity, were evaluated with radiographs and MRI scans. Stress fractures were diagnosed when consecutive radiographs showed local periosteal reaction or a fracture line, and shin splints were diagnosed in all the other cases. In all eight patients with stress fractures, an abnormally wide high signal in the localized bone marrow was the most detectable in the coronal fat-suppressed MRI scan. In 11 patients with shin splints, the coronal fat-suppressed MRI scans showed a linear abnormally high signal along the medial posterior surface of the tibia, and in seven patients with shin splints, the MRI scans showed a linear abnormally high signal along the medial bone marrow. No MRI scans of shin splints showed an abnormally wide high signal in the bone marrow as observed on MRI scans of stress fractures. This study showed that fat-suppressed MRI is useful for discrimination between stress fracture and shin splints before radiographs show a detectable periosteal reaction in the tibia.

Cerebral Myiasis Associated with Artificial Cranioplasty Flap: A Case Report.

PubMed

Giri, Sachin Ashok; Kotecha, Nitin; Giri, Deepali; Diyora, Batuk; Nayak, Naren; Sharma, Alok

2016-03-01

Cranioplasty is a commonly performed procedure for the repair of cranial defects. Various materials have been used for this procedure and have a good safety profile. Human cerebral myiasis is an exceedingly rare condition. It involves the invasion of live or dead human tissues by larvae of the insect species dipterous. We describe the first case of cerebral myiasis associated with an artificial cranioplasty bone flap. There was delayed cerebral cortex infestation of the species dipterous after cranioplasty with polymethyl methacrylate bone flap. The patient initially presented with an acute subdural hematoma and contaminated, comminuted frontal bone fracture that required craniectomy with interval cranioplasty at 3 months. Two years after the index procedure, the patient presented for neurosurgical follow-up because of 2 months of nonhealing ulcers and a foul smell emanating from the cranioplasty site, as well as acute onset of unilateral arm and leg weakness. Surgical exploration found live larvae invading the dura and cerebral cortex, an area that was thoroughly debrided with good outcomes for the patient. Cerebral myiasis can be managed via surgical and antibiotic therapy to obtain a good clinical outcome. Copyright © 2016 Elsevier Inc. All rights reserved.

Osmotically driven tensile stress in collagen-based mineralized tissues.

PubMed

Bertinetti, Luca; Masic, Admir; Schuetz, Roman; Barbetta, Aurelio; Seidt, Britta; Wagermaier, Wolfgang; Fratzl, Peter

2015-12-01

Collagen is the most abundant protein in mammals and its primary role is to serve as mechanical support in many extracellular matrices such as those of bones, tendons, skin or blood vessels. Water is an integral part of the collagen structure, but its role is still poorly understood, though it is well-known that the mechanical properties of collagen depend on hydration. Recently, it was shown that the conformation of the collagen triple helix changes upon water removal, leading to a contraction of the molecule with considerable forces. Here we investigate the influence of mineralization on this effect by studying bone and turkey leg tendon (TLT) as model systems. Indeed, TLT partially mineralizes so that well-aligned collagen with various mineral contents can be found in the same tendon. We show that water removal leads to collagen contraction in all cases generating tensile stresses up to 80MPa. Moreover, this contraction of collagen puts mineral particles under compression leading to strains of around 1%, which implies localized compressive loads in mineral of up to 800MPa. This suggests that collagen dehydration upon mineralization is at the origin of the compressive pre-strains commonly observed in bone mineral. Copyright © 2015 Elsevier Ltd. All rights reserved.

Femoral Reconstruction Using External Fixation

PubMed Central

Palatnik, Yevgeniy; Rozbruch, S. Robert

2011-01-01

Background. The use of an external fixator for the purpose of distraction osteogenesis has been applied to a wide range of orthopedic problems caused by such diverse etiologies as congenital disease, metabolic conditions, infections, traumatic injuries, and congenital short stature. The purpose of this study was to analyze our experience of utilizing this method in patients undergoing a variety of orthopedic procedures of the femur. Methods. We retrospectively reviewed our experience of using external fixation for femoral reconstruction. Three subgroups were defined based on the primary reconstruction goal lengthening, deformity correction, and repair of nonunion/bone defect. Factors such as leg length discrepancy (LLD), limb alignment, and external fixation time and complications were evaluated for the entire group and the 3 subgroups. Results. There was substantial improvement in the overall LLD, femoral length discrepancy, and limb alignment as measured by mechanical axis deviation (MAD) and lateral distal femoral angle (LDFA) for the entire group as well as the subgroups. Conclusions. The Ilizarov external fixator allows for decreased surgical exposure and preservation of blood supply to bone, avoidance of bone grafting and internal fixation, and simultaneous lengthening and deformity correction, making it a very useful technique for femoral reconstruction. PMID:21991425

[Fat embolism syndrome following lower limb fracture despite rapid external fixation. Two case reports and review of the literature].

PubMed

Kleinert, K; Marug, D; Soklic, P; Simmen, H-P

2009-09-01

Fat embolism syndrome (FES) is a rare complication occurring in 0.9-2.2% of patients following long bone fractures. Patients present with a classical triad of respiratory manifestations, cerebral effects and petechiae. The incidence of FES is reduced by early immobilization of fractures and by minimally invasive operative management. Nevertheless, two healthy young men suffered from FES after immediate (within 3 h after trauma) external fixation of lower leg fractures. This postoperative complication should always be considered even after conservative or minimally invasive therapy.

Computed tomography of coxofemoral injury in five mute swans (Cygnus olor).

PubMed

Gumpenberger, Michaela; Scope, Alexandra

2012-10-01

Five mute swans (Cygnus olor) were presented with inability to stand or with abnormal positioning of a leg. Clinical examinations indicated the possibility of femoral fractures or coxofemoral luxations. The suspected diagnosis was proven by means of computed tomography (CT), while superimposition of gastrointestinal contents or other artefacts limited radiographic diagnosis in three birds. A typical CT sign for lesions of the coxofemoral joint apart from femoral displacement was haemorrhage within the pelvic bones (especially around the acetabulum), found in four of the five birds. Small femoral head avulsion fractures could be detected only with CT.

[Subtalar arthrodesis].

PubMed

Fuhrmann, R A; Pillukat, T

2016-06-01

Realignment and stabilization of the hindfoot by subtalar joint arthrodesis. Idiopathic/posttraumatic arthritis, inflammatory arthritis of the subtalar joint with/without hindfoot malalignment. Optional flatfoot/cavovarus foot reconstruction. Inflammation, vascular disturbances, nicotine abuse. Approach dependent on assessment. Lateral approach: Supine position. Incision above the sinus tarsi. Exposure of subtalar joint. Removal of cartilage and breakage of the subchondral sclerosis. In valgus malalignment, interposition of corticocancellous bone segment; in varus malalignment resection of bone segment from the calcaneus. Reposition and temporarily stabilization with Kirschner wires. Imaging of hindfoot alignment. Stabilization with cannulated screws. Posterolateral approach: Prone position. Incision parallel to the lateral Achilles tendon border. Removal of cartilage and breakage of subchondral sclerosis. Medial approach: Supine position. Incision just above and parallel to the posterior tibial tendon. Removal of cartilage and breakage of subchondral sclerosis. Stabilization with screws. Lower leg walker with partial weightbearing. Active exercises of the ankle. After a 6‑week X‑ray, increase of weightbearing. Full weightbearing not before 8 weeks; with interpositioning bone grafts not before 10-12 weeks. Stable walking shoes. Active mobilization of the ankle. Of 43 isolated subtalar arthrodesis procedures, 5 wound healing disorders and no infections developed. Significantly improved AOFAS hindfood score. Well-aligned heel observed in 34 patients; 5 varus and 2 valgus malalignments. Sensory disturbances in 8 patients; minor ankle flexion limitations. Full bone healing in 36 subtalar joints, pseudarthrosis in 4 patients.

Dosimetric comparison between VMAT with different dose calculation algorithms and protons for soft-tissue sarcoma radiotherapy.

PubMed

Fogliata, Antonella; Scorsetti, Marta; Navarria, Piera; Catalano, Maddalena; Clivio, Alessandro; Cozzi, Luca; Lobefalo, Francesca; Nicolini, Giorgia; Palumbo, Valentina; Pellegrini, Chiara; Reggiori, Giacomo; Roggio, Antonella; Vanetti, Eugenio; Alongi, Filippo; Pentimalli, Sara; Mancosu, Pietro

2013-04-01

To appraise the potential of volumetric modulated arc therapy (VMAT, RapidArc) and proton beams to simultaneously achieve target coverage and enhanced sparing of bone tissue in the treatment of soft-tissue sarcoma with adequate target coverage. Ten patients presenting with soft-tissue sarcoma of the leg were collected for the study. Dose was prescribed to 66.5 Gy in 25 fractions to the planning target volume (PTV) while significant maximum dose to the bone was constrained to 50 Gy. Plans were optimised according to the RapidArc technique with 6 MV photon beams or for intensity modulated protons. RapidArc photon plans were computed with: 1) AAA; 2) Acuros XB as dose to medium; and 3) Acuros XB as dose to water. All plans acceptably met the criteria of target coverage (V95% >90-95%) and bone sparing (D(1 cm3) <50 Gy). Significantly higher PTV dose homogeneity was found for proton plans. Near-to-maximum dose to bone was similar for RapidArc and protons, while volume receiving medium/low dose levels was minimised with protons. Similar results were obtained for the remaining normal tissue. Dose distributions calculated with the dose to water option resulted ~5% higher than corresponding ones computed as dose to medium. High plan quality was demonstrated for both VMAT and proton techniques when applied to soft-tissue sarcoma.

Effect of ethnicity and sex on the growth of the axial and appendicular skeleton of children living in a developing country.

PubMed

Nyati, Lukhanyo H; Norris, Shane A; Cameron, Noel; Pettifor, John M

2006-05-01

Bones in the axial and appendicular skeletons exhibit heterogeneous growth patterns between different ethnic and sex groups. However, the influence of this differential growth on the expression of bone mineral content is not yet established. The aims of the present study were to investigate: 1) whether there are ethnic and sex differences in axial and appendicular dimensions of South African children; and 2) whether regional segment length is a better predictor of bone mass than stature. Anthropometric measurements of stature, weight, sitting height, and limb lengths were taken on 368 black and white, male and female 9-year-old children. DXA (dual-energy x-ray absorptiometry) scans of the distal ulna, distal radius, and hip and lumbar spine were also obtained. Analyses of covariance were performed to assess differences in limb lengths, adjusted for differences in stature. Multiple regression analyses were used to assess significant predictors of site-specific bone mass. Stature-adjusted means of limb lengths show that black boys have longer legs and humeri but shorter trunks than white boys. In addition, black children have longer forearms than white children, and girls have longer thighs than boys. The regression analysis demonstrated that site-specific bone mass was more strongly associated with regional segment length than stature, but this had little effect on the overall pattern of ethnic and sex differences. In conclusion, there is a differential effect of ethnicity and sex on the growth of the axial and appendicular skeletons, and regional segment length is a better predictor of site-specific bone mass than stature. Copyright 2005 Wiley-Liss, Inc.

Systematic review of raloxifene in postmenopausal Japanese women with osteoporosis or low bone mass (osteopenia)

PubMed Central

Fujiwara, Saeko; Hamaya, Etsuro; Sato, Masayo; Graham-Clarke, Peita; Flynn, Jennifer A; Burge, Russel

2014-01-01

Purpose To systematically review the literature describing the efficacy, effectiveness, and safety of raloxifene for postmenopausal Japanese women with osteoporosis or low bone mass (osteopenia). Materials and methods Medline via PubMed and Embase was systematically searched using prespecified terms. Retrieved publications were screened and included if they described randomized controlled trials or observational studies of postmenopausal Japanese women with osteoporosis or osteopenia treated with raloxifene and reported one or more outcome measures (change in bone mineral density [BMD]; fracture incidence; change in bone-turnover markers, hip structural geometry, or blood–lipid profile; occurrence of adverse events; and change in quality of life or pain). Excluded publications were case studies, editorials, letters to the editor, narrative reviews, or publications from non-peer-reviewed journals; multidrug, multicountry, or multidisease studies with no drug-, country-, or disease-level analysis; or studies of participants on dialysis. Results Of the 292 publications retrieved, 15 publications (seven randomized controlled trials, eight observational studies) were included for review. Overall findings were statistically significant increases in BMD of the lumbar spine (nine publications), but not the hip region (eight publications), a low incidence of vertebral fracture (three publications), decreases in markers of bone turnover (eleven publications), improved hip structural geometry (two publications), improved blood–lipid profiles (five publications), a low incidence of hot flushes, leg cramps, venous thromboembolism, and stroke (12 publications), and improved quality of life and pain relief (one publication). Conclusion Findings support raloxifene for reducing vertebral fracture risk by improving BMD and reducing bone turnover in postmenopausal Japanese women with osteoporosis or osteopenia. Careful consideration of fracture risk and the risk–benefit profile of antiosteoporosis medications is required when managing patients with osteoporosis. PMID:25395843

Systematic review of raloxifene in postmenopausal Japanese women with osteoporosis or low bone mass (osteopenia).

PubMed

Fujiwara, Saeko; Hamaya, Etsuro; Sato, Masayo; Graham-Clarke, Peita; Flynn, Jennifer A; Burge, Russel

2014-01-01

To systematically review the literature describing the efficacy, effectiveness, and safety of raloxifene for postmenopausal Japanese women with osteoporosis or low bone mass (osteopenia). Medline via PubMed and Embase was systematically searched using prespecified terms. Retrieved publications were screened and included if they described randomized controlled trials or observational studies of postmenopausal Japanese women with osteoporosis or osteopenia treated with raloxifene and reported one or more outcome measures (change in bone mineral density [BMD]; fracture incidence; change in bone-turnover markers, hip structural geometry, or blood-lipid profile; occurrence of adverse events; and change in quality of life or pain). Excluded publications were case studies, editorials, letters to the editor, narrative reviews, or publications from non-peer-reviewed journals; multidrug, multicountry, or multidisease studies with no drug-, country-, or disease-level analysis; or studies of participants on dialysis. Of the 292 publications retrieved, 15 publications (seven randomized controlled trials, eight observational studies) were included for review. Overall findings were statistically significant increases in BMD of the lumbar spine (nine publications), but not the hip region (eight publications), a low incidence of vertebral fracture (three publications), decreases in markers of bone turnover (eleven publications), improved hip structural geometry (two publications), improved blood-lipid profiles (five publications), a low incidence of hot flushes, leg cramps, venous thromboembolism, and stroke (12 publications), and improved quality of life and pain relief (one publication). Findings support raloxifene for reducing vertebral fracture risk by improving BMD and reducing bone turnover in postmenopausal Japanese women with osteoporosis or osteopenia. Careful consideration of fracture risk and the risk-benefit profile of antiosteoporosis medications is required when managing patients with osteoporosis.

Skeletal response to diet with soya bean seeds used as primary source of protein in growing broiler chickens.

PubMed

Olkowski, B; Charuta, A; Radzki, R; Bieńko, M; Toczko, R

2016-08-01

The study was conducted using 120 commercial broiler chicks (Ross 308) randomly allocated to two experimental groups. The experimental diets, differing only in protein source, either solvent-extracted soya bean meal (SBM) or traditional (non-genetically modified) full-fat soya bean seeds (FFS), were prepared using practical corn-based formulation designed to meet nutritional requirements of broilers. Performance parameters were monitored weekly. Also, the subjects were evaluated daily for overt changes in skeletal anatomy and gait physiology. Randomly selected chickens from each group (seven males and seven females) were euthanized at 2, 3, 4 and 6 weeks of age, and bone specimens were collected for further study. Bone mineral density (BMD) and bone mineral content (BMC) were determined in tibiotarsal bones. Broilers fed FFS diet showed retarded growth rate and decreased feed intake (both p < 0.001). Both BMD and BMC parameters were significantly lower (p < 0.05) in bones of chickens from the FFS group in comparison with the SBM group. The chickens fed the FFS diet showed higher incidence of skeletal pathology including angular deformities and torticollis (both p < 0.01). Of note, cases of torticollis were observed only in FFS group. In many cases, skeletal abnormalities resulted in considerable changes in gait pattern, and in some instances, the pathology of leg bones was so advanced that the affected individuals were unable to walk, but this deformity was not seen in SBM group. From this study, it can be inferred that raw soya beans contain factors that have some specific detrimental effects on skeletal system of chickens. Journal of Animal Physiology and Animal Nutrition © 2016 Blackwell Verlag GmbH.

Nutritional factors affecting poultry bone health.

PubMed

Fleming, Robert H

2008-05-01

Outlined are two main current research concerns relating to skeletal disorders in poultry: (a) osteoporosis in egg-laying hens; (b) leg problems caused by rapid bone growth in broiler chickens. Surveys indicate that 30% of caged laying hens suffer at least one lifetime fracture (a severe welfare issue). Modern hybrids produce one egg per d for 50 weeks. For this period 'normal' bone turnover ceases; only medullary bone (MB) is formed, a woven bone type of limited structural value. MB is resorbed for eggshell formation alongside structural bone, leading to increased fracture risk. Avian osteoporosis is reduced by activity and genetic selection but nutrition is also important. Fluoride and vitamin K are beneficial but the timing of nutritional intervention is important. Ca, inorganic P and vitamin D must be adequate and the form of Ca is critical. Limestone fed as particulates benefits skeletal and eggshell quality. In hens fed particulate limestone compared with flour-fed hens the tibiotarsus breaking strength and radiographic density are increased at 56 weeks of age (P<0.01 and P<0.001 respectively) and the number of tartrate-resistant acid phosphatase-positive stained active osteoclasts (mean number per microscopic field) is decreased (P<0.001). In broiler (meat) chickens selection for rapid growth from approximately 50 g to 3 kg in 42 d has inadvertently produced skeletal disorders such as tibial dyschondroplasia, rickets and associated valgus-varus deformities leading to lameness. The beneficial skeletal effects during growth of increased dietary n-3 PUFA:n-6 PUFA (utilising salmon oil) have been demonstrated. Experiments simulating daylight UVB levels have produced beneficial skeletal effects in Ca- and vitamin D-deficient chicks.

Whole Body Vibration Training is Osteogenic at the Spine in College-Age Men and Women.

PubMed

Ligouri, Gianna C; Shoepe, Todd C; Almstedt, Hawley C

2012-03-01

Osteoporosis is a chronic skeletal disease characterized by low bone mass which is currently challenging the American health care system. Maximizing peak bone mass early in life is a cost-effective method for preventing osteoporosis. Whole body vibration (WBV) is a novel exercise method with the potential to increase bone mass, therefore optimizing peak bone and decreasing the risk for osteoporotic fracture. The aim of this investigation was to evaluate changes in bone mineral density at the hip, spine, and whole body in college-age men and women who underwent a WBV training protocol. Active men (n=6) and women (n=4), ages 18-22 participated in the WBV training; while an additional 14 volunteers (1 male, 13 female) served as controls. All participants completed baseline and follow-up questionnaires to assess health history, physical activity, dietary intake, and menstrual history. The WBV training program, using a Vibraflex 550, incorporated squats, stiff-leg dead lifts, stationary lunges, push-up holds, bent-over rows, and jumps performed on the platform, and occurred 3 times a week, for 12 weeks. Dual energy x-ray absorptiometry (Hologic Explorer, Waltham, MA, USA) was used to assess bone mineral density (BMD, g/cm(2)). A two-tailed, t-test identified significantly different changes in BMD between the WBV and control groups at the lateral spine (average change of 0.022 vs. -0.015 g/cm(2)). The WBV group experienced a 2.7% and 1.0% increase in BMD in the lateral spine and posterior-anterior spine while the control group decreased 1.9% and 0.9%, respectively. Results indicate that 12 weeks of WBV training was osteogenic at the spine in college-age men and women.

Measurement of bone adjacent to tibial shaft fracture.

PubMed

Findlay, S C; Eastell, R; Ingle, B M

2002-12-01

Delayed union and non-union are common complications after fracture of the tibial shaft. Response of the surrounding bone as a fracture heals could be monitored using techniques currently used in the study of osteoporosis. The aims of our study were to: (1) evaluate the decrement in bone measurements made close to the fracture using dual-energy X-ray absorptiometry (DXA), quantitative ultrasound (QUS) and peripheral quantitative computed tomography (pQCT); (2) compare values for fractured versus non-fractured leg to determine the duration of decrement in bone measurements; and (3) calculate short-term precision in DXA, QUS and pQCT in order to calculate the ratio of decrement to precision (response ratio, RR) to determine the optimal test for monitoring changes after tibial fracture. The biggest decrement in bone measurements at the ipsilateral limb of 28 patients with tibial shaft fracture was observed at the pQCT tibial trabecular sites (distal = 19%, p<0.0001; proximal 5% = 21%, p<0.001; proximal 10% = 28%, p<0.001) and the ultradistal tibia/fibula measured by DXA (19%, p<0.0001). When comparing Z-scores, the magnitude of decrements at the ipsilateral limb was bigger for variables measured directly at the tibia, both proximal and distal to the fracture. The magnitude of the decrement in ultradistal tibia/fibula BMD decreased as the time since fracture increased ( r = 0.55). When response ratios are considered, pQCT measurements at the distal tibia (RR 6-8) and proximal 5% and 10% trabecular sites (RR 5 and 9 respectively) were found to be the most sensitive to change. Therefore, pQCT of the trabecular regions of either the proximal or distal tibia should prove the most sensitive measurement for monitoring changes in bone adjacent to a tibial shaft fracture.

Limb muscle sound speed estimation by ultrasound computed tomography excluding receivers in bone shadow

NASA Astrophysics Data System (ADS)

Qu, Xiaolei; Azuma, Takashi; Lin, Hongxiang; Takeuchi, Hideki; Itani, Kazunori; Tamano, Satoshi; Takagi, Shu; Sakuma, Ichiro

2017-03-01

Sarcopenia is the degenerative loss of skeletal muscle ability associated with aging. One reason is the increasing of adipose ratio of muscle, which can be estimated by the speed of sound (SOS), since SOSs of muscle and adipose are different (about 7%). For SOS imaging, the conventional bent-ray method iteratively finds ray paths and corrects SOS along them by travel-time. However, the iteration is difficult to converge for soft tissue with bone inside, because of large speed variation. In this study, the bent-ray method is modified to produce SOS images for limb muscle with bone inside. The modified method includes three steps. First, travel-time is picked up by a proposed Akaike Information Criterion (AIC) with energy term (AICE) method. The energy term is employed for detecting and abandoning the transmissive wave through bone (low energy wave). It results in failed reconstruction for bone, but makes iteration convergence and gives correct SOS for skeletal muscle. Second, ray paths are traced using Fermat's principle. Finally, simultaneous algebraic reconstruction technique (SART) is employed to correct SOS along ray paths, but excluding paths with low energy wave which may pass through bone. The simulation evaluation was implemented by k-wave toolbox using a model of upper arm. As the result, SOS of muscle was 1572.0+/-7.3 m/s, closing to 1567.0 m/s in the model. For vivo evaluation, a ring transducer prototype was employed to scan the cross sections of lower arm and leg of a healthy volunteer. And the skeletal muscle SOSs were 1564.0+/-14.8 m/s and 1564.1±18.0 m/s, respectively.

Clinical Results and Complications of Lower Limb Lengthening for Fibular Hemimelia: A Report of Eight Cases.

PubMed

Mishima, Kenichi; Kitoh, Hiroshi; Iwata, Koji; Matsushita, Masaki; Nishida, Yoshihiro; Hattori, Tadashi; Ishiguro, Naoki

2016-05-01

Fibular hemimelia is a rare but the most common congenital long bone deficiency, encompassing a broad range of anomalies from isolated fibular hypoplasia up to substantial femoral and tibial shortening with ankle deformity and foot deficiency. Most cases of fibular hemimelia manifest clinically significant leg length discrepancy (LLD) with time that requires adequate correction by bone lengthening for stable walking. Bone lengthening procedures, especially those for pathological bones, are sometimes associated with severe complications, such as delayed consolidation, fractures, and deformities of the lengthened bones, leading to prolonged healing time and residual LLD at skeletal maturity. The purpose of this study was to review our clinical results of lower limb lengthening for fibular hemimelia.This study included 8 Japanese patients who diagnosed with fibular hemimelia from physical and radiological findings characteristic of fibular hemimelia and underwent single or staged femoral and/or tibial lengthening during growth or after skeletal maturity. LLD, state of the lengthened callus, and bone alignment were evaluated with full-length radiographs of the lower limb. Previous interventions, associated congenital anomalies, regenerate fractures were recorded with reference to medical charts and confirmed on appropriate radiographs. Successful lengthening was defined as the healing index <50 days/cm without regenerate fractures.A significant difference was observed in age at surgery between successful and unsuccessful lengthening. The incidence of regenerate fractures was significantly correlated with callus maturity before frame removal. LLD was corrected within 11 mm, whereas mechanical axis deviated laterally.Particular attention should be paid to the status of callus maturation and the mechanical axis deviation during the treatment period in fibular hemimelia.

Free microvascular rotationplasty with nerve repair for rhabdomyosarcoma in a 18-month-old patient.

PubMed

Pérez-García, Alberto; Salom, Marta; Villaverde-Doménech, María Eloísa; Baixauli, Francisco; Simón-Sanz, Eduardo

2017-05-01

Rotationplasty is a limb-sparing surgical option in lower limb malignancies. Sciatic or tibial nerve encasement has been considered an absolute contraindication to this procedure. We report a case of an 18-month-old girl with a rhabdomyosarcoma that affected the leg and popliteal fossa, with neurovascular involvement. Knee and proximal leg intercalary resection was performed followed by reconstruction with free microvascular rotationplasty and neurorraphy from tibial division of sciatic nerve to sural and tibial nerves, and from saphenous nerve to superficial peroneal nerve. Postoperative course was uneventful and ambulation with a provisional prosthesis was restarted during the sixth week after surgery. Bone consolidation was observed after two months. Eighteen months later, the patient had a good gait pattern with a below-knee prosthesis and had recovered sensation in the whole foot and ankle area. This case shows that rotationplasty with nerve repair may provide a sensate stump, which is vital for successful prosthetic adaptation. We believe it may be considered as an alternative to above-knee amputation in tumors with sciatic involvement. © 2017 Wiley Periodicals, Inc.

Breed and maturity effects on Churra Galega Bragançana and Suffolk lamb carcass characteristics: Killing-out proportion and composition.

PubMed

Rodrigues, S; Cadavez, V; Teixeira, A

2006-02-01

The aim of this work was to study the carcass killing-out proportions and carcass composition of Churra Galega Bragançana (CGB) and Suffolk sheep at 20%, 25%, 30% and 35% of maturity. Forty-eight male lambs were used, 24 CGB and 24 Suffolks from the Bragança's School of Agriculture sheep flock. Suffolk lambs had greater proportions of leg, shoulder and breast joints, but lower proportions of rib, anterior rib and neck joints. Increasing maturity caused a significant decrease in leg and shoulder proportions and an increase in chump proportion. Suffolk lambs had significantly greater muscle and significantly less subcutaneous fat and kidney and pelvic fat percentages than CGB lambs. With the increase of maturity, a significant increase in intermuscular fat and a significant decrease in bone proportion were observed. It was concluded that, under the management conditions of this work, Suffolks were preferred for meat production, since at a comparable stage of maturity they had greater proportions of expensive cuts and greater carcass lean percentage.

Foot-ankle complex injury risk curves using calcaneus bone mineral density data.

PubMed

Yoganandan, Narayan; Chirvi, Sajal; Voo, Liming; DeVogel, Nicholas; Pintar, Frank A; Banerjee, Anjishnu

2017-08-01

Biomechanical data from post mortem human subject (PMHS) experiments are used to derive human injury probability curves and develop injury criteria. This process has been used in previous and current automotive crashworthiness studies, Federal safety standards, and dummy design and development. Human bone strength decreases as the individuals reach their elderly age. Injury risk curves using the primary predictor variable (e.g., force) should therefore account for such strength reduction when the test data are collected from PMHS specimens of different ages (age at the time of death). This demographic variable is meant to be a surrogate for fracture, often representing bone strength as other parameters have not been routinely gathered in previous experiments. However, bone mineral densities (BMD) can be gathered from tested specimens (presented in this manuscript). The objective of this study is to investigate different approaches of accounting for BMD in the development of human injury risk curves. Using simulated underbody blast (UBB) loading experiments conducted with the PMHS lower leg-foot-ankle complexes, a comparison is made between the two methods: treating BMD as a covariate and pre-scaling test data based on BMD. Twelve PMHS lower leg-foot-ankle specimens were subjected to UBB loads. Calcaneus BMD was obtained from quantitative computed tomography (QCT) images. Fracture forces were recorded using a load cell. They were treated as uncensored data in the survival analysis model which used the Weibull distribution in both methods. The width of the normalized confidence interval (NCIS) was obtained using the mean and ± 95% confidence limit curves. The mean peak forces of 3.9kN and 8.6kN were associated with the 5% and 50% probability of injury for the covariate method of deriving the risk curve for the reference age of 45 years. The mean forces of 5.4 kN and 9.2kN were associated with the 5% and 50% probability of injury for the pre-scaled method. The NCIS magnitudes were greater in the covariate-based risk curves (0.52-1.00) than in the risk curves based on the pre-scaled method (0.24-0.66). The pre-scaling method resulted in a generally greater injury force and a tighter injury risk curve confidence interval. Although not directly applicable to the foot-ankle fractures, when compared with the use of spine BMD from QCT scans to pre-scale the force, the calcaneus BMD scaled data produced greater force at the same risk level in general. Pre-scaling the force data using BMD is an alternate, and likely a more accurate, method instead of using covariate to account for the age-related bone strength change in deriving risk curves from biomechanical experiments using PMHS. Because of the proximity of the calcaneus bone to the impacting load, it is suggested to use and determine the BMD of the foot-ankle bone in future UBB and other loading conditions to derive human injury probability curves for the foot-ankle complex. Copyright © 2017. Published by Elsevier Ltd.

Mesenchymal stem cell therapy in the treatment of hip osteoarthritis.

PubMed

Mardones, Rodrigo; Jofré, Claudio M; Tobar, L; Minguell, José J

2017-07-01

This study was performed to investigate the safety and efficacy of the intra-articular infusion of ex vivo expanded autologous bone marrow-derived mesenchymal stem cells (BM-MSC) to a cohort of patients with articular cartilage defects in the hip. The above rationale is sustained by the notion that MSCs express a chondrocyte differential potential and produce extracellular matrix molecules as well as regulatory signals, that may well contribute to cure the function of the damaged hip joint. A cohort of 10 patients with functional and radiological evidences of hip osteoarthritis, either in one or both legs, was included in the study. BM-MSC (the cell product) were prepared and infused into the damaged articulation(s) of each patient (60 × 10 6 cells in 3 weekly/doses). Before and after completion of the cell infusion scheme, patients were evaluated (hip scores for pain, stiffness, physical function, range of motion), to assess whether the infusion of the respective cell product was beneficial. The intra-articular injection of three consecutive weekly doses of ex vivo expanded autologous BM-MSC to patients with articular cartilage defects in the hip and proved to be a safe and clinically effective treatment in the restoration of hip function and range of motion. In addition, the statistical significance of the above data is in line with the observation that the radiographic scores (Tönnis Classification of Osteoarthritis) of the damaged leg(s) remained without variation in 9 out of 10 patients, after the administration of the cell product.

Influence of phytase added to a vegetarian diet on bone metabolism in pregnant and lactating sows.

PubMed

Liesegang, A; Loch, L; Bürgi, E; Risteli, J

2005-01-01

The purpose of the study was to find out if the supplementation of phytase to a diet of gestating and lactating sows has any effects on performance and bone parameters of the animals. Forty primiparous gilts were assigned into four groups: group A with phytase [4.2 g total phosphorus (P)/kg (gestation) and 4.5 g total P/kg (lactation)], group B without phytase (with phytase supplementation in diet for rearing) and same P content as group A, group C without phytase and higher P contents [5.0 g total P/kg (gestation) and 5.5 g total P/kg (lactation)] and group D with the same diet as group B (no phytase during the rearing). A 6-phytase was used in this trial (750 FTU/kg diet). The four diets were fed during gestation and lactation. Faeces were collected to determine apparent digestibility of minerals. Blood samples were taken to analyse minerals and bone markers. After weaning the sows were slaughtered and the bones of one hind leg were prepared to measure bone mineral density (BMD) and bone mineral content (BMC) of the tibia. Bone ash and mineral content of the phalanx III were determined. Mean P concentrations in serum decreased during gestation and lactation. But there were no significant differences between the groups. Bone formation marker bone-specific alkaline phosphatase decreased at the beginning of lactation whereas bone resorption marker serum crosslaps increased. The BMD and BMC of the tibia were slightly higher in the groups fed higher concentrations of P and phytase. The ash and mineral contents of the phalanx were the highest for the group fed the highest concentration of P. The apparent digestibility of P increased during gestation mostly in group A (57%--> 69%). In conclusion, high P content and addition of phytase to the diet induced a slightly higher ash content of the bones. It is of high importance, that sows during gestation absorb enough P, to avoid lamenesses and sudden fractures. As not many studies with phytase have been performed during gestation and lactation in sows yet, we can recommend, that phytase as supplement can be used to keep P in the diet at a lower level without negative consequences for bone health.

Effect of antiresorptive and anabolic bone therapy on development of osteoarthritis in a posttraumatic rat model of OA.

PubMed

Bagi, Cedo M; Berryman, Edwin; Zakur, David E; Wilkie, Dean; Andresen, Catharine J

2015-11-06

Osteoarthritis (OA) is a leading cause of disability, but despite the high unmet clinical need and extensive research seeking dependable therapeutic interventions, no proven disease-modifying treatment for OA is currently available. Due to the close interaction and interplay between the articular cartilage and the subchondral bone plate, it has been hypothesized that antiresorptive drugs can also reduce cartilage degradation, inhibit excessive turnover of the subchondral bone plate, prevent osteophyte formation, and/or that bone anabolic drugs might also stimulate cartilage synthesis by chondrocytes and preserve cartilage integrity. The benefit of intensive zoledronate (Zol) and parathyroid hormone (PTH) therapy for bone and cartilage metabolism was evaluated in a rat model of OA. Medial meniscectomy (MM) was used to induce OA in male Lewis rats. Therapy with Zol and human PTH was initiated immediately after surgery. A dynamic weight-bearing (DWB) system was deployed to evaluate the weight-bearing capacity of the front and hind legs. At the end of the 10-week study, the rats were euthanized and the cartilage pathology was evaluated by contrast (Hexabrix)-enhanced μCT imaging and traditional histology. Bone tissue was evaluated at the tibial metaphysis and epiphysis, including the subchondral bone. Histological techniques and dynamic histomorphometry were used to evaluate cartilage morphology and bone mineralization. The results of this study highlight the complex changes in bone metabolism in different bone compartments influenced by local factors, including inflammation, pain and mechanical loads. Surgery caused severe and extensive deterioration of the articular cartilage at the medial tibial plateau, as evidenced by contrast-enhanced μCT and histology. The study results showed the negative impact of MM surgery on the weight-bearing capacity of the operated limb, which was not corrected by treatment. Although both Zol and PTH improved subchondral bone mass and Zol reduced serum CTX-II level, both treatments failed to prevent or correct cartilage deterioration, osteophyte formation and mechanical incapacity. The various methods utilized in this study showed that aggressive treatment with Zol and PTH did not have the capacity to prevent or correct the deterioration of the hyaline cartilage, thickening of the subchondral bone plate, osteophyte formation or the mechanical incapacity of the osteoarthritic knee.

Effect of tibial bone resection on the development of fast- and slow-twitch skeletal muscles in foetal sheep.

PubMed

West, J M; Williams, N A; Luff, A R; Walker, D W

2000-04-01

To determine if longitudinal bone growth affects the differentiation of fast- and slow-twitch muscles, the tibial bone was sectioned at 90 days gestation in foetal sheep so that the lower leg was permanently without structural support. At 140 days (term is approximately 147 days) the contractile properties of whole muscles, activation profiles of single fibres and ultrastructure of fast- and slow-twitch muscles from the hindlimbs were studied. The contractile and activation profiles of the slow-twitch soleus muscles were significantly affected by tibial bone resection (TIBX). The soleus muscles from the TIBX hindlimbs showed: (1) a decrease in the time to peak of the twitch responses from 106.2 +/- 10.7 ms (control, n = 4) to 65.1 +/- 2.48 ms (TIBX, n = 5); (2) fatigue profiles more characteristic of those observed in the fast-twitch muscles: and (3) Ca2+ - and Sr2+ -activation profiles of skinned fibres similar to those from intact hindlimbs at earlier stages of gestation. In the FDL, TIBX did not significantly change whole muscle twitch contraction time, the fatigue profile or the Ca2+ - and Sr2+ -activation profiles of skinned fibres. Electron microscopy showed an increased deposition of glycogen in both soleus and FDL muscles. This study shows that the development of the slow-twitch phenotype is impeded in the absence of the physical support normally provided by the tibial bone. We suggest that longitudinal stretch is an important factor in allowing full expression of the slow-twitch phenotype.

Effects of whole-body vibration training on physical function, bone and muscle mass in adolescents and young adults with cerebral palsy.

PubMed

Gusso, Silmara; Munns, Craig F; Colle, Patrícia; Derraik, José G B; Biggs, Janene B; Cutfield, Wayne S; Hofman, Paul L

2016-03-03

We performed a clinical trial on the effects of whole-body vibration training (WBVT) on muscle function and bone health of adolescents and young adults with cerebral palsy. Forty participants (11.3-20.8 years) with mild to moderate cerebral palsy (GMFCS II-III) underwent 20-week WBVT on a vibration plate for 9 minutes/day 4 times/week at 20 Hz (without controls). Assessments included 6-minute walk test, whole-body DXA, lower leg pQCT scans, and muscle function (force plate). Twenty weeks of WBVT were associated with increased lean mass in the total body (+770 g; p = 0.0003), trunk (+410 g; p = 0.004), and lower limbs (+240 g; p = 0.012). Bone mineral content increased in total body (+48 g; p = 0.0001), lumbar spine (+2.7 g; p = 0.0003), and lower limbs (+13 g; p < 0.0001). Similarly, bone mineral density increased in total body (+0.008 g/cm(2); p = 0.013), lumbar spine (+0.014 g/cm(2); p = 0.003), and lower limbs (+0.023 g/cm(2); p < 0.0001). Participants reduced the time taken to perform the chair test, and improved the distance walked in the 6-minute walk test by 11% and 35% for those with GMFCS II and III, respectively. WBVT was associated with increases in muscle mass and bone mass and density, and improved mobility of adolescents and young adults with cerebral palsy.

Carbon/PEEK composite materials as an alternative for stainless steel/titanium hip prosthesis: a finite element study.

PubMed

Rezaei, Farshid; Hassani, Kamran; Solhjoei, Nosratollah; Karimi, Alireza

2015-12-01

Total hip replacement (THR) has been ranked within the most typical surgical processes in the world. The durability of the prosthesis and loosening of prosthesis are the main concerns that mostly reported after THR surgeries. In THR, the femoral prosthesis can be fixed by either cement or cementless methods in the patient's bones. In both procedures, the stability of the prosthesis in the hosted bone has a key asset in its long-term durability and performance. This study aimed to execute a comparative finite element simulation to assess the load transfer between the prosthesis, which is made of carbon/PEEK composite and stainless steel/titanium, and the femur bone. The mechanical behavior of the cortical bone was assumed as a linear transverse isotropic while the spongy bone was modeled like a linear isotropic material. The implants were made of stainless steel (316L) and titanium alloy as they are common materials for implants. The results showed that the carbon/PEEK composites provide a flatter load transfer from the upper body to the leg compared to the stainless steel/titanium prosthesis. Furthermore, the results showed that the von Mises stress, principal stress, and the strain in the carbon/PEEK composites prosthesis were significantly lower than that made of the stainless steel/titanium. The results also imply that the carbon/PEEK composites can be applied to introduce a new optimum design for femoral prosthesis with adjustable stiffness, which can decrease the stress shielding and interface stress. These findings will help clinicians and biomedical experts to increase their knowledge about the hip replacement.

Quantification of osteoblastic activity in epiphyseal growth plates by quantitative bone SPECT/CT.

PubMed

Yamane, Tomohiko; Kuji, Ichiei; Seto, Akira; Matsunari, Ichiro

2018-06-01

Quantifying the function of the epiphyseal plate is worthwhile for the management of children with growth disorders. The aim of this retrospective study was to quantify the osteoblastic activity at the epiphyseal plate using the quantitative bone SPECT/CT. We enrolled patients under the age of 20 years who received Tc-99m hydroxymethylene diphosphonate bone scintigraphy acquired by a quantitative SPECT/CT scanner. The images were reconstructed by ordered subset conjugate-gradient minimizer, and the uptake on the distal margin of the femur was quantified by peak standardized uptake value (SUVpeak). A public database of standard body height was used to calculate growth velocities (cm/year). Fifteen patients (6.9-19.7 years, 9 female, 6 male) were enrolled and a total of 25 legs were analyzed. SUVpeak in the epiphyseal plate was 18.9 ± 2.4 (average ± standard deviation) in the subjects under 15 years and decreased gradually by aging. The SUVpeak correlated significantly with the age- and sex-matched growth velocity obtained from the database (R 2  = 0.83, p < 0.0001). The SUV measured by quantitative bone SPECT/CT was increased at the epiphyseal plates of children under the age of 15 years in comparison with the older group, corresponding to higher osteoblastic activity. Moreover, this study suggested a correlation between growth velocity and the SUV. Although this is a small retrospective pilot study, the objective and quantitative values measured by the quantitative bone SPECT/CT has the potential to improve the management of children with growth disorder.

Effects of 96 Weeks of Rosuvastatin on Bone, Muscle, and Fat in HIV-Infected Adults on Effective Antiretroviral Therapy.

PubMed

Erlandson, Kristine M; Jiang, Ying; Debanne, Sara M; McComsey, Grace A

2016-04-01

Heightened inflammation and immune activation are associated with lower bone mineral density (BMD) and lean body mass (LBM) among HIV-infected persons. We hypothesized that a reduction in inflammation with rosuvastatin would be associated with improvements in BMD and LBM. HIV-infected participants on stable antiretroviral therapy without statin indication and with heightened immune activation (≥19% CD8(+)CD38(+)HLA-DR(+) T cells) or inflammation (hsCRP ≥2 mg/liter) were randomized to rosuvastatin 10 mg daily or placebo for 96 weeks. Among 72 participants randomized to rosuvastatin and 75 to placebo, there were no significant differences in the relative changes in BMD (p > 0.29) or in fat (p ≥ 0.19). A trend toward increased LBM (p = 0.059) was seen in the rosuvastatin arm without differences in creatinine kinase or self-reported physical activity (p ≥ 0.10). In a multivariable regression model, rosuvastatin was associated with a significant positive effect on LBM after adjusting for age, sex, race, smoking status, and detectable HIV-1 viral load. Higher baseline sCD163 correlated with increases in LBM from weeks 0 to 96 (p = 0.023); greater changes in total and leg lean mass were seen among statin users with higher compared to lower baseline IP-10 levels (LBM 1.8 vs. -0.3%; p = 0.028 and leg lean mass 2.9 vs. -1.7%; p = 0.012). Rosuvastatin is associated with an absence of toxicity on BMD and a potential benefit on LBM over 96 weeks of therapy. The preservation of LBM in the rosuvastatin arm over the 2 years of the study is of major clinical relevance in delaying loss of muscle mass with aging.

Empirically Based Composite Fracture Prediction Model From the Global Longitudinal Study of Osteoporosis in Postmenopausal Women (GLOW)

PubMed Central

Compston, Juliet E.; Chapurlat, Roland D.; Pfeilschifter, Johannes; Cooper, Cyrus; Hosmer, David W.; Adachi, Jonathan D.; Anderson, Frederick A.; Díez-Pérez, Adolfo; Greenspan, Susan L.; Netelenbos, J. Coen; Nieves, Jeri W.; Rossini, Maurizio; Watts, Nelson B.; Hooven, Frederick H.; LaCroix, Andrea Z.; March, Lyn; Roux, Christian; Saag, Kenneth G.; Siris, Ethel S.; Silverman, Stuart; Gehlbach, Stephen H.

2014-01-01

Context: Several fracture prediction models that combine fractures at different sites into a composite outcome are in current use. However, to the extent individual fracture sites have differing risk factor profiles, model discrimination is impaired. Objective: The objective of the study was to improve model discrimination by developing a 5-year composite fracture prediction model for fracture sites that display similar risk profiles. Design: This was a prospective, observational cohort study. Setting: The study was conducted at primary care practices in 10 countries. Patients: Women aged 55 years or older participated in the study. Intervention: Self-administered questionnaires collected data on patient characteristics, fracture risk factors, and previous fractures. Main Outcome Measure: The main outcome is time to first clinical fracture of hip, pelvis, upper leg, clavicle, or spine, each of which exhibits a strong association with advanced age. Results: Of four composite fracture models considered, model discrimination (c index) is highest for an age-related fracture model (c index of 0.75, 47 066 women), and lowest for Fracture Risk Assessment Tool (FRAX) major fracture and a 10-site model (c indices of 0.67 and 0.65). The unadjusted increase in fracture risk for an additional 10 years of age ranges from 80% to 180% for the individual bones in the age-associated model. Five other fracture sites not considered for the age-associated model (upper arm/shoulder, rib, wrist, lower leg, and ankle) have age associations for an additional 10 years of age from a 10% decrease to a 60% increase. Conclusions: After examining results for 10 different bone fracture sites, advanced age appeared the single best possibility for uniting several different sites, resulting in an empirically based composite fracture risk model. PMID:24423345

Evaluation of nano-technology-modified zirconia oral implants: a study in rabbits.

PubMed

Lee, Jaebum; Sieweke, Janet H; Rodriguez, Nancy A; Schüpbach, Peter; Lindström, Håkan; Susin, Cristiano; Wikesjö, Ulf M E

2009-07-01

The objective of this study was to screen candidate nano-technology-modified, micro-structured zirconia implant surfaces relative to local bone formation and osseointegration. Proprietary nano-technology surface-modified (calcium phosphate: CaP) micro-structured zirconia implants (A and C), control micro-structured zirconia implants (ZiUnite), and titanium porous oxide implants (TiUnite) were implanted into the femoral condyle in 40 adult male New Zealand White rabbits. Each animal received one implant in each hind leg; thus, 20 animals received A and C implants and 20 animals received ZiUnite and TiUnite implants in contralateral hind legs. Ten animals/group were euthanized at weeks 3 and 6 when biopsies of the implant sites were processed for histometric analysis using digital photomicrographs produced using backscatter scanning electron microscopy. The TiUnite surface demonstrated significantly greater bone-implant contact (BIC) (77.6+/-2.6%) compared with the A (64.6+/-3.6%) and C (62.2+/-3.1%) surfaces at 3 weeks (p<0.05). Numerical differences between ZiUnite (70.5+/-3.1%) and A and C surfaces did not reach statistical significance (p>0.05). Similarly, there were non-significant differences between the TiUnite and the ZiUnite surfaces (p>0.05). At 6 weeks, there were no significant differences in BIC between the TiUnite (67.1+/-4.2%), ZiUnite (69.7+/-5.7%), A (68.6+/-1.9%), and C (64.5+/-4.1%) surfaces (p>0.05). TiUnite and ZiUnite implant surfaces exhibit high levels of osseointegration that, in this model, confirm their advanced osteoconductive properties. Addition of CaP nano-technology to the ZiUnite surface does not enhance the already advanced osteoconductivity displayed by the TiUnite and ZiUnite implant surfaces.

Treatment of shepherd’s crook deformity in patients with polyostotic fibrous dysplasia using a new type of custom made retrograde intramedullary nail: a technical note

PubMed Central

Hefti, F.; Donnan, L.; Krieg, A. H.

2017-01-01

Aims The severe form of coxa vara, the ‘shepherd’s crook deformity’, is always a consequence of a locally extensive form of polyostotic fibrous dysplasia (or McCune-Albright syndrome). Treatment of this deformity is a challenge. The soft bone does not tolerate any implant that depends on the stability of the cortical bone (like plates or external fixators). Intramedullary nails are the most appropriate implants for stabilisation, but if they are inserted from the greater trochanter, they cannot correct the varus deformity enough. Patients and Methods We have developed a special intramedullary nail that can be inserted from the osteotomy site and can be driven retrograde into the femoral neck in an appropriate valgus position. We have operated 15 legs in 13 patients. The average age at surgery was 14 years and 5 months (6 to 28.9). In all, 11 femora had been operated before (unsuccessfully) with various implants. Results The average follow-up was 54.2 months (7 to 132). The average correction of the neck/(distal) shaft angle was 57.5° (10° to 80°) ( = 72.8%). While pre-operatively none of the patients was able to walk without aid, at follow-up only one patient was unable to walk, three used the aid of crutches because of tibial lesions and one patient had an increased external rotation of the leg. At follow-up, most patients were free of pain. One implant broke and had to be replaced. Conclusion This new operative method offers the possibility of efficient correction and stabilisation of this severe and difficult deformation. PMID:28439311

Union Rate and Complications in Spine Fusion with Recombinant Human Bone Morphogenetic Protein-7: Systematic Review and Meta-Analysis.

PubMed

Vavken, Julia; Vavken, Patrick; Mameghani, Alexander; Schaeren, Stefan

2016-03-01

Study Design Systematic review and meta-analysis. Objective The objective of this meta-analysis was to evaluate the current best evidence to assess effectiveness and safety of recombinant human bone morphogenetic protein-7 (rhBMP-7) as a biological stimulant in spine fusion. Methods Studies were included if they reported on outcomes after spine fusion with rhBMP-7. The data was synthesized using Mantel-Haenszel pooled risk ratios (RRs) with 95% confidence intervals (CIs). Main end points were union rate, overall complications, postoperative back and leg pain, revision rates, and new-onset cancer. Results Our search produced 796 studies, 6 of which were eligible for inclusion. These studies report on a total of 442 patients (328 experimental, 114 controls) with a mean age of 59 ± 11 years. Our analysis showed no statistically significant differences in union rates (RR 0.97, 95% CI 0.84 to 1.11, p = 0.247), overall complications (RR 0.92, 95% CI 0.71 to 1.20, p = 0.545), postoperative back and leg pain (RR 1.03, 95% CI 0.48 to 2.19, p = 0.941), or revision rate (RR 0.81, 95% CI 0.47 to 1.40, p = 0.449). There was a mathematical indicator of increased tumor rates, but with only one case, the clinical meaningfulness of this finding is questionable. Conclusion We were not able to find data in support of the use of rhBMP-7 for spine fusion. We found no evidence for increased complication or revision rates with rhBMP-7. On the other hand, we also found no evidence in support of improved union rates.

[Applied anatomy study and clinical application of great saphenous veno-saphenous neurocutaneous vascular flap].

PubMed

Li, Zelong; Ding, Zihai; Wang, Peixin; Xie, Yibo; Zeng, Bo

2006-03-01

To provide the anatomic basis for defect repair of the knee, leg, foot and ankle with great saphenous veno-saphenous neurocutaneous vascular island flaps. The origin, diameter, branches, distribution and anastomoses of the saphenous artery and saphenous neurocutaneous vascular were observed on 20 sides of adult leg specimens and 4 fresh cadaver voluntary legs. Another 4 fresh cadaver voluntary legs were radiographed with a soft X-ray system after the intravenous injection of Vermilion and cross-sections under profound fascial, other hand, micro-anatomic examination was also performed in these 4 fresh cadaver legs. The soft tissue defects in lower extremity, upper extremity, heel or Hucou in hand were repaired with the proximal or distal pedicle flaps or free flaps in 18 patients (12 males and 6 females,aging from 7 to 53 years). The defect was caused by trauma, tumour, ulcer and scar. The locations were Hucou (1 case), upper leg (3 cases), lower extremity and heal (14 cases). Of then, 7 cases were complicated by bone exposure, 3 cases by tendon exposure and 1 case by steel espouse, the defect size were 4 cm x 4 cm to 7 cm x 13 cm. The flap sizes were 4 cm x 6 cm to 8 cm x 15 cm, which pedicle length was 8-11 cm with 2.5-4.0 cm fascia and 1-2 cm skin at width. Genus descending genicular artery began from 9.33 +/- 0.81 cm away from upper the condyles medialis, it branched saphenous artery accompanying saphenous nerve descendent. And saphenous artery reached the surface of the skin 7.21 +/- 0.82 cm away from lower the condyles medialis, and anastomosed with the branches of tibialis posterior artery, like "Y" or "T" pattern. The chain linking system of arteries were found accompanying along the great saphenous vein as saphenous nerve, and then a axis blood vessel was formed. The small artery of only 0.05-0.10 mm in diameter, distributed around the great saphenous vein within 5-8 mm and arranged parallelly along the vein like water wave in soft X-ray film. All proximal flaps, distal pedicle flaps and free flaps survived well. The appearance, sensation and function were satisfactory in 14 patients after a follow-up of 6-12 months. The great saphenous vein as well as saphenous neurocutaneous has a chain linking system vascular net. A flap with the vascular net can be transplanted by free, by reversed pedicle, or by direct pedicle to repair the wound of upper leg and foot. A superficial vein-superficial neurocutaneous vascular flap with abundance blood supply and without sacrificing a main artery is a favourite method in repair of soft tissue defects in foot and lower extremity.

[Arthrodesis without bone fusion with an intramedullary modular nail for revision of infected total knee arthroplasty].

PubMed

Miralles-Muñoz, F A; Lizaur-Utrilla, A; Manrique-Lipa, C; López-Prats, F A

2014-01-01

To evaluate the outcome of knee fixation without bone fusion using an intramedullary modular nail and interposed cement. Retrospective study of 29 infected total knee arthroplasties with prospective data collection and a mean follow-up of 4.2 years (3-5). Complications included 2 recurrent infections, 1 peri-implant fracture, and 1 cortical erosion due to the tip of the femoral component. All of these were revised with successful results. The mean limb length discrepancy was 0.8 cm, with 24<1cm. Twenty-five patients reported no pain. The mean WOMAC-pain was 86.9, WOMAC-function 56.4, SF12-physical 45.1, and SF12-mental 53.7. Four patients needed a walking frame, and only two were dependent for daily activities. The Endo-Model Link nail is an effective method for knee fixation that restores the anatomical alignment of the limb with adequate leg length. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

Early failure mechanisms of constrained tripolar acetabular sockets used in revision total hip arthroplasty.

PubMed

Cooke, Christopher C; Hozack, William; Lavernia, Carlos; Sharkey, Peter; Shastri, Shani; Rothman, Richard H

2003-10-01

Fifty-eight patients received an Osteonics constrained acetabular implant for recurrent instability (46), girdlestone reimplant (8), correction of leg lengthening (3), and periprosthetic fracture (1). The constrained liner was inserted into a cementless shell (49), cemented into a pre-existing cementless shell (6), cemented into a cage (2), and cemented directly into the acetabular bone (1). Eight patients (13.8%) required reoperation for failure of the constrained implant. Type I failure (bone-prosthesis interface) occurred in 3 cases. Two cementless shells became loose, and in 1 patient, the constrained liner was cemented into an acetabular cage, which then failed by pivoting laterally about the superior fixation screws. Type II failure (liner locking mechanism) occurred in 2 cases. Type III failure (femoral head locking mechanism) occurred in 3 patients. Seven of the 8 failures occurred in patients with recurrent instability. Constrained liners are an effective method for treatment during revision total hip arthroplasty but should be used in select cases only.

Automated segmentation of knee and ankle regions of rats from CT images to quantify bone mineral density for monitoring treatments of rheumatoid arthritis

NASA Astrophysics Data System (ADS)

Cruz, Francisco; Sevilla, Raquel; Zhu, Joe; Vanko, Amy; Lee, Jung Hoon; Dogdas, Belma; Zhang, Weisheng

2014-03-01

Bone mineral density (BMD) obtained from a CT image is an imaging biomarker used pre-clinically for characterizing the Rheumatoid arthritis (RA) phenotype. We use this biomarker in animal studies for evaluating disease progression and for testing various compounds. In the current setting, BMD measurements are obtained manually by selecting the regions of interest from three-dimensional (3-D) CT images of rat legs, which results in a laborious and low-throughput process. Combining image processing techniques, such as intensity thresholding and skeletonization, with mathematical techniques in curve fitting and curvature calculations, we developed an algorithm for quick, consistent, and automatic detection of joints in large CT data sets. The implemented algorithm has reduced analysis time for a study with 200 CT images from 10 days to 3 days and has improved the robust detection of the obtained regions of interest compared with manual segmentation. This algorithm has been used successfully in over 40 studies.

Experiment K-6-27. Analysis of radiographs and biosamples from primate studies

NASA Technical Reports Server (NTRS)

Cann, C.; Rakhmanov, A.; Karolkov, V.

1990-01-01

Serial high-contrast radiographs were obtained of both arms and the right leg of two flight and four control monkeys for the period L-60 to S+16. Longitudinal growth of the tibia, radius and ulna was linear over this period in the control monkeys. In the flight monkey for whom the feeder malfunctioned, there were significant decreases in growth of the long bones. There were also hypermineralized growth arrest lines produced in the distal radial and ulnar metaphyses following resumption of growth. In the other flight monkey, there was a suggestion of decreased long bone growth during flight and immediate postflight periods, but this recovered by the end of the postflight control experiment. There was also an increase in intracortical resorption, indicative of skeletal activation. No major changes in cortical thickness or other parameters were noted, but modification of the techniques to obtain very high quality radiographs in further studies should allow subtle changes in these processes to be quantified.

[Influencing factors for trauma-induced tibial infection in underground coal mine].

PubMed

Meng, W Z; Guo, Y J; Liu, Z K; Li, Y F; Wang, G Z

2016-07-20

Objective: To investigate the influencing factors for trauma-induced tibial infection in underground coal mine. Methods: A retrospective analysis was performed for the clinical data of 1 090 patients with tibial fracture complicated by bone infection who were injured in underground coal mine and admitted to our hospital from January 1995 to August 2015, including the type of trauma, injured parts, severity, and treatment outcome. The association between risk factors and infection was analyzed. Results: Among the 1 090 patients, 357 had the clinical manifestations of acute and chronic bone infection, 219 had red and swollen legs with heat pain, and 138 experienced skin necrosis, rupture, and discharge of pus. The incidence rates of tibial infection from 1995 to 2001, from 2002 to 2008, and from 2009 to 2015 were 31%, 26.9%, and 20.2%, respectively. The incidence rate of bone infection in the proximal segment of the tibia was significantly higher than that in the middle and distal segments (42.1% vs 18.9%/27.1%, P <0.01) . As for patients with different types of trauma (Gustilo typing) , the patients with type III fracture had a significantly higher incidence rate of bone infection than those with type I/II infection (52.8% vs 21.8%/24.6%, P <0.01) . The incidence rates of bone infection after bone traction, internal fixation with steel plates, fixation with external fixator, and fixation with intramedullary nail were 20.7%, 43.5%, 21.4%, and 26.1%, respectively, suggesting that internal fixation with steel plates had a significantly higher incidence rate of bone infection than other fixation methods ( P <0.01) . The multivariate logistic regression analysis showed that the position of tibial fracture and type of fracture were independent risk factors for bone infection. Conclusion: There is a high incidence rate of trauma-induced tibial infection in workers in underground coal mine. The position of tibial fracture and type of fracture are independent risk factors for bone infection. Vacuum sealing drainage and Ilizarov technique can achieve a satisfactory therapeutic effect.

Long bone robustness during growth: A cross-sectional pQCT examination of children and young adults aged 5-29years.

PubMed

Rantalainen, Timo; Weeks, Benjamin K; Nogueira, Rossana C; Beck, Belinda R

2016-12-01

Skeletal robustness (cross-section size relative to length) is associated with stress fractures in adults, and appears to explain the high incidence of distal radius fractures in adolescents. However, little is known about the ontogeny of long bone robustness during the first three decades of life. Therefore, we explored the ontogeny of tibial, fibular, ulnar and radial robustness in a cross-sectional sample of 5 to 29year-old volunteers of both sexes. Peripheral quantitative computed tomography (pQCT) was used to evaluate cross-sections of the leg (4%, 14%, 38% and 66%), and forearm (4%, and 66%) in N=432 individuals. Robustness was evaluated as the total bone area divided by bone length. Differences between age-groups, sexes, and age-group×sex interactions were evaluated with ANOVA with Tukey's post hocs where appropriate. Most bone sites exhibited more robust bones in men than women (P<0.001 to 0.02), and in older age-groups than younger (P<0.001). Sex×age-group interaction was observed at the 66% and 38% tibia sites with robustness increasing more with age in men than in women (P=0.006 to 0.042). Post-hoc analyses indicated no sex differences prior to 13years-of-age, and notable exceptions to increasing robustness with age at the 4% radial and 66% tibial sites, which exhibited reduced robustness in age groups close to peak height velocity. In conclusion, the present results suggest that very little sexual dimorphism in long bone robustness exists prior to puberty, and that divergence occurs primarily after cessation of longitudinal growth. A period of relative diaphyseal slenderness was identified at age-groups coinciding with the adolescent growth spurt, which may be related to the relatively high incidence of frank and stress fracture in adolescents. Copyright © 2016 Elsevier Inc. All rights reserved.

Stationary Apparatus Would Apply Forces of Walking to Feet

NASA Technical Reports Server (NTRS)

Hauss, Jessica; Wood, John; Budinoff, Jason; Correia, Michael; Albrecht, Rudolf

2006-01-01

A proposed apparatus would apply controlled cyclic forces to both feet for the purpose of preventing the loss of bone density in a human subject whose bones are not subjected daily to the mechanical loads of normal activity in normal Earth gravitation. The apparatus was conceived for use by astronauts on long missions in outer space; it could also be used by bedridden patients on Earth, including patients too weak to generate the necessary forces by their own efforts. The apparatus (see figure) would be a modified version of a bicycle-like exercise machine, called the cycle ergometer with vibration isolation system (CEVIS), now aboard the International Space Station. Attached to each CEVIS pedal would be a computer-controlled stress/ vibration exciter connected to the heel portion of a special-purpose pedal. The user would wear custom shoes that would amount to standard bicycle shoes equipped with cleats for secure attachment of the balls of the feet to the special- purpose pedals. If possible, prior to use of the apparatus, the human subject would wear a portable network of recording accelerometers, while walking, jogging, and running. The information thus gathered would be fed to the computer, wherein it would be used to make the exciters apply forces and vibrations closely approximating the forces and vibrations experienced by that individual during normal exercise. It is anticipated that like the forces applied to bones during natural exercise, these artificial forces would stimulate the production of osteoblasts (bone-forming cells), as needed to prevent or retard loss of bone mass. In addition to helping to prevent deterioration of bones, the apparatus could be used in treating a person already suffering from osteoporosis. For this purpose, the magnitude of the applied forces could be reduced, if necessary, to a level at which weak hip and leg bones would still be stimulated to produce osteoblasts without exposing them to the full stresses of walking and thereby risking fracture.

[A case report: elephantiasis].

PubMed

Karagöz, Ergenekon; Karaahmetoğlu, Gökhan; Acar, Ali; Turhan, Vedat; Oncül, Oral; Görenek, Levent

2012-01-01

Klippel-Trenaunay syndrome (KTS) is a rare disease and a syndrome that is characterized by the triad of congenital port wine stains,venous malformations with or without varicose veins, bone or soft tissue hypertrophy. Lymphatic filariasis is a filarial disease which usually occurs with genital anomalies, pathologies associated with lymphedema or elephantiasis caused by a filarial infectious agent. In this case report, a 20-year-old male patient admitted to our clinic for diagnosis and treatment with right leg edema and lesions compatible with dermatological manifestations. In the list of differential diagnosis, filarial elephantiasis was also thought, consequently KTS was diagnosed. (Turkiye Parazitol Derg 2012; 36: 188-90).

Lumbosacral agenesis. Three cases of reconstruction using Cotrel-Dubousset or L-rod instrumentation.

PubMed

Dumont, C E; Damsin, J P; Forin, V; Carlioz, H

1993-07-01

Three patients with lumbosacral agenesis underwent surgery to lock the lumbopelvic instability. All three patients had an unstable sitting position and a kyphotic bearing that impaired intestinal transit or hampered further colostomy or ureterostomy. Luque instrumentation with iliac fixation performed according to Galveston was used in one patient. Cotrel-Dubousset instrumentation was used for the two other patients. Autografts plus allografts provided sufficient bone for fusion without requiring lower leg amputations. Increased hip flexion was obtained after pelvic stabilization, but knee flexion contracture remained the same. All patients showed improved intestinal transit or decreased urinary infections, and two patients attained a stable sitting position without aid.

Bilateral Carpus Valgus with Cranial Bowing of the Distal Radius in a Foal

PubMed Central

Caron, J. P.; Fretz, P. B.; Pharr, J. W.; Bailey, J. V.

1986-01-01

Bilateral carpus valgus with concomitant outward rotation and cranial bowing of the distal radii was diagnosed in a crossbred foal. The foal was not lame on admission and showed no radiographic evidence of carpal bone abnormalities. Surgery was limited to the most severely affected leg, and consisted of a combination of growth promotion (periosteal transection and stripping) and temporary physeal retardation (transphyseal bridging) procedures. Correction of the valgus deformity was nearly complete in the operated limb and substantial improvement was observed in the cranial bowing and outward rotation in both limbs, five months postoperatively. ImagesFigure 1.Figure 2. PMID:17422668

Proteus syndrome: a case report.

PubMed

Pangkanon, S; Limpongsanurak, W; Sangtawesin, V

2001-05-01

Proteus syndrome is a rare genetic disorder, characterized by partial gigantism of the hands and/or feet, asymmetry of the limbs, plantar hyperplasia, multiple hamartomatous subcutaneous tumors, hyperostoses, and long bone overgrowth. A one day old Thai male infant is reported with macrosomia, hemihypertrophy of the left side of the face and left leg, large feet, macrodactyly of toes, plantar hyperplasia, large subcutaneous mass with a violet-red surface over the left side of the chest wall and a large port-wine stain involving the lateral aspect of the right chest wall. The clinical findings, diagnostic criteria, differential diagnosis, and management of the Proteus syndrome are reviewed.

Mast‐cell sarcoma of the tibia

PubMed Central

Brčić, Luka; Vuletić, Lovorka Batelja; Stepan, Jasminka; Bonevski, Aleksandra; Jakovljević, Gordana; Gašparov, Slavko; Marjanović, Ksenija; Seiwerth, Sven

2007-01-01

The mast‐cell sarcoma of a bone is described here for the first time. The tumour presented in a 4‐year‐old boy, with pain, oedema and deformation of his right lower leg. Radiological findings revealed a destructive tumourous mass. Histopathological examination showed the tumour to be composed of large, atypical cells, with hyperchromatic oval and polygonal nuclei. The cytoplasm around them was eosinophilic with many basophilic and toluidine‐blue‐positive granules. These atypical mast cells were positive for chloroacetate esterase, c‐kit, tryptase and negative for myeloperoxidase. The primary disease quickly progressed to mast‐cell leukaemia, and despite intensive chemotherapy the patient died 18 months after first symptoms. PMID:17405977

Characterizing the Effects of Chronic 2G Centrifugation on the Rat Skeletal System

NASA Technical Reports Server (NTRS)

Johnson, Aimee; Scott, Ryan; Ronca, April E.; Hoban-Higgins, Tana M.; Fuller, Charles A.; Alwood, Joshua S.

2017-01-01

During weightlessness, the skeletal system of astronauts is negatively affected by decreased calcium absorption and bone mass loss. Therefore, it is necessary to counteract these changes for long-term skeletal health during space flights. Our long-term plan is to assess artificial gravity (AG) as a possible solution to mitigate these changes. In this study, we aim to determine the skeletal acclimation to chronic centrifugation. We hypothesize that a 2G hypergravity environment causes an anabolic response in growing male rats. Specifically, we predict chronic 2G to increase tissue mineral density, bone volume fraction of the cancellous tissue and to increase overall bone strength. Systemically, we predict that bone formation markers (i.e., osteocalcin) are elevated and resorption markers (i.e., tartrate resistant acid phosphatase) are decreased or unchanged from controls. The experiment has three groups, each with an n8: chronic 2g, cage control (housed on the centrifuge, but not spun), and a vivarium control (normal rat caging). Pre-pubescent, male Long-Evans rats were used to assess our hypothesis. This group was subject to 90 days of 2G via centrifugation performed at the Chronic Acceleration Research Unit (CARU) at University of California Davis. After 90 days, animals were euthanized and tissues collected. Blood was drawn via cardiac puncture and the right leg collected for structural (via microcomputed tomography) and strength quantification. Understanding how counteract these skeletal changes will have major impacts for both the space-faring astronauts and the people living on Earth.

Influence of hard vs. soft ground surfaces on bone accretion in prepubertal footballers.

PubMed

Carmona, M Plaza-; Vicente-Rodriguez, G; Martín-García, M; Burillo, P; Felipe, J L; Mata, E; Casajús, J A; Gallardo, L; Ara, I

2014-01-01

Information regarding osteogenic effects of physical activity performed on different playing surfaces is scarce. A total of 42 children (9.2±0.2 years, Tanner stages I-II) participated in this study. 14 were playing on artificial turf soft ground (SG), 14 on a natural non-grass hard ground (HG) and 14 were assigned to the sedentary control group (C). Whole body and hip scans (dual energy X-ray absorptiometry), anthropometric variables (weight and height) and physical fitness (VO2max) were determined in all participants. Bone mineral content (BMC) values were higher in the SG group compared to the C group at the legs (209.75±5.11 g vs. 187.42±5.14 g, respectively), pelvis (122.72±4.27 g vs. 98.58±4.29 g respectively) and whole-body level (1 126.1±22.81 g vs. 1 035.34±22.92 g, respectively). The hard ground (HG) group also showed higher values in the majority of BMC variables compared to the C group. Additionally, bone mineral density (BMD) was significantly higher at all sites of the hip in both active groups compared to control (P<0.05). No differences between HG and SG were found. In summary, similar bone mass accretion is obtained by prepubescent footballers independently of the surface on which they practice football. © Georg Thieme Verlag KG Stuttgart · New York.

Semi-automated intra-operative fluoroscopy guidance for osteotomy and external-fixator.

PubMed

Lin, Hong; Samchukov, Mikhail L; Birch, John G; Cherkashin, Alexander

2006-01-01

This paper outlines a semi-automated intra-operative fluoroscopy guidance and monitoring approach for osteotomy and external-fixator application in orthopedic surgery. Intra-operative Guidance module is one component of the "LegPerfect Suite" developed for assisting the surgical correction of lower extremity angular deformity. The Intra-operative Guidance module utilizes information from the preoperative surgical planning module as a guideline to overlay (register) its bone outline semi-automatically with the bone edge from the real-time fluoroscopic C-Arm X-Ray image in the operating room. In the registration process, scaling factor is obtained automatically through matching a fiducial template in the fluoroscopic image and a marker in the module. A triangle metal plate, placed on the operating table is used as fiducial template. The area of template image within the viewing area of the fluoroscopy machine is obtained by the image processing techniques such as edge detection and Hough transformation to extract the template from other objects in the fluoroscopy image. The area of fiducial template from fluoroscopic image is then compared with the area of the marker from the planning so as to obtain the scaling factor. After the scaling factor is obtained, the user can use simple operations by mouse to shift and rotate the preoperative planning to overlay the bone outline from planning with the bone edge from fluoroscopy image. In this way osteotomy levels and external fixator positioning on the limb can guided by the computerized preoperative plan.

DNA identification of human remains in Disaster Victim Identification (DVI): An efficient sampling method for muscle, bone, bone marrow and teeth.

PubMed

de Boer, Hans H; Maat, George J R; Kadarmo, D Aji; Widodo, Putut T; Kloosterman, Ate D; Kal, Arnoud J

2018-06-04

In disaster victim identification (DVI), DNA profiling is considered to be one of the most reliable and efficient means to identify bodies or separated body parts. This requires a post mortem DNA sample, and an ante mortem DNA sample of the presumed victim or their biological relative(s). Usually the collection of an adequate ante mortem sample is technically simple, but the acquisition of a good quality post mortem sample under unfavourable DVI circumstances is complicated due to the variable degree of preservation of the human remains and the high risk of DNA (cross) contamination. This paper provides the community with an efficient method to collect post-mortem DNA samples from muscle, bone, bone marrow and teeth, with a minimal risk of contamination. Our method has been applied in a recent, challenging DVI operation (i.e. the identification of the 298 victims of the MH17 airplane crash in 2014). 98,2% of the collected PM samples provided the DVI team with highly informative DNA genotyping results without the risk of contamination and consequent mistyping the victim's DNA. Moreover, the method is easy, cheap and quick. This paper provides the DVI community with a step-wise instructions with recommendations for the type of tissue to be sampled and the site of excision (preferably the upper leg). Although initially designed for DVI purposes, the method is also suited for the identification of individual victims. Copyright © 2018 Elsevier B.V. All rights reserved.

Stress Fractures of the Pelvis and Legs in Athletes

PubMed Central

Behrens, Steve B.; Deren, Matthew E.; Matson, Andrew; Fadale, Paul D.; Monchik, Keith O.

2013-01-01

Context: Stress fractures are common injuries in athletes, often difficult to diagnose. A stress fracture is a fatigue-induced fracture of bone caused by repeated applications of stress over time. Evidence Acquisition: PubMed articles published from 1974 to January 2012. Results: Intrinsic and extrinsic factors may predict the risk of stress fractures in athletes, including bone health, training, nutrition, and biomechanical factors. Based on their location, stress fractures may be categorized as low- or high-risk, depending on the likelihood of the injury developing into a complete fracture. Treatment for these injuries varies substantially and must account for the risk level of the fractured bone, the stage of fracture development, and the needs of the patient. High-risk fractures include the anterior tibia, lateral femoral neck, patella, medial malleolus, and femoral head. Low-risk fractures include the posteromedial tibia, fibula, medial femoral shaft, and pelvis. Magnetic resonance is the imaging test of choice for diagnosis. Conclusions: These injuries can lead to substantial lost time from participation. Treatment will vary by fracture location, but most stress fractures will heal with rest and modified weightbearing. Some may require more aggressive intervention, such as prolonged nonweightbearing movement or surgery. Contributing factors should also be addressed prior to return to sports. PMID:24427386

Assessment of Hip Fracture Risk Using Cross-Section Strain Energy Determined by QCT-Based Finite Element Modeling

PubMed Central

Kheirollahi, Hossein

2015-01-01

Accurate assessment of hip fracture risk is very important to prevent hip fracture and to monitor the effect of a treatment. A subject-specific QCT-based finite element model was constructed to assess hip fracture risk at the critical locations of femur during the single-leg stance and the sideways fall. The aim of this study was to improve the prediction of hip fracture risk by introducing a novel failure criterion to more accurately describe bone failure mechanism. Hip fracture risk index was defined using cross-section strain energy, which is able to integrate information of stresses, strains, and material properties affecting bone failure. It was found that the femoral neck and the intertrochanteric region have higher fracture risk than other parts of the femur, probably owing to the larger content of cancellous bone in these regions. The study results also suggested that women are more prone to hip fracture than men. The findings in this study have a good agreement with those clinical observations reported in the literature. The proposed hip fracture risk index based on strain energy has the potential of more accurate assessment of hip fracture risk. However, experimental validation should be conducted before its clinical applications. PMID:26601105

Impact of Martial Arts (Judo, Karate, and Kung Fu) on Bone Mineral Density Gains in Adolescents of Both Genders: 9-Month Follow-Up.

PubMed

Ito, Igor H; Kemper, Han C G; Agostinete, Ricardo R; Lynch, Kyle R; Christofaro, Diego G D; Ronque, Enio R; Fernandes, Rômulo A

2017-11-01

To compare bone mineral density (BMD) gains in adolescents of both genders stratified according to different martial art styles in a 9-month follow-up study. The longitudinal study consisted of 29 adolescents of both genders and age between 11 and 17 years stratified into a control group (not engaged in any sport) and 50 fighters (kung fu/karate, n = 29; judo, n = 21). All 79 subjects underwent anthropometric measures (weight, height, leg length, and height set) and dual-energy X-ray absorptiometry (BMD, in g/cm 2 ) at 2 moments, baseline and 9 months later. Maturity offset (age at peak height velocity), lean soft tissue, chronological age, and resistance training were treated as covariates. Male judoists presented higher gains in BMD-spine [0.098 g/cm 2 (95% confidence interval, 0.068-0.128)] than control group [0.040 g/cm 2 (95% confidence interval, 0.011-0.069)] (post hoc test with P = .030). There was no effect of martial art on BMD gains among girls. Independently of gender, in all multivariate models, lean soft tissue constituted the most relevant covariate. Judo practice in adolescents affected the bone accrual significantly after 9-month follow-up compared with controls, mainly in boys.

Osteosarcopenic Obesity Syndrome: What Is It and How Can It Be Identified and Diagnosed?

PubMed Central

2016-01-01

Conditions related to body composition and aging, such as osteopenic obesity, sarcopenia/sarcopenic obesity, and the newly termed osteosarcopenic obesity (triad of bone muscle and adipose tissue impairment), are beginning to gain recognition. However there is still a lack of definitive diagnostic criteria for these conditions. Little is known about the long-term impact of these combined conditions of osteoporosis, sarcopenia, and obesity in older adults. Many may go undiagnosed and progress untreated. Therefore, the objective of this research is to create diagnostic criteria for osteosarcopenic obesity in older women. The proposed diagnostic criteria are based on two types of assessments: physical, via body composition measurements, and functional, via physical performance measures. Body composition measurements such as T-scores for bone mineral density, appendicular lean mass for sarcopenia, and percent body fat could all be obtained via dual energy X-ray absorptiometry. Physical performance tests: handgrip strength, one-leg stance, walking speed, and sit-to-stand could be assessed with minimal equipment. A score could then be obtained to measure functional decline in the older adult. For diagnosing osteosarcopenic obesity and other conditions related to bone loss and muscle loss combined with obesity, a combination of measures may more adequately improve the assessment process. PMID:27667996

Mesenchymal stem cell therapy in the treatment of hip osteoarthritis

PubMed Central

Mardones, Rodrigo; Jofré, Claudio M.; Tobar, L.

2017-01-01

Abstract This study was performed to investigate the safety and efficacy of the intra-articular infusion of ex vivo expanded autologous bone marrow-derived mesenchymal stem cells (BM-MSC) to a cohort of patients with articular cartilage defects in the hip. The above rationale is sustained by the notion that MSCs express a chondrocyte differential potential and produce extracellular matrix molecules as well as regulatory signals, that may well contribute to cure the function of the damaged hip joint. A cohort of 10 patients with functional and radiological evidences of hip osteoarthritis, either in one or both legs, was included in the study. BM-MSC (the cell product) were prepared and infused into the damaged articulation(s) of each patient (60 × 106 cells in 3 weekly/doses). Before and after completion of the cell infusion scheme, patients were evaluated (hip scores for pain, stiffness, physical function, range of motion), to assess whether the infusion of the respective cell product was beneficial. The intra-articular injection of three consecutive weekly doses of ex vivo expanded autologous BM-MSC to patients with articular cartilage defects in the hip and proved to be a safe and clinically effective treatment in the restoration of hip function and range of motion. In addition, the statistical significance of the above data is in line with the observation that the radiographic scores (Tönnis Classification of Osteoarthritis) of the damaged leg(s) remained without variation in 9 out of 10 patients, after the administration of the cell product. PMID:28630737

Effects of whole-body vibration training on physical function, bone and muscle mass in adolescents and young adults with cerebral palsy

PubMed Central

Gusso, Silmara; Munns, Craig F; Colle, Patrícia; Derraik, José G B; Biggs, Janene B; Cutfield, Wayne S; Hofman, Paul L

2016-01-01

We performed a clinical trial on the effects of whole-body vibration training (WBVT) on muscle function and bone health of adolescents and young adults with cerebral palsy. Forty participants (11.3–20.8 years) with mild to moderate cerebral palsy (GMFCS II–III) underwent 20-week WBVT on a vibration plate for 9 minutes/day 4 times/week at 20 Hz (without controls). Assessments included 6-minute walk test, whole-body DXA, lower leg pQCT scans, and muscle function (force plate). Twenty weeks of WBVT were associated with increased lean mass in the total body (+770 g; p = 0.0003), trunk (+410 g; p = 0.004), and lower limbs (+240 g; p = 0.012). Bone mineral content increased in total body (+48 g; p = 0.0001), lumbar spine (+2.7 g; p = 0.0003), and lower limbs (+13 g; p < 0.0001). Similarly, bone mineral density increased in total body (+0.008 g/cm2; p = 0.013), lumbar spine (+0.014 g/cm2; p = 0.003), and lower limbs (+0.023 g/cm2; p < 0.0001). Participants reduced the time taken to perform the chair test, and improved the distance walked in the 6-minute walk test by 11% and 35% for those with GMFCS II and III, respectively. WBVT was associated with increases in muscle mass and bone mass and density, and improved mobility of adolescents and young adults with cerebral palsy. PMID:26936535

The role of cross-sectional geometry, curvature, and limb posture in maintaining equal safety factors: a computed tomography study.

PubMed

Brassey, Charlotte A; Kitchener, Andrew C; Withers, Philip J; Manning, Phillip L; Sellers, William I

2013-03-01

The limb bones of an elephant are considered to experience similar peak locomotory stresses as a shrew. "Safety factors" are maintained across the entire range of body masses through a combination of robusticity of long bones, postural variation, and modification of gait. The relative contributions of these variables remain uncertain. To test the role of shape change, we undertook X-ray tomographic scans of the leg bones of 60 species of mammals and birds, and extracted geometric properties. The maximum resistible forces the bones could withstand before yield under compressive, bending, and torsional loads were calculated using standard engineering equations incorporating curvature. Positive allometric scaling of cross-sectional properties with body mass was insufficient to prevent negative allometry of bending (F(b) ) and torsional maximum force (F(t) ) (and hence decreasing safety factors) in mammalian (femur F(b) ∞M(b) (0.76) , F(t) ∞M(b) (0.80) ; tibia F(b) ∞M(b) (0.80) , F(t) ∞M(b) (0.76) ) and avian hindlimbs (tibiotarsus F(b) ∞M(b) (0.88) , F(t) ∞M(b) (0.89) ) with the exception of avian femoral F(b) and F(t) . The minimum angle from horizontal a bone must be held while maintaining a given safety factor under combined compressive and bending loads increases with M(b) , with the exception of the avian femur. Postural erectness is shown as an effective means of achieving stress similarity in mammals. The scaling behavior of the avian femur is discussed in light of unusual posture and kinematics. Copyright © 2013 Wiley Periodicals, Inc.

Association between site-specific bone mineral density and glucose homeostasis and anthropometric traits in healthy men and women.

PubMed

Kim, Se-Min; Cui, Jinrui; Rhyu, Jane; Guo, Xiuqing; Chen, Yii-Der I; Hsueh, Willa A; Rotter, Jerome I; Goodarzi, Mark O

2018-06-01

Patients with type 2 diabetes mellitus have an increased risk of fracture despite normal or increased bone mineral density (BMD). Studies on the relationship of glucose homeostasis with BMD phenotypes have been inconclusive because distinguishing the roles of insulin resistance and hyperglycaemia in bone remodelling is challenging. In this study, we sought to define the relationship of site-specific BMD with glucose homeostasis traits and anthropometric traits. In a cross-sectional study, we examined 787 subjects from the Mexican-American Coronary Artery Disease (MACAD) cohort who had undergone euglycaemic-hyperinsulinaemic clamps, oral glucose tolerance testing and dual X-ray absorptiometry. Glucose homeostasis traits included insulinogenic index (IGI30), insulin sensitivity (M value), insulin clearance (MCRI), fasting insulin, fasting glucose and 2-hour glucose. Univariate and multivariate analyses were performed to assess the association of glucose homeostasis and anthropometric traits with site-specific BMD. Two-hour glucose was negatively associated with arm BMD in women, which remained significant in multivariate analysis (β = -.15, P = .0015). Positive correlations between fasting insulin and BMD at weight-bearing sites, including pelvis (β = .22, P < .0001) and legs (β = .17, P = .001) in women and pelvis (β = .33, P < .0001) in men, lost significance after multivariate adjustment. Lean mass exhibited strong independent positive associations with BMD at multiple sites in both sexes. Our findings suggest that (i) anabolic effects of insulin might work via mechanical loading from lean mass; (ii) a direct negative effect of increasing glucose might be more prominent at cortical-bone-rich sites in women; and (iii) lean mass is a strong positive predictor of bone mass. © 2018 John Wiley & Sons Ltd.

Ilizarov bone transport versus fibular graft for reconstruction of tibial bone defects in children.

PubMed

Abdelkhalek, Mostafa; El-Alfy, Barakat; Ali, Ayman M

2016-11-01

The aim of this study was to compare the results of treatment of segmental tibial defects in the pediatric age group using an Ilizarov external fixator versus a nonvascularized fibular bone graft. This study included 24 patients (age range from 5.5 to 15 years) with tibial bone defects: 13 patients were treated with bone transport (BT) and 11 patients were treated with a nonvascularized fibular graft (FG). The outcome parameters were bone results (union, deformity, infection, leg-length discrepancy) and functional results: external fixation index and external fixation time. In group A (BT), one patient developed refracture at the regenerate site, whereas, in group B (FG), after removal of the external fixator, one of the FGs developed a stress fracture. The external fixator time in group A was 10.7 months (range 8-14.5) versus 7.8 months (range 4-11.5 months) in group B (FG). In group A (BT), one patient had a limb-length discrepancy (LLD), whereas, in group B (FG), three patients had LLD. The functional and bone results of the Ilizarov BT technique were excellent in 23.1 and 30.8%, good in 38.5 and 46.2, fair in 30.8 and 15.4, and poor in 7.6 and 7.6%, respectively. The poor functional result was related to the poor bone result because of prolonged external fixator time resulting in significant pain, limited ankle motion, whereas the functional and bone results of fibular grafting were excellent in 9.1 and 18.2%, good in 63.6 and 45.5%, fair in 18.2 and 27.2%, and poor in 9.1 and 9.1%, respectively. Segmental tibial defects can be effectively treated with both methods. The FG method provides satisfactory results, with early removal of the external fixator. However, it had a limitation in patients with severe infection and those with LLD. Also, it requires a long duration of limb bracing until adequate hypertrophy of the graft. The Ilizarov method has the advantages of early weight bearing, treatment of postinfection bone defect in a one-stage surgery, and the possibility to treat the associated LLD. However, it has a long external fixation time.

Three-Dimensional Bio-Printed Scaffold Sleeves With Mesenchymal Stem Cells for Enhancement of Tendon-to-Bone Healing in Anterior Cruciate Ligament Reconstruction Using Soft-Tissue Tendon Graft.

PubMed

Park, Sin Hyung; Choi, Yeong-Jin; Moon, Sang Won; Lee, Byung Hoon; Shim, Jin-Hyung; Cho, Dong-Woo; Wang, Joon Ho

2018-01-01

To investigate the efficacy of the insertion of 3-dimensional (3D) bio-printed scaffold sleeves seeded with mesenchymal stem cells (MSCs) to enhance osteointegration between the tendon and tunnel bone in anterior cruciate ligament (ACL) reconstruction in a rabbit model. Scaffold sleeves were fabricated by 3D bio-printing. Before ACL reconstruction, MSCs were seeded into the scaffold sleeves. ACL reconstruction with hamstring tendon was performed on both legs of 15 adult rabbits (aged 12 weeks). We implanted 15 bone tunnels with scaffold sleeves with MSCs and implanted another 15 bone tunnels with scaffold sleeves without MSCs before passing the graft. The specimens were harvested at 4, 8, and 12 weeks. H&E staining, immunohistochemical staining of type II collagen, and micro-computed tomography of the tunnel cross-sectional area were evaluated. Histologic assessment was conducted with a histologic scoring system. In the histologic assessment, a smooth bone-to-tendon transition through broad fibrocartilage formation was identified in the treatment group, and the interface zone showed abundant type II collagen production on immunohistochemical staining. Bone-tendon healing histologic scores were significantly higher in the treatment group than in the control group at all time points. Micro-computed tomography at 12 weeks showed smaller tibial (control, 9.4 ± 0.9 mm 2 ; treatment, 5.8 ± 2.9 mm 2 ; P = .044) and femoral (control, 9.6 ± 2.9 mm 2 ; treatment, 6.0 ± 1.0 mm 2 ; P = .03) bone-tunnel areas in the treated group than in the control group. The 3D bio-printed scaffold sleeve with MSCs exhibited excellent results in osteointegration enhancement between the tendon and tunnel bone in ACL reconstruction in a rabbit model. If secure biological healing between the tendon graft and tunnel bone can be induced in the early postoperative period, earlier, more successful rehabilitation may be facilitated. Three-dimensional bio-printed scaffold sleeves with MSCs have the potential to accelerate bone-tendon healing in ACL reconstruction. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Duck gait: Relationship to hip angle, bone ash, bone density, and morphology.

PubMed

Robison, Cara I; Rice, Meredith; Makagon, Maja M; Karcher, Darrin M

2015-05-01

The rapid growth meat birds, including ducks, undergo requires skeletal integrity; however, fast growth may not be conducive to adequate bone structure. A relationship likely exists between skeletal changes and duck mobility. Reduced mobility in meat ducks may have impacts on welfare and production. This study examined the relationships among gait score, bone parameters, and hip angle. Commercial Pekin ducks, ages 14 d (n = 100), 21 d (n = 100), and 32 d (n = 100) were weighed and gait scored with a 3-point gait score system by an observer as they walked over a Tekscan gait analysis system. Gait was scored as GS0, GS1, or GS2 with a score of GS0 defined as good walking ability and a score of GS2 as poorest walking ability. Ducks were humanely euthanized, full body scanned using quantitative computed tomography (QCT), and the right femur and tibia were extracted. Leg bones were cleaned, measured, fat extracted, and ashed. QCT scans were rendered to create computerized 3D models where pelvic hip angles and bone density were measured. Statistical analysis was conducted using PROC MIXED with age and gait score in the model. Body weight increased with age, but within an age, body weight decreased as walking ability became worse (P < 0.01). As expected, linear increases in tibia and femur bone width and length were observed as the ducks aged (P < 0.01). Right and left hip angle increased with duck age (P < 0.01). Additionally, ducks with a GS2 had wider hip angles opposed to ducks with a GS0 (P < 0.01). Bone density increased linearly with both age and gait score (P < 0.05). Femur ash content was lowest in 32-day-old ducks and ducks with GS1 and GS2 (P < 0.0001). Tibia ash content increased with age, but decreased as gait score increased (P < 0.001). The observation that right hip angle changed with gait scores merits further investigation into the relationship between duck mobility and skeletal changes during growth. © 2015 Poultry Science Association Inc.

[Radiographic appraisal between metal and bone interosculate backfill after total hip arthroplasty with trabecular metal cup].

PubMed

Li, Wei; Zhou, Yi-Xin; Wu, Jian; Xu, Hui; Ji, Song-Jie

2009-02-15

To evaluate the bone refilling in the interface between the trabecular metal (TM) acetabular shell and the bone surface according to consecutive X film measuring after surgery. From July 2006 to July 2007, 35 patients (40 hips) accepted total hip replacement using trabecular metal monoblock acetabular cup system (TM). The cup was made of a ellipse shaped press fit Tantalum shell and high cross-linked PE liner (Longevity) with 28 mm inner diameter. The patients demography was: 16 male (20 hips), 19 female (20 hips), 5 bilateral hip replacements, age from 41 - 71 (mean 53), including 18 avascular necrosis hips, 16 osteoarthritis hips (including those secondary to a dysplasia hip), 4 avascular necrosis hips after femoral neck fracture, 2 Ankylosis Spondylitis. All the 40 total hip replacements used posterior approach, using hemispherical acetabular reamer and 2 mm press fit of final metal shell without screw fixation. The consecutive X film was taken at the end time of surgery and 2, 6, 12, 24 weeks, and 12 months. The clinical results was evaluate according to Harris scoring system, and the standard pelvis AP X film was measured at the interface between metal shell and the acetabular bone surface, witch was divided into five regions (A, B, C, D, E). Totally 32 patients (37 hips) were followed with average 8.7 months (7 - 12 months). The Harris before surgery was 50.5 (32 - 85), promoted to 91.0 (72 - 100), including 29 excellent, 6 good, 2 fair, and the total excellent and good rate was 94.6%. Complications include 4 patients leg length discrepancy from 1 - 2 cm, 3 patients moderate thigh pain and released after conservative therapy. No infection and dislocation was found. Twenty-one patients (23 hips) were found lucent line at the bone-metal interface from 1 - 5 mm, most common in B region and BC boundary than C, D, and CD boundary. All the patients followed was found the lucent line disappeared and refilled with bone at X film 24 weeks after surgery, however, no patients was found osteolysis and cup migration. The trabecular metal has strong capacity of bone conductive and bone inducement.

Anatomical and Functional Images of in vitro and in vivo Tissues by NIR Time-domain Diffuse Optical Tomography

NASA Astrophysics Data System (ADS)

Zhao, Huijuan; Gao, Feng; Tanikawa, Yukari; Homma, Kazuhiro; Onodera, Yoichi; Yamada, Yukio

Near infra-red (NIR) diffuse optical tomography (DOT) has gained much attention and it will be clinically applied to imaging breast, neonatal head, and the hemodynamics of the brain because of its noninvasiveness and deep penetration in biological tissue. Prior to achieving the imaging of infant brain using DOT, the developed methodologies need to be experimentally justified by imaging some real organs with simpler structures. Here we report our results of an in vitro chicken leg and an in vivo exercising human forearm from the data measured by a multi-channel time-resolved NIR system. Tomographic images were reconstructed by a two-dimensional image reconstruction algorithm based on a modified generalized pulse spectrum technique for simultaneous reconstruction of the µa and µs´. The absolute µa- and µs´-images revealed the inner structures of the chicken leg and the forearm, where the bones were clearly distinguished from the muscle. The Δµa-images showed the blood volume changes during the forearm exercise, proving that the system and the image reconstruction algorithm could potentially be used for imaging not only the anatomic structure but also the hemodynamics in neonatal heads.

Type 2 Diabetes Mellitus Is Associated With Better Bone Microarchitecture But Lower Bone Material Strength and Poorer Physical Function in Elderly Women: A Population-Based Study.

PubMed

Nilsson, Anna G; Sundh, Daniel; Johansson, Lisa; Nilsson, Martin; Mellström, Dan; Rudäng, Robert; Zoulakis, Michail; Wallander, Märit; Darelid, Anna; Lorentzon, Mattias

2017-05-01

Type 2 diabetes mellitus (T2DM) is associated with an increased risk of fractures according to several studies. The underlying mechanisms remain unclear, although small case-control studies indicate poor quality of the cortical bone. We have studied a population-based sample of women aged 75 to 80 years in Gothenburg, randomly invited from the population register. Areal bone mineral density (aBMD) was measured by dual-energy X-ray absorptiometry (Hologic Discovery A), bone microarchitecture by high-resolution peripheral quantitative computed tomography (HR-pQCT; ExtremeCT from Scanco Medical AG), and reference point indentation was performed with Osteoprobe (Active Life Scientific). Women with T2DM (n = 99) had higher aBMD compared to controls (n = 954). Ultradistal tibial and radial trabecular bone volume fraction (+11% and +15%, respectively), distal cortical volumetric BMD (+1.6% and +1.7%), cortical area (+11.5% and +9.3%), and failure load (+7.7% and +12.9%) were higher in diabetics than in controls. Cortical porosity was lower (mean ± SD: 1.5% ± 1.1% versus 2.0% ± 1.7%, p = 0.001) in T2DM in the distal radius but not in the ultradistal radius or the tibia. Adjustment for covariates (age, body mass index, glucocorticoid treatment, smoking, physical activity, calcium intake, bone-active drugs) eliminated the differences in aBMD but not in HR-pQCT bone variables. However, bone material strength index (BMSi) by reference point indentation was lower in T2DM (74.6 ± 7.6 versus 78.2 ± 7.5, p < 0.01), also after adjustment, and women with T2DM performed clearly worse in measures of physical function (one leg standing: -26%, 30-s chair-stand test: -7%, timed up and go: +12%, walking speed: +8%; p < 0.05-0.001) compared to controls. In conclusion, we observed a more favorable bone microarchitecture but no difference in adjusted aBMD in elderly women with T2DM in the population compared to nondiabetics. Reduced BMSi and impaired physical function may explain the increased fracture risk in T2DM. © 2016 American Society for Bone and Mineral Research. © 2016 American Society for Bone and Mineral Research.

The initial safe range of motion of the ankle joint after three methods of internal fixation of simulated fractures of the medial malleolus.

PubMed

Shimamura, Yoshio; Kaneko, Kazuo; Kume, Kazuhiko; Maeda, Mutsuhiro; Iwase, Hideaki

2006-07-01

Previous studies have demonstrated the safe passive range of ankle motion for inter-bone stiffness after internal fixation under load but there is a lack of information about the safe range of ankle motion for early rehabilitation in the absence of loading. The present study was designed to assess the effect of ankle movement on inter-bone displacement characteristics of medial malleolus fractures following three types of internal fixation to determine the safe range of motion. Five lower legs obtained during autopsy were used to assess three types of internal fixation (two with Kirschner-wires alone; two with Kirschner-wires plus tension band wiring; and, one with an AO/ASIF malleolar screw alone). Following a simulated fracture by sawing through the medial malleolus the displacement between the fractured bone ends was measured during a passive range of movement with continuous monitoring using omega (Omega) shaped transducers and a biaxial flexible goniometer. Statistical analysis was performed with repeated measures analysis of variance. Inter-bone displacement was not proportional to the magnitude of movement throughout the range of ankle motion as, when separation exceeded 25 microm, there was increasingly wide separation as plantar-flexion or dorsal-flexion was increased. There was no statistical significant difference between the small amount of inter-bone displacement observed with three types of fixation within the safe range of dorsal-flexion and plantar-flexion for early rehabilitation. However the inter-bone separation when fixation utilized two Kirschner-wires alone tended to be greater than when using the other two types of fixation during dorsal-flexion and eversion. The present study revealed a reproducible range of ankle motion for early rehabilitation which was estimated to be within the range of 20 degrees of dorsal-flexion and 10 degrees of plantar-flexion without eversion. Also, internal fixation with two Kirschner-wires alone does not seem to provide stability achieved by the other two forms of fixation.

Endoscopic removal of PMMA in hip revision surgery with a CO2 laser

NASA Astrophysics Data System (ADS)

Sazy, John; Kollmer, Charles; Uppal, Gurvinder S.; Lane, Gregory J.; Sherk, Henry H.

1991-05-01

Purpose: to compare CO2 laser to mechanical means of PMMA removal in total hip arthroplasty revision surgery. Materials and methods: Forty-five patients requiring hip revision surgery were studied and compared to historical controls. Cement was removed from the femoral canal utilizing a 30 centimeter laparoscope. A CO2 laser waveguide was passed through the laparoscope into the femoral canal and a TV camera was placed over the eye piece to permit visualization of the depths of the femoral canal on a video monitor. The leg was placed in a horizontal position which avoided the pooling of blood or saline in the depths of the femur. Under direct vision the distal plug could be vaporized with a 40 centimeter CO2 laser waveguide. Power settings of 20 to 25 watts and a superpulsed mode were used. A 2 mm suction tube was welded to the outside of the laparoscope permitting aspiration of the products of vaporization. Results: Of 45 hip revisions there were no shaft perforation, fractures or undue loss of bone stock. There was no statistically different stay in hospital time, blood loss or operative time between the CO2 revision group compared to the non-laser revision group, in which cement was removed by mechanical methods. Conclusions: Mechanical methods used in removing bone cement using high speed burrs, reamers, gouges, and osteotomies is technically difficult and fraught with complications including shaft fracture, perforations, and unnecessary loss of bone stock. The authors' experience using the CO2 laser in hip revision surgery has permitted the removal of bone cement. Use of a modified laparoscope has allowed for precise, complete removal of bone cement deep within the femoral shaft without complication or additional operative time. The authors now advocate the use of a CO2 laser with modified laparoscope in hip revision surgery in which bone cement is to be removed from within the femoral shaft.

The effects of a 6-month resistance training and dried plum consumption intervention on strength, body composition, blood markers of bone turnover, and inflammation in breast cancer survivors.

PubMed

Simonavice, Emily; Liu, Pei-Yang; Ilich, Jasminka Z; Kim, Jeong-Su; Arjmandi, Bahram; Panton, Lynn B

2014-06-01

The purpose of this study was to examine the effects of resistance training (RT) and dried plum (DP) consumption on strength, body composition, blood markers of bone, and inflammation in breast cancer survivors (BCS). Twenty-three BCS (RT, n = 12; RT+DP, n = 11), aged 64 ± 7 years, were evaluated at baseline and after 6 months of intervention on the following: muscular strength (chest press and leg extension) via 1-repetition maximums (1RMs); body composition, specifically bone mineral density (BMD) by dual energy X-ray absorptiometry; biochemical markers of bone turnover (bone-specific alkaline phosphatase (BAP), tartrate resistant acid phosphatase (TRAP-5b)); and inflammation (C-reactive protein (CRP)). Target RT prescription was 2 days/week of 10 exercises, including 2 sets of 8-12 repetitions at ∼60%-80% of 1RM. RT+DP also consumed 90 g of DP daily. There were no baseline differences between groups or any group-by-time interactions for any of the variables. BCS increased upper (p < 0.05) (RT: 64 ± 14 to 80 ± 17 kg; RT+DP: 72 ± 23 to 91 ± 20 kg) and lower (p < 0.05) (RT: 69 ± 20 to 87 ± 28 kg; RT+DP: 78 ± 19 to 100 ± 21 kg) body strength. Body composition and BMD improvements were not observed. TRAP-5b decreased in the RT group (p < 0.05) (4.55 ± 1.57 to 4.04 ± 1.63 U/L) and the RT+DP group (p = 0.07) (5.10 ± 2.75 to 4.27 ± 2.03 U/L). Changes in BAP and CRP were not observed. RT was effective for improving biochemical markers of bone turnover and muscular strength in BCS. A longer and higher intensity intervention may be needed to reveal the true effects of RT and DP on body composition and biochemical markers of inflammation.

Clinical Implications of Hip Flexion in the Measurement of Spinal Bone Mineral Density.

PubMed

Ikegami, Shota; Kamimura, Mikio; Uchiyama, Shigeharu; Nakamura, Yukio; Mukaiyama, Keijiro; Kato, Hiroyuki

2016-01-01

The aim of this study was to investigate if differences in leg positioning affect spinal bone mineral density (BMD) measurements and the detection of low bone mass. Subjects included 1039 Japanese patients, 878 women and 161 men (mean ages: 67 and 71 years, respectively). Spinal BMD (L1-4) was measured using dual-energy X-ray absorptiometry (DXA) with patients lying in 2 different positions: (1) supine on the scanning table with hips flexed and knees flexed over a 90° support pad (the standard position) and (2) simply supine (the supine position). Predictive indices were calculated for spinal DXA acquired with patients in the supine position. A BMD T-score of -2.5 or lower was set as the threshold for low bone mass. For the standard and the supine positions during scanning in women, BMDs were 0.911 and 0.915 g/cm(2), respectively; in men, they were 1.117  and 1.124 g/cm(2), respectively. The estimated systematic bias in BMD between the positions was 0.42% (95% confidence interval: 0.24, 0.59; p = 0.009). Random errors in the densitometry measurements for the standard and supine positions were 0.66% and 0.84%, respectively. There was no significant difference between the errors (p= 0.164). The likelihood ratios of a positive and negative test for the detection of low bone mass following supine DXA were 121.0 and 0.066, respectively, compared with results acquired using the standard position. In conclusion, DXA measurements acquired with patients in the supine position slightly overestimated BMD vs the standard position. However, the clinical equivalency between the positioning methods for DXA is preserved to the extent that low bone mass can be reliably detected in the supine position. Copyright © 2016 International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

A rare combination of amniotic constriction band with osteogenesis imperfecta.

PubMed

Shah, Krupa Hitesh; Shah, Hitesh

2015-11-11

Amniotic constriction bands and osteogenesis imperfecta are disorders arising from a collagen defect. We report a rare association of amniotic bands with osteogenesis imperfecta in a child. The child was born with multiple amniotic bands involving the right leg, both hands and both feet. Multiple fractures of long bones of lower limbs occurred in childhood due to trivial trauma. Deformities of the femur and tibia due to malunion with osteopenia and blue sclerae were present. The patient was treated with z plasty of constriction band of the right tibia and bisphosphonate for osteogenesis imperfecta. This rare association of both collagen diseases may provide further insight for the pathogenesis of these diseases. 2015 BMJ Publishing Group Ltd.

Four weeks of training in a sledge jump system improved the jump pattern to almost natural reactive jumps.

PubMed

Kramer, Andreas; Ritzmann, Ramona; Gruber, Markus; Gollhofer, Albert

2012-01-01

In spite of extensive training regimens during long-term space missions with existing training devices, astronauts suffer from muscle and bone loss. It has been suggested that reactive jumps inducing high forces in the muscles-consequently exposing the bones to high strains-help to counteract these degradations. In a previous study, a new sledge jump system (SJS) was found to allow fairly natural reactive jumps. The aim of the present study was to evaluate if training in the SJS would further reduce the differences between jumps in the SJS and normal jumps, particularly with respect to ground reaction forces (GRF) and rate of force development (RFD). Sixteen participants in a training group (TG) and 16 in a control group (CON) were tested before and after the TGs four-week hopping training in the SJS. During the tests, kinetic, kinematic and electromyographic data were compared between hops on the ground and in the SJS. After the training period, the GRF, the RFD and the leg stiffness in the SJS significantly increased for the TG (but not for CON) by 10, 35 and 38%, respectively. The kinematic and electromyographic data showed no significant changes. A short training regimen in the SJS reduced the differences between jumps in the SJS and normal jumps. Considering that a natural movement that exposes the muscles and thus also the bones to high loads is regarded as important for the preservation of muscle and bone, the SJS seems to be a promising countermeasure.

3D Optical Investigation of 2 Nail Systems Used in Tibiotalocalcaneal Arthrodesis: A Biomechanical Study.

PubMed

Evers, Julia; Lakemeier, Martin; Wähnert, Dirk; Schulze, Martin; Richter, Martinus; Raschke, Michael J; Ochman, Sabine

2017-05-01

Although retrograde intramedullary nails for tibiotalocalcaneal arthrodesis (TTCA) are an established fixation method, few studies have evaluated the stability of the available nail systems. The purpose of this study was to compare biomechanically the primary stability of 2 nail-systems, A3 (Small Bone Innovations) and HAN (Synthes), in human cadavers and analyze the exact point of instability in TTCA by means of optical measurement. In 6 pairs of lower legs (n = 12) of fresh-frozen human cadavers with osteoporotic bone structure, bone mineral density (BMD) was determined. Pairwise randomized implantation of either an HAN or A3 nail was executed. Performance and stability were measured by quasi-static tests using 3D motion tracking (NDI Optotrak-Certus) followed by cyclic loading tests during dorsi- and plantarflexion. 3D optical analysis in quasi-static tests showed a significantly lower degree of movement for the HAN nail in rotational and dorsi-/plantarflexion, especially in the subtalar joint. Cyclic loading tests were consistent with quasi-static tests. The A3 nail offered lower stability during axial torsion in the ankle and subtalar joints and during plantar- and dorsiflexion in the subtalar joint in osteoporotic bones. This study was the first to examine the primary stability of different arthrodesis nails in TTCA and their bony parts with a 3D motion analysis. The better stability of the locking-only HAN nail in this osteoporotic test setup could lead to more favorable results in comparison to the A3 nail in clinical use.

Body composition and bone mineral density of collegiate American football players

PubMed Central

Turnagöl, Hüseyin Hüsrev

2016-01-01

Abstract The aim of this study was to compare whole and segmental body composition and bone mineral density of collegiate American football players by playing positions. Forty collegiate American football players voluntarily participated in this study. Participants were categorized by playing positions into one of five categories i.e., defensive linemen, offensive linemen, defensive secondary players, offensive secondary players and receivers. Whole body composition and bone mineral density were measured by dual x-ray absorptiometry. Offensive and defensive linemen had higher body mass, a body mass index, lean mass and a fat mass index compared to the remaining three positions and a higher lean mass index compared to offensive secondary players and receivers. Offensive linemen had a higher body fat percentage and lower values of upper to lower lean mass than offensive and defensive secondary players and receivers, and higher total mass to the lean mass ratio and fat mass to the lean mass ratio compared to the other players. Offensive linemen had a higher fat mass index and fat mass to the lean mass ratio than defensive linemen. However, in all other measures they were similar. Offensive and defensive secondary players and receivers were similar with respect to the measured variables. Bone mineral density of the players was within the normal range and no difference in lean mass was observed between the legs. In conclusion, findings of this study showed that the total and segmental body composition profile of collegiate American football players reflected the demands of particular playing positions. PMID:28149373

Substitute CT generation from a single ultra short time echo MRI sequence: preliminary study

NASA Astrophysics Data System (ADS)

Ghose, Soumya; Dowling, Jason A.; Rai, Robba; Liney, Gary P.

2017-04-01

In MR guided radiation therapy planning both MR and CT images for a patient are acquired and co-registered to obtain a tissue specific HU map. Generation of the HU map directly from the MRI would eliminate the CT acquisition and may improve radiation therapy planning. In this preliminary study of substitute CT (sCT) generation, two porcine leg phantoms were scanned using a 3D ultrashort echo time (PETRA) sequence and co-registered to corresponding CT images to build tissue specific regression models. The model was created from one co-registered CT-PETRA pair to generate the sCT for the other PETRA image. An expectation maximization based clustering was performed on the co-registered PETRA image to identify the soft tissues, dense bone and air class membership probabilities. A tissue specific non linear regression model was built from one registered CT-PETRA pair dataset to predict the sCT of the second PETRA image in a two-fold cross validation schema. A complete substitute CT is generated in 3 min. The mean absolute HU error for air was 0.3 HU, bone was 95 HU, fat was 30 HU and for muscle it was 10 HU. The mean surface reconstruction error for the bone was 1.3 mm. The PETRA sequence enabled a low mean absolute surface distance for the bone and a low HU error for other classes. The sCT generated from a single PETRA sequence shows promise for the generation of fast sCT for MRI based radiation therapy planning.

A three-dimensional finite element model for biomechanical analysis of the hip.

PubMed

Chen, Guang-Xing; Yang, Liu; Li, Kai; He, Rui; Yang, Bin; Zhan, Yan; Wang, Zhi-Jun; Yu, Bing-Nin; Jian, Zhe

2013-11-01

The objective of this study was to construct a three-dimensional (3D) finite element model of the hip. The images of the hip were obtained from Chinese visible human dataset. The hip model includes acetabular bone, cartilage, labrum, and bone. The cartilage of femoral head was constructed using the AutoCAD and Solidworks software. The hip model was imported into ABAQUS analysis system. The contact surface of the hip joint was meshed. To verify the model, the single leg peak force was loaded, and contact area of the cartilage and labrum of the hip and pressure distribution in these structures were observed. The constructed 3D hip model reflected the real hip anatomy. Further, this model reflected biomechanical behavior similar to previous studies. In conclusion, this 3D finite element hip model avoids the disadvantages of other construction methods, such as imprecision of cartilage construction and the absence of labrum. Further, it provides basic data critical for accurately modeling normal and abnormal loads, and the effects of abnormal loads on the hip.

Effects of weight at slaughter and sex on the carcass characteristics of Florida suckling kids.

PubMed

Peña, Francisco; Perea, J; García, A; Acero, R

2007-03-01

The effect of slaughter weight and sex on some carcass traits of suckling kids of the Florida breed was evaluated. A total of 60 kids (30 male and 30 female), fed exclusively on milk replacers, were slaughtered at 7-8kg (group 1), 10-11kg (group 2) or 14-15kg (group 3) of liveweight (mean weights of 7.6kg, 10.8kg and 14.4kg, respectively). Higher slaughter weights decreased the percentage of subproducts (blood, skin, head, feet) and internal organs (lungs+traquea, heart, liver, spleen, thymus) but significantly increased the percentage of intestine and fat depots (omental fat and mesenteric fat). Higher slaughter weights also increased carcass measures (L 40.5 vs 49.1; F 22.5 vs 25.9; G 10.4 vs 14.2; Wr 10.1 vs 13.9; Wth 8.0 vs 10.5; Th 16.5 vs 199; B 32.3 vs 42.4; PT 41.5 vs 50.8), compactness carcass index (96.6 vs 152.3) and compactness leg index (27.5 vs 44.1). Sex only significantly affected the percentages of feet, internal organs, omental fat, measure L, carcass compactness index and hind limb compactness index. The meat colour and fat colour were mainly scored as pale and white respectively in the carcasses of the lightest animals, whereas heavier kids were scored as pink and cream. Slaughter weight also influenced significantly the carcass fatness (score 1 in lightest kids and 2 or 3 in heavier ones). There were no significant (p>0.05) differences between slaughter weight group and sex in dressing percentages. Percentages corresponding to the long leg, back and neck (30-33%, 18-19% and 8-10%, respectively) decreased when the slaughter weight increased, whereas the ribs (23-25%) and the flank (10-11%) increased slightly. The carcasses comprised 57-58% muscle, 22-25% bone, 5-6% subcutaneous fat and 9-12% intermuscular fat. The percentage muscle stayed the same with increasing slaughter weight, whereas the bone decreased and the fat increased. The carcasses of the heavier females contained less lean and more fat than the males. The bone percentage was significantly (p<0.05) lower in the females and the carcass fat percentage was significantly (p<0.05) higher than in the males.

Relationship of weight, height, and body mass index with fracture risk at different sites in postmenopausal women: the Global Longitudinal study of Osteoporosis in Women (GLOW).

PubMed

Compston, Juliet E; Flahive, Julie; Hosmer, David W; Watts, Nelson B; Siris, Ethel S; Silverman, Stuart; Saag, Kenneth G; Roux, Christian; Rossini, Maurizio; Pfeilschifter, Johannes; Nieves, Jeri W; Netelenbos, J Coen; March, Lyn; LaCroix, Andrea Z; Hooven, Frederick H; Greenspan, Susan L; Gehlbach, Stephen H; Díez-Pérez, Adolfo; Cooper, Cyrus; Chapurlat, Roland D; Boonen, Steven; Anderson, Frederick A; Adami, Silvano; Adachi, Jonathan D

2014-02-01

Low body mass index (BMI) is a well-established risk factor for fracture in postmenopausal women. Height and obesity have also been associated with increased fracture risk at some sites. We investigated the relationships of weight, BMI, and height with incident clinical fracture in a practice-based cohort of postmenopausal women participating in the Global Longitudinal study of Osteoporosis in Women (GLOW). Data were collected at baseline and at 1, 2, and 3 years. For hip, spine, wrist, pelvis, rib, upper arm/shoulder, clavicle, ankle, lower leg, and upper leg fractures, we modeled the time to incident self-reported fracture over a 3-year period using the Cox proportional hazards model and fitted the best linear or nonlinear models containing height, weight, and BMI. Of 52,939 women, 3628 (6.9%) reported an incident clinical fracture during the 3-year follow-up period. Linear BMI showed a significant inverse association with hip, clinical spine, and wrist fractures: adjusted hazard ratios (HRs) (95% confidence intervals [CIs]) per increase of 5 kg/m(2) were 0.80 (0.71-0.90), 0.83 (0.76-0.92), and 0.88 (0.83-0.94), respectively (all p < 0.001). For ankle fractures, linear weight showed a significant positive association: adjusted HR per 5-kg increase 1.05 (1.02-1.07) (p < 0.001). For upper arm/shoulder and clavicle fractures, only linear height was significantly associated: adjusted HRs per 10-cm increase were 0.85 (0.75-0.97) (p = 0.02) and 0.73 (0.57-0.92) (p = 0.009), respectively. For pelvic and rib fractures, the best models were for nonlinear BMI or weight (p = 0.05 and 0.03, respectively), with inverse associations at low BMI/body weight and positive associations at high values. These data demonstrate that the relationships between fracture and weight, BMI, and height are site-specific. The different associations may be mediated, at least in part, by effects on bone mineral density, bone structure and geometry, and patterns of falling. © 2014 American Society for Bone and Mineral Research.

Knee arthrodesis using a customised modular intramedullary nail in failed infected total knee arthroplasty.

PubMed

Putman, S; Kern, G; Senneville, E; Beltrand, E; Migaud, H

2013-06-01

Knee arthrodesis is used to treat patients with failed infected total knee arthroplasty (TKA). Among fixation methods, intramedullary nailing increases the chances of bone union but may carry a risk of infection around the nail. This risk is not well understood, because available case-series studies were not confined to patients with knee infection. Infection recurrence rates after knee arthrodesis with intramedullary nailing used to treat failed infected TKA are similar to those seen with other fixation methods. We retrospectively reviewed 31 cases of knee arthrodesis with fixation by a modular intramedullary nail performed at a subspecialized center treating complex osteoarticular infections (CRIOAC). The antibiotic regimen was determined based on multidisciplinary discussions and microbiological studies of preoperative and intraoperative specimens. Mean follow-up was 50 ± 22 months (range, 28-90 months). Arthrodesis was performed in one stage (n=6) or two stages (n=25). Success was defined as presence, after a postoperative follow-up of at least 24 months, based on the following criteria: normal erythrocyte sedimentation rate and/or C-reactive protein, no wound inflammation or sinus tract, no revision surgery, and no antibiotic treatment. Bone union was not a criterion for a successful arthrodesis procedure. Removal of the fixation material was required in three patients and long-term palliative antibiotic therapy in three patients (fixation material in place with repeated positive specimens) for a total of six failures due to infection (6/31, 19.4%). None of the patients experienced mechanical failure (no breakage of the material and no fixation failure of the nails designed to allow osteointegration). The mean leg length discrepancy was 10 ± 10 mm (range, 5-34 mm) and the mean Oxford score was 41 ± 11 (range, 23-58). The 50-month rate of arthrodesis survival to revision surgery for nail removal was 77.8 ± 4% and the 50-month rate of arthrodesis survival without revision surgery for persistent infection was 74.6 ± 4.2%. The infection recurrence rate was higher than with other fixation methods but remained acceptable (19.4%). Use of a modular intramedullary nail prevented major leg-length discrepancies, which are often poorly accepted by the patients, and allowed immediate weight bearing despite the often severe bone loss. Level IV, retrospective cohort study. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Does bone loss begin after weight loss ends? Results two years after weight loss or regain in postmenopausal women

PubMed Central

Von Thun, Nancy L.; Sukumar, Deeptha; Heymsfield, Steven B.; Shapses, Sue A.

2016-01-01

Objective Short-term weight loss is accompanied by bone loss in postmenopausal women. The longer-term impact on bone in the reduced overweight/obese woman compared to those who regain their weight was examined in this study using a case-control design. Methods Postmenopausal women (n = 42, body mass index of 28.3 ± 2.8 kg/m2; 60.7 ± 5.5 y) were recruited 2 years after the start of a 6 month weight loss trial and those who maintained their weight (WL-M) were matched to a cohort who regained weight (WL-R). Serum hormones and bone markers were measured in a subset. Bone mineral density (BMD) at the femoral neck (FN), trochanter, spine, radius, and total body and soft tissue composition were taken at baseline, 0.5 and 2 years. Results During WL, both groups lost 9.3 ± 3.4% body weight with no significant difference between groups. After weight loss, weight change was −0.1 ± 2.7 % and 6.0 ± 3.3% in the WL-M (n=22) and WL-R (n=20) groups, respectively. After 2 years, both groups lost BMD at the FN and trochanter (p ≤ 0.01), whereas only the WL-M group reduced BMD at the 1/3 radius (p < 0.001). There was a greater BMD loss at the trochanter (−6.8 ± 5.7%) and the 1/3 radius (−4.5 ± 3.3%) in the WL-M compared to the WL-R group after 2 years. Multiple linear regression showed that change in leg fat mass (but not trunk fat) contributed to trochanter BMD loss (p <0.05). Conclusions After 2 years, there is no BMD recovery of weight reduction-induced bone loss, irrespective of weight-regain. These data suggest that the period after weight loss may be an important point in time to prevent bone loss for both those who maintain or regain weight. PMID:24149920

Does bone loss begin after weight loss ends? Results 2 years after weight loss or regain in postmenopausal women.

PubMed

Von Thun, Nancy L; Sukumar, Deeptha; Heymsfield, Steven B; Shapses, Sue A

2014-05-01

Short-term weight loss is accompanied by bone loss in postmenopausal women. The longer-term impact of weight loss on bone in reduced overweight/obese women compared with women who regained their weight was examined in this study using a case-control design. Postmenopausal women (N = 42; mean [SD] body mass index, 28.3 [2.8] kg/m; mean [SD] age, 60.7 [5.5] y) were recruited 2 years after the start of a 6-month weight loss trial; those who maintained their weight (weight loss maintainer [WL-M] group) were matched to a cohort of women who regained their weight (weight loss regainer [WL-R] group). Serum hormones and bone markers were measured in a subset. Bone mineral density (BMD) at the femoral neck, trochanter, spine, radius, and total body, and soft-tissue composition were taken at baseline, 0.5 years, and 2 years. During weight loss, both groups lost 9.3% (3.4%) of body weight, with no significant difference between the groups. After weight loss, weight change was -0.1% (2.7%) and 6.0% (3.3%) in the WL-M (n = 22) and WL-R (n = 20) groups, respectively. After 2 years, both groups lost BMD at the femoral neck and trochanter (P ≤ 0.01), whereas only the WL-M group reduced BMD at the 1/3 radius (P < 0.001). There was greater BMD loss at the trochanter (-6.8% [5.7%]) and 1/3 radius (-4.5% [3.3%]) in the WL-M group compared with the WL-R group after 2 years. Multiple linear regression showed that change in leg fat mass (but not trunk fat) contributed to trochanter BMD loss (P < 0.05). After 2 years, there is no BMD recovery of weight reduction-induced bone loss, irrespective of weight regain. These data suggest that the period after weight loss may be an important point in time to prevent bone loss for those who maintain weight and those who regain weight.

Angle-stable and compressed angle-stable locking for tibiotalocalcaneal arthrodesis with retrograde intramedullary nails. Biomechanical evaluation.

PubMed

Mückley, Thomas; Hoffmeier, Konrad; Klos, Kajetan; Petrovitch, Alexander; von Oldenburg, Geert; Hofmann, Gunther O

2008-03-01

Retrograde intramedullary nailing is an established procedure for tibiotalocalcaneal arthrodesis. The goal of this study was to evaluate the effects of angle-stable locking or compressed angle-stable locking on the initial stability of the nails and on the behavior of the constructs under cyclic loading conditions. Tibiotalocalcaneal arthrodesis was performed in fifteen third-generation synthetic bones and twenty-four fresh-frozen cadaver legs with use of retrograde intramedullary nailing with three different locking modes: a Stryker nail with compressed angle-stable locking, a Stryker nail with angle-stable locking, and a statically locked Biomet nail. Analyses were performed of the initial stability of the specimens (range of motion) and the laxity of the constructs (neutral zone) in dorsiflexion/plantar flexion, varus/valgus, and external rotation/internal rotation. Cyclic testing up to 100,000 cycles was also performed. The range of motion and the neutral zone in dorsiflexion/plantar flexion at specific cycle increments were determined. In both bone models, the intramedullary nails with compressed angle-stable locking and those with angle-stable locking were significantly superior, in terms of a smaller range of motion and neutral zone, to the statically locked nails. The compressed angle-stable nails were superior to the angle-stable nails only in the synthetic bone model, in external/internal rotation. Cyclic testing showed the nails with angle-stable locking and those with compressed angle-stable locking to have greater stability in both models. In the synthetic bone model, compressed angle-stable locking was significantly better than angle-stable locking; in the cadaver bone model, there was no significant difference between these two locking modes. During cyclic testing, five statically locked nails in the cadaver bone model failed, whereas one nail with angle-stable locking and one with compressed angle-stable locking failed. Regardless of the bone model, the nails with angle-stable or compressed angle-stable locking had better initial stability and better stability following cycling than did the nails with static locking.

Lower Lean Mass Measured by Dual-Energy X-ray Absorptiometry (DXA) is Not Associated with Increased Risk of Hip Fracture in Women: The Framingham Osteoporosis Study.

PubMed

McLean, Robert R; Kiel, Douglas P; Berry, Sarah D; Broe, Kerry E; Zhang, Xiaochun; Cupples, L Adrienne; Hannan, Marian T

2018-01-05

Although muscle mass influences strength in older adults, it is unclear whether low lean mass measured by dual-energy X-ray absorptiometry (DXA) is an independent risk factor for hip fracture. Our objective was to determine the association between DXA lean mass and incident hip fracture risk among 1978 women aged 50 years and older participating in the Framingham Study Original and Offspring cohorts. Leg and total body lean mass (kg) were assessed from whole-body DXA scans collected in 1992-2001. Hip fracture follow-up extended from DXA assessment to the occurrence of fracture, death, drop-out, or end of follow-up in 2007. Cox proportional hazards regression was used to calculate hazard ratios (HR) and 95% confidence intervals (CI) estimating the relative risk of hip fracture associated with a 1-kg increase in baseline lean mass. Mean age was 66 years (range 50-93). Over a median of 8 years of follow-up, 99 hip fractures occurred. In models adjusted for age, height, study cohort, and percent total body fat, neither leg (HR 1.11; 95% CI 0.94, 1.31) nor total body (HR 1.06; 95% CI 0.99, 1.13) lean mass were associated with hip fracture. After further adjustment for femoral neck bone mineral density, leg lean mass results were similar (HR 1.10; 95% CI 0.93, 1.30). In contrast, 1 kg greater total body lean mass was associated with 9% higher hip fracture risk (HR 1.09; 95% CI 1.02, 1.18). Our findings suggest that in women, lower lean mass measured by DXA is not associated with increased risk of hip fracture.

Profiles of muscularity in junior Olympic weight lifters.

PubMed

Kanehisa, H; Funato, K; Abe, T; Fukunaga, T

2005-03-01

This study aimed to investigate the muscularity of strength-trained junior athletes. Muscle thickness (Mt) values at 10 sites (anterior forearm, anterior upper arm, posterior upper arm, chest, abdomen, back, anterior thigh, posterior thigh, anterior lower leg, and posterior lower leg) were determined in junior Olympic weight lifters (OWL, n=7, 15.1+/-0.3 y, mean+/-SD) and non-athletes (CON, n=13, 15.1+/-0.3 y) using a brightness mode ultrasonography. Skeletal age assessed with the Tanner-Whitehouse II method (20 hand-wrist bones) was similar in OWL (16.4+/-0.7 y) and CON (16.3+/-0.6 y). At the 6 sites (anterior forearm, anterior upper arm, posterior upper arm, chest, back and anterior thigh), OWL showed significantly greater Mt values than CON even in terms of Mt relative to body mass(1/3) Mt x BM(-1/3). On the other hand, there were no significant differences between the 2 groups in the Mt ratios of the anterior to posterior site in the upper arm, thigh and lower leg and those of the back to either the chest or abdomen in the trunk. For OWL only, skeletal age was significantly correlated to Mt x BM(-1/3) at the abdomen (r=0.869, p<0.05) and anterior thigh (r=0.883, p<0.05). The findings here indicate that 1) as compared to adolescent non-athletes, junior Olympic weight lifters show a greater muscularity in the upper body and anterior thigh without predominant development in either of anterior and posterior sites within the same body segment, 2) for junior Olympic weight lifters, the muscularity of abdominal and knee extensor muscles is influenced by the biological maturation.

Genome-wide Analysis of Body Proportion Classifies Height-Associated Variants by Mechanism of Action and Implicates Genes Important for Skeletal Development

PubMed Central

Chan, Yingleong; Salem, Rany M.; Hsu, Yu-Han H.; McMahon, George; Pers, Tune H.; Vedantam, Sailaja; Esko, Tonu; Guo, Michael H.; Lim, Elaine T.; Franke, Lude; Smith, George Davey; Strachan, David P.; Hirschhorn, Joel N.

2015-01-01

Human height is a composite measurement, reflecting the sum of leg, spine, and head lengths. Many common variants influence total height, but the effects of these or other variants on the components of height (body proportion) remain largely unknown. We studied sitting height ratio (SHR), the ratio of sitting height to total height, to identify such effects in 3,545 African Americans and 21,590 individuals of European ancestry. We found that SHR is heritable: 26% and 39% of the total variance of SHR can be explained by common variants in European and African Americans, respectively, and global European admixture is negatively correlated with SHR in African Americans (r2 ≈ 0.03). Six regions reached genome-wide significance (p < 5 × 10−8) for association with SHR and overlapped biological candidate genes, including TBX2 and IGFBP3. We found that 130 of 670 height-associated variants are nominally associated (p < 0.05) with SHR, more than expected by chance (p = 5 × 10−40). At these 130 loci, the height-increasing alleles are associated with either a decrease (71 loci) or increase (59 loci) in SHR, suggesting that different height loci disproportionally affect either leg length or spine/head length. Pathway analyses via DEPICT revealed that height loci affecting SHR, and especially those affecting leg length, show enrichment of different biological pathways (e.g., bone/cartilage/growth plate pathways) than do loci with no effect on SHR (e.g., embryonic development). These results highlight the value of using a pair of related but orthogonal phenotypes, in this case SHR with height, as a prism to dissect the biology underlying genetic associations in polygenic traits and diseases. PMID:25865494

A great enigma of the Italian Renaissance: paleopathological study on the death of Giovanni dalle Bande Nere (1498-1526) and historical relevance of a leg amputation.

PubMed

Fornaciari, Gino; Bartolozzi, Pietro; Bartolozzi, Carlo; Rossi, Barbara; Menchi, Ilario; Piccioli, Andrea

2014-09-10

The Medici project consisted in archeological and paleopathological researches on some members of the great dynasty of the Italian Renaissance. The remains of Giovanni de' Medici, so-called "dalle Bande Nere" (Forlì 1498- Mantua 1526) have not been investigated yet. The enigma of the fatal injury and leg amputation of the famous Captain excited curiosity of paleopathologists, medical scientists and Italian Society of Orthopedic and Traumatology which contributed to realize the project of exhumation and study of his skeletal remains. The aim of the study is to report the first anthropological and paleopathological results. The tomb of Giovanni and his wife Maria Salviati was explored and the skeletal remains were investigated. Anthropological and paleopathological examination defined: age at death, physical constitution and activity, skeletal diseases. The bones of the leg were studied macroscopically, under stereoscopic microscope, at X-ray and CT scans to detect type of injury and level of amputation. The skeleton and muscular insertions of Giovanni revealed a young-adult and vigorous man, subjected to stresses of military activity since adolescence. Right tibia was amputated below the proximal half of diaphysis leaving long tibio-fibular stumps with a horizontal cut only at the lateral portion. Thus, the surgeon limited to complete the traumatic hemi-amputation. Amputation in the Sixteenth Century technically consisted in guillotine incisions below the knee using crescent shaped knife and bony saw, usually leaving a quite long tibial stump. Amputations in the Sixteenth Century were contaminated and grossly performed not providing vascular binding nor wound closure. The surgeon performed the procedure in conformity with surgical knowledge of that period.

Changes in bone metabolic parameters following oral calcium supplementation in an adult patient with vitamin D-dependent rickets type 2A.

PubMed

Kinoshita, Yuka; Ito, Nobuaki; Makita, Noriko; Nangaku, Masaomi; Fukumoto, Seiji

2017-06-29

Vitamin D-dependent rickets type 2A (VDDR2A) is a rare inherited disorder with decreased tissue responsiveness to 1,25-dihydroxyvitamin D [1,25(OH) 2 D], caused by loss of function mutations in the vitamin D receptor (VDR) gene. Approximately 50 types of mutations have been identified so far that change amino acids in either the N-terminal DNA binding domain (DBD) or the C-terminal ligand binding domain (LBD) of the VDR protein. The degree of responsiveness to 1,25(OH) 2 D varies between patients with VDDR2A, which may depend on their residual VDR function. In this report, we describe a female patient with VDDR2A caused by an early stop codon (R30X) in the VDR gene that resulted in a severely truncated VDR protein. She developed alopecia and bowed legs within a year after birth and was diagnosed with rickets at the age of 2. She had been treated with active vitamin D and oral calcium supplementation until 22 years of age, when she developed secondary hyperparathyroidism and high bone turnover. The genetic diagnosis of VDDR2A promoted the discontinuation of active vitamin D treatment in favor of monotherapy with oral calcium supplementation. We observed amelioration of the secondary hyperparathyroidism and normalization of bone metabolic parameters within 6 years.

The Role of Musculoskeletal Dynamics and Neuromuscular Control in Stress Development in Bone

NASA Technical Reports Server (NTRS)

DeWoody, Yssa

1996-01-01

The role of forces produced by the musculotendon units in the stress development of the long bones during gait has not been fully analyzed. It is well known that the musculotendons act as actuators producing the joint torques which drive the body. Although the joint torques required to perform certain motor tasks can be recovered through a kinematic analysis, it remains a difficult problem to determine the actual forces produced by each muscle that resulted in these torques. As a consequence, few studies have focused on the role of individual muscles in the development of stress in the bone. This study takes a control theoretic approach to the problem. A seven-link, eight degrees of freedom model of the body is controlled by various muscle groups on each leg to simulate gait. The simulations incorporate Hill-type models of muscles with activation and contraction dynamics controlled through neural inputs. This direct approach allows one to know the exact muscle forces exerted by each musculotendon throughout the gait cycle as well the joint torques and reaction forces at the ankle and knee. Stress and strain computed by finite element analysis on skeletal members will be related to these derived loading conditions. Thus the role of musculoskeletal dynamics and neuromuscular control in the stress development of the tibia during gait can be analyzed.

Unicompartmental knee arthroplasty: is robotic technology more accurate than conventional technique?

PubMed

Citak, Mustafa; Suero, Eduardo M; Citak, Musa; Dunbar, Nicholas J; Branch, Sharon H; Conditt, Michael A; Banks, Scott A; Pearle, Andrew D

2013-08-01

Robotic-assisted unicompartmental knee arthroplasty (UKA) with rigid bone fixation "can significantly improve implant placement and leg alignment. The aim of this cadaveric study was to determine whether the use of robotic systems with dynamic bone tracking would provide more accurate UKA implant positioning compared to the conventional manual technique. Three-dimensional CT-based preoperative plans were created to determine the desired position and orientation for the tibial and femoral components. For each pair of cadaver knees, UKA was performed using traditional instrumentation on the left side and using a haptic robotic system on the right side. Postoperative CT scans were obtained and 3D-to-3D iterative closest point registration was performed. Implant position and orientation were compared to the preoperative plan. Surgical RMS errors for femoral component placement were within 1.9 mm and 3.7° in all directions of the planned implant position for the robotic group, while RMS errors for the manual group were within 5.4mm and 10.2°. Average RMS errors for tibial component placement were within 1.4mm and 5.0° in all directions for the robotic group; while, for the manual group, RMS errors were within 5.7 mm and 19.2°. UKA was more precise using a semiactive robotic system with dynamic bone tracking technology compared to the manual technique. Copyright © 2012 Elsevier B.V. All rights reserved.

Positive effects on bone mineralisation and muscular fitness after 10 months of intense school-based physical training for children aged 8–10 years: the FIT FIRST randomised controlled trial

PubMed Central

Larsen, Malte Nejst; Nielsen, Claus Malta; Helge, Eva Wulff; Madsen, Mads; Manniche, Vibeke; Hansen, Lone; Hansen, Peter Riis; Bangsbo, Jens

2018-01-01

Objectives We investigated whether musculoskeletal fitness of school children aged 8–10 years was affected by frequent intense PE sessions. Design and participants 295 Danish school children aged 8–10 years were cluster randomised to a small-sided ball game group (SSG) (n=96, four schools, five classes), a circuit strength training group (CST) (n=83, four schools, four classes) or a control group (CON, n=116, two schools, five classes). Intervention SSG or CST was performed 3×40 min/week over 10 months. Whole-body dual-energy X-ray absorptiometry (DXA) scans were used to determine areal bone mineral density (aBMD), bone mineral content (BMC) and lean body mass (LBM). Flamingo balance, standing long jump and 20-m sprint tests were used to determine muscular fitness. Results Analysis of baseline-to-10 months change scores showed between-group differences in favour of the interventions in whole-body aBMD (SSG vs CON: 8 mg/cm2, 95% CI 3 to 13; CST vs CON: 7 mg/cm2, 95% CI 2 to 13, p<0.05) and leg BMC (SSG vs CON: 11 g, 95% CI 4 to 18; CST vs CON: 11 g, 95% CI 3 to 18, p<0.05). SSG had higher change scores in leg aBMD compared with CON and CST (SSG vs CON: 19 mg/cm2, 95% CI 11 to 39, p<0.05; SSG vs CST: 12 mg/cm2, 95% CI 3 to 21, p<0.05), and CST had higher change scores in whole-body BMC compared with CON (CST vs CON: 25 g, 95% CI 10 to 39, p<0.05). Both training types resulted in higher change scores in postural balance (SSG vs CON: 2.4 fewer falls/min, 95% CI 0.3 to 4.5, CST vs CON: 3.6 fewer falls/min, 95% CI 1.3 to 5.9, p<0.05) and jump length (SSG vs CON: 10%, 95% CI 5 to 16%; CST vs CON: 9%, 95% CI 3 to 15%, p<0.05). No between-group differences were observed for sprint performance or LBM (p>0.05). Conclusions In conclusion, 3×40 min/week with SSG or CST over a full school year improves bone mineralisation and several aspects of muscular fitness of children aged 8–10 years, suggesting that well-organised intense physical education classes can contribute positively to develop musculoskeletal health in young children. Trial registration number NCT02000492, post results. PMID:27297443

Effects of badminton and ice hockey on bone mass in young males: a 12-year follow-up.

PubMed

Tervo, Taru; Nordström, Peter; Nordström, Anna

2010-09-01

The purpose of the present study was to investigate the influence of different types of weight bearing physical activity on bone mineral density (BMD, g/cm(2)) and evaluate any residual benefits after the active sports career. Beginning at 17 years of age, BMD was measured 5 times, during 12 years, in 19 badminton players, 48 ice hockey players, and 25 controls. During the active career, badminton players gained significantly more BMD compared to ice hockey players at all sites: in their femoral neck (mean difference (Delta) 0.06 g/cm(2), p=0.04), humerus (Delta 0.06 g/cm(2), p=0.01), lumbar spine (Delta 0.08 g/cm(2), p=0.01), and their legs (Delta 0.05 g/cm(2), p=0.003), after adjusting for age at baseline, changes in weight, height, and active years. BMD gains in badminton players were higher also compared to in controls at all sites (Delta 0.06-0.17 g/cm(2), p<0.01 for all). Eleven badminton players and 37 ice hockey players stopped their active career a mean of 6 years before the final follow-up. Both these groups lost significantly more BMD at the femoral neck and lumbar spine compared to the control group (Delta 0.05-0.12 g/cm(2), p<0.05 for all). At the final follow-up, badminton players had significantly higher BMD of the femoral neck, humerus, lumbar spine, and legs (Delta 0.08-0.20 g/cm(2), p<0.01 for all) than both ice hockey players and controls. In summary, the present study may suggest that badminton is a more osteogenic sport compared to ice hockey. The BMD benefits from previous training were partially sustained with reduced activity. Copyright 2010 Elsevier Inc. All rights reserved.

Longitudinal study of body composition in spinal cord injury patients.

PubMed

Singh, Roop; Rohilla, Rajesh K; Saini, Gaurav; Kaur, Kiranpreet

2014-03-01

Bone mass loss and muscle atrophy are the frequent complications occurring after spinal cord injury (SCI). The potential risks involved with these changes in the body composition have implications for the health of the SCI individual. Thus, there is a need to quantitate and monitor body composition changes accurately in an individual with SCI. Very few longitudinal studies have been reported in the literature to assess body composition and most include relatively small number of patients. The present prospective study aimed to evaluate the body composition changes longitudinally by DEXA in patients with acute SCI. Ninety five patients with acute SCI with neurological deficits were evaluated for bone mineral content (BMC), body composition [lean body mass (LBM) and fat mass] by dual-energy X-ray absorptiometry during the first year of SCI. There was a significant decrease in BMC (P < 0.05) and LBM (P < 0.05) and increase in total body fat mass (TBFM) and percentage fat at infra-lesional sites. The average decrease was 14.5% in BMC in lower extremities, 20.5% loss of LBM in legs and 15.1% loss of LBM in trunk, and increase of 0.2% in fat mass in legs and 17.3% increased fat in the lower limbs at 1 year. The tetraplegic patients had significant decrease in arm BMC (P < 0.001), arm LBM (P < 0.01) and fat percentage (P < 0.01) compared to paraplegics. Patients with complete motor injury had higher values of TBFM and fat percentage, but comparable values of BMC and LBM to patients with incomplete motor injury. Our findings suggest that there is a marked decrease in BMC and LBM with increase in adiposity during the first year of SCI. Although these changes depend on the level and initial severity of lesions, they are also influenced by the neurological recovery after SCI.

A prospective controlled study of diagnostic imaging for acute shin splints.

PubMed

Batt, M E; Ugalde, V; Anderson, M W; Shelton, D K

1998-11-01

The purpose of this prospective, observational study was to examine the relationship of clinical examination, plain radiograph (XR), triple-phase bone scan (TPBS), and magnetic resonance imaging (MRI) in the investigation of patients presenting with acute shin splints. 23 subjects with exercise induced lower leg pain and diffuse tibial tenderness of less than 3 months' duration were recruited. Subjects were excluded if there was clinical evidence of compartment syndrome, muscle hernia, or stress fracture. Each subject underwent XR, TPBS, and MRI within 2 wk of physical examination. Four asymptomatic controls underwent TPBS and MRI. Clinical findings, XR, TPBS, and MRI findings were independently recorded using a consistent template and subsequently analyzed. A single consensus lesion was chosen that provided the greatest overlap and highest grade to allow comparison of clinical and imaging findings. Sensitivity and specificity were calculated from data relating to clinical findings and diagnostic imaging. Eighteen subjects had bilateral symptoms and five unilateral with a mean duration of symptom of 5.4 wk (+/- 3.5). Of 41 symptomatic lower legs, there were TPBS abnormalities in 36 and MRI findings in 34. Analysis of clinical findings to TPBS and MRI demonstrated a sensitivity and specificity of 84%, 33% and 79%, 33%, respectively. Assuming TPBS as the "gold-standard," MRI findings demonstrated a sensitivity of 95% and specificity of 67%. There was poor agreement between the grading of TPBS and MRI (k = 0.3). In the 5/46 asymptomatic limbs, 3/5 demonstrated uptake on bone scan and 4/5 signal change with MRI. Imaging abnormalities were similarly seen in the four control patients. MRI may be used rather than TPBS and radiographs for evaluating acute tibial pain in athletes where avoidance of radiation exposure is desirable. Similar sensitivity and specificity may be expected from both investigations; however, in the light of abnormal TPBS and MRI findings in control and asymptomatic limbs, we recommend further studies be performed to define the extent of nonpathological TPBS and MRI changes.

Effects of whole body vibration on bone mineral density and falls: results of the randomized controlled ELVIS study with postmenopausal women.

PubMed

von Stengel, S; Kemmler, W; Engelke, K; Kalender, W A

2011-01-01

We determined whether the effect of exercise on bone mineral density (BMD) and falls can be enhanced by whole body vibration (WBV). In summary, the multi-purpose exercise training was effective to increase lumbar BMD but added WBV did not enhance this effect. However, falls were lowest in the exercise program combined with WBV. WBV is a new approach to reduce the risk of osteoporotic fractures. In the "Erlangen Longitudinal Vibration Study" (ELVIS), we investigated whether WBV enhances the effect of multifunctional exercise on BMD and falls. One hundred fifty-one postmenopausal women (68.5 ± 3.1 years) were randomly assigned to a: (1) conventional training group (TG); (2) conventional training group including vibration (TGV); and (3) wellness control group (CG). TG conducted an exercise program consisting of 20 min dancing aerobics, 5 min balance training, 20 min functional gymnastics, and 15 min dynamic leg-strength training on vibration plates (without vibration) twice a week. TGV performed an identical exercise regimen with vibration (25-35 Hz) during the leg-strengthening sequence. CG performed a low-intensity wellness program. BMD was measured at the hip and lumbar spine at baseline and follow-up using the DXA method. Falls were recorded daily via the calendar method. After 18 months, an increase in BMD at the lumbar spine was observed in both training groups (TGV: +1.5% vs. TG: +2.1%). The difference between the TG and the CG (1.7%) was significant. At the hip no changes were determined in either group. The fall frequency was significantly lower in TGV (0.7 falls/person) compared with CG (1.5), whereas the difference between TG (0.96) and CG was not significant. A multifunctional training program had a positive impact on lumbar BMD. The application of vibration did not enhance these effects. However, only the training including WBV affected the number of falls significantly.

Self-reported dietary intake of omega-3 fatty acids and association with bone and lower extremity function.

PubMed

Rousseau, James H; Kleppinger, Alison; Kenny, Anne M

2009-10-01

To assess the relationship between self-reported omega-3 fatty acid (O3FA) intake and bone mineral density (BMD) and lower extremity function in older adults. Cross-sectional analysis of baseline information from three separate ongoing studies of older adults, pooled for this analysis. Academic health center. Two hundred forty-seven men (n=118) and women (n=129) residing in the community or an assisted living facility. Self-reported dietary intake (O3FA, omega-6 fatty acids (O6FA), protein, and total calorie); BMD of the hip or heel; and lower extremity function including leg strength, chair rise time, walking speed, Timed Up and Go, and frailty. The mean reported intake of O3FA was 1.27 g/day. Correlation coefficients (r) between O3FA and T-scores from total femur (n=167) were 0.210 and 0.147 for combined femur and heel T scores. Similar correlations were found for leg strength (r=0.205) and chair rise time (r=-0.178), but the significance was lost when corrected for protein intake. Subjects with lower reported O3FA intake (<1.27 g/day) had lower BMD than those with higher reported O3FA intake. In a multiple regression analysis with femoral neck BMD as the dependent variable and reported intake of O3FA, O6FA, protein, and vitamin D as independent variables, reported O3FA intake was the only significant variable, accounting for 6% of the variance in BMD. Older adults had low reported intakes of O3FA. There was an association between greater reported O3FA intake and higher BMD. There was no independent association between reported O3FA intake and lower extremity function. Results from this preliminary report are promising and suggest further investigation.

Reliability of a Seven-Segment Foot Model with Medial and Lateral Midfoot and Forefoot Segments During Walking Gait.

PubMed

Cobb, Stephen C; Joshi, Mukta N; Pomeroy, Robin L

2016-12-01

In-vitro and invasive in-vivo studies have reported relatively independent motion in the medial and lateral forefoot segments during gait. However, most current surface-based models have not defined medial and lateral forefoot or midfoot segments. The purpose of the current study was to determine the reliability of a 7-segment foot model that includes medial and lateral midfoot and forefoot segments during walking gait. Three-dimensional positions of marker clusters located on the leg and 6 foot segments were tracked as 10 participants completed 5 walking trials. To examine the reliability of the foot model, coefficients of multiple correlation (CMC) were calculated across the trials for each participant. Three-dimensional stance time series and range of motion (ROM) during stance were also calculated for each functional articulation. CMCs for all of the functional articulations were ≥ 0.80. Overall, the rearfoot complex (leg-calcaneus segments) was the most reliable articulation and the medial midfoot complex (calcaneus-navicular segments) was the least reliable. With respect to ROM, reliability was greatest for plantarflexion/dorsiflexion and least for abduction/adduction. Further, the stance ROM and time-series patterns results between the current study and previous invasive in-vivo studies that have assessed actual bone motion were generally consistent.

Description and evaluation of operative deformity correction in calcium-deficiency rickets in Kaduna, northern Nigeria.

PubMed

Wesselsky, Viktor; Kitz, Christa; Jakob, Franz; Eulert, Jochen; Raab, Peter

2016-04-01

Rickets is a recurrent disease worldwide, especially in countries with limited resources (Nield et al Am Fam Physician 74(4):619-626, 2006; Thacher et al Ann Trop Paediatr 26(1):1-16, 2006). Medical therapy including orally administered calcium substitution is shown to improve a patients clinical symptoms and positively impact bone deformities, especially in the lower extremity. Even though orthopaedic intervention is necessary in a significant percentage of patients, few reports exist about operative deformity correction in patients wtih rickets. We describe our concept of operative treatment by single-stage, three-dimensional closing-wedge osteotomies on 45 deformed legs in 27 patients from the rural area of Kaduna, North Nigeria, with calcium-deficiency rickets and evaluate the early results in a 1.5-year follow-up. We found a significant improvement in parameters of quality of life, functionality, clinical and radiological angulation and angles following the definition of Paley et al., with a complication rate of 4 % under 88 osteotomies (Paley et al Orthop Clin North Am 25(3):425-65, 1994). The described operative therapy shows to be sufficient and with satisfactory results in correcting rickets-related leg deformities under rural circumstances with low availability of medical resources.

Screw fixation of the syndesmosis: a cadaver model comparing stainless steel and titanium screws and three and four cortical fixation.

PubMed

Beumer, Annechien; Campo, Martin M; Niesing, Ruud; Day, Judd; Kleinrensink, Gert-Jan; Swierstra, Bart A

2005-01-01

We assessed syndesmotic set screw strength and fixation capacity during cyclical testing in a cadaver model simulating protected weight bearing. Sixteen fresh frozen legs with artificial syndesmotic injuries and a syndesmotic set screw made of stainless steel or titanium, inserted through three or four cortices, were axially loaded with 800 N for 225,000 cycles in a materials testing machine. The 225,000 cycles equals the number of paces taken by a person walking in a below knee plaster during 9 weeks. Syndesmotic fixation failure was defined as: bone fracture, screw fatigue failure, screw pullout, and/or excessive syndesmotic widening. None of the 14 out of 16 successfully tested legs or screws failed. No difference was found in fixation of the syndesmosis when stainless steel screws were compared to titanium screws through three or four cortices. Mean lateral displacement found after testing was 1.05 mm (S.D. = 0.42). This increase in tibiofibular width exceeds values described in literature for the intact syndesmosis loaded with body weight. Based on this laboratory study it is concluded that the syndesmotic set screw cannot prevent excessive syndesmotic widening when loaded with a load comparable with body weight. Therefore, we advise that patients with a syndesmotic set screw in situ should not bear weight.

Rehabilitation of children and infants with osteogenesis imperfecta. A program for ambulation.

PubMed

Gerber, L H; Binder, H; Weintrob, J; Grange, D K; Shapiro, J; Fromherz, W; Berry, R; Conway, A; Nason, S; Marini, J

1990-02-01

Management of children and infants with osteogenesis imperfecta (OI) poses difficult decisions for pediatricians, orthopedists, and physiatrists. These children are frequently frail with disabling bone and joint deformities and fractures. In an eight-year cumulative management of 12 children with OI, a comprehensive program included strengthening exercises to the pelvic girdle and lower extremity muscles, in addition to pool exercises and molded seating to support upright posture. Long leg braces were fitted when the children were able to sit unsupported. All 12 were fitted with braces; nine were functional ambulators, and three were home ambulators. Six children required femoral plating or rodding, two of whom subsequently had the metal removed. Lower extremity fractures averaged one and one-half per year prior to bracing for nine children who had fractures. There was 0.83 fracture per year for the ten children who had fractures after bracing. The degree of femoral bowing increased in four, decreased in four, and remained unchanged in four, while the degree of tibial bowing increased in two, decreased in nine, and remained unchanged in one during the observation period. A comprehensive rehabilitation program and long leg bracing with surgical operations on the femur result in a high level of functional activity for children with OI with an acceptable level of risk for fracture.

Leg kinematics and kinetics in landing from a single-leg hop for distance. A comparison between dominant and non-dominant leg.

PubMed

van der Harst, J J; Gokeler, A; Hof, A L

2007-07-01

Anterior cruciate ligament (ACL) deficiency can be a major problem for athletes and subsequent reconstruction of the ACL may be indicated if a conservative regimen has failed. After ACL reconstruction signs of abnormality in the use of the leg remain for a long time. It is expected that the landing after a single-leg hop for distance (horizontal hop) might give insight in the differences in kinematics and kinetics between uninjured legs and ACL-reconstructed legs. Before the ACL-reconstructed leg can be compared with the contralateral leg, knowledge of differences between legs of uninjured subjects is needed. Kinematic and kinetic variables of both legs were measured with an optoelectronic system and a force plate and calculated by inverse dynamics. The dominant leg (the leg with biggest horizontal hop distance) and the contralateral leg of nine uninjured subjects were compared. No significant differences were found in most of the kinematic and kinetic variables between dominant leg and contralateral leg of uninjured subjects. Only hop distance and hip extension angles differed significantly. This study suggests that there are no important differences between dominant leg and contralateral leg in healthy subjects. As a consequence, the uninvolved leg of ACL-reconstructed patients can be used as a reference. The observed variables of this study can be used as a reference of normal values and normal differences between legs in healthy subjects.

Does a crouched leg posture enhance running stability and robustness?

PubMed

Blum, Yvonne; Birn-Jeffery, Aleksandra; Daley, Monica A; Seyfarth, Andre

2011-07-21

Humans and birds both walk and run bipedally on compliant legs. However, differences in leg architecture may result in species-specific leg control strategies as indicated by the observed gait patterns. In this work, control strategies for stable running are derived based on a conceptual model and compared with experimental data on running humans and pheasants (Phasianus colchicus). From a model perspective, running with compliant legs can be represented by the planar spring mass model and stabilized by applying swing leg control. Here, linear adaptations of the three leg parameters, leg angle, leg length and leg stiffness during late swing phase are assumed. Experimentally observed kinematic control parameters (leg rotation and leg length change) of human and avian running are compared, and interpreted within the context of this model, with specific focus on stability and robustness characteristics. The results suggest differences in stability characteristics and applied control strategies of human and avian running, which may relate to differences in leg posture (straight leg posture in humans, and crouched leg posture in birds). It has been suggested that crouched leg postures may improve stability. However, as the system of control strategies is overdetermined, our model findings suggest that a crouched leg posture does not necessarily enhance running stability. The model also predicts different leg stiffness adaptation rates for human and avian running, and suggests that a crouched avian leg posture, which is capable of both leg shortening and lengthening, allows for stable running without adjusting leg stiffness. In contrast, in straight-legged human running, the preparation of the ground contact seems to be more critical, requiring leg stiffness adjustment to remain stable. Finally, analysis of a simple robustness measure, the normalized maximum drop, suggests that the crouched leg posture may provide greater robustness to changes in terrain height. Copyright © 2011 Elsevier Ltd. All rights reserved.

Muscle and Myotendinous Tissue Properties at the Distal Tibia as Assessed by High-Resolution Peripheral Quantitative Computed Tomography.

PubMed

Erlandson, M C; Wong, A K O; Szabo, E; Vilayphiou, N; Zulliger, M A; Adachi, J D; Cheung, A M

High-resolution peripheral quantitative computed tomography (HR-pQCT) quantifies bone microstructure and density at the distal tibia where there is also a sizable amount of myotendinous (muscle and tendon) tissue (M T ); however, there is no method for the quantification of M T . This study aimed (1) to assess the feasibility of using HR-pQCT distal tibia scans to estimate M T properties using a custom algorithm, and (2) to determine the relationship between M T properties at the distal tibia and mid-leg muscle density (MD) obtained from pQCT. Postmenopausal women from the Hamilton cohort of the Canadian Multicenter Osteoporosis Study had a single-slice (2.3 ± 0.5 mm) 66% site pQCT scan measuring muscle cross-sectional area (MCSA) and MD. A standard HR-pQCT scan was acquired at the distal tibia. HR-pQCT-derived M T cross-sectional area (M T CSA) and M T density (M T D) were calculated using a custom algorithm in which thresholds (34.22-194.32 mg HA/cm 3 ) identified muscle seed volumes and were iteratively expanded. Pearson and Bland-Altman plots were used to assess correlations and systematic differences between pQCT- and HR-pQCT-derived muscle properties. Among 45 women (mean age: 74.6 ± 8.5 years, body mass index: 25.9 ± 4.3 kg/m 2 ), M T D was moderately correlated with mid-leg MD across the 2 modalities (r = 0.69-0.70, p < 0.01). Bland-Altman analyses revealed no evidence of directional bias for M T D-MD. HR-pQCT and pQCT measures of M T CSA and MCSA were moderately correlated (r = 0.44, p < 0.01). Bland-Altman plots for M T CSA revealed that larger MCSAs related to larger discrepancy between the distal and the mid-leg locations. This is the first study to assess the ability of HR-pQCT to measure M T size, density, and morphometry. HR-pQCT-derived M T D was moderately correlated with mid-leg MD from pQCT. This relationship suggests that distal M T may share common properties with muscle throughout the length of the leg. Future studies will assess the value of HR-pQCT-derived M T properties in the context of falls, mobility, and balance. Copyright © 2016 International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

Extendable pipe crawler

DOEpatents

Hapstack, Mark

1991-01-01

A pipe crawler having a front leg assembly and a back leg assembly connected together by two air cylinders, each leg assembly having four extendable legs and a pair of actuators for sliding the extendable legs radially outward to increase the range of the legs when the pipe crawler enters a section of a pipe having a larger diameter. The crawler crawls by "inchworm"-like motion, the front leg assembly and back leg assembly alternately engaging and disengaging the wall of the pipe to hold the pipe crawler as the air cylinders alternately advance the front leg assembly and bring up the rear leg assembly. The pair of actuators of each leg assembly are parallel, adjacent and opposing acting so that each slides two adjacent extendable legs radially outward.

Primary epidural malignant hemangiopericytoma of thoracic spinal column causing cord compression: case report.

PubMed

Mohammadianpanah, Mohammad; Torabinejad, Simin; Bagheri, Mohammad Hadi; Omidvari, Shapour; Mosalaei, Ahmad; Ahmadloo, Niloofar

2004-09-02

Hemangiopericytoma is an uncommon mesenchymal neoplasm that rarely affects the spinal canal. Primary malignant hemangiopericytoma of the spinal column is extremely rare. We report on a case of primary epidural malignant hemangiopericytoma of the thoracic spinal column that invaded vertebral bone and caused spinal cord compression in a 21-year-old man. The patient presented with progressive back pain over a four-month period that progressed to paraparesis, bilateral leg paresthesia and urinary incontinence. The surgical intervention involved laminectomy and subtotal resection of the tumor, with posterior vertebral fixation. Postoperative involved-field radiotherapy was administered. A marked neurological improvement was subsequently observed. We describe the clinical, radiological, and histological features of this tumor and review the literature.

β-Thalassemia intermedia: a comprehensive overview and novel approaches.

PubMed

Asadov, Chingiz; Alimirzoeva, Zohra; Mammadova, Tahira; Aliyeva, Gunay; Gafarova, Shahla; Mammadov, Jeyhun

2018-01-29

β-Thalassemia intermedia is a clinical condition of intermediate gravity between β-thalassemia minor, the asymptomatic carrier, and β-thalassemia major, the transfusion-dependent severe anemia. It is characterized by a significant clinical polymorphism, which is attributable to its genetic heterogeneity. Ineffective erythropoiesis, chronic anemia, and iron overload contribute to the clinical complications of thalassemia intermedia through stepwise pathophysiological mechanisms. These complications, including splenomegaly, extramedullary erythropoiesis, iron accumulation, leg ulcers, thrombophilia, and bone abnormalities can be managed via fetal hemoglobin induction, occasional transfusions, chelation, and in some cases, stem cell transplantation. Given its clinical diversity, thalassemia intermedia patients require tailored approaches to therapy. Here we present an overview and novel approaches to the genetic basis, pathophysiological mechanisms, clinical complications, and optimal management of thalassemia intermedia.

Chronic recurrent multifocal osteomyelitis exhibiting predominance of periosteal reaction.

PubMed

Queiroz, Rodolfo Mendes; Rocha, Pedro Henrique Pereira; Lauar, Lara Zupelli; Costa, Mauro José Brandão da; Laguna, Claudio Benedini; Oliveira, Rafael Gouvêa Gomes de

2017-04-01

Chronic recurrent multifocal osteomyelitis is an idiopathic nonpyogenic autoinflammatory bone disorder involving multiple sites, with clinical progression persisting for more than 6 months and which may have episodes of remission and exacerbation in the long term. It represents up to 2-5% of the cases of osteomyelitis, with an approximate incidence of up to 4/1,000,000 individuals, and average age of disease onset estimated between 8-11 years, predominantly in females. The legs are the most affected, with a predilection for metaphyseal regions along the growth plate. We describe the case of a female patient, aged 2 years and 5 months, with involvement of the left ulna, right jaw and left tibia, showing a predominance of periosteal reaction as main finding.

Effects of dietary chromium supplementation on muscle and bone mineral interaction in broiler chicken.

PubMed

Saeed, Abdullah A; Sandhu, Mansur A; Khilji, Muhammad S; Yousaf, Muhammad S; Rehman, Habib U; Tanvir, Zafar I; Ahmad, Tanveer

2017-07-01

The study was conducted to ascertain the effects of dietary chromium chloride (CrCl 3 ·6H 2 O) supplementation on mineral interaction in blood serum, leg muscles and bones of broilers at 35 th day of age. For this purpose, ninety male broiler chicks were divided into three groups. One served as control (group I) while, the other two groups were supplemented with CrCl 3 (group II-12.5mg/Kg feed; group III-25mg/Kg feed) from 12 to 28days of age. In serum, Cr concentration remained non-significant however, Zn, and K concentrations decreased (P<0.05) with both levels of Cr-supplementation. Furthermore, in muscles Cr, Cu, Ca and Na levels remained non-significant but concentrations of Zn and K decreased (P<0.05) with feed Cr enrichment. Chromium had a substantial effect on femur and fibula Zn retention with 25mg/Kg feed supplementation while, Cr deposition decreased (P<0.05) in fibula. Femur Ca (P<0.002), Na (P<0.001) and K (P<0.05) retention was inversely proportional to both Cr concentrations in feed. In tibia, Cu and Na concentration decreased (P<0.002) with high dietary Cr supplementation. Fibular Ca and Na concentrations remained significantly (P<0.001) lower in Cr supplemented groups. Bone robusticity index was non-significant but ash to weight ratio of femur, tibia and fibula decreased (P<0.05) in group III. Chromium supplementation has a major effect on serum or muscle Zn and K deposition while bone mineral interaction shows a major thrust on Zn, Ca and Na levels. Copyright © 2017 Elsevier GmbH. All rights reserved.

Association of physical performance measures with bone mineral density in postmenopausal women.

PubMed

Lindsey, Carleen; Brownbill, Rhonda A; Bohannon, Richard A; Ilich, Jasminka Z

2005-06-01

To investigate the association between physical performance measures and bone mineral density (BMD) in older women. Cross-sectional analysis. University research laboratory. Healthy postmenopausal women (N=116; mean age +/- standard deviation, 68.3+/-6.8y) in self-reported good health who were not taking medications known to affect bone, including hormone replacement therapy. Not applicable. Anthropometrics and BMD of the hip, spine, whole body, and forearm. Physical performance measures included normal and brisk 8-m gait speed, normal step length (NSL), brisk step length (BSL), timed 1-leg stance (OLS), timed sit-to-stand (STS), and grip strength. NSL, BSL, normal gait speed, brisk gait speed, OLS, and grip strength correlated significantly with several skeletal sites ( r range, .19-.38; P <.05). In multiple regression models containing body mass index, hours of total activity, total calcium intake, and age of menarche, NSL, BSL, normal and brisk gait speeds, OLS, and grip strength were all significantly associated with BMD of various skeletal sites (adjusted R 2 range, .11-.24; P <.05). Analysis of covariance showed that subjects with longer step lengths and faster normal and brisk gait speeds had higher BMD at the whole body, hip, and spine (brisk speed only). Those with a longer OLS had greater femoral neck BMD, and those with a stronger grip strength had greater BMD in the whole body and forearm ( P <.05). STS was not related to any skeletal site. Normal and brisk gait speed, NSL, BSL, OLS, and grip strength are all associated with BMD at the whole body, hip, spine, and forearm. Physical performance evaluation may help with osteoporosis prevention and treatment programs for postmenopausal women when bone density scores have not been obtained or are unavailable.

Arthrodesis After Infected Revision TKA: Retrospective Comparison of Intramedullary Nailing and External Fixation.

PubMed

Iacono, Francesco; Francesco, Iacono; Raspugli, Giovanni Francesco; Francesco, Raspugli Giovanni; Bruni, Danilo; Danilo, Bruni; Lo Presti, Mirco; Mirco, Lo Presti; Sharma, Bharat; Bharat, Sharma; Akkawi, Ibrahim; Ibrahim, Akkawi; Marcacci, Maurilio; Maurilio, Marcacci

2013-10-01

Infection after revision total knee arthroplasty (TKA) for previous septic TKA can be a challenging problem to treat due to loss of bone stock and soft tissue integrity. In these cases, arthrodesis is a well-recognized salvage procedure. The aim of this retrospective study was to compare the results as described by a Visual Analogue Scale (VAS) and the Lequesne Algofunctional Score (LAS) of knee arthrodeses performed by using either an external fixator (EF) or an intramedullary nail (IM). The study included 34 knee arthrodesis divided in two groups: first group included 12 patients treated with EF and the second group of 22 patients dealt with IM nail. Clinical and functional evaluation was performed using the VAS and the LAS. Full-length radiographs were used to verify limb length discrepancy. VAS and LAS results showed a substantial improvement relative to preoperative condition in both groups. However, the LAS was significantly better in the IM nail group. The mean leg length discrepancy was significantly greater (4.5 cm) in the first group than in the second one (0.8 cm). No recurrence of infection was observed in the EF group while there were three recurrent infections in the IM nail group. Our study supported the existing literature and found that reinfection after revision TKA can be effectively treated with arthrodesis. In presence of massive bone loss, we recommend arthrodesis with IM nail used as an endoprosthesis, without bone-on-bone fusion, to produce a stable and painless knee, while preserving the limb length. Use of an IM nail allowed us to get a better functional result than EF.

Skeletal dysplasia with craniofacial deformity and disproportionate dwarfism in hair sheep of northeastern Brazil.

PubMed

Dantas, F P M; Medeiros, G X; Figueiredo, A P M; Thompson, K; Riet-Correa, F

2014-01-01

This paper reports a newly described form of skeletal dysplasia affecting Brazilian hair sheep of the Cabugi breed. This breed is characterized by having a short head and in some cases the animals are smaller and more compact than sheep of similar breeds. Lambs born with craniofacial abnormalities and dwarfism that die at 2-6 months of age are frequent in this breed. In a flock of 68 ewes and three rams of the Cabugi breed, 134 lambs were born over a 4-year period. Of these, 14 (10.4%) had marked cranial abnormalities and dwarfism and died or were humanely destroyed, 43 (32%) had a normal face and 77 (57.5%) had the short face characteristic of the breed. Dwarf lambs were much smaller than normal, with short legs, a domed head with retruded muzzle and protruded mandible, sternal deformities and exophthalmic eyes situated more laterally in the face than normal. Microscopical examination of long bones of the limbs, bones of the base of the skull and vertebrae showed no lesions. Bones from four affected lambs and one control lamb were macerated for morphometric examination. Although the length of the spinal cord was similar, there was disproportionate shortening of the appendicular bones, particularly the distal segments. Thus the disease was defined as a skeletal dysplasia characterized by craniofacial deformity and disproportionate dwarfism. It is suggested that the disease is inherited as an incomplete dominant trait. The shortened face, which is a feature of the Cabugi breed, may represent the heterozygous state and the more severe, often lethal, dwarfism may occur in homozygotes. Copyright © 2013 Elsevier Ltd. All rights reserved.

Osteoporosis and gait and balance disturbances in older sarcopenic obese New Zealanders.

PubMed

Waters, D L; Hale, L; Grant, A M; Herbison, P; Goulding, A

2010-02-01

Bone, muscle, and fat may affect gait and balance in older adults. Osteoporosis was prevalent in low muscle mass participants and related to gait and balance deficits. Low muscle combined with high fat mass had more functional deficits and poorer bone health, which has implications for falls risk and fractures. Decreasing bone density and muscle mass and increasing fat mass may act synergistically to affect gait and balance in older adults. One hundred eighty-three older adults (age 72.7 +/- 6 years, range 56-93; body mass index 28.2 +/- 4.9, range 16.6-46.0) were recruited from a New Zealand falls prevention intervention trial. Total and appendicular skeletal muscle mass (ASM), percent fat, and bone mineralization were assessed by dual energy X-ray absorptiometry and used to characterize normal lean (NL, n = 51), sarcopenic (SS, n = 18), sarcopenic obese (SO, n = 29), and obese (OO, n = 85) phenotypes. Functional performance was assessed using timed up and go, chair stand, single leg stand, and step test. Regression models were adjusted for age, sex, medications, and physical activity. Femoral neck osteoporosis was present in 22% SS, 17% SO, 12% NL, and 7% OO. Femoral neck osteoporosis with low ASM predicted poor chair stand performance (beta -3.3, standard error 1.6, p = 0.04). SO scored lowest on the chair stand (p = 0.03) and step test (p = 0.03). Higher ASM predicted faster timed up and go performance (p = 0.001). Osteoporosis was prevalent in low ASM groups (SS and SO) and related to gait and balance deficits, particularly in the SO. This has implications for falls risk, fractures, and interventions.

1,25-Dihydroxyvitamin D3 and 22-oxa-1,25-dihydroxyvitamin D3 in vivo nuclear receptor binding in developing bone during endochondral and intramembranous ossification.

PubMed

Stumpf, W E; Koike, N; Hayakawa, N; Tokuda, K; Nishimiya, K; Tsuchiya, Y; Hirate, J; Okazaki, A; Kumaki, K

1994-09-01

Target cells for 3H-labeled 1 alpha, 25(OH)2 vitamin D3 [1,25(OH)2D3, vitamin D] and its analog 3H-labeled 22-oxa-1 alpha, 25(OH)2 vitamin D3 (OCT) have been identified during endochondral and intramembranous ossification in developing, undecalcified, unembedded bone, using thaw-mount autoradiography. Two-day-old neonatal rats were injected with [3H]1,25(OH)2D3 or [3H]OCT; after 2 h leg, spine, and head were frozen and sectioned. In the epiphyseal-metaphyseal region specific nuclear concentrations of [3H]1,25(OH)2D3 and [3H]OCT were observed in identical cell populations, being low in cells of the articular and resting zone, intermediate in the proliferating zone, and highest in hypertrophic chondrocytes and in osteoblasts and precursor cells. In the primary spongiosa intertrabecular spaces there were a large number of cells with nuclear labeling--probably osteoblasts and precursor cells. In contrast, in the secondary spongiosa intertrabecular spaces, apparent blood-forming cells were mostly unlabeled. Osteoblasts along bone spicules and compact bone in long bones, vertebrae, and head also showed strong nuclear labeling, as did cells of the periosteum. These data suggest that 1,25(OH)2D3 and OCT regulate development, differentiation, and activities of chondrocytes and osteoblasts, including differentiation of resting chondrocytes into proliferating and hypertrophic chondrocytes that involve "chondroclastic" enlargement of lacunae and "trans-differentiation" of surviving hypertrophic chondrocytes; differentiation of stroma cells into osteoblasts; and in periosteum and other regions of intramembranous ossification differentiation of precursor cells and osteoblasts. Nuclear receptor binding and their selective and hierarchical distribution during cell differentiation appear to correspond to multiple genomic effects toward growth, regeneration and repair. The findings indicate a physiological significance and therapeutic potential of 1,25(OH)2D3 and in particular of its less hypercalcemic analog OCT.

Greater Polar Moment of Inertia at the Tibia in Athletes Who Develop Stress Fractures

PubMed Central

Weidauer, Lee A.; Binkley, Teresa; Vukovich, Matt; Specker, Bonny

2014-01-01

Background: Several previous investigations have determined potential risk factors for stress fractures in athletes and military personnel. Purpose: To determine factors associated with the development of stress fractures in female athletes. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 88 female athletes (cross-country, n = 29; soccer, n = 15; swimming, n = 9; track and field, n = 14; volleyball, n = 12; and basketball, n = 9) aged 18 to 24 years were recruited to participate in a longitudinal bone study and had their left distal tibia at the 4%, 20%, and 66% sites scanned by peripheral quantitative computed tomography (pQCT). Patients included 23 athletes who developed stress fractures during the following year (cases). Whole body, hip, and spine scans were obtained using dual-energy x-ray absorptiometry (DXA). Analysis of covariance was used to determine differences in bone parameters between cases and controls after adjusting for height, lower leg length, lean mass, fat mass, and sport. Results: No differences were observed between cases and controls in any of the DXA measurements. Cases had significantly greater unadjusted trabecular bone mineral content (BMC), greater polar moment of inertia (PMI) at the 20% site, and greater cortical BMC at the 66% site; however, after adjusting for covariates, the differences became nonsignificant. When analyses were repeated using all individuals who had ever had a stress fracture as cases (n = 31) and after controlling for covariates, periosteal circumference was greater in the cases than the controls (71.1 ± 0.7 vs 69.4 ± 0.5 mm, respectively; P = .04). Conclusion: A history of stress fractures is associated with larger bones. These findings are important because larger bones were previously reported to be protective against fractures and stress fractures, but study findings indicate that may not always be true. One explanation could be that individuals who sustain stress fractures have greater loading that results in greater periosteal circumference but also results in the development of stress fractures. PMID:26535343

Greater Polar Moment of Inertia at the Tibia in Athletes Who Develop Stress Fractures.

PubMed

Weidauer, Lee A; Binkley, Teresa; Vukovich, Matt; Specker, Bonny

2014-07-01

Several previous investigations have determined potential risk factors for stress fractures in athletes and military personnel. To determine factors associated with the development of stress fractures in female athletes. Case-control study; Level of evidence, 3. A total of 88 female athletes (cross-country, n = 29; soccer, n = 15; swimming, n = 9; track and field, n = 14; volleyball, n = 12; and basketball, n = 9) aged 18 to 24 years were recruited to participate in a longitudinal bone study and had their left distal tibia at the 4%, 20%, and 66% sites scanned by peripheral quantitative computed tomography (pQCT). Patients included 23 athletes who developed stress fractures during the following year (cases). Whole body, hip, and spine scans were obtained using dual-energy x-ray absorptiometry (DXA). Analysis of covariance was used to determine differences in bone parameters between cases and controls after adjusting for height, lower leg length, lean mass, fat mass, and sport. No differences were observed between cases and controls in any of the DXA measurements. Cases had significantly greater unadjusted trabecular bone mineral content (BMC), greater polar moment of inertia (PMI) at the 20% site, and greater cortical BMC at the 66% site; however, after adjusting for covariates, the differences became nonsignificant. When analyses were repeated using all individuals who had ever had a stress fracture as cases (n = 31) and after controlling for covariates, periosteal circumference was greater in the cases than the controls (71.1 ± 0.7 vs 69.4 ± 0.5 mm, respectively; P = .04). A history of stress fractures is associated with larger bones. These findings are important because larger bones were previously reported to be protective against fractures and stress fractures, but study findings indicate that may not always be true. One explanation could be that individuals who sustain stress fractures have greater loading that results in greater periosteal circumference but also results in the development of stress fractures.

Transcription Factor Erg Variants and Functional Diversification of Chondrocytes during Limb Long Bone Development

PubMed Central

Iwamoto, Masahiro; Higuchi, Yoshinobu; Koyama, Eiki; Enomoto-Iwamoto, Motomi; Kurisu, Kojiro; Yeh, Helena; Abrams, William R.; Rosenbloom, Joel; Pacifici, Maurizio

2000-01-01

During limb development, chondrocytes located at the epiphyseal tip of long bone models give rise to articular tissue, whereas the more numerous chondrocytes in the shaft undergo maturation, hypertrophy, and mineralization and are replaced by bone cells. It is not understood how chondrocytes follow these alternative pathways to distinct fates and functions. In this study we describe the cloning of C-1-1, a novel variant of the ets transcription factor ch-ERG. C-1-1 lacks a short 27–amino acid segment located ∼80 amino acids upstream of the ets DNA binding domain. We found that in chick embryo long bone anlagen, C-1-1 expression characterizes developing articular chondrocytes, whereas ch-ERG expression is particularly prominent in prehypertrophic chondrocytes in the growth plate. To analyze the function of C-1-1 and ch-ERG, viral vectors were used to constitutively express each factor in developing chick leg buds and cultured chondrocytes. We found that virally driven expression of C-1-1 maintained chondrocytes in a stable and immature phenotype, blocked their maturation into hypertrophic cells, and prevented the replacement of cartilage with bone. It also induced synthesis of tenascin-C, an extracellular matrix protein that is a unique product of developing articular chondrocytes. In contrast, virally driven expression of ch-ERG significantly stimulated chondrocyte maturation in culture, as indicated by increases in alkaline phosphatase activity and deposition of a mineralized matrix; however, it had modest effects in vivo. The data show that C-1-1 and ch-ERG have diverse biological properties and distinct expression patterns during skeletogenesis, and are part of molecular mechanisms by which limb chondrocytes follow alternative developmental pathways. C-1-1 is the first transcription factor identified to date that appears to be instrumental in the genesis and function of epiphyseal articular chondrocytes. PMID:10893254

Tibial Inlay Press-fit Fixation Versus Interference Screw in Posterior Cruciate Ligament Reconstruction.

PubMed

Ettinger, Max; Büermann, Sarah; Calliess, Tilman; Omar, Mohamed; Krettek, Christian; Hurschler, Christof; Jagodzinski, Michael; Petri, Maximilian

2013-01-01

Reconstruction of the posterior cruciate ligament (PCL) by a tibial press-fit fixation of the patellar tendon with an accessory bone plug is a promising approach because no foreign materials are required. Until today, there is no data about the biomechanical properties of such press-fit fixations. The aim of this study was to compare the biomechanical qualities of a bone plug tibial inlay technique with the commonly applied interference screw of patellar tendon PCL grafts. Twenty patellar tendons including a bone block were harvested from ten human cadavers. The grafts were implanted into twenty legs of adult German country pigs. In group P, the grafts were attached in a press-fit technique with accessory bone plug. In group S, the grafts were fixed with an interference screw. Each group consisted of 10 specimens. The constructs were biomechanically analyzed in cyclic loading between 60 and 250 N for 500 cycles recording elongation. Finally, ultimate failure load and failure mode were analyzed. Ultimate failure load was 598.6±36.3 N in group P and 653.7±39.8 N in group S (not significant, P>0.05). Elongation during cyclic loading between the 1(st) and the 20(th) cycle was 3.4±0.9 mm for group P and 3.1±1 mm for group S. Between the 20(th) and the 500(th) cycle, elongation was 4.2±2.3 mm in group P and 2.5±0.9 mm in group S (not significant, P>0.05). This is the first study investigating the biomechanical properties of tibial press-fit fixation of the patellar tendon with accessory bone plug in posterior cruciate ligament reconstruction. The implant-free tibial inlay technique shows equal biomechanical characteristics compared to an interference screw fixation. Further in vivo studies are desirable to compare the biological behavior and clinical relevance of this fixation device.

Ankle salvage surgery with autologous circular pillar fibula augmentation and intramedullary hindfoot nail.

PubMed

Paul, Jochen; Barg, Alexej; Horisberger, Monika; Herrera, Mario; Henninger, Heath B; Valderrabano, Victor

2014-01-01

Tibiotalocalcaneal arthrodesis with an intramedullary hindfoot nail is an established procedure for fusion of the ankle and subtalar joints. In cases involving ankle bone loss, such as in failed total ankle replacement, it can be difficult to salvage with sufficient bone restoration stability and a physiologic leg length and avoiding below the knee amputation. In addition to the alternatives of using a structural allograft or metal bone substitution, we describe the use of autologous ipsilateral circular pillar fibula augmentation in tibiotalocalcaneal retrograde nail arthrodesis combined with a ventral (anterior) plate in a prospective series of 6 consecutive cases with a mean follow-up duration of 26 ± 9.95 (range 12 to 34) months. The 6 patients (3 female and 3 male), with a mean age of 55 ± 13.89 (range 38 to 73) years were treated with revision surgery of the ankle (1 after talectomy, 5 [83.33%] after failed ankle replacement). The visual analog scale for pain and the American Orthopaedic Foot and Ankle Society hindfoot score were used to assess functional outcome, and radiographs and computed tomography scans were used to determine the presence of fusion. All patients improved clinically from pre- to postoperatively in regard to the mean pain visual analog scale score (from 7.5 to 2.0) and American Orthopaedic Foot and Ankle Society hindfoot score (from 29 to 65 points, of an 86-point maximum for fused joints). Radiologically, no loss in the reduction or misalignment of the hindfoot was detected, and all cases fused solid. One patient (16.67%) required hardware removal. The fixation construct provided good clinical and radiologic outcomes, and we recommend it as an alternative to structural allografts or metallic bone grafts for revision ankle surgery with severe bone loss. Copyright © 2014 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Final height in central precocious puberty after long term treatment with a slow release GnRH agonist.

PubMed Central

Oostdijk, W; Rikken, B; Schreuder, S; Otten, B; Odink, R; Rouwé, C; Jansen, M; Gerver, W J; Waelkens, J; Drop, S

1996-01-01

OBJECTIVE: To study the resumption of puberty and the final height achieved in children with central precocious puberty (CPP) treated with the GnRH agonist triptorelin. PATIENTS: 31 girls and five boys with CPP who were treated with triptorelin 3.75 mg intramuscularly every four weeks. Girls were treated for a mean (SD) of 3.4 (1.0) years and were followed up for 4.0 (1.2) years after the treatment was stopped. RESULTS: The rate of bone maturation decreased during treatment and the predicted adult height increased from 158.2 (7.4) cm to 163.9 (7.5) cm at the end of treatment (p < 0.001). When treatment was stopped bone maturation accelerated, resulting in a final height of 161.6 (7.0) cm, which was higher than the predicted adult height at the start of treatment (p < 0.001). Height at the start of treatment was the most important factor positively influencing final height (r = 0.75, p < 0.001). Bone age at cessation of treatment negatively influenced final height (r = -0.52, p = 0.03). A negative correlation between bone age and height increment after discontinuation of treatment was observed (r = -0.85, p = 0.001). Residual growth capacity was optimal when bone age on cessation of treatment was 12 to 12.5 years. Body mass index increased during treatment and remained high on cessation. At final height, the ratio of sitting height to subischial leg length was normal. Menarche occurred at 12.3 (1.1) years, and at a median (range) of 1.1 (0.4 to 2.6) years after treatment was stopped. The ovaries were normal on pelvic ultrasonography. CONCLUSIONS: Treatment of CPP with triptorelin increases final height, with normal body proportions, and seems to increase body mass index. The best results were achieved in girls who were taller at the start of treatment. Puberty was resumed after treatment, without the occurrence of polycystic ovaries. PMID:8984913

Effect of a novel phytase on growth performance, apparent metabolizable energy, and the availability of minerals and amino acids in a low-phosphorus corn-soybean meal diet for broilers.

PubMed

Rutherfurd, S M; Chung, T K; Thomas, D V; Zou, M L; Moughan, P J

2012-05-01

The addition of microbial phytase to diets for broiler chickens has been shown to improve the availability of phytate P, total P, some other minerals, and amino acids. In this study, the effect of a novel microbial phytase expressed by synthetic genes in Aspergillus oryzae on amino acid and mineral availability was assessed. Phytase was incorporated (1,000 and 2,000 U/kg) into low-P corn-soybean meal-based diets for broilers. Broilers received the experimental diets for 3 wk, and excreta were collected from d 18 to 21 for the determination of AME and mineral retention. On the 22nd day, the broilers were killed and the left leg removed and ileal digesta collected. Ileal phytate P and total P absorption, ileal amino acid digestibility, as well as the bone mineral content and bone mineral density were determined. Ileal phytate P absorption and absorbed phytate P content of the low-P corn-soybean meal diet were significantly (P < 0.05) higher after dietary inclusion of the novel phytase (49-60% and 65-77% higher, respectively). Apparent ileal total P absorption and apparent total P retention was 12 to 16% and 14 to 19% higher (P < 0.05), respectively, after dietary inclusion of phytase. The bone mineral content and bone mineral density in the tibia were 32 to 35% and 19 to 21% higher (P < 0.05), respectively, after dietary phytase inclusion. The apparent ileal digestibility of threonine, tyrosine, and histidine increased significantly (P < 0.05) by 14, 9, and 7%, respectively, after dietary inclusion of microbial phytase. Overall, the inclusion of a novel microbial phytase into a low-P corn-soybean meal diet for broiler chickens greatly increased phytate P and total P absorption, bone mineral content and density, as well as the digestibility of some amino acids.

Navigation system for robot-assisted intra-articular lower-limb fracture surgery.

PubMed

Dagnino, Giulio; Georgilas, Ioannis; Köhler, Paul; Morad, Samir; Atkins, Roger; Dogramadzi, Sanja

2016-10-01

In the surgical treatment for lower-leg intra-articular fractures, the fragments have to be positioned and aligned to reconstruct the fractured bone as precisely as possible, to allow the joint to function correctly again. Standard procedures use 2D radiographs to estimate the desired reduction position of bone fragments. However, optimal correction in a 3D space requires 3D imaging. This paper introduces a new navigation system that uses pre-operative planning based on 3D CT data and intra-operative 3D guidance to virtually reduce lower-limb intra-articular fractures. Physical reduction in the fractures is then performed by our robotic system based on the virtual reduction. 3D models of bone fragments are segmented from CT scan. Fragments are pre-operatively visualized on the screen and virtually manipulated by the surgeon through a dedicated GUI to achieve the virtual reduction in the fracture. Intra-operatively, the actual position of the bone fragments is provided by an optical tracker enabling real-time 3D guidance. The motion commands for the robot connected to the bone fragment are generated, and the fracture physically reduced based on the surgeon's virtual reduction. To test the system, four femur models were fractured to obtain four different distal femur fracture types. Each one of them was subsequently reduced 20 times by a surgeon using our system. The navigation system allowed an orthopaedic surgeon to virtually reduce the fracture with a maximum residual positioning error of [Formula: see text] (translational) and [Formula: see text] (rotational). Correspondent physical reductions resulted in an accuracy of 1.03 ± 0.2 mm and [Formula: see text], when the robot reduced the fracture. Experimental outcome demonstrates the accuracy and effectiveness of the proposed navigation system, presenting a fracture reduction accuracy of about 1 mm and [Formula: see text], and meeting the clinical requirements for distal femur fracture reduction procedures.

Ability of Ultrasonography in Detection of Different Extremity Bone Fractures; a Case Series Study

PubMed Central

Bozorgi, Farzad; Shayesteh Azar, Massoud; Montazer, Seyed Hossein; Chabra, Aroona; Heidari, Seyed Farshad; Khalilian, Alireza

2017-01-01

Introduction: Despite radiography being the gold standard in evaluation of orthopedic injuries, using bedside ultrasonography has several potential supremacies such as avoiding exposure to ionizing radiation, availability in pre-hospital settings, being extensively accessible, and ability to be used on the bedside. The aim of the present study is to evaluate the diagnostic accuracy of ultrasonography in detection of extremity bone fractures. Methods: This study is a case series study, which was prospectively conducted on multiple blunt trauma patients, who were 18 years old or older, had stable hemodynamic, Glasgow coma scale 15, and signs or symptoms of a possible extremity bone fracture. After initial assessment, ultrasonography of suspected bones was performed by a trained emergency medicine resident and prevalence of true positive and false negative findings were calculated compared to plain radiology. Results: 108 patients with the mean age of 44.6 ± 20.4 years were studied (67.6% male). Analysis was done on 158 sites of fracture, which were confirmed with plain radiography. 91 (57.6%) cases were suspected to have upper extremity fracture(s) and 67 (42.4%) to have lower ones. The most frequent site of injuries were forearm (36.7%) in upper limbs and leg (27.8%) in lower limbs. Prevalence of true positive and false negative cases for fractures detected by ultrasonography were 59 (64.8%) and 32 (35.52%) for upper and 49 (73.1%) and 18 (26.9%) for lower extremities, respectively. In addition, prevalence of true positive and false negative detected cases for intra-articular fractures were 24 (48%) and 26 (52%), respectively. Conclusion The present study shows the moderate sensitivity (68.3%) of ultrasonography in detection of different extremity bone fractures. Ultrasonography showed the best sensitivity in detection of femur (100%) and humerus (76.2%) fractures, respectively. It had low sensitivity in detection of in intra-articular fractures. PMID:28286822

Ability of Ultrasonography in Detection of Different Extremity Bone Fractures; a Case Series Study.

PubMed

Bozorgi, Farzad; Shayesteh Azar, Massoud; Montazer, Seyed Hossein; Chabra, Aroona; Heidari, Seyed Farshad; Khalilian, Alireza

2017-01-01

Despite radiography being the gold standard in evaluation of orthopedic injuries, using bedside ultrasonography has several potential supremacies such as avoiding exposure to ionizing radiation, availability in pre-hospital settings, being extensively accessible, and ability to be used on the bedside. The aim of the present study is to evaluate the diagnostic accuracy of ultrasonography in detection of extremity bone fractures. This study is a case series study, which was prospectively conducted on multiple blunt trauma patients, who were 18 years old or older, had stable hemodynamic, Glasgow coma scale 15, and signs or symptoms of a possible extremity bone fracture. After initial assessment, ultrasonography of suspected bones was performed by a trained emergency medicine resident and prevalence of true positive and false negative findings were calculated compared to plain radiology. 108 patients with the mean age of 44.6 ± 20.4 years were studied (67.6% male). Analysis was done on 158 sites of fracture, which were confirmed with plain radiography. 91 (57.6%) cases were suspected to have upper extremity fracture(s) and 67 (42.4%) to have lower ones. The most frequent site of injuries were forearm (36.7%) in upper limbs and leg (27.8%) in lower limbs. Prevalence of true positive and false negative cases for fractures detected by ultrasonography were 59 (64.8%) and 32 (35.52%) for upper and 49 (73.1%) and 18 (26.9%) for lower extremities, respectively. In addition, prevalence of true positive and false negative detected cases for intra-articular fractures were 24 (48%) and 26 (52%), respectively. The present study shows the moderate sensitivity (68.3%) of ultrasonography in detection of different extremity bone fractures. Ultrasonography showed the best sensitivity in detection of femur (100%) and humerus (76.2%) fractures, respectively. It had low sensitivity in detection of in intra-articular fractures.

Extendable pipe crawler

DOEpatents

Hapstack, M.

1991-05-28

A pipe crawler is described having a front leg assembly and a back leg assembly connected together by two air cylinders, each leg assembly having four extendable legs and a pair of actuators for sliding the extendable legs radially outward to increase the range of the legs when the pipe crawler enters a section of a pipe having a larger diameter. The crawler crawls by inchworm'-like motion, the front leg assembly and back leg assembly alternately engaging and disengaging the wall of the pipe to hold the pipe crawler as the air cylinders alternately advance the front leg assembly and bring up the rear leg assembly. The pair of actuators of each leg assembly are parallel, adjacent and opposing acting so that each slides two adjacent extendable legs radially outward. 5 figures.

Extendable pipe crawler

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hapstack, M.

1991-05-28

A pipe crawler is described having a front leg assembly and a back leg assembly connected together by two air cylinders, each leg assembly having four extendable legs and a pair of actuators for sliding the extendable legs radially outward to increase the range of the legs when the pipe crawler enters a section of a pipe having a larger diameter. The crawler crawls by inchworm'-like motion, the front leg assembly and back leg assembly alternately engaging and disengaging the wall of the pipe to hold the pipe crawler as the air cylinders alternately advance the front leg assembly andmore » bring up the rear leg assembly. The pair of actuators of each leg assembly are parallel, adjacent and opposing acting so that each slides two adjacent extendable legs radially outward. 5 figures.« less

Extendable pipe crawler

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hapstack, M.

1990-05-01

A pipe crawler having a front leg assembly and a back leg assembly connected together by two air cylinders, each leg assembly having four extendable legs and a pair of actuators for sliding the extendable legs radically outward to increase the range of the legs when the pipe crawler enters a section of pipe having a larger diameter. The crawler crawls by inchworm''-like motion, the front leg assembly and back leg assembly alternately engaging and disengaging the wall of the pipe to hold the pipe crawler as the air cylinders alternately advance the front leg assembly and bring up themore » rear leg assembly. The pair of actuators of each leg assembly are parallel, adjacent and opposing acting so that each slides two adjacent extendable legs radially outward. 5 figs.« less

Management of septic non-union of the tibia by the induced membrane technique. What factors could improve results?

PubMed

Siboni, Renaud; Joseph, Etienne; Blasco, Laurent; Barbe, Coralie; Bajolet, Odile; Diallo, Saïdou; Ohl, Xavier

2018-06-07

Management of septic non-union of the tibia requires debridement and excision of all infected bone and soft tissues. Various surgical techniques have been described to fill the bone defect. The "Induced Membrane" technique, described by A. C. Masquelet in 1986, is a two-step procedure using a PMMA cement spacer around which an induced membrane develops, to be used in the second step as a bone graft holder for the bone graft. The purpose of this study was to assess our clinical and radiological results with this technique in a series managed in our department. Nineteen traumatic septic non-unions of the tibia were included in a retrospective single-center study between November 2007 and November 2014. All patients were followed up clinically and radiologically to assess bone union time. Multivariate analysis was used to identify factors influencing union. The series comprised 4 women and 14 men (19 legs); mean age was 53.9 years. Vascularized flap transfer was required in 26% of cases before the first stage of treatment. All patients underwent a two-step procedure, with a mean interval of 7.9 weeks. Mean bone defect after the first step was 52.4mm. The bone graft was harvested from the iliac crest in the majority of cases (18/19). The bone was stabilized with an external fixator, locking plate or plaster cast after the second step. Mean follow-up was 34 months. Bony union rate was 89% (17/19), at a mean 16 months after step 2. Eleven patients underwent one or more (mean 2.1) complementary procedures. Severity of index fracture skin opening was significantly correlated with union time (Gustilo III vs. Gustilo I or II, p=0.028). A trend was found for negative impact of smoking on union (p=0.06). Bone defect size did not correlate with union rate or time. The union rate was acceptable, at 89%, but with longer union time than reported in the literature. Many factors could explain this: lack of rigid fixation after step 2 (in case of plaster cast or external fixator), or failure to cease smoking. The results showed that the induced membrane technique is effective in treating tibial septic non-union, but could be improved by stable fixation after the second step and by cessation of smoking. IV, Retrospective study. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Active and Inactive Leg Hemodynamics during Sequential Single-Leg Interval Cycling.

PubMed

Gordon, Nicole; Abbiss, Chris R; Ihsan, Mohammed; Maiorana, Andrew J; Peiffer, Jeremiah J

2018-06-01

Leg order during sequential single-leg cycling (i.e., exercising both legs independently within a single session) may affect local muscular responses potentially influencing adaptations. This study examined the cardiovascular and skeletal muscle hemodynamic responses during double-leg and sequential single-leg cycling. Ten young healthy adults (28 ± 6 yr) completed six 1-min double-leg intervals interspersed with 1 min of passive recovery and, on a separate occasion, 12 (six with one leg followed by six with the other leg) 1-min single-leg intervals interspersed with 1 min of passive recovery. Oxygen consumption, heart rate, blood pressure, muscle oxygenation, muscle blood volume, and power output were measured throughout each session. Oxygen consumption, heart rate, and power output were not different between sets of single-leg intervals, but the average of both sets was lower than the double-leg intervals. Mean arterial pressure was higher during double-leg compared with sequential single-leg intervals (115 ± 9 vs 104 ± 9 mm Hg, P < 0.05) and higher during the initial compared with second set of single-leg intervals (108 ± 10 vs 101 ± 10 mm Hg, P < 0.05). The increase in muscle blood volume from baseline was similar between the active single leg and the double leg (267 ± 150 vs 214 ± 169 μM·cm, P = 0.26). The pattern of change in muscle blood volume from the initial to second set of intervals was significantly different (P < 0.05) when the leg was active in the initial (-52.3% ± 111.6%) compared with second set (65.1% ± 152.9%). These data indicate that the order in which each leg performs sequential single-leg cycling influences the local hemodynamic responses, with the inactive muscle influencing the stimulus experienced by the contralateral leg.

Quadrupedal gaits in hexapod animals - inter-leg coordination in free-walking adult stick insects.

PubMed

Grabowska, Martyna; Godlewska, Elzbieta; Schmidt, Joachim; Daun-Gruhn, Silvia

2012-12-15

The analysis of inter-leg coordination in insect walking is generally a study of six-legged locomotion. For decades, the stick insect Carausius morosus has been instrumental for unravelling the rules and mechanisms that control leg coordination in hexapeds. We analysed inter-leg coordination in C. morosus that freely walked on straight paths on plane surfaces with different slopes. Consecutive 1.7 s sections were assigned inter-leg coordination patterns (which we call gaits) based on footfall patterns. Regular gaits, i.e. wave, tetrapod or tripod gaits, occurred in different proportions depending on surface slopes. Tetrapod gaits were observed most frequently, wave gaits only occurred on 90 deg inclining slopes and tripod gaits occurred most often on 15 deg declining slopes, i.e. in 40% of the sections. Depending on the slope, 36-66% of the sections were assigned irregular gaits. Irregular gaits were mostly due to multiple stepping by the front legs, which is perhaps probing behaviour, not phase coupled to the middle legs' cycles. In irregular gaits, middle leg and hindleg coordination was regular, related to quadrupedal walk and wave gaits. Apparently, front legs uncouple from and couple to the walking system without compromising middle leg and hindleg coordination. In front leg amputees, the remaining legs were strictly coordinated. In hindleg and middle leg amputees, the front legs continued multiple stepping. The coordination of middle leg amputees was maladapted, with front legs and hindlegs performing multiple steps or ipsilateral legs being in simultaneous swing. Thus, afferent information from middle legs might be necessary for a regular hindleg stepping pattern.