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Sample records for calcaneus

  1. Fractures on the calcaneus

    OpenAIRE

    Tanke, Gerhardus Marinus Henricus

    1982-01-01

    ln 823 patients with a displaced calcaneus fracturea study was carried out to assess the difference in the duration until recovery between those patients who were treated by operation and those who were treated conservatively. This was preceded by a study of the literature in which the accent was placed on the various types of calcaneus fractures regarding fracture mechanism, epidemiology, diagnostics and symptomatology as well as the different methods of treatment (chaptersl I to IV). ... Zi...

  2. Axial calcaneus roentgenograph

    International Nuclear Information System (INIS)

    Low-frequency noise caused by intestinal gas, bone, or high-contrast subjects on roentgenographs often makes them difficult to read. The plantodorsal projection of the calcaneus taken by the conventional method has low-frequency noise because of its own high contrast for the long axis. Even if a higher X-ray tube voltage is used to reduce the low-frequency noise, middle- or high-frequency signals such as those of bone trabeculae are also reduced. We investigated a new method that takes into consideration the subject contrast between the part of the posterior calcanean articulation and distal part on the calcaneus projection, the spectrum of bone trabeculae, and the scatter fraction. The technique we introduced has some merit compared with the conventional method in that it reduces image distortion, provides low contrast for the long axis, and sharpens trabeculae images and articulations. (author)

  3. Normal CT anatomy of the calcaneus

    International Nuclear Information System (INIS)

    Normal sectional anatomy of the calcaneus with multiplanar CT examination was studied in 5 volunteers as the background for interpretation of various abnormalities. Major 3 sectional anatomy including plantar, coronal, sagittal and additional tuberosity planes are described. With CT examination of the calcaneus, 1. More detailed anatomy of 3 facets of subtalar joint (anterior, middle, and posterior facet) can be well visualized. 2. Its clinical applications in the tarsal trauma, tarsal coalition, subtalar infection, degenerative arthritis, club foot, pes planus and tarsal tumor could provide much more information's, which not obtained by conventional radiographic studies.

  4. Normal CT anatomy of the calcaneus

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Mun Gyu [Seoul District Armed Forces General Hospital, Seoul (Korea, Republic of); Kang, Heung Sik [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1986-10-15

    Normal sectional anatomy of the calcaneus with multiplanar CT examination was studied in 5 volunteers as the background for interpretation of various abnormalities. Major 3 sectional anatomy including plantar, coronal, sagittal and additional tuberosity planes are described. With CT examination of the calcaneus, 1. More detailed anatomy of 3 facets of subtalar joint (anterior, middle, and posterior facet) can be well visualized. 2. Its clinical applications in the tarsal trauma, tarsal coalition, subtalar infection, degenerative arthritis, club foot, pes planus and tarsal tumor could provide much more information's, which not obtained by conventional radiographic studies.

  5. Anterior process fractures of the calcaneus

    Energy Technology Data Exchange (ETDEWEB)

    Renfrew, D.L.; El-Khoury, G.Y.

    1985-07-01

    Fractures of the anterior process of the calcaneus are often missed. This error follows from the tendency to focus exclusively on the mortise and malleoli when a history of ankle trauma is supplied. Seven patients with this fracture are presented. The anatomy, mechanism of injury, clinical presentation, and the radiographic features of this injury are discussed.

  6. Open Calcaneus Fractures and Associated Injuries.

    Science.gov (United States)

    Worsham, Jacob R; Elliott, Mark R; Harris, Anthony M

    2016-01-01

    Open calcaneus fractures are usually the result of high-energy mechanisms and are associated with other orthopedic and whole body system injures. Understanding the difference between open versus closed fractures is essential for the provider, and they must be vigilant for the associated injuries that present with this condition. We performed a retrospective medical record review of 62 patients (64 calcaneus fractures) with open calcaneus fractures from January 2003 to January 2013 presenting at a level 1 trauma center. Sex, age, laterality, mechanism of injury, wound appearance, initial management, and associated injures were recorded. The most common mechanisms were motor vehicle accidents (35 [56.4%]) and falls from >6 ft (15 [24.1%]). Four (6.4%) patients had a posterior tibial artery transection. Eight (12.9%) patients had a femoral shaft fracture, 14 (22.5%) an ipsilateral ankle fracture, 16 (25.8%) a metatarsal fracture, and 11 (17.7%) had associated midfoot fractures. Of the midfoot fractures, 12 (19.3%) patients had a talus fracture and 5 (8.0%) a cuboid fracture. Spinal fractures were present in 9 (14.5%) of the patients, with lumbar fractures occurring in 6 (9.6%) patients. Fifteen (24.1%) patients had associated upper extremity fractures. Thirteen (20.9%) patients had an associated pulmonary injury, including 8 pneumothoraces. Ten (16.1%) patients had a closed head injury and 6 (9.6%) had an abdominal injury. Fifteen (23.4%) patients were treated with percutaneous wire fixation and 7 (10.9%) with open reduction internal fixation. A total of 44 (68.7%) fractures were treated without internal fixation. Overall, 5 (8.0%) patients with an open calcaneus fracture eventually underwent a below-the-knee amputation. Open calcaneus fractures are severe, high-energy injuries with the potential for considerable morbidity to the patient, given the high rate of concomitant orthopedic and whole body system injuries. Type III open injuries have an increased risk of

  7. Occult fracture of the calcaneus - another Toddler's fracture

    International Nuclear Information System (INIS)

    Fractures of the calcaneus have been considered rare among children. We feel this may be erroneous since in the last 12 months we have seen 10 such fractures among children, 19 and 41 months of age, who presented with acute limping. The fractures were detected with bone imaging which was performed when initial radiographs were noncontributory. Subsequent radiographs of the calcaneus were positive for fracture in 4 to 10 while follow up radiographs confirmed healing fractures in the two children so evaluated. The sensitivity of bone imaging for the detection of occult fractures in toddlers is emphasized. (orig.)

  8. Relationships between static histomorphometry and ultrasound in the human calcaneus.

    Science.gov (United States)

    Häusler, K D; Rich, P A; Smith, P C; Barry, E B

    1999-06-01

    The aim of this study was to explore the relationship(s) between histomorphometric measurements of cancellous bone structure and ultrasound. Ultrasonic measurements were made using a CUBA research system consisting of a pair of 1 Mhz unfocused transducers. Speed of sound (SOS) and broadband ultrasonic attenuation (BUA) were determined in 15 human cadaveric heels, with mean precision for all measurements coefficients of variation (CV) = 0.6% and 12%, respectively. The calcaneus was dissected and a 7.5 mm transcortical cylinder was removed from the path of ultrasound (US) transmission. The cortices were removed and the remaining cancellous core was sectioned into approximately 5 mm blocks, numbered from 1 to 6 (medial-lateral). Histomorphometric measurements were performed on decalcified, 5 microm-thick sections from blocks 1-6 using an automatic color image analysis system. There were significant differences between blocks 1 and 3-6 for BS/TV, BV/TV, Tb.N, and Tb. Sp (all P < 0.001), all decreasing in a medial-lateral direction (except Tb.Sp), implying that the medial portion of the calcaneus had more trabeculae with less spacing between them than the lateral portion. Furthermore, Tb.Th and BS/BV variables were uniform across the calcaneus, suggesting that individual trabeculae were of similar dimension. We found no significant correlations between US and histomorphometric parameters either averaged over all blocks or by using each block region separately. In conclusion, this study does not support the notion that US measurements of SOS and BUA through the heel reflect calcaneal cancellous bone structure, however, further studies using larger sample sizes may be warranted. PMID:10341018

  9. Tuberculosis of the calcaneus. Treatment and differential diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Richter, R.; Koehler, G.; Michels, P.

    1981-11-01

    Eight lesions in the calcaneus have been treated surgically between 1955 and 1979; of these, six were due to tuberculosis, one to chronic osteomyelitis and the other was a cyst. The diagnosis was confirmed bacteriologically and histologically. In all cases (average age 49.1 years) the human bacillus was proved to be the cause of an haematogenous infection. The lesion was confined to the posterior part of the bone and there was no extension into the calcaneo-navicular joint. One focus extended into the ankle joint. Two patients presented with fistulae. The interval from the onset of symptoms to confirmation of the diagnosis averaged 9.1 months. Three patients had previously been treated for tuberculosis (lung, pleura, kidney) and another patient, who had a simultaneous tuberculous infection of a sternoclavicular joint had suffered from tuberculous cervical lymphadenitis at the age of nine years.

  10. Pediatric and adolescent intra-articular fractures of the calcaneus

    Directory of Open Access Journals (Sweden)

    Marcel Dudda

    2013-06-01

    Full Text Available Calcaneal fractures in childhood are very rare, whereas particularly intra-articular displaced fractures are not typical in skeletally immature children. Various techniques of osteosynthesis have been described. This study aimed to determine clinical and radiological outcome after surgical treatment of intra-articular calcaneal fractures. Fourteen intra-articular fractures of the calcaneus were included in this retrospective study. Eleven children (2 girls and 9 boys aged 6-16 years (average age 11.5 years underwent surgical treatment. One child sustained a Type II open fracture of both calcanei. All injuries occurred after a high-energy trauma; 3 patients had multiple additional fractures. The clinical and radiological postoperative follow up was an average 44 months. In 4 cases, a reduction through a minimally invasive approach and fixation with K-wires or screws could be achieved. Eleven fractures were treated with open reduction and internal fixation with plate osteosynthesis, K-wires or screws. In one case with open fractures of both heel bones, an additional external fixator was applied. The surgical treatment approach adopted enabled the pre-operative Boehler’s angle (average 16° to be improved to an average 30°. In all cases, except for the patient with open fractures, a good functional result and outcome could be achieved. In calcaneal fractures in childhood, anatomical reduction is the determining factor, as in fractures in adults, whereas the surgical technique seems to have no influence on clinical outcome in children. The wound healing problems that have often been described were not observed in this age group.

  11. Finite Element Analysis of Foot and Ankle Impact Injury: Risk Evaluation of Calcaneus and Talus Fracture

    OpenAIRE

    Duo Wai-Chi Wong; Wenxin Niu; Yan Wang; Ming Zhang

    2016-01-01

    Introduction Foot and ankle impact injury is common in geriatric trauma and often leads to fracture of rearfoot, including calcaneus and talus. The objective of this study was to assess the influence of foot impact on the risk of calcaneus and talus fracture via finite element analysis. Methods A three-dimensional finite element model of foot and ankle was constructed based on magnetic resonance images of a female aged 28. The foot sustained a 7-kg passive impact through a foot plate. The sim...

  12. Occult fracture of the calcaneus - another toddler's fracture

    Energy Technology Data Exchange (ETDEWEB)

    Starshak, R.J.; Simons, G.W.; Sty, J.R.

    1984-01-01

    Fractures of the calcaneus have been considered rare among children. We feel this may be erroneous since in the last 12 months we have seen 10 such fractures among children, 19 and 41 months of age, who presented with acute limping. The fractures were detected with bone imaging which was performed when initial radiographs were noncontributory. Subsequent radiographs of the calcaneus were positive for fracture in 4 to 10 while follow up radiographs confirmed healing fractures in the two children so evaluated. The sensitivity of bone imaging for the detection of occult fractures in toddlers is emphasized.

  13. Finite Element Analysis of Foot and Ankle Impact Injury: Risk Evaluation of Calcaneus and Talus Fracture.

    Directory of Open Access Journals (Sweden)

    Duo Wai-Chi Wong

    Full Text Available Foot and ankle impact injury is common in geriatric trauma and often leads to fracture of rearfoot, including calcaneus and talus. The objective of this study was to assess the influence of foot impact on the risk of calcaneus and talus fracture via finite element analysis.A three-dimensional finite element model of foot and ankle was constructed based on magnetic resonance images of a female aged 28. The foot sustained a 7-kg passive impact through a foot plate. The simulated impact velocities were from 2.0 to 7.0 m/s with 1.0 m/s interval.At 5.0 m/s impact velocity, the maximum von Mises stress of the trabecular calcaneus and talus were 3.21MPa and 2.41MPa respectively, while that of the Tresca stress were 3.46MPa and 2.55MPa. About 94% and 84% of the trabecular calcaneus and talus exceeded the shear yielding stress, while 21.7% and 18.3% yielded the compressive stress. The peak stresses were distributed around the talocalcaneal articulation and the calcaneal tuberosity inferiorly, which corresponded to the common fracture sites.The prediction in this study showed that axial compressive impact at 5.0 m/s could produce considerable yielding of trabecular bone in both calcaneus and talus, dominantly by shear and compounded with compression that predispose the rearfoot in the risk of fracture. This study suggested the injury pattern and fracture mode of high energy trauma that provides insights in injury prevention and fracture management.

  14. Unusual Variant of the Nutcracker Fracture of the Calcaneus and Tarsal Navicular

    OpenAIRE

    Gajendran, Varun K.; Yoo, Brad J.; Hunter, John C.

    2015-01-01

    A 62-year-old woman with severe seizure disorder presented with right ankle and foot pain after being found down, presumably following a seizure recurrence. Imaging showed an acute comminuted fracture of the anterolateral aspect of the right calcaneus, as well as an acute avulsion fracture of the right navicular tuberosity at the site of insertion of the tibialis posterior tendon. This fracture pattern suggests forced abduction of the midfoot or forefoot with severe compression of the lateral...

  15. Osteomyelitis of the calcaneus in horses: 28 cases (1972-1987)

    International Nuclear Information System (INIS)

    Medical records of 28 horses with osteomyelitis of the calcaneus were reviewed to evaluate signalment, history, diagnostic and treatment methods, outcome, and long-term follow-up information. Trauma was the most commonly reported cause (24). Physical examination revealed lameness in 27 horses, and 22 (79%) had a wound or draining tract over the plantar aspect of the calcaneus. Radiography of all horses was done prior to the initiation of treatment, and follow-up radiography was done on 20 horses. The most common radiographic findings were soft tissue swelling (25), bony lysis of the calcaneus (17), bone fragments or sequestra from the tuber calcis (13), and periosteal new bone production or bony lysis of the sustentaculum tali (5). Association could not be found between initial radiographic findings and eventual outcome of the case. Positive bacterial cultures were obtained from 13 horses. A wide variety of gram-positive, gram-negative, and anaerobic organisms were isolated. Fourteen of the 15 isolates, for which susceptibilities were reported, were susceptible to penicillin, gentamicin, or trimethoprim sulfamethoxazole. Twenty-six of the 28 horses diagnosed as having osteomyelitis of the calcaneus were treated; 16 horses were treated with surgical debridement in addition to antimicrobial treatment, and 10 horses were treated with antimicrobial agents, anti-inflammatory drugs, or supportive wound care. There was no significant difference in survival rate of horses treated surgically and those treated conservatively. Six horses that were treated were later euthanatized for problems associated with chronic osteomyelitis, and 2 horses died or were euthanatized for unrelated problems. Eighteen horses (64%) were alive at last follow-up

  16. Assessment of bone property using quantitative ultrasound images based on whole calcaneus

    International Nuclear Information System (INIS)

    Osteoporosis is a systemic skeletal disease which leads to bone fragility. It was found that the evaluation of osteoporosis using quantitative ultrasound (QUS) parameters based on the whole calcaneus bone is better than a smaller circular ROI selected from a point with minimum density. Although it was claimed that inhomogeneity of the bone might be the main factor in causing such a difference, other factors, such as phase cancellation might also be the reason. In this paper, a modified contour deformable model (MCDM) was used to automatically detect the calcaneus contour from the QUS images. A three-dimensional calcaneus phantom (CIRS Inc., NV) was first used for the validation of MCDM and the demonstration of the phase cancellation effect. Then, nine subjects were recruited for human testing. From the phantom experiment, it was observed that the correlation coefficient between bone mineral density (BMD) and the parameter (BUA) evaluated based on the ROI selected with the whole calcaneus contour (R = 0.99) is better than other ROIs. The influence of ROI size, including 12, 14, 16 and 18 mm in diameter, and region-selecting methods, such as fixed region (ROIfix), automatic circular region (ROIcir) and calcaneal contour region (ROIanat), were evaluated for subject testing. The precision errors of the measured ultrasonic parameters for ROIanat (1.02 for BUA, 0.07 for SOS, 0.46 for STI) were smaller than ROIfix (3.75–4.23 for BUA, 0.42–0.54 for SOS, 1.79–2.71 for STI) and ROIcir (1.78–2.85 for BUA, 0.19–0.36 for SOS, 1.60–1.91 for STI). In conclusion, calculating QUS parameters using the whole calcaneal region provides a more precise and optimal measurement than a partial circular region (ROIfix or ROIcir). It has clinical implication that it could increase the diagnostic sensitivity of QUS

  17. Possible application of CT morphometry of the calcaneus and talus in forensic anthropological identification.

    Science.gov (United States)

    Inamori-Kawamoto, Osamu; Ishikawa, Takaki; Michiue, Tomomi; Mustafa, Asmaa Mohammed Hishmat; Sogawa, Nozomi; Kanou, Tetsuya; Oritani, Shigeki; Maeda, Hitoshi

    2016-03-01

    Computed tomography (CT) data provide information for volumetric and radiographic density analysis. The present study investigated the application of virtual CT volumetry of the tarsal bones to estimation of the sex, stature, and body weight using postmortem CT (PMCT) data of forensic autopsy cases. Three-dimensional (3D) images of the bilateral foot bones of intact Japanese subjects after adolescence (age ≥ 15 years, n = 179, 100 males and 79 females) were reconstructed on an automated CT image analyzer system. Measured parameters were mass volume, mean CT value (HU), and total CT value of the talus and calcaneus. Mean CT values of these bones showed age-dependent decreases in elderly subjects over 60 years of age for both sexes, with significant sex-related differences especially in the elderly. The mass volumes and total CT values of the talus and calcaneus showed significant sex-related differences, and also moderate correlations with body height and weight for bilateral bones in all cases (r = 0.58-0.78, p forensic identification; however, greater variations should be considered in body weight estimations of females. PMID:26362306

  18. Landing on your own two feet: a case report of bilateral calcaneus and open pilon fractures.

    Science.gov (United States)

    Tiedeken, Nathan C; Hampton, David; Shaffer, Gene

    2014-01-01

    High energy fractures of the distal tibial plafond and calcaneus have been associated with high functional morbidity and wound complications. Although both of these fractures result from a similar mechanism, they have rarely been reported to occur on an ipsilateral extremity. The combination of these 2 injuries on the same extremity would increase the likelihood of an adverse surgical or functional outcome. We present the case and management strategy of a 43-year-old male with bilateral open pilon fractures and closed calcaneal fractures after falling from a height. A staged protocol was used for the bilateral pilon fractures, with external fixation until operative fixation on day 9. Nonoperative management of the calcaneal fractures resulted in a successful functional outcome at 10 months of follow-up. Treatment of this fracture pattern must incorporate the condition of the soft tissues, an understanding of the fractures, and minimize patient risk factors to optimize the functional and surgical outcomes. PMID:24856663

  19. The Effects of Body Composition, Dietary Intake, and Physical Activity on Calcaneus Quantitative Ultrasound in Spanish Young Adults.

    Science.gov (United States)

    Correa-Rodríguez, María; Rio-Valle, Jacqueline Schmidt; González-Jiménez, Emilio; Rueda-Medina, Blanca

    2016-07-01

    Identifying modifiable factors that influence bone gain during early adulthood in order to maximize peak bone mass (PBM) is a potential primary strategy in the prevention of osteoporosis in later life. The present study examined the relationships between body composition, dietary intake and physical activity (PA), and bone health measured by quantitative ultrasound (QUS) at the right calcaneus. The study population consisted of 781 Spanish men and women (age 19.1 ± 3.6). Body composition, dietary intake, PA, and bone strength were assessed. Calcaneus QUS was significantly correlated with age, height, weight, body mass index, lean mass, fat mass, protein intake, and moderate and high PA. No significant correlation between calcium intake and broadband ultrasound attenuation (BUA, dB/MHz) was detected. Linear regression analyses revealed that independent variables accounted for 18.8% of the total variance of calcaneus BUA (p = .000). Lean mass and high PA were significant predictors of BUA variance in young adults (p = .000 and p = .045, respectively). Results indicate that lifestyle choices and their consequences during early adulthood could influence bone mass, particularly PA and lean mass. Furthermore, this study provides novel data about bone mass as indicated by the QUS measurements at the time of PBM acquisition. PMID:26933147

  20. Trabecular architecture in the StW 352 fossil hominin calcaneus.

    Science.gov (United States)

    Zeininger, Angel; Patel, Biren A; Zipfel, Bernhard; Carlson, Kristian J

    2016-08-01

    Australopithecus africanus has been interpreted as having a rigid lateral foot. One mechanism contributing to a rigid foot during push-off in humans is a calcaneocuboid joint (CCJ) with limited dorsiflexion and a "close-packed" talocalcaneal joint (TCJ). In contrast, apes likely have a greater CCJ range of motion and lack a close-packed TCJ. Differences in tarsal arthrokinematics may result in different joint loading environments. In Homo sapiens, we tested the hypothesis that dorsal and plantar CCJ and the TCJ show evidence of predictable habitual loading. In Pan troglodytes, Gorilla gorilla, Gorilla beringei, and Papio ursinus, we tested the hypothesis that only the dorsal CCJ shows evidence of predictable loading. Specifically, we predicted similarity in trabecular properties across the dorsal and plantar CCJ in H. sapiens, but dissimilarity in non-humans. Additionally, we investigated trabecular properties of an A. africanus calcaneus (StW 352) to evaluate joint loading patterns in this hominin and ultimately address the evolution of these properties in H. sapiens. Contrary to predictions, the H. sapiens dorsal CCJ has a significantly higher elongation index, bone volume fraction, trabecular thickness, and trabecular number than the plantar CCJ, while trabecular properties in non-humans do not always differ as predicted between regions. H. sapiens exhibits trabecular morphology indicative of less variable TCJ loading than other groups, having the most anisotropic and rod-like struts oriented in line with predicted principal loads. Multivariate analysis shows that the StW 352 dorsal CCJ matches P. ursinus best, while the plantar CCJ matches G. beringei best and the TCJ matches that of G. gorilla best. Overall patterns suggest that the StW 352 calcaneus experienced more variable loading than H. sapiens, but less variable loading than P. troglodytes, G. gorilla, G. beringei, and P. ursinus, consistent with a large range of foot movements, probably

  1. Nonlinear attenuation and dispersion in human calcaneus in vitro: statistical validation and relationships to microarchitecture.

    Science.gov (United States)

    Wear, Keith A

    2015-03-01

    Through-transmission measurements were performed on 30 human calcaneus samples in vitro. Nonlinear attenuation and dispersion measurements were investigated by estimating 95% confidence intervals of coefficients of polynomial expansions of log magnitude and phase of transmission coefficients. Bone mineral density (BMD) was measured with dual x-ray absorptiometry. Microarchitecture was measured with microcomputed tomography. Statistically significant nonlinear attenuation and nonzero dispersion were confirmed for a clinical bandwidth of 300-750 kHz in 40%-43% of bone samples. The mean linear coefficient for attenuation was 10.3 dB/cm MHz [95% confidence interval (CI): 9.0-11.6 dB/cm MHz]. The mean quadratic coefficient for attenuation was 1.6 dB/cm MHz(2) (95% CI: 0.4-2.8 dB/cm MHz(2)). Nonlinear attenuation provided little information regarding BMD or microarchitecture. The quadratic coefficient for phase (which is related to dispersion) showed moderate correlations with BMD (r = -0.65; 95% CI: -0.82 to -0.36), bone surface-to-volume ratio (r = 0.47; 95% CI: 0.12-0.72) and trabecular thickness (r = -0.40; 95% CI: -0.67 to -0.03). Dispersion was proportional to bone volume fraction raised to an exponent of 2.1 ± 0.2, which is similar to the value for parallel nylon-wire phantoms (2.4 ± 0.2) and supports a multiple-scattering model for dispersion. PMID:25786928

  2. Awareness of osteoporosis and its relationship with calcaneus quantitative ultrasound in a large Chinese community population

    Directory of Open Access Journals (Sweden)

    Xu J

    2013-06-01

    Full Text Available Jingjing Xu,1,* Min Sun,1,* Zhixiao Wang,1,* Qi Fu,1 Mengdei Cao,1 Zhenxin Zhu,1 Chuchen Meng,1 Yan Yan,1 Jia Mao,1 Hua Tao,1 Xiaoping Huang,1 Zheng Lin,2 Tao Yang,1 Wei He1 1Department of Endocrinology, 2Department of Nursing, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China *These authors contributed equally to this work Background: The People’s Republic of China has the largest population affected by osteoporosis in the world. However, no population-based survey of osteoporosis awareness in People’s Republic of China has been reported. This study investigated the level of basic awareness of osteoporosis in a large community in People’s Republic of China. The relationship between level of awareness and quantitative ultrasound (US measurements at the calcaneus was also assessed. Methods: A questionnaire was completed by 9983 men and women aged 40 years or older in Nanjing, People’s Republic of China, between June and December 2011. During this time, the study participants underwent quantitative US measurement. Data from 9049 of the subjects were included in the final analysis. Results: The proportion of subjects who were aware of osteoporosis was very low. Only 30.7% had heard of osteoporosis, and only 18.5% had heard of osteoporotic fracture. In total, 52.9% of the subjects drank milk, 16.0% took calcium, 7.1% took vitamin D, and 47.2% were performing regular physical activity. Logistic regression showed that more highly educated older women had significantly better awareness of osteoporosis (P 0.05. Conclusion: Awareness of osteoporosis in People’s Republic of China is very low. National awareness strategies should be implemented, especially for poorly educated young men. Keywords: osteoporosis, awareness, quantitative ultrasound, Chinese

  3. Sinus tarsi approach with trans-articular fixation for displaced intra-articular fractures of the calcaneus.

    Science.gov (United States)

    Ebraheim, N A; Elgafy, H; Sabry, F F; Freih, M; Abou-Chakra, I S

    2000-02-01

    The charts and radiographs of 99 patients with 106 intraarticular fractures of the calcaneus were retrospectively reviewed. There were 75 men and 24 women. The average age was forty-two (range, 17 to 81). Fifty-seven of the fractures were left and 49 were right. The mechanism of injury was a fall from a height in 69 patients and motor vehicle accident in 30 patients. According to Sanders classification, seventy-one cases (67%) had type II fractures, 25 cases (23.6%) had type III, and ten cases (9.4%) had type IV. All the patients had operative management through a limited sinus tarsi approach with minimal fixation of the fracture with one or several pins. One of the pins was usually applied from the talus to the calcaneus through the fracture after reduction of the posterior facet. Nine cases (8.5%) developed postoperative infection, four cases (3.8%) had superficial wound infection, four cases (3.8%) had pin tract infection and one case (0.9%) had osteomylitis. Our follow-up at an average of 29 months (range, 12 to 84 months) showed that the American Orthopedic Foot and Ankle Society, Ankle-Hindfoot Score for the all group was 77.6 (range, 31-91). Forty-one fractures (38.8%) were graded excellent, 39 fractures (36.7%) good, 14 fractures (13.2%) fair, and 12 fractures (11.3%) were failures. Although radiological degenerative changes in the subtalar joint were seen in 41 cases (38.7%), only six cases (5.6%) required subsequent subtalar fusion. The authors conclude that the operative method used in the current study which followed the principle of minimal soft tissue damage and minimal internal fixation may be a good option for management of calcaneus fractures. PMID:10694021

  4. The effect of sports activities in children and adolescents on the calcaneus - an investigation with quantitative ultrasound

    International Nuclear Information System (INIS)

    Purpose: To determine whether quantitative ultrasound (QUS) parameters speed of sound (SOS) and broadband ultrasound attenuation (BUA) on the calcaneus are different between athletic children and a reference population. Patients and Methods: From a college of physical education, 177 children and adolescents (121 boys and 56 girls, age range from 11 to 18 years) were included in this study. QUS was performed on the calcaneus using the Sahara trademark device (Hologic, USA). SOS and BUA were estimated. Regional reference values of 3299 children were used to determine significant differences between athletes and reference population. The influence of activity level, age, height, and weight was estimated using correlation analysis. Results: Sportsmen showed significant (p<0.05) higher values of the QUS parameters (SOS 1581.1 m/s; BUA 69.7 dB/MHz) compared to the reference data (SOS 1563.9 m/s; BUA 64.2 dB/MHz). Significant correlation was observed between BUA and the level of activity, age, weight, and height (p<0.01) and between SOS and weight and height (p<0.05). In the group of soccer players and athletes, significant correlation was found between BUA vs. age and BUA vs. weight (p<0.05). Furthermore, significant correlation was observed between BUA vs. age and weight in Judokas and Wrestlers. For the level of activity, a significant correlation to BUA was only found in the group of Judokas and Wrestlers (p<0.01). Conclusion: An increase in quantitative ultrasound parameters on the calcaneus occurs in children and adolescents with increased physical activity. (orig.)

  5. Preliminary application of 241-Americium calcaneus bone mineral density measurement in osteoporosis. Comparison with double X-ray densitometry of the lumber spine

    International Nuclear Information System (INIS)

    Bone mineral density (BMD) of calcaneus in 54 normals, 45 Osteoporosis, 25 suspected osteoporosis and 16 other non-osteoporosis patients, a total of 140 cases were measured by HUAKE (HK-1) 241-Americium BMD absorpmetry, among them 43 were compared with that of lumber spine (L2 - L4) measured by Lunar Corporation's Expert-XL absorpmeter. BMD of normal group of calcaneus was (409.8 +- 79.4) mg/cm2. The BMD were decreased slowly with the increasing age. The BMD of osteoporosis, suspected osteoporosis and non-osteoporosis group were 230.3 +- 62.3, 395.7 +- 57.4 and 363.3 +- 51.9 mg/cm2 respectively. The BMD of osteoporosis group was much lower than that of normal group, and also lower than that of the other two groups, among 26 patients (57.78%) had bone fracture, all was in accordance with the clinical diagnosis of osteoporosis. The BMD of suspected osteoporosis and non-osteoporosis had no significant difference with normal group. The coefficient variation (CV) of BMD in repeated measurement in calcaneus of 4 participants was less than 1.2%. The correlative coefficient (r) between BMD of calcaneus and lumber spine (L2 - L4) group was 0.6824. The correlative coefficient of normal young adult-matched percentage and T value in 2 groups were 0.6863 and 0.6755 respectively, whereas aged-matched percentage, Z value were 0.4614 and 0.5009 respectively. In conclusion 241-Americium calcaneus BMD absorpmetry has the advantage of low price, easy to operate, reliable and valuable in diagnosis osteoporosis. The correlations of calcaneus and lumber spine BMD, normal young adult-matched percentage and T value were rather good

  6. Incidence and MR imaging features of fractures of the anterior process of calcaneus in a consecutive patient population with ankle and foot symptoms

    International Nuclear Information System (INIS)

    To determine the incidence, appearances and associated injuries of fractures affecting the anterior process of calcaneus from a general population with foot and ankle symptoms. A retrospective review of foot and ankle MR imaging procedures was performed for detection of cases with a fracture affecting the anterior process of calcaneus over a four year period. Radiographs, MR imaging studies, radiology reports, medical records, and operative notes were reviewed. Imaging analysis included fracture pattern, displacement, associated fractures, and presence of tendon and ligamentous injuries. The incidence of anterior process of calcaneus fracture on MR imaging was 0.5% (14/2577). Fractures were more common in female subjects (71%, 10/14). Fracture orientation was predominantly vertical (93%, 13/14). No comminuted fractures were seen and only three fractures were displaced. Three of the eight MR imaging evident fractures of anterior process of calcaneus were seen on radiographs. Associated fractures of the talus (n=5), navicular bone (n=3), cuboid (n=2), and calcaneal body (n=1) were noted. Associated injuries to the anterior talofibular ligament (n=3) and tears of the peroneus brevis (n=3) and peroneus longus (n=1) tendons were present. All fractures were treated non-operatively. Two patients had subtalar joint steroid injection for symptomatic relief

  7. Incidence and MR imaging features of fractures of the anterior process of calcaneus in a consecutive patient population with ankle and foot symptoms

    Energy Technology Data Exchange (ETDEWEB)

    Ouellette, H.; Salamipour, H.; Thomas, B.J.; Kassarjian, A.; Torriani, M. [Division of Musculoskeletal Radiology, Massachusetts General Hospital, Boston, MA (United States)

    2006-11-15

    To determine the incidence, appearances and associated injuries of fractures affecting the anterior process of calcaneus from a general population with foot and ankle symptoms. A retrospective review of foot and ankle MR imaging procedures was performed for detection of cases with a fracture affecting the anterior process of calcaneus over a four year period. Radiographs, MR imaging studies, radiology reports, medical records, and operative notes were reviewed. Imaging analysis included fracture pattern, displacement, associated fractures, and presence of tendon and ligamentous injuries. The incidence of anterior process of calcaneus fracture on MR imaging was 0.5% (14/2577). Fractures were more common in female subjects (71%, 10/14). Fracture orientation was predominantly vertical (93%, 13/14). No comminuted fractures were seen and only three fractures were displaced. Three of the eight MR imaging evident fractures of anterior process of calcaneus were seen on radiographs. Associated fractures of the talus (n=5), navicular bone (n=3), cuboid (n=2), and calcaneal body (n=1) were noted. Associated injuries to the anterior talofibular ligament (n=3) and tears of the peroneus brevis (n=3) and peroneus longus (n=1) tendons were present. All fractures were treated non-operatively. Two patients had subtalar joint steroid injection for symptomatic relief.

  8. MR relaxometry of lumbar spine, hip, and calcaneus in healthy premenopausal women: relationship with dual energy X-ray absorptiometry and quantitative ultrasound

    International Nuclear Information System (INIS)

    This study evaluates if the reversible transverse relaxation rate (R2') assessed in vivo by MR of lumbar vertebrae, hip, and calcaneus is correlated with dual energy X-ray absorptiometry (DXA) and to quantitative ultrasound (QUS) of the calcaneus. Fifteen healthy premenopausal women aged 23-47 years were studied by DXA, QUS, and MR relaxometry. The GESFIDE sequence was used to separate the FID rate (R2*) into its two components, the non-reversible transverse relaxation rate (R2) and the reversible transverse relaxation rate (R2'). Long-term reproducibility was obtained by repeated measurements of hip and calcaneus in nine individuals after 300 ± 89 days. R2' and R2* of the calcaneus had a relationship to broad-band ultrasound attenuation (BUA; r=0.46, both p2' and R2* were correlated with bone mineral per area (BMA) of the hip (r>0.73, p0.66, p2 was correlated with BMAL1-L4 (r = 0.52, p 2' and R2* were not correlated with BMAL1-L4. When the right and left sides were compared in calcaneus and hip the correlation coefficient for R2' and R2* ranged from 0.76 to 0.86 (p2' and approximately 4% for R2*. Differences in R2 between individuals were not reproducible. The results of this study indicate that R2' and R2* measurements are reproducible and might be of value when evaluating bone quality of the hip and foot. (orig.)

  9. Quantitative ultrasound of the calcaneus with parametric imaging: correlation with bone mineral density at different sites and with anthropometric data in menopausal women

    Energy Technology Data Exchange (ETDEWEB)

    Louis, O.; Kaufman, L.; Osteaux, M

    2000-07-01

    Objective: To prospectively study the relationship of quantitative ultrasound of the calcaneus with anthromopometric variables and with bone mineral density (BMD) assessed at the level of the calcaneus as well as at other sites. Method: Osteosonography of the non-dominant calcaneus was performed in 135 menopausal women, using a DTU-one device with parametric imaging. Broadband ultrasound attenuation (BUA) and speed of sound (SOS) were assessed. BMD of the calcaneus (BMDcal) was measured using dual energy X-ray absorptiometry (DXA), in a subregion matched with the region of interest for osteosonography. BMD of the lumbar trabecular bone was measured using quantitative computed tomography (BMD QCT) while the non-dominant hip was studied using DXA, which provided the total bone mineral density (BMDhip) and that of the Ward triangle (BMDWard). Results: The Pearson correlation coefficients between BUA, SOS and the various measurements of BMD ranged from 0.305 (SOS versus BMDhip) to 0.717 (BUA versus BMDcal). BMD QCT and BMDWard were found to depend on age, but not on weight or height, while BUA, SOS, BMDcal, BMDhip were unrelated to age, but correlated with weight (SOS, BMDhip) or with weight and height (BUA, BMDcal). In a multiple stepwise regression analysis, age was a significant predictor for BMD QCT, BMD hip and BMDWard; BMD QCT, BMDWard and BMDhip admitted BUA as sole predictor, while BMDcal was significantly related to both BUA and SOS. Conclusion: BUA and SOS of the calcaneus, assessed in 135 menopausal women using a parametric imaging device, reflected BMDcal, measured with DXA at a matched region of interest, and did not decline significantly with age.

  10. Quantitative ultrasound of the calcaneus with parametric imaging: correlation with bone mineral density at different sites and with anthropometric data in menopausal women

    International Nuclear Information System (INIS)

    Objective: To prospectively study the relationship of quantitative ultrasound of the calcaneus with anthromopometric variables and with bone mineral density (BMD) assessed at the level of the calcaneus as well as at other sites. Method: Osteosonography of the non-dominant calcaneus was performed in 135 menopausal women, using a DTU-one device with parametric imaging. Broadband ultrasound attenuation (BUA) and speed of sound (SOS) were assessed. BMD of the calcaneus (BMDcal) was measured using dual energy X-ray absorptiometry (DXA), in a subregion matched with the region of interest for osteosonography. BMD of the lumbar trabecular bone was measured using quantitative computed tomography (BMD QCT) while the non-dominant hip was studied using DXA, which provided the total bone mineral density (BMDhip) and that of the Ward triangle (BMDWard). Results: The Pearson correlation coefficients between BUA, SOS and the various measurements of BMD ranged from 0.305 (SOS versus BMDhip) to 0.717 (BUA versus BMDcal). BMD QCT and BMDWard were found to depend on age, but not on weight or height, while BUA, SOS, BMDcal, BMDhip were unrelated to age, but correlated with weight (SOS, BMDhip) or with weight and height (BUA, BMDcal). In a multiple stepwise regression analysis, age was a significant predictor for BMD QCT, BMD hip and BMDWard; BMD QCT, BMDWard and BMDhip admitted BUA as sole predictor, while BMDcal was significantly related to both BUA and SOS. Conclusion: BUA and SOS of the calcaneus, assessed in 135 menopausal women using a parametric imaging device, reflected BMDcal, measured with DXA at a matched region of interest, and did not decline significantly with age

  11. Magnetic resonance imaging of the calcaneus: preliminary assessment of trabecular bone-dependent regional variations in marrow relaxation time compared with dual X-ray absorptiometry

    Science.gov (United States)

    Guglielmi, G.; Selby, K.; Blunt, B. A.; Jergas, M.; Newitt, D. C.; Genant, H. K.; Majumdar, S.

    1996-01-01

    RATIONALE AND OBJECTIVES: Marrow transverse relaxation time (T2*) in magnetic resonance (MR) imaging may be related to the density and structure of the surrounding trabecular network. We investigated regional variations of T2* in the human calcaneus and compared the findings with bone mineral density (BMD), as measured by dual X-ray absorpiometry (DXA). Short- and long-term precisions were evaluated first to determine whether MR imaging would be useful for the clinical assessment of disease status and progression in osteoporosis. METHODS: Gradient-recalled echo MR images of the calcaneus were acquired at 1.5 T from six volunteers. Measurements of T2* were compared with BMD and (for one volunteer) conventional radiography. RESULTS: T2* values showed significant regional variation; they typically were shortest in the superior region of the calcaneus. There was a linear correlation between MR and DXA measurements (r = .66 for 1/T2* versus BMD). Differences in T2* attributable to variations in analysis region-of-interest placement were not significant for five of the six volunteers. Sagittal MR images had short- and long-term precision errors of 4.2% and 3.3%, respectively. For DXA, the precision was 1.3% (coefficient of variation). CONCLUSION: MR imaging may be useful for trabecular bone assessment in the calcaneus. However, given the large regional variations in bone density and structure, the choice of an ROI is likely to play a major role in the accuracy, precision, and overall clinical efficacy of T2* measurements.

  12. Determination of the bone-mineral content of the peripheral skeleton (ulna and calcaneus) in chronic renal failure patients on maintenance dialysis using 125 I-photon absorptiometry

    International Nuclear Information System (INIS)

    The bone-mineral content (BMC) of the peripheral skeleton was measured in 53 chronic renal-failure patients on maintenance dialysis using the 125 I photon absorptiometry according to Cameron. 39.6% of the patients were found to have a clearly pathological calcium content in calcaneus and ulna (33%). In total BMC assessments 43.4% of the patients examined showed strongly reduced BMC values at two measurement sites at least. Average bone-mineral content was below the value of the corresponding normal groups in all age groups of the dialysis patients. In addition, a significant correlation was verified to exist between the calcium contents of calcaneus and ulna. A significant correlation was found as well between reduced BMC values and dialysis duration. The correlation between the increased serum level of alkaline phosphatase and the reduced mineral content of the skeleton was significant as well. A minor but not significant correlation existed between the increase of the parathormone (PTH) level in the serum and the decrease of calcium content in calcaneus and ulna. A good correlation was found when contrasting the results of visual roentgenography and the BMC values established by photodensitometry: the median BMC value of patients with clear pathological X-ray findings was significantly below the one of patients without pathological X-ray findings. However, photon absorptiometry is superior to the subjective evaluation of X-ray pictures in the early diagnosis of bone diseases involving bone-mineral loss. (orig.)

  13. A validation of the first genome-wide association study of calcaneus ultrasound parameters in the European Male Ageing Study

    Directory of Open Access Journals (Sweden)

    Han Thang S

    2011-01-01

    Full Text Available Abstract Background A number of single nucleotide polymorphisms (SNPs have been associated with broadband ultrasound attenuation (BUA and speed of sound (SOS as measured by quantitative ultrasound (QUS at the calcaneus in the Framingham 100K genome-wide association study (GWAS but have not been validated in independent studies. The aim of this analysis was to determine if these SNPs are associated with QUS measurements assessed in a large independent population of European middle-aged and elderly men. The association between these SNPs and bone mineral density (BMD measured using dual-energy X-ray absorptiometry (DXA was also tested. Methods Men aged 40-79 years (N = 2960 were recruited from population registers in seven European centres for participation in an observational study of male ageing, the European Male Ageing Study (EMAS. QUS at the calcaneus was measured in all subjects and blood was taken for genetic analysis. Lumbar spine (LS, femoral neck (FN and total hip (TH BMD were measured by DXA in a subsample of 620 men in two centres. SNPs associated with BUA or SOS in the Framingham study with p -4 were selected and genotyped using SEQUENOM technology. Linear regression was used to test for the association between SNPs and standardised (SD bone outcomes under an additive genetic model adjusting for centre. The same direction of effect and p Results Thirty-four of 38 selected SNPs were successfully genotyped in 2377 men. Suggestive evidence of replication was observed for a single SNP, rs3754032, which was associated with a higher SOS (β(SD = 0.07, p = 0.032 but not BUA (β(SD = 0.02, p = 0.505 and is located in the 3'UTR of WDR77 (WD repeat domain 77 also known as androgen receptor cofactor p44. A single SNP, rs238358, was associated with BMD at the LS (β(SD = -0.22, p = 0.014, FN (β(SD = -0.31,p = 0.001 and TH (β(SD = -0.36, p = 0.002 in a locus previously associated with LS BMD in large-scale GWAS, incorporating AKAP11 and RANKL

  14. [Double measurement of the Böhler angle: prognostic value of radiological angles in posterior facet fractures of the calcaneus].

    Science.gov (United States)

    Chaminade, B; Zographos, S; Uthéza, G

    2001-11-01

    In 1931, Böhler proposed that measuring the radiological angle of the tuberosity could be useful in posterior facet fractures of the calcaneus to evaluate initial damage as well as reduction quality. In opposition to the 1998 SOFCOT symposium, certain authors considered that the Böhler angle has no prognostic value. Progress in pathological anatomy has helped to better understand posterior facet fractures, justifying the use of a "double measurement". The fundamental fracture line separates the posterior facet into a lowered medial fragment and a pivoted lateral fragment. The double contour of the posterior facet visualized radiographically allows measurement of a medial Böhler angle and a lateral Böhler angle. It is demonstrated that is the smaller the medial Böhler angle, the greater the subtalar degeneration. Surgical restoration of a satisfactory Böhler angle is a necessary prerequisite for a good outcome. "Double measurement" of the Böhler angle on the lateral view contributes to the prognostic value of this historical angle. PMID:11845075

  15. Automatic standard plane adjustment on mobile C-Arm CT images of the calcaneus using atlas-based feature registration

    Science.gov (United States)

    Brehler, Michael; Görres, Joseph; Wolf, Ivo; Franke, Jochen; von Recum, Jan; Grützner, Paul A.; Meinzer, Hans-Peter; Nabers, Diana

    2014-03-01

    Intraarticular fractures of the calcaneus are routinely treated by open reduction and internal fixation followed by intraoperative imaging to validate the repositioning of bone fragments. C-Arm CT offers surgeons the possibility to directly verify the alignment of the fracture parts in 3D. Although the device provides more mobility, there is no sufficient information about the device-to-patient orientation for standard plane reconstruction. Hence, physicians have to manually align the image planes in a position that intersects with the articular surfaces. This can be a time-consuming step and imprecise adjustments lead to diagnostic errors. We address this issue by introducing novel semi-/automatic methods for adjustment of the standard planes on mobile C-Arm CT images. With the semi-automatic method, physicians can quickly adjust the planes by setting six points based on anatomical landmarks. The automatic method reconstructs the standard planes in two steps, first SURF keypoints (2D and newly introduced pseudo-3D) are generated for each image slice; secondly, these features are registered to an atlas point set and the parameters of the image planes are transformed accordingly. The accuracy of our method was evaluated on 51 mobile C-Arm CT images from clinical routine with manually adjusted standard planes by three physicians of different expertise. The average time of the experts (46s) deviated from the intermediate user (55s) by 9 seconds. By applying 2D SURF key points 88% of the articular surfaces were intersected correctly by the transformed standard planes with a calculation time of 10 seconds. The pseudo-3D features performed even better with 91% and 8 seconds.

  16. Comparison of T-score values obtained by ultrasound osteodensitometry of calcaneus and by dual-energy x-ray absorptiometry scan

    Directory of Open Access Journals (Sweden)

    Hadžiavdić Aleksandra

    2015-01-01

    Full Text Available Introduction. Osteoporosis is the most frequent metabolic disease of bones. Early detection of pathological loss of bone mineral density represents the first step in prevention, treatment and rehabilitation of osteoporosis. This study was aimed at establishing the correlation of T-score values obtained by ultrasound osteodensitometry of calcaneus with dual-energy x-ray absorptiometry scan. Material and Methods. The study was conducted on the sample of 569 female patients from September 13, 2010 to March 10, 2011. Measurement was made with ultrasound osteodensitometry of ACHILLES make. Quantitative ultrasound method revealed that 77 female patients had a lower value of T-score (osteopenia with risk factors or osteoporosis and they were referred to T-score measurement with dual-energy x-ray absorptiometry scan. Dual-energy x-ray absorptiometry scanning was performed using LUNAR DPX scanner and 49 female patients were examined. Results. It was concluded that there was no statistically significant difference between T-score values obtained by quantitative ultrasound and dual-energy x-ray absorptiometry scanning. Conclusion. According to this study, it is necessary to provide a greater number of scanners for ultrasound osteodensitometry of calcaneus in order to secure prevention and to refer the patients to further diagnosing on time.

  17. A Novel and Alternative Treatment Method for Diabetic Heel Ulceration Exposing the Calcaneus Which Is Not Suitable for Flap Surgery: Vacuum Assisted Sandwich Dermal Matrix

    Directory of Open Access Journals (Sweden)

    Ugur A. Bingol

    2015-01-01

    Full Text Available Background. Currently, free flaps and pedicled flaps are the first treatment choices for large heel ulcer reconstruction. However, flap reconstruction of heel ulcerations cannot be performed in all diabetics especially with concurrent severe peripheral vascular disease because of higher flap failure rate. In recent years, the use of acellular dermal matrix (ADM has emerged as an alternative treatment option for extremity ulcers. Methods. We present 13 diabetic patients with a large heel ulceration exposing the calcaneus, who were not eligible for flap surgery due to the presence of only one patent artery of trifurcation. These cases were treated with the vacuum assisted sandwich dermal matrix (VASDEM method. Results. None of the patients required amputation. Skin grafting was successful in ten patients. Although partial losses were observed in three patients, they were healed spontaneously without surgical interventions. During the follow-up period none of the patients developed ulceration on the treatment area. All patients maintained their preoperative ambulatory ability. Conclusion. VASDEM is a novel method offering opportunity for treatment before proceeding to amputation in diabetic heel ulceration exposing the calcaneus which is not suitable for flap surgery. It also has the potential to close wounds of all sizes independent of the vessel status and wound size in selected diabetic patients.

  18. 跟骨强度指数与影响因素相关性分析%Correlation of Calcaneus Stiffness Index and Its Influencing Factors

    Institute of Scientific and Technical Information of China (English)

    杨敏; 范茂丹; 周磊; 孙国栋; 陆鸣

    2011-01-01

    Objective: To study the correlation between calcaneus stiffness index and the influencing factors. Methods: We selected 1024 people in checkup.( 1 )We measured stiffness index of left calcaneus by Achilles quantitative ultrasound (QUS) systems;(2)we used the RGC-120 body weight scale to survey height, the body weight and calculates the body weight index; (3)We collect medical personnels' age, diet, exercise, smoking, drinking and other information of relevant factors by questionnaire surveies; (4)And associated all the factors with calcaneus stiffness index to carry on straight line correlation analysis and multiple regression analysis.Results: (1) The straight line correlation analysis result showed that the calcaneum stiffness index was positive correlated with height,body weight, body weight index, years of drinking milk, years of movement; (2) The results of multiple regression analysis showed that calcaneus stiffness index only has a significant regression effect with body weight index and years of movement Conclusion: Body weight index and years of movement are the independent factors of calcaneus stiffness index. They are significant on the diagnosis and prevention of osteoporosis.%目的:探讨跟骨强度指数与其影响因素的相关性.方法:共入选1024例体检人员.(1)通过Achilles定量超声(QUS)系统测量左跟骨强度指数;(2)使用RGC-120型体重秤测量身高、体重并计算体重指数;(3)通过问卷调查收集体检人员年龄、膳食、运动、吸烟、饮酒等影响因素的相关资料;(4)将各影响因素与跟骨强度指数进行相关分析和多元逐步回归分析.结果:(1)直线相关分析结果显示,跟骨强度指数与身高、体重、体重指数、饮用牛奶年数、运动年数呈正相关;(2)多因素逐步回归分析显示,跟骨强度指数仅与体重指数、运动年数具有显著的回归效果.结论:体重指数与运动年数是跟骨强度指数的独立影响因素,对骨质疏松的

  19. Determination on the mineral salt content of the peripheral skeleton (ulna and calcaneus) in thyroid patients using 125I gamma-radiation absorption measurement

    International Nuclear Information System (INIS)

    The bone mineral salt content (BMC) has been determined in this work for 69 female and 14 male hyperthyroid patients and 13 euthyroid adenoma patients by means of I125 gamma-radiation absorption measurement. It could be seen by comparison to healthy patients that hyperthyroid patients lie statistically significantly below the corresponding age and sex standard values, whilst the euthyroid adenoma female patients' values are found in the BMC normal range. It was furthermore shown that the menopause did not essentially influence the BMC values of Ulna and calcaneus. A further chapter treats the dependence of the BMC values on the hyperthyroidosis duration. Queries on whether the height of the BMC values depend on the f T4 index were treated, as well as whether patients showing different extents of clinical hyperthyroid indications, statistically significantly differ even with average BMC. A comparison of the average BMC values of pretreated and untreated hyperthyroidosis patients was made. (orig./MG)

  20. Association between polymorphisms of apolipoprotein E, bone mineral density of the lower forearm, quantitative ultrasound of the calcaneus and osteoporotic fractures in postmenopausal women with hip or lower forearm fracture

    DEFF Research Database (Denmark)

    Sennels, Henriette Pia; Sand, J C; Madsen, B; Lauritzen, J B; Fenger, Mogens; Jørgensen, H L

    2003-01-01

    fragment length polymorphism (PCR-RFLP) was used to detect the APOE genotypes. Quantitative ultrasound was measured at the calcaneus. Bone mineral density (BMD) of the lower forearm was measured with dual-energy X-ray absorptiometry. The distributions of genotype frequencies in this study were: E2/E2: 0......A genetic contribution to the development of osteoporosis is well documented. Although the association between the common allelic variation of apolipoprotein E (APOE), fracture risk, bone loss and bone mineral density (BMD) has been examined in several studies, the results of these investigations...... are contradictory. The aim of this study was to examine the association between polymorphisms of APOE, BMD of the lower forearm, quantitative ultrasound of the calcaneus and osteoporotic fractures in a population of postmenopausal women with hip or lower forearm fractures admitted to a department of...

  1. Influence of treatment with alendronate on the speed of sound, an ultrasound parameter, of the calcaneus in postmenopausal Japanese women with osteoporosis: a clinical practice-based observational study

    OpenAIRE

    Iwamoto J; Takada T; Sato Y; Matsumoto H

    2012-01-01

    Jun Iwamoto,1 Tetsuya Takada,2 Yoshihiro Sato,3 Hideo Matsumoto11Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, 2Department of Internal Medicine, Hiyoshi Medical Clinic, Kanagawa, 3Department of Neurology, Mitate Hospital, Fukuoka, JapanPurpose: The influence of alendronate (ALN) treatment on the quantitative ultrasound parameters of the calcaneus remains to be established in Japanese patients. The aim of the present clinical practice-based observational ...

  2. 探索2型糖尿病对跟骨骨密度的影响%Study the Effects of Diabetes Type 2 on Bone Mineral Density of Calcaneus

    Institute of Scientific and Technical Information of China (English)

    钱重阳

    2013-01-01

    目的:探究2型糖尿病对跟骨骨密度的影响及相关性。方法:选取40~80岁糖尿病患者80例,以及体检健康者80例作为对照。检测体质量指数,空腹及餐后2 h血浆葡萄糖水平,测定左足跟骨骨密度,将各指标进行相关性分析。结果:糖尿病病程与体质量指数和跟骨骨密度呈负相关(P<0.05);且糖尿病组的体质量指数的跟骨骨密度值较对照组小(P<0.05)。体质量指数值越大,跟骨骨密度越大,即两者呈正相关(P<0.05)。结论:在患有2型糖尿病的老年人群中,随着病程延长和体质量指数降低,跟骨骨密度逐渐降低,发生骨折的风险也逐渐增大。%Objective:To study the effects and correlation of type 2 diabetes on bone density of calcaneus.Methods: Selected 80 cases with diabetic from 40 to 80 years old and 80 health cases as control group,measuring their calcaneum bone density,body mass index,postprandial and after meal 2 h plasma glucose levels in order to have correlation analysis.Results:Duration of diabetes was negatively correlated with body mass index and bone density of calcaneus(P<0.05). And the bone density of calcaneus and diabetes group body mass index values are lower than the control group(P<0.05). Body mass index is high,bone density of calcaneus is greater,that there is a positive correlation(P<0.05).Conclusion:In older people with type 2 diabetes,with the prolongation of the duration and body mass index decreased,bone density of calcaneus decreased gradually, the risk of fractures increases.

  3. Assess the discrimination of Achilles InSight calcaneus quantitative ultrasound device for osteoporosis in Chinese women: Compared with dual energy X-ray absorptiometry measurements

    International Nuclear Information System (INIS)

    Since the implementation of quantitative ultrasound (QUS) technology may become a part of future clinical decision making to identify osteoporosis and prevent fractures, this study was initiated to evaluate the correlations of QUS parameters and axial bone mineral density (BMD) using dual energy X-ray absorptiometry (DXA) and to assess the discrimination of QUS measurements for osteoporosis and osteopenia defined by WHO criteria. 106 native Chinese women (aged 50.2 ± 10.9 SD, 21-74 years) were involved. Each subject received both QUS measurements at left calcaneus with Achilles InSight and DXA measurements with DPX-L at lumbar spine (L2-4), total hip and femoral neck. Achilles InSight provided the stiffness index (SI) which derived from Broadband Ultrasound Attenuation (BUA) and Speed of Sound (SOS), and the T-scores of SI were calculated. We found that the QUS parameter SI was statistically significant but medium correlated (r = 0.458-0.587) with DXA at the lumbar spine, total hip and femoral neck (P < 0.0001 for all correlations). With ROC analysis, the area under the ROC curve of diagnosis of osteoporosis and osteopenia were 0.933 and 0.796, respectively. To identify osteoporosis, when the T-score threshold of SI was defined as -1.4, the sensitivity was 100%, and the specificity was 73.7%. Our study confirmed that QUS measurements performed with Achilles InSight were capable to identify osteoporosis defined by axial BMD using DXA in Chinese women.

  4. Comparison of stress distribution between normal and malunion calcaneus%正常与畸形愈合跟骨应力分布的比较研究

    Institute of Scientific and Technical Information of China (English)

    黄海晶; 马信龙; 马剑雄; 金鸿宾

    2013-01-01

    general stress distribution of malunion of calcaneal,subtalar joint stress reduced.The main stress area of normal bone joints was in articular surface,while the main stress area of malunion model was in the lateral calcaneal close to the calcaneocuboid joint.The main stress of the outboard is high-er than that of inboard.Outboard is the main part of supporting load.Judging from the detailed comparison with bone structure,first of all,the subsidence of subtalar joint top resulted in partial backward of the main stress of the calcaneus,which shifted to the Achilles tendon attachment point.It increased from normal (1.51±0.22) MPa to (3.11±0.24) MPa.Joint top of the stress reduced from normal (6.71±0.37) MPa to (2.83± 0.49) MPa.Secondly,the calcaneus stress of the former calcaneocuboid articulation significantly increased,which increased from normal (0.46±0.15) MPa to (2.13±0.15) MPa,and sustentaculum tali stress decreased from 5.18 MPa to 1.41 MPa.Conclusion By finite element model of this subject,the study proves that subtalar joint surface collapsed in calcaneal fractures is the main causes of most pathological changes.The problem of the joint surface subsidence should be resolved firstly in a clinical treatment,and the normal height of the calcaneus should be restored.The internal stress distribution of calcaneal is essential to the pain in the related part of calcaneal.

  5. Influence of treatment with alendronate on the speed of sound, an ultrasound parameter, of the calcaneus in postmenopausal Japanese women with osteoporosis: a clinical practice-based observational study

    Directory of Open Access Journals (Sweden)

    Iwamoto J

    2012-06-01

    Full Text Available Jun Iwamoto,1 Tetsuya Takada,2 Yoshihiro Sato,3 Hideo Matsumoto11Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, 2Department of Internal Medicine, Hiyoshi Medical Clinic, Kanagawa, 3Department of Neurology, Mitate Hospital, Fukuoka, JapanPurpose: The influence of alendronate (ALN treatment on the quantitative ultrasound parameters of the calcaneus remains to be established in Japanese patients. The aim of the present clinical practice-based observational study was to examine the influence of ALN treatment for 1 year on the speed of sound (SOS of the calcaneus and bone turnover markers in postmenopausal Japanese women with osteoporosis.Patients and methods: Forty-five postmenopausal Japanese women with osteoporosis who had received treatment with ALN for more than 1 year were enrolled in the study. The SOS and bone turnover markers were monitored over 1 year of ALN treatment.Results: The urinary levels of cross-linked N-terminal telopeptides of type I collagen and serum levels of alkaline phosphatase decreased significantly from the baseline values (–44.9% at 3 months and –22.2% at 12 months, respectively. The SOS increased modestly, but significantly, from the baseline value (0.6% at both 6 and 12 months. The percentage decrease in the urinary levels of cross-linked N-terminal telopeptides of type I collagen at 3 months was significantly correlated with the percentage increase in the SOS only at 6 months (correlation coefficient, 0.299.Conclusion: The present study confirmed that ALN treatment suppressed bone turnover, producing a clinically significant increase in the SOS of the calcaneus in postmenopausal Japanese women with osteoporosis.Keywords: postmenopausal osteoporosis, quantitative ultrasound (QUS, SOS, bone turnover, biochemical markers

  6. Localização segura na colocação dos pinos percutâneos no calcâneo Safe localization for placement of percutaneous pins in the calcaneus

    Directory of Open Access Journals (Sweden)

    Pedro José Labronici

    2012-01-01

    Full Text Available OBJETIVO: Determinar as áreas de risco em seis zonas do calcanhar e quantificar os riscos de lesão das estruturas anatômicas (artéria, veia, nervo e tendão. MÉTODO: Foram utilizados 53 calcâneos de cadáveres divididos em três zonas e subdivididas em duas áreas, superior e inferior, por meio de uma linha longitudinal do calcâneo. O risco de lesão das estruturas anatômicas em relação a cada fio de Kirschner foi determinado pelo sistema de graduação segundo a classificação de Licht. A quantificação do risco total de lesão das estruturas anatômicas na colocação de mais de um fio foi calculada pela lei aditiva das probabilidades e pela lei do produto para eventos independentes. RESULTADOS: O cálculo dos riscos de lesão, segundo a classificação de Licht, demonstrou que o risco de lesão da artéria ou veia na zona IA é mais expressivo (43% em relação às lesões de nervo e tendão (13 e 0%, respectivamente. CONCLUSÃO: O estudo permitiu identificar as estruturas anatômicas mais vulneráveis e quantificar o risco de lesão no calcanhar.OBJECTIVE: To determine the areas presenting risk in six zones of the calcaneus, and to quantify the risks of injury to the anatomical structures (artery, vein, nerve and tendon. METHOD: Fifty-three calcaneus from cadavers were used, divided into three zones and each subdivided in two areas (upper and lower by means of a longitudinal line through the calcaneus. The risk of injury to the anatomical structures in relation to each Kirschner wire was determined using a graded system according to the Licht classification. The total risk of injury to the anatomical structures through placement of more than one wire was quantified using the additive law of probabilities and the product law for independent events. RESULTS: The injury risk calculation according to the Licht classification showed that the highest risk of injury to the artery or vein was in zone IA (43%, in relation to injuries to

  7. Association between polymorphisms of apolipoprotein E, bone mineral density of the lower forearm, quantitative ultrasound of the calcaneus and osteoporotic fractures in postmenopausal women with hip or lower forearm fracture

    DEFF Research Database (Denmark)

    Sennels, Henriette Pia; Sand, J C; Madsen, B; Lauritzen, J B; Fenger, Mogens; Jørgensen, H L

    2003-01-01

    A genetic contribution to the development of osteoporosis is well documented. Although the association between the common allelic variation of apolipoprotein E (APOE), fracture risk, bone loss and bone mineral density (BMD) has been examined in several studies, the results of these investigations...... fragment length polymorphism (PCR-RFLP) was used to detect the APOE genotypes. Quantitative ultrasound was measured at the calcaneus. Bone mineral density (BMD) of the lower forearm was measured with dual-energy X-ray absorptiometry. The distributions of genotype frequencies in this study were: E2/E2: 0...

  8. Method for microsurgical repairing of tendo calcaneus and complex tissue defect%跟腱及周围复合组织缺损的显微外科修复

    Institute of Scientific and Technical Information of China (English)

    刘勇; 张成进; 付兴茂; 王剑利; 王成琪; 张雪涛; 王蕾

    2013-01-01

    目的 探讨跟腱及周围复合组织缺损的显微外科修复方法及临床效果. 方法 自1994年6月至2011年3月,对356例跟腱伴周围复合组织缺损的患者采用不同的显微外科方法的治疗.根据跟腱缺损长度及周围软组织缺损情况分为A和B两类.A类为跟腱缺损在3 cm以内、皮肤缺损在3cm× 20 cm以内,采用跟腱直接缝合(166例)或Abraham倒“V-Y”腱成形术(72例)修复跟腱损伤,采用局部皮瓣转移(238例)修复周围软组织缺损.其中跟外侧皮瓣转移修复23例,足底内侧皮瓣转移修复58例,足背皮瓣转移修复40例,内踝上皮瓣转移修复48例,外踝上皮瓣转移修复24例,腓肠神经营养血管皮瓣转移修复29例,腓肠肌皮瓣推移修复修复16例.B类为跟腱缺损超过3 cm、皮肤缺损在3 cm×20 cm以上,跟腱难以直接缝合,则采用吻合血管的复合组织瓣一期修复跟腱和软组织缺损(118例).其中阔筋膜张肌皮瓣移植修复52例,膝上外侧复合组织瓣移植修复26例,背阔肌筋膜组织瓣移植修复24例,腹直肌前鞘肌皮瓣移植修复16例. 结果 临床应用356例,局部皮瓣转移238例中226例全部成活,12例部分成活,经换药后伤口愈合.游离组织瓣118例中109例全部成活,8例术后发生血管危象,经手术探查后成活,1例手术失败,改用其他组织瓣后存活.随访1.0 ~4.5年,平均3.2年,按Thermann功能评定:优240例,良86例,可22例,差8例,优良率91.6%. 结论 显微外科技术是修复跟腱伴周围复合组织缺损的优良方法,根据跟腱及周围复合组织缺损程度灵活选择不同的修复方法,可以达到良好的功能恢复目的.%Objectives To approach the method and clinical effect on tendo calcaneus and complex tissue defect with microsurgery repair.Methods Retrospective summary the methods of 356 cases with tendo calcaneus and complex tissueserious defect,which repaired by different microsurgery from June 1994 to March 201 1

  9. Determination on the mineral salt content of the peripheral skeleton (ulna and calcaneus) in thyroid patients using /sup 125/I gamma-radiation absorption measurement. Investigations on the dependence of the measured mineral salt values of various influencing parameters

    Energy Technology Data Exchange (ETDEWEB)

    Kotz, F.

    1979-07-17

    The bone mineral salt content (BMC) has been determined in this work for 69 female and 14 male hyperthyroid patients and 13 euthyroid adenoma patients by means of I/sup 125/ gamma-radiation absorption measurement. It could be seen by comparison to healthy patients that hyperthyroid patients lie statistically significantly below the corresponding age and sex standard values, whilst the euthyroid adenoma female patients' values are found in the BMC normal range. It was furthermore shown that the menopause did not essentially influence the BMC values of Ulna and calcaneus. A further chapter treats the dependence of the BMC values on the hyperthyroidosis duration. Queries on whether the height of the BMC values depend on the f T/sub 4/ index were treated, as well as whether patients showing different extents of clinical hyperthyroid indications, statistically significantly differ even with average BMC. A comparison of the average BMC values of pretreated and untreated hyperthyroidosis patients was made.

  10. Modification of the sinus tarsi approach for open reduction and plate fixation of intra-articular calcaneus fractures: the limits of proximal extension based upon the vascular anatomy of the lateral calcaneal artery.

    Science.gov (United States)

    Femino, John E; Vaseenon, Tanawat; Levin, David A; Yian, Edward H

    2010-01-01

    The treatment of displaced calcaneal fractures remains controversial. Early surgical management to restore articular congruence and the structural function of the calcaneus is widely accepted as the best way to avoid the negative consequences of malunion. Concerns remain however regarding the best approach for reducing and maintaining reduction of these complex fractures, while minimizing the risk of surgical complications. The potential for serious wound complications is a major concern, particularly breakdown of the lateral calcaneal skin flap with the extensile lateral approach. Various approaches have been developed to try and balance the need for direct reduction of the articular surface while minimizing the potential for wound complications. Palmer originally described a laterally based approach through the sinus tarsi for direct visualization of the articular surface for reduction. He and others have found this approach to be useful and reasonably safe. At times, however, it may be necessary to extend the limits of a small incision over the sinus tarsi to treat adjacent fractures or to aid reduction in more complex fractures. In addition, a limited sinus tarsi incision without elevation of the lateral calcaneal skin flap does not allow for plate fixation, a notable advantage of the extensile lateral approach, particularly in gaining reduction of the body of the calcaneus. The authors have used an extended sinus tarsi approach to include placement of plate percutaneously beneath the lateral calcaneal skin flap through a sinus tarsi approach, and to treat adjacent fractures and soft tissue injuries. A clinical series of 13 patients (including 7 chronic smokers and 1 with diabetes and vascular disease) with closed displaced intra-articular calcaneal fractures (Sanders types II and III) were treated by open reduction and internal fixation via this approach. Adjacent fractures were treated through the same incision. Two patients developed wound complications. No

  11. 钢板与克氏针内固定修复跟骨骨折:Gissane角及Bohler角与跟骨高度比较%Internal fixation with plate and Kirschner wire to repair calcaneal fractures:comparison of Gissane angle, Bohler angle and calcaneus height

    Institute of Scientific and Technical Information of China (English)

    马东弟; 杨振建; 宋锦旭; 高志峰; 孙立恒; 潘学文

    2015-01-01

      结果与结论:切开复位重建钢板内固定组治疗后的Gissane角、Bohler角及跟骨高度显著大于经皮撬拨复位克氏针固定组(P 0.05);切开复位重建钢板内固定组治疗后1年随访的足踝功能AOFAS评分显著高于经皮撬拨复位克氏针固定组(P OBJECTIVE:To compare and analyze the prognosis effect of open reduction and internal fixation and percutaneous poking fixation with Kirschner wire for calcaneal fractures. METHODS:A total of 62 patients with calcaneal fractures, who were treated in Tangshan Fengnan District Hospital from March 2012 to September 2013, were selected for this study. The patients were divided into two groups according to the therapy strategy:open reduction and internal fixation group (n=29) and percutaneous poking fixation with Kirschner wire group (n=33). Gissane angle, Bohler angle, calcaneus height, incidence of postoperative complication and AOFAS score (1-year fol ow-up) were compared between the two groups. RESULTS AND CONCLUSION:The Gissane angle, Bohler angle and calcaneus height in open reduction and internal fixation group were higher than percutaneous poking fixation with Kirschner wire group (P0.05). The AOFAS score during 1-year fol ow-up was significantly higher in open reduction and internal fixation group than in the percutaneous poking fixation with Kirschner wire group (P<0.05). Results indicated that open reduction and internal fixation could recover the regular structure of calcaneus and subtalar joint. Surgeon with skil ed operation skil s could ensure the safety of surgery. Open reduction and internal fixation can promote the prognosis of calcaneal fractures, and is better than percutaneous poking fixation with Kirschner wire.

  12. Estudo comparativo dos métodos conservador e cirúrgico para tratamento das lesões agudas do tendão do calcâneo Comparative study of conservative and surgical methods for the treatment of acute calcaneus tendon injuries

    Directory of Open Access Journals (Sweden)

    Marco Túlio Costa

    2007-01-01

    Full Text Available O tratamento das lesões agudas do tendão do calcâneo ainda permanece controverso. Com o objetivo de estabelecer diretrizes atuais, para o tratamento destas lesões, foi realizada uma revisão da literatura. Nos trabalhos avaliadas foram estudadas 1342 lesões, sendo o tratamento conservador utilizado em 354 lesões e o cirúrgico em 988. A imobilização suropodálica foi a mais utilizada, independentemente do tipo de tratamento. Não houve predomínio de nenhuma técnica cirúrgica, quando utilizado o tratamento cirúrgico. Concluiu-se que: Atualmente, não há, na literatura, um método de tratamento preferencial, conservador ou cirúrgico, que seja consenso entre os autores, o qual possa ser aplicado a todos os pacientes com lesão aguda do tendão do Calcâneo. Atletas de competição devem ser, preferencialmente, tratados com reparação cirúrgica do tendão. O tratamento conservador é o preferencial em pacientes sedentários ou idosos, portadores de doenças que elevem o risco cirúrgico. O tratamento cirúrgico, seguido de movimentação precoce do tornozelo, tem apresentado bons resultados em relação à recuperação funcional do tendão. A imobilização deve ser suropodálica, não sendo necessária a imobilização do joelho tanto no tratamento cirúrgico como no conservador destas lesões. A via de acesso medial é a via preferencial no tratamento cirúrgico, devido à menor probabilidade de lesão do nervo sural.The treatment of acute calcaneus tendon injuries remains controversial. Intending to establish updated guidelines for treating those injuries, a literature review was conducted. Among the papers assessed, 1342 injuries were studied, with conservative treatment being applied in 354 injuries and the surgical treatment in 988. Sural-podal immobilization was most frequently used, regardless of the kind of treatment. No surgical technique was prevalent when this kind of intervention was employed. The following were

  13. Estudo comparativo de propriedades biomecânicas da porção central do tendão calcâneo congelado e a fresco Comparative study on biomechanical properties of the central portion of frozen and fresh calcaneus tendon

    Directory of Open Access Journals (Sweden)

    Rodrigo Bezerra de Menezes Reiff

    2007-01-01

    Full Text Available Métodos de armazenamento de aloenxertos podem alterar certas características mecânicas dos tecidos. Com o objetivo de analisar a influência do fenômeno de congelamento e do tempo de armazenamento sobre as propriedades biomecânicas de tendões, os autores estudaram 40 tendões calcâneos obtidos de 20 cadáveres humanos com idade média de 41,95 anos, variando de 31 a 54 anos, sendo 17 do sexo masculino e três do sexo feminino. De cada cadáver foram retirados dois tendões, sendo que um foi testado a fresco e o contralateral congelado a - 85º C em freezer elétrico, durante um período de seis ou 12 semanas. Os corpos de prova foram submetidos a ensaios de tração em uma máquina de ensaios mecânicos Kratos K5002, fornecendo gráficos força-deformação. Foram analisados os parâmetros de força no limite de resistência máxima, rigidez, tensão no limite de resistência máxima, deformação relativa e módulo de elasticidade. Os resultados foram comparados e a analisados estatisticamente pelo método de "t-student", com índice de significância de 0,05, sendo que não houve diferença significativa nos valores obtidos entre os grupos. Concluímos que o congelamento a - 85º C não altera as propriedades biomecânicas de tendões, a despeito do tempo de armazenamento.Allograft storage methods can change some mechanical characteristics of tissues. With the objective of analyzing the influence of freezing phenomenon and storage time on tendons’ biomechanical properties, the authors studied 40 calcaneus tendons obtained from 20 human cadavers, with an average age of 41.95 years, ranging from 31 to 54 years old, being 17 males and three females. From each cadaver, two tendons were removed, one tested in its fresh state and the contralateral one frozen at -85º C in an electric freezer, during a period of six or 12 weeks. The bodies of evidence were submitted to traction assays in a Kratos K5002 mechanical assay machine, delivering

  14. Rare Case of Aspergillus ochraceus Osteomyelitis of Calcaneus Bone in a Patient with Diabetic Foot Ulcers

    Directory of Open Access Journals (Sweden)

    Farhang Babamahmoodi

    2015-01-01

    Full Text Available Diabetes is the most common metabolic disease in humans. One of the major complications of the disease is foot ulcer that is prone to infection. The most common causes of infection which have been reported in these patients are bacteria and fungi such as Candida, Aspergillus, and Rhizopus species. We report one such rare case with calcaneal osteomyelitis caused by Aspergillus ochraceus in a patient with diabetic foot osteomyelitis. The case was a 68-year-old male with a history of type II diabetes for 2 years. The patient had two ulcers on the right heel bones for the past 6 months with no significant improvement. One of the most important predisposing factors to infectious diseases, especially opportunistic fungal infection, is diabetes mellitus. Aspergillus species can involve bony tissue through vascular system, direct infection, and trauma. Proper and early diagnosis and treatment of diabetic foot infection can reduce or prevent complications, such as osteomyelitis and amputation. The annual examination of feet for skin and nail lesion, sensation, anatomical changes, and vascular circulation can be useful for prevention and control of infection.

  15. Rare Case of Aspergillus ochraceus Osteomyelitis of Calcaneus Bone in a Patient with Diabetic Foot Ulcers

    Science.gov (United States)

    Babamahmoodi, Farhang; Shokohi, Tahereh; Ahangarkani, Fatemeh; Nabili, Mojtaba; Afzalian Ashkezari, Elham; Alinezhad, Sosan

    2015-01-01

    Diabetes is the most common metabolic disease in humans. One of the major complications of the disease is foot ulcer that is prone to infection. The most common causes of infection which have been reported in these patients are bacteria and fungi such as Candida, Aspergillus, and Rhizopus species. We report one such rare case with calcaneal osteomyelitis caused by Aspergillus ochraceus in a patient with diabetic foot osteomyelitis. The case was a 68-year-old male with a history of type II diabetes for 2 years. The patient had two ulcers on the right heel bones for the past 6 months with no significant improvement. One of the most important predisposing factors to infectious diseases, especially opportunistic fungal infection, is diabetes mellitus. Aspergillus species can involve bony tissue through vascular system, direct infection, and trauma. Proper and early diagnosis and treatment of diabetic foot infection can reduce or prevent complications, such as osteomyelitis and amputation. The annual examination of feet for skin and nail lesion, sensation, anatomical changes, and vascular circulation can be useful for prevention and control of infection. PMID:26064128

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

    Science.gov (United States)

    Wear, K A; Stuber, A P; Reynolds, J C

    2000-10-01

    Ultrasonic attenuation and sound speed have been investigated in trabecular bone by numerous authors. Ultrasonic backscatter has received much less attention. To investigate relationships among these three ultrasonic parameters and bone mineral density (BMD), 30 defatted human calcanei were investigated in vitro. Normalized broadband ultrasonic attenuation (nBUA), sound speed (SOS), and logarithm of ultrasonic backscatter coefficient (LBC) were measured. Bone mineral density was assessed using single-beam dual energy x-ray absorptiometry (DEXA). The correlation coefficients of least squares linear regressions of the three individual ultrasound (US) parameters with BMD were 0.84 (nBUA), 0.84 (SOS) and 0.79 (LBC). The 95% confidence intervals for the correlation coefficients were 0. 69-0.92 (nBUA), 0.68-0.92 (SOS) and 0.60-0.90 (LBC). The correlations among pairs of US variables ranged from 0.63-0.79. Variations in nBUA accounted for r(2) = 62% of the variations in LBC. Variations in SOS accounted for r(2) = 40% of the variations in LBC. These results suggest that ultrasonic backscattering properties may contain substantial information not already contained in nBUA and SOS. A multiple regression model including all three US variables was somewhat more predictive of BMD than a model including only nBUA and SOS. PMID:11120369

  17. Variations in the Articular Facets on Superior Surface of Calcaneus in North Indian Population: A Dry Bone Study

    Directory of Open Access Journals (Sweden)

    G.S. Gindha

    2014-11-01

    Full Text Available This study was conducted in the department of anatomy of Gian Sagar Medical College, Ramnagar, Rajpura, District Patiala. 325 dry calcanei were studied. Out of which 167 were of right side and 158 were of left side and are of both sexes. The facet for talus were observed in all the calcanei. The grouping was done on the basis of number of facets present on the superior surface of calcanei. Group-I was having single facet on the two bones only (0.615 %. Group-II was having two facets and this group was further divided into three subgrpoups i.e Group-II (A,B,C, Group-II A (15.69 % of right side and (12.00 % left side. Group-II C (0.31 % of right side only. Group-III was having three facets i.e (20.62%. it was further divided into two subgroups i.e Group-III (A,B. Group-III A (8.62 % of right side and (12.00 % of left side and Group-III B (4.92 % right side and (4.3 % left side . It was concluded that the variations in differences between various types of facets on calcanei can result from differences in gait, habit of shoe wearing, sitting posture, clinical changes and embryological abnormalities of foot. Some of the types of facets can produce the problems in gait and can also cause pain in foot.

  18. [Dislocated intra-articular calcaneus fractures. Long-term follow-up after open reposition and osteosynthesis].

    Science.gov (United States)

    Funk, E M; Wiedemann, M; Bickel, R; Rüter, A

    1995-10-01

    A series of 98 patients with a total of 105 intra-articular fractures of the os calcis were operated on during a 10-year period between 1983 and 1992. We were able to follow up 60 patients with 64 fractures an average of 44 months (range, 18-105 months) postoperatively. At the time of follow up, 83.9% of patients had been back to work, 78.6% with the same employer as before. Five of the patients followed up had had to retire from work; each of these had one or more severe coexisting injuries. A compromising nerve injury occurred postoperatively in 3 out of 58 patients with closed fractures, in all cases following surgery with a medial or bilateral approach. In only 1 of the 58 patients followed up after closed fractures did a deep infection requiring arthrodesis occur. One patient had sympathetic reflex dystrophy (Sudeck). A good functional result in the lower ankle joint correlated with a good outcome. In contrast, postoperative improvement of the tuber angle and the degree of arthrosis seen radiographically did not. We conclude that operative repair of intraarticular calcaneal fractures is a procedure that can safely be procedure used to restore the ability to work in the majority of patients. The medial approach should preferably not be used, nor should the metal be extracted from the medial approach if this can be avoided. PMID:7502082

  19. Fatigue Fracture of the Calcaneus: From Early Diagnosis to Treatment: A Case Report of a Triathlon Athlete.

    Science.gov (United States)

    Serrano, Simão; Figueiredo, Pedro; Páscoa Pinheiro, João

    2016-06-01

    Stress fractures are frequently underdiagnosed and undertreated despite being common in sports. Early diagnosis is crucial; therefore, a high index of clinical suspicion is required. Complementary examinations are essential for diagnosis and follow-up. The authors report a clinical case of a young adult triathlon athlete referring mechanical pain in the rear left foot, with 2 weeks' progression. An earlier increase in daily training intensity was recorded. Complementary examinations confirmed a calcaneal fatigue fracture. Immobilization and no weight bearing were introduced for an initial period of 4 weeks, and the rehabilitation process was started. Progressive weight bearing was introduced between fourth and eighth weeks. Sports activity started at the 12th week. Boundaries to sports activity were eliminated by the 24th week, without pain or functional limitation. Repetitive overload to the heel and intense axial weight bearing in association to repetitive concentric/eccentric gastrocnemius contraction are related to calcaneal stress fracture, the second most common stress fracture in the foot. Calcaneal stress fractures can be adequately treated with activity modification, without casting or surgical intervention. When in the presence of bilateral stress fractures, metabolic and nutritional issues must be considered. The case report highlights the importance of sports medicine examination for detecting intrinsic and extrinsic fatigue fracture risk factors. PMID:26945212

  20. Peritendinous calcinosis of calcaneus tendon associated with dermatomyositis: correlation between conventional radiograph, ultrasound, magnetic resonance imaging and gross surgical pathology

    International Nuclear Information System (INIS)

    Interstitial calcinosis is an uncommon condition in which there is either localized or widely disseminated deposition of calcium in the skin, subcutaneous tissues, muscles, and tendons. Calcinosis is often associated with collagen diseases, scleroderma and dermatomyositis. The authors report a case of interstitial calcinosis associated with dermatomyositis studied with conventional radiograph, ultrasound and magnetic resonance imaging, and correlate the imaging findings with the results of surgical pathology gross examination. (author)

  1. The Discriminatory Capacity of BMD Measurements by DXL at the Calcaneus and DXA at the Hip and Spine Including Clinical Risk Factors to Detecting Patients with Vertebral Fractures

    Directory of Open Access Journals (Sweden)

    Muschitz Ch

    2013-01-01

    Full Text Available bDie diskriminatorische Schärfe von BMD-Messungen mittels DXL am Kalkaneus und DXA an der Hüfte und an der Wirbelsäule inklusive klinischer Risikofaktoren zur Erfassung von Patienten mit vertebralen Frakturen./bbr Einleitung: Das osteoporotische Frakturrisiko wird durch Knochenmineraldichte (BMD und klinische Risikofaktoren („clinical risk factors“ [CRF] determiniert. DXA-(„dual X-ray absorptiometry“- Messungen an der Hüfte und an der LWS gelten als Goldstandard für die BMD-Bestimmung. Diese Messungen sind häufig aufgrund degenerativer Veränderungen – vor allem bei älteren Personen – nicht verwertbar. Ein transportables DXL- („dual X-ray technology and laser“- Gerät mit Messort am Kalkaneus kann eine Alternative darstellen. Methoden: In dieser Studie wurden an 588 unbehandelten Frauen und Männern (mittleres Alter 64,4, Altersspanne 17,6–93,1 Jahre am gleichen Tag sowohl mittels DXA-Technik die BMD der Hüfte/LWS als auch mittels DXL die BMD am Kalkaneus bestimmt. Zusätzlich wurden die CRFs erhoben. 160 Patienten hatten radiologisch verifizierte Wirbelkörperfrakturen. Zur Bestimmung der Sensitivität und Spezifität wurden AUC-Kurven („area under the ROC curves“ berechnet. Resultate: Die AUC zum Nachweis von vertebralen Frakturen war für DXA am Schenkelhals und für DXL am Kalkaneus vergleichbar (DXL 0,665, DXA 0,670. Die AUC für CRFs ohne BMDMessungen war mit einem Wert von 0,805 deutlich den alleinigen BMD-Messungen überlegen. Die Kombination von BMD und CRF führte zu einer Verbesserung der prognostischen Vorhersage: DXA Schenkelhals und CRF: AUC 0,869, p = 0,002; DXL Kalkaneus und CRF: AUC 0,869, p = 0,059. Konklusion: Bei Patienten mit vertebralen Fragilitätsfrakturen sind BMD-Messungen mittels DXL am Kalkaneus vergleichbar zu BMDMessungen mittels DXA am Schenkelhals, die den Goldstandard darstellen. Die Kombination aus CRF und BMD-Messungen führt zu einer Verbesserung der Vorhersagewahrscheinlichkeit, um Patienten mit Wirbelkörperfrakturen klinisch zu erfassen.

  2. 77 FR 74873 - Notice of Inventory Completion: University of Montana, Missoula, MT; Museum of the Rockies at...

    Science.gov (United States)

    2012-12-18

    ... proximal phalanges, a right parietal fragment, a left mandibular canine, a right talus, a right calcaneus, a left calcaneus, and a right cuboid), two elements from the Terrace area (a partial femur and...

  3. Peritendinous calcinosis of calcaneus tendon associated with dermatomyositis: correlation between conventional radiograph, ultrasound, magnetic resonance imaging and gross surgical pathology; Calcinose peritendinea do tendao calcaneo associada a dermatomiosite: correlacao entre radiografia convencional, ultra-sonografia, ressonancia magnetica e macroscopia cirurgica

    Energy Technology Data Exchange (ETDEWEB)

    Rosa, Ana Claudia Ferreira; Gomide, Lidyane Marques de Paula; Lemes, Marcella Stival [Universidade Federal de Goias (UFG), Goiana, GO (Brazil). Faculdade de Medicina. Hospital das Clinicas; Costa, Edegmar Nunes; Rocha, Valney Luiz da [Universidade Federal de Goias (UFG), Goiania, GO (Brazil). Faculdade de Medicina. Dept. de Ortopedia; Machado, Marcio Martins; Santos Junior, Rubens Carneiro dos; Barros, Nestor de; Cerri, Giovanni Guido [Universidade Federal de Goias (UFG), Goiania, GO (Brazil). Faculdade de Medicina. Dept. de Radiologia; Sernik, Renato Antonio [Sao Paulo Univ., SP (Brazil). Hospital das Clinicas. Inst. de Radiologia; Nunes, Rodrigo Alvarenga [Universidade do Vale do Sapucai (UNIVAS), Pouso Alegre, MG (Brazil). Faculdade de Ciencias Medicas; Albieri, Alexandre Daher [Hospital de Acidentados de Goiania, GO (Brazil)

    2006-01-15

    Interstitial calcinosis is an uncommon condition in which there is either localized or widely disseminated deposition of calcium in the skin, subcutaneous tissues, muscles, and tendons. Calcinosis is often associated with collagen diseases, scleroderma and dermatomyositis. The authors report a case of interstitial calcinosis associated with dermatomyositis studied with conventional radiograph, ultrasound and magnetic resonance imaging, and correlate the imaging findings with the results of surgical pathology gross examination. (author)

  4. Study on Body Composition and Calcaneus Ultrasound Parameters of the Different Levels of Men Speed Skating Athletes%不同运动水平男子速滑运动员体成分与跟骨超声参数的研究

    Institute of Scientific and Technical Information of China (English)

    赵文艳

    2016-01-01

    The characteristics of body composition and cal-caneal ultrasound bone of the different level male speed skaters were analyzed. The author studied body composition and bone density of 88 healthy unused drugs male speed skaters in Heilongjiang Province by South Korea ZEUS9. 9 body composition analyzer and Franc Osteospace MEDILINK ultrasound bone measurement instrument. The results showed there was significant differences in body composition between the master and one or two stage Ath-letes,and there was not significant differences between pri-mary and secondary speed skating. There were not signifi-cantly difference in calcaneal ultrasound BUA and T values of different levels of sports speed skating athletes, but it showed freefall with improvement of sports level. The con-clusions showed that the athlete body composition was re-lated to athletic level. With the increase of sport level,fat and absolute and relative content of intracellular fluid was raised. Muscle protein, organic matter, total liquid index absolute value of excellent speed skating athletes were high,but the relative value was not dominant. It reflected there were still inadequate in our province athletes, we should pay attention to muscle training and nutrition intake. Long-term high-intensity exercise training reduces the calcaneal ultrasound bone of the speed skaters. Although the difference was not statistically significant,but we should be paid attention to the phenomenon. We should pay attention to exercise recovery period intake of nutrients,to promote the athlete bone health, improve the athlete’s athletic ability,in order to reduce the occurrence rate of sports injury in athletes guide.%分析不同运动水平男子速滑运动员身体成分与跟骨超声骨量的特点。应用韩国ZEUS9.9身体成分分析仪和法国Osteospace MEDI LINK超声骨量测量仪测定黑龙江省88名身体健康未使用药物的男子速滑运动员体成分和跟骨密度。结果显示:1.健将与一、二级速滑运动员体成分存在显著差异,而一级与二级速滑运动员体成分差异不显著。2.不同运动水平速滑运动员跟骨超声参数BUA和T值差异不显著,但呈现随运动水平的提高而下降的趋势。结果表明:速滑运动员身体成分与运动水平有关,随着运动水平的提高脂肪和细胞内液的绝对和相对含量增多,健将速滑运动员肌肉、蛋白质、矿物质、总体液指标的绝对值高,但相对值不占优势,反映出我省速滑运动员还存在不足,应重视肌肉训练及营养摄入;长期高强度的运动训练降低了速滑运动员跟骨超声骨量,虽然在统计学上差异不显著,但应引起重视,注意运动恢复期营养物质的摄入,对促进速滑运动员骨健康,提高运动员的运动能力,为降低运动员运动性损伤发生率提供指导。

  5. Tarsal Coalition

    Science.gov (United States)

    ... bones in the back of the foot (the tarsal bones). This abnormal connection, which can be composed of ... and pain in one or both feet. The tarsal bones include the calcaneus (heel bone), talus, navicular, cuboid, ...

  6. MR and sonographic findings at the malleolus of marathon runners

    International Nuclear Information System (INIS)

    Calcaneus tendons and ankles of 25 practising marathon runners were investigated by sonography and MR. We applied a 7.5 MHz transducer for sonography. Axial and sagittal T1-weighted, proton density-weighted, and T2-weighted SE images were performed. MR proved superior to sonography. Degenerative alterations of the calcaneus tendon, tendovaginitis of the flexor hallucis longus muscle, joint effusions and cartilage disease were diagnosed by MR but remained undetected by sonography. (orig.)

  7. Rearfoot posture of Australopithecus sediba and the evolution of the hominin longitudinal arch

    OpenAIRE

    Prang, Thomas C.

    2015-01-01

    The longitudinal arch is one of the hallmarks of the human foot but its evolutionary history remains controversial due to the fragmentary nature of the fossil record. In modern humans, the presence of a longitudinal arch is reflected in the angular relationships among the major surfaces of the human talus and calcaneus complex, which is also known as the rearfoot. A complete talus and calcaneus of Australopithecus sediba provide the opportunity to evaluate rearfoot posture in an early hominin...

  8. The effects of isolation on the mechanics of the human heel pad.

    OpenAIRE

    Aerts, P; Ker, R F; de Clercq, D.; Ilsley, D W

    1996-01-01

    In previous studies on the mechanical properties of the human heel pad (Bennett & Ker, 1990; Aerts et al. 1995) the fat pad and part of the calcaneus was removed from amputated test specimens. The present study tested whether this procedure influences the mechanical behaviour of the sample. Intact amputated feet were therefore mounted on steel rods driven through the calcaneus and placed in a mechanical test situation (pendulum or servohydraulic material tester). The mechanical properties of ...

  9. A Rare Cause of Heel Pain: Haglund’s Syndrome

    Directory of Open Access Journals (Sweden)

    Ümit DÜNDAR

    2008-04-01

    Full Text Available Pain in the posterior area of the heel may have different causes such as, insertion tendinitis of the achilles tendon, periostitis of calcaneus, bursitis and a Haglund exostosis. Haglund’s syndrome, or Haglund’s disease, is characterized by a painful bony prominence of the dorsal and lateral part of the calcaneus. Clinical symptoms are swelling in the cranial and lateral part of the calcaneus, sometimes pain on pressure on the achilles tendon and pain on active or passive dorsal and plantar flexion movement. A patient is presented here with posterior heel pain and diagnosed as Haglund’s syndrome. Turk J Phys Med Rehab 2008;54:33-5.

  10. The pathological changes in the hind limb of a horse from the Roman Period

    International Nuclear Information System (INIS)

    During the archaeological excavation of a multicultural settlement at the Nitra-Chrenova site (south-western Slovakia) an assemblage of animal bone remains was revealed. In one of the settlement features dated to the Roman period a complete horse skeleton was discovered. An investigation was carried out in the hind limb of the horse's skeleton involving macroscopic and radiographic analysis. Exostoses were observed on the tibia, talus, calcaneus, tarsal and metatarsal bones. The articular surfaces were destroyed. The anatomical structure of the talus, calcaneus and tarsal bones was not visible due to new bone formation. Additionally, osteomyelitis was observed in the talus, calcaneus and tarsal bones. It is suggested that the pathological changes developed during the septic inflammation process as a consequence of the complicated wound of the tarsal region or the tarsal joint perforating trauma

  11. Successful intraosseous infusion in the critically ill patient does not require a medullary cavity.

    LENUS (Irish Health Repository)

    McCarthy, Gerard

    2012-02-03

    OBJECTIVES: To demonstrate that successful intraosseous infusion in critically ill patients does not require bone that contains a medullary cavity. DESIGN: Infusion of methyl green dye via standard intraosseous needles into bones without medullary cavity-in this case calcaneus and radial styloid-in cadaveric specimens. SETTING: University department of anatomy. PARTICIPANTS: Two adult cadaveric specimens. MAIN OUTCOME MEASURES: Observation of methyl green dye in peripheral veins of the limb in which the intraosseous infusion was performed. RESULTS: Methyl green dye was observed in peripheral veins of the chosen limb in five out of eight intraosseous infusions into bones without medullary cavity-calcaneus and radial styloid. CONCLUSIONS: Successful intraosseous infusion does not always require injection into a bone with a medullary cavity. Practitioners attempting intraosseous access on critically ill patients in the emergency department or prehospital setting need not restrict themselves to such bones. Calcaneus and radial styloid are both an acceptable alternative to traditional recommended sites.

  12. Routine MRI findings of the asymptomatic foot in diabetic patients with unilateral Charcot foot

    Directory of Open Access Journals (Sweden)

    Poll Ludger W

    2010-04-01

    Full Text Available Abstract Background Imaging studies of bones in patients with sensory deficits are scarce. Aim To investigate bone MR images of the lower limb in diabetic patients with severe sensory polyneuropathy, and in control subjects without sensory deficits. Methods Routine T1 weighted and T2-fat-suppressed-STIR-sequences without contrast media were performed of the asymptomatic foot in 10 diabetic patients with polyneuropathy and unilateral inactive Charcot foot, and in 10 matched and 10 younger, non-obese unmatched control subjects. Simultaneously, a Gadolinium containing phantom was also assessed for reference. T1 weighted signal intensity (SI was recorded at representative regions of interest at the peritendineal soft tissue, the tibia, the calcaneus, and at the phantom. Any abnormal skeletal morphology was also recorded. Results Mean SI at the soft tissue, the calcaneus, and the tibia, respectively, was 105%, 105% and 84% of that at the phantom in the matched and unmatched control subjects, compared to 102% (soft tissue, 112% (calcaneus and 64% (tibia in the patients; differences of tibia vs. calcaneus or soft tissue were highly significant (p Conclusion MR imaging did not reveal grossly abnormal bone marrow signalling in the limbs with severe sensory polyneuropathy, but occult sequelae of previous traumatic injuries.

  13. Osteomyelitis Because of Mycobacterium Xenopi in an Immunocompetent Child.

    Science.gov (United States)

    Kuntz, Martin; Seidl, Maximilian; Henneke, Philipp

    2016-01-01

    We present the case of a 6-year-old, immunocompetent boy with chronic osteomyelitis of the calcaneus caused by Mycobacterium xenopi. Of note, typical histopathology was not visible on the first biopsy and developed only later over a period of 6 weeks, highlighting the difficult differential diagnosis of osteomyelitis caused by nontuberculous mycobacteria. PMID:26418244

  14. Appearance of the weight-bearing lateral radiograph in retrocalcaneal bursitis

    NARCIS (Netherlands)

    M.N. van Sterkenburg; B. Muller; M. Maas; I.N. Sierevelt; C.N. van Dijk

    2010-01-01

    Background and purpose A retrocalcaneal bursitis is caused by repetitive impingement of the bursa between the Achilles tendon and the posterosuperior calcaneus. The bursa is situated in the posteroinferior corner of Kager's triangle (retrocalcaneal recess), which is a radiolucency with sharp borders

  15. Disease: H00903 [KEGG MEDICUS

    Lifescience Database Archive (English)

    Full Text Available n idiopathic deformity of the lower limb that consists of malalignment of the bones and joints of the foot a...nd ankle. It is defined as a fixation of the foot in a hand-like orientation. The calcaneus, navicular and cuboid bones

  16. Finite Element Analysis of the Achilles Tendon While Running

    Directory of Open Access Journals (Sweden)

    Anițaș Răzvan

    2013-02-01

    Full Text Available Introduction: The Achilles tendon is the most frequent recipient of traumatic injuries. The aim of this study is to identify and describe the varying load at ankle level and especially at the Achilles tendon’s insertion on the calcaneus.

  17. Overset traethedsbrud i haelbenet

    DEFF Research Database (Denmark)

    Jeppesen, Katrine Arp; Palm, Henrik; Ebskov, Lars

    2009-01-01

    A stress fracture of the calcaneus is the result of rhythmically recurring sub-threshold traumata and is typically seen in athletes. The diagnosis is difficult because stress fractures are easily missed in traditional radiographs. It is therefore recommended to perform magnetic resonance imaging....

  18. Can We Measure the Heel Bump? Radiographic Evaluation of Haglund's Deformity.

    Science.gov (United States)

    Bulstra, Gythe H; van Rheenen, Thijs A; Scholtes, Vanessa A B

    2015-01-01

    Haglund's deformity is a symptomatic posterosuperior deformity of the heel. The lateral radiograph of the ankle will show a prominent, large, posterosuperior part of the calcaneus, which can be measured using the Fowler and Philips angle (FPA, the angle between the posterior and plantar surface of the calcaneus) and the calcaneal pitch angle (CPA, the angle between the sole of the foot and the plantar part of the calcaneus). Although these angles are commonly used, these radiographic angle measurements have never shown a relationship with Haglund's deformity. In 78 patients (51% male) with symptomatic Haglund's deformity and a control group of 100 patients (41% male) with no heel complaints, we measured the FPA and CPA on weightbearing lateral radiographs of the foot. Using an unpaired t tests, no significant difference was found between the 2 groups in the FPA (p = .40). We measured a significant difference in the CPA between the Haglund group and the control group (p = .014). Subgroup analysis showed that this difference was mainly found in females (p Haglund's deformity will have a greater CPA than will females without Haglund's deformity. The CPA showed a difference between the Haglund and non-Haglund groups, although mainly in females. Although the evidence from our study is limited, it would be interesting to study the CPA further, because it implicates the verticalization of the calcaneus. This change in position results in extra traction on the Achilles tendon and can eventually cause tendinitis and bursitis. Radiographic measurement should be used as an auxiliary tool. If the calcaneus tends to change position, it would be interesting to understand this process, which could eventually lead to improvement in the treatment of Haglund's deformity. PMID:25179453

  19. Unusual localizations of unicameral bone cysts and aneurysmal bone cysts: A retrospective review of 451 cases.

    Science.gov (United States)

    Aycan, Osman Emre; Çamurcu, İsmet Yalkın; Özer, Devrim; Arıkan, Yavuz; Kabukçuoğlu, Yavuz Selim

    2015-06-01

    Unicameral bone cysts (UBC) and aneurysmal bone cysts (ABC) are benign cystic lesions of bone which are easily diagnosed. However, unusual locations may lead to a false diagnosis. Therefore the aim of this retrospective study was to determine the frequency of unusual localizations. The authors studied 451 cases with histopathologically confirmed diagnosis of UBC or ABC, seen between 1981 and 2012. In the UBC group (352 cases) humerus, femur and calcaneus were found to be the most common sites, while acetabulum, scapula, scaphoid, lunatum, metacarpals, metatarsals, toe phalanges and ulna each accounted for less than 1%. In the ABC group (99 cases) the most common sites of involvement were femur, humerus and tibia, while finger phalanges, ilium, acetabulum, pubis, calcaneus, cuboid, and toe phalanges each accounted for only 1%. The differential diagnosis of cystic bone lesions should include both UBC and ABC. Pain complaints plead for the latter, except in case of fracture. PMID:26280957

  20. Effekt af træning og indlægssåler ved hyperpronation i foden

    DEFF Research Database (Denmark)

    Andreasen, Jane; Christensen, Marianne; Mølgaard, Carsten; Simonsen, Ole Højgaard; Kaalund, Søren; Lundbye-Christensen, Søren; Voigt, Michael

    almindelig klinisk undersøgelse - calcaneus vinkel større end 6 grader og forekomst af naviculare drop (affladiget medial længdebue).   Effektmål var smerte og funktionsmål målt på en VAS skala og ved AOFAS score. Derudover registreredes kliniske mål af calcaneusvinkel, navicularedrop og -drift. Fodens......, balancetræning, udspændingsøvelser og instruktion i hjemmeøvelser. Indlægssåler blev fremstillet af en bandagist ud fra en stående trykprofil udført på en Harris Mat.     Resultater Foreløbige resultater tyder på en effekt af træning på calcaneus vinkel og naviculare drift. Databearbejdning og analyse er i gang...

  1. Osteoporosis: a new approach of digital processing of radiological images

    International Nuclear Information System (INIS)

    The authors applied a method based on digital processing of radiological images (fast Fourier transform) to analyze the radius distal epiphysis and calcaneus spongy bone architecture. The study revealed distinct patterns of trabecular distribution. Prior studies about osteoporosis have focused on bone density quantification and its role on fracture prediction. However, resistance to fractures (mechanical strength) is also determined by structural arrangement of bone. THe digital processing (spectral analysis) was applied to radiological images of the radius and calcaneus from 15 normal and osteopenic individuals. Normal bone trabeculae showed an individualized behavior (stress lines). On the other hand, porotic bone trabeculae revealed a diffuse pattern (honey comb). The scattered frequency components showed that the porotic bone trabeculae were remodeled. This process would be responsible for the maintenance of its physical properties. (author)

  2. The role of the reversed oblique radiograph in trauma of the foot and ankle

    Energy Technology Data Exchange (ETDEWEB)

    Geusens, E.; Geyskens, W.; Brys, P. [Dept. of Radiology, University Hospitals, Leuven (Belgium); Janzing, H. [Dept. of Traumatology, University Hospitals, Leuven (Belgium)

    2000-03-01

    The objective of this study was to demonstrate the statistical significance of a reversed oblique radiograph of the foot in patients with ankle or foot trauma. In 100 consecutive patients a reversed oblique radiograph of the foot was taken in addition to the conventional plain films. Ten of 29 fractures were not visualised on the conventional films of foot and ankle and could only be diagnosed on the reversed oblique film. In 7 of these 10 cases an avulsion fracture at the anterolateral aspect of the calcaneus was present. This additional reversed oblique film of the foot seems to be of considerable importance, especially when an anterolateral avulsion fracture of the calcaneus is clinically suspected. (orig.)

  3. The effects of isolation on the mechanics of the human heel pad.

    Science.gov (United States)

    Aerts, P; Ker, R F; de Clercq, D; Ilsley, D W

    1996-04-01

    In previous studies on the mechanical properties of the human heel pad (Bennett & Ker, 1990; Aerts et al. 1995) the fat pad and part of the calcaneus was removed from amputated test specimens. The present study tested whether this procedure influences the mechanical behaviour of the sample. Intact amputated feet were therefore mounted on steel rods driven through the calcaneus and placed in a mechanical test situation (pendulum or servohydraulic material tester). The mechanical properties of the pad were determined for a series of experiments in which the pad was gradually freed from the foot in the way done by Bennett & Ker (1990) and Aerts et al. (1995). The results showed no observable differences in the mechanics of the pad by isolating it from the rest of the foot. Thus, in relation to human locomotion, the load-deformation relation of heel pads as described by Aerts et al. (1995) is the most appropriate to date. PMID:8621341

  4. Tuberculosis of the foot: An osteolytic variety

    OpenAIRE

    Dhillon, Mandeep S; Sameer Aggarwal; Sharad Prabhakar; Vikas Bachhal

    2012-01-01

    Background: Foot involvement in osteoarticular tuberculosis is uncommon and isolated bony involvement of foot bones with an osteolytic defect is even more rare; diagnostic and therapeutic delays can occur, worsening the prognosis. We present a retrospective series of osteolytic variety of foot tuberculosis. Materials and Methods: We present 24 osteolytic variety of foot tuberculosis (Eleven calcaneus, four cuboid, two cunieforms, one talus, three metatarsals, three phalanges) out of 92 fo...

  5. Form and function in the hominoid tarsal skeleton.

    OpenAIRE

    Harcourt-Smith, W. E. H.

    2003-01-01

    This thesis explores form variation in the adult tarsal skeleton of extant and fossil hominoids. Three dimensional coordinate data were obtained from five bones of the foot: the calcaneus, talus, cuboid, navicular and medial cuneiform. The comparative sample was made up of Homo sapiens, Pan troglodytes troglodytes, Pan paniscus, Gorilla gorilla gorilla and Pongo pygmaeus. The fossil sample consisted of tarsal remains assigned to a number of Late Pliocene taxa: Australopithecus ...

  6. The use of fibrin matrix-mixed gel-type autologous chondrocyte implantation in the treatment for osteochondral lesions of the talus

    OpenAIRE

    Lee, Kyung Tai; Kim, Jin Su; Young, Ki Won; Lee, Young Koo; Park, Young Uk; Kim, Yong Hoon; Cho, Hun ki

    2012-01-01

    Purpose This study assessed the clinical results and second-look arthroscopy after fibrin matrix-mixed gel-type autologous chondrocyte implantation to treat osteochondral lesions of the talus. Methods Chondrocytes were harvested from the cuboid surface of the calcaneus in 38 patients and cultured, and gel-type autologous chondrocyte implantation was performed with or without medial malleolar osteotomy. Preoperative American orthopedic foot and ankle society ankle-hind foot scores, visual anal...

  7. A possible Madura foot from medieval Estremoz, southern Portugal

    OpenAIRE

    Curto, Ana; Fernandes, Teresa

    2016-01-01

    Maduromycosis, commonly called Madura foot, is an infectious pathology caused by fungi or bacteria, and it is native of the tropical, subtropical and equatorial areas. This paper presents a well preserved male skeleton, between 23 and 57 years old from a medieval necropolis (13th-15th centuries) in Estremoz, Portugal.The left foot of this individual showed marked alterations on the morphology of the calcaneus and cuboid that are ankylosed, which led to arthrosis of the calcaneous and talus. T...

  8. The Congenital Radiouinar Synostcsis by a Rare Tarsal Callition

    OpenAIRE

    Cever, Ilhan; Guney, Nejat; Kir, Nail; Numan, Sinasi

    2004-01-01

    A Congenital pes plano-valgus case which is caused by o rare tarsal coalition. In this article, bilateral congenital tarsal coalition have been reported which is composed by bony fusion between the talus and the navicular and between the calcaneus, the cuboid and the lateral cuneiform. Triple artrodesis operation has been done in this case which has excessive pes plano-valgus deforinity together with severe pain.

  9. Effect of gender, age and anthropometric variables on plantar fascia thickness at different locations in asymptomatic subjects

    OpenAIRE

    Pascual Huerta, Javier; Alarcón García, Juan María

    2007-01-01

    The study was aimed to investigate plantar fascia thickness at different locations in healthy asymptomatic subjects and its relationship to the following variables: weight, height, sex and age. The study evaluates 96 feet of healthy asymptomatic volunteers. The plantar fascia thickness was measured at four different locations: 1 cm proximal to the insertion of the plantar fascia, at the insertion of the plantar fascia on the calcaneus and separate out 1 cm + 2 cm distal to the insertion. A 10...

  10. Appearance of the weight-bearing lateral radiograph in retrocalcaneal bursitis

    OpenAIRE

    Sterkenburg, van, M.N.; Muller, B.; Maas, M.; Sierevelt, I.N.; van Dijk

    2010-01-01

    Background and purpose A retrocalcaneal bursitis is caused by repetitive impingement of the bursa between the Achilles tendon and the posterosuperior calcaneus. The bursa is situated in the posteroinferior corner of Kager's triangle (retrocalcaneal recess), which is a radiolucency with sharp borders on the lateral radiograph of the ankle. If there is inflammation, the fluid-filled bursa is less radiolucent, making it difficult to delineate the retrocalcaneal recess. We assessed whether the ra...

  11. Acute shortening and angulation for limb salvage in a paediatric patient with a high-energy blast injury.

    Science.gov (United States)

    Pikkel, Yoav Yechezkel; Wilson, Jessica Jeanne; Kassis, Shokrey; Lerner, Alexander

    2014-01-01

    We present the case of an 8-year-old girl casualty of the Syrian conflict who arrived with open fractures of the right tibia and fibula with extensive bone and soft tissue loss as well as an open fracture of the left calcaneus as the result of a high-energy blast injury. She was successfully treated with repeated debridement procedures, external fixation with acute temporary shortening and angulation of the right leg and skin grafting to both lower limbs. PMID:24654251

  12. An unusual stress fracture: Bilateral posterior longitudinal stress fracture of tibia

    OpenAIRE

    Malkoc, Melih; Korkmaz, Ozgur; Ormeci, Tugrul; Oltulu, Ismail; Isyar, Mehmet; Mahirogulları, Mahir

    2014-01-01

    INTRODUCTION Stress fractures (SF) occur when healthy bone is subjected to cyclic loading, which the normal carrying range capacity is exceeded. Usually, stress fractures occur at the metatarsal bones, calcaneus, proximal or distal tibia and tends to be unilateral. PRESENTATION OF CASE This article presents a 58-year-old male patient with bilateral posterior longitudinal tibial stress fractures. A 58 years old male suffering for persistent left calf pain and decreased walking distance for las...

  13. Case report:Calcaneal fractures in a cat

    OpenAIRE

    Longley, Mark J; Hannes, Bergmann,; Langley-Hobbs, Sorrel J.

    2016-01-01

    A one year four month old male neutered domestic shorthair cat was presented for sudden onset, left pelvic limb lameness. Upon clinical examination, pain was localised to the hock region and the cat was found to have persistent deciduous teeth. No evidence of trauma was apparent. Radiographs revealed a transverse fracture at the base of the calcaneus. The fracture was stabilised with a Steinmann pin and tension band wire. Eleven weeks after fixation of the fracture, the cat presented with lam...

  14. Surgical treatment of Haglund’s disease: case report

    OpenAIRE

    Atesalp, A. Sabri; Demiralp, Bahtiyar; Erler, Kaan; Gur, Ethem

    2004-01-01

    Haglund’s disease is the posterior heel pain resulted from the retrocalceneal bursitis and chronic inflammation on the prominence of posterior calcaneus. It becomes prominent following excessive functional stresses. Surgery is an alternative choice of treatment. In the paper, we present the result of surgical procedure of 25 year old male with bilateral Haglund’s disease and surgical treatment principles of Haglund’s disease.

  15. The Variations in Calcaneal Articular Facets In North Indian Population and its Clinical Implication

    OpenAIRE

    Deepinder Kaur Gandhi; Maninder Singh; Anupama Mahajan; Seema

    2012-01-01

    Aims and Objectives- To know the most common type of calcanei in North Indian population and itsclinical importance. There are three articular facets on superior surface of calcaneus- anterior, middle andposterior. Three types of calcanei are noted according to number and arrangement of the articular facets-type A, B and C. Methodology - The present studywas done on 300 dry adult human calcanei of unknownsex taken from Department of Anatomy Sri Guru Ram Das Institute of Medical Sciences and R...

  16. Cerebral Fat Embolism Syndrome from Penetrating Trauma: A Rare Cause-and-Effect

    OpenAIRE

    Gleich, Stephen J.; Hannon, James D.

    2013-01-01

    A 42 year-old male sustained an accidental rifle gunshot wound to his left foot, resulting in fracture deformities of the calcaneus, navicular, cuneiform, 1st and 2nd metatarsal bases, and talus. As he was transported to our trauma center, he developed progressive encephalopathy. Urgent external fixator placement under general anesthesia was postponed due to his encephalopathy of unknown etiology. Brain magnetic resonance imaging demonstrated a “starfield” pattern of infarcts, consistent wit...

  17. The use of a combined bipedicled axial perforator based fasciocutaneous flap for the treatment of a traumatic diabetic foot wound: a case report

    OpenAIRE

    Ignatiadis, Ioannis A.; Georgakopoulos, Georgios D.; Tsiampa, Vassiliki A.; Matei, Ileana R.; Georgescu, Alexandru V.; Polyzois, Vasilios D.

    2011-01-01

    The axial and perforator vascularised fasciocutaneous flaps are reliable and effective treatment methods for covering lower limb post-traumatic, septic, Charcot, and diabetic foot wounds. The authors describe the unique utilisation of a hybrid flap as an axial-perforator flap combination for the treatment of a traumatic diabetic foot wound. Keywords: diabetic foot; trauma; calcaneus; fasciocutaneous flap; plastic surgery(Published: 7 February 2011)Citation: Diabetic Foot & Ankle 2011, 2: ...

  18. FUNCTIONAL NEUROLOGICAL TREATMENT OF A 12 YEAR OLD GIRL WITH ATAXIA AND POOR POSITION SENSE

    OpenAIRE

    BEATRICE TAPIA-BORGES

    2015-01-01

    BACKGROUND: The patient is a 12 year old girl with a history of occasional hand tremors bilaterally. She also complained of “pigeon toes”. She had difficulty riding a bike and considered herself “clumsy” because she occasionally dropped objects. METHODS: Examination revealed reduced right arm swing with dual task. Decomposition of movement with finger to nose test bilaterally. Excessive foot pronation, pes planus, and calcaneus valgus was observed bilaterally during gait and ...

  19. Exercise and risk factors of osteoporotic fractures in elderly women

    OpenAIRE

    Korpelainen, R.

    2005-01-01

    Abstract The aim of this study was to examine lifestyle risk factors for low bone mass, falls and fractures, and to determine the effect of 30-month exercise trial on bone mass, balance, muscle strength and gait in elderly women. Reliability of an inclinometric method for assessing postural sway was evaluated. Data on risk factors, falls and fractures were collected by questionnaires, and calcaneus and radius bone mass were measured from 1,222 women. Lifetime physical activity, low occ...

  20. Interest of CT Scan in evaluation of recent articular fractures of calcaneum

    Energy Technology Data Exchange (ETDEWEB)

    Liebault, B.; Cronier, P.; Namour, A.; Rieux, D.; Dauver, A.

    1989-01-01

    After mentioning the results of the survey carried on 28 patients suffering from recent calcaneus articulary fractures, the authors point out 9 main points to take into account when a TDM analysis of these lesions is to be done: they recommend to practice a double obliguity incidence that seems to be an efficient guide for a therapeutic decision. They insist on the usefulness of the TDM examination provided it is undertaken after the operation and the removal of the osteosynthesis equipment.

  1. Comparison Of Medial Arch-Supporting Insoles And Heel Pads In The Treatment Of Plantar Fasciitis

    Directory of Open Access Journals (Sweden)

    Malkoc Melih

    2015-03-01

    Full Text Available Plantar fasciitis is a disorder caused by inflammation of the insertion point of the plantar fascia over the medial tubercle of the calcaneus. Foot orthotics are used to treat plantar fasciitis. Heel pads medialise the centre of force, whereas medial arch supporting insoles lateralise the force. We assessed the clinical results of the treatment of plantar fasciitis with silicone heel pads and medial arch-supported silicone insoles.

  2. Primary Care Management of Plantar Fasciitis.

    Science.gov (United States)

    Melvin, Thomas J; Tankersley, Zach J; Qazi, Zain N; Jasko, John J; Odono, Russell; Shuler, Franklin D

    2015-01-01

    Plantar fasciitis (PF) is present in 10% of the population and is the most common cause of plantar heel pain. PF is painful, can alter daily activities and presents as a sharp pain localized to the plantar foot and medial heel. The underlying etiology involves microtrauma to the plantar fascia, specifically at its insertion point on the calcaneus. Successful management of plantar fasciitis is typically achieved with the conservative therapy approaches discussed. PMID:26665894

  3. Thermographic Imaging of the Superficial Temperature in Racing Greyhounds before and after the Race

    OpenAIRE

    Mari Vainionpää; Esa-Pekka Tienhaara; Marja Raekallio; Jouni Junnila; Marjatta Snellman; Outi Vainio

    2012-01-01

    A total of 47 racing greyhounds were enrolled in this study on two race days (in July and September, resp.) at a racetrack. Twelve of the dogs participated in the study on both days. Thermographic images were taken before and after each race. From the images, superficial temperature points of selected sites (tendo calcaneus, musculus gastrocnemius, musculus gracilis, and musculus biceps femoris portio caudalis) were taken and used to investigate the differences in superficial temperatures bef...

  4. Anatomy and arthrokinematics of the human ankle and intertarsal joints

    International Nuclear Information System (INIS)

    In the ankle (talocrural) joint, the lower end of the tibia and fibula embrace the trochlea tali. Thus, an approximately uniaxial joint is formed which permits dorsiflexion and plantarflexion of the foot against the leg. Due to the geometry of the trochlea tali, conjunct lateral rotation of the fibula against the tibia occurs at the tibiofibular articulations synchronously with active dorsiflexion at the ankle joint. Movements at the talocrural joints are mainly limited by the opposing muscles as well as by strong collateral ligaments. Talus and calcaneus form a functional unit connected by posterior and anterior articulations. The posterior articulation is the subtalar (talocalcaneal) joint; in the anterior articulation, talar facets of the calcaneus together with the posterior surface of the navicular and the superior fibrocartilaginous surface of the plantar calcaneonavicular ligament form a concavity for the talar head. Thus, the talocalcaneonavicular joint is a compound and - like the subtalar joint - a multiaxial articulation. On the weightbearing foot, the distal tarsus and metatarsus are pronated and supinated against the talus in order to maintain plantigrade contact. When the foot is off the ground, these movements are modified to eversion and inversion, also involving the calcaneocuboid joint. In addition, movements between the calcaneus and cuboid also occur during pronative or supinative changes between the fore- and hindfoot. Limitation of movements is due to leg muscles as well as strong ligaments. Finally, the cuneonavicular, cuboideonavicular, intercuneiform and cuneocuboid joints permit some additional alterations of the loaded foot in contact with the ground. (orig.)

  5. Imaging findings of tarsal chondroblastoma

    International Nuclear Information System (INIS)

    Objective: To analysis the imaging features of the chondroblastoma in the tarsal bone. Methods: The locations of 134 cases of pathologically confirmed chondroblastoma were retrospectively analyzed. Eleven of them were in tarsal bones and their X-ray and CT findings were analyzed. Results: Of the 11 cases of tarsal chondroblastoma, 6 were in talus, 3 were in calcaneus and 2 cases were in navicular bones. They were examined by the X-ray and 5 cases had additional CT scans. The common locations were the posterior portion of the talus and calcaneus. The X-ray findings included expansive destruction (10/11), mild osteosclerosis (11/11), bone ridge (9/11), articular facet destruction (7/11) and spot or patching calcification (6/11). The imaging findings of CT included articular facets destruction (5/5), bone ridge (5/5) and spot or patching calcification (2/5). Conclusion: The talus and the calcaneus are the frequently involved location of tarsal chondroblastoma. Its X-ray and CT findings are characteristic but not exclusive. (authors)

  6. Radiographic imaging of calcaneal fractures - the surgeons view point

    International Nuclear Information System (INIS)

    This paper presents a detailed description of calcaneal fractures, which are underestimated and neglected despite their relatively high frequency. In association with significant anatomic destruction of the calcaneus they lead to unsatisfactory results of fracture treatment. Radiographic features of a healthy calcaneal bone together with pathomechanism and radiographic attributes of most common fracture types are presented. The prognostic role of the posterior talo-calcaneal joint and extraarticular anatomy of the calcaneus are emphasized. Special attention is directed to the methods of calcaneal imaging, especially the most valuable in the authors opinion - lateral radiographic view and computed tomography. Other commonly used views: axial, antero-posterior or Broden, are also described, with explanation why they are rarely recommended. The widely used standard classification system for calcaneal fractures introduced by Sanders, based on computed tomography is presented. Correct x-ray imaging is the basis for further diagnostic workup and treatment, giving also valuable prognostic information. The orthopedic surgeon, who undertakes the difficult task of treating the broken calcaneus receives thorough information about bone damage, which helps to realize the consequences of injury and of possible negligence. According to the authors experience, problems discussed in this paper are rarely fully appreciated by radiologists and orthopedic surgeons resulting in, often, catastrophic consequences. (author)

  7. Comparison of the femoral neck bone density, quantitative ultrasound and bone density of the heel between dominant and non-dominant side

    Energy Technology Data Exchange (ETDEWEB)

    Meszaros, Szilvia [First Department of Internal Medicine, Faculty of Medicine, Semmelweis University, Koranyi Sandor Str. 2/a, Budapest H-1083 (Hungary); Ferencz, Viktoria [First Department of Internal Medicine, Faculty of Medicine, Semmelweis University, Koranyi Sandor Str. 2/a, Budapest H-1083 (Hungary); Csupor, Emoke [Health Service, Budavar Local Authorities, Budapest (Hungary); Mester, Adam [Department of Radiology and Oncotherapy, Faculty of Medicine, Semmelweis University, Budapest (Hungary); Hosszu, Eva [Second Department of Paediatrics, Faculty of Medicine, Semmelweis University, Budapest (Hungary); Toth, Edit [Department of Reumatology, Ferenc Flor County Hospital, Kerepestarcsa (Hungary); Horvath, Csaba [First Department of Internal Medicine, Faculty of Medicine, Semmelweis University, Koranyi Sandor Str. 2/a, Budapest H-1083 (Hungary)]. E-mail: horcsa@bel1.sote.hu

    2006-11-15

    Our study was initiated to evaluate whether there are differences between the two sides, depending on hand dominance, in densitometry values and quantitative ultrasound parameters (QUS) of the lower limb. One hundred and six women and 44 men were involved. The hand dominance was determined by interview. The bone mineral density (BMD) of the left and the right femoral necks and the calcanei were measured by dual-energy X-ray absorpiometry (DXA). The QUS examination consisted of measuring the attenuation (BUA), the speed of the ultrasound (SOS) and quantitative ultrasound index (QUI) transversing the left and right calcanei. The density of the neck of femur of the non-dominant side did not differ from that of the dominant side. On the other hand, BMD, BUA and the QUI of the calcaneus were higher on the non-dominant side in both genders (p < 0.05 for each parameter). No similar differences were seen for the SOS values. Our study has confirmed the side-to-side differences of the calcaneus in both genders, lower values were found on the dominant side. No similar differences were seen on the femur. The AUC values seemed to be higher on the dominant side, however, these differences were not strictly significant. In the case of peripheral site (heel) measurements, the practical significance of our observations is that they raise the possibility of performing peripheral DXA and QUS examinations of the calcaneus on the dominant side of the patient according to handedness.

  8. Rearfoot posture of Australopithecus sediba and the evolution of the hominin longitudinal arch.

    Science.gov (United States)

    Prang, Thomas C

    2015-01-01

    The longitudinal arch is one of the hallmarks of the human foot but its evolutionary history remains controversial due to the fragmentary nature of the fossil record. In modern humans, the presence of a longitudinal arch is reflected in the angular relationships among the major surfaces of the human talus and calcaneus complex, which is also known as the rearfoot. A complete talus and calcaneus of Australopithecus sediba provide the opportunity to evaluate rearfoot posture in an early hominin for the first time. Here I show that A. sediba is indistinguishable from extant African apes in the angular configuration of its rearfoot, which strongly suggests that it lacked a longitudinal arch. Inferences made from isolated fossils support the hypothesis that Australopithecus afarensis possessed an arched foot. However, tali attributed to temporally younger taxa like Australopithecus africanus and Homo floresiensis are more similar to those of A. sediba. The inferred absence of a longitudinal arch in A. sediba would be biomechanically consistent with prior suggestions of increased midtarsal mobility in this taxon. The morphological patterns in talus and calcaneus angular relationships among fossil hominins suggest that there was diversity in traits associated with the longitudinal arch in the Plio-Pleistocene. PMID:26628197

  9. Broadband ultrasound attenuation imaging: influence of location of region of measurement.

    Science.gov (United States)

    Damilakis, J; Papadakis, A; Perisinakis, K; Gourtsoyiannis, N

    2001-01-01

    The aim of the study was to investigate the effect of three different regions of interest (ROIs) varying in size and shape on broadband ultrasound attenuation (BUA) measurements of the calcaneus. Two hundred and sixty-five postmenopausal Caucasian women participated in this study. In 43 women osteoporotic fractures were documented on spinal radiographs. Bone mineral density (BMD) measurements of the lumbar spine and the femur were made using dual-energy X-ray absorptiometry. BUA measurements were obtained at a circular ROI automatically determined by the imaging system (ROIc), at a manually traced irregular ROI encompassing the posterior part of the calcaneus (ROIi), and at an anatomical square ROI located in the posterior part of the calcaneus (ROIs). Reproducibility was better in ROIc than in ROIi and ROIs. High correlations were found between BUA measurements with ROIc and ROIs (r = 0.981, P ROIc and ROIi (r = 0.965, P ROIc compared with ROIi and ROIs. No significant difference was found between the areas under the ROC curve at ROIi, ROIc, and ROIs for women with fractures. The results show that superior reproducibility makes ROIc the most appropriate region of BUA measurement in a comparison with ROIi and ROIs. PMID:11471598

  10. Percutaneous reduction combined with bone graft in treatment of displaced intra-articular calcaneal fractures

    Institute of Scientific and Technical Information of China (English)

    Wang Xianhui; Mei Jiong; Li Shanzhu; Ni Ming; Shang Hongjing

    2009-01-01

    Objective: To introduce the experience and key points of percutaneous reduction combined with bone graft to treat calcaneal fractures. Methods: Percutaneous reduction and internal fixation combined with bone graft was performed from April 2004 to April 2006 on 15 cases (16 sides) with intra-articular calcaneal fractures including 13 males (14 feet) and 2 females (2 feet) ,with average age of 36. 6 years (24-61 years). All patients underwent radiography including lateral and axial views for calcaneus, oblique view for foot and three-dimensional CT imaging reconstruction. According to Sanders classification, there were 12 feet of type Ⅱ (3 type Ⅱ a, 3 type Ⅱ b and 8 type Ⅱ c)and 2 feet of type lilac. The length of calcaneus was recovered through traction by Steinmann pin which passed through calcaneal tubercle perpendicularly and the posterior facet was elevated until reduction by a curve scissors through an 0.5 cm incision along the primary fracture line of lateral calcaneus. The calcaneus was fixed with different cannulated cancellous screws according to the type of fractures. Then bone graft was injected to fill the defect of calcaneus through lateral incision. Results: All patients were followed up for an average of 18.4 months (ranged, 12 to 34 months). No complication such as wound infection, screw breakage and calcaneum varus was found postoperatively. The average time for bone healing was 10 weeks. The results were excellent in 12 cases, good in 4 cases according to the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score. The rate of excellent and good clinical results was 100%. The mean AOFAS hindfoot score in tongue type group (86.5+4.4) was better than in joint depression type group (81.2±1.7, P<0.05). Radiography showed basic restoration of Bohler's angle, Gissane's angle and calcaneal shape. Conclusion: The combination of percutaneous reduction and injectable bone graft is suitable for surgical treatment of Sanders 11 and III type

  11. Efeitos no tornozelo da mielomeningocele pós-tenodese de Westin Effects of myelomeningocele in the ankle after Westin tenodesis

    Directory of Open Access Journals (Sweden)

    Patrícia Maria de Moraes Barros Fucs

    2007-12-01

    Full Text Available OBJETIVO: Avaliar o aumento do crescimento fibular em pacientes portadores de seqüela da mielomeningocele com deformidades em pé calcâneo e valgismo do tornozelo submetidos à tenodese de Westin. MÉTODOS: O estudo avaliou seis pacientes (12 pés portadores de seqüela de mielomeningocele, deambuladores comunitários, submetidos à tenodese do calcâneo na fíbula com pontos transósseos, seguindo a técnica originalmente descrita por Westin, no período de janeiro de 1996 a dezembro de 2000. RESULTADOS: A análise dos resultados da diferença de altura intermaleolar em pacientes com seqüela de mielomeningocele apresentando deformidade tipo pé calcâneo, submetidos ao tratamento cirúrgico com tenodese do calcâneo pela técnica de Westin, evidenciou crescimento do maléolo lateral importante quando comparado com as medidas pré-operatórias (p OBJECTIVE: To evaluate the increased fibular growth in patients with myelomeningocele sequelae with deformities in calcaneus foot and ankle valgus submitted to Westin tenodesis. METHODS: The study evaluated six patients (12 feet with myelomeningocele sequelae, ambulant, submitted to tenodesis of the calcaneus tendon in the fibula, with transbone stitches following the technique that was originally described by Westin, from January 1996 to December 2000. RESULTS: Analysis of the results of the intermaleolar height difference presenting calcaneus foot deformity and submitted to surgical treatment with calcaneus tendon tenodesis according to the Westin technique showed a major growth of the lateral malleolus when compared to pre-operative measurements (p < 0.05. Results also show that the lateral malleolus growth is not related to the patient age when he or she was submitted to surgery. All of the six patients presented different growth patterns along the follow-up. When the authors evaluated the correction of the valgus angle in the ankle, they found a decrease of the angle, with partial or total

  12. Control of torque direction by spinal pathways at the cat ankle joint.

    Science.gov (United States)

    Nichols, T R; Lawrence, J H; Bonasera, S J

    1993-01-01

    To study the biomechanics of the calcaneal tendon's complex insertion onto the calcaneus, we measured torque-time trajectories exerted by the triceps surae and tibialis anterior muscles in eight unanesthetized decerebrate cats using a multi-axis force-moment sensor placed at the ankle joint. The ankle was constrained to an angle of 110 degrees plantarflexion. Muscles were activated using crossed-extension (XER), flexion (FWR), and caudal cutaneous sural nerve (SNR) reflexes. Torque contributions of other muscles activated by these reflexes were eliminated by denervation or tenotomy. In two animals, miniature pressure transducers were implanted among tendon fibers from the lateral gastrocnemius (LG) muscle that insert straight into the calcaneus or among tendon fibers from the medial gastrocnemius (MG) that cross over and insert on the lateral aspect of calcaneus. Reflexively evoked torques had the following directions: FWR, dorsiflexion and adduction; SNR, plantarflexion and abduction; and XER, plantarflexion and modest abduction or adduction. The proportion of abduction torque to plantarflexion torque was always greater for SNR than XER; this difference was about 50% of the magnitude of abduction torque generated by tetanic stimulation of the peronei. During SNR, pressures were higher in regions of the calcaneal tendon originating from MG than regions originating from LG. Similarly, pressures within the MG portion of the calcaneal tendon were higher during SNR than during XER, although these two reflexes produced matched ankle plantarflexion forces. Selective tenotomies and electromyographic recordings further demonstrated that MG generated most of the torque in response to SNR, while soleus, LG, and MG all generated torques in response to XER.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8150057

  13. Determination of normal values for navicular drop during walking: a new model correcting for foot length and gender

    Directory of Open Access Journals (Sweden)

    Nielsen Rasmus G

    2009-05-01

    Full Text Available Abstract Background The navicular drop test is a measure to evaluate the function of the medial longitudinal arch, which is important for examination of patients with overuse injuries. Conflicting results have been found with regard to differences in navicular drop between healthy and injured participants. Normal values have not yet been established as foot length, age, gender, and Body Mass Index (BMI may influence the navicular drop. The purpose of the study was to investigate the influence of foot length, age, gender, and BMI on the navicular drop during walking. Methods Navicular drop was measured with a novel technique (Video Sequence Analysis, VSA using 2D video. Flat reflective markers were placed on the medial side of the calcaneus, the navicular tuberosity, and the head of the first metatarsal bone. The navicular drop was calculated as the perpendicular distance between the marker on the navicular tuberosity and the line between the markers on calcaneus and first metatarsal head. The distance between the floor and the line in standing position between the markers on calcaneus and first metatarsal were added afterwards. Results 280 randomly selected participants without any foot problems were analysed during treadmill walking (144 men, 136 women. Foot length had a significant influence on the navicular drop in both men (p Conclusion The study demonstrated that the dynamic navicular drop is influenced by foot length and gender. Lack of adjustment for these factors may explain, at least to some extent, the disagreement between previous studies on navicular drop. Future studies should account for differences in these parameters.

  14. MRI of rupture of the spring ligament complex with talo-cuboid impaction

    International Nuclear Information System (INIS)

    The spring ligament complex is essential for the stability of the longitudinal arch of the foot and includes the ligaments between the calcaneus and the talus at the superomedial to inferoplantar aspect of the foot. Tears of the spring ligament complex are most commonly degenerative in etiology and secondary to concomitant abnormality of the posterior tibial tendon. We report MRI findings in a 30-year-old man who presented with traumatic rupture of the spring ligament complex, seen following dislocation of the talonavicular joint. We also describe the previously unreported MRI features of talo-cuboid impaction secondary to disruption of the spring ligament complex. (orig.)

  15. MRI of rupture of the spring ligament complex with talo-cuboid impaction

    Energy Technology Data Exchange (ETDEWEB)

    Kavanagh, E.C. [University of Pittsburgh Medical Center, Department of Radiology, Pittsburgh, PA (United States); Koulouris, G. [Department of Radiology, Melbourne, VIC (Australia); Gopez, A.; Zoga, A.; Morrison, W.B. [Thomas Jefferson University Hospital, Department of Radiology, Philadelphia, PA (United States); Raikin, S. [Thomas Jefferson University Hospital, Department of Orthopedics, Philadelphia, PA (United States)

    2007-06-15

    The spring ligament complex is essential for the stability of the longitudinal arch of the foot and includes the ligaments between the calcaneus and the talus at the superomedial to inferoplantar aspect of the foot. Tears of the spring ligament complex are most commonly degenerative in etiology and secondary to concomitant abnormality of the posterior tibial tendon. We report MRI findings in a 30-year-old man who presented with traumatic rupture of the spring ligament complex, seen following dislocation of the talonavicular joint. We also describe the previously unreported MRI features of talo-cuboid impaction secondary to disruption of the spring ligament complex. (orig.)

  16. Las fracturas por avulsión de la tuberosidad posterior del clacáneo

    OpenAIRE

    Arenas Miquélez, A.; Ayala Palacios, Higinio; Arenas Planelles, Antonio; Garbayo Marturet, Antonio Jesús

    2004-01-01

    Se presentan 6 casos de fractura por avulsión de la tuberosidad posterior del calcáneo (fracturas en pico de pato), tratadas todas ellas en nuestro centro, 5 de ellas quirúrgicamente (reducción abierta + osteosíntesis con tornillos). Los resultados han sido satisfactorios en todos los casos tanto en el aspecto cosmético como funcional. The authors present 6 cases of avulsion fracture of the posterior tuberosity of the calcaneus (beak fractures), treated all of them in our hospital, 5 of...

  17. Effectiveness of Orthoses and Foot Training in patients with Patellofemoral Pain and hyperpronation

    DEFF Research Database (Denmark)

    Mølgaard, Carsten; Kaalund, Søren; Christensen, Marianne;

    .   Methods and Measures: Forty patellofemoral patients, with excessive foot pronation were prospectively randomised to undergo a regimen of supervised exercise once a week for 3 months or to a control group. Both groups received a standard regimen of three supervised session with a physiotherapist over 3...... the knee slightly bended. • Pain by palpation of the parapatellar regions lateral or medial. • Pain by compression of patella against femur. • Pain by concentric contraction of quadriceps against resistance. All participants were clinically defined as excessive pronators, when the calcaneus angle was...

  18. Three-Phase 99mTc MDP Bone Scintigraphy and SPECT-CT in Sinus Tarsi Syndrome.

    Science.gov (United States)

    Usmani, Sharjeel; Abu Al Huda, Fawaz; Al Kandari, Farida

    2016-04-01

    Sinus tarsi syndrome is a pain in the lateral side of the hind foot that is responsive to injection of local anesthetic agents. We report a case of a 42-year-old man who presented with pain over the lateral aspect of the right foot. Laboratory investigations and x-ray were normal. Bone scintigraphy showed hyperemia and increase tracer uptake in right hind foot. SPECT-CT localizes this uptake at the inferior aspect of the talus and superior aspects of the calcaneus. Diagnosis of sinus tarsi syndrome was made on the basis of history, clinical examination, and bone scintigraphy findings. Local conservative therapy was initiated. PMID:26673237

  19. Gastrocnemius recession.

    Science.gov (United States)

    Anderson, John G; Bohay, Donald R; Eller, Erik B; Witt, Bryan L

    2014-12-01

    The Grand Rapids Arch Collapse classifications create a novel system for categorizing and correlating numerous common foot and ankle conditions related to a falling arch. The algorithm for treating these conditions is exceptionally replicable and has excellent outcomes. Gastrocnemius equinus diagnosis plays a crucial role in the pathology of arch collapse. A contracture of the gastrocnemius muscle is increasingly recognized as the cause of several foot and ankle conditions. The authors have expanded their indications for gastrocnemius recession to include arch pain without radiographic abnormality, calcaneus apophysitis, plantar fasciitis/fibromas, Achilles tendonosis, early-onset diabetic Charcot arthropathy, and neuropathic forefoot ulcers. PMID:25456721

  20. Gait Analysis by Multi Video Sequence Analysis

    DEFF Research Database (Denmark)

    Jensen, Karsten; Juhl, Jens

    2009-01-01

    The project presented in this article aims to develop software so that close-range photogrammetry with sufficient accuracy can be used to point out the most frequent foot mal positions and monitor the effect of the traditional treatment. The project is carried out as a cooperation between the Ort...... Sequence Analysis (MVSA). Results show that the developed MVSA system, in the following called Fodex, can measure the navicula height with a precision of 0.5-0.8 mm. The calcaneus angle can be measured with a precision of 0.8-1.5 degrees....

  1. Calcaneal insufficiency avulsion fractures in diabetic patients

    International Nuclear Information System (INIS)

    This paper presents a calcaneal fracture pattern that appears to be unique to diabetic patients. Radiographs and clinical records of 58 patients with calcaneal fractures were evaluated, 18 were diabetic and 40 nondiabetic. All 18 diabetic patients were insulin dependent and had clinically evident peripheral neuropathy. Thirteen had juvenile-onset diabetes. The average time from the diagnosis of diabetes mellitus to insufficiency fracture was 21 years. Sixteen of the diabetic patients had no history of significant trauma, and 13 of them had insufficiency avulsion fractures limited to the posterior third of the calcaneus

  2. My Experience as a Foot and Ankle Trauma Surgeon in Montreal, Canada: What's Not in the Books.

    Science.gov (United States)

    Leduc, Stéphane; Nault, Marie-Lyne; Rouleau, Dominique M; Hebert-Davies, Jonah

    2016-06-01

    Foot and ankle fractures are sometimes seen as routine and easy to treat. However, many fractures vary from typical patterns and require more complex management. Obtaining good outcomes in these situations can be challenging. Often, the difference between average and good results has to do with preoperative planning and good surgical technique. This article outlines numerous techniques and tricks that are not always mentioned in classic textbooks. It focuses on ankle, talus, calcaneus, and midfoot fractures, and discusses numerous techniques and aids to avoid potential problems that may be encountered intraoperatively. PMID:27261808

  3. Presence of a long accessory flexor tendon of the toes in surgical treatment for tendinopathy of the insertion of the calcaneal tendon: case report

    Directory of Open Access Journals (Sweden)

    Nelson Pelozo Gomes Júnior

    2016-02-01

    Full Text Available ABSTRACT The presence of accessory tendons in the foot and ankle needs to be recognized, given that depending on their location, they may cause disorders relating either to pain processes or to handling of the surgical findings. We describe the presence of an accessory flexor tendon of the toes, seen in surgical exposure for transferring the long flexor tendon of the hallux to the calcaneus, due to the presence of a disorder of tendinopathy of the insertion of the calcaneal tendon in association with Haglund's syndrome.

  4. THE GEM IN GASTROCNEMIUS: THE FABELLA

    Directory of Open Access Journals (Sweden)

    Ashfaq Ul Hassan

    2013-09-01

    Full Text Available Sesamoid bones are small seed like bones which can be found in the hand, knee, and foot. Their unique structure works to protect the tendon, and to increase its mechanical effect. Examples of sesamoid bones include the os acromiale, os styloideum, metacarpal and hallux sesamoids, patella, os trigonum, os calcaneus secundarius, accessory navicular, os peroneum, and os intermetatarseum. The Sesamoid bones are so named because they resemble a sesame seed. WE present a brief description about Fabella , a small Sesamoid bone occasionally found in the lateral head of Gastrocnemius muscle, its surgical and medical importance .Presence of Fabella can be confused with certain Orthopedic Problems.

  5. Contribution of the BMI Level or the Body Fat Percentage Level to Bone-Mass

    OpenAIRE

    高畑,陽子; 穴井,孝信

    2011-01-01

    It is unclear which body mass index (BMI) or body fat percentage level has the strongest effect on the bone mass in young women.We examined the data gathered from 233 adolescent girls in a junior high,high school,and university to ascertain the relationship between BMI or body fat percentage and bone mass. The transmission index (TI) of the calcaneus was measured using an ultrasound bone densitometer. The subjects were classified into 3 groups by BMI and body fat percentage se...

  6. Presence of a long accessory flexor tendon of the toes in surgical treatment for tendinopathy of the insertion of the calcaneal tendon: case report☆

    Science.gov (United States)

    Gomes Júnior, Nelson Pelozo; Andreoli, Carlos Vicente; Pochini, Alberto de Castro; Raduan, Fernando Cipolini; Ejnisman, Benno; Cohen, Moisés

    2015-01-01

    The presence of accessory tendons in the foot and ankle needs to be recognized, given that depending on their location, they may cause disorders relating either to pain processes or to handling of the surgical findings. We describe the presence of an accessory flexor tendon of the toes, seen in surgical exposure for transferring the long flexor tendon of the hallux to the calcaneus, due to the presence of a disorder of tendinopathy of the insertion of the calcaneal tendon in association with Haglund's syndrome. PMID:26962495

  7. MRI in long-term evaluation of reconstructed hind-feet of land-mine trauma patients

    International Nuclear Information System (INIS)

    Introduction: The purpose of this study was to assess the flap reconstructed hind feet of patients with MRI who were traumatized by land-mine. Materials and methods: T1 and T2 weighted images were obtained in 7 patients, 12 months later the reconstruction of their hind feet by myocutaneous flaps after land-mine trauma. Results: In all patients T2 signal intensities of the myocutaneous flaps were slightly high compared to normal undisturbed muscle. Slight vascular engorgement was noted in the vicinity of the flaps in all cases. There were ankle joint ankylose (n = 1), tarsal coalition (n = 3), sklerosis within the calcaneus (n = 1), bone cortex irregularities (n = 3), absence of calcaneus (n = 4), deformity in talus and bone marrow edema (n = 1), navicular edema (n = 2), remodeling in the superior aspect of talus neck (n = 2), absence of talus (n = 2), talocalcaneal ankylose (n = 1), small collection in the superior aspect of flap (n = 1), drenage canules (n = 1). Conclusion: In reconstructed hind feet by myocutaneus flaps done for land-mine traumas, MRI presents useful information by displaying detailed anatomy of the flaps, bones, joints, soft tissues and associated complications

  8. An osteomalacia related to phosphate diabetes - bone scintigraphy with SPECT/CT contribution

    International Nuclear Information System (INIS)

    We report the case of a 59-year-old woman, investigated for disabling pain of the left thigh, unrelated to any traumatic event. Interrogation had found diffuse pain of myalgia-type and arthralgia-type for approximately a year without local inflammatory signs and insufficiency fractures of both calcaneus two years before. The Technetium 99m-labeled hydroxy-methylene diphosphonate (99mTc-H.D.P.) whole-body bone scintigraphy evidenced multiple hot spots on the higher third of left femur, rib cage, sternum, scapula, pelvis, right hip and both calcaneus. Moreover, a more diffuse and heterogeneous prominent uptake appeared on rib cage, spine and pelvis. These images suggested a diffuse metastatic disease of the skeleton. The single photon emission computerized tomography guided by computerized tomography (SPECT/CT), centered on lumbar spine, pelvis and the upper end of femurs showed that the multiple hot spots were in fact bone fractures. These findings pointed diagnosis to a metabolic disease. The clinical context was in favour of an osteomalacia. Further explorations showed an osteomalacia related to phosphate diabetes. A thorough work-up did not reveal any known aetiology. To date, idiopathic phosphate diabetes seems the most likely diagnosis. Nuclear medicine input in osteomalacia is discussed. (authors)

  9. Human calcanei from the Middle Pleistocene site of Sima de los Huesos (Sierra de Atapuerca, Burgos, Spain).

    Science.gov (United States)

    Pablos, Adrián; Martínez, Ignacio; Lorenzo, Carlos; Sala, Nohemi; Gracia-Téllez, Ana; Arsuaga, Juan Luis

    2014-11-01

    The existence of calcanei in the fossil record prior to modern humans and Neandertals is very scarce. This skeletal element is fundamental to understanding the evolution of the morphology of the foot in human evolution. Here we present and metrically and comparatively describe 29 calcaneus remains from the Middle Pleistocene site of Sima de los Huesos (SH) (Sierra de Atapuerca, Burgos, Spain). These calcanei belong to 15 individuals (nine adults, two adolescents and four immature individuals). The metric and morphological differences in the calcanei among Middle and Late Pleistocene hominins tend to be subtle. However, the calcanei from SH are broad and robust with large articular surfaces and most significantly, exhibit a very projected sustentaculum tali. A biomechanical and phylogenetic interpretation is proffered to explain the observed morphology of these calcanei. It has been possible to propose tentative sex assignments for the SH calcanei based on size, using methods similar to those used to establish sex from the talus bones from SH. The estimation of stature based on the calcaneus provides a mean of 175.3 cm for males and 160.6 for females, which is similar to that obtained using other skeletal parts from the site. In sum, the SH calcanei are robust with a proportionally long tubercle and a projected sustentaculum tali, which are traits shared by Neandertals. PMID:24962476

  10. [Lower limb salvage with a free fillet fibula flap harvested from the contralateral amputated leg].

    Science.gov (United States)

    Bouyer, M; Corcella, D; Forli, A; Mesquida, V; Semere, A; Moutet, F

    2015-06-01

    We report a unusual case of "fillet flap" to reconstruct the lower limb with the amputated contralateral leg. This kind of procedure was first described by Foucher et al. in 1980 for traumatic hand surgery as the "bank finger". A 34-year-old man suffered a microlight accident with bilateral open legs fractures. A large skin defect of the left leg exposed the ankle, the calcaneus and a non-vascularized part of the tibial nerve (10 cm). The patient came to the OR for surgical debridement and had massive bone resection of the left calcaneus. The right leg showed limited skin defect at the lower part, exposing the medial side of the ankle and a tibial bone defect, measuring 10 cm. Salvage the left leg was impossible due to complex nerve, bones and skin associated injuries, so this leg was sacrificed and used as a donor limb, to harvest a free fibula flap for contralateral tibial reconstruction. At 18 months of follow-up, the patient was very satisfied, the clinical result was very good on both lower limbs and X-rays showed excellent integration of the free fibula flap. The patient had normal dailies occupations, can run and have bicycle sport practice with a functional left leg fit prosthesis. This case showed an original application of the "fillet flap concept" to resolve complex and rare traumatic situations interesting the both lower limbs. In our opinion, this strategy must be a part of the plastic surgeon skills in uncommon situations. PMID:25069828

  11. Experimental study of the subtalar joint axis: preliminary investigation.

    Science.gov (United States)

    Zographos, S; Chaminade, B; Hobatho, M C; Utheza, G

    2000-01-01

    An experimental study of the subtalar joint has been conducted with the aim of establishing its axis of movement as well as analysing the associated movement. For description of the axis, CT data for five positions of a single foot were reconstructed using a 3D programme, the 3D data was processed by Patran software. Measures of angular displacements were made from three amputated feet placed in a specially constructed foot frame. Four instantaneous axes of movement could be defined. Calculation of displacements showed an important rolling of the calcaneus (45 degrees). Tacking was evident in inversion, with an opposite displacement between the front and rear part of the calcaneus, whereas during eversion tacking affected only the rear part of the bone: these results were confirmed by 3D reconstructions. Henke's axis was described as that for the talonavicular joint, but acceptable for the subtalar joint. Several authors investigating the coordinates of this axis have reported large differences and described screw-like movements, the latter being incompatible with a fixed axis: instantaneous axes, however are compatible with a screw-like movement. The subtalar joint appears to work as a pivot joint during inversion and as a plane joint during eversion. Although Henke's axis has pedagogical value the subtalar joint has a series of instantaneous axes. PMID:11236321

  12. Tensile properties of fresh human calcaneal (Achilles) tendons.

    Science.gov (United States)

    Louis-Ugbo, John; Leeson, Benjamin; Hutton, William C

    2004-01-01

    The purpose of this study was to measure the tensile properties of fresh human calcaneal (Achilles) tendons. Twenty fresh cadaveric (age range = 57-93 years) bone-Achilles tendon complexes were harvested within 24 hr postmortem. The calcaneus together with 15 cm of the Achilles tendon extending proximally from the insertion on the calcaneus was clamped and biomechanically tested. Each tendon was firmly fixed in clamps in an MTS Systems Corporation MTS testing machine and tension was applied at a displacement rate of 8 cm per minute until the tendon failed. The tensile force and tensile strain (as measured using an extensometer) were recorded and plotted using onboard software. The narrow age range of our donors prevented any meaningful correlation between age and tensile properties; however, the results showed that: 1) the average ultimate tensile strength (UTS) of the human Achilles tendon was 1189 N (range = 360-1,965), 2) there was a correlation between left and right legs for UTS, 3) there was a correlation between left and right legs in regard to cross sectional area, and 4) there was no correlation between UTS and cross-sectional area. PMID:14695585

  13. MRI in long-term evaluation of reconstructed hind-feet of land-mine trauma patients

    Energy Technology Data Exchange (ETDEWEB)

    Sanal, Hatice Tuba [Department of Radiology, Gulhane Military Medical Academy, Ankara (Turkey)], E-mail: tubasanal@yahoo.com; Bulakbasi, Nail; Kocaoglu, Murat; Yildirim, Duzgun [Department of Radiology, Gulhane Military Medical Academy, Ankara (Turkey)

    2007-08-15

    Introduction: The purpose of this study was to assess the flap reconstructed hind feet of patients with MRI who were traumatized by land-mine. Materials and methods: T1 and T2 weighted images were obtained in 7 patients, 12 months later the reconstruction of their hind feet by myocutaneous flaps after land-mine trauma. Results: In all patients T2 signal intensities of the myocutaneous flaps were slightly high compared to normal undisturbed muscle. Slight vascular engorgement was noted in the vicinity of the flaps in all cases. There were ankle joint ankylose (n = 1), tarsal coalition (n = 3), sklerosis within the calcaneus (n = 1), bone cortex irregularities (n = 3), absence of calcaneus (n = 4), deformity in talus and bone marrow edema (n = 1), navicular edema (n = 2), remodeling in the superior aspect of talus neck (n = 2), absence of talus (n = 2), talocalcaneal ankylose (n = 1), small collection in the superior aspect of flap (n = 1), drenage canules (n = 1). Conclusion: In reconstructed hind feet by myocutaneus flaps done for land-mine traumas, MRI presents useful information by displaying detailed anatomy of the flaps, bones, joints, soft tissues and associated complications.

  14. Frequency of osteoporosis in an ambulatory setting in Lahore using quantitative calcaneal ultrasound

    International Nuclear Information System (INIS)

    Objective: To find out the frequency of osteoporosis in an ambulatory setting using quantitative ultrasound of the calcaneus and to compare it between age and gender sub-groups. Methods: The cross-sectional survey was conducted at Akhtar Saeed Trust Teaching Hospital, Lahore, from July to December 2011 and comprised all those who visited the out-patient department of the hospital and agreed to participate in the study. Quantitative ultrasound of the calcaneus was done to diagnose osteoporosis. SPSS 20 was used for statistical analysis. Results: Of the 660 participants, 454 (68.8%) were women. The mean age of the participants was 34+-11.8 years (range: 10-80 years). Osteoporosis was present in 123 (18.6%) and osteopenia in 423 (64.1%) of the participants. Females had greater prevalence of osteoporosis than males (n=101; 22% vs n=22; 10.7%; p45 years had higher prevalence of osteoporosis than with age 45 years, 20.6% had osteoporosis while among the females with age >45 years, 41.3% had osteoporosis. Mean ages of participants with normal bone mineral density, osteopenia and osteoporosis were 30.6+-8.7; 33.7+-11.3; and 38.1+-14.4 years respectively (p<0.01). Conclusion: Osteoporosis was found to be a common occurrence, affecting females over 45 years of age more than any other sub-group. (author)

  15. Clinical evaluation of stress fractures using bone scintigraphy

    International Nuclear Information System (INIS)

    Clinical evaluation of stress fractures were performed in 58 athletes using bone scintigraphy with sup(99m)Tc-MDP. Stress fractures of the tibia were most often seen in the males with running type sports. They occurred more often in the proximal tibia and on the right side. Stress fractures of the fibula were most often seen in females with jumping type sports, such as volley ball. They occurred more often in the distal fibula and on the right side. Tarsal bone fractures were seen most often rugby players. Metatarsal fractures occurred in the third fourth and fifth metatarsals. No lesion was seen in the first and second metatarsals. We feel that stress fractures of the femur can be differentiated from osteosarcoma by small loculated radionuclide accumulation as well as symptome, course and tomographic and CT finding. Bilateral involvement was seen in two cases in patellae and calcanei. Most of the other fractures were seen on the right side. Negative radiographs were seen in 36% of the patients and occurred most commonly in the tarsal bones excluding calcaneus. Bone scintigrams were positive in all cases and were most useful in fractures of the tarsal bones excluding calcaneus. (author)

  16. Pirogow’s Amputation: A Modification of the Operation Method

    Directory of Open Access Journals (Sweden)

    M. Bueschges

    2013-01-01

    Full Text Available Introduction. Pirogow’s amputation at the ankle presents a valuable alternative to lower leg amputation for patients with the corresponding indications. Although this method offers the ability to stay mobile without the use of a prosthesis, it is rarely performed. This paper proposes a modification regarding the operation method of the Pirogow amputation. The results of the modified operation method on ten patients were objectified 12 months after the operation using a patient questionnaire (Ankle Score. Material and Methods. We modified the original method by rotating the calcaneus. To fix the calcaneus to the tibia, Kirschner wire and a 3/0 spongiosa tension screw as well as a Fixateur externe were used. Results. 70% of those questioned who were amputated following the modified Pirogow method indicated an excellent or very good result in total points whereas in the control group (original Pirogow’s amputation only 40% reported excellent or very good result. In addition, the level of pain experienced one year after the completed operation showed different results in favour of the group being operated with the modified way. Furthermore, patients in both groups showed differences in radiological results, postoperative leg length difference, and postoperative mobility. Conclusion. The modified Pirogow amputation presents a valuable alternative to the original amputation method for patients with the corresponding indications. The benefits are found in the significantly reduced pain, difference in reduced radiological complications, the increase in mobility without a prosthesis, and the reduction of postoperative leg length difference.

  17. A Novel Technique for Closed Reduction and Fixation of Paediatric Calcaneal Fracture Dislocation Injuries

    Science.gov (United States)

    Faroug, Radwane; Stirling, Paul; Ali, Farhan

    2013-01-01

    Paediatric calcaneal fractures are rare injuries usually managed conservatively or with open reduction and internal fixation (ORIF). Closed reduction was previously thought to be impossible, and very few cases are reported in the literature. We report a new technique for closed reduction using Ilizarov half-rings. We report successful closed reduction and screwless fixation of an extra-articular calcaneal fracture dislocation in a 7-year-old boy. Reduction was achieved using two Ilizarov half-ring frames arranged perpendicular to each other, enabling simultaneous application of longitudinal and rotational traction. Anatomical reduction was achieved with restored angles of Bohler and Gissane. Two K-wires were the definitive fixation. Bony union with good functional outcome and minimal pain was achieved at eight-weeks follow up. ORIF of calcaneal fractures provides good functional outcome but is associated with high rates of malunion and postoperative pain. Preservation of the unique soft tissue envelope surrounding the calcaneus reduces the risk of infection. Closed reduction prevents distortion of these tissues and may lead to faster healing and mobilisation. Closed reduction and screwless fixation of paediatric calcaneal fractures is an achievable management option. Our technique has preserved the soft tissue envelope surrounding the calcaneus, has avoided retained metalwork related complications, and has resulted in a good functional outcome. PMID:23819090

  18. A Novel Technique for Closed Reduction and Fixation of Paediatric Calcaneal Fracture Dislocation Injuries

    Directory of Open Access Journals (Sweden)

    Radwane Faroug

    2013-01-01

    Full Text Available Paediatric calcaneal fractures are rare injuries usually managed conservatively or with open reduction and internal fixation (ORIF. Closed reduction was previously thought to be impossible, and very few cases are reported in the literature. We report a new technique for closed reduction using Ilizarov half-rings. We report successful closed reduction and screwless fixation of an extra-articular calcaneal fracture dislocation in a 7-year-old boy. Reduction was achieved using two Ilizarov half-ring frames arranged perpendicular to each other, enabling simultaneous application of longitudinal and rotational traction. Anatomical reduction was achieved with restored angles of Bohler and Gissane. Two K-wires were the definitive fixation. Bony union with good functional outcome and minimal pain was achieved at eight-weeks follow up. ORIF of calcaneal fractures provides good functional outcome but is associated with high rates of malunion and postoperative pain. Preservation of the unique soft tissue envelope surrounding the calcaneus reduces the risk of infection. Closed reduction prevents distortion of these tissues and may lead to faster healing and mobilisation. Closed reduction and screwless fixation of paediatric calcaneal fractures is an achievable management option. Our technique has preserved the soft tissue envelope surrounding the calcaneus, has avoided retained metalwork related complications, and has resulted in a good functional outcome.

  19. Monitoring trabecular bone microdamage using a dynamic acousto-elastic testing method.

    Science.gov (United States)

    Moreschi, H; Callé, S; Guerard, S; Mitton, D; Renaud, G; Defontaine, M

    2011-03-01

    Dynamic acousto-elastic testing (DAET) is based on the coupling of a low-frequency (LF) acoustic wave and high-frequency ultrasound (US) pulses (probing wave). It was developed to measure US viscoelastic and dissipative non-linearity in trabecular bone. It is well known that this complex biphasic medium contains microdamage, even when tissues are healthy. The purpose of the present study was to assess the sensitivity of DAET to monitor microdamage in human calcanei. Three protocols were therefore performed to investigate the regional heterogeneity of the calcaneus, the correlation between DAET measurements and microdamage revealed by histology, and DAET sensitivity to mechanically induced fatigue microdamage. The non-linear elastic parameter beta was computed for all these protocols. The study demonstrated the presence of high viscoelastic and dissipative non-linearity only in the region of the calcaneus close to the anterior talocalcaneal articulation (region of high bone density). Protocols 1 and 2 also showed that most unsorted calcanei did not naturally exhibit high non-linearity, which is correlated with a low level of microcracks. Nevertheless, when microdamage was actually present, high levels of US non-linearity were always found, with characteristic non-linear signatures such as hysteresis and tension/compression asymmetry. Finally, protocol 3 demonstrated the high sensitivity of DAET measurement to fatigue-induced microdamage. PMID:21485329

  20. Nervus cutaneus femoris posterior pedicle flap for repairing large soft tissue defects at the heel or inferior segment of the shank

    Institute of Scientific and Technical Information of China (English)

    WANG Rui-ying; HU Jun-zu; XIN Lin-wei; TANG Ji-cun; GAO Yan

    2009-01-01

    Objective: To investigate the clinical effect of the nervus cutaneus femoris posterior pedicle flap on repairing large soft tissue defects at the heel or inferior segment of the shank.Methods: Totally 14 cases were followed up for 8-22 months (mean 15.5 months) to observe the clinical effects of nervus cutaneus femoris posterior pedicle flap on repairing large soft tissue defects of the heel or inferior segment of the shank. Among them, there were 3 patients afflicted with infection and cutaneous defects in the middle and inferior segment of the shank after internal fixation of open fracture, 4 patients with soft tissue defects of the ankle and uncovered tendo calcaneus, and 7 patients with soft tissue defects of the heel and exposed calcaneus.Results: The flaps survived well in 13 cases and partial necrosis occurred in 1 case that was thereafter cured with changing dressing. Various extents of pain and stiffness of the knee joints were present in all cases and disappeared through 1-8 weeks' (mean 3.2 weeks) functional exercises. The last follow-up showed that all the flaps kept good texture and satisfactory appearance.Conclusions: The nervus cutaneus femoris posterior pedicle flap, having the advantages of simple surgical procedures, anastomosing the nerves and restoring the sensation of recipient site, can be used for recovering large soft tissue defects of the shank and ankle.

  1. An osteomalacia related to phosphate diabetes - bone scintigraphy with SPECT/CT contribution; Une osteomalacie liee a un diabete phosphore - role de la scintigraphie osseuse couplee a la TEMP-TDM

    Energy Technology Data Exchange (ETDEWEB)

    Ruyer, A.; Granier, P.; Mourad, M. [Centre Hospitalier Antoine-Gayraud, Service de Medecine Nucleaire, 11 - Carcassonne (France)

    2009-12-15

    We report the case of a 59-year-old woman, investigated for disabling pain of the left thigh, unrelated to any traumatic event. Interrogation had found diffuse pain of myalgia-type and arthralgia-type for approximately a year without local inflammatory signs and insufficiency fractures of both calcaneus two years before. The Technetium {sup 99m}-labeled hydroxy-methylene diphosphonate ({sup 99m}Tc-H.D.P.) whole-body bone scintigraphy evidenced multiple hot spots on the higher third of left femur, rib cage, sternum, scapula, pelvis, right hip and both calcaneus. Moreover, a more diffuse and heterogeneous prominent uptake appeared on rib cage, spine and pelvis. These images suggested a diffuse metastatic disease of the skeleton. The single photon emission computerized tomography guided by computerized tomography (SPECT/CT), centered on lumbar spine, pelvis and the upper end of femurs showed that the multiple hot spots were in fact bone fractures. These findings pointed diagnosis to a metabolic disease. The clinical context was in favour of an osteomalacia. Further explorations showed an osteomalacia related to phosphate diabetes. A thorough work-up did not reveal any known aetiology. To date, idiopathic phosphate diabetes seems the most likely diagnosis. Nuclear medicine input in osteomalacia is discussed. (authors)

  2. Reflex sympathetic dystrophy/complex regional pain syndrome, type 1

    Directory of Open Access Journals (Sweden)

    S.H. Botha

    2004-02-01

    Full Text Available Complex regional pain syndrome (CPRS, type 1 is a pain disorder that develops unpredictably and can follow a minor injury. A 12-year-old boy presented with severe pain in the feet and could not walk or stand weight bearing. Normal X-rays showed osteopenic changes and radiolucent lines, which appeared to be stress fractures. Three-phase bone scintigraphy showed no uptake in the left lower leg on the blood pool phase or on the immediate or delayed images. This indicated typical CPRS type 1 in children. The uptake in the right foot was increased and the stress fracture and other illness could not be differentiated. Computed tomography was done to exclude stress fractures. Only osteopenic changes in both calcaneus bones were found and there was no evidence of cortical stress fractures. Magnetic resonance images revealed oedema in the calcaneus and talus bones of both feet. The patient received epidural narcotic infusion with sympathetic blockage for 1 week combined with extensive physiotherapy. The blood pool phase of the bone scan became normal within 2 weeks, and increased uptake in both feet was noticed. The patient was followed up with MRI every 3 months and the bone marrow oedema disappeared after 6 months.

  3. Correlation between quantitative ultrasound parameters of the calcinosis and bone density of the spine and femur in Arabian women: Relation to menopausal status

    International Nuclear Information System (INIS)

    Aims: Quantitative ultrasound (QUS) of the calcaneus is being frequently used to screen for osteoporosis. This technique correlates very well with dual-energy X-ray absorptiometry (DXA) of the spine and femur, and predicts fracture risk in postmenopausal women. The correlation between QUS and DXA in premenopausal women with prevalent vitamin D deficiency however is not known. We assessed the correlation between both techniques in 55 pre- and postmenopausal Arabian women, a population with high prevalence of vitamin D deficiency. Methods: BMD of the right calcaneus was estimated by Sahara ultrasound (Hologic, Waltham, MA). Spine and right total femur BMD was determined by DXA scan (Lunar Expert XL, Madison, WI). Results: Overall, the correlation between calcaneal BMD estimated by QUS and spine and femur BMD measured by DXA in pre- and postmenopausal United Arab Emirates women was statistically significant (r=0.41; p=0.002 for spine and r=0.44; p=0.001 for femur, respectively). In postmenopausal women, all correlations between DXA and QUS parameters were statistically significant. In contrast, only BUA and SOS correlated significantly with spine BMD in premenopausal women. Conclusion: The correlation between DXA and QUS is statistically significant in postmenopausal United Arab Emirates women. However, this correlation is much weaker in premenopausal UAE women suggesting that other factors such as vitamin D deficiency may influence this correlation

  4. Modified anteroposterior and oblique radiographs of the midfoot and their efficiency in demonstrating the tarsometatarsal joints

    International Nuclear Information System (INIS)

    Aim: To assess whether conventional and modified anteroposterior and oblique radiographs of the midfoot can be used to demonstrate tarsometatarsal (TMT) joints clearly. Materials and methods: Conventional anteroposterior and oblique radiographs of the midfoot were taken of 152 volunteers. Modified radiographs of the midfoot were taken of 14 volunteers by tilting the radiographic system tube and placing volunteers’ feet on different footboards. Both conventional and modified radiographs were taken of 27 patients with midfoot injuries to demonstrate the injuries to the TMT joints. Two radiologists assessed the radiological demonstration of the TMT joints. Statistical analyses were performed using SPSS 13.0 for Windows. Results: Conventional radiographs of the midfoot did not sufficiently clearly demonstrate TMT joints. They could not demonstrate the majority of the TMT joints. The modified anteroposterior radiographs of the midfoot taken with the radiographic system tube tilted 30° towards the calcaneus demonstrated most TMT joints clearly. The modified oblique radiographs taken with the foot placed on a 30° footboard and with the radiographic system tube tilted 20° towards the calcaneus also showed the majority of TMT joints clearly. For the evaluation of midfoot injuries, modified radiographs perform better than conventional radiographs. Conclusions: Modified anteroposterior and oblique radiographs, which allow clear detection of the articulation and trabeculae of TMT joints, are valuable alternatives when assessing TMT joints.

  5. Reproducibility of X-ray bone densitometry and quantitative ultrasound - data from clinical practice

    International Nuclear Information System (INIS)

    The Quality Control (QC) plays a crucial role in the proper functioning of any bone density measurement device. Our study was aimed at evaluation of: 1) QC for several years of a Dual-energy X-ray (DXA) bone densitometry unit Hologic QDR-4500, and 2) in vivo precision of DXA lumbar spine and total hip, as well as quantitative ultrasound (QUS) of the calcaneus and radius. 3 groups of postmenopausal women at mean ages between 52 and 58 years were scanned twice on the same device (1st group Hologic QDR 4500 A; 2nd group - QUS Sahara Hologic, 3rd group - QUS Sunlight Omnisense 5000/7000). Long-term BMD reproducibility of the QDR 4500 unit in vitro, expressed as coefficient of variation, was 0.39 %. At the lumbar spine the in vivo precision error was 1.35%. Among the different regions of interest in the proximal femur precision decreased as follows: total hip (0.95 %) → trochanter (1.29 %) → femoral neck (1.31 %) → Ward's (3.14 %). The precision of QUS of the distal radius (0.59 %) was much better than that of the calcaneus (3.36 %). Our precision results are in line with those published abroad, which is due to the high qualification of the Bulgarian technicians. We discussed the clinical importance of the least significant change with the different methods. Our data underline the need for one leading bone densitometry centre to be accredited as the Bulgarian Reference Centre

  6. Risk of injury to vascular-nerve bundle after calcaneal fracture: comparison among three techniques

    Directory of Open Access Journals (Sweden)

    Pedro José Labronici

    2016-04-01

    Full Text Available OBJECTIVE: To ascertain whether the number of screws or pins placed in the calcaneus might increase the risk of injury when three different techniques for treating calcaneal fractures. METHOD: 126 radiographs of patients who suffered displaced calcaneal fractures were retrospectively analyzed. Three surgical techniques were analyzed on an interobserver basis: 31 radiographs of patients treated using plates that were not specific for the calcaneus, 48 using specific plates and 47 using an external fixator. The risk of injury to the anatomical structures in relation to each Kirschner wire or screw was determined using a graded system in accordance with the Licht classification. The total risk of injury to the anatomical structures through placement of more than one wire/screw was quantified using the additive law of probabilities for the product, for independent events. RESULTS: All of the models presented high explanatory power for the risk evaluated, since the coefficient of determination values (R2 were greater than 98.6 for all the models. Therefore, the set of variables studied explained more than 98.6% of the variations in the risks of injury to arteries, veins or nerves and can be classified as excellent models for prevention of injuries. CONCLUSION: The risk of injury to arteries, veins or nerves is not defined by the total number of pins/screws. The region and the number of pins/screws in each region define and determine the best distribution of the risk.

  7. Risk of injury to vascular-nerve bundle after calcaneal fracture: comparison among three techniques

    Science.gov (United States)

    Labronici, Pedro José; Reder, Vitor Rodrigues; de Araujo Marins Filho, Guilherme Ferreira; Pires, Robinson Esteves Santos; Fernandes, Hélio Jorge Alvachian; Mercadante, Marcelo Tomanik

    2016-01-01

    Objective To ascertain whether the number of screws or pins placed in the calcaneus might increase the risk of injury when three different techniques for treating calcaneal fractures. Method 126 radiographs of patients who suffered displaced calcaneal fractures were retrospectively analyzed. Three surgical techniques were analyzed on an interobserver basis: 31 radiographs of patients treated using plates that were not specific for the calcaneus, 48 using specific plates and 47 using an external fixator. The risk of injury to the anatomical structures in relation to each Kirschner wire or screw was determined using a graded system in accordance with the Licht classification. The total risk of injury to the anatomical structures through placement of more than one wire/screw was quantified using the additive law of probabilities for the product, for independent events. Results All of the models presented high explanatory power for the risk evaluated, since the coefficient of determination values (R2) were greater than 98.6 for all the models. Therefore, the set of variables studied explained more than 98.6% of the variations in the risks of injury to arteries, veins or nerves and can be classified as excellent models for prevention of injuries. Conclusion The risk of injury to arteries, veins or nerves is not defined by the total number of pins/screws. The region and the number of pins/screws in each region define and determine the best distribution of the risk. PMID:27069891

  8. Anatomy and arthrokinematics of the human ankle and intertarsal joints; Anatomie und Kinematik der Sprunggelenke des Menschen

    Energy Technology Data Exchange (ETDEWEB)

    Pretterklieber, M.L. [Vienna Univ. (Austria). Pathologisch-Anatomisches Inst.

    1999-01-01

    In the ankle (talocrural) joint, the lower end of the tibia and fibula embrace the trochlea tali. Thus, an approximately uniaxial joint is formed which permits dorsiflexion and plantarflexion of the foot against the leg. Due to the geometry of the trochlea tali, conjunct lateral rotation of the fibula against the tibia occurs at the tibiofibular articulations synchronously with active dorsiflexion at the ankle joint. Movements at the talocrural joints are mainly limited by the opposing muscles as well as by strong collateral ligaments. Talus and calcaneus form a functional unit connected by posterior and anterior articulations. The posterior articulation is the subtalar (talocalcaneal) joint; in the anterior articulation, talar facets of the calcaneus together with the posterior surface of the navicular and the superior fibrocartilaginous surface of the plantar calcaneonavicular ligament form a concavity for the talar head. Thus, the talocalcaneonavicular joint is a compound and - like the subtalar joint - a multiaxial articulation. On the weightbearing foot, the distal tarsus and metatarsus are pronated and supinated against the talus in order to maintain plantigrade contact. When the foot is off the ground, these movements are modified to eversion and inversion, also involving the calcaneocuboid joint. In addition, movements between the calcaneus and cuboid also occur during pronative or supinative changes between the fore- and hindfoot. Limitation of movements is due to leg muscles as well as strong ligaments. Finally, the cuneonavicular, cuboideonavicular, intercuneiform and cuneocuboid joints permit some additional alterations of the loaded foot in contact with the ground. (orig.) [Deutsch] Der Komplex der Sprunggelenke stellt die Verbindung von Unterschenkel und Fuss des Menschen her. In der Articulation talocruralis, dem oberen Sprunggelenk, stehen die distalen Enden von Tibia und Fibula mit der Trochlea tali im Gelenkkontakt. In diesem von starken

  9. Clinical and radiological findings of myocetoma

    International Nuclear Information System (INIS)

    Objective: To investigate the clinical radiologic characteristics of mycetoma. Methods: Radiographs of 33 cases of Madura confirmed by surgery and pathology were retrospectively analyzed. Results: Of 33 cases, multiple bones were involved in 27 and single bone in 6. A total of 180 bones were destroyed including metatarsus (42), cuneiform (33), phalanges of toes (26), cuboid (11), navicula (10), talus (9), calcaneus (8), tibia (1), carpus (22), metacarpus (12), phalanges of fingers (6). X-ray changes included erosive (20) and lyric (6) destruction of bone; erosion and sclerosis (3), sclerosis (2); irregular diaphysis and cortical thickening (5), periosteal reaction (6), surrounding osteoporosis (9), joint space narrowing (7), with indistinct articular margins. Lamellar sequestrum was noted within 2 lesions. Conclusion: Mycetoma bone infection is extensive and often involves multiple bones. The main x-ray findings are erosive and lyric destruction of bone. The radiographic appearance of the Maduta foot is similar to that of chronic pyogenic osteomyelitis with some distinctions. (authors)

  10. Can bone marrow edema be seen on STIR images of the ankle and foot after 1 week of running?

    Energy Technology Data Exchange (ETDEWEB)

    Trappeniers, L.; Maeseneer, M. de E-mail: midema@village.uunet.be; Ridder, F. de; Machiels, F.; Shahabpour, M.; Tebache, C.; Verhellen, R.; Osteaux, M

    2003-07-01

    Purpose: To evaluate whether initiation of running in sedentary individuals would lead to bone marrow edema on MR images, within the time span of 1 week. Materials and methods: The feet of 10 healthy volunteers were imaged by MR imaging before and after running during 30 min a day for 1 week. The images were evaluated by consensus of 2 musculoskeletal radiologists who graded the presence of bone marrow edema on a 4-point scale. Edema scores and number of bones involved before and after running were compared statistically. Results: Edema was present on the baseline images in 3 subjects. After running edema showed an increase or was present in 5 subjects. The changes after running were statistically significant. Bones involved were the talus, calcaneus, navicular bone, cuboid bone, and 5th metatarsal. Conclusion: Edema patterns can be seen in the feet of asymptomatic individuals. During initiation of running an increase of edema or development of new edema areas can be seen.

  11. Stress fractures of ankle and wrist in childhood: nature and frequency

    International Nuclear Information System (INIS)

    Stress fractures of many etiologies are found not infrequently in various tarsal bones but are less commonly recognized in carpal bones. To assess the distribution of tarsal and carpal stress fractures. During the last three decades, the senior author collected locations of tarsal and carpal bone stress fracture callus seen on plain radiographs. 527 children with tarsal and carpal stress fractures were identified (88 children had multiple bones involved). The totals were: calcaneus 244, cuboid 188, talus 121, navicular 24, cuneiforms 23, capitate 18, lunate 1, and scaphoid 1. Stress fractures were more frequently seen once we became aware each particular bone could be involved. Tarsal and carpal stress fractures in children are not rare. Careful perusal of these bones is urged in all susceptible children with limping or wrist pain. (orig.)

  12. Can bone marrow edema be seen on STIR images of the ankle and foot after 1 week of running?

    International Nuclear Information System (INIS)

    Purpose: To evaluate whether initiation of running in sedentary individuals would lead to bone marrow edema on MR images, within the time span of 1 week. Materials and methods: The feet of 10 healthy volunteers were imaged by MR imaging before and after running during 30 min a day for 1 week. The images were evaluated by consensus of 2 musculoskeletal radiologists who graded the presence of bone marrow edema on a 4-point scale. Edema scores and number of bones involved before and after running were compared statistically. Results: Edema was present on the baseline images in 3 subjects. After running edema showed an increase or was present in 5 subjects. The changes after running were statistically significant. Bones involved were the talus, calcaneus, navicular bone, cuboid bone, and 5th metatarsal. Conclusion: Edema patterns can be seen in the feet of asymptomatic individuals. During initiation of running an increase of edema or development of new edema areas can be seen

  13. Os cuboideum secundarium: A rare accessory ossicle with the potential to mimic a mass on magnetic resonance imaging

    International Nuclear Information System (INIS)

    Accessory ossicles are common incidental findings on radiographs of the ankle and foot. While typically asymptomatic and of no clinical significance, they are sometimes associated with local pain or even mistaken for pathological conditions such as fractures. Given the potential for misinterpretation, it is important to understand their typical locations and appearances. This case highlights an exceptionally rare accessory ossicle called the os cuboideum secundarium, located adjacent to the cuboid and calcaneus. Interestingly, this case demonstrates the potential for this rare ossicle to mimic a mass on magnetic resonance imaging (MRI). Furthermore, despite the significant improvements in the understanding of musculoskeletal pathology afforded by advancements in cross-sectional imaging techniques, this case is a reminder of certain pitfalls that remain. Lastly, it highlights the importance of radiographs as an initial diagnostic study in evaluating foot pain. (orig.)

  14. Stress fractures of ankle and wrist in childhood: nature and frequency

    Energy Technology Data Exchange (ETDEWEB)

    Oestreich, Alan E. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Bhojwani, Nicholas [University of Cincinnati College of Medicine, Cincinnati, OH (United States)

    2010-08-15

    Stress fractures of many etiologies are found not infrequently in various tarsal bones but are less commonly recognized in carpal bones. To assess the distribution of tarsal and carpal stress fractures. During the last three decades, the senior author collected locations of tarsal and carpal bone stress fracture callus seen on plain radiographs. 527 children with tarsal and carpal stress fractures were identified (88 children had multiple bones involved). The totals were: calcaneus 244, cuboid 188, talus 121, navicular 24, cuneiforms 23, capitate 18, lunate 1, and scaphoid 1. Stress fractures were more frequently seen once we became aware each particular bone could be involved. Tarsal and carpal stress fractures in children are not rare. Careful perusal of these bones is urged in all susceptible children with limping or wrist pain. (orig.)

  15. Apophysitis of the lower limbs: imaging findings; Apofisites dos membros inferiores: aspectos de imagem

    Energy Technology Data Exchange (ETDEWEB)

    Barbosa, Priscila Rodrigues; Santos, Durval C. Barros; Longo, Carlos Henrique; Luna, Rodrigo de Castro; Kim, Nelson Ji Tae; Rosemberg, Laercio A.; Funari, Marcelo Gusmao Buarque [Hospital Israelita Albert Einstein, Sao Paulo, SP (Brazil). Dept. de Imagem]. E-mail: pill-rb@uol.com.br

    2005-07-01

    Apophyses are secondary ossification centers that appear during growth. These ossification centers are under traction forces because of insertion of muscles and ligaments. When traction stress become greater in magnitude and frequency irritation of physis (growth plate) may occur resulting in apophysitis. Apophysitis injuries typically occur in active adolescents and usually presents as peri-articular pain associated with growth, skeletal immaturity, repetitive microtrauma and muscle-tendon imbalance. The most common types of apophysitis of the include Osgood-Schlatter disease (tibial tuberosity), apophysitis of the hip (iliac crest, ischial tuberosity), Sever's disease (posterior calcaneus), Sindig-Larsen-Johansson syndrome (inferior patella), and Iselin's disease (fifth metarsal base). The aim of this study was to show the main magnetic resonance imaging and X-rays findings in patients with these diseases and to discuss the frequent differential diagnosis. (author)

  16. Biomechanics – Elastic Foundation Applied in Modelling of Calcaneal Nails

    Directory of Open Access Journals (Sweden)

    Sejda František

    2015-12-01

    Full Text Available This paper presents a strength analysis of a calcaneal nail (material Ti6Al4V and stainless steel which is used to treat complex heel fractures. The application focuses on a unique calcaneal nail, the C-NAIL, produced by Medin a.s. (Nové Město na Moravě, Czech Republic. The paper first presents an analysis of fracture types, treatment methods and loading of the calcaneus. It then presents an analysis of limit conditions and loading. Calculations (displacement and stress are performed for 6 and 7 fixing screws using FEM (Ansys Workbench 14 software. The calculation involves a new, original application of an elastic foundation, which effectively replaces the complex interaction of the calcaneal nail and the heel bone.

  17. Fractures and dislocations of the midfoot: Lisfranc and Chopart injuries.

    Science.gov (United States)

    Benirschke, Stephen K; Meinberg, Eric G; Anderson, Sarah A; Jones, Clifford B; Cole, Peter A

    2013-01-01

    The midfoot is a complex association of five bones and many articulations between the forefoot metatarsals and the talus and calcaneus, which make up the hindfoot. These anatomic relationships are connected and restrained by an even more complex network of ligaments, capsules, and fascia, which must function as a unit to provide normal and painless locomotion. The common eponyms of Lisfranc and Chopart refer to the distal and proximal joint relationships of the midfoot, respectively. Midfoot injuries range from single ligament strains to complicated fracture-dislocations involving multiple bones and joints. To provide best outcomes for patients, it is important to understand the anatomy and the mechanical function of the midfoot; to review the epidemiology, mechanism, and classification of injuries encountered in an orthopaedic clinical practice; and to review the principles, indications, and surgical techniques for managing midfoot fractures and dislocations. PMID:23395016

  18. FEATURES OF THE X-RAY ANATOMICAL CONDITIONS OF THE FOOT AND ANKLE IN CHILDREN WITH FIBULAR APLASIA

    Directory of Open Access Journals (Sweden)

    Dmitry Stepanovich Buklaev

    2013-03-01

    Full Text Available The article contains the results of the analysis of radiographs of the foot and ankle in 84 children with malformations of the fibula. We found that infants’ relation to the ankle joint is often normal, as in the sagittal and frontal planes. With increasing age the number of posterior subluxation increases as well as anteriorly, laterally. Also dislocations of the foot were presented. The most significant relationships were violations of the subtalar joint. There were pronation, supinatsion, positions of calcaneus bone and its lateroposition, which was the most frequent cause of valgus deformity. Also we found a violation of the form of the talus such as a flattening of the block, smoothing of the neck. In rare cases of the varus deformity of the foot abnormalities of the tarsal bones were observed.

  19. Poor accuracy of calcaneous ultrasounds in the selection of postmenopausal women affected by vertebral osteoporosis diagnosed by DXA

    International Nuclear Information System (INIS)

    Aim: Bone Mineral Density (BMD) is the strongest skeletal predictor of fractures. DXA densitometric technique is the reference method to diagnose osteoporosis. Large prospective studies have confirmed that both Broad Band Ultrasound Attenuation (BUA) and Speed Of Sound (SOS) measurements at calcaneus predict vertebral fractures independently of densitometry. The aim of this study was to verify the capacity of calcaneal ultrasound (US) to detect women with vertebral osteoporosis diagnosed by DXA. Material and Methods: 453 women (aged 60-70 yrs), were investigated both with calcaneal US and spine DXA. WHO diagnostic criteria were applied both to DXA and US. Results: 202 and 251 women resulted osteoporotic and non osteoporotic at spine, respectively. Calcaneal US were not able to detect with sufficient accuracy the women diagnosed as osteoporotic at the spine (71-73 % of false negative and 11% of false positive results both for BUA and SOS). Conclusion: In conclusion, calcaneal US do not permit to individually diagnose vertebral osteoporosis

  20. Do three-dimensional reconstructions add to the diagnostic value of computed tomography in the field of traumatology?

    International Nuclear Information System (INIS)

    Very little time was needed for three-dimensional techniques to show that they are of great importance to the accurracy and, above all, interpretation of CT-based diagnostic findings in the skeleton. This method is not associated with any increased risks from radiation and if there is no absolute requirement for a 'second plane' to be displayed, as for instance in fractures of the calcaneus, radiation exposure can be reduced even further. Particular mention should here also be made of the sternoclavicular joint, coracoid process and intervertebral foramina, even more so as we feel that the diagnostic advantages offered by three-dimensional techniques in traumatology have so far not been described in sufficient detail. (orig./GDG)

  1. Bone density determination using I125 densitometry with idiopathic scoliosis

    International Nuclear Information System (INIS)

    Based on the assumption that radiographs from patients with idiopathic scoliosis show osteoporotic changes in the curved area, investigation with I125-densitometry were made, and specifically with measurement points at the ulna and the calcaneus. A difference in the bone density between patients with scoliosis and normal controls could not be proven. The mineral-salt content of the scoliosis patients lay on the average 6.5 to 9.3% lower than the normal controls. No relation could be found between the degree of curvature of the scoliosis and the peripheral bone density, from which it can be concluded that no generalized mineral-salt deficiency exists. Radiographs show only local changes (photo densitometry, computed tomography). (TRV)

  2. A new computerised method for the assessment of skeletal maturity in the newborn infant

    Energy Technology Data Exchange (ETDEWEB)

    Argemi, J. [Department of Paediatrics, Consorci Hospitalari Parc Tauli, Barcelona (Spain); Badia, J. [Department of Paediatrics, Consorci Hospitalari Parc Tauli, Barcelona (Spain)

    1997-04-01

    Of the existing methods for assessment of skeletal maturity in children over 1 year of age none is particularly suited to the newborn infant. We describe a computerised method by which area, perimeter and progression in the shape of ossification centres of talus and calcaneus are evaluated separately. From single lateral radiographs of the left ankle of 302 normal term and preterm infants whose birth weights were appropriate for gestational age we constructed reference curves of areas and perimeters at different gestational ages, as well as frequency distributions of each morphological maturity stage. This method may be applicable in assessing skeletal maturity in pathological conditions, such as intrauterine growth retardation and congenital hypothyroidism. (orig.). With 6 figs.

  3. Precise and feasible measurements of lateral calcaneal lengthening osteotomies by radiostereometric analysis in cadaver feet

    DEFF Research Database (Denmark)

    Martinkevich, P; Rahbek, Ole; Møller-Madsen, B;

    2015-01-01

    OBJECTIVES: Lengthening osteotomies of the calcaneus in children are in general grafted with bone from the iliac crest. Artificial bone grafts have been introduced, however, their structural and clinical durability has not been documented. Radiostereometric analysis (RSA) is a very accurate and...... precise method for measurements of rigid body movements including the evaluation of joint implant and fracture stability, however, RSA has not previously been used in clinical studies of calcaneal osteotomies. We assessed the precision of RSA as a measurement tool in a lateral calcaneal lengthening...... poorly dispersed markers. Precision was assessed as systematic bias and 95% repeatability limits. RESULTS: Systematic bias was generally below 0.10 mm for translations. Precision of migration measurements was below 0.2 mm for translations in the osteotomy. CONCLUSION: RSA is a precise tool for the...

  4. Bone mineral density in female athletes representing sports with different loading characteristics of the skeleton.

    Science.gov (United States)

    Heinonen, A; Oja, P; Kannus, P; Sievänen, H; Haapasalo, H; Mänttäri, A; Vuori, I

    1995-09-01

    To address the hypothesis that osteogenic effect of physical loading increases with increasing strain rates and peak forces, we examined 59 competitive Finnish female athletes (representing three sports with different skeletal loading characteristics), physically active referents (they reported an average of five various types of exercise sessions per week), and sedentary referents (two sessions per week) using dual energy X-ray absorptiometry. The measured anatomic sites were at the lumbar spine, femoral neck, distal femur, patella, proximal tibia, calcaneus, and distal radius. The athlete group consisted of aerobic dancers (N = 27), squash players (N = 18), and speed skaters (N = 14). The squash players had the highest values for weight-adjusted bone mineral density (BMD) at the lumbar spine (13.8% p forces, is more effective in bone formation than training with a large number of low-force repetitions. PMID:8541131

  5. Soft tissue injuries of the tarsus

    International Nuclear Information System (INIS)

    Contrast radiography provides a clear survey of the size, shape, and location of extratendovaginal fluid-filled cavities, distended bursa, and tendon sheaths and demonstrates intersynovial communication. Ultrasonography effectively demonstrates Achilles tendon injury, slippage of the SDFT off the summit of the calcaneus, assorted ligamentous injuries, and cystic or solid extratendovaginal masses. It will also demonstrate distended bursae and tendon sheaths, but it is not as effective in demonstrating a synovial herniation, or a narrow synovial fistula. Contrast radiography may prove to be the imaging modality of choice for examination of fluctuating swellings, whereas ultrasonography is preferred for the assessment of firm swellings. Routine radiographic evaluation in the clinical assessment of soft tissue injuries in the hock region continues to play an invaluable diagnostic role

  6. Congenital and acquired orthopedic abnormalities in patients with myelomeningocele.

    Science.gov (United States)

    Westcott, M A; Dynes, M C; Remer, E M; Donaldson, J S; Dias, L S

    1992-11-01

    This article presents a radiologic review of the spectrum of acquired and congenital orthopedic abnormalities found in patients with myelomeningocele. These abnormalities are caused predominantly by muscle imbalance, paralysis, and decreased sensation in the lower extremity. Iatrogenic injury, such as a postoperative tethered cord, may also cause bone abnormalities. Selected images were obtained from more than 800 children. Important entities presented include spinal curvatures such as kyphosis, scoliosis, and lordosis; subluxation and dislocation of the hip, coxa valga, contractures of the hip, and femoral torsion; knee deformities; rotational abnormalities of the lower extremity and external and internal torsion; ankle and foot abnormalities such as ankle valgus, calcaneus foot, congenital vertical talus (rocker-bottom deformity), and talipes equinovarus; and metaphyseal, diaphyseal, and physeal fractures. Familiarity with congenital abnormalities and an understanding of the pathogenesis of acquired disorders in patients with myelomeningocele are essential for proper radiologic interpretation and timely therapy. PMID:1439018

  7. Radiodiagnosis of hemophiliac bone pseudotumors

    International Nuclear Information System (INIS)

    Of 259 hemophiliacs bone pseudotumors were diagnosed in 11 (4.3 %); they were localised in the femur (6 cases), calcaneus (4) and in the iliac bone (3). Two cases of combined fermoral and calcaneal lesions and 4 cases of bone fracture were observed. As a rule, pseudotumors developed in hemophiliacs with severe disease. An x-ray picture of a pseudotumor depended on its site and was characterized by a large soft tissue tumor shadow, often with calcinosis, and serious destructive changes in bones in the form or round foci of 7 cm in diameter with clear-cut contours. An adge defect of the cortical layer was defined in the diaphysis of the femoral bone (15 cm long). Destructive changes were often accompanied by osteosclerosis and periostitis

  8. MRI appearances of the anterior fibulocalcaneus muscle: a rare anterior compartment muscle

    Energy Technology Data Exchange (ETDEWEB)

    Upadhyay, Bhavin [Basildon and Thurrock University Hospitals NHS Foundation Trust, Imaging Department, Essex (United Kingdom); Amiras, Dimitri [Imperial College Health Care NHS Trust, Imaging Department, London (United Kingdom)

    2015-05-01

    MRI of a 62-year-old female presenting with ankle pain demonstrated an accessory muscle within the anterior compartment of the lower leg. The muscle originated from the fibula and anterior crural septum. The tendon passed anterior to the lateral malleolus and inserted at the critical angle of Gissane on the calcaneus. This muscle was initially described in the anatomic literature by Lambert and Atsas in 2010. To our knowledge, this is the first time the MRI appearances of this muscle has been described in the radiological literature. Awareness of the fibulocalcaneal muscle is important as it may represent a cause of ankle pain. In addition, the tendon could potentially be harvested for use in reconstructive procedures. (orig.)

  9. Development of pulser/receiver for measuring the thickness of heel bone

    International Nuclear Information System (INIS)

    Ultrasound has been applied to the diagnosis of osteoporosis. Although several ultrasound devices have already been developed for bone covered with thin skin such as the calcaneus to predict failure risk of other bones, the precision of these ultrasonic methods can be adversely affected by the bone shape and inconsistent positioning. In this study, we developed a specially designed ultrasonic pulser/receiver for visualizing the bone quality and thickness simultaneously. The three dimensional image obtained from the data of quality and shape could allow better assessment of bone. The acrylic and bone specimens were used for evaluating performance of the pulser/receiver in the measurement of material quality and thickness. The results demonstrated that the method used in this study can be applied to the improvement of currently available ultrasound devices.

  10. Roentgenographic appearance of ossification centers in the Japanese fetus, stillborn and neonatal death infants, Hiroshima and Nagasaki

    Energy Technology Data Exchange (ETDEWEB)

    Kawamoto, Sadahisa

    1964-01-01

    A roentgenographic study of the presence of the ossification centers has been made on a total of 235 cases of miscarriage, therapeutic abortion, stillbirth and neonatal death according to criteria of sex, length of gestational age, and weight at birth. The cases were aged from 16 to 42 gestational weeks. The weight of the cases ranged from 110 g to 3780 g at birth. The order of appearance of the eight centers in fetal life was as follows: Ischium, pubis, calcaneus, talus, distal epiphysis of femur, hyoid, proximal epiphysis of tibia, and cuboid bone. Some of the eight ossification centers appeared earlier in girls than in boys of the same gestational age and birth weight. The osseous development of Japanese fetuses and infants weighing over 2000 g was judged less mature than in similar Caucasian and Negro subjects. 10 references, 1 figure, 6 tables.

  11. Apophysitis of the lower limbs: imaging findings

    International Nuclear Information System (INIS)

    Apophyses are secondary ossification centers that appear during growth. These ossification centers are under traction forces because of insertion of muscles and ligaments. When traction stress become greater in magnitude and frequency irritation of physis (growth plate) may occur resulting in apophysitis. Apophysitis injuries typically occur in active adolescents and usually presents as peri-articular pain associated with growth, skeletal immaturity, repetitive microtrauma and muscle-tendon imbalance. The most common types of apophysitis of the include Osgood-Schlatter disease (tibial tuberosity), apophysitis of the hip (iliac crest, ischial tuberosity), Sever's disease (posterior calcaneus), Sindig-Larsen-Johansson syndrome (inferior patella), and Iselin's disease (fifth metarsal base). The aim of this study was to show the main magnetic resonance imaging and X-rays findings in patients with these diseases and to discuss the frequent differential diagnosis. (author)

  12. Os cuboideum secundarium: A rare accessory ossicle with the potential to mimic a mass on magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kauffmann, Gregory [University of Chicago, Pritzker School of Medicine, Chicago, IL (United States); Stacy, G.S. [University of Chicago, Section of Musculoskeletal Radiology, Department of Radiology, Chicago, IL (United States)

    2014-01-15

    Accessory ossicles are common incidental findings on radiographs of the ankle and foot. While typically asymptomatic and of no clinical significance, they are sometimes associated with local pain or even mistaken for pathological conditions such as fractures. Given the potential for misinterpretation, it is important to understand their typical locations and appearances. This case highlights an exceptionally rare accessory ossicle called the os cuboideum secundarium, located adjacent to the cuboid and calcaneus. Interestingly, this case demonstrates the potential for this rare ossicle to mimic a mass on magnetic resonance imaging (MRI). Furthermore, despite the significant improvements in the understanding of musculoskeletal pathology afforded by advancements in cross-sectional imaging techniques, this case is a reminder of certain pitfalls that remain. Lastly, it highlights the importance of radiographs as an initial diagnostic study in evaluating foot pain. (orig.)

  13. Subtalar dislocation without associated fractures: Case report and review of literature.

    Science.gov (United States)

    Giannoulis, Dionisios; Papadopoulos, Dimitrios V; Lykissas, Marios G; Koulouvaris, Panagiotis; Gkiatas, Ioannis; Mavrodontidis, Alexandros

    2015-04-18

    Isolated subtalar dislocations are unusual injuries due to the inherent instability of the talus. Subtalar dislocations are frequently associated with fractures of the malleoli, the talus, the calcaneus or the fifth metatarsal. Four types of subtalar dislocation have been described according to the direction of the foot in relation to the talus: medial, lateral posterior and anterior. It has been shown that some of these dislocations may spontaneously reduce. A rare case of a 36-year-old male patient who sustained a closed medial subtalar dislocation without any associated fractures of the ankle is reported. The patient suffered a pure closed medial subtalar dislocation that is hardly reported in the literature. Six months after injury the patient did not report any pain, had a satisfactory range of motion, and no signs of residual instability or early posttraumatic osteoarthritis. The traumatic mechanism, the treatment options, and the importance of a stable and prompt closed reduction and early mobilization are discussed. PMID:25893182

  14. Compartments of the foot: topographic anatomy.

    Science.gov (United States)

    Faymonville, C; Andermahr, J; Seidel, U; Müller, L P; Skouras, E; Eysel, P; Stein, G

    2012-12-01

    Recent publications have renewed the debate regarding the number of foot compartments. There is also no consensus regarding allocation of individual muscles and communication between compartments. The current study examines the anatomic topography of the foot compartments anew using 32 injections of epoxy-resin and subsequent sheet plastination in 12 cadaveric foot specimens. Six compartments were identified: dorsal, medial, lateral, superficial central, deep forefoot, and deep hindfoot compartments. Communication was evident between the deep hindfoot compartment and the superficial central and deep central forefoot compartments. In the hindfoot, the neurovascular bundles were located in separate tissue sheaths between the central hindfoot compartment and the medial compartment. In the forefoot, the medial and lateral bundles entered the deep central forefoot compartment. The deep central hindfoot compartment housed the quadratus plantae muscle, and after calcaneus fracture could develop an isolated compartment syndrome. PMID:22638720

  15. Biomechanical comparison of conventional and anatomical calcaneal plates for the treatment of intraarticular calcaneal fractures - a finite element study.

    Science.gov (United States)

    Yu, Bin; Chen, Wen-Chuan; Lee, Pei-Yuan; Lin, Kang-Ping; Lin, Kun-Jhih; Tsai, Cheng-Lun; Wei, Hung-Wen

    2016-10-01

    Initial stability is essential for open reduction internal fixation of intraarticular calcaneal fractures. Geometrical feature of a calcaneal plate is influential to its endurance under physiological load. It is unclear if conventional and pre-contoured anatomical calcaneal plates may exhibit differently in biomechanical perspective. A Sanders' Type II-B intraarticular calcaneal fracture model was reconstructed to evaluate the effectiveness of calcaneal plates using finite element methods. Incremental vertical joint loads up to 450 N were exerted on the subtalar joint to evaluate the stability and safety of the calcaneal plates and bony structure. Results revealed that the anatomical calcaneal plate model had greater average structural stiffness (585.7 N/mm) and lower von Mises stress on the plate (774.5 MPa) compared to those observed in the conventional calcaneal plate model (stiffness: 430.9 N/mm; stress on plate: 867.1 MPa). Although both maximal compressive and maximal tensile stress and strain were lower in the anatomical calcaneal plate group, greater loads on fixation screws were found (average 172.7 MPa compared to 82.18 MPa in the conventional calcaneal plate). It was noted that high magnitude stress concentrations would occur where the bone plate bridges the fracture line on the lateral side of the calcaneus bone. Sufficient fixation strength at the posterolateral calcaneus bone is important for maintaining subtalar joint load after reduction and fixation of a Sanders' Type II-B calcaneal fracture. In addition, geometrical design of a calcaneal plate should worth considering for the mechanical safety in practical usage. PMID:26813403

  16. Plantar talar head contusions and osteochondral fractures: associated findings on ankle MRI and proposed mechanism of injury

    International Nuclear Information System (INIS)

    To evaluate the significance of plantar talar head injury (PTHI) in predicting osseous and soft tissue injuries on ankle MRI. The IRB approved this HIPAA-compliant retrospective study. The study group consisted of 41 ankle MRIs with PTHI that occurred at our institution over a 5 1/2 year period. Eighty MRIs with bone injuries in other locations matched for age, time interval since injury, and gender formed a control group. Injuries to the following structures were recorded: medial malleolus, lateral malleolus/distal fibula, posterior malleolus, talus, calcaneus, navicular, cuboid, lateral, medial and syndesmotic ligaments, spring ligament complex, and extensor digitorum brevis (EDB) muscle. Twenty separate logistic regressions determined which injuries PTHI predicted, using the Holm procedure to control for family-wise alpha at 0.05. PTHI strongly predicted the occurrence of injuries involving the anterior process of the calcaneus [24 % of cases, odds ratio (OR) 12.66], plantar components of the spring ligament (27 %, OR 9.43), calcaneal origin of the EDB and attachment of the dorsolateral calcaneocuboid ligament (22 %, OR 7.22), cuboid (51 %, OR 6.58), EDB (27 %, OR 5.49), anteromedial talus (66 %, OR 4.78), and posteromedial talus (49 %, OR 4.48). PTHI strongly predicted lack of occurrence of syndesmotic ligament injury (OR 19.6). The PTHI group had a high incidence of lateral ligamentous injury (78 %), but not significantly different from the control group (53 %). PTHI is strongly associated with injury involving the transverse tarsal joint complex. We hypothesize it results from talo-cuboid and/or talo-calcaneal impaction from a supination injury of the foot and ankle. (orig.)

  17. Ultrasonography of ankle ligaments

    International Nuclear Information System (INIS)

    The lateral collateral ligament of the ankle is a complex of 3 ligaments: The anterior and posterior talofibular ligaments and the calcaneofibular ligament; these ligaments work together to support the lateral aspect of the ankle. The anterior talofibular (ATF) ligament (Fig. 1) runs from the anterior of the talus. The probe is placed in a slightly oblique position from the malleolus toward the forefoot. The ligament is hyperechoic when its fibres are perpendicular to the ultrasound beam (anisotropy artifact is present in ligaments as well as in tendons). It is approximately 2 mm thick and, during examination, must be straight and tight from one insertion point to the other, as seen in Fig. 2. The posterior talofibular (PTF) ligament, which runs from the posterior part of the malleolus to the posterior part of the talus, is difficult to see on US, being partially or sometimes completely hidden by the malleolus. The calcaneofibular ligament forms the middle portion of the lateral collateral ligament. It is tight between the inferior part of the lateral malleolus and the calcaneus, and runs in a slightly posterior oblique direction toward the heel (Fig. 3). The ligament lies on the deep surface of the fibular tendons, forming a hammock to fall deep on the calcaneus surface (Fig. 4). The calcaneofibular ligament is approximately 2-3 nun thick and is hyperechoic in the distal two-thirds only because of the obliquity of the proximal part. When examining this ligament, it is mandatory that the ankle be flexed dorsally; this stretches the ligament so that it can be seen clearly. (author)

  18. Congenital vascular malformations in scintigraphic evaluation

    International Nuclear Information System (INIS)

    Congenital vascular malformations are tumour-like, non-neoplastic lesions caused by disorders of vascular tissue morphogenesis. They are characterised by a normal cell replacement cycle throughout all growth phases and do not undergo spontaneous involution. Here we present a scintigraphic image of familial congenital vascular malformations in two sisters. A 17-years-old young woman with a history of multiple hospitalisations for foci of vascular anomalies appearing progressively in the upper and lower right limbs, chest wall and spleen. A Parkes Weber syndrome was diagnosed based on the clinical picture. Due to the occurrence of new foci of malformations, a whole-body scintigraphic examination was performed. A 12-years-old girl reported a lump in the right lower limb present for approximately 2 years, which was clinically identified as a vascular lesion in the area of calcaneus and talus. Phleboscintigraphy visualized normal radiomarker outflow from the feet via the deep venous system, also observed in the superficial venous system once the tourniquets were released. In static and whole-body examinations vascular malformations were visualised in the area of the medial cuneiform, navicular and talus bones of the left foot, as well as in the projection of right calcaneus and above the right talocrural joint. People with undiagnosed disorders related to the presence of vascular malformations should undergo periodic follow-up to identify lesions that may be the cause of potentially serious complications and to assess the results of treatment. Presented scintigraphic methods may be used for both diagnosing and monitoring of disease progression

  19. EFFECT OF ORTHOTICS AND FOOTWEAR ON STATIC REARFOOT KINEMATICS

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    Molly Winkelmeyer

    2006-09-01

    Full Text Available This study examined the effect of foot orthotics and footwear on static rearfoot kinematics. Thirty-four subjects (5 males, 29 females from physical therapy clinics and the college community gave informed consent to participate. Subject age was 42 (18 years; subject height was 1.7 (0.1 meters; subject body mass was 72.6 (12.1 kg. Markers were placed on specific sites of the lower leg and calcaneus to determine the rearfoot angle. Rearfoot angle was measured with a goniometer and digitized with video-based software (Ariel Performance Analysis System. A calcaneal mold was utilized to determine the position of the calcaneus in the shod conditions. Static rearfoot angles were measured in the following conditions: barefoot (B, barefoot with the calcaneal mold (BM, barefoot with the calcaneal mold plus the orthotic (BMO, shod with the calcaneal mold (SM, and shod with the calcaneal mold plus the orthotic (SMO. An independent t-test analyzed differences between each condition as measured with the APAS and goniometer. A one-way analysis of variance (ANOVA was utilized to determine statistically significant differences among the 5 foot conditions (p 0.05 between the APAS and goniometer measurements within each condition. One-way ANOVA showed a significant difference (p < 0.01 among the five conditions as measured by APAS. Post-hoc analysis determined that the difference between BM and SM; and the BM and SMO conditions were significantly different (p < 0.01. It was observed that the orthotic slightly decreased the amount of calcaneal eversion in the standing position. The shoes worn in the study, though neutral in construction, did significantly alter rearfoot kinematics in comparison to BM

  20. The effect of fracture type and angular deterioration on the functional outcome of calcaneal fractures

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    Atilla Polat

    2011-03-01

    Full Text Available The aim of this study was to determine the effect of fracture type and angular deterioration on the outcome of calcaneal fractures.Materials and methods: Thirty-two patients (23 males, 9 females; mean age 45 years with calcaneus fractures retrospectively reviewed. Twenty-four fractures were closed, and eight fractures were open. Böhler and Gissane angles were measured using patient’s before, and after reduction X-ray films. According to the Essex-Lopresti classification there were three type I, 14 type II, and 15 type III fractures. Five patients were treated with casting (Group I, 19 patients with closed reduction K-wire application (Group II, and 8 patients with plate fixation. Final clinical outcome were assessed by Maryland Foot Score. Mean follow-up period was 109 weeks.Results: Mean Böhler and Gissane angles were 7°, 85° before reduction, and 20°, 100° after reduction, respectively. The mean Maryland Foot Score was 62 (range 55-72 in Group I, 68 (range 40-90, and 66 (range 58-79 in group II.The Maryland Foot score in Type I fracture was higher than Type III (p=0.025, and Typ II (p=0.094, respectively. In terms of last radiologic examination, the Maryland Foot Score was higher in those angle’s were in normal border than whose angle’s were abnormal (p=0.027 and p=0.02, respectively. Mean correction of angles in Group III were more than Group I, and Gruop II (p<0.05.Conclusion: Severe calcaneus fracture was related to poor functional outcome. Böhler and Gissane angle can be more corrected with plate fixation method, but has similar functional outcome.

  1. Wholebody and pinhole bone scan manifestations of reiter's syndorme: distribution pattern and specific and early signs

    International Nuclear Information System (INIS)

    We wish to describe the characteristics panoramic wholebody bone distribution, and specific and preradiographic pinhole bone scan signs of Reiter's syndrome(RS) featured by pauciarthritis and enthesopathies in and about weight-bearing joints of the lower extremities and axial bones. We analyzed 55 sets of wholebody and pinhole bone scintigraphs of 55 patients with RS. The population was 44 men and 11 women with age ranging from 15 to 52 yr (mean=29.3). The scintigraphy was performed 2-2.5 hr pi of Tc-99m-HDP using a single-head gamma camera with a LEHR collimator and a 4-mm pinhole collimator for the wholebody and pinhole scintigraphy, respectively. We found 223 lesions with increased tracer uptake in total. Wholebody scans showed asymmetric pauciarticular distribution in weight bearing joints and periarticular entheses in the lower extremities in 63.2% (calcaneus=24.2%, ankle=8.1%, tibia=8.1% and others). The sternum, sacroiliac joint and spine were involved in 8.5%, 5.8% and 4.5%, respectively. Pinhole scan portrayed many specific signs including the 'tear-drop' sign of paravertebral ossification. 'whiskers' sign of femoral osteophytes and 'knuckle bone' sign of sausage digit. Twenty-four lesions (10.8%) showed preradiogrpahic signs in symptomatic ehthesopathies mostly in the calcaneus and proximal tibia. Nine cases with calcaneal enthesopathies and four cases with proximal tibial enthesopathy without radiographic bone change showed intense tracer uptake. Wholebody and pinhole magnification scans were useful in studying RS. The asymmetric pauciarticular distribution in the weight-bearing bones with enthesopathies was characteristic. Pinhole scan portrayed many specific signs and was sensitive permitting accurate preradiographic diagnosis in many cases

  2. Closed Reduction and Percutaneous Fixation of Calcaneal Fractures in Children.

    Science.gov (United States)

    Feng, Yongzeng; Yu, Yang; Shui, Xiaolong; Ying, Xiaozhou; Cai, Leyi; Hong, Jianjun

    2016-07-01

    Open reduction and internal fixation has been widely used to treat displaced intra-articular calcaneus fractures in children. However, the complications of surgical trauma and the wound created through the extended lateral approach cannot be ignored. This study analyzed the outcomes of displaced intra-articular calcaneal fractures in children treated with closed reduction and percutaneous fixation. Medical records of pediatric patients who had displaced intra-articular calcaneus fractures and underwent closed reduction and percutaneous fixation at the study institution between January 2008 and January 2013 were reviewed. Preoperative radiographs and computed tomography scans were used to evaluate and classify the fractures. Clinical outcomes and radiographic findings were assessed at postoperative follow-up. The study included 14 displaced intra-articular calcaneal fractures in 11 patients (7 boys and 4 girls). Mean patient age was 11.18 years (range, 6-16 years), and average follow-up time was 42.8 months postoperatively (range, 12-72 months). There were 6 tongue-type fractures and 8 joint depression-type fractures, based on the Essex-Lopresti classification, and there were 11 type II and 3 type III fractures, based on the Sanders classification. Average Böhler angle was 8.00° (range, -5° to 18°) preoperatively and 30.79° (range, 26° to 40°) postoperatively (P<.001). Average subjective American Orthopaedic Foot and Ankle Society hindfoot score was 65.7 (range, 52-68). No patients had wound breakdown or infection. In the treatment of displaced intra-articular calcaneal fractures in pediatric patients, closed reduction and percutaneous fixation achieved good outcomes, with few complications. [Orthopedics. 2016; 39(4):e744-e748.]. PMID:27111072

  3. Controlled trial of the effects of milk basic protein (MBP) supplementation on bone metabolism in healthy adult women.

    Science.gov (United States)

    Aoe, S; Toba, Y; Yamamura, J; Kawakami, H; Yahiro, M; Kumegawa, M; Itabashi, A; Takada, Y

    2001-04-01

    Milk has more beneficial effects on bone health compared to other food sources. Recent in vitro and in vivo studies showed that milk whey protein, especially its basic protein fraction, contains several components capable of both promoting bone formation and inhibiting bone resorption. However, the effects of milk basic protein (MBP) on bone metabolism of humans are not known. The object of this study was to examine the effects of MBP on bone metabolism of healthy adult women. Thirty-three normal healthy women were randomly assigned to treatment with either placebo or MBP (40 mg per day) for six months. The bone mineral density (BMD) of the left calcaneus of each subject was measured at the beginning of the study and after six months of treatment, by dual-energy x-ray absorptiometry. Serum and urine indices of bone metabolism were measured at the base line, three-month intervals, and the end of the study. Daily intake of nutrients was monitored by a three-day food record made at three and six months. The mean (+/- SD) rate of left calcaneus BMD gain of women in the MBP group (3.42 +/- 2.05%) was significantly higher than that of women in the placebo group (2.01 +/- 1.75%, P = 0.042). As compared with the placebo group, urinary cross-linked N-teleopeptides of type-I collagen/creatinine and deoxypyridinoline/creatinine were significantly decreased in the MBP group (p supplementation of 40 mg in healthy adult women can significantly increase their BMD independent of dietary intake of minerals and vitamins. This increase in BMD might be primarily mediated through inhibition of osteoclast-mediated bone resorption by the MBP supplementation. PMID:11388472

  4. Plantar talar head contusions and osteochondral fractures: associated findings on ankle MRI and proposed mechanism of injury

    Energy Technology Data Exchange (ETDEWEB)

    Gorbachova, Tetyana; Wang, Peter S.; Hu, Bing [Einstein Medical Center Philadelphia, Department of Radiology, Philadelphia, PA (United States); Horrow, Jay C. [Drexel University, Department of Anesthesiology and Perioperative Medicine, Philadelphia, PA (United States)

    2016-06-15

    To evaluate the significance of plantar talar head injury (PTHI) in predicting osseous and soft tissue injuries on ankle MRI. The IRB approved this HIPAA-compliant retrospective study. The study group consisted of 41 ankle MRIs with PTHI that occurred at our institution over a 5 1/2 year period. Eighty MRIs with bone injuries in other locations matched for age, time interval since injury, and gender formed a control group. Injuries to the following structures were recorded: medial malleolus, lateral malleolus/distal fibula, posterior malleolus, talus, calcaneus, navicular, cuboid, lateral, medial and syndesmotic ligaments, spring ligament complex, and extensor digitorum brevis (EDB) muscle. Twenty separate logistic regressions determined which injuries PTHI predicted, using the Holm procedure to control for family-wise alpha at 0.05. PTHI strongly predicted the occurrence of injuries involving the anterior process of the calcaneus [24 % of cases, odds ratio (OR) 12.66], plantar components of the spring ligament (27 %, OR 9.43), calcaneal origin of the EDB and attachment of the dorsolateral calcaneocuboid ligament (22 %, OR 7.22), cuboid (51 %, OR 6.58), EDB (27 %, OR 5.49), anteromedial talus (66 %, OR 4.78), and posteromedial talus (49 %, OR 4.48). PTHI strongly predicted lack of occurrence of syndesmotic ligament injury (OR 19.6). The PTHI group had a high incidence of lateral ligamentous injury (78 %), but not significantly different from the control group (53 %). PTHI is strongly associated with injury involving the transverse tarsal joint complex. We hypothesize it results from talo-cuboid and/or talo-calcaneal impaction from a supination injury of the foot and ankle. (orig.)

  5. The subtalar joint complex of Australopithecus sediba.

    Science.gov (United States)

    Prang, Thomas C

    2016-01-01

    The hominin talus has figured prominently in previous studies of the functional morphology of the talocrural joint, but the talocalcaneal and talonavicular joints have received comparatively less attention despite their functional importance as components of the subtalar joint complex. An associated complete talus and calcaneus attributed to the Malapa Hominin 2 (MH2) individual of Australopithecus sediba offers the opportunity to evaluate the subtalar joint complex in an early hominin. Furthermore, detailed morphological comparisons of A. sediba to other fossil hominins such as Australopithecus africanus have not yet been conducted. Here I quantify joint curvatures and angular measurements among extant hominoids and fossil hominins to evaluate the functional morphology of the subtalar joint complex of A. sediba. Australopithecus sediba uniquely combines talocalcaneal joint morphology indicative of mobility with specializations of the talonavicular joint that provide medial midtarsal stabilization. Multivariate analyses of talus and calcaneus variables show that A. sediba is most similar to extant gorillas in the morphology of the subtalar joint complex. In contrast, other hominins, such as OH 8, are more similar to modern humans. The morphological similarity between MH2 (U.W. 88-98/99) and specimens from Sterkfontein, Member 4 (StW 88, StW 102, StW 352) in morphologies of the talonavicular and talocalcaneal joints suggests that A. sediba may have possessed a foot that was functionally similar to that of A. africanus. This combination of morphologies in the A. sediba foot is probably derived among hominins and suggests that arboreality may have been adaptively significant for southern African Australopithecus. PMID:26767963

  6. Osteoporosis and Osteopathy Markers in Patients with Mastocytosis

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    Nilüfer Alpay Kanıtez

    2015-03-01

    Full Text Available OBJECTIVE: Osteoporosis, osteosclerosis, and lytic bone lesions have been observed in patients with systemic mastocytosis (SM. We examined bone mineral density (BMD biochemical turnover markers and serum tryptase levels in SM, which is considered a rare disease. METHODS: Seventeen adult patients (5 females, 12 males; median age: 33 years, range: 20-64 with mastocytosis were included in this study. We investigated the value of quantitative ultrasound (QUS of the calcaneus in the assessment of BMD in SM patients, as well as BMD of the lumbar spine (L1-L4, femoral neck, and distal radius using dual energy x-ray absorptiometry (DXA and plasma tryptase levels, biochemical markers of bone turnover. RESULTS: At lumbar spine L1-L4, the femoral neck, and the distal radius or as calcaneus stiffness, 12 of 17 patients had T-scores of less than -1 at least at 1 site, reflecting osteopenia. Three of 17 patients had T-scores showing osteoporosis (T-score <-2.5. There was no relationship between DXA and bone lesion severity. We also found a significant positive correlation between tryptase levels and disease severity, as well as between disease severity and pyridinoline (p<0.01 by Spearman’s test. CONCLUSION: DXA and calcaneal QUS may not be appropriate techniques to assess bone involvement in SM patients because of the effects of osteosclerosis. This study further shows that the osteoclastic marker pyridinoline is helpful in patients with severe disease activity and sclerotic bone lesions to show bone demineralization.

  7. Avaliação funcional e radiográfica do pé torto congênito tratado cirurgicamente Functional and radiographic evaluation of the surgically-treated congenital clubfoot

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    Luiz Carlos Ribeiro Lara

    2007-07-01

    do tratamento do pé torto congênito idiopático.OBJECTIVE: To review radiographic aspects of idiopathic congenital clubfeet operated on and compare them to the surgical results achieved. METHODS: The sample include 68 congenital clubfeet that were operated on with posteromedial, and/or lateral release of the soft parts. The age at the time of surgery varied from 6 to 24 months, and post-operative follow-up lasted from 1 to 16 years, with a mean of 4.87 years. At the time of evaluating results, anteroposterior and profile X-rays with charge were made of the feet, and the talus-calcaneus, talus-first metatarsus, and calcaneus-fifth metatarsus angles were plotted. A review was also made of the percentage movement backwards of the fibula onto the tibia, and the relation of the tibia and the navicular position in relation to the talus in both radiographic plans. RESULTS: 90.8% satisfactory results and 9.2% unsatisfactory results were obtained. The mean talus-calcaneus angle in the anteroposterior X-ray was 23.20º, and it was 23.20º in the profile X-ray, with no statistical significance. The talus-first metatarsus angle presented a mean of 4.84º, and the calcaneus-fifth metatarsus angle had a mean of 7.70º, both correlating to the results (P = 0.003. The percentage movement backwards of the fibula onto the tibia had a mean value of 60.67% (P = 0.007. CONCLUSIONS: 1º When they were wider than 10º and 12º, the respective angles of the talus-first metatarsus in the anteroposterior X-rays, and of the calcaneus-fifth metatarsus in anteroposterior X-rays were significant for those clubfeet that had unsatisfactory results; 2º the better the navicular alignment in relation to the talus in anteroposterior X-rays and in profile X-rays, the better the results; 3º the percent relation of the backwards movement of the fibula onto the tibial was higher in those feet with unsatisfactory results; 4º in anteroposterior and in profile X-rays, the talus-calcaneus angle did not

  8. 经跗骨窦间隙入路微创内固定治疗跟骨关节内骨折的解剖研究与临床应用%Anatomical study and clinical application of minimally invasive internal fixation in the treatment of intra-articular fractures of calcaneum via sinus tarsi approach

    Institute of Scientific and Technical Information of China (English)

    孔建中; 郑立程; 水小龙; 郭晓山; 李士

    2009-01-01

    Objective To investigate the anatomical features, operative method and efficacy of internal fixation in the treatment of iutra-articular fractures of caleaneum via the sinus tarsi approach. Methods The pathway, branches distribution and anastomosis of perforating descending branch of peroneal artery were observed on 18 adult cadaveric lower limbs. A sinus tarsi approach was designed. From July 2001 to January 2008, 71 intra-articular calcaneal fractures in 68 patients were treated with open reduction and internal fixation via sinus tarsi approach at lateral sides of calcaneus. According to the Sanders classification, there were 26 type Ⅱ fractures, 32 type Ⅲ fractures and 13 type Ⅳ fractures. Results All patients were followed up for a mean period of 39.3 months (13-85 months), and the fractures were completely healed. There was a significant difference in the length, width and height of the calcaneus, Bohler angle and Gissane angle before and after operation (P < 0.01). According to Maryland Foot Score, the operative effect was excellent in 33 feet, good in 29 feet, fair in 6 feet and poor in 3 feet. Conclusion Open reduction and internal fixation via sinus tarsi approach is an effective method for minimally invasive treatment of intraarticular fractures of the calcaneus, with the advantages of good clinical results and causing minimal damage to soft tissues.%目的 探讨经跗骨窦间隙入路手术治疗跟骨关节内骨折的解剖学基础、手术方法及临床疗效评价. 方法 通过对18侧红色乳胶灌注的成人尸体下肢标本进行解剖研究,观测腓动脉终末穿支降支的走行、分支及吻合情况.2001年7月-2008年1月,对68例(71足)跟骨关节内骨折患者采用设计的经跗骨窦间隙入路切开复位内固定治疗.骨折根据Sanders分型:Ⅱ型26足,Ⅲ型32足,Ⅳ型13足. 结果 所有患者平均随访时间39.3个月(13~85个月),随访时骨折均愈合.跟骨长度、宽度、高度、Bohler角

  9. Fracture Surgery of the extremities with the intra-operative use of 3D-RX: A randomized multicenter trial (EF3X-trial

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    Marmor Meir

    2011-07-01

    Full Text Available Abstract Background Posttraumatic osteoarthritis can develop after an intra-articular extremity fracture, leading to pain and loss of function. According to international guidelines, anatomical reduction and fixation are the basis for an optimal functional result. In order to achieve this during fracture surgery, an optimal view on the position of the bone fragments and fixation material is a necessity. The currently used 2D-fluoroscopy does not provide sufficient insight, in particular in cases with complex anatomy or subtle injury, and even an 18-26% suboptimal fracture reduction is reported for the ankle and foot. More intra-operative information is therefore needed. Recently the 3D-RX-system was developed, which provides conventional 2D-fluoroscopic images as well as a 3D-reconstruction of bony structures. This modality provides more information, which consequently leads to extra corrections in 18-30% of the fracture operations. However, the effect of the extra corrections on the quality of the anatomical fracture reduction and fixation as well as on patient relevant outcomes has never been investigated. The objective of this study protocol is to investigate the effectiveness of the intra-operative use of the 3D-RX-system as compared to the conventional 2D-fluoroscopy in patients with traumatic intra-articular fractures of the wrist, ankle and calcaneus. The effectiveness will be assessed in two different areas: 1 the quality of fracture reduction and fixation, based on the current golden standard, Computed Tomography. 2 The patient-relevant outcomes like functional outcome range of motion and pain. In addition, the diagnostic accuracy of the 3D-RX-scan will be determined in a clinical setting and a cost-effectiveness as well as a cost-utility analysis will be performed. Methods/design In this protocol for an international multicenter randomized clinical trial, adult patients (age > 17 years with a traumatic intra-articular fracture of the

  10. 碳素棒外固定支架治疗跟骨开放性骨折的疗效观察%Treatment of open fracture of the calcaneum with a new external fixation

    Institute of Scientific and Technical Information of China (English)

    丁亮; 薛锋; 肖海军; 何志敏; 张东

    2013-01-01

    目的 探讨外支架治疗跟骨开放性骨折的技术方法和治疗效果.方法 2005年3月~2011年12月,对24例跟骨开放性骨折,经急诊清创后实施外固定支架治疗,骨折按按Sanders分型,Ⅱ型12例,Ⅲ型9例,Ⅳ型3例.软组织损伤按Gustilo分类:Ⅰ型12例,Ⅱ型10例,ⅢA型2例.结果 随访5~26个月(平均13.1月),按Maryland足部评分系统评价手术效果,优8例,占33.3%,良12例,占50.0%,可4例,占16.7%,优良率为83.3%.后关节面、B(o)hler角及Gissane角均得到良好的恢复.结论 采用外固定支架治疗跟骨开放性骨折,手术效果良好,且便于软组织损伤的处理,是一种效果理想的治疗方法.%OBJECTIVE To investigate the operative treatment of open fractures of the calcaneus by using a new external fixation.METHODS We have treated 19 displaced intra-articular calcaneal fractures (Sanders type Ⅱ 12,Ⅲ 9,Ⅳ 3).Soft tissue injury according to Gustilo classification:12 cases of type Ⅰ,10 cases of type Ⅱ,2 cases of ⅢA.The patients were treated by reduction and a new external fixation.RESULTS After an average follow-up of 13.1 months (range,5 to 26 months),no complications were found.and all had acceptable reduction.Based on the Maryland grading system,8 feet were excellent,12 good and 4 fair.CONCLUSION The new external fixation approach is a good option for management of open calcaneus fractures.It is simple and effective and easy to deal with soft tissue injury.

  11. The value of calcaneal bone mass measurement using a dual X-ray laser calscan device in risk screening for osteoporosis

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    Gulseren Kayalar

    2009-01-01

    Full Text Available OBJECTIVE: To evaluate how bone mineral density in the calcaneus measured by a dual energy X-ray laser (DXL correlates with bone mineral density in the spine and hip in Turkish women over 40 years of age and to determine whether calcaneal dual energy X-ray laser variables are associated with clinical risk factors to the same extent as axial bone mineral density measurements obtained using dual energy x-ray absorbtiometry (DXA. MATERIALS AND METHODS: A total of 2,884 Turkish women, aged 40-90 years, living in Ankara were randomly selected. Calcaneal bone mineral density was evaluated using a dual energy X-ray laser Calscan device. Subjects exhibiting a calcaneal dual energy X-ray laser T- score <-2.5 received a referral for DXA of the spine and hip. Besides dual energy X-ray laser measurements, all subjects were questioned about their medical history and the most relevant risk factors for osteoporosis. RESULTS: Using a T-score threshold of -2.5, which is recommended by the World Health Organization (WHO, dual energy X-ray laser calcaneal measurements showed that 13% of the subjects had osteoporosis, while another 56% had osteopenia. The mean calcaneal dual energy X-ray laser T-score of postmenopausal subjects who were smokers with a positive history of fracture, hormone replacement therapy (HRT, covered dressing style, lower educational level, no regular exercise habits, and low tea consumption was significantly lower than that obtained for the other group (p<0.05. A significant correlation was observed between the calcaneal dual energy X-ray laser T-score and age (r=-0.465, p=0.001, body mass index (BMI (r=0.223, p=0.001, number of live births (r=-0.229, p=0.001, breast feeding time (r=-0.064, p=0.001, and age at menarche (r=-0.050, p=0.008. The correlations between calcaneal DXL and DXA T-scores (r=0.340, p=0.001 and calcaneal DXL and DXA Z-scores (r=0.360, p=0.001 at the spine, and calcaneal DXL and DXA T- scores (r=0.28, p=0.001 and calcaneal

  12. MORPHOLOGICAL VARIATIONS OF MUSCLE PLANTARIS: ANATOMICAL AND CLINICAL INSIGHT

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    Mohini M Joshi

    2014-10-01

    Full Text Available Background: Plantaris is large muscle in mammals other than primates. Plantaris muscle has long been a subject of much confusion and speculation Evolutionists have speculated on its phylogenetic significance, as a vestigial organ, while surgeons have removed it ‘useless vestige’ to employ its tendon as a spare part for the surgical repair, example tendon transfer operations and reconstruction and as a graft in reconstruction of ligaments etc. In humans it is reduced greatly in size, power, and function and may even be absent. Aim: With this background the aim of the present work is to study morphology, describe the observed variations of the Plantaris muscle, and to discuss the functional significance of Plantaris muscle. Methodology: For the present work 84 limbs available in the department of Anatomy were dissected. The posterior aspect of the knee was dissected using standard surgical equipment and dissection techniques. The Plantaris muscle was isolated and length of fleshy belly and tendon were measured. Any variations in origin, insertion and size were recorded. Result: Mean length of fleshy belly of the Plantaris muscle was 8.39 cm on right side and 8.16 cm on left side. In present study Plantaris muscle was absent 6.66% on right side of the leg; while 12.82 % on left side. In present study variation in insertion of the Plantaris were observed like insertion along medial margin of tendocalcaneus on to calcaneus, in front of tendocalcaneus on to calcaneus, fused to tendocalcaneus and insertion of the Plantaris on deep fascia of leg at the level of ankle. Other variations noted were two bellies of the Plantaris one from lateral supracondylar ridge and other from deep surface of Gastrocnemius, two heads of Plantaris: Both bellies were fused in the lower part producing bipennate arrangement, thin & thick belly of the Plantaris muscle. Variations were also observed in relation to origin that Plantaris muscle originating from deep surface

  13. Screening with ultrasound of the heel may contribute to the prevention in osteoporosis

    Institute of Scientific and Technical Information of China (English)

    Sun Ai-Jun; Megumu Kasai; Jack Wang; John C T; Richard N P

    2005-01-01

    Objective: To calibrate a Quantitative Ultrasonography (QUS) system against densitometry by defining the sensitivity and specificity of the method, and to propose a series of QUS interpretation thresholds to classify the individual risk with regards to the risk of developing osteoporosis in later life. Methods: Subjects were recruited in New York City over a 1-year period. Women with amenorrhea for at least 12 months were defined as postmenopausal, and all other women as premenopausal. Bone mineral density (BMD) was measured with a dual energy X-ray absorptiometer (DXA) and QUS performed with the calcaneus of broadband ultrasound attenuation (BUA) and speed of sound (SOS) using the Lunar Achilles system. Statistical analysis was performed using SPSS software Version 10.0. Results: Two hundred twenty-eight premenopausal and menopausal women were recruited. Most of the participants were Hispanic, Caucasian and African-American in this study. All the subjects had DXA and QUS examined and T-score was got from both. The statistical results showed that the T-score of QUS has a significant relationship with that of DXA(spine: r=0.557, P<0.0001;femur: r=0.611,P<0.0001). Both QUS and DXA T-score has a significant and negative relationship with age (QUS: r=-0.241, P<0.0001; Spine: r=-0.277, P<0.0001; femur: -0.296, P<0.0001). When T-score of heel ultrasound -1.5 was set as the interpretation threshold, the osteoporosis patients with T-score of DXA-femur scan (100%) and DXA-spine (77.10%) less than -2.5 were detected. As well, the specificities of T-score -1.5 of QUS for DXA-femur and DXA-spine were 67.5% and 72.8%, respectively. In addition, if we set -1.0 of T-score of QUS as the cutoff, 74.80% and 79.60% of the osteopenia based on DXA of spine and femur were identified. The specificities were 59.4% and 57.7%. Conclusions: QUS of the calcaneus may be an effective method for providing risk stratification for osteoporosis, and for the closely associated future risk

  14. New method for assessment of skeletal maturity in the first 2 years of life

    Energy Technology Data Exchange (ETDEWEB)

    Hernandez, M.; Sanchez, E.; Sobradillo, B.; Rincon, J.M.; Narvaiza, J.L.

    1988-09-01

    We present an original scoring method for assessing skeletal maturity in the first 2 years of life. We propose a lateral radiograph of the ankle and foot. Five different bony centers were examined: The calcaneus, the cuboid, the third cuneiform, the distal tibial epiphysis and the distal fibular epiphysis. The maturity scores given to the different stages of each bony center were calculated in proportion to the coefficients of regression between the skeletal maturity and a factor that expresses the influence of weight and head circumference as high multiple correlation coefficients of skeletal maturity with the factor obtained (0.920 for boys ad 0.929 for girls). Our method was standardized in a children population of less than two years of life in Biscaye, where 1,164 radiographs were taken. The distribution of scores in this study shows the discriminative ability of our method and its validity as an adequate method for skeletal maturity assessment in children less than 2 years of age.

  15. A novel treatment for bone lesions of multifocal epithelioid sarcoma-like hemangioendothelioma.

    Science.gov (United States)

    Davis, Adrian T; Guo, A Mary; Phillips, Nancy J; Greenberg, David D

    2015-07-01

    Epithelioid sarcoma-like hemangioendothelioma (ES-H) is a rare, indolent vascular neoplasm with characteristics similar to epithelioid sarcoma. It typically affects young males who present with skin and subcutaneous lesions in the extremities. Bone lesions, occurring in approximately 20% of patients, are often multifocal, seen in conjunction with soft tissue lesions, and usually found in bones of the lower extremities. This report details the case of a 20-year-old male who presented with a 1-year history of painful skin lesions on his left lower extremity. Staging studies revealed bone lesions in the cuboid and calcaneus. Bone and soft tissue pathology was consistent with ES-H. The soft tissue lesions were treated with wide excision and the bony lesions with radiofrequency ablation (RFA). The patient had no evidence of recurrence at the 2-year follow-up. Treatment of ES-H typically consists of wide excision of all soft tissue lesions and possible adjuvant radiation therapy. Management of bony lesions has included marginal excision, wide excision, amputation, chemotherapy, observation, or a combination of these modalities. ES-H has the potential for distant metastases. There is no consensus regarding the appropriate treatment of multifocal epithelioid sarcoma-like hemangioendothelioma involving bone. A potential treatment strategy of wide excision of soft tissue lesions and RFA of bone lesions is proposed. PMID:25564226

  16. A new method for assessment of skeletal maturity in the first 2 years of life

    International Nuclear Information System (INIS)

    We present an original scoring method for assessing skeletal maturity in the first 2 years of life. We propose a lateral radiograph of the ankle and foot. Five different bony centers were examined: The calcaneus, the cuboid, the third cuneiform, the distal tibial epiphysis and the distal fibular epiphysis. The maturity scores given to the different stages of each bony center were calculated in proportion to the coefficients of regression between the skeletal maturity and a factor that expresses the influence of weight and head circumference as high multiple correlation coefficients of skeletal maturity with the factor obtained (0.920 for boys ad 0.929 for girls). Our method was standardized in a children population of less than two years of life in Biscaye, where 1,164 radiographs were taken. The distribution of scores in this study shows the discriminative ability of our method and its validity as an adequate method for skeletal maturity assessment in children less than 2 years of age. (orig.)

  17. 3D morphology of the rear foot from MRI data: technical validation and clinical description

    Science.gov (United States)

    Stindel, Eric; Udupa, Jayaram K.; Hirsch, Bruce E.; Odhner, Dewey; Couture, Christine

    1998-06-01

    The purpose of this work is to characterize the 3D morphology of the bones of the rear foot using MR data. This work has two subaims: (1) to study the variability of the various computed architectural measures as a result of the subjectivity and variations in the various processing operations; (2) to study the morphology of the bones included in the peritalar complex. Each image data set utilized in this study consists of 60 longitudinal slices of the foot acquired on a 1.5 T commercial GE MR system. Our description of the rear foot morphology is based mainly on the principal axes, which represent the inertia axes of the bones, as well as on the bone surfaces. We use the live-wire method for segmenting and forming the surfaces of the bones. In the first part of this work, we focus on the dependence of the principal axes system on segmentation and on scan orientation. In the second part, we describe the normal morphology of the rear foot considering the four bones (calcaneus, cuboid, navicular, talus) and compare them to a population from the Upper Pleistocene. We conclude that this non-invasive method can be used in live patients to characterize the bone morphology or as a comparative method to classify population of bones. in spite of the variations involved in the various processing operations.

  18. Clinical and X-ray findings of mycetoma (report of 18 cases)

    International Nuclear Information System (INIS)

    Objective: To investigate the characteristic clinical and X-ray findings of mycetoma and to enhance the understanding of mycetoma. Methods: The clinical and X-ray findings of mycetoma in 18 cases were analyzed with the review of literatures. There were 11 males and 7 females, the age ranged from 21-65 years, with the average of 41.5 year. The cases were all peasants, barefoot and with the history of trauma, which lasted for 4-17 years with the average of 9.8 year. Results: Sixty-seven lesions of bone in 18 cases (30 metatarsal, 20 cuneiform, 7 cuboid, 5 phalanx, 3 tibia, 2 calcaneus) were presented, including 8 rodent, 3 osteolytic, 3 cystic, 2 rodent and sclerosis changes, 2 sclerosis, 9 irregular thickened bony cortex, 7 irregular deleted bony cortex, 12 periosteal reaction, 3 irregular crest of bone in lesion, 13 rarefaction of bone cortex, 11 swimmy of surface arthrosis, 8 constriction of interval arthrosis, 2 spot calcification in the soft tissue, 2 sequestrum, and 2 soft tissue mass. The mycelium had been discovered in grain in 18 cases and the colour of grain was from brown to black. Conclusion: Mycetoma involves extensively and tends to involve multiple bones. The main X-ray findings are rodent and osteolytic changes

  19. Burst Fractures as a Result of Attempted Suicide by Jumping

    Science.gov (United States)

    Kim, Do Young; Park, Jeong Yoon; Kim, Kyung Hyun; Kuh, Sung Uk; Chin, Dong Kyu; Kim, Keun Su; Cho, Yong Eun; Jin, Byoung Ho

    2014-01-01

    Objective Jumping from high place for the purpose of suicide results in various damages to body area. A burst fracture of vertebrae is representative of them and we reviewed eight patients who were diagnosed with spinal burst fracture following suicide falling-down. The demographics, characteristics, performed operation, combined injuries, psychological past histories of the patients were analyzed. Methods A retrospective study was made of patients who are diagnosed with vertebral burst fracture from falling-down with the purpose of suicide admitted to department of neurosurgery of the author's hospital, covering the period between 2003 and 2012. Results Total eight patients were suicidal jumper. There were eleven vertebral burst fractures in eight patients and mean age was 26.5 years old. Seven patients already had psychological past history and there were various combined injuries except vertebrae burst fracture. The ankle fracture such as calcaneus, talus, navicular and malleolus was the most common injury and there were also various combined injury. Conclusion Suicidal jumper is different from incidental faller in some aspects because of different injury mechanism. For managing suicidal jumper, physician had to consider patients' age, affected site, psychiatric problem and combined injuries. Each department related to the injuries of patient have to cooperate each other with departments of psychiatry and rehabilitation from beginning to end.

  20. MRI multiplanar reconstruction in the assessment of congenital talipes equinovarus

    International Nuclear Information System (INIS)

    Background. Magnetic resonance imaging (MRI) has been shown to be a useful tool in the evaluation of the complex deformities which are present in congenital talipes equinovarus (clubfoot). Objective. To evaluate MRI with the multiplanar reconstruction (MPR) technique as a new method for assessment of clubfoot. Materials and methods. Seven infants with 11 clubfeet were studied by using three-dimensional gradient-echo MR sequences. MPR was performed from the acquired image data in orthogonal, single and double oblique planes to demonstrate the complex deformities in clubfoot. Three angles (talar body-neck angle, talocalcaneal left-right angle and the talocalcaneal superior-inferior angle) were defined for measuring the medial angulation of the talar neck and the rotation of the calcaneus in relation to the talus. Results. The method clearly demonstrated the pathological anatomy of the clubfeet, especially the talonavicular articulations. Dislocation of the navicular bone was observed in 9 of the 11 feet. The angle measurements were easily conducted with MPR, and these angles differed considerably among the patients. Conclusions. The information provided by this method is useful for classification of the severity of clubfoot deformities. (orig.)

  1. MRI multiplanar reconstruction in the assessment of congenital talipes equinovarus

    Energy Technology Data Exchange (ETDEWEB)

    Wang Chen [Department of Diagnostic Radiology, Uppsala University Hospital, Uppsala (Sweden)]|[Department of Diagnostic Radiology, Uppsala Univ. (Sweden); Petursdottir, S.; Rehnberg, L. [Department of Orthopaedics, Uppsala University Hospital, Uppsala (Sweden); Leifsdottir, I. [Department of Diagnostic Radiology, Uppsala University Hospital, Uppsala (Sweden); Ahlstroem, H.

    1999-04-01

    Background. Magnetic resonance imaging (MRI) has been shown to be a useful tool in the evaluation of the complex deformities which are present in congenital talipes equinovarus (clubfoot). Objective. To evaluate MRI with the multiplanar reconstruction (MPR) technique as a new method for assessment of clubfoot. Materials and methods. Seven infants with 11 clubfeet were studied by using three-dimensional gradient-echo MR sequences. MPR was performed from the acquired image data in orthogonal, single and double oblique planes to demonstrate the complex deformities in clubfoot. Three angles (talar body-neck angle, talocalcaneal left-right angle and the talocalcaneal superior-inferior angle) were defined for measuring the medial angulation of the talar neck and the rotation of the calcaneus in relation to the talus. Results. The method clearly demonstrated the pathological anatomy of the clubfeet, especially the talonavicular articulations. Dislocation of the navicular bone was observed in 9 of the 11 feet. The angle measurements were easily conducted with MPR, and these angles differed considerably among the patients. Conclusions. The information provided by this method is useful for classification of the severity of clubfoot deformities. (orig.) With 5 figs., 1 tab., 16 refs.

  2. Precision of different quantitative ultrasound densitometers

    International Nuclear Information System (INIS)

    Full text: Quantitative ultrasound (QUS) of the calcaneus, which measures Speed of Sound (SOS) and Broadband ultrasound attenuation (BUA), is predictive of the risk of osteoporotic fracture. However, the utility of QUS for predicting fracture risk or for monitoring treatment efficacy depends on its precision and reliability. Published results and manufacturers data vary significantly due to differences in statistical methodology. We have assessed the precision of the current model of the Lunar Achilles and the McCue Cuba QUS densitometers; the most commonly used QUS machines in Australia. Twenty seven subjects had duplicate QUS measurements performed on the same day on both machines. These data were used to calculate the within pair standard deviation (SD) the co-efficient of variation, CV and the standardised co efficient of variation (sCV) which is corrected for the dynamic range. In addition, the co-efficient of reliability (R) was calculated as an index of reliability which is independent of the population mean value, or the dynamic range of the measurements. R ranges between 0 (for no reliability) to 1(for a perfect reliability). The results indicate that the precision of QUS is dependent on the dynamic range and the instrument. Furthermore, they suggest that while QUS is a useful predictor of fracture risk, at present it has limited clinical value in monitoring short term age-related bone loss of 1-2% per year

  3. Osteosclerotic metaphyseal dysplasia: a skeletal dysplasia that may mimic lead poisoning in a child with hypotonia and seizures

    International Nuclear Information System (INIS)

    We report the case of a 23-month-old male with hypotonia, developmental delay, and complex seizures. Radiographs revealed profound sclerosis of the metaphyses and epiphyses of the long and short bones in the extremities, with a unique pattern of distribution. Sclerosis also involved the anterior ribs, iliac crests, talus, and calcaneus. The skull and vertebral bodies appeared unaffected. Blood lead levels were normal. We believe that this constellation of clinical and radiographic abnormalities closely resembles osteosclerotic metaphyseal dysplasia (OMD) due to an autosomal recessive defect. Characteristic skeletal findings were instrumental in determining the diagnosis. OMD is a very rare sclerosing bone disorder, first described in 1993. The syndrome is characterized clinically by developmental delay of a progressive nature, hypotonia, elevated alkaline phosphatase, and late-onset spastic paraplegia. We encountered a young child with these neurologic symptoms who displayed sclerotic metaphyseal changes on hand radiographs obtained to determine the bone age. Lead poisoning, a known cause of metaphyseal sclerosis, was initially suspected. Careful analysis of the metaphyseal bone changes helped to distinguish this bone dysplasia from lead poisoning and other causes of metaphyseal sclerosis. (orig.)

  4. Treatment of a High-Risk Diabetic Patient with Peripheral Vascular Disease and Osteomyelitis.

    Science.gov (United States)

    Allen, Latricia L; Kalmar, Garrett; Driver, Vickie R

    2016-06-01

    We report a case of calcaneal osteomyelitis that was surgically resected from a patient with diabetes and peripheral vascular disease. A 91-year-old male with history of type 2 diabetes, peripheral vascular disease, balloon angioplasty, and recent (2 months ago) stent of the superficial femoral artery presented to the emergency department with a left heel wound infection probed to bone. The patient reported having been on intravenous Zosyn for several months via an outside infectious disease provider for clinical suspicion of osteomyelitis, but noted no improvement. This report includes information regarding the clinical examination and imaging findings, which were used to assess this high-risk patient. Our patient underwent a partial calcanectomy and completed a 6-week course of intravenous antibiotics. The purpose of this case report is to illustrate limb preservation in a high-risk patient with compromised vascular supply who underwent a partial calcanectomy for treatment of calcaneal osteomyelitis. The patient underwent surgical resection of the calcaneus without complications and healed unremarkably with the ability to ambulate while wearing an ankle foot orthosis with a custom shoe. This report was authorized for publication as an educational report to contribute to generalizable knowledge and does not include any patient health information. PMID:27423990

  5. Effect of gender, age and anthropometric variables on plantar fascia thickness at different locations in asymptomatic subjects

    Energy Technology Data Exchange (ETDEWEB)

    Pascual Huerta, Javier [Department of Podiatry, Universidad Europea de Madrid (Spain)]. E-mail: javier.pascual@uem.es; Alarcon Garcia, Juan Maria [Ultrasound Unit, Hospital Nuestra Senora de America, Madrid (Spain)

    2007-06-15

    Purpose: The study was aimed to investigate plantar fascia thickness at different locations in healthy asymptomatic subjects and its relationship to the following variables: weight, height, sex and age. Material and methods: The study evaluates 96 feet of healthy asymptomatic volunteers. The plantar fascia thickness was measured at four different locations: 1 cm proximal to the insertion of the plantar fascia, at the insertion of the plantar fascia on the calcaneus and separate out 1 cm + 2 cm distal to the insertion. A 10 MHz linear-array transducer was used. Results: There were statistically significant differences in plantar fascia thickness at the four different locations (p < 0.001) although no differences in PF thickness were found between the two distal from insertion locations (1 and 2 cm). Multiple regression analysis showed sex as independent predictor of plantar fascia thickness at 1 cm proximal to the insertion. At origin and 1 cm distal to insertion weight was an independent predictor of plantar fascia thickness. Conclusions: There are differences of thickness at different locations of plantar fascia measured by ultrasonography. Thickness at 1 cm proximal to the insertion is influenced by sex and thickness at origin and at 1 cm distal to the insertion has a direct relationship with body weight. This could be attributed to the overloading effect that weight has on plantar fascia in healthy symptomatic subjects at these two locations. Height and age did not seem to influence as independent variables in plantar fascia thickness among non-painful subjects.

  6. Dioxin-like compounds are not associated with bone strength measured by ultrasonography in Inuit women from Nunavik (Canada: results of a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Alexandra-Cristina Paunescu

    2013-05-01

    Full Text Available Background. Bone strength in Inuit people appears lower than that of non-Aboriginals. Inuit are exposed to persistent organic pollutants including dioxin-like compounds (DLCs through their traditional diet that comprises predatory fish and marine mammal fat. Results from experimental and population studies suggest that some DLCs can alter bone metabolism and increase bone fragility. Objective. This cross-sectional descriptive study was conducted to examine the relationship between the stiffness index (SI and plasma concentrations of total DLCs or specific dioxin-like polychlorinated biphenyls (DL-PCBs in Inuit women of Nunavik (Northern Quebec, Canada. Methods. SI was determined by ultrasonography at the right calcaneus of 194 Inuit women aged 35–72 years who participated to Qanuippitaa? How Are We? Nunavik Inuit Health Survey in 2004. Plasma total DLC levels were quantified by measuring the aryl hydrocarbon receptor–mediated transcriptional activity elicited by plasma sample extracts in a cell-based reporter gene assay. Plasma concentrations of DL-PCBs nos. 105, 118, 156, 157, 167 and 189 were measured by gas chromatography–mass spectrometry. We used multiple linear regression analyses to investigate relations between total DLCs or specific DL-PCBs and SI, taking into consideration several potential confounders. Results. Neither total plasma DLCs nor specific DL-PCBs were associated with SI after adjustment for several confounders and covariates. Conclusion. Our results do not support a relation between exposure to DLCs and bone strength measured by ultrasonography in Inuit women of Nunavik.

  7. Os Trigonum Syndrome: A Case Study

    Directory of Open Access Journals (Sweden)

    Yasemin Turan

    2013-05-01

    Full Text Available Os trigonum syndrome is one of the rare causes of posterior foot pain. Ostrigonum, which is placed at the posterior of talus, is an accessory bone. Ostrigonum syndrome causes back foot pain due to compression between talusand calcaneus. In this study, we present a case of os trigonum syndrome ,which is a rare disease and is generally missed. A 65-year-old female patientwith a complaint of left foot pain for the last 2 months persented to our outpatientclinic. In the physical examination, plantar flexion of the ankle andtoe was painful. Patient’s pain was evaluated by the visual analog scale andnoted as 8 cm. There was sensitivity at the posterior of talus during palpation.Os trigonum syndrome was diagnosed based on radiological examinationsand a physical therapy program consisting of transcutaneous electrical nervestimulation (TENS, cold pack, foot and ankle range of motion and strengtheningexercises was started. After the treatment, pain VAS decreased to 2cm,and then the patient was followed clinically. As in our case, os trigonum syndromeshould also be taken into consideration in patients complaining withposterior foot pain apart from other frequently encountered causes. In suchcases, physical therapy programs are very effective in pain management andin reducing the cost of treatment. Turk J Phys Med Rehab 2013;59:161-4.

  8. MECHANISMS FOR TRICEPS SURAE INJURY IN HIGH PERFORMANCE FRONT ROW RUGBY UNION PLAYERS: A KINEMATIC ANALYSIS OF SCRUMMAGING DRILLS

    Directory of Open Access Journals (Sweden)

    Carol A. Flavell

    2013-03-01

    Full Text Available The front row of a rugby union scrum consists of three players. The loose head prop, hooker and tight head prop. The objective of this study was to determine if known biomechanical risk factors for triceps surae muscle injury are exhibited in the lower limb of front row players during contested scrummaging. Eleven high performance front row rugby union players were landmarked bilaterally at the posterior superior iliac spine (PSIS, greater trochanter, lateral femoral epicondyle, midline of the calcaneus above the plantar aspect of the heel, midline lower leg 5cm and 20cm proximal to the lateral malleolus, at the axis of subtalar joint, lateral malleolus, and head of the fifth metatarsal. Players were video recorded during a series of 2 on 1 live scrummaging drills. Biomechanical three dimensional analysis identified large angular displacements, and increased peak velocities and accelerations at the ankle joint during attacking scrummaging drill techniques when in the stance phase of gait. This places the triceps surae as increased risk of injury and provides valuable information for training staff regarding injury prevention and scrum training practices for front row players

  9. Influence of cortical endplates on ultrasonic properties of trabecular bone

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yoon Mi; Lee, Kang Il [Dept. of Physics, Kangwon National University, Chuncheon (Korea, Republic of)

    2015-04-15

    The present study investigated the influence of thick cortical endplates on the ultrasonic properties of trabecular bone in a femur with a high fracture risk. Twelve trabecular bone samples were prepared from bovine femurs, and acrylic plates with thicknesses of 1.25, 1.80, and 2.75 mm were manufactured to simulate the cortical endplates using acrylic with a density and a sound speed similar to cortical bone. Although the thickness of the acrylic plates attached to the two sides of the trabecular bone increased, high correlations were observed between the speed of sound and the apparent bone density of the trabecular bone, with Pearson's correlation coefficients of 0.80-0.86. High correlations were also observed between the attenuation coefficient at 0.5 mm and the apparent bone density of the trabecular bone, with Pearson's correlation coefficients of 0.84-0.91. These results suggest that the speed of sound and attenuation coefficient at a specific frequency measured in a femur with relatively thick cortical endplates compared to the calcaneus could be used as indices for predicting the bone mineral density of the femur.

  10. Super-oxidized solution (Dermacyn Wound Care) as adjuvant treatment in the postoperative management of complicated diabetic foot osteomyelitis: preliminary experience in a specialized department.

    Science.gov (United States)

    Aragón-Sánchez, Javier; Lázaro-Martínez, Jose Luis; Quintana-Marrero, Yurena; Sanz-Corbalán, Irene; Hernández-Herrero, Maria J; Cabrera-Galván, Juan J

    2013-06-01

    Surgery is usually used to treat diabetic foot osteomyelitis (DFO), whether primarily or in cases in which antibiotics are not able to control infection. In many cases, the bone is only partially removed, which means that residual infection remains in the bone margins, and the wound is left open to heal by secondary intent. The use of culture-guided postoperative antibiotic treatment and adequate management of the wound must be addressed. No trials exist dealing with local treatment in the postoperative management of these cases of complicated DFO. We decided to test a super-oxidized solution, Dermacyn Wound Care (DWC; Oculus Innovative Sciences Netherlands BV, Sittard, Netherlands) to obtain preliminary experience in patients in whom infected bone remained in the surgical wounds. Our hypothesis was that DWC could be useful to control infection in the residual infected bone and surrounding soft tissues and would thus facilitate healing. Fourteen consecutive patients who underwent conservative surgery for DFO, in whom clean bone margins could not be assured, were treated in the postoperative period with DWC. Eleven cases were located in the forefoot, 6 on the first ray and the rest in lesser toes, 1 in the Lisfranc joint, and 2 on the calcaneus. No side effects appeared during treatment. Neither allergies nor skin dermatitis were found. Limb salvage was successfully achieved in 100% of the cases. Healing was achieved in a median period of 6.8 weeks. PMID:23446366

  11. Dependences of Ultrasonic Parameters for Osteoporosis Diagnosis on Bone Mineral Density

    International Nuclear Information System (INIS)

    Quantitative ultrasound technologies for osteoporosis diagnosis measure ultrasonic parameters such as speed of sound(SOS) and normalized broadband ultrasound attenuation(nBUA) in the calcaneus (heel bone). In the present study, the dependences of SOS and nBUA on bone mineral density in the proximal femur with high risk of fracture were investigated by using 20 trabecular bone samples extracted from bovine femurs. SOS and nBUA in the femoral trabecular bone samples were measured by using a transverse transmission method with one matched pair of ultrasonic transducers with a center frequency of 1.0 MHz. SOS and nBUA measured in the 20 trabecular bone samples exhibited high Pearson's correlation coefficients (r) of r = 0.83 and 0.72 with apparent bone density, respectively. The multiple regression analysis with SOS and nBUA as independent variables and apparent bone density as a dependent variable showed that the correlation coefficient r = 0.85 of the multiple linear regression model was higher than those of the simple linear regression model with either parameter SOS or nBUA as an independent variable. These high linear correlations between the ultrasonic parameters and the bone density suggest that the ultrasonic parameters measured in the femur can be useful for predicting the femoral bone mineral density.

  12. Effect of Retrograde Reaming for Tibiotalocalcaneal Arthrodesis on Subtalar Joint Destruction: A Cadaveric Study.

    Science.gov (United States)

    Lowe, Jason A; Routh, Lucas K; Leary, Jeffrey T; Buzhardt, Paul C

    2016-01-01

    Recent published data have suggested successful union of subtalar and tibiotalar joints without formal debridement during tibiotalocalcaneal (TTC) fusion procedures. Although previous studies have reported on the importance of the proper guidewire starting point and trajectory to obtain appropriate hindfoot alignment for successful fusion, to our knowledge, no studies have quantified the amount of articular damage to the subtalar joint with retrograde reaming. We hypothesized that reaming would destroy >50% of the posterior facet of the subtalar joint. The bilateral lower extremities of 5 cadavers were obtained and the subtalar joints exposed. Retrograde TTC nail guidewires were inserted, and a 12-mm reamer was passed through the subtalar and ankle joints. Pre- and postreaming images of the subtalar joint were obtained to compare the amount of joint destruction after reaming. We found an average of 5.89% articular destruction of the talar posterior facet and an average of 4.01% articular destruction of the posterior facet of the calcaneus. No damage to the middle facets of the subtalar joint was observed. TTC nailing is a successful procedure for ankle and subtalar joint fusion. Published studies have reported successful subtalar union using TTC nailing without formal open debridement of the subtalar joint, preserving the soft tissue envelope. TTC nail insertion using a 12-mm reamer will destroy 5.89% and 4.01% of the respective talar and calcaneal posterior facets of the subtalar joint. PMID:26372551

  13. The exploration of the changes in bone metabolism in patients with abnormal thyroid function

    International Nuclear Information System (INIS)

    To explore the changes in bone metabolism with abnormal thyroid function, BGP and PTH in 91 patients with hyperthyroidism, 37 patients with hypothyroidism, 51 controls, were measured by means of IRMA, calcaneus heel bone density (BMD) was measured by means of 241Am single photon absorptiometry. BGP levels in hyperthyroidism were significantly higher than those in controls (P < 0.001). BGP levels in hypothyroidism were significantly lower than those in controls (P < 0.001). PTH levels in hyperthyroidism were a little lower than those in controls (P < 0.05). PTH levels in hypothyroidism were significantly higher than those in controls (P < 0.001). The measurement of BMD showed that the prevalence rates of osteoporosis (OP) in hyperthyroidism and hypothyroidism were significantly higher than those in controls. In hyperthyroidism and hypothyroidism groups the age of OP tends to be younger. The patients with hyperthyroidism over 55 years of age were all suffered from OP. The changes in BGP and PTH were earlier than BMD, so BGP and PTH can be used as sensitive indicator of the changes in bone metabolism with abnormal thyroid function, especially for curative effect observations

  14. [Changes in bones of the foot and development of inserting tendons of the lower leg musculature in tibial aplasia].

    Science.gov (United States)

    Selke, B; Bogusch, G

    1989-01-01

    Skeleton, muscles and tendons were investigated in 3 lower legs with aplasia of the tibia. The tibiofibular joint appears to be rather a syndesmosis than a diarthrosis. In all 3 cases, talus and calcaneus are connected by a synostosis. Also in the other parts of the skeleton of the feet, synarthroses with different extensions are found. The muscles, normally originating from the tibia, have shifted their origin to the fibula. The proximal part of the inserting tendons under the retinacula is quite normal. Also, their distal part in the region of the metatarsalia and of the digits exhibits no alterations. In the region of the tarsus in which already alterations in bone formation are found, the tendons of the flexor muscles of the toes exhibit some variations. Often the muscles show a new, strong insertion into the bones of the tarsus. The normal connection between the proximal and distal parts of the tendons is sometimes still indicated by a thin bundle of collagenous fibers. In all 3 cases, the tibialis anterior muscle inserts into the distal part of the tendons of the flexor muscles of the toes, indicating that there are also connections between tendons of muscles from different blastemas. PMID:2816255

  15. Dependences of Ultrasonic Parameters for Osteoporosis Diagnosis on Bone Mineral Density

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Kyo Seung; Kim, Yoon Mi; Park, Jong Chan; Choi, Min Joo; Lee, Kang Il [Department of Physics, Kangwon National University, Chuncheon (Korea, Republic of)

    2012-10-15

    Quantitative ultrasound technologies for osteoporosis diagnosis measure ultrasonic parameters such as speed of sound(SOS) and normalized broadband ultrasound attenuation(nBUA) in the calcaneus (heel bone). In the present study, the dependences of SOS and nBUA on bone mineral density in the proximal femur with high risk of fracture were investigated by using 20 trabecular bone samples extracted from bovine femurs. SOS and nBUA in the femoral trabecular bone samples were measured by using a transverse transmission method with one matched pair of ultrasonic transducers with a center frequency of 1.0 MHz. SOS and nBUA measured in the 20 trabecular bone samples exhibited high Pearson's correlation coefficients (r) of r = 0.83 and 0.72 with apparent bone density, respectively. The multiple regression analysis with SOS and nBUA as independent variables and apparent bone density as a dependent variable showed that the correlation coefficient r = 0.85 of the multiple linear regression model was higher than those of the simple linear regression model with either parameter SOS or nBUA as an independent variable. These high linear correlations between the ultrasonic parameters and the bone density suggest that the ultrasonic parameters measured in the femur can be useful for predicting the femoral bone mineral density.

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

    Science.gov (United States)

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

    2008-01-01

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

  17. Long-term reproducibility optimization of an x-ray process for bone architectural evaluation during osteoporosis

    International Nuclear Information System (INIS)

    Non-invasive and in vivo assessment of bone architectural changes at high resolution is of considerable interest in osteoporosis. In this note, the use of an x-ray acquisition system in the evaluation of the architectural quality of trabecular bone by radiographic texture analysis is optimized to achieve good long-term reproducibility. First, radiographic and digitization processes are modelled and defined. Procedures to make radiographs and their digital images are fixed. Then, measurements of the modulation transfer function (MTF) of the entire acquisition chain were completed. These measurements provide an MTF in excess of 30% at a spatial frequency of 2.5 lp/mm. Also, results of a fractal texture analysis made on digital images of calcaneus radiographs show a mean coefficient of variation of 2.07%. These data show that good long-term reproducibility can make the x-ray acquisition system efficient for patient follow-up, or evaluation of treatment regimes for osteoporosis. Finally, it is shown that fractal texture parameters are statistically different in an osteoporotic population and in a control group. Therefore, this system should also be of medical interest. (author)

  18. Suicidio por salto al vacío

    Directory of Open Access Journals (Sweden)

    Braulio Ernesto P. Linares

    1995-05-01

    Full Text Available La tendencia al suicidio se asocia con problemas de soledad, abandono sicológico en la infancia, drogadicción, enfermedades graves, etc. Y en pacientes psiquiátricos es más común tras ser dados de alta. En Argentina los suicidios aumentaron en 25% de 1990 a 1992, y el 78 % de las víctimas fueron de sexo masculino. La proporción por salto al vacío aumentó , especialmente en áreas urbanas. En 40 casos argentinos hubo introducción basal del fémur (25%, fractura del calcáneo en 17%, fracturas de pelvis o cuello del fémur en 7% y estallido hepático en 20%.Suicidal tendencies are associated with loneliness, lack of psychological attention during childhood, drug addiction, serious illness, etc., In psyciatric patients, it is more frequent shortly after they are dismissed from the hospital. In Argentina, the suicide rate increased by 25% from 1990 to 1992, and 78% of the victims are males. The proportion that jumped to death increased, particularly inurban areas. In 40 Argentinian cases there was a basalpenetration of the femur (25%, fracture of the calcaneus bone (17%, fracture of pelvis o femur cervix (7% and explosion of the liver (20%.

  19. A novel finite element method based biomechanical model for HIT-robot assisted orthopedic surgery system.

    Science.gov (United States)

    Jia, Zhiheng; Du, Zhijiang; Wang, Monan

    2006-01-01

    To build a biomechanical human model can make much sense for surgical training and surgical rehearse. Especially, it will be more meaningful to develop a biomechanical model to guide the control strategy for the medical robots in HIT-Robot Assisted Orthopedic Surgery System (HIT-RAOS). In this paper, based the successful work of others, a novel reliable finite element method based biomechanical model for HIT-RAOS was developed to simulate the force needed in reposition procedure. Geometrical model was obtained from 3D reconstruction from CT images of a just died man. Using this boundary information, the finite element model of the leg including part of femur, broken upper tibia, broken lower tibia, talus, calcaneus, Kirschner nail, muscles and other soft tissues was created in ANSYS. Furthermore, as it was too difficult to reconstruct the accurate geometry model from CT images, a new simplified muscle model was presented. The bony structures and tendons were defined as linearly elastic, while soft tissues and muscle fibers were assumed to be hyper elastic. To validate this model, the same dead man was involved to simulate the patient, and a set of data of the force needed to separate the two broken bones and the distance between them in reposition procedure was recorded. Then, another set of data was acquired from the finite element analysis. After comparison, the two sets of data matched well. The Finite Element model was proved to be acceptable. PMID:17959437

  20. Sex estimation from the tarsal bones in a Portuguese sample: a machine learning approach.

    Science.gov (United States)

    Navega, David; Vicente, Ricardo; Vieira, Duarte N; Ross, Ann H; Cunha, Eugénia

    2015-05-01

    Sex estimation is extremely important in the analysis of human remains as many of the subsequent biological parameters are sex specific (e.g., age at death, stature, and ancestry). When dealing with incomplete or fragmented remains, metric analysis of the tarsal bones of the feet has proven valuable. In this study, the utility of 18 width, length, and height tarsal measurements were assessed for sex-related variation in a Portuguese sample. A total of 300 males and females from the Coimbra Identified Skeletal Collection were used to develop sex prediction models based on statistical and machine learning algorithm such as discriminant function analysis, logistic regression, classification trees, and artificial neural networks. All models were evaluated using 10-fold cross-validation and an independent test sample composed of 60 males and females from the Identified Skeletal Collection of the 21st Century. Results showed that tarsal bone sex-related variation can be easily captured with a high degree of repeatability. A simple tree-based multivariate algorithm involving measurements from the calcaneus, talus, first and third cuneiforms, and cuboid resulted in 88.3% correct sex estimation both on training and independent test sets. Traditional statistical classifiers such as the discriminant function analysis were outperformed by machine learning techniques. Results obtained show that machine learning algorithm are an important tool the forensic practitioners should consider when developing new standards for sex estimation. PMID:25186617

  1. CT for diagnosing fractures of the undersurface of the talus and mechanism of injury

    International Nuclear Information System (INIS)

    Talus fractures whose fracture lines extend to the subtalar joint, except fractures of the neck and the body of the talus, are defined as fractures of the lower portion of the talus. It is difficult to make a correctly diagnosis of inferior fractures of the talus by plain radiography or tomography alone. The author encountered 12 cases of inferior fractures of the talus between 1989 and 1997, and CT imaging in 2 directions, in the horizontal and frontal plane, was useful in making the diagnosis. The correct diagnosis rate was 100%, and differentiation of the site and extent of the fractures was possible. Based on the CT findings, the fractures were classified into 8 types (fractures of the lateral process of the talus, fractures of the medial tubercle, fractures of the posterior process, and combinations of the above, and comminuted fractures). The mechanism of the injuries was also investigated, and the fractures of the lateral process of the talus seemed to have been caused by excessive eversion force on the ankle joint, with the lateral process becoming trapped between the fibula and the calcaneus. Medial tubercle fractures also seemed to be caused by forcible inversion of the ankle, with the tip of the medial malleous impacting and the medial tubercle being trapped between it and the sustentaculum tali. The comminuted fractures seem to have been caused by axial compression added to various of external forces. (K.H.)

  2. Functional total and subtotal heel reconstruction with free composite osteofasciocutaneous groin flaps of the deep circumflex iliac vessels.

    Science.gov (United States)

    Peek, Alberto; Giessler, Goetz A

    2006-06-01

    Functional and esthetic reconstruction of the bony and tendinous structures with a stable, sensate soft tissue integument after complex posttraumatic defects of the heel is demanding. Cases are rare in the literature and hardly comparable due to their heterogeneity. The reconstructive approach has to consider both patient profile and the reconstructive tree, with free microvascular flaps playing a primary role. The goals are the reconstruction of both osteotendinous structures and slender soft tissue lining for proper shoe fitting for ambulation and mechanical and thermal protection. The flap should be sensate in weightbearing areas to optimize gait and to prevent long-term complications by ulcers. The osteofasciocutaneous deep inferior circumflex artery (DCIA) flap is especially suitable for complex heel defects with subtotal or total loss of the calcaneal bone as all components (iliac bone, groin skin, and fascia lata) can have a wide range of size and shape. We operated on 2 cases with this variable composite flap. One patient had a complete heel defect by war shrapnel. The complete calcaneus, soft heel, and Achilles tendon were reconstructed. The second patient had an empty os calcis after a comminuted fracture and a lateral crush-induced soft tissue defect. In both patients, a stable wound closure, osseous integration, and weightbearing ambulation could be achieved. PMID:16721075

  3. Influence of cortical endplates on ultrasonic properties of trabecular bone

    International Nuclear Information System (INIS)

    The present study investigated the influence of thick cortical endplates on the ultrasonic properties of trabecular bone in a femur with a high fracture risk. Twelve trabecular bone samples were prepared from bovine femurs, and acrylic plates with thicknesses of 1.25, 1.80, and 2.75 mm were manufactured to simulate the cortical endplates using acrylic with a density and a sound speed similar to cortical bone. Although the thickness of the acrylic plates attached to the two sides of the trabecular bone increased, high correlations were observed between the speed of sound and the apparent bone density of the trabecular bone, with Pearson's correlation coefficients of 0.80-0.86. High correlations were also observed between the attenuation coefficient at 0.5 mm and the apparent bone density of the trabecular bone, with Pearson's correlation coefficients of 0.84-0.91. These results suggest that the speed of sound and attenuation coefficient at a specific frequency measured in a femur with relatively thick cortical endplates compared to the calcaneus could be used as indices for predicting the bone mineral density of the femur.

  4. An axially symmetric gamma-ray backscatter system for DuMond spectrometry

    International Nuclear Information System (INIS)

    An axially symmetric spectrometer is described which evolved from a program of measuring Compton profiles with unusually high geometric efficiency. When fitted with a large-volume Ge detector for combined X-ray and γ-ray spectrometry, such as the 51 mm diameter LO-AX detector from EG and G, it allows Compton profiles to be measured at counting rates in excess of 20000 cps. The axially symmetric configuration is also suited to high-efficiency analyses of thick targets by both XRF and Rayleigh/Compton (R/C) ratios. The same spectra permit a competitive binary-system analysis based on the shape of the Compton profile. Both this new analysis, which we call DuMond spectrometry, and R/C analysis are applied to studies of osteoporosis in the calcaneus with promising results. The combination of high intrinsic and geometric detection efficiency makes it practical to use very weak sources (≅ 100 MBq) and unusually low, localized doses (≅ 1 μGy) per reading. (orig.)

  5. Biomechanical and structural parameters of tendons in rats subjected to swimming exercise.

    Science.gov (United States)

    Bezerra, M A; Santos de Lira, K D; Coutinho, M P G; de Mesquita, G N; Novaes, K A; da Silva, R T B; de Brito Nascimento, A K; Inácio Teixeira, M F H B; Moraes, S R A

    2013-12-01

    The aim of this study was to evaluate the effect of swimming exercise, without overloading, on the biomechanical parameters of the calcaneal tendon of rats. 27 male Wistar rats (70 days) were distributed randomly into 2 groups, Control Group (CG; n=15) with restricted movements inside the cage and Swimming Group (SG; n=12), subjected to exercise training in a tank with a water temperature of 30±1°C, for 1 h/day, 5 days/week for 8 weeks. All animals were kept in a reversed light/dark cycle of 12 h with access to food and water ad libitum. After that, they were anesthetized and had their calcaneus tendons collected from their left rear paws. The tendon was submitted to a mechanical test on a conventional test machine. From the stress vs. strain curve, the biomechanical data were analyzed. For the statistical analysis, the Student-T test was used (pexercise training, without overloading, was an important stimulus for improving the biomechanical parameters and structural properties of the calcaneal tendon. PMID:23740340

  6. Unilateral Absence of Plantaris muscle in Ethiopian Cadavers – a case report

    Directory of Open Access Journals (Sweden)

    Hafte Assefa Beyene

    2016-02-01

    Full Text Available Plantaris is the largest muscle in mammals other than primates. It runs alongside the gastrosoleus complex, and continues along the medial aspect of the Achilles tendon (AT before inserting onto the greater tuberosity of the calcaneus. The plantaris muscle is vestigial in human beings and has much clinical importance. It is known to present several anatomical variations in terms of its occurrence, origin, course, relation with surrounding neurovascular structures and insertion. It may be absent unilaterally or bilaterally. The plantaris muscle is absent in 7–10% of the human population. Two such variations were observed unilaterally in the present report in which absence of the right plantaris muscle were seen in the right lower limb of the two cadavers. Despite its vestigial nature, injury to plantaris muscle can present a diagnostic challenge among clinicians and radiologists. Surgical importance of the muscle lies in successful use of its tendon for reconstructive surgery. Therefore, Knowledge of anatomical variations of the plantaris muscle is important for physiotherapists, plastic surgeons performing tendon transfer operations, clinicians diagnosing muscle tears and radiologists interpreting MRI scans.

  7. Exploring Eucladoceros ecomorphology using geometric morphometrics.

    Science.gov (United States)

    Curran, Sabrina C

    2015-01-01

    An increasingly common method for reconstructing paleoenvironmental parameters of hominin sites is ecological functional morphology (ecomorphology). This study provides a geometric morphometric study of cervid rearlimb morphology as it relates to phylogeny, size, and ecomorphology. These methods are then applied to an extinct Pleistocene cervid, Eucladoceros, which is found in some of the earliest hominin-occupied sites in Eurasia. Variation in cervid postcranial functional morphology associated with different habitats can be summarized as trade-offs between joint stability versus mobility and rapid movement versus power-generation. Cervids in open habitats emphasize limb stability to avoid joint dislocation during rapid flight from predators. Closed-adapted cervids require more joint mobility to rapidly switch directions in complex habitats. Two skeletal features (of the tibia and calcaneus) have significant phylogenetic signals, while two (the femur and third phalanx) do not. Additionally, morphology of two of these features (tibia and third phalanx) were correlated with body size. For the tibial analysis (but not the third phalanx) this correlation was ameliorated when phylogeny was taken into account. Eucladoceros specimens from France and Romania fall on the more open side of the habitat continuum, a result that is at odds with reconstructions of their diet as browsers, suggesting that they may have had a behavioral regime unlike any extant cervid. PMID:25338504

  8. Lower extremity injury criteria for evaluating military vehicle occupant injury in underbelly blast events.

    Science.gov (United States)

    McKay, Brian J; Bir, Cynthia A

    2009-11-01

    Anti-vehicular (AV) landmines and improvised explosive devices (IED) have accounted for more than half of the United States military hostile casualties and wounded in Operation Iraqi Freedom (OIF) (Department of Defense Personnel & Procurement Statistics, 2009). The lower extremity is the predominantly injured body region following an AV mine or IED blast accounting for 26 percent of all combat injuries in OIF (Owens et al., 2007). Detonations occurring under the vehicle transmit high amplitude and short duration axial loads onto the foot-ankle-tibia region of the occupant causing injuries to the lower leg. The current effort was initiated to develop lower extremity injury criteria for occupants involved in underbelly blast impacts. Eighteen lower extremity post mortem human specimens (PMHS) were instrumented with an implantable load cell and strain gages and impacted at one of three incrementally severe AV axial loading conditions. Twelve of the 18 PMHS specimens sustained fractures of the calcaneus, talus, fibula and/or tibia. The initiation of skeletal injury was precisely detected by strain gages and corresponded with local peak axial tibia force. Survival analysis identified peak axial tibia force and impactor velocity as the two best predictors of incapacitating injury. A tibia axial force of 5,931 N and impactor velocity of 10.8 m/s corresponds with a 50 percent risk of an incapacitating injury. The criteria may be utilized to predict the probability of lower extremity incapacitating injury in underbelly blast impacts. PMID:20058557

  9. In vivo measurement of lead in the bones of smelter workers using the four-element 'clover-leaf' geometry detector system

    International Nuclear Information System (INIS)

    A total of 497 smelter employees from New Brunswick participated in a bone lead survey conducted by McMaster University in 2008 to examine the efficiency of lead exposure control programmes and a four-element 'clover-leaf' geometry detector system. Nearly 42% of the subjects had participated in both the previous surveys performed in 1994 and 1999. After developing the clover-leaf geometry system in 2006, the reliability of the system based on examining the consistency of four detectors and improving the minimum detection limit (MDL) was tested for the first time in 2008 by measuring lead levels of a large population that was occupationally exposed to lead. The Z test was used to study the distribution of the lead concentration calculated based on Kα and Kβ lead x-rays, where the results were broadly consistent with a normal distribution criterion, with relatively small means and standard deviations of between 1 and 2. The MDL of the clover-leaf geometry system was improved on average for tibia and calcaneus by a factor of 3.1 compared to the 1999 and 1994 surveys in which a conventional system (one detector) was used. Furthermore, by comparing the results of the three mentioned surveys, the 2008 results were found to represent the highest precision.

  10. Correlations of radiological assessment of skeletal maturity and orthopaedic injuries in the standardbred

    International Nuclear Information System (INIS)

    The aim of this study was to define a correlation between the incidence of orthopaedic injuries and the skeletal maturity, radiologically assessed, in a group of 23 standardbred horses. Starting at 18 months of age, radiograms of calcaneus and distal radial physis were taken at two months intervals, until X-ray evidence of closure. All the physis were blindly graded as: C: open physis; B-: initial evidence of central closure; B: partially closed physis; B+: full closure of the central portion of the physis; A: closed physis. Based on this classification, the horses were grouped as I (immature subject - C, B- and B), or M (mature subject - B+ and A). Orthopaedic injuries were classified as major lesion, if causing prolonged or definitive interruption of training, or minor, if causing brief or no interruption of training. Estimation of injury incidence in the different groups was calculated using the chi-square test (significance level P0.01). The average ages of physis closure (mean +- SD) were 24.1 +- 2.6 months (range 19-28), for the calcaneal physis, and 28.2 +- 2 months (range 26-33), for the distal radial physis, without significant differences between colts and fillies. In our study, according to a previous report, no correlation between X-ray skeletal maturity and incidence of orthopaedic injuries was demonstrated

  11. The Association between Coffee Consumption and Bone Status in Young Adult Males according to Calcium Intake Level.

    Science.gov (United States)

    Choi, Mi-Kyeong; Kim, Mi-Hyun

    2016-07-01

    The purpose of this study was to investigate the association between coffee consumption and bone status (bone mineral density and bone metabolism-related markers) according to calcium intake level in Korean young adult males. Healthy and nonsmoking males (19-26 years, n = 330) participated in this study. Anthropometric measurements, dietary habits, and nutrient intakes were surveyed. Bone status of the calcaneus was measured by using quantitative ultrasound (QUS). Bone metabolism-related markers including serum total alkaline phosphatase activity (TALP), N-mid osteocalcin (OC), and type 1 collagen C-terminal telopeptide (1CTP) were analyzed. The subjects were divided into two groups based on daily calcium intake level: a calcium-sufficient group (calcium intake ≥ 75% RI, n = 171) and a calcium-deficient group (calcium intake coffee consumption: no-coffee, less than one serving of coffee per day, and one or more servings of coffee per day. There were no significant differences in height, body weight, body mass index, energy intake, or calcium intake among the three coffee consumption subgroups. QUS parameters and serum 1CTP, TALP, and OC were not significantly different among either the two calcium-intake groups or the three coffee consumption subgroups. Our results may show that current coffee consumption level in Korean young men is not significantly associated with their bone status and metabolism according to the calcium intake level. PMID:27482522

  12. [Anatomical variants of the medial calcaneal nerve and the Baxter nerve in the tarsal tunnel].

    Science.gov (United States)

    Martín-Oliva, X; Elgueta-Grillo, J; Veliz-Ayta, P; Orosco-Villaseñor, S; Elgueta-Grillo, M; Viladot-Perice, R

    2013-01-01

    The tarsal tunnel is composed of the posterior border of the medial malleoulus, the posterior aspect of the talus and the medial aspect of the calcaneus. The medial calcaneal nerve emerges from the posterior aspect of the posterior tibial nerve in 75% of cases and from the lateral plantar nerve in the remaining 25%. Finally, the medial calcaneal nerve ends as a single terminal branch in 79% of cases and in numerous terminal branches in the remaining 21%. To describe the anatomical variants of the posterior tibial nerve and its terminal branches. To describe the steps for tarsal tunnel release. To describe Baxter nerve release. The anatomical variants of the posterior tibial nerve and its terminal branches within the tarsal tunnel were studied. Then the Lam technique was performed; it consists of: 1) opening of the laciniate ligament, 2) opening of the fascia over the abductor hallucis muscle, 3) exoneurolysis of the posterior tibial nerve and its terminal branches, identifying the emergence and pathway of the medial calcaneal branch, the lateral plantar nerve and its Baxter nerve branch and the medial plantar nerve. Baxter nerve was found in 100% of cases. In 100% of cases in our series the nerve going to the abductor digiti minimi muscle of the foot was found; 87.5% of cases had two terminal branches. The dissections proved that a crucial step was the release of the distal tarsal tunnel. PMID:24701749

  13. Bilateral accessory flexor digitorum muscle in the posterior compartment of the leg

    Directory of Open Access Journals (Sweden)

    Singh R

    2010-10-01

    Full Text Available Deep muscles of the posterior compartment of the leg constitute of the flexor hallucis longus, flexor digitorum and tibialis posterior. During the routine dissection of a 53-year-old male cadaver of Indian origin, an accessory muscle was observed in the posterior compartment of the both the legs, deep to the soleus muscle. The muscle originated as a slender tendon from the medial border of the tibia, led to a small belly of the muscle fibers arranged bipinnately and converged into another slender tendon. The tendon got inserted at the second toe in the left foot, after joining both the slip of the flexor hallucis longus and the flexor digitorum longus muscle tendon in the sole. In the right leg, the accessory muscle tendon was inserted to the calcaneus with fibrous attachments to the quadratus plantae, flexor hallucis longus and the flexor digitorum longus. The present case will facilitate in interpretation of the medial side swelling of the leg, tarsal tunnel syndrome or pain due to muscle entrapment, by the radiologists surgeons and orthopedists.

  14. Osteoporosis of lumbar spine, hip joints and calcaneous: a clinical-radiological study

    International Nuclear Information System (INIS)

    In order to accurately ascertain the presence of osteoporosis, the AA examined 92 women over 65 by means of radiographies of lumbar spine, hip joints and calcaneus. They concluded that even with examinations by four investigators the certainty ratio is 29.8% of the X-ray examinations reviewed, which is still very low. The ratio psoas-3rd lumbar vertebra width is an indicator which is difficult to apply in women over 65 owing to the prevalence of lumbar scoliosis in this age group. Pain is a complaint commonly found in this age group. 82 patients (89.2%) complained of some kind of pain (abdominal, articular bones and spine) but the complaint of pain in general was more frequent in the osteoporotic group. The women in the osteoporotic group were leaner than non-osteoporotic ones, as measured by the ratio height (which may be shortened) to weight (p < 0.05), and also older (p < 0.05) patients. The gamma globulin was elevated in 55.5% of the patients in this sample and the relative tests aided in detecting three cases of more serious pathologies. (author)

  15. Internal compression treatment of intra-articular fracture of the calcaneum by anatomical plate with compression bolt through sinus tarsi approach%经跗骨窦入路解剖钢板加压骨栓内加压治疗跟骨关节内骨折

    Institute of Scientific and Technical Information of China (English)

    王庆贤; 张英泽; 潘进社; 吴希瑞; 彭阿钦; 王鹏程

    2011-01-01

    Objective To observe the curative effect of internal compression in the treatment of intra-articular fracture of the calcaneus by anatomical plate with compression bolt through the sinus tarsi approach.Methods Forty-nine patients with 62 calcaneal fractures treated with anatomical plate with compression bolt through sinus tarsi approach from September 2006 to May 2009 were enrolled in the study.According to Sanders classification,there were 39 patients with type Ⅱ fractures,20 with type Ⅲ fractures and three with type Ⅳ fractures.The axial and lateral view X-ray radiographs and the axial,semi-coronal and sagittal computed tomography (CT) images of the heel were taken before and after operation.The reduction of posterior articular surface of calcaneus and calcaneal shape was observed and the width,height,length,B(o)hler' s angle and Gissan' s angle were measured on the radiographs,respectively.Partial weight bearing was allowed 12 weeks after operation and full weight beating was allowed 16 weeks after operation.The anatomical plates were removed 8-15 months after operation.The Maryland hindfoot score system was applied to evaluate the function of the hindfoot postoperatively.Results All the patients were followed up for 7.5-23 months (average 10.6 months),which showed no wound infection.The reduction of the posterior facet was nearly anatomical (less than 3 mm articular displacement) in all patients and the shape of the calcaneus was satisfactory.The width,height,length,B(o)hler' s angle and Gissan' s angle were improved significantly in all patients (P <0.01 ).According to Maryland hindfoot scoring system,29 feet scored 90-100 points (excellent),18 feet scored 80-90 points (good),10 feet scored 70-80 points (moderate) and 5 feet scored 60-70 points (poor).A total of 40 patients (82%) were able to return to their original occupations at mean 9.1 months ( 6.0-12.9 months ) after the injury.Conclusion The anatomical plate with compression bolt internal

  16. Determinants of Bone Strength Estimated by Calcaneal Ultrasonography in Inuit Women from Nuuk (Greenland

    Directory of Open Access Journals (Sweden)

    Alexandra-Cristina Paunescu

    2014-01-01

    Full Text Available This study was conducted to identify determinants of bone strength estimated by quantitative ultrasonography (QUS at the calcaneus of Greenlandic Inuit women. A total of 153 Inuit women from Nuuk, aged from 49 to 64 years, participated in the first QUS measurement (year 2000 with an Achilles Lunar instrument (speed of sound (SOS; broadband ultrasound attenuation (BUA; stiffness index (SI. A second measurement was performed two years later (year 2002 in 121 participants. Several factors known to be associated with bone strength were recorded at baseline for 118 of them. Determinants of QUS parameters were identified using an automatic (stepwise selection of variables in linear regression. Significant determinants of baseline QUS measurements were age and body weight for all QUS parameters, height for BUA and SI, and hormone replacement therapy (HRT use for SI. Significant predictors of follow-up QUS measurements were baseline QUS values, the smoking status and HRT use for all QUS parameters, omega-3/omega-6 PUFA content ratio of erythrocytes membrane phospholipids (BUA and SI, and menopausal status (BUA. Several modifiable dietary factors, such as a diet rich in omega-3 PUFAs and lifestyle factors (i.e., smoking, taking HRT, were shown to determine QUS parameters after a follow-up of two years.

  17. Sonographic evaluation of plantar fasciitis and relation to body mass index

    Energy Technology Data Exchange (ETDEWEB)

    Ozdemir, Huseyin [Department of Radiology Firat University, Faculty of Medicine, Elazig 23119 (Turkey)]. E-mail: ozdemir@firat.edu.tr; Yilmaz, Erhan [Department Orthopedic Firat University, Faculty of Medicine, Elazig (Turkey); Murat, Ayse [Department of Radiology Firat University, Faculty of Medicine, Elazig 23119 (Turkey); Karakurt, Lokman [Department Orthopedic Firat University, Faculty of Medicine, Elazig (Turkey); Poyraz, A. Kursad [Department of Radiology Firat University, Faculty of Medicine, Elazig 23119 (Turkey); Ogur, Erkin [Department of Radiology Firat University, Faculty of Medicine, Elazig 23119 (Turkey)

    2005-06-01

    Purpose: We have investigated the role of sonography in the diagnosis of plantar fasciitis. Materials and methods: This study evaluates 39 patients with plantar fasciitis and control group of 22 healthy volunteers. The plantar fascia thickness was measured 5 mm distal to the insertion of the calcaneus of plantar aponeurosis. Qualitative parameters such as decreased echogenity, biconvexity, perifascial fluid and calcification of plantar fascia were also noted. Results: Mean plantar fascia thickness was measured 2.9 mm in patients with unilateral heel pain, 2.2 mm for contralateral normal heel and 2.5 mm for control group. There was a statistically significant difference between heel with plantar fasciitis, contralateral normal heel and control groups (p = 0.009 and 0.0001, respectively). Mean body mass index was 28 kg/m{sup 2} in patients with heel pain and 25 kg/m{sup 2} in control group. Body mass index measurements were significantly different between plantar fasciitis and control groups. We found reduced plantar fascia echogenity in 16 cases (41%), calcaneal spur in 20 cases (51%), biconvex appearance in two cases (5.1%) and perifascial fluid in one case (2.5%). Conclusion: We conclude that in patients with plantar fasciitis, ultrasound may detect relatively small differences in plantar fascia thickness even in clinically unequivocal plantar fasciitis.

  18. Relation of Reproductive Factors and Heel Quantitative Ultrasound Parameters in Normal Women of Tehran

    Directory of Open Access Journals (Sweden)

    B Larijani

    2004-11-01

    Full Text Available Quantitative Ultrasound (QUS is a noninvasive, inexpensive and portable method for bone densitometry. It may measure some other parameters in addition to BMD, like elasticity and micro architecture. This study designed to determine the relation between reproductive factors and calcaneus QUS parameters in normal women of Tehran. BMD of heel in 151 normal women, 20-72Y/O (participator of Iranian Multi center Osteoporosis Study was assessed using Achilles+ (GE, Lunar Corporation, USA. After assessment of normal values, Stiffness Index percentiles acquired. With consideration of correlation between variables, multiple regression analysis was used. Mean±SD values of Speed of Sound (SOS, Broad Band Ultrasound Attenuation (BUA and Stiffness Index (SI, was 36/751527/25, 121/4215/1, 94/4617/92, respectively. Parameters decreased with age (P<0/01. Years of menopause significantly related with QUS parameters and age of menopause significant related with SOS and SI. Results show effectiveness of some reproductive factors on QUS parameters.

  19. Localized accumulation of lead within and among bones from lead-dosed goats

    International Nuclear Information System (INIS)

    The principal aim of this study was to gain a better understanding of where lead (Pb) accumulates and how it is distributed, within the bones of dosed goats. Adult goats were periodically dosed with Pb over a number of years for the primary purpose of producing blood pools containing endogenously bound Pb, for the New York State Blood Lead Proficiency Testing Program. Bone samples (e.g., primarily tibia, femur, humerus, and radius) were collected post-mortem from 11 animals and were analyzed for Pb content by acid digestion and electrothermal atomic absorption spectrometry (ETAAS or GFAAS). Average tibia Pb levels were found to correlate strongly with the cumulative Pb dose (r2=0.81). However, the concentration of Pb in different bones and even within a small area of the same bone varied tremendously. Blood-rich trabecular (spongy) bone, such as the patella and calcaneus, were much more enriched in Pb than was cortical (compact) bone. In some dosed animals, the Pb concentration in the tibia was markedly higher at the proximal and distal ends of the bone compared to the mid-shaft. The implications of these findings with regard to the noninvasive measurement of lead in bone by XRF methods are discussed.

  20. Oxidative stress as a risk factor for osteoporosis in elderly Mexicans as characterized by antioxidant enzymes

    Directory of Open Access Journals (Sweden)

    Correa-Muñoz Elsa

    2007-12-01

    Full Text Available Abstract Background Oxidative stress (OxS has recently been linked with osteoporosis; however, we do not know the influence of OxS as an independent risk factor for this disease. Methods We conducted a case-control study in 94 subjects ≥60 years of age, 50 healthy and 44 with osteoporosis. We measured total antioxidant status, plasma lipid peroxides, antioxidant activity of superoxide dismutase and glutathione peroxidase (GPx, and calculated the SOD/GPx ratio. Bone mineral density was obtained at the peripheral DXA in calcaneus using a portable Norland Apollo Densitometer®. Osteoporosis was considered when subjects had a BMD of 2.5 standard deviations or more below the mean value for young adults. Results GPx antioxidant activity was significantly lower in the group of subjects with osteoporosis in comparison with the group of healthy subjects (p p p = 0.034. Conclusion Our findings suggest that OxS is an independent risk factor for osteoporosis linked to increase of SOD/GPx ratio.

  1. Low Magnitude Mechanical Signals Reduce Risk-Factors for Fracture during 90-Day Bed Rest

    Science.gov (United States)

    Muir, J. W.; Xia, Y.; Holquin, N.; Judex, S.; Qin, Y.; Evans, H.; Lang, T.; Rubin, C.

    2007-01-01

    Long duration spaceflight leads to multiple deleterious changes to the musculoskeletal system, where loss of bone density, an order of magnitude more severe than that which follows the menopause, combined with increased instability, conspire to elevate the risk of bone fracture due to falls on return to gravitational fields. Here, a ground-based analog for spaceflight is used to evaluate the efficacy of a low-magnitude mechanical intervention, VIBE (Vibrational Inhibition of Bone Erosion), as a potential countermeasure to preserve musculoskeletal integrity in the face of disuse. Twenty-six subjects consented to ninety days of six-degree head-down tilt bed-rest. 18 completed the 90d protocol, 8 of which received daily 10-minute exposure to 30 Hz, 0.3g VIBE, applied in the supine position using a vest elastically coupled to the vibrating platform. The shoulder harness induced a load of 60% of the subjects body weight. At baseline and 90d, Qualitative Ultrasound Scans (QUS) of the calcaneus and CT-scans of the hip and spine were performed to measure changes in bone density. Postural control (PC) was assessed through center of pressure (COP) recordings while subjects stood on a force platform for 4 minutes of quiet stance with eyes closed, and again with eyes opened. As compared to control bedrest subjects,

  2. The foot and ankle of Australopithecus sediba.

    Science.gov (United States)

    Zipfel, Bernhard; DeSilva, Jeremy M; Kidd, Robert S; Carlson, Kristian J; Churchill, Steven E; Berger, Lee R

    2011-09-01

    A well-preserved and articulated partial foot and ankle of Australopithecus sediba, including an associated complete adult distal tibia, talus, and calcaneus, have been discovered at the Malapa site, South Africa, and reported in direct association with the female paratype Malapa Hominin 2. These fossils reveal a mosaic of primitive and derived features that are distinct from those seen in other hominins. The ankle (talocrural) joint is mostly humanlike in form and inferred function, and there is some evidence for a humanlike arch and Achilles tendon. However, Au. sediba is apelike in possessing a more gracile calcaneal body and a more robust medial malleolus than expected. These observations suggest, if present models of foot function are correct, that Au. sediba may have practiced a unique form of bipedalism and some degree of arboreality. Given the combination of features in the Au. sediba foot, as well as comparisons between Au. sediba and older hominins, homoplasy is implied in the acquisition of bipedal adaptations in the hominin foot. PMID:21903807

  3. Periostin secreted by mesenchymal stem cells supports tendon formation in an ectopic mouse model.

    Science.gov (United States)

    Noack, Sandra; Seiffart, Virginia; Willbold, Elmar; Laggies, Sandra; Winkel, Andreas; Shahab-Osterloh, Sandra; Flörkemeier, Thilo; Hertwig, Falk; Steinhoff, Christine; Nuber, Ulrike A; Gross, Gerhard; Hoffmann, Andrea

    2014-08-15

    True tendon regeneration in human patients remains a vision of musculoskeletal therapies. In comparison to other mesenchymal lineages the biology of tenogenic differentiation is barely understood. Specifically, easy and efficient protocols are lacking that might enable tendon cell and tissue differentiation based on adult (stem) cell sources. In the murine mesenchymal progenitor cell line C3H10T½, overexpression of the growth factor bone morphogenetic protein 2 (BMP2) and a constitutively active transcription factor, Smad8 L+MH2, mediates tendon cell differentiation in vitro and the formation of tendon-like tissue in vivo. We hypothesized that during this differentiation secreted factors involved in extracellular matrix formation exert a major impact on tendon development. Gene expression analyses revealed four genes encoding secreted factors that are notably upregulated: periostin, C-type lectin domain family 3 (member b), RNase A4, and follistatin-like 1. These factors have not previously been implicated in tendon biology. Among these, periostin showed a specific expression in tenocytes of adult mouse Achilles tendon and in chondrocytes within the nonmineralized fibrocartilage zone of the enthesis with the calcaneus. Overexpression of periostin alone or in combination with constitutively active BMP receptor type in human mesenchymal stem cells and subsequent implantation into ectopic sites in mice demonstrated a reproducible moderate tenogenic capacity that has not been described before. Therefore, periostin may belong to the factors contributing to the development of tenogenic tissue. PMID:24809660

  4. A novel method for defining the Greyhound talocrural joint axis of rotation for hinged transarticular external skeletal fixation.

    Science.gov (United States)

    Colborne, G R; Hadley, N R; Wallace, A M

    2013-01-01

    In order to apply hinged transarticular external skeletal fixation for stabilization of the injured canine tarsal joint, knowledge of the three-dimensional (3D) location and orientation of the transverse axis is necessary. This method of immobilization may be used as a primary or adjunctive method of stabilisation for a large number of traumatic conditions. Using pin-mounted markers in the cadaveric Greyhound crus and talus, a closed-form solution of absolute orientation was used to identify, on radiographs, the lateral and medial locations of the transverse axis by tracking the 3D excursions of the markers during flexion and extension. A line was drawn across the dorsal aspect of the calcaneus from the most dorsal point on the distal articular surface(proximal intertarsal joint: PIJ) to the most dorsal point on its proximal articulation with the body of the talus, and the location of the centre of rotation was expressed in terms of the length of that line. In seven Greyhound tarsal joints, the medial end of the axis was located 73 ± 10% proximal to the PIJ and 11 ± 7% dorsal to the line. The lateral end was 73 ± 9% proximal tothe PIJ and -2 ± 3% plantar to the line. PMID:23612749

  5. Thermographic imaging of the superficial temperature in racing greyhounds before and after the race.

    Science.gov (United States)

    Vainionpää, Mari; Tienhaara, Esa-Pekka; Raekallio, Marja; Junnila, Jouni; Snellman, Marjatta; Vainio, Outi

    2012-01-01

    A total of 47 racing greyhounds were enrolled in this study on two race days (in July and September, resp.) at a racetrack. Twelve of the dogs participated in the study on both days. Thermographic images were taken before and after each race. From the images, superficial temperature points of selected sites (tendo calcaneus, musculus gastrocnemius, musculus gracilis, and musculus biceps femoris portio caudalis) were taken and used to investigate the differences in superficial temperatures before and after the race. The thermographic images were compared between the right and left legs of a dog, between the raced distances, and between the two race days. The theoretical heat capacity of a racing greyhound was calculated. With regard to all distances raced, the superficial temperatures measured from the musculus gastrocnemius were significantly higher after the race than at baseline. No significant differences were found between the left and right legs of a dog after completing any of the distances. Significant difference was found between the two race days. The heat loss mechanisms of racing greyhounds during the race through forced conduction, radiation, evaporation, and panting can be considered adequate when observing the calculated heat capacity of the dogs. PMID:23097633

  6. Thermographic Imaging of the Superficial Temperature in Racing Greyhounds before and after the Race

    Directory of Open Access Journals (Sweden)

    Mari Vainionpää

    2012-01-01

    Full Text Available A total of 47 racing greyhounds were enrolled in this study on two race days (in July and September, resp. at a racetrack. Twelve of the dogs participated in the study on both days. Thermographic images were taken before and after each race. From the images, superficial temperature points of selected sites (tendo calcaneus, musculus gastrocnemius, musculus gracilis, and musculus biceps femoris portio caudalis were taken and used to investigate the differences in superficial temperatures before and after the race. The thermographic images were compared between the right and left legs of a dog, between the raced distances, and between the two race days. The theoretical heat capacity of a racing greyhound was calculated. With regard to all distances raced, the superficial temperatures measured from the musculus gastrocnemius were significantly higher after the race than at baseline. No significant differences were found between the left and right legs of a dog after completing any of the distances. Significant difference was found between the two race days. The heat loss mechanisms of racing greyhounds during the race through forced conduction, radiation, evaporation, and panting can be considered adequate when observing the calculated heat capacity of the dogs.

  7. Efficacy of computed tomography guided radiofrequency ablation forosteoid osteomas in 31 patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jung Hoon; Ahn, Joong Mo; Lee, Joon Woo; Lee, Guen Young; Lee, Eu Gene; Oh, Joo Han; Cho, Hwan Seong; Kang, Heung Sik [Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2015-04-15

    To present the clinical outcome of computed tomography (CT) guided radiofrequency ablation (RFA) for osteoid osteoma. Thirty-one patients (M:F = 23:8, mean age: 20 years, range: 4-54 years) who underwent RFA for clinically suspected osteoid osteoma from May 2004 to December 2013 were retrospectively reviewed. RFA was done in all cases under CT guidance by one of three radiologists in our department. Electronic medical records and images were retrospectively reviewed in all patients. Lesions were located in femur (n = 20), tibia (n = 5), fibula (n = 2), humerus (n = 3), talus (n = 2), and calcaneus (n = 1). On discharge, 27 of 33 cases showed complete remission of pain (82%). One major complication (compartment syndrome) and 2 minor complications (reactive synovitis, minimal skin burn at electrode insertion site) were observed. On the last follow-up (0-78 months, mean: 12.6 months) 27 of 33 cases were successfully treated (82%) and had no more complaints. 3 cases presented remaining pain (9%). In 3 cases relapse occurred (9%) and RFA was repeated in 1 case. The repeated treatment was successful. CT-guided RFA is an effective method for the treatment of osteoid osteoma.

  8. CT for diagnosing fractures of the undersurface of the talus and mechanism of injury

    Energy Technology Data Exchange (ETDEWEB)

    Okamoto, Hideaki; Shibata, Yoshimori; Nishi, Genzaburo; Tago, Kyoji; Tsuchiya, Daiji; Chiba, Takehiro; Okumura, Hisashi [Aichiken Koseiren Kainan Hospital, Yatomi (Japan); Ikeda, Takeshi; Wada, Ikuo

    2000-02-01

    Talus fractures whose fracture lines extend to the subtalar joint, except fractures of the neck and the body of the talus, are defined as fractures of the lower portion of the talus. It is difficult to make a correctly diagnosis of inferior fractures of the talus by plain radiography or tomography alone. The author encountered 12 cases of inferior fractures of the talus between 1989 and 1997, and CT imaging in 2 directions, in the horizontal and frontal plane, was useful in making the diagnosis. The correct diagnosis rate was 100%, and differentiation of the site and extent of the fractures was possible. Based on the CT findings, the fractures were classified into 8 types (fractures of the lateral process of the talus, fractures of the medial tubercle, fractures of the posterior process, and combinations of the above, and comminuted fractures). The mechanism of the injuries was also investigated, and the fractures of the lateral process of the talus seemed to have been caused by excessive eversion force on the ankle joint, with the lateral process becoming trapped between the fibula and the calcaneus. Medial tubercle fractures also seemed to be caused by forcible inversion of the ankle, with the tip of the medial malleous impacting and the medial tubercle being trapped between it and the sustentaculum tali. The comminuted fractures seem to have been caused by axial compression added to various of external forces. (K.H.)

  9. A New Technique to Increase Reliability in Measuring the Axis of Bone.

    Science.gov (United States)

    Lin, Chia-Sheng; Wu, Tai-Yin; Wang, Ting-Ming; Hou, Sheng-Mou; Shih, Kao-Shang; Liaw, Chen-Kun

    2016-01-01

    Measuring bone angles is an important method for diagnosing disease and predicting the prognosis in orthopedics. Traditionally, the angle is measured using lines drawn manually and adjusted by the naked eye. The purpose of the present study was to propose new methods to measure the bone angles formed by the axes of the calcaneus with good reliability and low operational error. The 2 new methods used linear regression analysis of the points inside and on the "envelope" line. The traditional method used the vector of the lines drawn for calculation. Digital radiographs of the lateral view of the feet from 51 patients were collected, and the angles were measured using these 3 methods. Next, we analyzed the reliability, differences, and correlations of these 3 methods. The intra- and interobserver comparisons revealed significant differences between the results of the 2 new methods and those of the traditional method. In addition, the new methods had greater reliability and better intra- and interobserver correlations than did the traditional method. We suggest that these 2 new methods to measure bone axis should be added to the Picture Archiving and Communication System to obtain more reliable and standardized data in clinical practice and for future research purposes. PMID:26364234

  10. Os trigonum syndrome.

    Science.gov (United States)

    Nault, Marie-Lyne; Kocher, Mininder S; Micheli, Lyle J

    2014-09-01

    Os trigonum syndrome is the result of an overuse injury of the posterior ankle caused by repetitive plantar flexion stress. It is predominantly seen in ballet dancers and soccer players and is primarily a clinical diagnosis of exacerbated posterior ankle pain while dancing on pointe or demi-pointe or while doing push-off maneuvers. Symptoms may improve with rest or activity modification. Imaging studies, including a lateral radiographic view of the ankle in maximal plantar flexion, will typically reveal the os trigonum between the posterior tibial lip and calcaneus. If an os trigonum is absent on radiography, an MRI may reveal scar tissue behind the posterior talus, a condition associated with similar symptoms. Os trigonum syndrome is often associated with pathology of the flexor hallucis longus tendon. Treatment begins with nonsurgical measures. In addition to physical therapy, symptomatic athletes may need surgical excision of os trigonum secondary to unavoidable plantar flexion associated with their sport. This surgery can be performed using open or arthroscopic approaches. PMID:25157036

  11. Study on the repeatability and correlation of warm-air and solid coupled mode ultrasound bone strength device%热固耦合式超声骨强度仪的可重复性及相关性研究

    Institute of Scientific and Technical Information of China (English)

    王杰; 倪朝民; 陈焱焱; 马祖长; 孙怡宁; 金艳; 张勤良

    2012-01-01

    目的:评估一款国产热固耦合式超声骨强度仪的可重复性和有效性.方法:选择11名志愿者,用该仪器测得右跟骨的两个超声参数,分别是超声速度(SOS)和宽带超声衰减(BUA),计算每个参数的变异系数均方根百分比(CVRMS%),评估该仪器的短期可重复性;选择18名志愿者,用类似的方法评估该仪器的中期可重复性;选择29名志愿者,用双能X线吸收法(DEXA)测量腰椎骨密度(BMD),并与用该仪器测得的跟骨SOS,BUA值进行相关性分析,评估该仪器的有效性.结果:①超声参数SOS,BUA的短期CVRMS%分别为0.30,4.24;中期CVRMS%分别为0.41,4.20.②SOS与腰椎BMD的相关系数r=0.486(P< 0.01),BUA与腰椎BMD的相关系数r=0.629(P< 0.01).结论:与国际主流定量超声(QUS)检测仪器相比,热同耦合式超声骨强度仪具有较高的可重复性和准确性,可用于临床骨质状况评估.%Objective: To evaluate the repeatability and correlation of warm-air and solid coupled mode ultrasound bone strength device made in China.Method: Eleven and eighteen volunteers' right calcaneus ultrasound parameters, speed of sound (SOS) and broad-band ultrasound attenuation (BUA), were detected with the device, percentages of root-mean square of coefficient of variation (CVrms%) of ultrasound parameters were calculated respectively, and used to assess the short- and middle-term repeatability of the device; 29 volunteers' right calcaneus ultrasound parameters (SOS, BUA) were de-tected with the device and bone mineral density (BMD) of lumbar spine were detected with dual energy X-ray absorptiometry (DEXA).Result: ?The short-term CVRMs% were 4.24% for BUA, and 0.30% for SOS; the middle-term CVRms% were 4.20% for BUA, and 0.41% for SOS. ?The correlations between BMD of lumbar spine were 0.629 (P<0.01) for BUA and 0.486 (P<0.01) for SOS.Conclusion: Compared to international top-grade quantitative ultrasound(QUS) testing device, the warm-air and solid coupled

  12. 经跗骨窦入路拉力螺纹钉加克氏针内固定治疗跟骨关节内骨折%Treatment of Intra-articular Fracture of the Calcaneum by Lag Screw and K-wire through Sinus Tarsi Approach

    Institute of Scientific and Technical Information of China (English)

    王庆贤; 张英泽; 潘进社; 吴希瑞; 张国川; 李衡; 焦振清

    2011-01-01

    目的:探讨经跗骨窦入路拉力螺纹钉加克氏针内固定治疗跟骨关节内骨折的临床疗效.方法:采用经跗骨窦入路克氏针加拉力螺纹钉内固定术治疗跟骨关节内骨折31例(42侧),其中Sanders分型II型23侧,III型17侧,IV型2侧.术后4周拔除外露克氏针,术后6~12个月去除拉力螺纹钉.结果:术后并发切口皮缘坏死2例,经清创换药后,局麻下直接缝合治愈.术后随访8.5~25个月,平均12.7个月.所有患者跟骨后关节面复位满意,跟骨外形及高度恢复满意,但部分患者跟骨宽度恢复不满意.根据Maryland后足功能评价标准,本组90~100分18侧,80~90分12侧,70~80分9侧,60~70分3侧.结论:经跗骨窦入路拉力螺纹钉加克氏针内固定术具有显露充分、复位满意、内固定可靠、软组织创伤小、切口感染风险低等优点,是治疗跟骨关节内骨折的方法之一.%Objective : To observe the operative treatment of intra - articular fracture of the calcaneus by K - wire and lag screw through the sinus tarsi approach. Methods :31 patients with 42 calcaneal fractures were treated with K - wire and lag screw through sinus tarsi approach. According to Sanders classification, there were 23 type Ⅱ fractures, 17 type Ⅲ fractures and 2 type Ⅳ fractures. The K - wires were pulled out at 4 weeks after operation. The lag screws were pulled out from 6 to 12 months after operation. Results : Two cases had incision - edge necrosis and treated by dress - changing and direct suture at the second stage. All of the cases had follow - up from 8. 5 ~ 25 months ( averaged 12. 7 months ). The reduction of the posterior facet was graded as nearly anatomical ( less than 3 mm articular displacement ) in all cases. The conture and height of the calcaneus were regained satisfactorily, but the width was not regained satisfactorily in some patients. According to Maryland hindfoot scoring system, 18 feet scored 90 ~ 100 points, 12 feet scored

  13. Assessment of plantar fasciitis using shear wave elastography%剪切波弹性成像评价足底筋膜炎

    Institute of Scientific and Technical Information of China (English)

    张立宁; 万文博; 张立海; 肖红雨; 罗渝昆; 费翔; 郑志新; 唐佩福

    2014-01-01

    目的:利用剪切波弹性成像技术比较不同年龄段正常人及足底筋膜炎患者的足底筋膜的厚度和硬度。方法对23名足底筋膜炎患者和30例健康志愿者进行剪切波弹性超声检查,测量足底筋膜跟骨止点及距离跟骨止点1 cm处的厚度和弹性模量值。结果老年组足底筋膜明显比年轻组厚(P=0.005),弹性模量值明显比年轻组小(P=0.000)。足底筋膜炎组足底筋膜厚度明显比老年组厚(P=0.001),弹性模量值明显比老年组小(P=0.000)。足底筋膜炎组的足底筋膜跟骨止点处弹性模量值比距离跟骨止点处1 cm的筋膜弹性值低(P=0.000),而健康志愿者年轻组和老年组的两个位置的弹性模量差异无统计学意义(P=0.172, P=0.126)。结论剪切波弹性成像能定量评估足底筋膜的硬度,足底筋膜的硬度随年龄增加而变小,足底筋膜炎的筋膜硬度较正常筋膜变小。%Objective To assess the stiffness and thickness of the plantar fascia using shear wave elastography (SWE) in healthy volunteers of different ages and in patients with plantar fasciitis. Methods The bilateral feet of 30 healthy volunteers and 23 patients with plantar fasciitis were examined with SWE. The plantar fascia thickness and elasticity modulus value were measured at the insertion of the calcaneus and at 1 cm from the insertion. Results The elderly volunteers had a significantly greater plantar fascia thickness measured using conventional ultrasound (P=0.005) and a significantly lower elasticity modulus value than the young volunteers (P=0.000). The patients with fasciitis had a significantly greater plantar fascia thickness (P=0.001) and a lower elasticity modulus value than the elderly volunteers (P=0.000). The elasticity modulus value was significantly lower at the calcaneus insertion than at 1 cm from the insertion in patients with fasciitis (P=0.000) but showed no significantly difference between the

  14. Chondroblastoma of the hands and feet

    International Nuclear Information System (INIS)

    To review the imaging findings, age and gender distribution of chondroblastoma of the hands and feet. Twenty-five cases of pathologically proven chondroblastoma of the hands and feet were reviewed. Available imaging modalities included radiographs (n=24), CT (n=3), MRI (n=5), and radionuclide bone scintigraphy (n=1). The following imaging features for each case were tabulated: location, presence of sclerotic margin, calcification, expansion, presence of fluid/fluid levels on cross-sectional imaging and surrounding edema on MRI. The images were evaluated for skeletal maturity using closure of the physeal plate in the region as a standard. The average age at time of diagnosis was 23 years (range 7-57 years). Eighty-four percent (n=21) of the patients were skeletally mature. Males (20 of 25) outnumbered females by a ratio of 5:1. The bones of the foot accounted for 22 cases: calcaneus (n=8), talus (n=8), metatarsals (n=3), and the cuboid (n=3). The bones of the hand accounted for three cases: phalanx (n=1), triquetrum (n=1), and a metacarpal (n=1). Radiographically all lesions were osteolytic with identifiable calcification in 54% (13 of 24). Fluid/fluid levels were seen in four of five cases on MRI. Edema on MR images was seen in 40% (2 of 5). The size of the lesions ranged from 2 to 41 cm2. Chondroblastomas of the hands and feet share many of the radiographic characteristics seen in the long bones, but manifest in skeletally mature patients with a higher male to female ratio than in long bone chondroblastoma. Talar and calcaneal lesions were encountered only in males. Chondroblastoma of the wrist and hand appears to be exceptionally rare. (orig.)

  15. Tuberculosis of the foot: An osteolytic variety

    Directory of Open Access Journals (Sweden)

    Mandeep S Dhillon

    2012-01-01

    Full Text Available Background: Foot involvement in osteoarticular tuberculosis is uncommon and isolated bony involvement of foot bones with an osteolytic defect is even more rare; diagnostic and therapeutic delays can occur, worsening the prognosis. We present a retrospective series of osteolytic variety of foot tuberculosis. Materials and Methods: We present 24 osteolytic variety of foot tuberculosis (Eleven calcaneus, four cuboid, two cunieforms, one talus, three metatarsals, three phalanges out of 92 foot TB cases collected over last 20 years. There were 16 adults and eight children. Tissue diagnosis was established in 23 of 24 cases based on PCR AFB staining, culture, and histopathology. Surgical intervention was reserved for patients with either a juxtaarticular focus threatening to involve a joint or an impending collapse of a midfoot bone with cystic destruction. Results: Fifteen cases had an osteolytic lesion on the radiographs resembling a space-occupying lesion, five had patchy osteolysis, while four showed coke like sequestra; one patient had a lesion in two bones. Antitubercular chemotherapy after biopsy was sufficient to heal the lesion in 19 cases, while in five cases surgical debridement needed to be done. The lesions healed eventually. At an average followup of 8.3 years, (range 2-15 years there were no recurrences and all patients were free from pain, with no restriction of movements. Six patients complained of occasional pain during walking on uneven ground. Conclusion: When tuberculous pathology is limited to the bone, the prognosis is better than in articular disease, as there is less deformity, and hence, less residual pain and disability.

  16. Sensitivity of the Oxford Foot Model to marker misplacement: A systematic single-case investigation.

    Science.gov (United States)

    Carty, Christopher P; Walsh, Henry P J; Gillett, Jarred G

    2015-09-01

    The purpose of this paper was to systematically assess the effect of Oxford Foot Model (OFM) marker misplacement on hindfoot relative to tibia, and forefoot relative to hindfoot kinematic calculations during the stance phase of gait. Marker trajectories were recorded with an 8-camera motion analysis system (Vicon Motion Systems Ltd., UK) and ground reaction forces were recorded from three force platforms (AMTI, USA). A custom built marker cluster consisting of 4 markers in a square arrangement (diagonal distance 2 cm) was used to assess the effect of marker misplacement in the superior, inferior, anterior and posterior direction for the sustentaculum tali (STL), the proximal 1st metatarsal (P1M), distal 5th metatarsal (D5M), proximal 5th metatarsal (P5M) and lateral calcaneus (LCA) markers. In addition manual movement of the heel complex 1 cm superiorly, inferiorly, medially and laterally, and also an alignment error of 10° inversion and 10° eversion was assessed. Clinically meaningful effects of marker misplacement were determined using a threshold indicating the minimal clinically important difference. Misplacement of the heel-wand complex had the most pronounced effect on mean kinematic profiles during the stance phase across all degrees-of-freedom with respect to hindfoot-tibia and forefoot-hindfoot angles. Vertical marker misplacement of the D5M and P5M markers affected the sagittal plane, and to a lesser extent frontal plane, forefoot-hindfoot kinematics. In conclusion, the OFM is highly sensitive to misplacement of the heel-wand complex in all directions and the P5M marker in the vertical direction. PMID:26163347

  17. Midterm Follow-Up of Talectomy for Severe Rigid Equinovarus Feet.

    Science.gov (United States)

    El-Sherbini, Mostafa H; Omran, Ahmed A

    2015-01-01

    Rigid equinovarus foot is a challenging problem. Talectomy has been advocated as a salvage procedure to achieve a plantigrade painless foot in the treatment of rigid equinovarus deformity. The present prospective observational study evaluated the effectiveness of talectomy in the treatment of Dimeglio grade IV rigid equinovarus feet. Nineteen feet in 13 patients were treated by talectomy from September 2001 through January 2012 (10-year, 2-month period). Of the 13 patients, 9 (69.23%) had a foot deformity due to arthrogryposis multiplex congenita and 1 (7.69%) each due to sacral agenesis, spastic cerebral palsy, neglected congenital talipes equinovarus, and post-traumatic contracture. Of the 13 patients, 9 (69.23%) were male and 4 (30.77%) were female. Their mean age was 7.7 (range 3 to 26) years. The mean follow-up duration was 6.4 (range 2 to 11) years. Along with talectomy, excision of the navicular was performed in 8 feet (42.11%), calcaneal osteotomy with a laterally based wedge in 8 (42.11%), and calcaneocuboid fusion in 3 feet (15.79%). Postoperatively, all the feet improved to Dimeglio grade II and were painless, and 16 feet (84.22%) were plantigrade; 1 foot (5.26%) had residual equinus resulting from incomplete removal of the talus and 2 (10.53%) had residual varus. Also, 3 feet (15.79%) had forefoot adduction (2 residual and 1 recurrent) that required a second surgery to correct the deformity. From our experience, talectomy is an effective procedure for correction of severe rigid equinovarus feet, provided that the talus is completely removed and the calcaneus is positioned correctly in the ankle mortise. PMID:26359619

  18. High-signal T2 changes of the bone marrow of the foot and ankle in children: red marrow or traumatic changes?

    Energy Technology Data Exchange (ETDEWEB)

    Shabshin, Nogah [Thomas Jefferson Medical College, Department of Radiology, Philadelphia, PA (United States); Chaim Sheba Medical Center, Department of Diagnostic Imaging, Tel-HaShomer (Israel); Schweitzer, Mark E. [NYU/Hospital for Joint Diseases, Department of Radiology, New York, NY (United States); Morrison, William B. [Thomas Jefferson Medical College, Department of Radiology, Philadelphia, PA (United States); Carrino, John A. [Thomas Jefferson Medical College, Department of Radiology, Philadelphia, PA (United States); Brigham and Women' s Hospital, Department of Radiology, Boston, MA (United States); Keller, Marc S.; Grissom, Leslie E. [DuPont Hospital for Children, Department of Medical Imaging, Wilmington, DE (United States)

    2006-07-15

    High-signal T2-weighted bone marrow changes can be found in both bone marrow edema and hematopoietic marrow and are often seen on pediatric MR images of the feet and ankle. To evaluate whether high-signal T2 changes of the bone marrow seen on pediatric MRI of feet and ankles represent residual hematopoietic marrow. A total of 402 bones in 41 pediatric MRI studies of feet and ankles (34 children, 1-18 years) were reviewed by two observers who were blinded to the patients' ages. The studies were reviewed for the presence of high-signal changes of the bone marrow on sagittal fluid-sensitive images. The frequency and location of these foci were correlated with the patients' ages. High-signal T2 changes of the bone marrow were seen in 45/402 bones (11%) and in 24/41 patients younger than 16 years (59%). The changes were most commonly located in the calcaneus (54%), followed by the talus (35%) and navicular bone (35%), invariably at the endosteal surface. In 16 ankles, such foci were seen in the feet but not in the distal tibia/fibula. Symmetric presence (two ankles) or absence (four ankles) of high-signal marrow were seen in six of seven patients with bilateral ankles. High-signal T2 changes of the bone marrow in pediatric feet and ankle MRIs have a symmetric, fairly consistent pattern and disappear after the age of 15 years. We believe that these high-signal areas are normal and represent residual hematopoietic marrow. (orig.)

  19. High-signal T2 changes of the bone marrow of the foot and ankle in children: red marrow or traumatic changes?

    International Nuclear Information System (INIS)

    High-signal T2-weighted bone marrow changes can be found in both bone marrow edema and hematopoietic marrow and are often seen on pediatric MR images of the feet and ankle. To evaluate whether high-signal T2 changes of the bone marrow seen on pediatric MRI of feet and ankles represent residual hematopoietic marrow. A total of 402 bones in 41 pediatric MRI studies of feet and ankles (34 children, 1-18 years) were reviewed by two observers who were blinded to the patients' ages. The studies were reviewed for the presence of high-signal changes of the bone marrow on sagittal fluid-sensitive images. The frequency and location of these foci were correlated with the patients' ages. High-signal T2 changes of the bone marrow were seen in 45/402 bones (11%) and in 24/41 patients younger than 16 years (59%). The changes were most commonly located in the calcaneus (54%), followed by the talus (35%) and navicular bone (35%), invariably at the endosteal surface. In 16 ankles, such foci were seen in the feet but not in the distal tibia/fibula. Symmetric presence (two ankles) or absence (four ankles) of high-signal marrow were seen in six of seven patients with bilateral ankles. High-signal T2 changes of the bone marrow in pediatric feet and ankle MRIs have a symmetric, fairly consistent pattern and disappear after the age of 15 years. We believe that these high-signal areas are normal and represent residual hematopoietic marrow. (orig.)

  20. Medial subtalar dislocation: Case report

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    Manojlović Radovan

    2010-01-01

    Full Text Available Introduction. Subtalar dislocation (SI is a term that refers to an injury in which there is dislocation of the talonavicular and talocalcanear joint, although the tibiotalar joint is intact. Case Outline. A case of medial subtalar dislocation as a result of basketball injury, so-called 'basketball foot', is presented. Closed reposition in i.v. anaesthesia was performed with the patient in supine position and a knee flexed at 90 degrees. Longitudinal manual traction in line of deformity was carried out in plantar flexion. The reposition continued with abduction and eversion simultaneously increasing dorsiflexion. It was made in the first attempt and completed instantly. Rehabilitation was initiated after 5 weeks of immobilization. One year after the injury, the functional outcome was excellent with full range of motion and the patient was symptom-free. For better interpretation of roentgenogram, bone model of subtalar dislocation was made using the cadaver bone. Conclusion. Although the treatment of such injury is usually successful, diagnosis can be difficult because it is a rare injury, and moreover, X-ray of the injury can be confusing due to superposition of bones. Radiograms revealed superposition of the calcaneus, tarsal and metatarsal bones which was radiographically visualized in the anterior-posterior projection as one osseous block inward from the talus, and on the lateral view as in an osteal block below the tibial bone. Prompt recognition of these injuries followed by proper, delicately closed reduction under anaesthesia is crucial for achieving a good functional result in case of medial subtalar dislocation.

  1. Appendicular bone mass and knee and hand osteoarthritis in Japanese women: a cross-sectional study

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    Moji Kazuhiko

    2002-10-01

    Full Text Available Abstract Background It has been reported that there is an inverse association between osteoarthritis (OA and osteoporosis. However, the relationship of bone mass to OA in a Japanese population whose rates of OA are different from Caucasians remains uncertain. Methods We studied the association of appendicular bone mineral density (second metacarpal; mBMD and quantitative bone ultrasound (calcaneus; stiffness index with knee and hand OA among 567 Japanese community-dwelling women. Knee and hand radiographs were scored for OA using Kellgren-Lawrence (K/L scales. In addition, we evaluated the presence of osteophytes and of joint space narrowing. The hand joints were examined at the distal and proximal interphalangeal (DIP, PIP and first metacarpophalangeal/carpometacarpal (MCP/CMC joints. Results After adjusting for age and body mass index (BMI, stiffness index was significantly higher in women with K/L scale, grade 3 at CMC/MCP joint compared with those with no OA. Adjusted means of stiffness index and mBMD were significantly higher in women with definite osteophytes at the CMC/MCP joint compared to those without osteophytes, whereas there were no significant differences for knee, DIP and PIP joints. Stiffness index, but not mBMD, was higher in women with definite joint space narrowing at the CMC/MCP joint compared with those with no joint space narrowing. Conclusions Appendicular bone mass was increased with OA at the CMC/MCP joint, especially among women with osteophytes. Our findings suggest that the association of peripheral bone mass with OA for knee, DIP or PIP may be less clearcut in Japanese women than in other populations.

  2. Calcaneal acrometastasis from urothelial carcinoma of the ureter: a case report and literature review

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    Ryder JH

    2013-04-01

    Full Text Available Jonathan H Ryder,1 Sean V McGarry,2 Jue Wang1  1Division of Oncology/Hematology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA; 2Department of Orthopaedic Surgery and Rehabilitation, University of Nebraska Medical Center, Omaha, Nebraska, USA Purpose: Ureteral cancer is a rare entity. Typical symptoms are painless hematuria as well as flank pain. Bone metastasis of ureteral cancer can occur in nearby bone structures, such as the spine, pelvis, and hip bone. Distal bone metastasis, such as that in the calcaneus bone, however, is rare. Case report: An 82-year-old woman presented to the orthopedic clinic at the university hospital with a 3-month history of left heel pain. A magnetic resonance imaging (MRI of her foot demonstrated a calcaneal lytic lesion. A biopsy of the lytic lesion showed urothelial carcinoma with squamous differentiation. A computed tomography (CT scan of the abdomen and pelvis showed left hydronephrosis and an obstructive mass in the left ureter, at the iliac crossing. The patient received combined therapy that included local radiation, bisphosphonate, and chemotherapy, with complete resolution of her cancer-related symptoms. However, she eventually died from the progressive disease, 20 months after the initial diagnosis. Conclusion: This case highlights the rare presentation of ureter cancer with an initial presentation of foot pain, secondary to calcaneal metastasis. Multimodality therapy provides effective palliation of symptoms and improved quality of life. We also reviewed the literature and discuss the clinical benefits of multidisciplinary cancer care in elderly patients. Keywords: urothelial carcinoma, elderly, calcaneal acrometastasis, multimodality therapy, chemotherapy, radiation

  3. Mechanisms for triceps surae injury in high performance front row rugby union players: a kinematic analysis of scrummaging drills.

    Science.gov (United States)

    Flavell, Carol A; Sayers, Mark G L; Gordon, Susan J; Lee, James B

    2013-01-01

    The front row of a rugby union scrum consists of three players. The loose head prop, hooker and tight head prop. The objective of this study was to determine if known biomechanical risk factors for triceps surae muscle injury are exhibited in the lower limb of front row players during contested scrummaging. Eleven high performance front row rugby union players were landmarked bilaterally at the posterior superior iliac spine (PSIS), greater trochanter, lateral femoral epicondyle, midline of the calcaneus above the plantar aspect of the heel, midline lower leg 5cm and 20cm proximal to the lateral malleolus, at the axis of subtalar joint, lateral malleolus, and head of the fifth metatarsal. Players were video recorded during a series of 2 on 1 live scrummaging drills. Biomechanical three dimensional analysis identified large angular displacements, and increased peak velocities and accelerations at the ankle joint during attacking scrummaging drill techniques when in the stance phase of gait. This places the triceps surae as increased risk of injury and provides valuable information for training staff regarding injury prevention and scrum training practices for front row players. Key pointsFront rowers exhibited patterns of single leg weight bearing, in a position of greater ankle plantar flexion and knee extension at toe off during scrummaging, which is a risk position for TS injury.Front rowers also exhibited greater acceleration at the ankle, knee, and hip joints, and greater changes in ankle ROM from toe strike to toe off during attacking scrum drills.These reported accelerations and joint displacements may be risk factors for TS injury, as the ankle is accelerating into plantar flexion at final push off and the muscle is shortening from an elongated state. PMID:24149740

  4. Clinical analysis of internal fixation with plastic titanium plate in the treatment of calcaneal fractures%可塑性钛钢板内固定治疗跟骨关节内骨折

    Institute of Scientific and Technical Information of China (English)

    杨新宇; 吴海华

    2012-01-01

    目的 探讨切开复位可塑性跟骨钛钢板内固定治疗跟骨骨折的疗效.方法 SandersⅡ、Ⅲ、Ⅳ型跟骨关节内骨折患者29例共32足,采用手术切开复位并予可塑性跟骨钛钢板进行内固定,观察临床疗效.结果 29例患者均获随访,按照Msryland Foot Score系统进行术后功能评价,其中优21足、良9足、可2足,优良率93.7%.结论 手术切开复位、可塑性钛钢板内固定治疗跟骨关节内骨折是一种有效可靠的治疗方法.%Objective To study the application of open reduction and plasticity titanium plate in the treatment of calcaneal fracture.Methods 29 patients with sanders Ⅱ、Ⅲ、V calcaneal fracture were treated by surgery with open reduction and titanium plate fixation.The clinical effects were observed.Results All patients were followed by Maryland Foot score postoperative functional evaluation system,the group of 29 cases of fracture,excellent 21 cases,good 9 cases,acceptable 2 cases,excellent rate was 93.7%.Condtusion The open reduction and internat fixation with plastic titanic plate was reliable to treat displaced intra-articular fracture of calcaneus.

  5. Comparison of Dual Energy X-Ray Absorptiometry and Quantitative Ultrasonography Measurements in Osteoporotic Patients - Original Investigation

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    Şule Tütün

    2008-08-01

    Full Text Available Aim: Osteoporosis (OP is a skelatal disease of bone fragility resulting from micro-architectural deteriotarion and decreased bone mass. There are many studies in literature that show high sensibility and specifity of quantitative ultrasonography (QUS. Recently many comparatives studies of QUS and dual energy X-ray absorbtiometry (DEXA have been made. In this study we aimed to investigate correlation of QUS and DEXA measurments in 53 women with postmenopausal osteoporosis were enrolled in this study. Material and Method: Fifty three postmenopausal women with osteoporosis were studied: Ultrasound parameters were measured by the DTU-one imaging ultrasonometer in the calcaneus. BMD was assessed by dual-energy X-ray absorptiometry (DEXA at the lumbar spine, femoral neck, and trochanter. QUS measurements of the postmenopausal women was compared with DEXA measurements. Results: There was a significant correlation between QUS T scores and DEXA L2-L4 T scores (r =0.463 p=0.000 p<0.005, there was a significant correlation between QUS Z scores and DEXA L2-L4 Z scores (r =0.589 p=0.000 p<0.005 , there was a significant correlation between QUS T scores and DEXA femur neck T scores (r =0.463 p=0.000 p<0.005 , there was a significant correlation between QUS Z scores and DEXA femur Z scores (r =0.418 p=0.000 p<0.005. Conclusion: Consequently QUS results were correlated with DEXA results in postmenopausal osteoporotic patients. (From the World of Osteoporosis 2008;14:26-8

  6. An `ameridelphian' marsupial from the early Eocene of Australia supports a complex model of Southern Hemisphere marsupial biogeography

    Science.gov (United States)

    Beck, Robin M. D.

    2012-09-01

    Recent molecular data strongly support the monophyly of all extant Australian and New Guinean marsupials (Eomarsupialia) to the exclusion of extant South American marsupials. This, together with available geological and fossil evidence, has been used to argue that the presence of marsupials in Australia is simply the result of a single dispersal event from South America during the latest Cretaceous or Palaeocene, without subsequent dispersals between the two continents. Here, I describe an isolated ankle bone (calcaneus) of a metatherian from the early Eocene Tingamarra Local Fauna in northeastern Australia. Strikingly, this specimen, QM F30060, lacks the `continuous lower ankle joint pattern' (CLAJP), presence of which is a highly distinctive apomorphy of the marsupial clade Australidelphia, which includes Eomarsupialia, the living South American microbiotherian Dromiciops and the Tingamarran fossil marsupial Djarthia. Comparisons with a range of marsupials and stem-metatherians strongly suggest that the absence of the CLAJP in QM F30060 is plesiomorphic, and that this specimen represents the first unequivocal non-australidelphian (`ameridelphian') metatherian known from Australia. This interpretation is confirmed by phylogenetic analyses that place QM F30060 within (crown-group) Marsupialia, but outside Australidelphia. Based on these results, the distribution of marsupials within Gondwana cannot be explained by simply a single dispersal event from South America and Australia. Either there were multiple dispersals by marsupials (and possibly also stem-metatherians) between South America and Australia, in one or both directions, or, alternatively, there was a broadly similar metatherian fauna stretching across southern South America, Antarctica and Australia during the Late Cretaceous-early Palaeogene.

  7. A new anisotropy index on trabecular bone radiographic images using the fast Fourier transform

    International Nuclear Information System (INIS)

    The degree of anisotropy (DA) on radiographs is related to bone structure, we present a new index to assess DA. In a region of interest from calcaneus radiographs, we applied a Fast Fourier Transform (FFT). All the FFT spectra involve the horizontal and vertical components corresponding respectively to longitudinal and transversal trabeculae. By visual inspection, we measured the spreading angles: Dispersion Longitudinal Index (DLI) and Dispersion Transverse Index (DTI) and calculated DA = 180/(DLI+DTI). To test the reliability of DA assessment, we synthesized images simulating radiological projections of periodic structures with elements more or less disoriented. Firstly, we tested synthetic images which comprised a large variety of structures from highly anisotropic structure to the almost isotropic, DA was ranging from 1.3 to 3.8 respectively. The analysis of the FFT spectra was performed by two observers, the Coefficients of Variation were 1.5% and 3.1 % for intra-and inter-observer reproducibility, respectively. In 22 post-menopausal women with osteoporotic fracture cases and 44 age-matched controls, DA values were respectively 1.87 ± 0.15 versus 1.72 ± 0.18 (p = 0.001). From the ROC analysis, the Area Under Curve (AUC) were respectively 0.65, 0.62, 0.64, 0.77 for lumbar spine, femoral neck, total femoral BMD and DA. The highest DA values in fracture cases suggest that the structure is more anisotropic in osteoporosis due to preferential deletion of trabeculae in some directions

  8. Effect of age and disease on bone mass in Japanese patients with schizophrenia

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    Sugawara Norio

    2012-02-01

    Full Text Available Abstract Background There have been a limited number of studies comparing bone mass between patients with schizophrenia and the general population. The aim of this study was to compare the bone mass of schizophrenia patients with that of healthy subjects in Japan. Methods We recruited patients (n = 362, aged 48.8 ± 15.4 (mean ± SD years who were diagnosed with schizophrenia or schizoaffective disorder based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV. Bone mass was measured using quantitative ultrasound densitometry of the calcaneus. The osteosono-assessment index (OSI was calculated as a function of the speed of sound and the transmission index. For comparative analysis, OSI data from 832 adults who participated in the Iwaki Health Promotion Project 2009 was used as representative of the general community. Results Mean OSI values among male schizophrenic patients were lower than those in the general population in the case of individuals aged 40 and older. In females, mean OSI values among schizophrenic patients were lower than those in the general community in those aged 60 and older. In an analysis using the general linear model, a significant interaction was observed between subject groups and age in males. Conclusions Older schizophrenic patients exhibit lower bone mass than that observed in the general population. Our data also demonstrate gender and group differences among schizophrenic patients and controls with regard to changes in bone mass associated with aging. These results indicate that intervention programs designed to delay or prevent decreased bone mass in schizophrenic patients might be tailored according to gender.

  9. Normal skeletal development and imaging pitfalls of the calcaneal apophysis: MRI features

    Energy Technology Data Exchange (ETDEWEB)

    Rossi, Ignacio [Musculoskeletal Research Fellow at NYU Langone Medical Center, New York, NY (United States); Centro de Diagnostico Dr. Enrique Rossi, Buenos Aires (Argentina); Rosenberg, Zehava [NYU Langone Medical Center, New York, NY (United States); Zember, Jonathan [Albert Einstein College of Medicine Jacobi Medical Center, Bronx, NY (United States)

    2016-04-15

    Heel pain in children and secondary MR imaging (MRI) of the hindfoot have been increasing in incidence. Our purpose is to illustrate the, previously unreported, MRI stages in development of the posterior calcaneal apophysis, with attention to imaging pitfalls. This should aid in distinguishing normal growth from true disease. Consecutive ankle MRIs in children <18 years, from 2008-2014, were subdivided into 0≤5, 5≤10, 10≤15 and 15≤18 age groups and retrospectively reviewed for development of the calcaneal apophysis. 204 ankle MRI studies in 188 children were identified. 40 studies were excluded with final cohort of 164 studies in 154 patients (82 boys, 72 girls). The calcaneal apophysis was cartilaginous until age 5. Foci of decreased as well as increased signal were embedded in cartilage, prior to ossification. Early, secondary ossification centers appeared in plantar third of the apophysis in 100 % of children by age 7. Increased T2 signal in the ossifications was seen in 30 % of children. Apohyseal fusion began at 12 and was complete in 78 % of 14≤15 year olds and in 88 % of 15≤18 year olds. Curvilinear low signal in the ossification centers, paralleling, but distinguished from growth plate, and not be confused with fracture line, was common. Development of the posterior calcaneus follows a unique sequence. Apophyseal fusion occurs earlier than reported in the literature. Familiarity with this maturation pattern, in particular the apophyseal increased T2 signal and the linear low signal paralleling the growth plate, will avoid misinterpreting it for pathology. (orig.)

  10. Performance on the Star Excursion Balance Test predicts functional turnout angle in pre-pubescent female dancers.

    Science.gov (United States)

    Filipa, Alyson R; Smith, Teresa R; Paterno, Mark V; Ford, Kevin R; Hewett, Timothy E

    2013-12-01

    The purpose of this study was to determine if there was a predictive relationship between performance on the Star Excursion Balance Test (SEBT) and functional turnout angle (FTA) in prepubescent female dancers. Ten dance students, ages 5 to 9 years (mean: 7.3 years), were recruited for this study. The SEBT required the subject to reach in the anterior, posterior-medial, and posteriorlateral directions with her free-limb foot while standing on the reference limb. A composite reach score was determined by calculating the sum of distance reached in the three directions and normalizing to leg length. The FTA was assessed in first position by measuring the angle of bisection between the second and third metatarsals and the midpoint of the calcaneus. Linear regression was used to determine if there was a predictive relationship between performance on the SEBT and FTA in this cohort. The subjects demonstrated a mean FTA of 90.3° ± 17.7°. Composite reach on the dominant limb normalized to leg length (81.4 ± 11.1%) during the SEBT was a significant predictor of FTA (r(2) = 0.49, p = 0.02), while performance on the non-dominant limb (81.9 ± 10.8%) indicated a trend toward a predictive association (r(2) = 0.35, p = 0.07). A decreased composite reach score was predictive of decreased FTA. These measurements may serve as an important screening tool for identifying dancers at risk for lower extremity injury. PMID:24565332

  11. [Hallux valgus--an atavism?].

    Science.gov (United States)

    Klaue, K

    2004-07-01

    In biology, atavism is generally understood as a biological phenomenon which brings to sight a recurrent phenotypic character which was lost for extinct generations. Phylogenic evolution of homo sapiens demonstrates today that the first plantar ray in tetrapods has always been a very stable ray and the lateral foot experienced a progressive adduction to the talo-metatarsal axis, together with a remodeling of the lateral column of the foot and a progressive valgus of the calcaneus beneath the talus. The foot appears as a strongly modified extremity, starting at a prehensile foot organ, common to our ancestors. In homo sapiens, the hand became a very mobile, less loaded organ, while the foot became a rather less mobile, but more loaded organ. The first ray, distal to Lisfranc's ligament, has no ligamentous structure holding it to the second ray. Stability is thus precarious and controlled by extrinsic and intrinsic muscles. Passive mobility of the tarso-metatarsal joints has been studied in vitro and in vivo. A relationship between unstable or hypermobile first ray and relevant Hallux valgus deformity has been demonstrated. Factors which facilitate the deformity are a long hallux and a functional equinus of the foot. Clinical pathology includes metatarsalgia, hammer toes, together with metatarsus primus varus and shortened gastrocnemii. Logical treatment of relevant and painful deformity includes tarso-metatarsal fusion with or without fusion to the second metatarsus. Osteotomies seem less secure in severe cases on the long run. In conclusion, Hallux valgus cannot be considered as an atavism because clinical history and findings do not correspond to the archaic prehensile foot and its evolution, but rather do correspond to a weak spot on a (still) fragile, often overloaded, phylogenetically young organ. PMID:15354748

  12. Anterior process calcaneal fractures: a systematic evaluation of associated conditions

    International Nuclear Information System (INIS)

    The objective was to evaluate the association, by MRI, of anterior calcaneal process fractures with tarsal coalitions, ankle sprains, and bifurcate ligament abnormalities. A retrospective review of 1,479 foot and ankle MR images was performed, over a period of 5 years, for isolated anterior process fractures of the calcaneus. Fifteen 1.5-T MR examinations were systematically evaluated by two radiologists in consensus. Marrow edema patterns, presence of a calcaneonavicular coalition, as well as bifurcate and anterior talofibular ligaments, were evaluated. There were 15 fractures of the anterior calcaneal process with an incidence of 1%. The average patient age was 51 years (range 25-82). Twelve patients were women and 3 were men. The majority of the fractures (14 out of 15) presented as an edema pattern on T2-weighted images, either diffuse (9 out of 15), or vertical (5 out of 15). One case did not show marrow edema, but rather a hypointense line. Nine patients (60%) demonstrated calcaneonavicular coalition and anterior calcaneal process fracture. In 6 patients (50%) the anterior talofibular ligament (ATFL) was thickened. Three patients did not have axial images, and were classified as non-conclusive for the ATFL evaluation. The bifurcate ligament was thickened with hyperintense signal demonstrating a sprain in 9 out of 13 (69%). Only 2 patients (16.5%) had an anterior calcaneal process fracture without any associated abnormality. We believe that there is a probable association of anterior process fractures and calcaneonavicular coalitions. We also feel, based on our results and the prior literature that there is likely also an association with both ATFL injuries and bifurcate ligament injuries. (orig.)

  13. The lateral calcaneal artery: Anatomic basis for planning safe surgical approaches.

    Science.gov (United States)

    Elsaidy, Mohamed A; El-Shafey, Khaled

    2009-10-01

    The proximity of the lateral calcaneal artery (LCA) to surgical incisions applied to the lateral hindfoot makes it vulnerable to iatrogenic injury and subsequent postoperative skin necrosis. This study aimed to investigate the course of the LCA and to define anatomical points that can be used by surgeons during lateral approaches to the calcaneus. Thirteen leg-ankle-foot specimens were dissected and the superficial course of the LCA was outlined by three anatomic points: (a) tip of lateral malleolus, (b) the point where it pierces the deep fascia, and (c) the point where it crosses the line connecting the lateral malleolus with the insertion of Achilles tendon. Fifteen healthy volunteers were investigated by color Doppler ultrasound where the diameter and depth of LCA were measured. The LCA pierced the deep fascia at a maximum height of 4.5 cm (mean 3.78) above the midpoint of a line extending from the lateral malleolus to the insertion of Achilles tendon. It crossed the previous line at a maximum distance of 3 cm (mean 2.6) posterior to lateral malleolus. At this point, its mean diameter was 1.75 mm on the right and 1.73 mm on the left sides, while its mean depth was 7.73 mm on the right and 8.0 mm on the left sides. A dangerous triangle that contained the superficial course of the artery was mapped out in the lower lateral part of the leg. This triangle should be considered during surgical approaches applied to the lateral hindfoot to avoid damage of the LCA. PMID:19637301

  14. Normal skeletal development and imaging pitfalls of the calcaneal apophysis: MRI features

    International Nuclear Information System (INIS)

    Heel pain in children and secondary MR imaging (MRI) of the hindfoot have been increasing in incidence. Our purpose is to illustrate the, previously unreported, MRI stages in development of the posterior calcaneal apophysis, with attention to imaging pitfalls. This should aid in distinguishing normal growth from true disease. Consecutive ankle MRIs in children <18 years, from 2008-2014, were subdivided into 0≤5, 5≤10, 10≤15 and 15≤18 age groups and retrospectively reviewed for development of the calcaneal apophysis. 204 ankle MRI studies in 188 children were identified. 40 studies were excluded with final cohort of 164 studies in 154 patients (82 boys, 72 girls). The calcaneal apophysis was cartilaginous until age 5. Foci of decreased as well as increased signal were embedded in cartilage, prior to ossification. Early, secondary ossification centers appeared in plantar third of the apophysis in 100 % of children by age 7. Increased T2 signal in the ossifications was seen in 30 % of children. Apohyseal fusion began at 12 and was complete in 78 % of 14≤15 year olds and in 88 % of 15≤18 year olds. Curvilinear low signal in the ossification centers, paralleling, but distinguished from growth plate, and not be confused with fracture line, was common. Development of the posterior calcaneus follows a unique sequence. Apophyseal fusion occurs earlier than reported in the literature. Familiarity with this maturation pattern, in particular the apophyseal increased T2 signal and the linear low signal paralleling the growth plate, will avoid misinterpreting it for pathology. (orig.)

  15. Clinical results of resection arthrodesis by triangular external fixation for posttraumatic arthrosis of the ankle joint in 89 cases

    Directory of Open Access Journals (Sweden)

    Kiene J

    2009-01-01

    Full Text Available Abstract The methods for ankle arthrodesis differ significantly, probably a sign that no method is clearly superior to others. In the last ten years there is a clear favour toward internal fixation. We retrospectively evaluate the technique and evaluate the clinical long term results of external fixation in a triangular frame. Patients and Methods From 1994 to 2001 a consecutive series of 95 patients with end stage arthritis of the ankle joint were treated. Retrospectively the case notes were evaluated regarding trauma history, medical complaints, further injuries and illnesses, walking and pain status and occupational issues and the clinical examination before arthrodesis. Mean age at the index procedure was 45.4 years (18-82, 67 patients were male (70.5%. Via a bilateral approach the malleoli and the joint surfaces were resected. An AO fixator was applied with two Steinmann-nails inserted with approximately 8 cm distance in the distal tibia, one in the neck of the talus and one in the dorsal calcaneus. The fixator was removed after approximately 12 weeks. Follow up examination at mean 4.4 years included a standardised questionnaire and a clinical examination including the criteria of the AOFAS-Score and radiographs. Results: Due to different complications, 8 (8.9% further surgical procedures were necessary including 1 below knee amputation. In 4 patients a non-union of the ankle arthrodesis developed (4.5%. The mean AOFAS score improved from 20.8 to 69.3 points. Conclusion Non-union rates and clinical results of arthrodesis by triangular external fixation of the ankle joint do not differ to internal fixation methods. The complication rate and the reduced patient comfort reserve this method mainly for infected arthritis and complicated soft tissue situations.

  16. Chondroblastoma of the hands and feet

    Energy Technology Data Exchange (ETDEWEB)

    Davila, Jesse A.; Amrami, Kimberly K.; Sundaram, Murali; Adkins, Mark C. [Mayo Clinic, Department of Radiology, Rochester (United States); Unni, Krishnan K. [Mayo Clinic, Department of Surgical Pathology, Rochester (United States)

    2004-10-01

    To review the imaging findings, age and gender distribution of chondroblastoma of the hands and feet. Twenty-five cases of pathologically proven chondroblastoma of the hands and feet were reviewed. Available imaging modalities included radiographs (n=24), CT (n=3), MRI (n=5), and radionuclide bone scintigraphy (n=1). The following imaging features for each case were tabulated: location, presence of sclerotic margin, calcification, expansion, presence of fluid/fluid levels on cross-sectional imaging and surrounding edema on MRI. The images were evaluated for skeletal maturity using closure of the physeal plate in the region as a standard. The average age at time of diagnosis was 23 years (range 7-57 years). Eighty-four percent (n=21) of the patients were skeletally mature. Males (20 of 25) outnumbered females by a ratio of 5:1. The bones of the foot accounted for 22 cases: calcaneus (n=8), talus (n=8), metatarsals (n=3), and the cuboid (n=3). The bones of the hand accounted for three cases: phalanx (n=1), triquetrum (n=1), and a metacarpal (n=1). Radiographically all lesions were osteolytic with identifiable calcification in 54% (13 of 24). Fluid/fluid levels were seen in four of five cases on MRI. Edema on MR images was seen in 40% (2 of 5). The size of the lesions ranged from 2 to 41 cm{sup 2}. Chondroblastomas of the hands and feet share many of the radiographic characteristics seen in the long bones, but manifest in skeletally mature patients with a higher male to female ratio than in long bone chondroblastoma. Talar and calcaneal lesions were encountered only in males. Chondroblastoma of the wrist and hand appears to be exceptionally rare. (orig.)

  17. Tendon entrapments and dislocations in ankle and hindfoot fractures: evaluation with multidetector computed tomography.

    Science.gov (United States)

    Ballard, David H; Campbell, Kevin J; Blanton, Lee E; Williams, Jason T; Sangster, Guillermo; Hollister, Anne M; Simoncini, Alberto A

    2016-08-01

    The purpose of this study was to assess the incidence of tendon entrapments and tendon dislocations associated with ankle and hindfoot fractures in patients studied by multidetector computed tomography (MDCT). Additionally, we describe particular tendon injuries associated with specific fractures. This was a retrospective review of all individuals with a trauma-protocol CT for suspected ankle and/or hindfoot fractures during a consecutive 41-month time period at a single Level I Trauma Center. Each patient's images were evaluated by two radiologists and an orthopedic surgeon for tendon entrapment, tendon dislocation, and bone(s) fractured or dislocated. There were 398 patients with ankle and/or hindfoot fractures that showed tendon entrapment or dislocation in 64 (16.1 %) patients. There were 30 (46.9 %) patients with 40 tendon entrapments, 31 (48.4 %) patients with 59 tendon dislocations, and three (4.7 %) patients with both tendon entrapment and dislocation. All patients with tendon entrapments were seen with either pilon fractures and/or a combination of posterior, medial, or lateral malleolar fractures. The most frequently entrapped tendon was the posterior tibialis tendon (PTT) in 27 patients (27/30, 90.0 %). The peroneal tendons were the most frequently dislocated, representing 27 (87.1 %) of patients with tendon dislocation; all resulted from a talar or calcaneal fracture or subluxation. This study demonstrates that tendon entrapments and tendon dislocations are commonly seen in complex fractures of the ankle and hindfoot. Pilon fractures were associated with the majority of tendon entrapments, whereas calcaneus fractures were associated with the majority of tendon dislocations. PMID:27234977

  18. A STUDY OF FUNCTIONAL OUT COME OF INTRA - ARTICULAR CALCANEAL FRACTURES TREATED SURGICALLY

    Directory of Open Access Journals (Sweden)

    Prashanth

    2015-10-01

    Full Text Available The calcaneus (O scalcis is the largest and most often fractured tarsal bone. The treatment of calcaneal fractures continues to pose a challenge for the trauma surgeons despite advancement in surgical technique and implant devices. The prognosis for an extra - articular fra cture is uniformly good, but that for an intra - articular fracture is varied. The management of every aspect of intra - articular calcaneal fractures is controversial. Although some studies have demonstrated good results after open reduction and internal fixa tion of intra - articular calcaneal fractures, a few other studies say otherwise. The method of internal fixation is also a point of debate, with various proponents advocating fixation with pins, screws or plate fixation with screws. Even there is no consens us regarding the surgical approach, with many having been described, including medial, lateral, combined medial and lateral, extended lateral and sinus tarsi approaches. So it is the need of the hour, to identify treatment techniques, which use lesser hard ware, to provide better functional outcomes in terms of shorter duration of treatment, better stability and early weight bearing and so also the role of non - operative treatment in the calcaneal fracture management. In this study, we have attempted to evalu ate the results of calcaneal fracture management by open reduction and internal fixation. Ours is a prospective study centered in the Gandhi hospital from Nov 2012 to April 2014 in which 30 patients with intra - articular calcaneal fractures were treated by open reduction and internal fixation and the results were evaluated with AOFAS scoring system. In our analysis, we observed that an anatomical reduction to restore Bohler’s and Gissanes angles associated with rigid internal fixation is essential for better fu n ctional results.

  19. Metric sex estimation from the postcranial skeleton for the Colombian population.

    Science.gov (United States)

    Moore, Megan K; DiGangi, Elizabeth A; Niño Ruíz, Francis Paola; Hidalgo Davila, Oscar Joaquín; Sanabria Medina, César

    2016-05-01

    This research explores the best univariate and multivariate indicators for sex estimation using 51 standard osteometric measurements of all six major postcranial long bones, bones of the shoulder girdle, pelvic girdle, and the calcaneus from a modern, Colombian skeletal collection. The hypotheses being tested are (1) that postcrania will yield accurate sex classification rates and (2) the shoulder girdle will demonstrate the highest discrimination, based on results from previous research. The sample consists of 134 individuals (50 females, 84 males) between the ages of 19 and 93 with a mean age of 47 years. The sample is from the Colombian Skeletal Collection, consisting of skeletons from cemeteries in Bogotá, with recent years of death. The methods include univariate and multivariate discriminant function analysis (DFA). The results for this sample indicate the same general pattern of univariate classification effectiveness as found in research on North Americans; however, here the humerus performs better than the distal femur and proximal tibia as demonstrated in some North American samples. The cross-validated percent correct univariate classification for the postcranial elements ranges from 64.8% to 86.1% (paids in forensic individuation, as the long bones of the postcranial elements are relatively resistant to taphonomic processes. Furthermore, the ability to achieve such a high degree of success from a single bone is preferable for the fast-paced forensic anthropology laboratories in Colombia that process hundreds to thousands of cases each year. This research plays an important role in the development of population standards in Colombia and South America and provides a robust method that can withstand courtroom scrutiny. PMID:27032896

  20. Magnetic resonance imaging of the ankle in female ballet dancers en pointe

    International Nuclear Information System (INIS)

    Background: Ballet dancers require extreme range of motion of the ankle, especially weight-bearing maximum plantar flexion (en pointe). In spite of a high prevalence of foot and ankle injuries in ballet dancers, the anatomy and pathoanatomy of this position have not been sufficiently studied in weight-bearing. Magnetic resonance imaging (MRI) is a beneficial method for such study. Purpose: To develop an MRI method of evaluating the ankles of female ballet dancers standing en pointe and to assess whether pathological findings from the MR images were associated with ankle pain reported by the subjects. Material and Methods: Nine female ballet dancers (age, 21±2.9 years; dance experience, 16±4.1 years; en pointe dance experience, 7±4.9 years) completed an ankle pain visual analog scale questionnaire and underwent T1- and T2-weighted scans using a 0.25 T open MRI device. The ankle was scanned in three positions: supine with full plantar flexion, standing with the ankle in anatomical position, and standing en pointe. Results: Obtaining MR images of the ballet dancers en pointe was successful in spite of limitations imposed by the difficulty of remaining motionless in the en pointe position during scanning. MRI signs of ankle pathology and anatomical variants were observed. Convergence of the posterior edge of the tibial plafond, posterior talus, and superior calcaneus was noted in 100% of cases. Widened anterior joint congruity and synovitis/joint effusion were present in 71% and 67%, respectively. Anterior tibial and/or talar spurs and Stieda's process were each seen in 44%. However, clinical signs did not always correlate with pain reported by the subjects. Conclusion: This study successfully established an ankle imaging technique for ballet dancers en pointe that can be used in the future to assess the relationship between en pointe positioning and ankle pathoanatomy in ballet dancers

  1. Plantar-flexion of the ankle joint complex in terminal stance is initiated by subtalar plantar-flexion: A bi-planar fluoroscopy study.

    Science.gov (United States)

    Koo, Seungbum; Lee, Kyoung Min; Cha, Young Joo

    2015-10-01

    Gross motion of the ankle joint complex (AJC) is a summation of the ankle and subtalar joints. Although AJC kinematics have been widely used to evaluate the function of the AJC, the coordinated movements of the ankle and subtalar joints are not well understood. The purpose of this study was to accurately quantify the individual kinematics of the ankle and subtalar joints in the intact foot during ground walking by using a bi-planar fluoroscopic system. Bi-planar fluoroscopic images of the foot and ankle during walking and standing were acquired from 10 healthy subjects. The three-dimensional movements of the tibia, talus, and calcaneus were calculated with a three-dimensional/two-dimensional registration method. The skeletal kinematics were quantified from 9% to 86% of the full stance phase because of the limited camera speed of the X-ray system. At the beginning of terminal stance, plantar-flexion of the AJC was initiated in the subtalar joint on average at 75% ranging from 62% to 76% of the stance phase, and plantar-flexion of the ankle joint did not start until 86% of the stance phase. The earlier change to plantar-flexion in the AJC than the ankle joint due to the early plantar-flexion in the subtalar joint was observed in 8 of the 10 subjects. This phenomenon could be explained by the absence of direct muscle insertion on the talus. Preceding subtalar plantar-flexion could contribute to efficient and stable ankle plantar-flexion by locking the midtarsal joint, but this explanation needs further investigation. PMID:26238571

  2. Sonographic evaluation of plantar fasciitis

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Sook Ja; Choi, Yun Sun; Tien, Kuang Lung; Jung, Hye Jeon; Lee, Kyoung Tae; Yoon, Yong Kyu [Eulji College of Medicine Eulji Hospital, Seoul (Korea, Republic of)

    1999-03-01

    To evaluate the sonographic findings of plantar fasciitis. Both feet of 30 patients(mean age, 44years) in whom plantar fasciitis had been clinically diagnosed, and those of healthy volunteers(mean age, 34years) were evaluated with ultrasound(US) using a 7.0MHz linear array transducer. Heel pain was unilateral in 26 patients and bilateral in four. Sagittal sonograms were obtained in the prone position, and the thickness of the plantar fascia was measured at its proximal end near its insertion into the calcaneus. We also evaluated hypoechoic fascia, perifascial fluid collection, fiber rupture, calcaneal spur and calcifications. Plantar fascia thickness was significantly greater in the heels of patients with plantar fasciitis(3.2-8mm; mean, 5.1{+-}1.12) than in their asymptomatic heels(1.3-5mm; mean, 3.5{+-}0.78)(p<0.0001), in which it was similar to that of heels of patients in the control group(1.8-5mm; mean, 3.0{+-}0.71)(p<0.0001). The proximal plantar fascia was hypoechoic in 31 symptomatic heels(91.2%), in four asymptomatic heels(15.4%), and in none of the patients in the control group. Calcaneal spurs were identified in sixteen symptomatic heels(47.1%), and in two which were asymptomatic(7.7%). Perifascial fluid collection was identified in only two symptomatic heels(5.9%). In plantar fasciitis, sonography demonstrates that the fascia is thicker as well as hypoechic. For the clinical diagnosis of planter fasciitis, US can therefore be used as an adjunct to clinical diagnosis.

  3. Pilon骨折的治疗与临床康复%Treatment and clinical rehabilitation of Pilon fracture

    Institute of Scientific and Technical Information of China (English)

    陈维华; 苏佳灿

    2003-01-01

    AIM:To analyze the effect of three kinds of method on different types of Pilon fracture and advance the best treatment plan.METHODS:From March 1989 to August 2000,107 patients were regarded as having Pilon fracture by two hospitals,among which 76 cases were followed up.They were divided into three groups according to treatment method.A group included 24 cases with the treatment of manual reduction,traction of calcaneus and plaster exopexy.B group included 30 cases with the treatment of AO key shaped anatomical steal plate.C group included 22 cases with the treatment of limited internal fixation combined with exopexy stand.RESULTS:After 6 months to 8 years follow up,it was found that three kinds of treatment methods had obvious differences on the complications and effects of different types of fracture.In A group,the excellent and good rate of treatment on I type fracture was 70% ,II type was 25% ,III type was 0% .In B group,the excellent and good rate of treatment on I type fracture was 78.6% ,II type s 87.5% ,III type was 37.5% .In C group,the excellent and good rate of treatment on I type was 75% ,II type was 80% ,III type 80% .CONCLUSION:Summarizing kinds of factors,the treatment of A group applied in I type fracture,B group applied in II type fracture and C group applied in III type fracture.

  4. Increased bone density and decreased bone turnover, but no evident alteration of fracture susceptibility in elderly women with diabetes mellitus.

    Science.gov (United States)

    Gerdhem, P; Isaksson, A; Akesson, K; Obrant, Karl J

    2005-12-01

    Bone density, bone turnover and fracture susceptibility were evaluated in 1,132 randomly recruited women, all 75 years old. Seventy-four of the women had diabetes, while 1,058 women did not. Areal bone mineral density (aBMD) of the hip and lumbar spine was investigated by dual energy X-ray absorptiometry (DXA), and bone mass of the calcaneus was measured by ultrasound. Urinary deoxypyridinoline/creatinine (U-DPD/Crea) and serum C-terminal cross-linked telopeptide of type 1 collagen (S-CTX) were assessed as markers of bone resorption. Serum bone-specific alkaline phosphatase (S-bone ALP) and serum osteocalcin (S-OC) were assessed as markers of bone formation. Also, serum 25(OH) vitamin D and serum parathyroid hormone (S-PTH) were assessed. Fracture susceptibility was evaluated retrospectively and prospectively for up to 6.5 years. In diabetic women, the aBMD of the femoral neck was 11% higher (pCrea, S-CTX, and S-OC were decreased when compared with non-diabetic women (p=0.001 or less). After correction for covariance of body weight and plasma creatinine, S-CTX (p<0.001) and S-OC (p<0.001) were still lower in the diabetic women. Diabetic patients had hypovitaminosis D (p=0.008), a difference explained by differences in time spent outdoors and body weight. S-PTH did not differ between the groups. Women with diabetes had no more lifetime fractures (52%) than women without diabetic disease (57%), (p=0.31). This study shows that elderly women with diabetes and without severe renal insufficiency have high bone mass and low bone turnover. The high bone mass and low bone turnover is not likely to have a strong influence on fracture susceptibility. PMID:15824889

  5. Imaging features of foot osteoid osteoma

    Energy Technology Data Exchange (ETDEWEB)

    Shukla, Satyen; Clarke, Andrew W.; Saifuddin, Asif [Royal National Orthopaedic Hospital NHS Trust, Department of Radiology, Stanmore, Middlesex (United Kingdom)

    2010-07-15

    We performed a retrospective review of the imaging of nine patients with a diagnosis of foot osteoid osteoma (OO). Radiographs, computed tomography (CT) and magnetic resonance imaging (MRI) had been performed in all patients. Radiographic features evaluated were the identification of a nidus and cortical thickening. CT features noted were nidus location (affected bone - intramedullary, intracortical, subarticular) and nidus calcification. MRI features noted were the presence of an identifiable nidus, presence and grade of bone oedema and whether a joint effusion was identified. Of the nine patients, three were female and six male, with a mean age of 21 years (range 11-39 years). Classical symptoms of OO (night pain, relief with aspirin) were identified in five of eight (62.5%) cases (in one case, the medical records could not be retrieved). In five patients the lesion was located in the hindfoot (four calcaneus, one talus), while four were in the mid- or forefoot (two metatarsal and two phalangeal). Radiographs were normal in all patients with hindfoot OO. CT identified the nidus in all cases (89%) except one terminal phalanx lesion, while MRI demonstrated a nidus in six of nine cases (67%). The nidus was of predominantly intermediate signal intensity on T1-weighted (T1W) sequences, with intermediate to high signal intensity on T2-weighted (T2W) sequences. High-grade bone marrow oedema, limited to the affected bone and adjacent soft tissue oedema was identified in all cases. In a young patient with chronic hindfoot pain and a normal radiograph, MRI features suggestive of possible OO include extensive bone marrow oedema limited to one bone, with a possible nidus demonstrated in two-thirds of cases. The presence or absence of a nidus should be confirmed with high-resolution CT. (orig.)

  6. Vitamin D and musculoskeletal status in Nova Scotian women who wear concealing clothing.

    Science.gov (United States)

    Ojah, Rani C I; Welch, Jo M

    2012-05-01

    Bone and muscle weakness due to vitamin D deficiency is common among Muslim women who reside in sunny, equatorial countries. The purpose of this study was to determine if living in a northern maritime location additionally disadvantages women who wear concealing clothes. A cross-sectional matched pair design was used to compare women who habitually wore concealing clothing with women who dressed according to western norms. Each premenopausal hijab-wearing woman (n = 11) was matched by age, height, weight and skin tone with a western-dressed woman. Subjects were tested by hand grip dynamometry to assess muscular strength and by quantitative ultrasound at the calcaneus to assess bone status. Nutritional intake was obtained by 24 h recall. Serum 25-hydroxyvitamin D (s-25(OH)D) status was determined in seven matched pairs. The hijab group had lower s-25(OH)D than women who wore western clothes (40 ± 28 vs. 81 ± 32 nmol/L, p= 0.01). Grip strength in the right hand was lower in the hijab-wearing women (p = 0.05) but this appeared to be due to less participation in intense exercise. Bone status did not differ between groups (p= 0.9). Dietary intake of vitamin D was lower in the hijab-wearers (316 ± 353 vs. 601 ± 341 IU/day, p= 0.001). This pilot study suggests that women living in a northern maritime location appear to be at risk for vitamin D insufficiency and therefore should consider taking vitamin D supplements. PMID:22690323

  7. Vitamin D and Musculoskeletal Status in Nova Scotian Women Who Wear Concealing Clothing

    Directory of Open Access Journals (Sweden)

    Jo M. Welch

    2012-05-01

    Full Text Available Bone and muscle weakness due to vitamin D deficiency is common among Muslim women who reside in sunny, equatorial countries. The purpose of this study was to determine if living in a northern maritime location additionally disadvantages women who wear concealing clothes. A cross-sectional matched pair design was used to compare women who habitually wore concealing clothing with women who dressed according to western norms. Each premenopausal hijab-wearing woman (n = 11 was matched by age, height, weight and skin tone with a western-dressed woman. Subjects were tested by hand grip dynamometry to assess muscular strength and by quantitative ultrasound at the calcaneus to assess bone status. Nutritional intake was obtained by 24 h recall. Serum 25-hydroxyvitamin D (s-25(OHD status was determined in seven matched pairs. The hijab group had lower s-25(OHD than women who wore western clothes (40 ± 28 vs. 81 ± 32 nmol/L, p = 0.01. Grip strength in the right hand was lower in the hijab-wearing women (p = 0.05 but this appeared to be due to less participation in intense exercise. Bone status did not differ between groups (p = 0.9. Dietary intake of vitamin D was lower in the hijab-wearers (316 ± 353 vs. 601 ± 341 IU/day, p = 0.001. This pilot study suggests that women living in a northern maritime location appear to be at risk for vitamin D insufficiency and therefore should consider taking vitamin D supplements.

  8. Geographic variation in gorilla limb bones.

    Science.gov (United States)

    Jabbour, Rebecca S; Pearman, Tessa L

    2016-06-01

    Gorilla systematics has received increased attention over recent decades from primatologists, conservationists, and paleontologists. Studies of geographic variation in DNA, skulls, and teeth have led to new taxonomic proposals, such as recognition of two gorilla species, Gorilla gorilla (western gorilla) and Gorilla beringei (eastern gorilla). Postcranial differences between mountain gorillas (G. beringei beringei) and western lowland gorillas (G. g. gorilla) have a long history of study, but differences between the limb bones of the eastern and western species have not yet been examined with an emphasis on geographic variation within each species. In addition, proposals for recognition of the Cross River gorilla as Gorilla gorilla diehli and gorillas from Tshiaberimu and Kahuzi as G. b. rex-pymaeorum have not been evaluated in the context of geographic variation in the forelimb and hindlimb skeletons. Forty-three linear measurements were collected from limb bones of 266 adult gorillas representing populations of G. b. beringei, Gorilla beringei graueri, G. g. gorilla, and G. g. diehli in order to investigate geographic diversity. Skeletal elements included the humerus, radius, third metacarpal, third proximal hand phalanx, femur, tibia, calcaneus, first metatarsal, third metatarsal, and third proximal foot phalanx. Comparisons of means and principal components analyses clearly differentiate eastern and western gorillas, indicating that eastern gorillas have absolutely and relatively smaller hands and feet, among other differences. Gorilla subspecies and populations cluster consistently by species, although G. g. diehli may be similar to the eastern gorillas in having small hands and feet. The subspecies of G. beringei are distinguished less strongly and by different variables than the two gorilla species. Populations of G. b. graueri are variable, and Kahuzi and Tshiaberimu specimens do not cluster together. Results support the possible influence of

  9. Skeletal deformations of newborn mice after X-ray exposure in fetal stage, with particular regard to hyperplastic growth phenomena in the neurocranium

    International Nuclear Information System (INIS)

    The following comprises a literary review of the effects of prenatal X-ray irradiation, known mainly from the mouse. Our own investigations were carried out with NMRI mice which on gestation days 11-13, 11-16 or 14-16 were exposed to whole-body irradiation comprising individual daily doses of between 80 and 160 R. All the examinations were carried out on the 18th day of gestation. Findings of special nature were ascertained on the talus and calcaneus. These bones indicate that the X-ray irradiation has an accelerating effect on development. It was possible to ascertain a corresponding effect with regard to the deformations of the os supraoccipital. After irradiation with 3 x 120 R and 3 x 160 R on the 11th-13th gestation days, both inhibitory deformities and also the occurence of an additional, novel bone anlage were observed. These findings were subjected to detailed histological examinations. In doing so, it was found that following a single irradiation with 200 R on the 12th day of gestation, 86,6% of the fetuses showed hyperostoses on the roof of the skull. In 13,2% of all cases there was in addition a clear, abnormal chondrification of the neurocranium, at the same time combined with an excessive formation of the bone, which protruded deep into the cerebral hemispheres. The patogeneses of this excessive growth phenomenon is explained on the basis of the complex relationship between the fetal brain formation and the formation of the skull cap. (orig./AJ)

  10. The reverse sural fasciocutaneous flap for the treatment of traumatic, infectious or diabetic foot and ankle wounds: A retrospective review of 16 patients

    Directory of Open Access Journals (Sweden)

    Ioannis A. Ignatiadis

    2011-01-01

    Full Text Available The authors present their experience with the use of sural fasciocutaneous flaps for the treatment of various soft tissue defects in the lower limb. This paper is a review of these flaps carried out between 2003 and 2008. The series consists of 16 patients, 11 men and 5 women with an average age of 41 years (17-81 and with a follow-up period between 2 and 7 years. The etiology was major velocity accident in six cases, diabetes mellitus with osteomyelitis after ORIF for fractures (2, work accident in five, and another two cases with complications of lower limb injuries. The defect areas were located on calcaneus, malleolar area, tarsal area and lower tibia. Associated risk factors in the patients for the flap performance were diabetes (five patients and cigarette smoking (ten patients.The technique is based on the use of a reverse-flow island sural flap combined with other flaps in three cases (cross-leg, peroneal, gastrocnemius. The anatomical structures which constituted the pedicle were the superficial and deep fascia, the sural nerve, the lesser saphenous vein and skin.The flap was viable in all 15 patients. On 8 cases was achieved direct closure, on three cases occurred a superficial necrosis and was skin grafted, on one case was observed partial necrosis which was treated with a second flap (posterior tibial perforator flap and another one occurred delayed skin healing.The sural fasciocutaneous flap is useful for the treatment of severe and complex injuries and their complications in diabetic and non diabetic lower limbs. Its technical advantages are easy dissection, preservation of more important vascular structures in the limb and complete coverage of the soft tissue defects in just one operation without the need of microsurgical anastomosis. Thus this flap offers excellent donor sites for repairing soft tissue defects in foot and ankle.

  11. Magnetic resonance imaging of the ankle in female ballet dancers en pointe

    Energy Technology Data Exchange (ETDEWEB)

    Russell, Jeffrey A. (Dept. of Dance, Univ. of California-Irvine, Irvine, CA (United States)), e-mail: jeff.russell@uci.edu; Shave, Ruth M. (Dept. of Radiology, Russells Hall Hospital, Dudley (United Kingdom)); Yoshioka, Hiroshi (Dept. of Radiological Sciences, Univ. of California-Irvine, Irvine, CA (United States)); Kruse, David W. (Dept. of Orthopaedic Surgery and Family Medicine, Univ. of California-Irvine, Irvine, CA (United States)); Koutedakis, Yiannis; Wyon, Matthew A. (School of Sport, Performing Arts and Leisure, Univ. of Wolverhampton, Walsall (United Kingdom))

    2010-07-15

    Background: Ballet dancers require extreme range of motion of the ankle, especially weight-bearing maximum plantar flexion (en pointe). In spite of a high prevalence of foot and ankle injuries in ballet dancers, the anatomy and pathoanatomy of this position have not been sufficiently studied in weight-bearing. Magnetic resonance imaging (MRI) is a beneficial method for such study. Purpose: To develop an MRI method of evaluating the ankles of female ballet dancers standing en pointe and to assess whether pathological findings from the MR images were associated with ankle pain reported by the subjects. Material and Methods: Nine female ballet dancers (age, 21+-2.9 years; dance experience, 16+-4.1 years; en pointe dance experience, 7+-4.9 years) completed an ankle pain visual analog scale questionnaire and underwent T1- and T2-weighted scans using a 0.25 T open MRI device. The ankle was scanned in three positions: supine with full plantar flexion, standing with the ankle in anatomical position, and standing en pointe. Results: Obtaining MR images of the ballet dancers en pointe was successful in spite of limitations imposed by the difficulty of remaining motionless in the en pointe position during scanning. MRI signs of ankle pathology and anatomical variants were observed. Convergence of the posterior edge of the tibial plafond, posterior talus, and superior calcaneus was noted in 100% of cases. Widened anterior joint congruity and synovitis/joint effusion were present in 71% and 67%, respectively. Anterior tibial and/or talar spurs and Stieda's process were each seen in 44%. However, clinical signs did not always correlate with pain reported by the subjects. Conclusion: This study successfully established an ankle imaging technique for ballet dancers en pointe that can be used in the future to assess the relationship between en pointe positioning and ankle pathoanatomy in ballet dancers

  12. Anterior process calcaneal fractures: a systematic evaluation of associated conditions

    Energy Technology Data Exchange (ETDEWEB)

    Petrover, David [NYU Hospital for Joint Disease, Radiology Department, New York, NY (United States); Hopital Beaujon, Service de Radiologie, Paris (France); Schweitzer, Mark E. [NYU Hospital for Joint Disease, Radiology Department, New York, NY (United States); Laredo, J.D. [Hopital Lariboisiere, Service de Radiologie, Paris (France)

    2007-07-15

    The objective was to evaluate the association, by MRI, of anterior calcaneal process fractures with tarsal coalitions, ankle sprains, and bifurcate ligament abnormalities. A retrospective review of 1,479 foot and ankle MR images was performed, over a period of 5 years, for isolated anterior process fractures of the calcaneus. Fifteen 1.5-T MR examinations were systematically evaluated by two radiologists in consensus. Marrow edema patterns, presence of a calcaneonavicular coalition, as well as bifurcate and anterior talofibular ligaments, were evaluated. There were 15 fractures of the anterior calcaneal process with an incidence of 1%. The average patient age was 51 years (range 25-82). Twelve patients were women and 3 were men. The majority of the fractures (14 out of 15) presented as an edema pattern on T2-weighted images, either diffuse (9 out of 15), or vertical (5 out of 15). One case did not show marrow edema, but rather a hypointense line. Nine patients (60%) demonstrated calcaneonavicular coalition and anterior calcaneal process fracture. In 6 patients (50%) the anterior talofibular ligament (ATFL) was thickened. Three patients did not have axial images, and were classified as non-conclusive for the ATFL evaluation. The bifurcate ligament was thickened with hyperintense signal demonstrating a sprain in 9 out of 13 (69%). Only 2 patients (16.5%) had an anterior calcaneal process fracture without any associated abnormality. We believe that there is a probable association of anterior process fractures and calcaneonavicular coalitions. We also feel, based on our results and the prior literature that there is likely also an association with both ATFL injuries and bifurcate ligament injuries. (orig.)

  13. Posttraumatic severe infection of the ankle joint - long term results of the treatment with resection arthrodesis in 133 cases

    Directory of Open Access Journals (Sweden)

    Kienast B

    2010-02-01

    Full Text Available Abstract Although there is a clear trend toward internal fixation for ankle arthrodesis, there is general consensus that external fixation is required for cases of posttraumatic infection. We retrospectively evaluated the technique and clinical long term results of external fixation in a triangular frame for cases of posttraumatic infection of the ankle. From 1993 to 2006 a consecutive series of 155 patients with an infection of the ankle was included in our study. 133 cases of the advanced "Gächter" stage III and IV were treated with arthrodesis. We treated the patients with a two step treatment plan. After radical debridement and sequestrectomy the malleoli and the joint surfaces were resected. An AO fixator was applied with two Steinmann-nails inserted in the tibia and in the calcaneus and the gap was temporary filled with gentamicin beads as the first step. In the second step we performed an autologous bone graft after a period of four weeks. The case notes were evaluated regarding trauma history, medical complaints, further injuries and illnesses, walking and pain status and occupational issues. Mean age at the index procedure was 49.7 years (18-82, 104 patients were male (67,1%. Follow up examination after mean 4.5 years included a standardised questionnaire and a clinical examination including the criteria of the AO-FAS-Score and radiographs. 92,7% of the cases lead to a stable arthrodesis. In 5 patients the arthrodesis was found partly-stable. In six patients (4,5% the infection was not controllable during the treatment process. These patients had to be treated with a below knee amputation. The mean AOFAS score at follow up was 63,7 (53-92. Overall there is a high degree of remaining disability. The complication rate and the reduced patient comfort reserve this method mainly for infection. Joint salvage is possible in the majority of cases with an earlier stage I and II infection.

  14. Mechanism of the anterior drawer test for diagnosis of ligaments injury at the ankle: a finite element study%踝关节韧带损伤前抽屉试验机制的有限元研究

    Institute of Scientific and Technical Information of China (English)

    许灿; 张明彦; 李康华

    2011-01-01

    目的 利用经过验证的踝关节模型研究前抽屉试验检测踝关节外侧韧带损伤的机制.方法 应用MRI扫描1个健康人的踝关节,利用MIMICS及ANSYS建立踝关节模型.验证模型正确性后,在踝关节不同屈曲角度下行前抽屉试验,观察距骨前移距离及踝关节周围主要韧带应力的变化规律.结果 踝关节中立位时距骨前移距离较大,前向拉力较小时距骨前移增加更明显.结论 踝关节处于跖屈位时,利用较小的前向拉力检测距腓前韧带断裂最为敏感.%Objective To devise a validated nonlinear 3D mathematical model of the anterior drawer test to calculate the forces in ligaments and the kinematics of talus and calcaneus.Methods MRI was used to obtain the configuration of a normal ankle.With the software of MIMICS and ANSYS, 3D model of the ankle was built.At different position of the ankle, the anterior drawer test was performed and the anterior translation of the talus was recorded.Results The highest laxity of the ankle was detected in the neutral position.The anterior translation of the talus was more obvious under low load.Conclusions The test performed in plantar flexion position with low anterior force is more sensitive for detecting the anterior talofihular ligament tear in comparison with the one performed in neutral position with high load.

  15. Bone mineral density in women on long-term mud-bath therapy in a Salus per Aquam (SPA environment

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    A. Loi

    2013-07-01

    Full Text Available The objective of this study was to assess bone mineral density (BMD in women on long-term mud-bath therapy (MBT for osteoarthritis in a Salus per Aquam (SPA environment. Two hundred and fifty female patients were randomly enrolled in this study in the SPA center of Sardara (Cagliari, Italy where they were treated with a combination of daily full body mudpacks and bicarbonate-alkaline mineral water baths at cycles of 2 weeks/year. BMD was evaluated by means of calcaneus ultrasonometry (Sahara Hologic Inc., Bedford, MA, USA and results analyzed according to duration of treatment and clinical variables. In the group of patients undergoing MBT for more than 10 years (group A and for 3 to 10 years (group B a reduced frequency of osteopenia and osteoporosis was detected (35.8% and 7.6% group A; 38.4% and 8.5% group B, respectively compared to controls (group C (48.9% and 23.4%, P<0.01 and P<0.001. Furthermore, higher T-score values were detected in group A and B (-1.05±1.28 and -1.24±0.94, respectively compared to group C (-1.93±0.78 (P<0.0002 and P<0.0001. Similar results were observed in the analysis of data restricted to women in menopause only. Long-term mud-bath therapy in SPA environment appeared to be beneficial for BMD.

  16. Effects of Bone Young’s Modulus on Finite Element Analysis in the Lateral Ankle Biomechanics

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    W. X. Niu

    2013-01-01

    Full Text Available Finite element analysis (FEA is a powerful tool in biomechanics. The mechanical properties of biological tissue used in FEA modeling are mainly from experimental data, which vary greatly and are sometimes uncertain. The purpose of this study was to research how Young’s modulus affects the computations of a foot-ankle FEA model. A computer simulation and an in-vitro experiment were carried out to investigate the effects of incremental Young’s modulus of bone on the stress and strain outcomes in the computational simulation. A precise 3-dimensional finite element model was constructed based on an in-vitro specimen of human foot and ankle. Young’s moduli were assigned as four levels of 7.3, 14.6, 21.9 and 29.2 GPa respectively. The proximal tibia and fibula were completely limited to six degrees of freedom, and the ankle was loaded to inversion 10° and 20° through the calcaneus. Six cadaveric foot-ankle specimens were loaded as same as the finite element model, and strain was measured at two positions of the distal fibula. The bone stress was less affected by assignment of Young’s modulus. With increasing of Young’s modulus, the bone strain decreased linearly. Young’s modulus of 29.2 GPa was advisable to get the satisfactory surface strain results. In the future study, more ideal model should be constructed to represent the nonlinearity, anisotropy and inhomogeneity, as the same time to provide reasonable outputs of the interested parameters.

  17. Prevalence of low trauma fractures in long-term kidney transplant patients with preserved renal function

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    J.W.R. Braga Júnior

    2006-01-01

    Full Text Available We evaluated the prevalence of low bone mineral density (BMD and osteoporotic fractures in kidney transplantation (KT patients and determined risk factors associated with osteoporotic fractures. The study was conducted on 191 patients (94 men and 97 women with first KT for 3 years or more presenting stable and preserved renal function (serum creatinine levels lower than 2.5 mg/dl. KT patients were on immunosuppressive therapy and the cumulative doses of these drugs were also evaluated. BMD was determined by dual-energy X-ray absorptiometry at multiple sites (spine, femur and total body. Quantitative ultrasound of the calcaneus (broadband ultrasound attenuation, speed of sound, and stiffness index, SI was also performed. Twenty-four percent (46 of all patients had either vertebral (29/46 or appendicular (17/46 fractures. We found osteoporosis and osteopenia in 8.5-13.4 and 30.9-35.1% of KT patients, respectively. Women had more fractures than men. In women, prevalent fractures were associated with diabetes mellitus [OR = 11.5, 95% CI (2.4-55.7], time since menopause [OR = 3.7, 95% CI (1.2-11.9], femoral neck BMD [OR = 1.99, 95% CI (1.4-2.8], cumulative dose of steroids [OR = 1.1, 95% CI (1.02-1.12] and low SI [OR = 1.1, 95% CI (1.0-1.2]. In men, fractures were associated with lower lumbar spine BMD [OR = 1.75, 95% CI (1.1-2.7], lower SI [OR = 1.1, 95% CI (1.03-1.13], duration of dialysis [OR = 1.3, 95% CI (1.13-2.7], and lower body mass index [OR = 1.24, 95% CI (1.1-1.4. Our results demonstrate high prevalence of low BMD and osteoporotic fractures in patients receiving a successful kidney transplant and indicate the need for specific intervention to prevent osteoporosis in this population.

  18. Sonographic evaluation of acute osteomyelitis in infants

    International Nuclear Information System (INIS)

    To analyze the related sonographic findings and to determine the value of sonography in establishing the diagnosis of acute osteomyelitis in infants. The sonographic findings of eleven infants aged 10 days-4 months (mean, 45 days) with acute osteomyelitis were retrospectively evaluated. The involved bones were the femur (n=5), humerus (n=2), tibia (n=2), rib(n=1), sternum (n=1), and calcaneus (n=1). Discontinuity or destruction of cortical margins, echotexture of the metaphysis and epiphysis, the presence of subperiosteal hypoechoic lesion, adjacent soft tissue swelling, distension of the joint capsule, the echotexture of joint effusion, and dislocation or subluxation of the involved joint were evaluated. The sonographic findings were compared with the plain radiographic (n=12) and MR (n=5) findings, with special attention to the identification of the metaphyseal or epiphyseal bony lesions and the involvement of adjacent joints. The sonographic findings of osteomyelitis were cortical discontinuity or destruction (n=12), hypoechoic lesions with an echogenic rim in the metaphysis (n=12), subperiosteal hypoechoic lesions (n=8), soft tissue swelling (n=9), a distended hip joint, with echogenic fluid (n=5), ill-demarcated echogenic lesions in the capital femoral epiphysis (n=5), and a subluxated hip joint (n=3). Plain radiographs revealed well or ill-defined osteolytic lesions in the metaphysis, accompanied by cortical destruction (n=8), new periosteal bone formation (n=3) and reactive sclerosis (n=2). Abnormality of the femoral epiphyses and joint involvement were not detected on plain radiographs, and in four cases no abnormality was noted. MR imaging showed that at T1WI, affected bony lesions were of low signal intensity and enhaned, with high signal intensity at T2WI. In all cases, both metaphyseal and epiphyseal lesions were demonstrated at MRI, but in one of the three cases in which an epiphyseal lesion was seen at MRI, this was not detected at US. Sonography is

  19. Micromechanical evaluation of bone microstructures under load

    Science.gov (United States)

    Mueller, Ralph; Boesch, Tobias; Jarak, Drazen; Stauber, Martin; Nazarian, Ara; Tantillo, Michelle; Boyd, Steven

    2002-01-01

    Many bones within the axial and appendicular skeleton are subjected to repetitive, cyclic loading during the course of ordinary daily activities. If this repetitive loading is of sufficient magnitude or duration, fatigue failure of the bone tissue may result. In clinical orthopedics, trabecular fatigue fractures are observed as compressive stress fractures in the proximal femur, vertebrae, calcaneus and tibia, and are often preceded by buckling and bending of microstructural elements. However, the relative importance of bone density and architecture in the aetiology of these fractures is poorly understood. The aim of the study was to investigate failure mechanisms of 3D trabecular bone using micro-computed tomography (mCT). Because of its nondestructive nature, mCT represents an ideal approach for performing not only static measurements of bone architecture but also dynamic measurements of failure initiation and propagation as well as damage accumulation. For the purpose of the study, a novel micro-compression device was devised to measure loaded trabecular bone specimens directly in a micro-tomographic system. A 3D snapshot of the structure under load was taken for each load step in the mCT providing 34 mm nominal resolution. An integrated mini-button load cell in the compression device combined with the displacement computed directly from the mCT scout view was used to record the load-displacement curve. From the series of 3D images, failure of the trabecular architecture could be observed, and in a rod-like type of architecture it could be described by an initial buckling and bending of structural elements followed by a collapse of the overloaded trabeculae. A computational method was developed to quantify individual trabecular strains during failure. The four main steps of the algorithm were (i) sequential image alignment, (ii) identification of landmarks (trabecular nodes), (iii) determine nodal connectivity, and (iv) to compute the nodal displacements and

  20. The relationship between the bone mineral density and urinary cadmium concentration of residents in an industrial complex

    International Nuclear Information System (INIS)

    Background: An association between cadmium exposure and bone mineral density (BMD) has been demonstrated in elderly women, but has not been well studied in youths and men. Some studies report either no or a weak association between cadmium exposure and bone damage. Objectives: This study was designed to investigate the relationship between the urinary cadmium (U-Cd) levels and BMD of females and males of all ages. Methods: A total of 804 residents near an industrial complex were surveyed in 2007. U-Cd and BMD on the heel (non-dominant calcaneus) were analyzed with AAS-GTA and Dual-Energy X-ray absorptiometry, respectively. Demographic characteristics were collected by structured questionnaires. Osteoporosis and osteopenia were defined by BMD cut-off values and T-scores set by the WHO; T score>-1, normal; -2.5< T score <-1, osteopenia; and T score <-2.5, osteoporosis. Logistic and multiple linear regressions were applied to estimate the association between U-Cd levels and BMD. Results: The U-Cd levels in females (0.64 μg/g creatinine) were higher than those in males (0.48 μg/g creatinine) (p<0.001). With the logistic regression model, osteopenia was associated with high U-Cd levels (≥1.0 μg/g creatinine) in females (OR=2.92; 95% CI, 1.51-5.64) and in males (OR=3.37; 95% CI, 1.09-10.38). With the multiple linear regression model, the BMD of the adult group was negatively associated with U-Cd (<0.05), gender (female, p<0.001) and age (p<0.001). The BMD of participants who were ≤19 years of age was negatively associated with gender (female, p<0.01), whereas it was positively associated with age and BMI (p<0.001). BMD was not associated with exercise, smoking habits, alcohol consumption, job or parental education. Conclusion: Results suggested that U-Cd might be associated with osteopenia as well as osteoporosis in both male and female adults. Age and female gender were negatively associated with BMD in the adult group, whereas age was positively associated with

  1. A ultrassonometria óssea e o risco de fraturas em idosas Quantitative ultrasound and risk of fractures in elderly women

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    Patricia Pereira de Oliveira

    2011-12-01

    Full Text Available OBJETIVO: Verificar a prevalência de risco de fratura estimada pela ultrassonometria óssea de calcâneo (UOC em uma população de idosas e sua associação com fatores de risco. MÉTODOS: Estudo transversal com amostra selecionada aleatoriamente e submetida a questionário estruturado sobre fatores de risco para fratura e UOC. RESULTADOS: Foram estudadas 168 mulheres brancas, menopausadas, com média de idade de 69,56 ± 6,27 anos; 81% da população de estudo tinha exame alterado, sendo 41% consideradas de maior risco. As mulheres com exames alterados tinham menor peso, altura e IMC, e tinham menores valores de SOS, BUA, BQI e T-score. Após ajuste, o IMC manteve significância para UOC alterada (OR = 3,37, IC 1,19-9,56, p = 0,02 e a história prévia de fraturas para UOC da faixa de maior risco (OR = 4,44, IC 1,16-16,96, p = 0,03. CONCLUSÃO: Observamos alta prevalência de risco para fraturas determinado pela UOC, superior ao de outros estudos brasileiros, e sua associação com IMC e história prévia de fraturas.OBJECTIVE: To verify the prevalence of women with risk of fractures estimated by ultrasonometry of the calcaneus (UOC in a population of elderly women and its association with clinical risk factors. METHODS: Cross-sectional study of which sample was randomly selected and submitted to a structured questionnaire about risk factors for fractures. All women underwent UOC. RESULTS: We studied 168 Caucasian postmenopausal women, with a mean age of 69.56 ± 6.27 years; 81% of these women had abnormal test results and 41% of the abnormal results were considered higher risk. Women with abnormal test results had lower weight, height and BMI, and had lower values of SOS, BUA, BQI and T-score. After adjustment, BMI remained significant for abnormal UOC (OR = 3.37, 95% CI: 1.19 9.56, p = 0.02, and history of previous fractures for UOC of the higher risk range (OR = 4.44, 95% CI: 1.16-16.96, p = 0.03. CONCLUSION: We observed a high prevalence

  2. Laws' masks descriptors applied to bone texture analysis: an innovative and discriminant tool in osteoporosis

    Energy Technology Data Exchange (ETDEWEB)

    Rachidi, M. [Orleans Hospital, INSERM Unit U658, Orleans (France); INSERM-U658. IPROS Hopital Porte Madeleine, Orleans (France); Marchadier, A. [Orleans Hospital, IPROS, Orleans (France); Gadois, C. [D3A Medical Systems, Orleans (France); Lespessailles, E. [Ipros-service de Rhumatologie CHR d' Orleans, Orleans (France); Chappard, C.; Benhamou, C.L. [Orleans Hospital, INSERM Unit U658, Orleans (France)

    2008-06-15

    The objective of this study was to explore Laws' masks analysis to describe structural variations of trabecular bone due to osteoporosis on high-resolution digital radiographs and to check its dependence on the spatial resolution. Laws' masks are well established as one of the best methods for texture analysis in image processing and are used in various applications, but not in bone tissue characterisation. This method is based on masks that aim to filter the images. From each mask, five classical statistical parameters can be calculated. The study was performed on 182 healthy postmenopausal women with no fractures and 114 age-matched women with fractures [26 hip fractures (HFs), 29 vertebrae fractures (VFs), 29 wrist fractures (WFs) and 30 other fractures (OFs)]. For all subjects radiographs were obtained of the calcaneus with a new high-resolution X-ray device with direct digitisation (BMA, D3A, France). The lumbar spine, femoral neck, and total hip bone mineral density (BMD) were assessed by dual-energy X-ray absorptiometry. In terms of reproducibility, the best results were obtained with the TR{sub E5E5} mask, especially for three parameters: 'mean', 'standard deviation' and 'entropy' with, respectively, in vivo mid-term root mean square average coefficient of variation (RMSCV)%=1.79, 4.24 and 2.05. The 'mean' and 'entropy' parameters had a better reproducibility but 'standard deviation' showed a better discriminant power. Thus, for univariate analysis, the difference between subjects with fractures and controls was significant (P<10{sup -3}) and significant for each fracture group independently (P<10{sup -4} for HF, P=0.025 for VF and P < 10{sup -3} for OF). After multivariate analysis with adjustment for age and total hip BMD, the difference concerning the 'standard deviation' parameter remained statistically significant between the control group and the HF and VF groups (P<5 x 10

  3. The influence of ibandronate treatment on bone density and biochemical bone markers in patients with osteogenesis imperfecta

    Directory of Open Access Journals (Sweden)

    Ingmar Ipach

    2012-09-01

    Full Text Available Osteogenesis imperfecta (OI is characterized by different signs including increased bone fragility, short stature, blue sclera, abnormal tooth growth and often secondary immobility. No curative therapy has been found for this rare disease up to now, and different pharmacological substances have been tried as treatment for severe forms of OI. Promising results were seen with intravenous bisphosphonates in the treatment of patients with OI. The aim of present study was to show the effect of intravenous ibandronate therapy on bone density and bone metabolism markers. We analyzed the data of 27 patients with the diagnosis of OI who were treated off-label with intravenous ibandronate. Ibandronate was administered by intravenous infusion every three months at a dosage of 0.3-2 mg. Bone turnover markers and bone density were measured before starting therapy and every three months during treatment. Bone density was measured by using an ultrasound imaging system providing an accurate image of the calcaneus and by evaluating broadband ultrasound attenuation (BUA. Twenty-seven patients were treated with intravenous iban- dronate during the observation period. 18 were female. The mean age of all patients was 23.9 years ± 19.6 (range 4-63. Seventeen patients were categorized to have OI Type I, 5 patients to have OI Type III and 5 patients to have OI Type IV. There was a statistically significant decrease in total alkaline phosphatase (P<0.0001. We detected also a statistically significant decrease in the ratio urinary deoxypyridinoline/urinary creatinine (P=0.0048 and the ratio urinary pyridinoline/urinary creatinine (P<0.0001 respectively. There was also a statistically significant increase in serum magnesium (P=0.034 and BUA (P=0.0071. No statistically significant changes were seen for total serum calcium (P=0.16, the ratio of urine calcium/urine creatinine (P=0.29, alkaline phosphatase (isoform bone (P=0.3, procollagen-I-peptide (P=0.5, osteocalcin (P=0

  4. Understanding the links among neuromedin U gene, beta2-adrenoceptor gene and bone health: an observational study in European children.

    Directory of Open Access Journals (Sweden)

    Francesco Gianfagna

    Full Text Available Neuromedin U, encoded by the NMU gene, is a hypothalamic neuropeptide that regulates both energy metabolism and bone mass. The beta-2 adrenergic receptor, encoded by the ADRB2 gene, mediates several effects of catecholamine hormones and neurotransmitters in bone. We investigated whether NMU single nucleotide polymorphisms (SNPs and haplotypes, as well as functional ADRB2 SNPs, are associated with bone stiffness in children from the IDEFICS cohort, also evaluating whether NMU and ADRB2 interact to affect this trait. A sample of 2,274 subjects (52.5% boys, age 6.2 ± 1.8 years from eight European countries, having data on calcaneus bone stiffness index (SI, mean of both feet and genotyping (NMU gene: rs6827359, rs12500837, rs9999653; ADRB2 gene: rs1042713, rs1042714, was studied. After false discovery rate adjustment, SI was significantly associated with all NMU SNPs. rs6827359 CC homozygotes showed the strongest association (recessive model, Δ= -1.8, p=0.006. Among the five retrieved haplotypes with frequencies higher than 1% (range 2.0-43.9%, the CCT haplotype (frequency=39.7% was associated with lower SI values (dominant model, Δ= -1.0, p=0.04 as compared to the most prevalent haplotype. A non-significant decrease in SI was observed in in ADRB2 rs1042713 GG homozygotes, while subjects carrying SI-lowering genotypes at both SNPs (frequency = 8.4% showed much lower SI than non-carriers (Δ= -3.9, p<0.0001; p for interaction=0.025. The association was more evident in preschool girls, in whom SI showed a curvilinear trend across ages. In subgroup analyses, rs9999653 CC NMU or both GG ADRB2 genotypes were associated with either lower serum calcium or β-CrossLaps levels (p=0.01. This study in European children shows, for the first time in humans, a role for NMU gene through interaction with ADRB2 gene in bone strength regulation, more evident in preschool girls.

  5. Understanding the links among neuromedin U gene, beta2-adrenoceptor gene and bone health: an observational study in European children.

    Science.gov (United States)

    Gianfagna, Francesco; Cugino, Daniela; Ahrens, Wolfgang; Bailey, Mark E S; Bammann, Karin; Herrmann, Diana; Koni, Anna C; Kourides, Yiannis; Marild, Staffan; Molnár, Dénes; Moreno, Luis A; Pitsiladis, Yannis P; Russo, Paola; Siani, Alfonso; Sieri, Sabina; Sioen, Isabelle; Veidebaum, Toomas; Iacoviello, Licia

    2013-01-01

    Neuromedin U, encoded by the NMU gene, is a hypothalamic neuropeptide that regulates both energy metabolism and bone mass. The beta-2 adrenergic receptor, encoded by the ADRB2 gene, mediates several effects of catecholamine hormones and neurotransmitters in bone. We investigated whether NMU single nucleotide polymorphisms (SNPs) and haplotypes, as well as functional ADRB2 SNPs, are associated with bone stiffness in children from the IDEFICS cohort, also evaluating whether NMU and ADRB2 interact to affect this trait. A sample of 2,274 subjects (52.5% boys, age 6.2 ± 1.8 years) from eight European countries, having data on calcaneus bone stiffness index (SI, mean of both feet) and genotyping (NMU gene: rs6827359, rs12500837, rs9999653; ADRB2 gene: rs1042713, rs1042714), was studied. After false discovery rate adjustment, SI was significantly associated with all NMU SNPs. rs6827359 CC homozygotes showed the strongest association (recessive model, Δ= -1.8, p=0.006). Among the five retrieved haplotypes with frequencies higher than 1% (range 2.0-43.9%), the CCT haplotype (frequency=39.7%) was associated with lower SI values (dominant model, Δ= -1.0, p=0.04) as compared to the most prevalent haplotype. A non-significant decrease in SI was observed in in ADRB2 rs1042713 GG homozygotes, while subjects carrying SI-lowering genotypes at both SNPs (frequency = 8.4%) showed much lower SI than non-carriers (Δ= -3.9, p<0.0001; p for interaction=0.025). The association was more evident in preschool girls, in whom SI showed a curvilinear trend across ages. In subgroup analyses, rs9999653 CC NMU or both GG ADRB2 genotypes were associated with either lower serum calcium or β-CrossLaps levels (p=0.01). This study in European children shows, for the first time in humans, a role for NMU gene through interaction with ADRB2 gene in bone strength regulation, more evident in preschool girls. PMID:23936460

  6. Retrospective Study of Serum Sclerostin Measurements in Bed Rest Subjects

    Science.gov (United States)

    Spatz, J. M.; Fields, E. E.; Yu, E. W.; Divieti, Pajevic P.; Bouxsein, M. L.; Sibonga, M. L.; Zwart, S. R.; Smith, S. M.

    2011-01-01

    Animal models and human studies suggest that osteocytes regulate the skeleton s response to mechanical unloading at the cellular level in part by an increase in sclerostin, an inhibitor of the anabolic Wnt pathway. However, few studies have reported changes in serum sclerostin in humans exposed to reduced mechanical loading. Thus, we determined changes in serum sclerostin and bone turnover markers in healthy adult men who participated in a controlled bed rest study. Seven healthy adult men (31 +/- 3 yrs old) underwent 90-day six-degree head down tilt bed rest at the University of Texas Medical Branch in Galveston's Institute for Translational Sciences - Clinical Research Center (ITS-CRC). Serum sclerostin, PTH, serum markers of bone turnover (bone specific alkaline phosphatase, RANKL/OPG, and osteocalcin), urinary calcium and phosphorus excretion, and 24 hour pooled urinary markers of bone resorption (NTX, DPD, PYD) were evaluated pre-bed rest (BL), bed rest day 28 (BR-28), bed rest day 60 (BR-60), and bed rest day 90 (BR-90). In addition, bone mineral density (BMD) was assessed by dual-energy X-ray absorptiometry (DXA) at BL, BR-60, and post bed rest day 5 (BR+5). Data are reported as mean +/- standard deviation. We used repeated measures ANOVA to compare baseline values to BR-28, BR-60, and BR-90. RESULTS Consistent with prior reports, BMD declined significantly (1-2% per month) at weight-bearing skeletal sites (spine, hip, femur neck, and calcaneus). Serum sclerostin levels were elevated above BL at BR-28 (+29% +/- 20%, p = 0.003), BR-60 (+42% +/- 31%, p < 0.001), and BR-90 (22% +/- 21%, p = 0.07). Serum PTH levels were reduced at BR-28 (-17% +/- 16%, p = 0.02), BR-60 (-24% +/- 14%, p = 0.03), and returned to baseline at BR-90 (-21% +/- 21%, p = 0.14). Serum bone turnover markers did not change, however urinary bone resorption markers and calcium were significantly elevated following bed rest (p < 0.01). CONCLUSION We observed an increase of serum sclerostin

  7. Fluid Shifts

    Science.gov (United States)

    Stenger, M.; Hargens, A.; Dulchavsky, S.; Ebert, D.; Lee, S.; Lauriie, S.; Garcia, K.; Sargsyan, A.; Martin, D.; Ribeiro, L.; Lui, J.; Macias, B.; Arbeille, P.; Danielson, R.; Chang, D.; Johnston, S.; Ploutz-Snyder, R.; Smith, S.

    2016-01-01

    NASA is focusing on long-duration missions on the International Space Station (ISS) and future exploration-class missions beyond low-Earth orbit. Visual acuity changes observed after short-duration missions were largely transient, but more than 50% of ISS astronauts experienced more profound, chronic changes with objective structural and functional findings such as papilledema and choroidal folds. Globe flattening, optic nerve sheath dilation, and optic nerve tortuosity also are apparent. This pattern is referred to as the visual impairment and intracranial pressure (VIIP) syndrome. VIIP signs and symptoms, as well as postflight lumbar puncture data, suggest that elevated intracranial pressure (ICP) may be associated with the spaceflight-induced cephalad fluid shifts, but this hypothesis has not been tested. The purpose of this study is to characterize fluid distribution and compartmentalization associated with long-duration spaceflight, and to correlate these findings with vision changes and other elements of the VIIP syndrome. We also seek to determine whether the magnitude of fluid shifts during spaceflight, as well as the VIIP-related effects of those shifts, is predicted by the crewmember's preflight conditions and responses to acute hemodynamic manipulations (such as head-down tilt). Lastly, we will evaluate the patterns of fluid distribution in ISS astronauts during acute reversal of fluid shifts through application of lower body negative pressure (LBNP) interventions to characterize and explain general and individual responses. METHODS: We will examine a variety of physiologic variables in 10 long-duration ISS crewmembers using the test conditions and timeline presented in the Figure below. Measures include: (1) fluid compartmentalization (total body water by D2O, extracellular fluid by NaBr, intracellular fluid by calculation, plasma volume by CO rebreathe, interstitial fluid by calculation); (2) forehead/eyelids, tibia, calcaneus tissue thickness (by

  8. Outcome of open reduction and internal fixation of intraarticular calcaneal fracture fixed with locking calcaneal plate

    Directory of Open Access Journals (Sweden)

    Jain Saurabh

    2013-12-01

    internal fixation with locking calcaneal plate gives sound functional outcome, i.e. restoring anatomically reconstruction of height, width, Bohler’s and Gissiane’s angles of the calcaneum, and allow- ing early mobilization. Key words: Calcaneus; Fractures, bone; Bone plates; Fracture fixation, internal

  9. 跟骨骨折内固定手术并发症58例分析%Analysis of complication of the fixed surgery of calcaneum bone fracture in 58 cases

    Institute of Scientific and Technical Information of China (English)

    王春辉; 吴兵; 盛文辉; 王自钢

    2011-01-01

    Objective To discuss complications of the fixed surgery of internal fixation of intra- articular calcaneal fracture. Methods Totally 64 sides of calcaneal fracture in 58 patients were treated with open reduction and Y-shaped plate fixation through lateral approach. All the cases were followed up, and the associated complications were analyzed retrospectively. Results The clinical results were evaluated according to Maryland Foot Score.Excellent and good results were acchieved in 55 cases. The precentage of complication was 85.9%. The complications were foud in 9 cases, including postoprerative wound dehiscence,malunion,infection etc. Conclusions The complications of internal fixations treating fractures arc related to anatomic features of calcaneus.%目的 探讨跟骨关节内骨折内固定手术并发症的发生原因、预防和对策.方法 收集2004年9月至2009年7月在石河子市人民医院采用切开复位+"Y"形钢板内固定伴必要时自体植骨治疗的Ⅱ~Ⅳ型跟骨骨折58例(共64足)患者的临床资料进行回顾性分析.结果 采用Maryland足部评分标准评价手术效果:优良55足,优良率为85.9%,9足发生术后复位不佳、畸形愈合、切口延迟愈合、感染等并发症.发生明确的早期并发症6足,发生率15.5%.结论 跟骨骨折内固定手术并发症与其解剖特点和骨折机制有关,采取相应措施可有效减少并发症的发生.

  10. The ESR1 (6q25 locus is associated with calcaneal ultrasound parameters and radial volumetric bone mineral density in European men.

    Directory of Open Access Journals (Sweden)

    Kate L Holliday

    Full Text Available PURPOSE: Genome-wide association studies (GWAS have identified 6q25, which incorporates the oestrogen receptor α gene (ESR1, as a quantitative trait locus for areal bone mineral density (BMD(a of the hip and lumbar spine. The aim of this study was to determine the influence of this locus on other bone health outcomes; calcaneal ultrasound (QUS parameters, radial peripheral quantitative computed tomography (pQCT parameters and markers of bone turnover in a population sample of European men. METHODS: Eight single nucleotide polymorphisms (SNP in the 6q25 locus were genotyped in men aged 40-79 years from 7 European countries, participating in the European Male Ageing Study (EMAS. The associations between SNPs and measured bone parameters were tested under an additive genetic model adjusting for centre using linear regression. RESULTS: 2468 men, mean (SD aged 59.9 (11.1 years had QUS measurements performed and bone turnover marker levels measured. A subset of 628 men had DXA and pQCT measurements. Multiple independent SNPs showed significant associations with BMD using all three measurement techniques. Most notably, rs1999805 was associated with a 0.10 SD (95%CI 0.05, 0.16; p = 0.0001 lower estimated BMD at the calcaneus, a 0.14 SD (95%CI 0.05, 0.24; p = 0.004 lower total hip BMD(a, a 0.12 SD (95%CI 0.02, 0.23; p = 0.026 lower lumbar spine BMD(a and a 0.18 SD (95%CI 0.06, 0.29; p = 0.003 lower trabecular BMD at the distal radius for each copy of the minor allele. There was no association with serum levels of bone turnover markers and a single SNP which was associated with cortical density was also associated with cortical BMC and thickness. CONCLUSIONS: Our data replicate previous associations found between SNPs in the 6q25 locus and BMD(a at the hip and extend these data to include associations with calcaneal ultrasound parameters and radial volumetric BMD.

  11. AN EVALUATION OF THE REARFOOT POSTURE IN INDIVIDUALS WITH PATELLOFEMORAL PAIN SYNDROME

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    Wendy Gilleard

    2004-11-01

    Full Text Available Structural abnormalities of the foot may cause abnormal subtalar joint compensatory motion in order to attain normal function of the lower extremity during gait although studies have not been conclusive. Current conflict in the literature may be related to the differing measures focused on the varying protocols and also the absence of a control group in some studies. This study investigated the rearfoot posture including Subtalar Joint Neutral Position (STJN and Relaxed Calcaneal Standing (RCS measurements in patellofemoral pain syndrome (PFPS and healthy subjects. The angle of STJN during non-weight bearing position and the two dimensional (2D rearfoot RCS posture was measured using a goniometer in 14 healthy females and 13 females with PFPS. The RCS posture was also measured three dimensionally (3D by attaching external markers to a tibia shell and the calcaneus and videoing with a four-camera three-dimensional motion analysis system. A one way ANOVA was used to assess the differences between the groups. The 2D and 3D RCS were significantly different between the groups (p ¡Ü 0.001 with mean -0.23¡ã ¡À 1.35¡ã , 2.52¡ã ¡À 3.11¡ã for the control group and 2.35¡ã ¡À 1.4¡ã, 7.02¡ã ¡À 3.33¡ã for the clinical group respectively. STJN showed a slight rearfoot varus (although significant p = 0.04 in PFPS (-2.20¡ã ¡À 1.51¡ã compared to the control group (-1.00¡ã ¡À 1.36¡ã. Negative values indicated inversion and positive values indicated eversion. The 2D and 3D RCS showed a significantly more everted posture of the rearfoot for the PFPS group. Subtalar joint varus may contribute to the increased eversion during relaxed standing in the PFPS group. Rearfoot measurements may be an important addition to other clinical measurements taken to explore the underlying aetiology of subjects with PFPS.

  12. Procedures for rat in situ skeletal muscle contractile properties.

    Science.gov (United States)

    MacIntosh, Brian R; Esau, Shane P; Holash, R John; Fletcher, Jared R

    2011-01-01

    There are many circumstances where it is desirable to obtain the contractile response of skeletal muscle under physiological circumstances: normal circulation, intact whole muscle, at body temperature. This includes the study of contractile responses like posttetanic potentiation, staircase and fatigue. Furthermore, the consequences of disease, disuse, injury, training and drug treatment can be of interest. This video demonstrates appropriate procedures to set up and use this valuable muscle preparation. To set up this preparation, the animal must be anesthetized, and the medial gastrocnemius muscle is surgically isolated, with the origin intact. Care must be taken to maintain the blood and nerve supplies. A long section of the sciatic nerve is cleared of connective tissue, and severed proximally. All branches of the distal stump that do not innervate the medial gastrocnemius muscle are severed. The distal nerve stump is inserted into a cuff lined with stainless steel stimulating wires. The calcaneus is severed, leaving a small piece of bone still attached to the Achilles tendon. Sonometric crystals and/or electrodes for electromyography can be inserted. Immobilization by metal probes in the femur and tibia prevents movement of the muscle origin. The Achilles tendon is attached to the force transducer and the loosened skin is pulled up at the sides to form a container that is filled with warmed paraffin oil. The oil distributes heat evenly and minimizes evaporative heat loss. A heat lamp is directed on the muscle, and the muscle and rat are allowed to warm up to 37°C. While it is warming, maximal voltage and optimal length can be determined. These are important initial conditions for any experiment on intact whole muscle. The experiment may include determination of standard contractile properties, like the force-frequency relationship, force-length relationship, and force-velocity relationship. With care in surgical isolation, immobilization of the origin of the

  13. The relationship between the bone mineral density and urinary cadmium concentration of residents in an industrial complex

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Minah; Paek, Domyung [Institute of Health and Environment, Department of Environmental Health, School of Public Health, Seoul National University, Gwanak-599, Gwanak-gu, Seoul 151-742 (Korea, Republic of); Yoon, Chungsik, E-mail: csyoon@snu.ac.kr [Institute of Health and Environment, Department of Environmental Health, School of Public Health, Seoul National University, Gwanak-599, Gwanak-gu, Seoul 151-742 (Korea, Republic of)

    2011-01-15

    Background: An association between cadmium exposure and bone mineral density (BMD) has been demonstrated in elderly women, but has not been well studied in youths and men. Some studies report either no or a weak association between cadmium exposure and bone damage. Objectives: This study was designed to investigate the relationship between the urinary cadmium (U-Cd) levels and BMD of females and males of all ages. Methods: A total of 804 residents near an industrial complex were surveyed in 2007. U-Cd and BMD on the heel (non-dominant calcaneus) were analyzed with AAS-GTA and Dual-Energy X-ray absorptiometry, respectively. Demographic characteristics were collected by structured questionnaires. Osteoporosis and osteopenia were defined by BMD cut-off values and T-scores set by the WHO; T score>-1, normal; -2.5=}1.0 {mu}g/g creatinine) in females (OR=2.92; 95% CI, 1.51-5.64) and in males (OR=3.37; 95% CI, 1.09-10.38). With the multiple linear regression model, the BMD of the adult group was negatively associated with U-Cd (<0.05), gender (female, p<0.001) and age (p<0.001). The BMD of participants who were {<=}19 years of age was negatively associated with gender (female, p<0.01), whereas it was positively associated with age and BMI (p<0.001). BMD was not associated with exercise, smoking habits, alcohol consumption, job or parental education. Conclusion: Results suggested that U-Cd might be associated with osteopenia as well as osteoporosis in both male and female adults. Age and female gender were negatively associated with BMD in the adult group, whereas age was positively

  14. Tratamento cirúrgico do pé eqüino na paralisia cerebral: uma revisão sistemática e quantitativa da literatura Surgical treatment of equinus varus deformity of the foot in cerebral palsy: a systematic and quantitative review of the literature

    Directory of Open Access Journals (Sweden)

    Rodrigo Montezuma César de Assumpção

    2008-09-01

    -up. The studies in which the mean age of patients at the time of surgery was older than seven years show a smaller sum total of relative risks when compared to the group with mean ager younger than seven years, showing a significant reduction of the absolute risk. The comparative analysis of studies that mention performance of lengthening of the calcaneus tendon shows a lower sum total of risks when compared to studies that mention lengthening in the muscle-tendon junction, but with a small reduction in absolute risk. CONCLUSIONS: Zetaplasty for the lengthening of the calcaneus tendon tends to be safer. Patients should operated on after seven years of age. In the long term, the risk of recurrence increases significantly, which reinforces the need for a follow-up of these patients at least till they reach skeletal maturity.

  15. Effects of exercise on lipid metabolism and musculoskeletal fitness in female athletes

    Institute of Scientific and Technical Information of China (English)

    Kung-Tung Chen; Rong-Sen Yang

    2004-01-01

    AIM: This study investigated the effects of intense training on lipid metabolism, bone metabolism and bone mineral density (BMD) in female athletes.METHODS: Sixty-six female subjects participated in this study,age ranging from 18 to 55 years. The sample group included thirty-six athletic subjects and the control group comprised thirty non-athletic individuals. Five athletes competed with national level (5/36) and nine non-athletic subjects (9/30) were postmenopausal women. The assessment items included body composition, radius BMD, calcaneus BMD, lung function,muscular endurance, renal and liver function, bone marker assay and hormone status. All data were analysed, using SPSS 10.0 software, and were presented as mean rank statistical difference, using the Kurskal-Wallis (K-W) test. After that the non-parameter statistics were used. EitherKvalue or Pvalue below 0.05 was considered significant.RESULTS: Udne deoxypyddinoline/creatinine (Dpd/Cre) levels increased significantly (5.93±2.31 vs6.85±1.43,k<0.01),sit-reach (29.30±9.48 cm vs 41.31±-9.43 cm, K<0.001,P<0.001), 1 minute sit-ups with bended knees (1 min situps) (17.60±9.34 count vs 30.00±10.38 count, K<0.001,P<0.001), and vertical jump (25.27±6.63 cm vs 34.69±7.99cm,K<0.001, P<0.001) improved significantly in the athletes group. The athletes group also had a significantly increased level of estriol (E3) (0.14±0.13 pg/mL vs0.07±0.04 pg/mL,K<0.01, P<0.01), radius BMD (1.37±0.49 gm/cm2 vs1.19±0.40gm/cm2,K<0.05) ,nd calcaneus BMD (0.57±0.17 gm/cm2 vs-0.20±0.17 gm/cm2, K<0.01, P<0.05)compared with those of the controls. The high density lipoprotein (HDL)(65.00±14.02 mg/dL vs52.26±4.84 mg/dL,K<0.05, P<0.05)was significantly lower in postmenopausal inactive athletes (5/36) than premenopausal active athletes (31/36). On the other hand, low-density lipoprotein (LDL) (98.35±-23.84 mg/dL vs 131.00±21.63 mg/dL,K<0.05, ,P<0.01), cholesterol (CHO)(164.03±27.01 mg/dL vs 193

  16. 3D automatic anatomy segmentation based on iterative graph-cut-ASM

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Xinjian; Bagci, Ulas [Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Building 10 Room 1C515, Bethesda, Maryland 20892-1182 and Life Sciences Research Center, School of Life Sciences and Technology, Xidian University, Xi' an 710071 (China); Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Building 10 Room 1C515, Bethesda, Maryland 20892-1182 (United States)

    2011-08-15

    Purpose: This paper studies the feasibility of developing an automatic anatomy segmentation (AAS) system in clinical radiology and demonstrates its operation on clinical 3D images. Methods: The AAS system, the authors are developing consists of two main parts: object recognition and object delineation. As for recognition, a hierarchical 3D scale-based multiobject method is used for the multiobject recognition task, which incorporates intensity weighted ball-scale (b-scale) information into the active shape model (ASM). For object delineation, an iterative graph-cut-ASM (IGCASM) algorithm is proposed, which effectively combines the rich statistical shape information embodied in ASM with the globally optimal delineation capability of the GC method. The presented IGCASM algorithm is a 3D generalization of the 2D GC-ASM method that they proposed previously in Chen et al.[Proc. SPIE, 7259, 72590C1-72590C-8 (2009)]. The proposed methods are tested on two datasets comprised of images obtained from 20 patients (10 male and 10 female) of clinical abdominal CT scans, and 11 foot magnetic resonance imaging (MRI) scans. The test is for four organs (liver, left and right kidneys, and spleen) segmentation, five foot bones (calcaneus, tibia, cuboid, talus, and navicular). The recognition and delineation accuracies were evaluated separately. The recognition accuracy was evaluated in terms of translation, rotation, and scale (size) error. The delineation accuracy was evaluated in terms of true and false positive volume fractions (TPVF, FPVF). The efficiency of the delineation method was also evaluated on an Intel Pentium IV PC with a 3.4 GHZ CPU machine. Results: The recognition accuracies in terms of translation, rotation, and scale error over all organs are about 8 mm, 10 deg. and 0.03, and over all foot bones are about 3.5709 mm, 0.35 deg. and 0.025, respectively. The accuracy of delineation over all organs for all subjects as expressed in TPVF and FPVF is 93.01% and 0.22%, and

  17. Radiography and sonography of clubfoot: A comparative study

    Directory of Open Access Journals (Sweden)

    Satish Kumar Bhargava

    2012-01-01

    Full Text Available Background: Congenital talipes equinovarus is a common foot deformity afflicting children with reported incidence varying from 0.9/1000 to 7/1000 in various populations. The success reported with Ponseti method when started at an early age requires an imaging modality to quantitate the deformity. Sonography being a radiation free, easily available non-invasive imaging has been investigated for this purpose. Various studies have described the sonographic anatomy of normal neonatal foot and clubfoot and correlated the degree of severity with trends in sonographic measurements. However, none of these studies have correlated clinical, radiographic and sonographic parameters of all the component deformities in clubfoot. The present study aims to compare the radiographic and sonographic parameters in various grades of clubfoot. Materials and Methods: Thirty-one children with unilateral clubfoot were examined clinically and graded according to the Demeglio system of classification of clubfoot severity. Antero-posterior (AP and lateral radiographs of both normal and affected feet were obtained in maximum correction and AP talo-calcaneal (T-C, AP talo-first metatarsal (TMT and lateral T-C angles were measured. Sonographic examination was done in medial, lateral, dorsal and posterior projections of both feet in static neutral position and after Ponseti manouever in the position of maximum correctability in dynamic sonography. Normal foot was taken as control in all cases. The sonographic parameters measured were as follows : Medial malleolar- navicular distance (MMN and medial soft tissue thickness (STT on medial projection, calcaneo-cuboid (C-C distance, calcaneo-cuboid (C-C angle and maximum length of calcaneus on lateral projection, length of talus on dorsal projection; and tibiocalcaneal (T-C distance, posterior soft tissue thickness and length of tendoachilles on posterior projection. Also, medial displacement of navicular relative to talus, mobility

  18. 3D automatic anatomy segmentation based on iterative graph-cut-ASM

    International Nuclear Information System (INIS)

    Purpose: This paper studies the feasibility of developing an automatic anatomy segmentation (AAS) system in clinical radiology and demonstrates its operation on clinical 3D images. Methods: The AAS system, the authors are developing consists of two main parts: object recognition and object delineation. As for recognition, a hierarchical 3D scale-based multiobject method is used for the multiobject recognition task, which incorporates intensity weighted ball-scale (b-scale) information into the active shape model (ASM). For object delineation, an iterative graph-cut-ASM (IGCASM) algorithm is proposed, which effectively combines the rich statistical shape information embodied in ASM with the globally optimal delineation capability of the GC method. The presented IGCASM algorithm is a 3D generalization of the 2D GC-ASM method that they proposed previously in Chen et al.[Proc. SPIE, 7259, 72590C1-72590C-8 (2009)]. The proposed methods are tested on two datasets comprised of images obtained from 20 patients (10 male and 10 female) of clinical abdominal CT scans, and 11 foot magnetic resonance imaging (MRI) scans. The test is for four organs (liver, left and right kidneys, and spleen) segmentation, five foot bones (calcaneus, tibia, cuboid, talus, and navicular). The recognition and delineation accuracies were evaluated separately. The recognition accuracy was evaluated in terms of translation, rotation, and scale (size) error. The delineation accuracy was evaluated in terms of true and false positive volume fractions (TPVF, FPVF). The efficiency of the delineation method was also evaluated on an Intel Pentium IV PC with a 3.4 GHZ CPU machine. Results: The recognition accuracies in terms of translation, rotation, and scale error over all organs are about 8 mm, 10 deg. and 0.03, and over all foot bones are about 3.5709 mm, 0.35 deg. and 0.025, respectively. The accuracy of delineation over all organs for all subjects as expressed in TPVF and FPVF is 93.01% and 0.22%, and

  19. Validación de cuestionarios para el estudio de hábitos alimentarios y masa ósea Validation of questionnaires for the study of food habits and bone mass

    Directory of Open Access Journals (Sweden)

    A. Rivas

    2009-10-01

    results of the food frequency questionnaire were compared with 24-hr recall findings. Calcaneus BMD was measured by densitometry. Results: The validity of the questionnaire was demonstrated, with Spearman correlation coefficients of 0.014 to 0.467. The Bland-Altman test also found no differences in study variables between the two methods. Correlation analysis showed that the BMD was significantly associated with the intake of vitamin D, vitamin A, vitamin B12, folate, thiamine and iron. Total fat consumption was not associated with BMD but the intake of monounsaturated fatty acids, EPA, DHA and cholesterol showed a significant correlation. Conclusion: The questionnaire evaluates the consumption of energy and nutrients with adequate validity. Its application revealed the importance for bone health of a diet rich in B-group vitamins, vitamin D, calcium, iron, monounsaturated fatty acids and n-3.

  20. Staged treatment strategy for chronic osteomyelitis%慢性骨髓炎的分期治疗策略

    Institute of Scientific and Technical Information of China (English)

    赵刚; 齐明; 张伯松; 黄雷

    2012-01-01

    Background: Chronic osteomyelitis is a difficult problem. The purpose of this article is to apply a proper method to solve it. Objective: The aim of the study is to explore the effects of application of debridement, irrigation and vacuum sealing drainage combined with implantation of calcium phosphate or cement impregnated with antibiotics in treatment of chronic osteomyelitis. Methods: From March 2008 to March 2012, 27 patients were treated by using debridement, wound irrigation and vacuum sealing drainage in the first stage, and implanted with calcium phosphate or cement loaded with antibiotics in the second stage. There were 21 males and 6 females with an average age of 38 years (range, 20 to 77 years). Osteomyelitis occurred in tibia in 17 cases, in femur in 7 cases and calcaneus in 3 cases. Results: All the patients were followed up for 27 (6-51) months on average. Of them, 25 patients were cured , but the infection in 2 cases were unfortunately uncontrolled. Conclusions: Staged treatment by means of debridment, irrigation and VSD in the first stage, and implantation calcium phosphate or cement loaded with antibiotics in the second stage, is a effective method of chronic osteomyelitis.%背景:慢性骨髓炎是骨科临床的疑难杂症之一,本文旨在探讨一种目前比较合理的治疗方式.目的:探讨运用灌洗负压引流和可吸收人工骨或者骨水泥混合抗生素分期治疗慢性骨髓炎的临床效果.方法:2008年3月至2012年3月采用一期清创灌洗负压引流,二期可吸收人工骨或者骨水泥混合抗生素植入治疗27例慢性骨髓炎患者,男21例,女6例;年龄20~77岁,平均38岁;骨髓炎发生部位:胫腓骨17例,股骨7例,跟骨3例.结果:27例患者均得到随访,随访时间6~51个月(平均27个月),25例痊愈,2例复发.结论:一期清创、灌洗负压引流,二期可吸收人工骨或者骨水泥混合抗生素治疗慢性骨髓炎可以取得良好的临床疗效.

  1. Bursite peritrocantérica: descrição de nova manobra semiológica para auxílio diagnóstico Peritrochanteric bursits: a description of a new semiologic maneuver for diagnostic assistance

    Directory of Open Access Journals (Sweden)

    Edson Noburo Fujiki

    2008-01-01

    Full Text Available O estudo tem como objetivo testar a validade de nova manobra semiológica no diagnóstico de bursite peritrocantérica. Foram avaliados 30 pacientes, com diagnóstico clínico de bursite do grande trocanter. Todos os pacientes foram submetidos à radiografia de bacia AP e Perfil. Quando necessário, outros exames de imagem foram realizados, com a finalidade de descartar doenças associadas; os pacientes foram submetidos a duas manobras semiológicas no quadril são e afetado. TESTE 1: paciente em decúbito dorsal, o membro examinado é aduzido em extensão cruzando sobre o membro contralateral, com o calcâneo em contato com a maca, faz-se a flexão do quadril até aproximadamente 90º, o quadril ao final da manobra estará em flexão, adução e leve rotação externa, durante a manobra poderá ser referida dor na região do trocanter maior. TESTE 2: a posição final do TESTE 1, é a posição inicial desta, faz-se a adução forçada do quadril, pode haver referencia de dor ou exacerbação. Os resultados das manobras foram submetidos ao estudo estatístico, que demonstrou serem os exames diferentes entre si, porém complementares. O teste 2 mostrou ser positivo em 96,6%. As manobras semiológicas denominadas de TESTE 1 e 2, podem ser utilizadas como auxiliares nos diagnósticos clínicos das bursites peritrocanterianas.The objective of the present study was to test the validity of a semiologic maneuver on the diagnosis of peritrochanteric bursitis. Thirty patients with a clinical diagnosis of great trochanter bursitis were assessed. All patients were submitted to X-ray studies at AP and LP. Whenever necessary, other imaging tests were performed, intending to rule out any associated diseases; the patients were submitted to two semiologic maneuvers on both hips, the affected and the normal one. TEST 1: with patient at supine position, the examined limb is adduced in extension and crossing it over the contralateral limb, with the calcaneus

  2. Assessment Of Knowledge And Practices Related To Tuberculosis And Associated Factors Among HIV Positive People In Addis Ababa, Ethiopia

    Directory of Open Access Journals (Sweden)

    Rahel Abebe

    2012-03-01

    Objectives- To know the most common type of calcanei in North Indian population and itsclinical importance. There are three articular facets on superior surface of calcaneus- anterior, middle andposterior. Three types of calcanei are noted according to number and arrangement of the articular facets-type A, B and C. Methodology - The present studywasdone on 300 dry adult human calcanei of unknownsex taken from Department of Anatomy Sri Guru Ram Das Institute of Medical Sciences and ResearchVallah (Amritsar. Results- In our study Type B was found as the most common type. Type A is the nextmost common. Interpretation- The talocalcaneal joint is important in arthritis and coalition, flat foot, valgus deformity, congenital anomalies and intra articular fractures.

  3. 长期冬泳对老年人骨健康指标的影响%Effect of long-term winter swimming on bone health in the elderly

    Institute of Scientific and Technical Information of China (English)

    赵春琪

    2014-01-01

    Objective To investigate the effect of long-term winter swimming on bone mineral density ( BMD ) and bone metabolism in the elderly.Methods A total of 114 elderly people, aging from 55 to 65 years old, were selected and divided into winter swimming group and control group.BUA, SOS, QUI, and BMD values of the calcaneus were determined using the Sahara Clinical Bone Sonometer.The serum levels of calcium (Ca), phosphorous (P), and ALP were determined using MODULAR automatic biochemical analyzer.The content of osteocalcin ( BGP) and tartrate-resistant acid phosphatase 5b ( TRACP5b) was determined using S200 type microplate reader.Results The average values of BUA, SOS, QUI, and BMD in the winter swimming group were higher than those in the control group, and the difference was significant (P<0.01).The average value of ALP between the groups was significantly different (P<0.05).The significant difference of the average serum levels of Ca, BGP, and TRACP5b between two groups was also observed ( P <0.01).Conclusion Winter swimming can improve the bone metabolism and BMD in the elderly men.It has a positive significance to improve the overall health of the elderly.So it is a good exercise for the elderly people.%目的:了解长期冬泳运动对老年人骨密度和骨代谢指标的影响。方法以114名55~65岁的老年人为研究对象,分为冬泳组和对照组。采用Sahara Clinical Bone Sonometer 超声骨密度测定仪测定跟骨宽带超声衰减(BUA)、超声声速(SOS)、定量超声指数(QUI)和骨密度(BMD)。采用MODULAR全自动生化分析仪测定血清钙(Ca)、磷(P)和碱性磷酸酶(ALP)含量,同时采用S200型酶标仪测定骨钙素( BGP)、抗酒石酸酸性磷酸酶5b ( TRACP5b)含量。结果冬泳组男性老年人的BUA、SOS、QUI和BMD均值高于对照组,且存在非常显著的组间差异( P<0.01);冬泳组和对照组老年人的ALP均值存在显著的组间差异(P<0

  4. New method for evaluation of cutaneous sensibility in diabetic feet: preliminary report Novo método para avaliação da sensibilidade cutânea do pé diabético: relato preliminar

    Directory of Open Access Journals (Sweden)

    Marcus Castro Ferreira

    2004-01-01

    Full Text Available Diabetic neuropathy is an important complication of the disease, responsible for ulceration and amputation of the foot. Prevention of these problems is difficult mainly because there is no method to correctly access sensibility on the skin of the foot. The introduction of the Pressure-Specified Sensory Device (PSSD TM in the last decade made possible the measurement of pressure thresholds sensed by the patient, such as touch, both static and in movement, on a continuous scale. This paper is the first in Brazil to report the use of this device to measure cutaneous sensibility in 3 areas of the foot: the hallux pulp, the calcaneus, and the dorsum, which are territories of the tibial and fibular nerves. METHOD: Non-diabetic patients were measured as controls, and 2 groups of diabetic patients - with and without ulcers - were compared. The PSSD TM was used to test the 3 areas described above. The following were evaluated: 1 PS (1-point static, 1 PD (1-point dynamic, 2 PS (2-points static, 2 PD (2-points dynamic. RESULTS: The diabetic group had poorer sensibility compared to controls and diabetics with ulcers had poorer sensibility when compared to diabetics without ulcers. The differences were statistically significant (P A neuropatia diabética é uma complicação importante do Diabetes melitus, responsável por ulcerações e amputações de membros inferiores. A prevenção desses problemas é difícil principalmente pela ausência de métodos que avaliem de forma precisa a sensibilidade cutânea dos pés. A introdução do PSSD TM (Pressure-Specified Sensory Device na década passada tornou possível a medição dos limiares cutâneos de pressão. Estes são sentidos como estímulos táteis tanto estáticos como dinâmicos. Este artigo é o primeiro no Brasil a relatar o uso do PSSD TM para avaliar 3 áreas dos pés: polpa do hallux, calcâneo e dorso do pé, territórios de inervação dos nervos tibial e fibular. MÉTODO: Pacientes não diab

  5. Caracterização dos portadores de diabetes submetidos à amputação de membros inferiores em Londrina, Estado do Paraná - doi: 10.4025/actascihealthsci.v32i2.7754 Characterization of diabetic patients submitted to lower limb amputation in Londrina, Paraná State - doi: 10.4025/actascihealthsci.v32i2.7754

    Directory of Open Access Journals (Sweden)

    Maria do Carmo Lourenço Haddad

    2010-09-01

    % of patients had diabetic neuropathy, 93% had lower limb ulcers, 52% had gangrene. They remained hospitalized an average of 14 days, and the length of hospital stay varied from 3 to 50 days. Of the amputations performed, 30% involved the thigh, 30% toes, 27.50% upper third of the leg, 5% transmetatarsal region, 5% knee disarticulation and 2.5% calcaneus bone. The increase in amputations is cause for concern for the quality of life of these patients, considering the physical and psychological impact that amputation has on the individual. Furthermore, higher government and institutional costs will be required to assist the health needs of these patients. It was concluded that prevention is the best alternative to reduce this amputation rate and improve the quality of life of diabetics.

  6. 少见部位软骨母细胞瘤的影像诊断%Imaging diagnosis of chondroblastoma in unusual locations

    Institute of Scientific and Technical Information of China (English)

    戴灼南; 司建荣

    2012-01-01

    Objective:To investigate the imaging features and their value in the diagnosis of chondroblastoma in unusual locations. Methods:The clinical materials of 7 cases with pathology proved chondroblastoma in unusual locations were retrospectively analyzed,involving talus (n=2) .calcaneus (n = 2) ,patella,ischial tuberosity and inferior ramus of pubis for one case each. In these 7 patients, plain radiography (n= 7) ,computed tomography (n=4) and magnetic resonance imaging (n=4) were performed. Results:Expansive bone destruction (n=5) and cystic bone destrution (n= 1) were assessed on radiography, also patchy sclerosis around the lesion (n=3) and intra-tumoral spotty calcifications (n=l). Of the 4 cases undergone CT, there were expansive bone destruction, patchy sclerosis around the lesion and intra-tumoral patchy or spotty calcifications. Expansive bone destruction were showed in 3 cases on MRI with heterogeneous signal intensities. peripheral linear hypo-intensity and obvious bone marrow edema. Conclusion; Imaging features of chondroblastoma in unusual locations included expansive destruction of bone,and peripheral bone marrow edema. Combined utilization of plain films,CT and MRI is helpful for the diagnosis and differential diagnosis of chondroblastoma in unusual locations.%目的:探讨少见部位软骨母细胞瘤的影像学表现及其临床诊断价值.方法:回顾性分析经病理证实的7例少见部位软骨母细胞瘤患者的病例资料.肿瘤位于距骨2例、跟骨2例、髌骨、坐骨结节及耻骨下支各1例.行X线平片检查7例,CT平扫4例,MRI平扫及增强检查4例.结果:X线平片示膨胀性骨质破坏5例,囊状骨质破坏1例,灶周硬化3例,病灶内小斑片状钙化1例;平片漏诊1例.4例CT均显示膨胀性骨质破坏,灶周硬化,病灶内斑点状或小斑片状钙化.MRI上病变呈膨胀性骨质破坏3例,囊状骨质破坏1例,4例病灶信号均混杂,灶周均可见低信号线状影及明显的骨髓水肿.结

  7. The new bi - directional compression fracture malunion of calcaneal nail care%新型双向加压钉治疗跟骨骨折畸形愈合的护理

    Institute of Scientific and Technical Information of China (English)

    郑慧琳; 余旭辉; 段清萍; 张弘; 饶绮

    2015-01-01

    目的::探讨新型双向加压钉治疗跟骨骨折畸形愈合的护理方法。方法:选择陈旧性跟骨骨折畸形愈合患者30例,采集患者症状、体征及 X 线摄片或 CT 检查的相关数据,根据畸形的类型、程度、临床表现,实施新型双向加压钉矫形手术治疗,在围术期进行系统的护理。结果:30例患者33足手术时间15~45 min,平均时间(28.3±6.7)min;术中失血16~52 ml。术后 X 线片及螺旋 CT 扫描复查,均显示跟骨外侧突出骨块及跟骨横径已恢复正常。所有患者均顺利出院,术后随访时间12~30个月,平均17.5个月。 X 线片显示跟骨高度、宽度、Bohler 角基本恢复正常。根据美国骨科足踝外科学会的踝后足评分标准评分,60~70分1例,71~80分5例,81~90分18例,91~100分6例。结论:对陈旧性跟骨骨折患者行新型双向加压钉治疗,在围术期进行精心的护理,可有效减少并发症,提高手术成功率。%Objective:To explore the new bi - directional compression fracture malunion of calcaneal nail care. Methods:30 cases of calcaneal fracture mal-union cases,collecting patient symptoms,signs and X - ray or CT examination of the relevant data,according to the clinical types,degrees,deformity,the im-plementation of the new bi - directional compression nail for treatment of orthopedic operation,in the perioperative period nursing system. Results:30 cases of 33 foot operation time 15 - 45 min,average time was (28. 3 ± 6. 7)min;intraoperative blood loss was 16 - 52 ml. after X - ray and spiral CT scans showed prominent,lateral calcaneus bone block and calcaneal diameter has returned to normal. All patients were successfully discharged,postoperative follow - up, patients were followed up for 12 - 30 months,average 17. 5 months. X - ray showed the calcaneal height,width,the angle of Bohler returned to normal. Ac-cording to the Institute of USA Department of orthopedics of foot and ankle surgery ankle hindfoot score

  8. Micro-compression: a novel technique for the nondestructive assessment of local bone failure.

    Science.gov (United States)

    Müller, R; Gerber, S C; Hayes, W C

    1998-12-01

    Many bones within the axial and appendicular skeleton are subjected to repetitive, cyclic loading during the course of ordinary daily activities. If this repetitive loading is of sufficient magnitude or duration, fatigue failure of the bone tissue may result. In clinical orthopedics, trabecular fatigue fractures are observed as compressive stress fractures in the proximal femur, vertebrae, calcaneus and tibia, and are often preceded by buckling and bending of microstructural elements. However, the relative importance of bone density and architecture in the etiology of these fractures is poorly understood. The aim of the study was to investigate failure mechanisms of 3D trabecular bone using micro-computed tomography (microCT). Because of its nondestructive nature, microCT represents an ideal approach for performing not only static measurements of bone architecture but also dynamic measurements of failure initiation and propagation as well as damage accumulation. For the purpose of the study, a novel micro-compression device was devised to measure loaded trabecular bone specimens directly in a micro-tomographic system. The measurement window in the device was made of a radiolucent, highly stiff plastic to enable X-rays to penetrate the material. The micro-compressor has an outer diameter of 19 mm and a total length of 65 mm. The internal load chamber fits wet or dry bone specimens with maximal diameters of 9 mm and maximal lengths of 22 mm. For the actual measurement, first, the unloaded bone is measured in the microCT. Second, a load-displacement curve is recorded where the load is measured with an integrated mini-button load cell and the displacement is computed directly from the microCT scout-view. For each load case, a 3D snap-shot of the structure under load is taken providing 34 microm nominal resolution. Initial measurements included specimens from bovine tibiae and whale spine to investigate the influence of the structure type on the failure mechanism. In a

  9. Medial retromalleolar perforator adipofascial flap: anatomical and clinical study%内踝后穿支筋膜皮下瓣的解剖与临床研究

    Institute of Scientific and Technical Information of China (English)

    张英琪; 张世民

    2011-01-01

    目的 介绍内踝后穿支筋膜皮下瓣的血管解剖基础与初步临床应用效果. 方法 解剖24侧新鲜下肢灌注标本,观察内踝后间隙内胫后动脉发出的穿支血管情况.临床切取内踝后穿支筋膜皮下瓣,翻转修复跟内侧创伤缺损5例.结果 内踝后间隙长约4cm,前界为内踝及趾长屈肌腱,后方为跟腱,表面为深筋膜覆盖,间隙内有疏松脂肪组织.在内踝后间隙内走行的胫后动脉发出2~3条皮肤穿支血管,口径0.1~0.7mm,一般小于0.5 mm,但数量恒定.内踝后穿支与上方的胫后动脉最远侧肌间隔穿支血管间有互补性,在筋膜表面和皮下组织中有丰富血管吻合.临床上以内踝后穿支血管为轴点(内踝最下缘上方1~2 cm),设计切取远端蒂筋膜皮下瓣,面积5~6 cm×6~12 cm,修复5例跟骨开放性骨折的内侧创面,筋膜瓣均成活.结论 内踝后穿支筋膜皮下瓣相对传统的肌间隔穿支血管组织瓣,其旋转轴点下移,减少小腿供区损伤,无静脉回流障碍,受区组织柔软活动度好,更适合修复足跟内侧的创面.%Objective To introduce the anatomical study and clinical experience of medial retromalleolar perforator adipofascial flap. Methods Microsurgical anatomic study was carried out on 24 fresh cadaver limbs, and was focused on the distal perforators of the posterior tibial artery. Then five clinical cases of distally based medial retromalleolar perforator flaps were raised for medial wound coverage of the calcaneus after open fracture. Results The terminal part of posterior tibial artery run distally in the medial retromalleolar space. The space was usually 4cm long, with its anterior border of medial malleolus and flexor digitorum longus tendon, medial border of Achilles tendon, covered by deep fascia, and filled with areolar fatty tissue, hi the space, there were about 2-3 fasciocutaneous perforators with caliber ranged 0.1-0.7 mm, usually less than 0.5mm with an average 0.47mm

  10. Image analysis of the distribution of tophus in ankle joint and tarsal joint%痛风患者踝跗关节痛风石沉积特点的影像学分析

    Institute of Scientific and Technical Information of China (English)

    孙德政; 杨青; 胡亚彬; 段峰; 于华龙

    2014-01-01

    目的:应用多排螺旋 CT 对踝跗关节痛风石常见沉积部位进行分析,并对痛风发病机制进行探讨研究。方法对临床确诊34例踝跗关节痛风患者的双踝跗关节行 CT 平扫检查,其中55个踝跗关节可见痛风石沉积。将痛风石沉积部位分为韧带组、肌腱组及关节组,并分别对其进行记录、分析。结果韧带组中常见受累韧带依次为距腓前韧带(n=38)、内侧韧带(距骨跟骨端)(n=30)、距跟骨间韧带(n=29)(P <0.05)。肌腱组最常受累肌腱为跟腱(n=18),其次为胫骨后肌腱(n=7)(P <0.05)。关节组依次为楔间关节(n=15)、胫腓下关节(n=10)(P <0.05)。结论距腓前韧带为踝跗关节痛风石最常受累韧带,跟腱为最常受累肌腱。痛风石最易累及的关节为楔骨间关节。%Objective To analyze the distribution of tophus in ankle and tarsal joints by multislice spiral computed tomography (MSCT)and to explore the pathogenesis of gout.Methods 34 patients with a documented diagnosis of gout underwent CT examina-tion of bilateral ankle and tarsal joints,and 55 ankle and tarsal joints were observed tophus.The sites of tophus deposition were cate-gorized into groups of ligament,tendon and joint in order to record and analyze.Results The tophus were showed at the anterior talofibular ligament (n=38),the medial ligament (the site of talus and calcaneus)(n=30)and the interosseous talocalcaneal liga-ment (n=29)(P <0.05)in the group of ligament;at achilles tendon (n= 18),followed by tibialis posterior tendon (n= 7)(P <0.05)in the group of tendon;at articulations intercuneiformes (n=1 5)and inferior tibiofibular articulation (n= 10)(P <0.05 )in the group of joint.Conclusion In ankle and tarsal joints,tophus is commonly deposited at the anterior talofibular ligament,at the achilles tendon and the articulationes intercuneiformes.

  11. To Investigate the Application of Spiral CT Three-dimensional Reconstruction of the Value of Calcaneal Fractures%跟骨骨折应用螺旋 CT 三维重建的价值探讨

    Institute of Scientific and Technical Information of China (English)

    李海源; 李小满; 高莉丽; 林秀琼; 蔡映红; 梁玉英

    2015-01-01

    Objective Analysis of spiral CT three-dimensional reconstruction imaging in the diagnosis of trauma in the clinical value of calcaneus .Methods Collection the patients with calcaneal injury to our hospital for diagnosis and treatment in November 2 0 1 2 to November 2 0 1 4 ,selection of image data w hich patients had X-ray examination and three-dimensional reconstruction of spiral CT examination ,comparison of X -ray and spiral CT 3 D reconstruction ,by using the SPSS1 9 .0 statistical software using chi square test analysis of the dif-ference between X-ray and spiral CT 3 D reconstruction in diagnosis ,classification of calcaneal fracture .Results X-ray examination and CT 3 D reconstruction for diagnosis if there is no statistical significance of calcaneal fracture(P=0 .371 >0 .05 ) ,the fracture type classification (comminuted ,intra-articular) are highly statisti-cally significant( P<0 .0 1 ) .Conclusion X-ray and spiral CT 3 D reconstruction is the basic way to check the calcaneum bone fracture ,but the spiral CT three-dimensional reconstruction can specifically form more intu-itive ,comprehensive ,clear observation of fracture ,bring convenience for Department of orthopedics diagnosis and treatment .%目的:分析螺旋CT三维重建成像技术在诊断跟骨外伤中临床价值。方法收集2012年11月至2014年11月间到我院接受诊治的跟骨外伤患者,挑选其中患者均有进行X线平片检查及螺旋CT三维重建检查的影像资料,比较X线平片检查及螺旋CT三维重建,采用SPSS 19.0统计软件应用卡方检验分析X线平片检查及螺旋CT三维重建对跟骨骨折诊断、分类的差异。结果 X线平片检查与CT三维重建对于诊断是否有跟骨骨折无统计学意义(P=0.371>0.05),对于骨折类型分类(粉碎性、关节内)有高度统计学意义( P<0.01)。结论 X线平片检查及螺旋CT三维重建都是跟骨骨折检查的基本方式,但螺旋CT三维重

  12. 小趾展肌神经与神经源性跟痛症关系的解剖学基础%Anatomic relationship of abductor digiti miniini nerve and neuragenic painful heel syndrome

    Institute of Scientific and Technical Information of China (English)

    冯成安; 孙俊; 刘宗良; 范炜; 张东葵; 陆地

    2012-01-01

    related to the occurrence of the plantar fasciitis. The calcaneus spur doesn't always cause the NPHS.

  13. Intraosseous lipoma: radiological findings Lipoma intra-ósseo: achados radiológicos

    Directory of Open Access Journals (Sweden)

    Özgür Öztekin

    2008-04-01

    Full Text Available OBJECTIVE: Intraosseous lipomas may be less rare lesions than previously suggested in the literature. They have frequently been misdiagnosed as other benign bone lesions. A combination of computed tomography, magnetic resonance imaging and radiography is essential for decreasing misdiagnosis rates. MATERIALS AND METHODS: This retrospective study presents ten cases of intraosseous lipoma. The patients' ages ranged from 25 to 80 years, and six of them were female. Six patients presented with bone pain, whereas four patients were asymptomatic with incidentally discovered lesions. The involved bones were: femur (four patients, tibia (two patients, calcaneus (one patient, sacrum (one patient, iliac bone (one patient, navicular bone (one patient. All of the patients were assessed by means of conventional radiography, computed tomography and magnetic resonance imaging of the affected region. RESULTS: In all of the cases, plain films revealed well-defined lytic lesions. Both computed tomography and magnetic resonance imaging were quite useful in demonstrating fat within the femur. The histologic pattern of all tumors was that of mature adipose tissue. CONCLUSION: Intraosseous lipoma is a well-defined entity that may develop with varying presentations. Plain radiographs alone cannot establish the diagnosis of this lesion. However, both computed tomography and magnetic resonance imaging are quite useful methods in these cases.OBJETIVO: Lipomas intra-ósseos podem ser lesões menos raras do que anteriormente sugerido na literatura. Freqüentemente têm sido erroneamente diagnosticados como outras lesões ósseas benignas. A combinação de tomografia computadorizada, ressonância magnética e radiografia é essencial para reduzir as taxas de erro diagnóstico. MATERIAIS E MÉTODOS: Este estudo retrospectivo apresenta dez casos de lipoma intra-ósseo. As idades dos pacientes variavam entre 25 e 80 anos, e seis deles eram do sexo feminino. Seis pacientes

  14. Diagnosis and surgical treatment of thoracolumbar vertebral Chance fractures caused by a fall%坠落伤致胸腰椎Chance骨折的诊断与外科治疗

    Institute of Scientific and Technical Information of China (English)

    王根林; 杨惠林; 蔡鑫; 史金辉; 唐天驷

    2008-01-01

    Objective To explore the diagnosis of Chance fractures of thoracolumbar spine and the clinical efficacy of segmental pedicle screw instrumentation in the treatment.Methods The clinicsl data of 16 patients with Chance fractures from January 2000 to January 2007 were retrospectively analyzed.All patients were treated with segmental pedicle screw instrumentation.Radiology and the Oswestry Disability Index(ODI)were used to evaluate the efficacy.Results One case associated with open dislocation of ankle and craniocerebral iniury,3 cases with calcaneus fracture and 1 with kidney contusion.All cases were followed up from 7 months to 6 years.with a mean of 2.6 years.There were no operation complications.The anterior vertebral body height of fracture vertebra was restored from preoperative(63.3±6.8)% to postoperative(92.1±4.0)%,at the follow-up(90.7±3.6)%.There was a significant improvement between preoperative and postoperative values(P0.05).The mean ODl was 4.9.Conclusions The injuries associated with Chance fracture caused by a fall and its mechanism are different from those with the safety belt injury.The segmental pedicle screw instrumentation can rebuild spinal stabilization and restore spinal alignment in treatment of Chance fractures.%目的 探讨坠落伤致胸腰椎Chance骨折的诊断及短节段椎弓根螺钉系统治疗的疗效.方法 回顾性分析2000年1月至2007年1月收治的由高处坠落伤所致16例Chance骨折患者的临床资料.所有患者均接受短节段椎弓根螺钉系统内固定治疗,术后通过影像学检查和Oswestry功能障碍指数综合评价其疗效.结果 1例合并踝关节开放脱位与颅脑损伤,3例合并跟骨骨折,1例合并肾挫伤.无手术并发症.随访7个月~6年,平均2.6年.伤椎前缘高度由术前平均(63.3±6.8)%恢复至术后(92.1±4.0)%(P0.05).随访时患者Oswestry功能障碍指数平均为4.9.结论 高处坠落伤所致胸腰椎Chance骨折的合并伤及损伤机制不同于安

  15. Caracterização dos portadores de diabetes submetidos à amputação de membros inferiores em Londrina, Estado do Paraná = Characterization of diabetic patients submitted to lower limb amputation in Londrina, Paraná State

    Directory of Open Access Journals (Sweden)

    Maira Sayuri Sakay Bortoletto

    2010-07-01

    patients had diabetic neuropathy, 93% had lower limb ulcers, 52% had gangrene. They remained hospitalized an average of 14 days, and the length of hospital stay varied from 3 to 50 days. Of the amputations performed, 30% involved the thigh, 30% toes, 27.50% upper third of the leg, 5% transmetatarsal region, 5% knee disarticulation and 2.5% calcaneus bone. The increase in amputations is cause for concern for the quality of life of these patients, considering the physical and psychological impact that amputation has on the individual. Furthermore, higher government and institutional costs will be required to assist the health needs of these patients. It was concluded that prevention is the best alternative to reduce this amputation rate and improve the quality of life of diabetics.

  16. Terapia hormonal y calidad del hueso Hormone therapy and bone quality

    Directory of Open Access Journals (Sweden)

    2005-08-01

    multidisciplinary office of climacteric of “Ramón Gonzales Coro” Gynecoobstetric Hospital from January 1997 to December 2003, it was determined the bone quality by dual X-ray absorptiometry in the lumbar region (L2-L4 or by calcaneus ultrasound (CALUS. They receive continuing treatment with estrogenic therapy (E or with progestogenous estrogens (PE for no less than a year (n = 30. Women who were not able to receive RHT were grouped and evaluated as a control group (n = 12. During an average observation time of 2 years, the females that receieved RHT improved their bone quality in 16.8 %, whereas those of the control group got worse in 8 % of the cases. The initial results, although modest, showed the usefulness of RHT for improving the bone quality and the need to continue carrying out studies that allow to define in our setting the persistance of bone improvement, as well as the magnitude of postmenopausic osteoporosis.

  17. 组合性手术治疗脊柱裂后遗踝足畸形%Combined procedure for the treatment of ankle and foot deformities secondary to spina bifida

    Institute of Scientific and Technical Information of China (English)

    焦绍锋; 秦泗河; 任龙喜; 葛建忠; 吴鸿飞; 王振军; 郑学建

    2012-01-01

    and varus deformities were treated by tendon transfer and calcaneal osteotomy; 15 patients with flail deformities were managed treated by bone fusion between calcaneus and talus and shortening of achilles tendon ; 9 patients with claw toe deformities were treated by bone fusion of interphalangeal joint or Ilizarov's distraction. AOFAS (American Orthopaedic Foot & Ankle Society)comprehensive scoring system was used to evaluate subjective pain and objective functional. ResultS;Seventy-nine (127 feet) of 107 patients were followed up,and the duration ranged from 48 to 180 months ( averaged,64 months). According to AOFAS scoring system,the results were rated as excellent in 89 feet,good in 26 feet,moderate in 9 feet and poor in 3 feet. Conclusion;Treatment strategies for ankle-foot deformities mainly included four principles,deformity correction,muscular balance,joint stability and reservation of foot elasticity. Different combined procedure was applied for different foot deformities and received good therapeutic effects.

  18. 南昌市社区中老年人群生活方式与骨密度测定现状调查及分析%The on-site community investigation and analysis on lifestyle and the present situation of bone mineral density with middle aged and elderly people in Nanchang city

    Institute of Scientific and Technical Information of China (English)

    章玉玲; 王晨秀; 刘精东; 霍亚南; 林安华; 程丽红

    2013-01-01

    目的 了解南昌市社区40岁以上人群生活方式与骨密度测定情况,为社区骨密度异常的预防和干预措施提供依据.方法 应用超声骨密度检测仪测量南昌市社区10 002名40岁以上人群的跟骨骨密度,骨密度分为骨量正常、骨量减少和骨质疏松.并对所有受试者进行问卷调查,问卷内容包括基本信息、一般情况、生活方式等,测量血压、身高、体质量、腰围、臀围.计算体重指数.分析吸烟、饮酒、牛奶、碳酸饮料、运动与骨密度间的关系.结果 骨质疏松患病率男为6.8%,女为10.4%;骨量减少患病率男为43.8%,女为39.7%.各年龄组的男女受调查者间骨质情况分布比较差异均有统计学意义.牛奶和碳酸饮料摄入情况及运动情况对男性受调查者的骨质水平有影响.吸烟、碳酸饮料及牛奶的饮用情况和运动状况对女性受调查者的骨质水平有影响.结论 女性、高龄、少运动、奶类摄入量低者的骨密度异常患病率高,吸烟、饮酒对骨密度异常的影响有待进一步研究.%Objective To get the facts on lifestyle and bone mineral density among the community residents who are above 40 years old in Nanchang,therefore to offer reference for prevention and treatment to the community residents with abnormal bone mineral density.Methods Use Ultrasound bone mineral density detection instrument to detect the calcaneus mineral density among 10 002 community residents who were over 40 years old.The results can be classified as normal,osteopenia and osteoporosis.A questionnaire survey was conducted among all interviewees.The questionnaire consisted of basic information,general situation,lifestyle,height,weight,waistline,hipline.The body mass index was calculated.The relationship between bone mineral density and smoking,drinking,milk,sodas,sports,etc was analyzed.Results As to osteoporosis,the morbidity of male patients was 6.8%,and that of female patients was

  19. 儿童高弓内翻足:畸形评估与治疗选择%Cavovarus foot in children: evaluation of deformity and choice of treatment

    Institute of Scientific and Technical Information of China (English)

    闫桂森; 杨征; 鲁明; 朱振华; 张建立; 郭源

    2015-01-01

    Objective To precisely assess the deformity of cavovarus foot in children for selecting individualized procedures.Methods A total of 27 surgical patients with 41 cavovarus feet were reviewed.Their average age was 11.3 (7.1-14.5) years.The surgical indications included pains,frequent ankle sprains and shoe-wearing problem.And the findings of medical history,neurologic evaluations and symptoms/signs of foot were recorded.The Coleman block test was used to determine the flexibility of hindfoot.Weight-bearing anteroposterior and lateral radiographs and Coleman block view radiographs of feet were taken to assess the component and apex of deformity.And the results were classified by Wicart grading system.Results All foot deformities were acquired.And 80% (33/ 41) of them were associated with neurologic disease.Cavus deformity was located at the first metatarsal in 12 feet undergoing first metatarsal dorsiflexion osteotomy (M1-DFO) at medial column in 16 feet with M1-DFO and opening plantar wedge osteotomy of cuneiform,at midfoot in 13 feet with midfoot osteotomy.The plantar release and cuboid closing wedge osteotomy were performed in all 41 feet.The fixed varus of calcaneus was found in 18 feet with calcaneal valgus osteotomy.Muscle balance was restored by anterior transfer of posterior tibialis in 21 feet and peroneus longus to brevis tendon transfer in 15 feet.The average follow-up was 28 (6 51) months.And the results were graded as excellent in 34 feet and fair in 7 feet.Conclusions Pediatric cavovarus foot is an acquired deformity with an abnormal elevation of sole tripod and concurrent neurologic diseases.And satisfactory outcomes may be obtained by careful foot examinations and optimal operations.%目的 准确评估儿童高弓内翻足畸形并选择针对性治疗方法.方法 回顾性分析2008年1月至2013年6月手术治疗的儿童高弓内翻足27例41足的临床资料,年龄7.1~14.5岁,平均11.3岁.手术指征为存在固定畸形引起疼痛、

  20. 切开复位内固定术治疗Sanders Ⅱ、Ⅲ型跟骨骨折的疗效观察%The open reduction and internal fixation treatment of Sanders type Ⅱ、Ⅲ calcaneal fracture

    Institute of Scientific and Technical Information of China (English)

    李海峰; 季伟; 白雪东; 贾治伟

    2011-01-01

    reduce the posterior facet, then autologous iliac bone grafting were done and the plastic calcaneus titanium plates were inplant. The maintenance of Bohler's angle., Gissane's angle and the width of the calcaneum as well as the bone union were evaluated for all patients. Results All incisions on 23 foots were cured at 2 weeks to 3 weeks after operation without infection and necrotic skin. The patients were followed up for an average of 16 months (range, 12-24 months). The reduction of the posterior articular facet was graded as anatomic or nearly anatomic in all fractures. The width , Bohler's and Gissane's angle of the calcaneum improved in all patients. Conclusion It would be a good procedure for the treatment of Sanders type Ⅱ 、Ⅲ calcaneous fracture with open reduction and internal fixation if the perioperative management, operation time and surgical technique were selected correctly.

  1. Treatment of osteomyelitis and soft tissue defects at distal region of leg and foot by pedicled peroneus brevis muscle flaps and reverse island flaps with sural nerve and blood supplying vessels%腓骨短肌肌瓣联合腓肠神经营养血管逆行岛状皮瓣治疗患者小腿远端及足部骨髓炎伴软组织缺损

    Institute of Scientific and Technical Information of China (English)

    胡骁骅; 陈忠; 黎明; 杜伟力; 王成; 沈余明

    2013-01-01

    lateral aspect of calcaneus.After debridement,soft tissue defect sizes ranged from 4 cm× 2 cm to 13 cm × 9 cm,and bone defect sizes ranged from 3.0 cm×3.0 cm×3.0 cm to 6.0 cm×3.0 cm×4.0 cm.The distally pedicled peroneus brevis muscle flaps with size ranging from 11 cm ×3 cm to 16 cm ×4 cm were used to fill the wound cavities of bone defects,and reverse island flaps with sural nerve and blood supplying vessels with size ranging from 5 cm × 3 cm to 14 cm × 10 cm were used for the repair of soft tissue defects.Flap donor sites were closed by direct suture or skin grafting.Results Muscle flaps and flaps survived in 11 cases,and the wounds healed well.Necrosis appeared in flap and muscle flap at the distal end in one patient,which was repaired with posterior tibial artery perforator myocutaneous flap.Patients were followed up for 6 to 24 months.Osteomyelitis did not recur,and both the texture and shape of flaps were satisfactory.Conclusions The distally pedicled peroneus brevis muscle flaps and reverse island flaps with sural nerve and blood supplying vessels are suitable for the repair of osteomyelitis and soft tissue defects at distal region of leg and foot.The operation is simple,safe,reliable,and easy to perform.

  2. Observations of the origin and insertion of the plantar aponeurosis based on anatomic and sonographic analysis%跖腱膜起点的解剖及超声影像学研究

    Institute of Scientific and Technical Information of China (English)

    程迅生; 章仁品; 罗福成; 张勇

    2009-01-01

    Objective To identify the exact origin and insertion of plantar aponeurosis and the anatomic relationship of calcaneal spur to plantar aponeurosis. Methods Fourteen specimen of feet were dissected and radiographed. Three fetus feet were observed histologically. Sonographic evaluation was carried out on 20 normal adults and 52 patients with plantar fasciitis. Results (1) Anatomic observation found that plantar aponeurosis was located under the medial process of caleaneus but not attached to it, and proximally attached to the plantar aspect of calcaneal tuborosity. The insertion (origin) of plantar aponeurosis was not a point but a face. Posteriorly the plantar aponeurosis and fascia of Archlles heel were fused or transmigrated together,entirely covered and attached very coherently to the plantar and posterior aspect of calcaneal tuborosity. (2) Histological observation of heel of fetuses found plantar aponeurosis and fascia of Arehlles heel were eosinophil band-like structure. Both continued at the plantar and posterior aspect of calcaneus and attached closely to bone at this area. There were no significant demarcation between them. (3) Sonographic evaluation:normal plantar aponeurosis showed a thin band-like echo, its orgin attached to entire plantar aspect of calcaneal tuberosity and continued with fascia coming posteriorly from Archlles heel. No distinct boundary existed between these two fascias. When plantar fasciitis occurred, the orgin of plantar aponeurosis thickened significantly,this phenomenon could be detected in wholly plantar aspect of calcaneal tuberrosity. The heel spur didn't located within plantar aponeurosis. Conclusions Plantar aponeurosis orginates from entire plantar aspect of cancaneal tuberosity. Heel spur oeeures in the orgin of the intrinsic musculature, such as flexor digitorum brevis,and doesn't locate within plantar aponeurosis.%目的 研究跖腱膜起点的确切部位及其与跟骨骨刺的关系.方法 对14只足标

  3. Treatment of flatfoot deformity with concurrent spinal disease in children%合并脊柱疾患儿童扁平足的外科治疗

    Institute of Scientific and Technical Information of China (English)

    宋卫东; 李德; 刘尚礼; 黄建荣; 沈慧勇; 黄东生; 马若凡

    2010-01-01

    - 14 ) years old and the average follow-up time 22 (14 -64) months. All cases were satisfied with the appearance and function according to Maryland foot score. Five were excellent, 2 good and 2 fair postoperatively versus 2 fair and 7 failed preoperatively. The total excellent and good rate was 77. 8%. In the early stage after tenden transfer in 4 patients, the lateral view of height arch, talus-first metatarsal angle, calcaneus navicular-first metatarsal angle and talonavicular coverage angle improved. Yet it lost the improved angle and reverted to the pre-operative state. No degenerative change was detected in tarsus joints during the long follow-up. Conclusion The special and sequential surgical procedure may be an effective regimen in the treatment of flatfoot deformity with concurrent spinal disease in children.

  4. Changes of bone mineral density of patients with chronic obstructive pulmonary disease and analysis of the related factors%慢性阻塞性肺疾病患者骨密度改变及相关因素分析

    Institute of Scientific and Technical Information of China (English)

    秦潇; 冷松; 王镇山

    2013-01-01

    CAT评分也有相关性(r值分别为-0.659、-0.463、0.175、-0.178,P值均<0.05),SOS与hs-CRP呈负相关(r=-0.390,P<0.05);Logistic回归分析表明PaO2和FEV1%是COPD患者骨密度减低的危险因素.结论 COPD患者的骨密度较同龄健康体检者减低,PaO2减低、肺功能差是骨密度减低的危险因素,推测与COPD的慢性炎性反应有关.%Objective To study the relationship between chronic obstructive pulmonary disease (COPD) and osteoporosis by measuring the bone mineral density (BMD),lung function,blood gas analysis,calcium ion,high sensitive C reactive protein (hs-CRP) and the quality of life.Methods BMD measuring was performed by ultrasound dry bone densitometer in 32 patients with COPD (COPD group) and 35 healthy controls (control group).The ultrasonic transmission speed (SOS),SOS T,fracture risk factor (OSI) and bone strength (TI) were measured at the sites of the left calcaneus.COPD group was divided into three groups according to lung function,3 cases of mild,14 cases of moderate and 15 cases of severe.According to the level of BMD,there were another three groups,3 cases with normal BMD,24 cases with lower BMD,and 5 cases with osteoporosis.According to the history of systemic glucocorticoid application,COPD group was divided into two groups,10 cases with glucocorticoid application and 22 cases without glucocorticoid application.The levels of BMD between COPD group and control group were compared,and the correlation between BMD and lung function,blood gas analysis,calcium ion,hs-CRP and the quality of life in patients with COPD was analyzed.Results COPD group had lower BMD than that in control group (P < 0.05).In COPD group,the severe patients had lower BMD than the moderate patients (P < 0.05),and the severe patients had only lower SOS than the mild patients(P < 0.05),but there was no statistic significant difference in BMD between the moderate and mild patients(P > 0.05).According to the level of BMD