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Sample records for calcaneus

  1. Minimally Invasive Osteotomies of the Calcaneus.

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    Guyton, Gregory P

    2016-09-01

    Osteotomies of the calcaneus are powerful surgical tools, representing a critical component of the surgical reconstruction of pes planus and pes cavus deformity. Modern minimally invasive calcaneal osteotomies can be performed safely with a burr through a lateral incision. Although greater kerf is generated with the burr, the effect is modest, can be minimized, and is compatible with many fixation techniques. A hinged jig renders the procedure more reproducible and accessible.

  2. Aneurysmal Bone Cyst of the Calcaneus

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    Veysel Kaplanoglu

    2014-01-01

    Full Text Available Aneurysmal bone cysts (ABCs are benign, non-neoplastic, expansile, vascular, locally destructive lesions. The lesion may arise de novo (65% or secondarily (35% in pre-existing benign or malignant lesions (giant cell tumor, osteoblastoma, chondroblastoma, angioma, and others. The calcaneus is a rare localization for ABC, comprising only 1.6% of the cases. In this paper, we present a case of a female patient with a 3-month history of heel pain that got worse and was accompanied by swelling and difficulty in walking. The magnetic resonance images of the postero-lateral calcaneus showed a contrast-enhanced cystic lesion located in the medullary cavity; exophytic portion of the tumor extended into the soft tissue causing distinctive cortical thinning. Heterogeneous hyperintense septae formations and blood level components were also detected. After correlation with pathology results, the lesion was diagnosed as an ABC. Since an ABC of the calcaneus is a rarely seen phenomenon, we present the radiologic findings in this case and a review of the literature.

  3. Open Calcaneus Fractures and Associated Injuries.

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    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

  4. An intraosseous lipoma of the calcaneus: a case report.

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    Pappas, Alexander J; Haffner, Kyle E; Mendicino, Samuel S

    2014-01-01

    Intraosseous lipomas are one of the rarest bone tumors found in the body. The incidence has been reported to be intraosseous lipoma in the calcaneus include plantar fasciitis, retrocalcaneal bursitis, gout, stress fracture, unicameral bone cyst, aneurysmal bone cyst, osteoblastoma, enchondroma, chondromyxoid fibroma, nonossifying fibroma, giant cell tumor, chondroblastoma, fibrous dysplasia, and chondrosarcoma. It has been reported that 60% to 70% of patients with an intraosseous lipoma present with symptoms. This article describes a case of a pathologic fracture secondary to a large intraosseous lipoma, the surgical treatments, and the subsequent resolution of symptoms. The purpose of our report was 3-fold: (1) to increase awareness of intraosseous lipomas and their potential to cause pathologic fractures in the calcaneus; (2) to suggest a possible treatment protocol for intraosseous lipomas in the calcaneus; and (3) to describe a rare case of an intraosseous lipoma of the calcaneus not located exclusively in the neutral triangle.

  5. Intraosseous lipoma of the calcaneus mimicking plantar fascitis.

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    Karthik, K; Aarthi, S

    2011-06-01

    Benign lytic lesions of the calcaneus are rare and are usually asymptomatic. We report this case of a 55-year-old man with bilateral non-traumatic plantar heel pain, which was treated conservatively as plantar fasciitis. At three months follow-up, the patient had complete relief of symptoms in the left heel with partial relief of symptoms on the right side. However under the insistence of the patient an X-ray was taken, which revealed an expansile lytic lesion of the right calcaneus and a normal left heel. CT-scan revealed an expansile lytic lesion on the right calcaneus and an early lytic lesion in the left calcaneus. Following surgical intervention, the diagnosis was confirmed as intra-osseous lipoma and the patient was completely symptom free at two-year follow-up. Patients presenting with non-traumatic heel pain should be explained about the possible causes of heel pain, and should be offered X-ray at the first visit. In patients with X-ray showing unilateral lipoma of the calcaneus, CT scan should be offered to rule out involvement of the opposite side.

  6. Primary Lymphoma of the Calcaneus: A Case Report

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    Khodamorad Jamshidi

    2016-07-01

    Full Text Available Introduction Primary Non-Hodgkin’s lymphoma (NHL of the bone is a rare condition. Calcaneus is also an uncommon site for this kind of lymphoma. Case Presentation We hereby present a case of primary non-Hodgkin’s lymphoma of the calcaneus, which was diagnosed and treated at our hospital. The patient had a minor twisting trauma of his ankle but symptoms were present for one year after trauma. The patient complained from instability and swelling of his ankle. After paraclinic assessments, a pathologic lesion was detected in his calcaneus, so incisional biopsy was done and the pathology diagnosis was a large B-cell non-Hodgkin’s lymphoma. Bone marrow assessment was negative for the disease. The patient was treated by chemotherapy and radiotherapy and currently the disease is in remission and patient is doing his previous full activity without any important complication. Conclusions Lymphoma is a rare condition in the foot region but we suggest to be more wise for chronic, uncommon symptoms after minor injuries, as lymphoma of the bone can present mysterious and nonspecific symptoms as was seen in this patient. It may be better to do more assessments to prevent delayed diagnosis of such rare conditions. These rare cases may have atypical imaging and clinical appearance, which can lead to misdiagnosis.

  7. Stress analysis of three-dimensional finite element model of malunion calcaneus during gait

    Institute of Scientific and Technical Information of China (English)

    刘立峰; 蔡锦方; 梁进

    2004-01-01

    Objective: To analyze the stress distribution of calcaneus with posterior articular facet compressed after fracture and talus during gait. Methods: A wedge under the posterior articular was transected from a normal finite element model of calcaneus and talus to simulate malformation of compression of the posterior facet after fracture of calcaneus. The model was used to simulate for three subphases of the stance during the gait(heel-strike, midstance, push-off) and calculate the finite element. The results were compared with normal situation. Results: The stress distribution within the bone in situation of malformation was obtained and regions of elevated stresses for three subphases were located. The results were significantly different from that of normal situation. Conclusion: The simulation of calcaneus and talus in malformation has important clinic implication and can provide an insight into the factors contributing to many clinic pathogenic changes after fracture of calcaneus.

  8. Tuberculosis of the calcaneus. Treatment and differential diagnosis

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    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.

  9. An accessory ossification centre in the calcaneus with talonavicular and second metatarsocuneiform coalitions

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    Turhan, A.U.; Aydin, H.; Aynaci, O. [KTU Farabi Hospital, Department of Orthopaedic Surgery, Trabzon (Turkey); Dinc, H. [KTU Farabi Hospital, Department of Radiology, Trabzon (Turkey)

    1999-04-01

    We present the case of an 11-year-old girl with an accessory ossification centre of the calcaneus with talonavicular and second metatarsocuneiform coalitions, and bilateral os tibiale externum. (orig.) With 3 figs., 4 refs.

  10. Metric analysis of loading magnitudes at articular and non-articular weight-bearing surfaces in human calcaneus.

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    Mahato, Niladri Kumar; Murthy, S Sathiya Narayana

    2013-03-01

    The calcaneus is axially loaded at its articular interface with the talus. A large bulk of this load is transmitted to the ground across the non-articular tubercles at the plantar surface of the bone. A small part of the incumbent load sustained by the calcaneus is directed towards the forefoot at the calcaneo-cuboid junction. This study investigates the proportion of load distributed across the articular and non-articular surfaces of the calcaneus. The present study demonstrates strong and significant correlation between some of the load bearing variables and suggests the need for further investigations to understand the effect of angular aspects of axial loading on the calcaneus. Accounting for the relative distribution of weight across the articular and non-articular areas may enable us to appreciate the internal trabecular structure of the calcaneus in light of its clinical importance.

  11. Case report 529: Osteosarcoma of calcaneus with Rothmund-Thompson syndrome (RTS)

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    Baro, P.R.; Bastart, F.M.; Bartrina, J.R.; Mateo, J.M.; Vidal, M.T.R.

    1989-04-01

    A new case of Rothmund Thomson syndrome (RTS) diagnosed at infancy is described. This patient developed a lesion in the calcaneus classified histologically as an osteosarcoma. Twelve months later she developed metastasic lesions in a rib and in the lungs. This case is the fourth reported osteosarcoma in a patient with the RTS syndrome. (orig./GDG).

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

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    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.

  13. Superior performance of cone beam tomography in detecting a calcaneus fracture.

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    Lohse, Christian; Catala-Lehnen, Philip; Regier, Marc; Heiland, Max

    2015-01-01

    Cone beam computed tomography is a state-of-the-art imaging tool, initially developed for dental and maxillofacial application. With its high resolution and low radiation dose, cone beam tomography has been expanding its application fields, for example, to diagnosis of traumata and fractures in the head and neck area. In this study, we demonstrate superior and satisfactory performance of cone beam tomography for the imaging of a calcaneus fracture in comparison to conventional X-ray and computed tomography.

  14. Sex determination from the calcaneus in a 20th century Greek population using discriminant function analysis.

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    Peckmann, Tanya R; Orr, Kayla; Meek, Susan; Manolis, Sotiris K

    2015-12-01

    The skull and post-cranium have been used for the determination of sex for unknown human remains. However, in forensic cases where skeletal remains often exhibit postmortem damage and taphonomic changes the calcaneus may be used for the determination of sex as it is a preservationally favored bone. The goal of the present research was to derive discriminant function equations from the calcaneus for estimation of sex from a contemporary Greek population. Nine parameters were measured on 198 individuals (103 males and 95 females), ranging in age from 20 to 99 years old, from the University of Athens Human Skeletal Reference Collection. The statistical analyses showed that all variables were sexually dimorphic. Discriminant function score equations were generated for use in sex determination. The average accuracy of sex classification ranged from 70% to 90% for the univariate analysis, 82.9% to 87.5% for the direct method, and 86.2% for the stepwise method. Comparisons to other populations were made. Overall, the cross-validated accuracies ranged from 48.6% to 56.1% with males most often identified correctly and females most often misidentified. The calcaneus was shown to be useful for sex determination in the twentieth century Greek population.

  15. Eumycetoma Osteomyelitis of the Calcaneus in a Child: A Radiologic-Pathologic Correlation following Total Calcanectomy

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    Tamer Ahmed EL-Sobky

    2015-01-01

    Full Text Available Fungi are unusual causes of pedal osteomyelitis in children and adolescents. Eumycetoma is a chronic cutaneous and subcutaneous infection caused by various genera of fungi. A provisional diagnosis of foot mycetoma is made after clinical assessment. Radiologic-pathologic correlation is an essential supplement for the accurate diagnosis of osteoarticular infections. This paper aims to sensitize orthopedic surgeons, radiologists, and pathologists to the importance of correlative imaging findings in relation to surgical and microscopic pathology in osteoarticular infections, specifically eumycetoma osteomyelitis of the foot. From our review of the published data, the present case is the first report of radiologic-pathologic correlation in eumycetoma osteomyelitis of the calcaneus. This paper describes a case of eumycetoma osteomyelitis of the calcaneus in a child in which diagnostic X-rays and magnetic resonance imaging (MRI were correlated with the surgical and microscopic pathologic features, for establishing an appropriate diagnosis and treatment. We conclude that there is a significant agreement between radiologic and pathologic evaluation for assessment of eumycetoma osteomyelitis of the calcaneus. Radiologic-pathologic correlation amplified our interpretation of imaging information available on plain radiographs and MRI and augmented diagnostic confidence. Similarly, anatomic-histopathological correlations consolidated diagnostic accuracy.

  16. Ankle morphology amplifies calcaneus movement relative to triceps surae muscle shortening.

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    Csapo, R; Hodgson, J; Kinugasa, R; Edgerton, V R; Sinha, S

    2013-08-15

    The present study investigated the mechanical role of the dorsoventral curvature of the Achilles tendon in the conversion of the shortening of the plantarflexor muscles into ankle joint rotation. Dynamic, sagittal-plane magnetic resonance spin-tagged images of the ankle joint were acquired in six healthy subjects during both passive and active plantarflexion movements driven by a magnetic resonance compatible servomotor-controlled foot-pedal device. Several points on these images were tracked to determine the 1) path and deformation of the Achilles tendon, 2) ankle's center of rotation, and 3) tendon moment arms. The degree of mechanical amplification of joint movement was calculated as the ratio of the displacements of the calcaneus and myotendinous junction. In plantarflexion, significant deflection of the Achilles tendon was evident in both the passive (165.7 ± 7.4°; 180° representing a straight tendon) and active trials (166.9 ± 8.8°). This bend in the dorsoventral direction acts to move the Achilles tendon closer to the ankle's center of rotation, resulting in an ∼5% reduction of moment arm length. Over the entire range of movement, the overall displacement of the calcaneus exceeded the displacement of the myotendinous junction by ∼37%, with the mechanical gains being smaller in dorsi- and larger in plantarflexed joint positions. This is the first study to assess noninvasively and in vivo using MRI the curvature of the Achilles tendon during both passive and active plantarflexion movements. The dorsoventral tendon curvature amplifies the shortening of the plantarflexor muscles, resulting in a greater displacement of the tendon's insertion into the calcaneus compared with its origin.

  17. Treatment of chondroblastoma of the calcaneus with a secondary aneurysmal bone cyst using endoscopic curettage without bone grafting.

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    Otsuka, Takanobu; Kobayashi, Masaaki; Yonezawa, Masato; Kamiyama, Fumiaki; Matsushita, Yasusi; Matsui, Nobuo

    2002-04-01

    Chondroblastoma is a relatively rare benign bone tumor. Approximately 7% of chondroblastomas occur in the calcaneus, and 17% of chondroblastoma associated with cystic lesions. We report a case of a chondroblastoma in the calcaneus with a secondary aneurysmal bone cyst treated successfully by endoscopic curettage without bone grafting. New bone formation is facilitated by minimal damage to the bone and soft tissue. The cosmetic results of this procedure are good. Two years later, the patient is asymptomatic with no radiographic evidence of recurrence. Endoscopic curettage without bone grafting is a promising new treatment for chondroblastoma.

  18. Intra-articular osteoid osteoma of the calcaneus: a case report and review

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    Tomo Hamada, MD

    2016-09-01

    Full Text Available Osteoid osteoma of the calcaneus is rare and frequently misdiagnosed as arthritis because of similar symptoms. In addition, radiographic findings may be nonspecific, and magnetic resonance imaging (MRI may show a bone marrow edema and changes in adjacent soft tissue. A 19-year-old man presented with a 6-month history of persistent pain and swelling in the left hind foot; diagnostic computed tomography and MRI analyses revealed lesions suggesting an intra-articular osteoid osteoma of the calcaneus. Initial MRI did not show specific findings. On operation, the tumor was removed by curettage; pathologic findings demonstrated woven bone trabeculae surrounded by connective tissue, confirming the diagnosis. To the best of our knowledge, MRI scans in all cases of calcaneal osteoid osteoma reported till 3 months after the injury exhibited a nidus. We believe that calcaneal osteoid osteoma should be considered as a differential diagnosis in patients undergoing MRI 3 months after symptom presentation; early computed tomography is critical in diagnosis.

  19. The effect of cortical endplates on ultrasound velocity through the calcaneus: an in vitro study.

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    Njeh, C F; Langton, C M

    1997-05-01

    Ultrasound velocity has been reported as a good predictor of bone strength measured in vitro using standard mechanical testing techniques. Such mechanical investigation of bone strength cannot be carried out in vivo, because of the invasive nature of the testing. Therefore to be able to extrapolate the in vitro findings to the clinical situation, the effect of cortex on ultrasound transmission velocity through the calcaneus is required. This was investigated in vitro by measuring ultrasound velocity through samples of different modification using a CUBAResearch ultrasound machine. The different sample modifications were: "whole" (soft tissue removed), "core" (cylindrical sample), "can" (cancellous sample without the cortex) and "def" (defatted cancellous sample). Ultrasound transmission velocity for the various sample modification were highly correlated with each other (r = 0.80-0.97). Coring resulted in a 0.77% increase in the mean velocity. Substituting bone marrow (defatting) with water at room temperature had no measurable effect on the ultrasound velocity. The velocity in the whole samples and the cancellous samples were statistically different with the cortex introducing only a 2% increase in the ultrasound velocity. Therefore the in vivo ultrasound velocity measured at the calcaneus is determined mainly by the cancellous bone component which is more sensitive to osteoporotic changes. Hence the reported ability of ultrasound velocity in vitro to predict bone strength could be expected in vivo.

  20. Chondromyxoid fibroma of the calcaneus: two case reports and literature review.

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    Roberts, Eric J; Meier, Molly J; Hild, Gina; Masadeh, Suhail; Hardy, Mark; Bakotic, Bradley W

    2013-01-01

    Chondromyxoid fibroma occurs primarily in the long tubular bones of the lower extremity, with the foot representing the second most frequent location after the knee. This benign cartilaginous tumor of bone is currently the rarest reported neoplasm of cartilaginous origin. This mass can mimic other benign and malignant bone tumors owing to its variable histologic features. We report 2 cases of chondromyxoid fibroma of the calcaneus with varying presentations. Initially, advanced imaging studies pointed to a diagnosis of a unicameral bone cyst. Pathologic examination is difficult but can be used to differentiate this lesion from more serious conditions. A quick and accurate diagnosis of chondromyxoid fibroma can prevent unnecessary treatment that could be harmful to the patient.

  1. [Percutaneous fluoroscopic and arthroscopic controlled screw fixation of posterior facet fractures of the calcaneus].

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    Nehme, A; Chaminade, B; Chiron, P; Fabie, F; Tricoire, J-L; Puget, J

    2004-05-01

    We describe a new technique for reduction and percutaneous osteosynthesis of displaced posterior facet fractures of the calcaneus which appears to overcome the problems encountered with other percutaneous methods described for this type of surgery. The method relies on the use of traction which allows automatic reduction of the greater tubersosity. The patient is installed on an orthopedic traction table. Pin traction provides anatomic reduction of the posterior articular surface and restitution of Böhler's angle under fluoroscopic and arthroscopic control. We used this technique in thirteen patients with fifteen displaced posterior facet fractures of the calcaneum. Mean patient age was 50.4 Years. Mean follow-up was twenty Months. We did not have any cutaneous or infectious complications in this short series. In the majority of the cases, the overall functional and physical results were excellent or good. The mean Böhler's angle was 27 degrees, corresponding to 83% correction compared with the healthy side. These preliminary results are encouraging. We were able to restitute calcaneum anatomy, shorten hospital stay, and avoid all skin complications. Indications for this percutaneous technique could be widened. It is a valid alternative to open treatment of posterior facet fractures of the calcaneum.

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

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    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. Subjects with a history of a previous osteoporotic fracture also had better awareness (P < 0.05 than subjects without such a history, except for those who drank milk. Similar to previous reports, female sex, old age, a low education level, and a personal history of osteoporotic fracture were significantly associated with a low quantitative US measurement (P < 0.001. Further, drinking milk

  3. Sarcomatous degeneration of Pagets disease in the calcaneus: a case report; Degeneracao sarcomatosa de doenca de Paget do calcaneo: relato de caso

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    Matiotti, Simone Berwig; Tramunt, Conrado Silva; Duarte, Rogerio Dias; Duarte, Rodrigo Dias; Duarte, Wolmir Lourenco [Clinica Serdil, Porto Alegre, RS (Brazil)]. E-mail: smat2@hotmail.com; Soder, Janine Bernardi [Fundacao Saint Pastous, Porto Alegre, RS (Brazil). Clinica Serdil

    2009-01-15

    Neoplastic degeneration in Paget's disease is a rare complication (approximately 1% of cases) and, despite the treatment, presents a poor prognosis. The authors report a case of a male, 82-year-old patient with long standing Paget's disease who presented imaging findings of malignant degeneration in the calcaneus histopathologically diagnosed as sarcomatous degeneration (author)

  4. Diabetes and change in bone mineral density at the hip, calcaneus, spine, and radius in older women

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    Ann V. Schwartz

    2013-05-01

    Full Text Available Older women with type 2 diabetes mellitus (DM have higher bone mineral density (BMD but also have higher rates of fracture compared to those without DM. Limited evidence suggests that DM may also be associated with more rapid bone loss. To determine if bone loss rates differ by DM status in older women, we analyzed BMD data in the Study of Osteoporotic Fractures (SOF between 1986 and 1998. SOF participants were women >65 years at baseline who were recruited from four regions in the U.S. DM was ascertained by self-report. BMD was measured with dual x-ray absorptiometry (DXA at baseline and at least one follow-up visit at the hip (N=6624 and calcaneus (N=6700 and, on a subset of women, at the spine (N=396 and distal radius (N=306. Annualized percent change in BMD was compared by DM status, using random effects models. Of 6,867 women with at least one follow-up DXA scan, 409 had DM at baseline. Mean age was 70.8 (SD 4.7 years. Baseline BMD was higher in women with DM at all measured sites. In models adjusted for age and clinic, women with prevalent DM lost bone more rapidly than those without DM at the femoral neck (-0.96% vs. -0.59% per year, p < 0.001, total hip (-0.98% vs. -0.70% per year, p<0.001, calcaneus (-1.64% vs. -1.40% per year, p=0.005, and spine (-0.33% vs. +0.33% per year, p=0.033, but not at the distal radius (-0.97% vs. -0.90% per year, p=0.91. These findings suggest that despite higher baseline BMD, older women with DM experience more rapid bone loss than those without DM at the hip, spine and calcaneus, but not the radius. Higher rates of bone loss may partially explain higher fracture rates in older women with DM.

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

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    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.

  6. Intraosseous primary malignant peripheral nerve sheath tumor of the calcaneus: An unusual case and review of literature

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    Gaurav Pratap Singh Gahlot

    2015-01-01

    Full Text Available Malignant peripheral nerve sheath tumors (MPNSTs are uncommon sarcomas that originate from a peripheral nerve or neurofibroma either spontaneously or in association with neurofibromatosis type 1. MPNSTs account for approximately 5% of all soft tissue malignancies. The tumor is commonly seen in the extremities and trunk. Most of these tumors are high-grade with the potential to recur and metastasize. Common metastatic sites include the lungs, bone, and pleura. Primary intraosseous MPNST is rare, and the diagnosis of intraosseous MPNST, especially in an unusual location is difficult because of its cellular origin, histomorphological similarities with other sarcomas, and bone is the most common site for metastasis. We report an unusual case of MPNST of the calcaneus in a young male.

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

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    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

  8. Bone mineral density of the calcaneus in 70- to 81-yr-old male athletes and a population sample.

    Science.gov (United States)

    Suominen, H; Rahkila, P

    1991-11-01

    Bone mineral content (BMC/W) and density (BMD) were studied in 70- to 81-yr-old active male endurance-trained (long-distance runners, cross-country skiers, N = 67), strength-trained (throwers, weight-lifters, N = 14), and speed-trained (sprinters, jumpers, N = 16) athletes. A population sample of similar age (N = 42) served as a control group. The measurements were performed at the calcaneus by single-energy photon absorption. The endurance-trained athletes had higher bone width and depth, and the strength and speed-trained athletes higher bone depth than the control subjects. The three groups of athletes showed 19-28% higher BMC (g.cm-1) and BMC/W (g.cm-2) than the control group (P less than 0.01-0.001). When the results were corrected for bone depth by assessing BMD (g.cm-3), the mean differences between the athletes and controls were 11-16% (P less than 0.05-0.01, not significant for the strength group). The highest BMD values were associated with moderate training for running and cross-country skiing. BMD did not correlate with serum total testosterone, but there was a negative correlation between BMD and sex hormone binding globulin and a positive correlation between BMD and the free androgen index in the endurance group. The results indicate that athletes having a long-term training history and being still active at over 70 yr of age preserve superior trabecular bone mass compared with the average male population of the same age.

  9. Lateral column lengthening for acquired adult flatfoot deformity caused by posterior tibial tendon dysfunction stage II: a retrospective comparison of calcaneus osteotomy with calcaneocuboid distraction arthrodesis.

    Science.gov (United States)

    Haeseker, Guus A; Mureau, Marc A; Faber, Frank W M

    2010-01-01

    In this study, clinical and radiological results after lateral column lengthening by calcaneocuboid distraction arthrodesis and calcaneus osteotomy were compared. Thirty-three patients (35 feet) treated with lateral column lengthening by distraction arthrodesis (14 patients, 16 feet; group I) or by calcaneus osteotomy (19 patients, 19 feet; group II) for adult-acquired flatfoot deformity caused by stage II posterior tibial tendon dysfunction were compared retrospectively. Mean follow-up was 42.4 months (range, 6-78 months) for group I and 15.8 months (range, 6-32 months) for group II (P < .001). The American Orthopaedic Foot & Ankle Society ankle-hindfoot score was determined, 4 variables were measured on preoperative and postoperative weight-bearing radiographs, and a number of independent and outcome variables, including patient satisfaction, were recorded. Group 2 had a significantly higher American Orthopaedic Foot & Ankle Society score compared with group I (mean, 85 vs. 72, respectively; P < .02) at time of last follow-up, and there were no dissatisfied patients in group I, whereas 2 patients in group II were dissatisfied with the result of the operation. All radiological results were significantly better at time of follow-up in both groups (except for talocalcaneal angle in group I), although no significant differences were noted in the amount of change in radiographic measurements between the groups. No significant correlation was found between follow-up time and radiographic improvement, indicating stable radiographic measurements over time. In group II, 13 mild calcaneocuboid subluxations were observed. In both groups, 1 nonunion and 1 wound complication occurred. Based on our experience with the patients described in this report, we recommend lateral column lengthening by means of calcaneus osteotomy rather than distraction arthrodesis of the calcaneocuboid joint, for correction of stage II posterior tibial tendon dysfunction.

  10. Risk factors for bone mineral density at the calcaneus in 40–59 year-old male workers: A cross-sectional study in Korea

    Directory of Open Access Journals (Sweden)

    Kim Chong-Soon

    2008-07-01

    Full Text Available Abstract Background Few epidemiologic studies have attempted to investigate the prevalence and risk factors for osteopenia and osteoporosis in middle-aged Asian men. We performed this study to determine the prevalence and risk factors of osteopenia and osteoporosis in this population. Methods This cross-sectional study was conducted from March to July, 2004. The subjects were 2,073 males aged from 40 to 59 years in the KHNP (Korea Hydro & Nuclear Power workplace-based cohort. Bone mineral density (BMD was measured by peripheral, dual-energy, X-ray absorptiometry (DXA at the calcaneus. Anthropometric and lifestyle factors were investigated using a standard, self-reported questionnaire. Results BMD was 0.60 ± 0.09 g/cm2 (mean ± standard deviation and was negatively correlated with age (r = -0.18, P P P P P P In multiple linear regression analysis, the independent determinants associated with BMD were increasing age (coefficient = -0.002, P P P P P Conclusion We suggest that BMD of the calcaneus is correlated negatively with exposure to smoke and increased WHR, but positively with regular exercise and increased BMI.

  11. The modeling of digital Sanders classification for calcaneus fractures%跟骨骨折Sanders分型数字化模型的初步建立

    Institute of Scientific and Technical Information of China (English)

    陈继铭; 钟环; 冯柏淋

    2015-01-01

    Objective To investigate the modeling of digital Sanders classification for calcaneus fractures. Methods The enrolled healthy male volunteers, who had no congenital foot disease and trauma history, were taken regular physical examination and imaging examination to exclude abnormal foot lesions, and agreed to take part in the research content, whose foot data were collected by 64-slice CT scan. And the CT data were exported in the form of dicom for the process of image segmentation via Mimics 10. 01, to build the complete three-dimensional modeling of calcaneus. Based on Sanders classification principles, the simulation module of Mimics software was used to build the calcaneus fractures model, and then saved as STL files. Finally, the selected models, via the Cult3D Designer plug-in, were inserted into webpage for the demonstration of virtual reality. Results The digital models of calcaneus fractures with high visualization were capable of achieving vivid demonstration and observation from different angles and orientations based on web page. Conclusions The digital model of calcaneus fractures enhances the surgeon’s understanding of Sanders classification pre-and intra-operatively. Furthermore, the modeling based on the web page of virtual reality reveals its tremendous potential in the application of preoperative planning, remote surgical education and diagnosis of complicated clinical cases.%目的:在正常人CT薄层影像数据基础上建立跟骨骨折Sanders分型的数字化仿真模型。方法对1名既往无先天性足部病史及外伤史,常规体格检查和影像学检查排除足部异常病变,并同意参加研究项目的健康成年男性志愿者行足跟部64层螺旋CT扫描,采用Mimics 10.01软件进行断层影像(Dicom文件数据)分割处理,重建完整跟骨3D模型;基于Sanders分型原则,采用Mimics 10.01软件的“Simulation”模块对跟骨模型进行骨折造模并输出STL文件保存

  12. 跟骨距下关节内移位骨折的手术治疗与术后康复%Operative treatment and postoperative rehabilitation of displaced intra-articular fractures of calcaneus

    Institute of Scientific and Technical Information of China (English)

    金晨; 胡小鹏; 杨裕红; 张德常; 陈学桂; 吴揭地

    2002-01-01

    @@ Background:Fracture of calcaneus often leads to pain,deformity,function of foot is impaired and even permanent function impairments are left.Many divergence existed in treatment of severe intra articular fracture existed,but with the development of pedal surgery and deep study of biomechanics anatomy,especially building of BO theory,the therapeutic programs have become clearer.

  13. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

    Jin Ningning, E-mail: ningning_jin@163.com [Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100032 (China); Lin Shouqing, E-mail: Shouqing_Lin2003@yahoo.com.cn [Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100032 (China); Zhang Ying, E-mail: steel_lee@sina.com.cn [Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100032 (China); Chen Fengling, E-mail: bjzqk@126.com [Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100032 (China)

    2010-11-15

    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 (L{sub 2-4}), 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.

  15. 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

  16. The effect of sports activities in children and adolescents on the calcaneus - an investigation with quantitative ultrasound; Einfluss sportlicher Aktivitaet von Kindern und Jugendlichen auf den Kalkaneus - Eine Untersuchung mit quantitativem Ultraschall

    Energy Technology Data Exchange (ETDEWEB)

    Mentzel, H.J.; Malich, A.; Boettcher, J.; Vogt, S.; Kaiser, W.A. [Inst. fuer Diagnostische und Interventionelle Radiologie, Klinikum der Friedrich-Schiller-Univ., Jena (Germany); Wuensche, K. [Rontgenavdelingen, HNT Sykehuset Namsos (Norway)

    2005-04-01

    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.)

  17. Three-dimensional finite element analysis of calcaneus fracture treated with plate fixation%三维有限元分析钢板内固定治疗跟骨骨折*

    Institute of Scientific and Technical Information of China (English)

    黄诸侯; 李俊; 杜景文; 陈日齐; 张建新

    2013-01-01

      背景:有多种钢板治疗跟骨骨折,但究竟哪种效果更好,目前尚无定论。  目的:在跟骨骨折三维有限元模型上模拟加载3种类型的钢板,观察比较应力、应变及移位等生物力学性能。  方法:在踝关节中立位和背伸20°位建立跟骨骨折三维有限元模型,分别模拟使用跟骨Ⅰ型、Ⅱ型、Ⅲ型3种形状钢板对骨折进行固定,加载后计算内固定物自身的应力分布、骨骼的应力分布及骨折块间的移位程度。  结果与结论:①两种体位骨折模型3种固定方式下的钢板应力分布都不均匀,钢板前部应力水平均高于后部,Ⅰ型钢板的应力分布相对比较均匀。②两种体位骨折模型3种固定方式下跟骨的应力最大值均在跟骨前部,而正常跟骨最大应力值在跟结节处,Ⅰ型钢板固定跟骨骨折后骨骼的最大应力值均小于Ⅱ型、Ⅲ型钢板。③两种体位骨折模型3种固定方式下均发生了骨折块间的位移,其位移趋势是一致的。结果显示,与Ⅱ型、Ⅲ型钢板固定相比较,跟骨Ⅰ型钢板固定后所承受应力更小,且应力分布更均匀,较符合生物力学原理。%BACKGROUND:There are many types of plate can be used for the treatment of calcaneus fracture, but it is not clear which type has the best effect. OBJECTIVE:To observe and compare the biomechanical properties, such as stress, strain and displacement of three types of plate through loading them on the three-dimensional finite element model of calcaneus fracture. METHODS:The three-dimensional finite element model of calcaneus fracture was established when the ankle joint was in neutral position and back stretches 20° position, then the type Ⅰ, type Ⅱ and type Ⅲ plates were used to fix the fracture model. Through loading force on the model, the stress distribution of plates and calcaneus, and displacement between fracture gaps were calculated

  18. 老年女性跟骨超声参数与股骨近端生物力学的相关性%Correlation between ultrasound parameters of calcaneus and biomechanics of proximal femoral in elderly women

    Institute of Scientific and Technical Information of China (English)

    李明; 吕厚辰; 张里程; 尹鹏滨; 唐佩福; 张立海

    2015-01-01

    Objective To discuss the correlation between quantitative ultrasound parameters of calcaneus and biomechanical properties of proximal femoral in elderly women.Methods Thirty-four elderly women with femoral neck fracture admitted to department of orthopaedics in Chinese PLA General Hospital from January 2014 to June 2014 were enrolled. All patients had undergone total hip replacement surgery and the quantitative ultrasound (QUS) of calcaneus. The weight-bearing area of cancellous bone in femoral head after total hip replacement was measured by quantitative computed tomography (QCT) and biomechanical test. The relevance of the above test results was explored. Results Speed of sound (SOS), broadband ultrasound attenuation (BUA) and bone mineral density (BMD) of calcaneus were positively correlated with BMD of weight-bearing area of cancellous bone (r=0.411,P<0.05;r=0.366,P<0.05;r=0.495,P<0.01). Calcaneus stiffness index and Young's Modulus of weight-bearing area of cancellous bone were correlated with BMD of weight-bearing area of cancellous bone (r=0.490,P<0.01;r=0.483,P<0.01). Stiffness and Young's Modulus were positively correlated (r=0.418,P<0.05).Conclusion Stiffness of calcaneus quantitative ultrasound parameters can reflect proximal femoral biomechanics in some extent in elderly women, which has a reference value to prognosis osteoporosis of the proximal femoral fracture in elderly women.%目的:探讨老年女性跟骨超声参数与股骨近端生物力学性质的相关性。方法连续纳入2014年1-6月就诊于我院骨科的老年女性股骨颈骨折患者34例,均行髋关节置换术、跟骨定量超声(quantitative ultrasound,QUS)、股骨头负重区骨松质行定量计算机断层扫描(quantitative computed tomography,QCT)及生物力学测试,探讨上述检测结果相关程度。结果跟骨超声传播速度(speed of sound,SOS)、超声振幅衰减平均值(broadband ultrasound attenuatio,BUA)及跟骨超声骨密度(Est. BMD

  19. 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

  20. Análise comparativa das propriedades mecânicas do ligamento da patela e do tendão calcâneo Comparative analysis of the mechanical properties of the patellar ligament and calcaneus tendon

    Directory of Open Access Journals (Sweden)

    Sérgio Swain Müller

    2004-09-01

    Full Text Available Com a finalidade de se comparar as propriedades mecânicas do ligamento da patela e do tendão calcâneo foram realizados ensaios de tração em material obtido de 25 cadáveres humanos. A idade dos doadores foi 58 ± 14 anos (33-85, sendo 19 (76% masculinos e 6 (24% femininos, 23 brancos (92% e dois negros (8%. Os materiais foram testados em seus 10 mm centrais, com velocidade de aplicação de carga de 30 mm/min. Foi obtida a área de secção dos corpos de prova para que fossem estudadas as propriedades estruturais e materiais. Foram estudadas as seguintes variáveis: carga máxima (N, tensão(MPa, módulo de elasticidade (MPa, energia (Nm, alongamento absoluto (mm e específico (%, limite de proporcionalidade (N, além da tensão (MPa e alongamentos neste ponto. A análise estatística revelou que ambos possuem carga máxima, limite de proporcionalidade e tensão semelhantes (p>0,05. Nas outras variáveis ocorreu diferença significativa (pTraction tests were performed in specimens obtained from 25 human cadavers, with the purpose of comparing the mechanical properties of the patellar ligament and the calcaneus tendon. Age range of donors was 58 ± 14 years (33-85. There were 19 (76% males and 6 (24% females; 23 whites (92% and 2 blacks (8%. The 10-mm central portion of the specimens was tested at a load application rate level of 30 mm/min. The cross-sectional area of the specimens was obtained so that their structural and material properties could be studied. The following variables were studied: ultimate load (N, stress (MPa, elasticity modulus (Mpa, energy (Nm, absolute (mm and specific strain (%, yield point (N, yield point stress (MPa. Statistical analysis revealed that both the patellar ligament and the calcaneus tendon, the ultimate load, proportionality limits and ultimate stress, were similar (p>0.05. The other variables showed significant differences (p<0.05. Energy and strain values were higher in the calcaneus tendon. The

  1. The one-stage surgical treatment of traumatic chronic osteomyelitis on the calcaneus%一期手术治疗跟骨创伤性慢性骨髓炎

    Institute of Scientific and Technical Information of China (English)

    陈琴; 黄凯

    2016-01-01

    目的:探讨腓动脉穿支(肌)皮瓣联合载抗生素人工骨一期治疗跟骨创伤性慢性骨髓炎的临床疗效。方法对32例跟骨创伤性慢性骨髓炎患者在一期扩创彻底清除骨髓炎病灶的基础上采用载抗生素人工骨植骨抗感染、切取腓动动脉穿支(肌)皮瓣覆盖创面的方式修复治疗。结果患者均获得随访,时间6~32个月。皮瓣均成活,外观形态良好。骨髓炎无复发情况,骨折愈合情况良好,无畸形愈合,骨性愈合时间为6~9.8个月。结论腓动脉穿支(肌)皮瓣联合载抗生素人工骨一期治疗跟骨创伤性慢性骨髓炎是治疗创伤性慢性骨髓炎较理想的方法。%Objective To discuss the clinical efficacy of debridement, peroneal artery perforator ( muscle) flap com-bined with bone substitute contained antibiotics one-stage treatment of traumatic chronic osteomyelitis on the calcane-us. Methods On the basis of debridement and complete removal of the osteomyelitis lesion,32 cases of patients with traumatic chronic osteomyelitis on the calcaneus were used bone graft contained antibiotics anti-infective, peroneal ar-tery perforator ( muscle) flap to cover the wound. Results All 32 patients were followed up for 6~32 months. Pa-tients with skin flap were survival, with good shape, no recurrence of osteomyelitis. Fracture got healing well, no de-formity healing occurred, bony healing time was 6~9. 8 months. Conclusions Peroneal artery perforators ( muscle) flap combined with bone contained antibiotics one-stage treatment of traumatic chronic osteomyelitis on the calcaneus is an ideal method.

  2. Finite element analysis of calcaneus stress distributions with variant heights%跟骨高度改变对跟骨应力变化影响的有限元分析

    Institute of Scientific and Technical Information of China (English)

    王一民

    2014-01-01

    背景:跟骨骨折常伴有跟骨高度的减少,相比于手术指证较为明确的跟骨关节内骨折,关节外骨折跟骨高度减少达到多少时需要手术尚无标准,因此需要找到较为量化的手术指征。  目的:以有限元分析方法探讨跟骨高度不同程度改变后跟骨应力的变化情况。  方法:建立正常足踝模型,并在此基础上建立跟骨高度减少5,10,15,20 mm时的有限元模型,测量不同跟骨高度时的应力分布、应力峰值及位置。  结果与结论:正常模型跟骨的应力集中出现在后关节面后内方、后关节面前内方及跟骰关节面,最大应力出现在后关节面后内方,最大应力值16.608 MPa。跟骨高度减小后跟骰关节面处应力集中消失,跟骨高度减少5,10,15及20 mm时,应力峰值分别为18.325,19.674,22.491及25.694 MPa。提示跟骨高度改变后应力增大集中现象明显,术中应尽可能将高度恢复至正常,若复位困难时至少应将高度丢失复位至10 mm以内。%BACKGROUND:Calcaneal fractures are often accompanied with a height reduction in the calcaneus. Compared to the intra-articular fracture with much specific operation indications, there is no standard to the reduction of calcaneal height that needs a surgery in extra-articular fractures. Therefore, it is necessary to find a more quantitative operation indication. OBJECTIVE:To explore the changes in calcaneus stress distribution along with the varying calcaneal height through finite element analysis. METHODS:A three-dimensional finite element model of the normal ankle was developed. Four finite element models with the calcaneus height decrease in 5, 10, 15 and 20 mm were developed based on the normal ankle model. And the VonMises distribution of the calcaneus, the maximal stress and its location were respectively analyzed. RESULTS AND CONCLUSION:In the normal ankle model, the stress concentration was found

  3. Fuzzy logic structure analysis of trabecular bone of the calcaneus to estimate proximal femur fracture load and discriminate subjects with and without vertebral fractures using high-resolution magnetic resonance imaging at 1.5 T and 3 T.

    Science.gov (United States)

    Patel, Priyesh V; Eckstein, Felix; Carballido-Gamio, Julio; Phan, Catherine; Matsuura, Maiko; Lochmüller, Eva-Maria; Majumdar, Sharmila; Link, Thomas M

    2007-10-01

    Newly developed fuzzy logic-derived structural parameters were used to characterize trabecular bone architecture in high-resolution magnetic resonance imaging (HR-MRI) of human cadaver calcaneus specimens. These parameters were compared to standard histomorphological structural measures and analyzed concerning performance in discriminating vertebral fracture status and estimating proximal femur fracture load. Sets of 60 sagittal 1.5 T and 3.0 T HR-MRI images of the calcaneus were obtained in 39 cadavers using a fast gradient recalled echo sequence. Structural parameters equivalent to bone histomorphometry and fuzzy logic-derived parameters were calculated using two chosen regions of interest. Calcaneal, spine, and hip bone mineral density (BMD) measurements were also obtained. Fracture status of the thoracic and lumbar spine was assessed on lateral radiographs. Finally, mechanical strength testing of the proximal femur was performed. Diagnostic performance in discriminating vertebral fracture status and estimating femoral fracture load was calculated using regression analyses, two-tailed t-tests of significance, and receiver operating characteristic (ROC) analyses. Significant correlations were obtained at both field strengths between all structural and fuzzy logic parameters (r up to 0.92). Correlations between histomorphological or fuzzy logic parameters and calcaneal BMD were mostly significant (r up to 0.78). ROC analyses demonstrated that standard structural parameters were able to differentiate persons with and without vertebral fractures (area under the curve [A(Z)] up to 0.73). However, none of the parameters obtained in the 1.5-T images and none of the fuzzy logic parameters discriminated persons with and without vertebral fractures. Significant correlations were found between fuzzy or structural parameters and femoral fracture load. Using multiple regression analysis, none of the structural or fuzzy parameters were found to add discriminative value to BMD

  4. 间断横褥式缝合对预防跟骨骨折术后切口并发症的作用%The preventative effect of discontinuous transverse mattress suture on postoperative incision complications of calcaneus fractures

    Institute of Scientific and Technical Information of China (English)

    刘志久; 袁光辉

    2012-01-01

    Objective:To explore the preventative effect of discontinuous transverse mattress suture on postoperative incision complications of calcaneus fractures. Methods: The medical records of patients with calcaneus fractures treated by open reduction and plate internal fixation through the lateral approach were analyzed retrospectively. Ninety-two patients(107 feet) were included into the study,male 86 cases, while female 6 cases;ranging in age from 17 to 66 years with a median of 37. 5 years;ranging from 7 to 12 days with a median of 9. 5 days in time intervals from injury to surgery. Sixty-three feet of 55 patients ( group Ⅰ )were administrated with discontinuous transverse mattress suture,while 44 feet of 37 patients( group Ⅱ ) were administrated with layered suture. Such incision complications as tension blister around the incision, skin necrosis at the incision margin, cutting incision skin by sutures, plate exposure were recorded respectively. Results: After the operation, four feet with tension blister around the incision and one foot with skin necrosis at the incision margin were found in group Ⅰ , which were all healed after dressing change. For the patients in group Ⅱ ,four feet with skin necrosis at the incision margin, three feet with simultaneous signss of tension blister,skin necrosis at the incision margin and cutting incision skin by sutures and two feet with tension blister were found and were healed after dressing change, and one case with plate exposure was found and healed after flap transplantation. There were no statistical difference in incidence rate of tension blister, cutting incision skin by sutures and plate exposure between the two groups(x2 =0. 817,P =0. 366;P = 0. 067 ;P =0.411) ; while the incidence rate of skin necrosis at the incision margin and the overall incision complications of groupⅡ was higher than that of group Ⅰ (x2 = 5. 751 ,P=0. 017;x2 =6. 111 ,P= 0.013). Conclusion; The incidence rate of postoperative incision

  5. 罂粟碱促进跟骨骨折手术切口愈合的疗效评价%Evaluation of promotive effect on incision healing after the operation of calcaneus fractures by using papaverine

    Institute of Scientific and Technical Information of China (English)

    汤俊君; 张建; 吴克俭; 刘亭茹; 张永刚

    2015-01-01

    Objective To evaluate the promotive effect on incision healing after the operation of calcaneus fractures by using papaverine. Methods From 2010 to 2013, 52 patients with calcaneus fractures were divided into 2 groups according to whether papaverine was used or not after the operation. There were 29 patients ( 33 feet ) in treatment group and 23 patients ( 25 feet ) in control group. All the patients underwent open reduction and internal ifxation with L-type calcaneal lateral incision, and the time of regular drainage lasted for 48 hours after the operation. The clinical data were recorded in all the patients, including gender, age, degree of soft tissue injury, classiifcation of fracture, time from injury to operation, operation time, intraoperative amount of bleeding, drying time and healing time of the incision, length of unhealthy skin and incidence of complications of the incision and function score of the foot at 1 year after the operation. Statistical analysis was performed. Results There were no statistically signiifcant differences in gender, age, degree of soft tissue injury, classiifcation of fracture, time from injury to operation, operation time, intraoperative amount of bleeding and function score of the foot at 1 year after the operation between the 2 groups. In control group, the average time of incision drying was ( 6.2±1.9 ) days and the average time of incision healing was ( 17.8±3.1 ) days. The good ratio of incision health degree was 64.0%. While in treatment group, the average time of incision drying was ( 5.1±1.2 ) days and the average time of incision healing was ( 15.7±2.6 ) days. The good ratio of incision health degree was 84.8%. The differences between the 2 groups were statistically signiifcant ( P<0.0355, 0.0063, 0.0328 ). Conclusions Papaverine can promote incision healing and decrease complications after the operation of calcaneus fractures.%目的:评价跟骨骨折术后使用罂粟碱对手术切口

  6. Juvenile intraosseous gout of the calcaneus

    Energy Technology Data Exchange (ETDEWEB)

    Yun, Chun-Ho; Fang, Yang-Kai; Hung, Yu-Chung [Mackay Memorial Hospital, Department of Radiology, Taipei (Taiwan); Shih, Shin-Lin; Huang, Jon-Kway [Taipei Medical University, Department of Radiology, Taipei (Taiwan)

    2005-09-01

    Gout presenting as an osteolytic lesion is exceedingly rare in children with asymptomatic hyperuricemia. We report the clinical and radiological presentation of intraosseous gout in a 13-year-old boy. (orig.)

  7. [Menopause and ultrasonographic measurements of calcaneus].

    Science.gov (United States)

    López-Caudana, Alma Ethelia; Castillo-Calderón, María Griselda; Ávila-Jiménez, Laura

    2014-01-01

    INTRODUCCIÓN: en México no se han documentado mediciones ultrasonográficas de calcáneo —densidad mineral ósea (DMO), atenuación de ultrasonido (BUA), velocidad del sonido (SOS) e índice ultrasonográfico cuantitativo (QUI)— y sus diferencias por condición de menopausia. Este estudio documentó valores en mujeres pre y posmenopáusicas, y diferencias ajustadas entre ambos grupos. MÉTODOS: diseño transversal. Participaron 862 mujeres de 20 a 90 años, usuarias del Sistema para el Desarrollo Integral de la Familia en Morelos, incorporadas por muestreo consecutivo. Se identificaron sus características sociodemográficas, familiares, reproductivas y de estilos de vida. Con ultrasonido cuantitativo (QUS), equipo Sunlight Omnisense 7000 S, se midieron DMO, BUA, SOS y QUI en calcáneo, estimando diferencias ajustadas de BUA, SOS y QUI entre pre y posmenopáusicas mediante regresión lineal.

  8. The relationship between calcaneus bone mineral density and metabolic syndrome%定量超声检测的跟骨骨密度与代谢综合征的关系

    Institute of Scientific and Technical Information of China (English)

    孙启虹; 巴建明; 陈康; 闫文华; 王先令; 谷伟军; 汪保安; 王健松; 王淑梅

    2014-01-01

    目的 探索定量超声检测跟骨骨密度(BMD)与代谢综合征(MS)及其各组分之间的关系.方法 横断面研究,对象为北京某社区常住居民.按性别、绝经与否分组,每组再分为MS和非MS组,分析MS对BMD的影响.MS采用中华医学会糖尿病学分会制定的诊断标准.结果 5 552例受试者纳入分析.男女比例1:1.8,年龄40~87岁,其中,男1 987例,年龄(59.4±7.3)岁;女3 565例,年龄(56.9±7.2)岁,绝经前后女性比例1:3.7.MS患病率:男29.0%,女24.4%.协方差分析显示,MS组与非MS组BMD差异无统计学意义.但是随着MS组分数目由0个增加至4个,绝经后女性BMD有增加的趋势,协方差分析显示,BMD的增加有统计学意义(P<0.05).多元线性回归分析提示绝经后女性MS组的BMD与年龄呈负相关(β=-0.034,P<0.001)、与BMI(β=0.046,P=0.001)、收缩压(β =0.007,P=0.039)、TG(β=0.066,P=0.034)呈正相关.结论 随着MS组分数目的增加,绝经后女性BMD有增加的趋势,BMD与BMI、收缩压、TG呈正相关.%Objective To evaluate the association between calcaneus bone mineral density (BMD) and metabolic syndrome (MS).Methods A cross-sectional study was carried out in 5 552 subjects with 1 987 men and 3 565 women (age:40-87 years old).MS was defined according to Chinese Diabetes Society criteria.BMD was assessed by quantitative ultrasound.Results The proportion of MS was 29.0% in male and 24.4% in female.There were no differences in BMD between MS and non-MS subjects in both genders.Linear trend analysis displayed that BMD was positively associated with the increase of MS components in post-menopausal women after adjustment of age,ALT,creatinine and exercises (P < 0.05).Moreover,multiple regression analysis showed that BMD was inversely correlated with age (β =-0.034,P < 0.001) and positively correlated with BMI(β =0.046,P =0.001),TG (β =0.066,P =0.034) and systolic blood pressure(SBP) (β =0.007,P =0.039) in post-menopausal women with MS

  9. 241镅跟骨骨密度测定在骨质疏松症中的初步应用 ——与腰椎骨密度测定的对比研究%Preliminary application of 241-Americium calcaneus bone mineral density measurement in osteoporosis ——comparison with double X-ray densitometry of the lumber spine

    Institute of Scientific and Technical Information of China (English)

    管梁; 朱承谟; 李培勇; 王辉; 濮鸣芳; 仇季高

    2001-01-01

    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 increased age. The BMD of osteoporosis, suspected osteoporosis and non-osteoporosis group were 230.3±62.3, 395.7±57.4 and 363.3±51.9mg/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 ospteoporosis and non-osteoporosis had no significant difference with normal group. The coefficient variation (CV) of BMD in repeated measurement in calcaneus of 4 pariticipants 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 percentagy and T value were rather good.%为评价跟骨骨密度测定在骨质疏松症中的初步临床应用及与腰椎测定结果的相关性,用国产华科(HK-1型)241镅骨密度仪测定了140例跟骨骨密度(BMD)。其中正常人组54例,骨质疏松确诊组45例,骨质疏松可疑组25例和其他非骨质疏松组16例。其中43例与美国Luner 公司的Expert-XL图像骨密度仪腰

  10. Treatment of linguiform calcaneus fracture by close nail-pry reduction and internal fixation with hollow screws%闭合撬拨复位经皮空心螺钉内固定治疗跟骨舌形骨折

    Institute of Scientific and Technical Information of China (English)

    涂淑强; 黄科棣; 帅永明; 徐南云; 袁秋文; 郭剑

    2012-01-01

    Objective: To study the curative effects of close nail-pry reduction and internal fixation with hollow screws for treatment of linguiform calcaneus fracture. Methods: From May 2006 to October 2009,32 patients (35 feel) with linguiform calcaneus fracture were treated by close nail-pry reduction and internal fixation with hollow screws, including 23 males and 9 females ranging in age from 25 to 46 years, with a mean of 37.6 years. According to Paley classification, 3 cases were Paley II a, and 29 cases were Paley II b. All cases were close fractures. The time from injury to operation was 3 to 10 days after most swelling subsided. BBhler angle and Gissane angle were measured by X-ray before and after operation. The therapeutic effect was assessed according to ZHANG Tie-liang's foot score. Results:All the patients were followed-up for 6 to 18 months,with a mean of 12 months. All fractures gained bone healing. The time of fracture healing averaged 12 months. The fractures healed completely and no infection occurred. According to ZHANG Tie-liang's foot scale,the postoperative function was excellent in 18 feet,good in 10 feet, moderate in 5 feet and poor in 2 feet. The Bohler angle and Gissane angle were significant improved after treatment (P<0.01 ). Conclusion: The surgical method of close nail-pry reduction and internal fixation with hollow screws for treatment of linguiform calcaneus fracture can regain the foot function, with minimal injury, fewer complications, earlier recovery and lower costs.%目的:探讨闭合撬拨复位经皮空心螺钉内固定治疗跟骨舌形骨折的手术疗效.方法:自2006年5月至2009年10月共收治32例(35足)跟骨舌形骨折,男23例,女9例;年龄25~46岁,平均37.6岁.根据Paley分类法:PaleyⅡa型3例,PaleyⅡb型29例,均为闭合性骨折.手术时间为伤后3~10d,均等局部肿胀消退至中、轻度后手术.通过X线片测量手术前后B(o)hler角及Gissane角,并按张铁良足部综

  11. The clinical analysis of reverse peroneus brevis muscle flaps for bone exposure after the operation of calcaneus fracture%逆行腓骨短肌肌瓣修复跟骨骨折术后骨外露临床体会

    Institute of Scientific and Technical Information of China (English)

    张学东; 杨润功; 于振山; 张亚奎; 王雪飞

    2011-01-01

    目的探讨逆行腓骨短肌肌瓣在修复跟骨骨折术后骨外露的可行性.方法自2007年1月至2010年2月收治跟骨骨折内固定术后所致骨外露病例11例,其中男7例,女4例,年龄18~50岁,平均35.2岁;开放性骨折3例,闭合性骨折8例,手术原切口均为跟骨外侧"L"形切口,跟骨解剖型钢板内固定.创面缺损范围1.5cm×2.3cm~3.0cm×4.0cm,病程为2-4个月;所有病例均进行多次换药不见好转.手术时首先给予原切口扩创,清除坏死组织和炎性肉芽组织,取出内固定物.设计并切取同侧腓骨短肌逆行肌瓣充填缺损区,观察血运良好后,表面予以中厚游离皮片覆盖,打包加压,石膏托固定2周,供区均直接缝合.结果所有病例术后转移肌瓣及植皮完全成活,仅1例伴肌瓣下感染,换药后愈合.11例患者随访时间为2-20个月,平均4.5个月;术后皮瓣质地、外形良好,足踝活动稳定,无并发症发生,均可正常行走,无疼痛.结论逆行腓骨短肌肌瓣修复跟骨骨折术后骨外露,操作简单、成功率高、并发症少,可获得满意临床疗效.%Objective To investigate the feasibility of reverse peroneus brevis muscle flaps for bone exposure after the operation of calcaneus fracture.Methods From January 2007 to Feburary 2010, there were 11 cases (7 males and 4 females) of bone exposure after the operation of calcaneus fracture with internal fixation.The average age was 35.2 years (range; 18-50).3 cases were of opening fracture and 8 cases were of closed fracture.A11 patients had "L" incision on the lateral calcaneus site and were fixed with anatomical plate.The area of soft tissue defect was 1.5×2.3cm3.0×4.0cm.The course of disease ranged from 2 months to 4 months.Incisions of all the patients were not improved after dressing changes many times.The intemal plate was dropped out after incision expansion and debridement of necrotic tissue and inflammatory granulation tissue.Peroneus brevis muscle flap was

  12. Analysis of bone mineral density of the calcaneus using ultrasound in 476 healthy adult males in Bama, Guangxi%广西巴马476名健康成年男性跟骨超声骨密度分析

    Institute of Scientific and Technical Information of China (English)

    徐世民; 刘鹏; 李琴; 冯哲

    2013-01-01

    Objective To investigate the changing pattern of bone mineral density ( BMD ) along with the changes of age, height, weight, and BMI by testing BMD in healthy adult males in Bama, Guangxi. Methods Four hundred and seventy - six healthy adult males, aging from 20 to 111 years old, were selected randomly. They were divided into 7 groups according to a 10-year-age division. People over 80 years old were in the same group. BMD of the calcaneus was tested using ultrasound BMD detector ( Korea ). A SPSS1 6. 0 software was used to analyze the data. Results The peak SI of BMD of the calcaneus in males presented in the group of 20 - 30 years old. SI of BMD declined along with the increase of age. The prevalence of osteoporosis in males increased along with the increase of age. Partial correlation analysis showed that SI of BMD in males was negatively correlated with age ( r = -0. 216, P <0.05 ). And it was significantly correlated with weight ( r = 0. 167 , P < 0. 05 ). But SI of BMD in males did not have correlation with height and BMI. Conclusions SI of BMD in healthy males, aging from 20 to 111 years old, in Bama, Guangxi is significantly correlated with age and weight. The SI acquired in this study provides reference value of BMD and the clinical diagnosis of osteoporosis in males in this region.%目的 检测广西巴马地区健康成年男性的骨密度,探讨其骨密度随年龄、身高、体重和BMI变化的规律.方法 采用韩国生产跟骨超声骨密度测定仪对广西巴马地区随机抽取的476名20~111岁健康成年男性进行跟骨SI测量.按不同年龄分组,每组10岁,80岁以上合并为1组,共7组,对所测量的数据通过SPSS16.0进行分析.结果 男性跟骨SI峰值骨密度在20~30岁年龄段,SI随着年龄的增加出现下降的趋势.男性骨质疏松症的患病率随年龄的增加而逐步升高.偏相关性分析显示,男性SI与年龄呈现负相关(r=-0.219,P<0.05)与体重有显著(r=0.167,P<0.05)关系,但

  13. 跟骨B(o)hler 角改变对跟骨应力影响的有限元分析%Finite Elem ent A nalysis of Changes of B(o)hler′s Angle in Calcaneus Stress Distribution

    Institute of Scientific and Technical Information of China (English)

    王一民; 黄爱军; 黄醒中; 周序玲; 曾瑞芬

    2013-01-01

    Objective To explore the changes of B(o)hler's angle in calcaneus stress distribution through finite element analysis(FEA),and to privode the theoretical foundation for treatment.Methods Three-dimentional FE model of the normal ankle were developed. Four FE models that the B(o)hler's angle decreased 5°, 10°, 15cand 20° were developed based on the normal ankle model. And the vonM ises distribution of the calcaneus ,the maxim stress and displacement were respectly analyzed.Results In the normal ankle model,stress concentration was found in the posterior inner part of the posterior articular facet ,the anterior inner part of the posterior articular facet and the calcaneocuboid articular surface,and the highest stress was 16. 608 MPa. The stress concentration in the calcaneocuboid articular surface was disappeared when the B(o)hler's angle decreased,and the highest stress of the model that the B(o)hler's angle decreased 5°, 10°, 15°and 20° was 18. 492 MPa,18. 603 MPa,19. 674 MPa and 19. 899 9 MPa respectively. Conclusion It seems that the B(o)hler's angle is an index in the clinic to judge the severity of the calcaneal fracture and evaluate the therapeutic effect. The B(o)hler's angle should be regained to the normal level. If the reduction of the fracture is difficult,the decreasing of the B(o)hler's angle should be limited to 15°.%目的 以有限元分析方法探讨B(o)hler 角改变不同角度后跟骨应力的变化情况,为B(o)hler 角作为临床判定骨折严重程度和评估疗效提供理论依据.方法 建立正常足踝模型,并在此基础上建立B(o)hler 角减少5°、10°、15°、20°时的有限元模型,研究5 种模型的应力分布、应力峰值及位置.结果 正常模型跟骨的应力集中出现在后关节面后内方、后关节面前内方及跟骰关节面,最大应力出现在后关节面后内方,最大应力值16.608 MPa.B(o)hler 角减小后跟骰关节面处应力集中消失,B(o)hler 角减少5°、10°、15°及20

  14. Meta analysis of the clinical outcomes between Minimally invasive internal fixation and open reduction in treatment of calcaneus fracture%微创内固定与切开复位治疗跟骨骨折疗效比较Meta分析

    Institute of Scientific and Technical Information of China (English)

    王东; 王起奎; 周君琳

    2015-01-01

    Objective To compare the safety and clinical outcome between minimally invasive internal fixation and open reduction in treatment of calcaneus fracture based on Meta analysis.Methods A computer-based online search of the Cochrane library,Medline database,CNKI,Wan Fang database,the Chinese biomedical literature database,PubMed,Ovid database and all was performed for clinical trials regarding minimally invasive internal fixation and open reduction in treatment of calcaneus fracture.Meta analysis was used to analyze the postoperative local soft tissue,calcaneal last follow-up Bohler angle and Gissane angle.Results A total of 17 studies were included(used Jadad quality grading,one is 7 points,two is 4 points,four is 3 points,ten is 2 points),involving 1138 patients,including 569 patients used minimally invasive internal fixation and 569 used open reduction.Meta analysis showed that the incidence of postoperative local soft tissue poor healing used minimally invasive internal fixation is lower than used open reduction about,the difference was statistically significant [OR =0.26,95% CI:(0.14,0.47),P < 0.01].Meta analysis showed that the calcaneal last follow-up Bohler angle of minimally invasive internal fixation was lower than open reduction,the difference was statistically significant [WMD =-1.29,95% CI:(-2.39,-0.19),P =0.02].There were no statistically significant differences in the calcaneal last follow-up Bohler angle between minimally invasive internal fixation and open reduction[WMD =1.01,95%CI:(-3.02,5.04),P =0.62].Conclusions Regardless of the calcaneal fracture type,minimally invasive internal fixation or open reduction,the postoperative Bohler angle and Gissane angle at the calcaneus mechanical recovery characteristics are the same.However,the postoperative soft tissue healing of minimally invasivc internal fixation is less better than open reduction.%目的 系统评价微创内固定与切开复位治疗跟骨骨折的安全性与疗效.方法 计

  15. The single-bundle and single-tunnel reconstruction of anterior cruciate ligament using achilles tendon allograft with attached calcaneus under arthroscopy%关节镜下带跟骨异体跟腱单束单隧道重建前交叉韧带

    Institute of Scientific and Technical Information of China (English)

    冯会成; 黄迅悟; 孙继桐; 常青; 毕龙; 余方圆

    2013-01-01

    Objective To investigate the effectiveness of anterior cruciate ligament (ACL) reconstruction using achilles tendon allograft with attached calcaneus in promoting the tendon-bone healing through comparing with that of ACL reconstruction using simple tendon allograft under arthroscopy. Methods From January 2008 to December 2009, 41 patients with ACL injuries in accordance with the inclusion criteria were treated. They were randomly divided into 2 groups according to different treatment methods. In the trial group, ACL reconstruction using achilles tendon allograft with attached calcaneus was performed on 21 patients. In the control group, ACL reconstruction using simple tendon allograft was performed on 20 patients. There were no significant differences in such general data as the age, gender, cause of injury, disease duration, preoperative functional score and so on between the 2 groups (P>0.05), which were comparable. The single-bundle and single-tunnel ACL reconstruction was performed in both groups. Results All the incisions in both groups were healed by the first intention 2 weeks postoperatively. The patients were followed up for an average period of 26 months (range; 24-28 months) in the trial group, and 28 months (range; 24-30 months) in the control group. 2 years after the operation, 15 cases (71.4%) were negative in the Lachman test, and 16 cases (76.2%) were negative in the anterior drawer test in the trail group. In contrast, 14 cases (70.0%) and 15 cases (75.0%) were negative respectively in the control group. There were no significant differences in the Lysholm score and International Knee Documentation Committee (IKDC) score between the 2 groups 2 years after the operation (P>0.05). The CT exam showed the bone tunnel diameter was enlarged in different degrees in both groups 2 years after the operation, when compared with that 1 month postoperatively. However, the rate of bone tunnel enlargement in the trial group (4/21, 19.0%) was obviously less than

  16. [Gait analysis after intra-articular calcaneus fractures].

    Science.gov (United States)

    Siegmeth, A; Petje, G; Mittlmeier, T; Vécsei, V

    1996-01-01

    We retrospectively compared 20 patients with displaced intra-articular calcaneal fractures by clinical assessment and dynamic pedography. Eleven were treated operatively, 9 conservatively. The purpose was to identify differences in post-traumatic gait performance and to correlate the pedographic data to a clinical score to show its reliability. Twenty individuals without a history of foot injuries were used as a control group. Both groups had restricted motion in the subtalar joint, increased hindfoot and midfoot loading and decreased forefoot loading. Furthermore, they showed prolonged contact phases and an impaired ability to speed up gait during the toe-off phase. Load transfer from the hindfoot to the forefoot showed typical distribution patterns. The operatively treated group showed better functional results with fewer subjective complaints.

  17. Abnormal attachments between a plantar aponeurosis and calcaneus

    OpenAIRE

    KALNIEV, MANOL ANASTASOV; Krastev,Dimo; KRASTEV, NIKOLAY; VIDINOV, KALIN; VELTCHEV, LUDMIL; Mileva, Milka

    2013-01-01

    Background and aims The plantar aponeurosis or fascia is a thick fascial seal located on the lower surface of the sole. It consists of three parts central, lateral, and medial. The central portion is the thickest. It is narrow behind and wider in front. The central portion has two strong vertical intermuscular septa which are directed upward into the foot. The lateral and medial portions are thinner. The medial portion is thinnest. The lateral portion is thin in front and thick behind. The ma...

  18. TWINFIX TI QUICK-T锚钉治疗跟腱止点撕脱的临床研究%The Clinical Study on the Use of TWINFIX TI QUICK-T Suture Anchor to Repair the Avulsion of the Bony Insertion of the Achilles Tendon at the Calcaneus

    Institute of Scientific and Technical Information of China (English)

    林忠勤; 王伟; 程少文; 张伟; 寇冬权; 彭磊

    2011-01-01

    Objective Using TWINFIX TI QUICK-T suture anchors to repair the Achilles tendon close to its insertion avulsion.Evaluating its efficacy,to provide reference for clinical treatment.Methods Total 16 with the avulsion of the bony insertion of the Achilles tendon at the calcaneus were treated with TWINFIX TI QUICK-T suture anchor from 2007 to now.10 males and 6 females ;aged 22 to 65 years ,mean 44.7 years old.7 cases the left side,right side in 9 cases.By AOFAS ankle and hindfoot scoring function evaluated.Results Followed up 6~24 months,average of 13 months.No one cases happened suture dehiscence ,wound infection occurred ,main blood vessel nerve injury,fixation failure and other complications after operation and were normal anatomic relations and the appearance and function are satisfactory.Among 16cases, 12cases had the excellent results, 2case had the good results, 2case had fair results.The total excellent and good rate was 87.5%.Conclusion More reasonable and secure fixation method is necessary in order to allow early functional rehabilitation.We use a technique to repair the Achilles tendon close to its insertion avulsion or tendon Achilles avulsion fracture (fix the avulsed fragment of Achilles tendon insertion) with TWINFIX TI QUICK-T suture anchors.This can neutralize the pull of the triceps surae and early post-operative rehabilitation program is allowed,it is conducive to a better recovery of the ankle joint function postoperative.%目的 应用TWINFIX TI QUICK-T治疗跟腱止点撕脱伤,评价其疗效,为临床治疗提供参考.方法 2007年9月至2010年5月采用TWINFIX TI QUICK-T锚钉治疗跟腱止点撕脱伤16例,男10例,女6例;平均44.7岁.左侧7例,右侧9例.按AOFAS踝与后足功能评分标准评价疗效.结果 随访6~24个月,平均13个月.术后无一例出现缝线裂开、切口感染、主要血管及神经损伤、内固定失效等并发症,术后恢复正常解剖关系及外观,踝关节功能恢复满意.本组16

  19. 三种不同手术方式治疗跟骨骨折的疗效分析%Efficacy of three approaches for fractures of calcaneus:percutaneous reduction surgery, L-shaped lateral approach and small sinus tarsi approach

    Institute of Scientific and Technical Information of China (English)

    葛晨; 徐向阳; 王亚梓; 刘津浩; 朱渊

    2014-01-01

    比较有显著统计学差异。末次随访时撬拨组的AOFAS评分显著低于另两组(Q<0.05),但“L”形切口组与小切口组之间无明显统计学差异(Q>0.05)。三组的SF36评分无明显统计学差异。再次手术发生率分别为撬拨组12.00%,“L”形切口组15.71%,小切口组2.67%,三组间有统计学差异。结论:对于骨折块较完整、单纯跟距关节面塌陷骨折,撬拨复位手术时间短、损伤小、无伤口愈合问题,存在部分复位丢失,发生距下关节炎后常需行距下关节融合。“L”形切口与小切口疗效相当,但小切口直接暴露距下关节面,便于复位;内固定物少;医源性软组织损伤小。小切口是一种有效的治疗跟骨关节内骨折的方法;术后并发症及再次手术发生率明显低于其他两种方法。%Background:Fractures of calcaneus are complex injuries with a high incidence in feet and usually the result of a fall from a great height. Surgical techniques are the preferred methods for displaced and comminuted fractures. Due to the rising rate of complications after operation, such as wound infection and pain, controversies remain regarding treatment options and sur-gical approaches. In this article, we attempted to investigate clinical effects by three different surgical treatments. Objective:To compare the complications and outcomes of three operations to determine the better approach for the treat-ment of calcaneal intraarticular fracture. Methods:Between 1990 and 2010, 175 patients were admitted for 195 calcaneal fracture, including 50 feet with percutane-ous reduction by leverage, 70 feet with L-shaped lateral approach and 75 feet with small sinus tarsi approach. All fractures were fresh closed fractures of calcaneus. There were 95 cases of SandersⅡand 78 cases of SandersⅢ. The mean age of the patients was 43 years (range, 22-62 years). The measured parameters during treatment were compared between

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

    OpenAIRE

    Xu J; Sun M; Wang Z.; Fu Q; Cao M; Zhu Z; Meng C; Yan Y; Mao J; Tao H; Huang X.; Lin Z; Yang T; He W.

    2013-01-01

    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 wor...

  1. Magnetic resonance imaging of distal tibia and calcaneus for forensic age estimation in living individuals.

    Science.gov (United States)

    Ekizoglu, Oguzhan; Hocaoglu, Elif; Can, Ismail Ozgur; Inci, Ercan; Aksoy, Sema; Bilgili, Mustafa Gokhan

    2015-07-01

    In recent years, methods by which to decrease radiation exposure during age estimation have gained importance and become a main research area in the forensic sciences. Imaging tools such as X-ray and computed tomography (CT) are accepted as the main diagnostic methods for evaluation of the epiphysis in living individuals; however, radiation exposure and superimposition are the main disadvantages of these techniques. Magnetic resonance (MR) imaging provides an advantage in terms of preventing radiation exposure. In this study, we performed an MR analysis of the degree of fusion of the distal tibia and calcaneal epiphysis and investigated the utility of this technique in the Turkish population. Using the three-stage method described by Saint-Martin et al., we retrospectively evaluated 167 MR images (97 males, 70 females; mean age, 17.7 ± 4.8 years for males and 17.6 ± 4.9 years for females; age range of all subjects, 8-25 years). Intraobserver and interobserver evaluation showed good repeatability and consistency of this method. Stages 2 and 3 ossification of the distal tibial epiphysis first occurred at age 14 and 15 years in males and 12 and 14 years in females, respectively. Stages 2 and 3 ossification of the calcaneal epiphysis first occurred at age 14 and 16 years in males and 10 and 12 years in females, respectively. When performed alone, MR analysis of the distal tibial and calcaneal epiphysis offers limited information for forensic age estimation. However, we suggest that MR analysis can be used as a supportive method when it is necessary to avoid repeated radiation exposure.

  2. Incidence of tendon entrapment and dislocation with calcaneus and pilon fractures on CT examination

    Energy Technology Data Exchange (ETDEWEB)

    Tresley, Jonathan [Jackson Memorial Hospital, Department of Diagnostic Radiology, Miami, FL (United States); University of Wisconsin-Madison, Department of Radiology, Madison, WI (United States); Subhawong, Ty K.; Singer, Adam D.; Clifford, Paul D. [Jackson Memorial Hospital, Department of Diagnostic Radiology, Miami, FL (United States)

    2016-07-15

    To examine the association between tibial pilon and calcaneal fracture classification and tendon entrapment or dislocation. After institutional review board approval, we retrospectively reviewed consecutive CT scans with calcaneal or pilon fractures from 5 years at a level 1 trauma center. We categorized calcaneal fractures according to the Sanders classification, and pilon fractures according to the Ruedi and Allgower and the Arbeitsgemeinschaft fuer Osteosynthesefragen-Orthopaedic Trauma Association (AO-OTA) classifications. Ankle tendons were assessed for dislocation or entrapment. Fisher's exact test was used for statistical analysis with significance at p < 0.05. A total of 312 fractures (91 pilon only, 193 calcaneal only, and 14 ankles with ipsilateral pilon and calcaneal fractures) were identified in 273 patients. Twenty-two pilon, 42 calcaneal, and nine combination fractures were associated with 99 occurrences of tendon entrapment or superior peroneal retinacular injury. Such findings were associated with multiple fractures (p = 0.002). Multifragmentary pilon fractures were associated with posterior tibial and flexor digitorum longus tendon entrapment (p < 0.0001 and p = 0.0003 for Ruedi/Allgower and AO-OTA, respectively), and multifragmentary Sanders type 3 or 4 calcaneal fractures were associated with superior peroneal retinacular injury (p = 0.0473) compared to simple fracture patterns. Thirty-nine percent of tendon entrapments or retinacular injuries were prospectively identified, 85 % by musculoskeletal radiologists (p < 0.0001). Approximately 25 % of calcaneal and pilon fractures were retrospectively identified to contain posteromedial tendon entrapment or superior peroneal retinacular injury. Radiologists should meticulously search for such injuries, particularly when analyzing multifragmentary and multiple fractures. (orig.)

  3. 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.

  4. Displaced Intra-articular Fractures of the Calcaneus: with an emphasis on minimally invasive surgery

    NARCIS (Netherlands)

    T. Schepers (Tim)

    2009-01-01

    textabstractDisplaced intra-articular calcaneal fractures are complex injuries. Classically these fractures are treated with open reduction and internal fixation (ORIF) or conservatively. When comparing these two treatment modalities, ORIF has a significantly higher rate of wound complications and c

  5. Clinical effect of two operation methods in treatment of Sanders II type calcaneus fractures

    Institute of Scientific and Technical Information of China (English)

    Dong Liu; Jun Hua; Yong-Ming Sun; Lu-Min Cao

    2015-01-01

    Objective:To explore the differences between percutaneous reduction hollow screw internal fixation and open reduction plate internal fixation in the treatment of Sanders II type calcaneal fracture.Method:68 patients with Sanders II type calcaneal fracture from January, 2012 to February, 2013 were divided into poking group and open reduction group, 34 cases in each group. They were treated with poking reduction and internal fixation, as well as open reduction and internal fixation, and then followed up for one year successfully. The operation time, hospitalization time, wound healing time and the amount of bleeding were compared. The Maryland foot score system was employed to assess the function recovery of two groups and the related complications were recorded.Result:The operation time, hospitalization time, incision healing time and the amount of bleeding in operation of poking group were significantly less than the open reduction group; The excellent rate of functional recovery of poking group and open reduction group were 79.41% and 82.35%. The difference between two groups had no statistical significance; the complication rate of poking group and open reduction group were 2.94% and 17.65%. The difference between two groups had statistical significance.Conclusion:Poking reduction combined with internal fixation for the treatment of Sanders II type calcaneal fracture can not only reduce the wound and intraoperative bleeding, shorten operation and hospitalization time, but also prevent the occurrence of complications.

  6. Vitamin D and Calcium Intakes, Physical Activity, and Calcaneus BMC among School-Going 13-Year Old Malaysian Adolescents

    Directory of Open Access Journals (Sweden)

    A. A. Suriawati

    2016-10-01

    Full Text Available Background: Dietary calcium and vitamin D are essential for bone development. Apart from diet, physical activity may potentially improve and sustain bone health. Objective: To investigate the relationship between the dietary intake of calcium and vitamin D, physical activity, and bone mineral content (BMC in 13-year-old Malaysian adolescents. Design: Cross-sectional. Setting: Selected public secondary schools from the central and northern regions of Peninsular Malaysia. Participants: The subjects were from the Malaysian Health and Adolescents Longitudinal Research Team Cohort study (MyHeARTs. Methods: The data included seven-day diet histories, anthropometric measurements, and the BMC of calcaneal bone using a portable broadband ultrasound bone densitometer. Nutritionist Pro software was used to calculate the dietary calcium and vitamin D intakes from the diet histories, based on the Nutrient Composition of Malaysian Food Database guidance for the dietary calcium intake and the Singapore Energy and Nutrient Composition of Food Database for vitamin D intake. Results: A total of 289 adolescents (65.7% females were recruited. The average dietary intakes of calcium and vitamin D were 377 ± 12 mg/day and 2.51 ± 0.12 µg/day, respectively, with the majority of subjects failing to meet the Recommended Nutrient Intake (RNI of Malaysia for dietary calcium and vitamin D. All the subjects had a normal Z-score for the BMC (−2.00 or higher with a mean of 0.55 ± 0.01. From the statistical analysis of the factors contributing to BMC, it was found that for those subjects with a higher intake of vitamin D, a higher combination of the intake of vitamin D and calcium resulted in significantly higher BMC quartiles. The regression analysis showed that the BMC might have been influenced by the vitamin D intake. Conclusions: A combination of the intake of vitamin D and calcium is positively associated with the BMC.

  7. Prostate cancer metastasis to calcaneus: a solitary lesion at an atypical site, dormant for more than 10 years

    Science.gov (United States)

    McCarthy, Michael T; Ebrahem, Hawa; Aibdeen, Zariena; Hodnett, Philip A; Mulcahy, Elizabeth

    2016-01-01

    In prostate cancer patients, if bone scan demonstrates a solitary lesion in atypical area, this is possibly an indication of metastatic disease. Therefore, biopsy confirmation is required to determine the nature of the abnormality and therefore dictates further staging investigations and treatment options. PMID:27757245

  8. 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.

  9. Vitamin D and Calcium Intakes, Physical Activity, and Calcaneus BMC among School-Going 13-Year Old Malaysian Adolescents

    Science.gov (United States)

    Suriawati, A. A.; Abdul Majid, Hazreen; Al-Sadat, Nabilla; Mohamed, Mohd Nahar Azmi; Jalaludin, Muhammad Yazid

    2016-01-01

    Background: Dietary calcium and vitamin D are essential for bone development. Apart from diet, physical activity may potentially improve and sustain bone health. Objective: To investigate the relationship between the dietary intake of calcium and vitamin D, physical activity, and bone mineral content (BMC) in 13-year-old Malaysian adolescents. Design: Cross-sectional. Setting: Selected public secondary schools from the central and northern regions of Peninsular Malaysia. Participants: The subjects were from the Malaysian Health and Adolescents Longitudinal Research Team Cohort study (MyHeARTs). Methods: The data included seven-day diet histories, anthropometric measurements, and the BMC of calcaneal bone using a portable broadband ultrasound bone densitometer. Nutritionist Pro software was used to calculate the dietary calcium and vitamin D intakes from the diet histories, based on the Nutrient Composition of Malaysian Food Database guidance for the dietary calcium intake and the Singapore Energy and Nutrient Composition of Food Database for vitamin D intake. Results: A total of 289 adolescents (65.7% females) were recruited. The average dietary intakes of calcium and vitamin D were 377 ± 12 mg/day and 2.51 ± 0.12 µg/day, respectively, with the majority of subjects failing to meet the Recommended Nutrient Intake (RNI) of Malaysia for dietary calcium and vitamin D. All the subjects had a normal Z-score for the BMC (−2.00 or higher) with a mean of 0.55 ± 0.01. From the statistical analysis of the factors contributing to BMC, it was found that for those subjects with a higher intake of vitamin D, a higher combination of the intake of vitamin D and calcium resulted in significantly higher BMC quartiles. The regression analysis showed that the BMC might have been influenced by the vitamin D intake. Conclusions: A combination of the intake of vitamin D and calcium is positively associated with the BMC. PMID:27783041

  10. The influence of cortical end-plate on broadband ultrasound attenuation measurements at the human calcaneus using scanning confocal ultrasound

    Science.gov (United States)

    Xia, Yi; Lin, Wei; Qin, Yi-Xian

    2005-09-01

    Quantitative ultrasound (QUS) assessment, including broadband ultrasound attenuation (BUA), is an efficient technique for assessing bone quality in various statuses, e.g., osteoporosis. While assessing trabecular bone loss is essential to bone quality, the existence of cortical bone can substantially reduce the accuracy of BUA measurement. In this study, we developed an approach to quantify the influence of the cortical end-plate in the QUS on 18 cadaver calcanei using both analytical and experimental analyses. A simplified cortical-trabecular-cortical sandwich model has been developed for simulation of wave propagations. Results show that the cortical end-plate has a significant effect on BUA (yielding 8.5+/-3.6 dB/MHz in cortical bone alone), approximately 15% of the BUA value over the whole bone BUA measurement (54.1+/-20.1 dB/MHz). The phenomenon has been predicted by the developed analytical model with a high correlation (r2=0.63,pdiagnosis of bone diseases.

  11. 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.

  12. 脆骨症伴双侧跟骨鸟嘴型骨折1例%Bilateral bird mouth type fracture of calcaneus with osteogenesis imperfecta

    Institute of Scientific and Technical Information of China (English)

    周礼智; 马本山

    2001-01-01

    @@ 1病例资料 患者,女,15岁,左跟部跌伤1 h入院.既往有多次骨折史,其母为脆骨症患者.检查:身体矮小,蓝巩膜,周身关节松驰.左前臂掌侧成角畸形,右肘内翻.左跟部皮肤青紫、畸形,摸到向后上移位突出的骨块.

  13. Open reduction and internal fixation of OTA type C2-C4 fractures of the calcaneus with a triple-plate technique.

    Science.gov (United States)

    Brunner, Alexander; Müller, Jochen; Regazzoni, Pietro; Babst, Reto

    2012-01-01

    The purpose of this study was to present a surgical technique of open reduction and internal fixation of displaced intra-articular calcaneal fractures with 3 AO mini-fragment plates and to evaluate the clinical and radiological outcome of a consecutive group of patients after a mean follow-up of 41.7 months. A series of 54 patients (16 women and 38 men) with 62 calcaneal fractures were treated over a period of 6.5 years. Forty-five patients with 50 calcaneal fractures were completely clinically and radiologically followed up. Clinical follow-up included assessment of range of motion, pain according to a visual analogue scale, the American Orthopaedic Foot and Ankle Society hindfoot score, and the short-form 36 health survey. Radiological follow-up included plain axial and lateral radiographs and measurement of the Böhler's angle and Gissane's angle. Independent Student's t test and paired Student's t test were used alongside the chi-square test to compare clinical and radiological data and score values between different groups of patients. Eleven patients showed breakage of the osteosynthesis material during the healing process and 2 patients sustained deep wound infection requiring revision surgery. At the final follow-up all fractures had healed. The average range of motion was supination 26.4° (range 0° to 50°; SD 11.6°), pronation 15.4° (range 0° to 30°; SD 6.4°), dorsal extension 14.3° (range -10° to 30°; SD 8.0°), and plantarflexion 39.6° (range 20° to 65°; SD 11.7°). Patients with OTA type C4 fractures achieved significantly lower supination (p fracture types. The mean visual analog scale pain score was 3.6 (range 0 to 8; SD 2.3) points, average American Orthopaedic Foot and Ankle Society hindfoot score was 70.8 (range 33 to 100; SD 17.1) points, and the mean short-form 36 score was 60.98 (range 22.9 to 93.0; SD 18.4) points. The mean postoperative Böhler's angle was 28.9° (range 8° to 38°; SD 7.1°), which decreased to 23.6° (range 4° to 34°; SD 8.7°) at the final follow-up, and the mean postoperative Gissane's angle was 108.6° (range 80° to 140°; SD 11.8°), which finally decreased to 102.4° (range 72° to 126°; SD 12.7°). No statistically significant differences regarding Böhler's and Gissane's angles were found between different OTA fracture types. In conclusion, the presented surgical technique was found to provide comparable and adequate reduction of OTA type C2-C4 injuries based on statistically insignificant differences in radiographic measures of postoperative fracture reduction. Greater limitation in subtalar motion was observed in OTA type C4 fractures in comparison with less severe fractures (p < .01).

  14. Calcaneal chondroblastoma with secondary aneurysmal bone cyst: a case report.

    Science.gov (United States)

    Guedes, Alex; Barreto, Bruno; Soares Barreto, Lara Grimaldi; Athanazio, Daniel A; Athanazio, Paulo R F

    2010-01-01

    We present a case of destructive chondroblastoma associated with secondary aneurysmal bone cyst involving the left calcaneus. Because of the extensive destruction of the calcaneus, total calcanectomy was the treatment of choice.

  15. Prenatal utrasonographic dagnosis of foot deformities using view of five phalanx-metatarsale-calcaneus fetal pedis%产前超声五趾-跖-跟骨足底平面筛查足畸形的价值

    Institute of Scientific and Technical Information of China (English)

    吕国荣; 刘云萍; 吴家祥

    2015-01-01

    目的 探讨产前超声五趾-跖-跟骨足底平面在筛查胎儿足畸形中的价值.方法 连续性选取10 015胎14~40孕周高危胎儿作为研究对象,产前超声检查采用五趾-跖-跟骨足底平面筛查足畸形,并与随访结果进行比较.结果 胎儿足长随孕周增加而增大(F=8.2,P<0.01),单纯先天性马蹄内翻足胎儿的患侧足长变短(x2=49.1,P<0.01).五趾-跖-跟骨足底平面超声诊断胎儿足畸形准确率为99.60%(9975/10 015),敏感度为85.29%(116/136),特异度为99.80%(9859/9879),阳性预测值为85.29%(116/136),阴性预测值为99.80%(9859/9879).结论 五趾-跖-跟骨足底平面可用于胎儿足畸形的产前超声筛查,并可提高诊断水平.

  16. 经跟距固定器治疗跟骨关节内移位骨折%Treatment of the inter-articular fracture of calcaneus with the External Fixation Device Through Calcaneo-talar

    Institute of Scientific and Technical Information of China (English)

    赵波; 于治涛; 刘宣成; 尚晓辉

    2003-01-01

    目的:探讨应用经跟距外固定器治疗跟骨关节内移位骨折的临床效果.方法:回顾总结自1997年以来采取经跟距外固定器复位固定的跟骨骨折患者34例,包括感染情况和肢体功能恢复情况评分.随访时间6~35个月,平均15.6个月.结果:术后6~35个月所有患者均无感染;其中,优20例,良11例,可1例,差2例.平均得分80.6分,优良率89.2%.结论:经跟距外固定器能够很好地维持Bohler角及跟骨的高度,术后无需石膏外固定,能早期进行足趾及踝关节的功能练习,降低了骨折并发症和后遗症的发生.但对Ⅳ型骨折效果差.

  17. 足跟骨软骨母细胞瘤的影像诊断及鉴别诊断%Chondroblastoma of Calcaneus in Radiological Findings And the Differential Diagnosis

    Institute of Scientific and Technical Information of China (English)

    任成龙; 马光明; 韩东; 魏伟; 段海峰; 贺太平

    2015-01-01

    目的:探讨足跟骨软骨母细胞瘤(Chondroblastoma,CB)的影像表现.材料与方法:回顾性分析经临床病理证实的12例足跟骨软骨母细胞瘤的X线、CT及MRI影像表现.结果:12例跟骨软骨母细胞瘤均表现为边界清晰、伴有硬化边、偏心性生长、膨胀感不明显的肿块;8例子X线可见片絮状钙化,7例CT可见砂砾状钙化,1例可见网格状分隔;3例CT表现为硬化边不完整,边缘毛刺;MRI示12例T1WI低于脂肪信号,稍高于肌肉信号伴硬化边明显,T2WI信号不均匀,坏死囊变呈高信号,钙化呈高信号.2例出现滑膜囊积液及骺软骨板增厚.结论:足跟骨软骨母细胞瘤影像学表现具有一定特征,结合X线、CT及MRI影像表现,有助于诊断及鉴别诊断.

  18. 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;

    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....... In conclusion, this study showed no association between bone mass parameters (BMD, speed of sound (SOS), broadband ultrasound attenuation (BUA)), hip or lower forearm fracture and APOE genotypes in a population of postmenopausal women and age-matched controls....

  19. Modification of expanded lateral L-shaped approach for treatment of intraarticular fractures of calcaneus%改良扩大跟外侧L形入路治疗跟骨关节内骨折

    Institute of Scientific and Technical Information of China (English)

    李嗣生; 孙军; 潘承波; 刘法银; 张子峰; 李玲; 王维军

    2009-01-01

    目的 对跟骨经典扩大跟外侧L形入路进行改良,并探讨其临床应用效果. 方法 自2004年7月至2009年1月应用改良扩大跟外侧L形入路对81例89足(8例双侧)跟骨关节内骨折施行切开复位内固定术,观察临床效果.并与同期采用经典跟外侧扩大L形入路的32例患者的疗效进行比较. 结果 所有患者随访6~48个月,平均30.6个月,骨折全部愈合.按Maryland足部评分系统评价术后功能,其中改良组平均(84.37±12.22)分,优良率为83.2%;经典跟外侧扩大L形入路组平均(81.72±13.91)分,优良率为81.3%.两组术后Maryland足部评分值及优良率比较差异均无统计学意义(t=1.014,P>0.05;X~2=0.009,P>0.05).两组术后皮瓣坏死发生率及腓肠皮神经损伤发生率比较,差异有统计学意义(P 0.05; X~2=0.009, P>0.05). Only flap necrosis and lesion to sural cutaneous nerve occurred in the 2 groups and there were significant differences between the two (P < 0.05). Conclusion The modified expanded lateral L-shaped approach can protect maximally the lateral pedal artery and its con-comitant sural cutaneous nerve, thus effectively preventing such complications as flap necrosis, incision dis-union and skin functional impairment at the operation area.

  20. Effects of physical activities on calcaneus' bone mineral density and sex hormone in young and middle-aged female%运动对青年女性跟骨骨密度及性激素的影响

    Institute of Scientific and Technical Information of China (English)

    封飞虎; 崔友琼

    2007-01-01

    对60名武汉体育学院健康女性研究生进行了测试,探索运动对青年女性跟骨骨密度及性激素的影响.结果发现:体育专业组的女生跟骨BUA、SOS、STI等指标均高于体育锻炼组,RRF低于体育锻炼组;体育锻炼组的BUA、SOS、STI等指标均高于对照组,而RRF低于对照组.体育专业组E2显著高于对照组,体育锻炼组E2与对照组之间无显著差异;3组之间的t值没有显著性差异.可见,长期适宜的运动对提高青年女性跟骨的BUA、SOS、STI,降低RRF都具有显著性影响.E2、T对女性跟骨骨密度具有影响趋势,但都没有统计学意义.

  1. 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)

  2. 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。

  3. Finite Element Analysis of the Achilles Tendon While Running

    OpenAIRE

    Anițaș Răzvan; Lucaciu Do

    2013-01-01

    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.

  4. Return to Running and Sports Participation After Limb Salvage

    Science.gov (United States)

    2011-07-01

    fractures , one IIIC tibial shaft fracture , one G/A IIIB tibial pilon fracture , one G/A IIIB calcaneus fracture , and one distal fibula fracture ...3 25 IIIB tibial pilon fracture , multiple tarsal/metatarsal fractures MCC 4 24 IIIB calcaneus fracture HVGSW 5 29 IIIB distal fibula fracture MVA 6 32...Freedom and Operation Enduring Freedom. The majority of these injuries involve lower extremity trauma, specifically open fractures of the tibia

  5. Lower Extremity Function following Partial Calcanectomy in High-Risk Limb Salvage Patients

    Directory of Open Access Journals (Sweden)

    Noah G. Oliver

    2015-01-01

    Full Text Available Partial calcanectomy (PC is an established limb salvage procedure for treatment of deep heel ulceration with concomitant calcaneal osteomyelitis. The purpose of this study is to determine if a relationship exists between the amount of calcaneus removed during PC and the resulting lower extremity function and limb salvage outcomes. Consecutive PC patients were retrospectively divided into two cohorts defined by the amount of calcaneus resected before wound closure: patients in cohort 1 retained = 50% of calcaneus, while patients in cohort 2 underwent resection of >50% of the calcaneus. The Lower Extremity Function Scale (LEFS was used to assess postoperative lower extremity function. The average amount of calcaneus resected was 13% ± 9.2 (1–39% and 74% ± 19.5 (51–100 in cohorts 1 and 2, respectively (P<0.0001. Below knee amputation was performed in 7 (28% and 5 (29% of subjects in cohorts 1 and 2, respectively (P=1.0. The average LEFS score was 33.9 ± 15.0 for subjects in cohort 1 and 36.2 ± 19.9 for the subjects cohort 2 (P=0.8257 which correlates to “moderate to quite a bit of difficulty.” Our study suggests that regardless of the amount of calcaneus resected, PC provides a viable treatment option for high-risk patients with calcaneal osteomyelitis.

  6. 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.

  7. The Use of Calcaneal Anatomic Plate in Arthroscopically-assisted Open Reduction and Internal Fixation of Intra-articular Calcaneal Fractures

    Institute of Scientific and Technical Information of China (English)

    WANG Hong; ZHANG Qingsong; DUAN Deyu; YAN Lijun

    2006-01-01

    To discuss and evaluate the method and effect of using calcaneal anatomic plate in treatment of intra-articular fractures of the calcaneus with assistant of arthroscope, 86 intra-articular fractures of the calcaneus in 78 patients were reduced by open reduction, and rigid fixation was made with calcaneal anatomic plate under assistant of arthroscope. The average follow-up duration was 18 months (range 12-30 months). The effect of treatment was evaluated according to AOFAS and X-ray before and after operation. The results showed that 86 patients have obtained satisfactory reduction according to X-ray, and there was significant difference before and after operation (P<0.01), the total excellent and fine rate was 91.86 %. Treating intra-articular fractures of the calcaneus with calcaneal anatomic plate under arthroscope may provide more chance to achieve anatomical reconstruction, which can lead to satisfied recovery of function and few complication.

  8. X-ray image characteristics and related measurements in the ankles of 118 adult patients with Kashin-Beck disease

    Institute of Scientific and Technical Information of China (English)

    Zeng Yi; Zhou Zongke; Shen Bin; Yang Jing; Kang Pengde; Zhou Xuan; Zou Ling

    2014-01-01

    Background Kashin-Beck disease (KBD) is a chronic,degenerative osteoarthropathy that causes severe skeletal deformation.Although many researchers have proven that almost all KBD patients who showed an increaseing proximo-distal gradient had radiographic abnormalities of the ankle,few detailed description of radiographic changes in the ankles of patients with KBD has been reported,especially for variable measurements of ankle changes.The purpose of this study was to demonstrate the radiographic characteristics of the ankles of adult KBD patients.Methods One hundred and eighteen adult KBD patients from september to October 2010 in Rongtang county in China were examined with lateral radiographs of the right ankle.The morphological abnormalities in the talus,calcaneus,navicular bone,distal tibia,and joint space were analyzed,and the calcaneus length,height,length-height ratio,tuber angle,front angle,plantar angle,and distal tibia anteroposterior (AP) length were measured using Riepert's method.Results Eighty-one patients (68.6%) had abnormal ankle radiographs; 72 (88.9%) patients had talus changes,69 (85.2%) patients had calcaneus changes,28 (34.6%) patients had navicular bone changes,and 48 (59.2%) patients had distal tibia changes.For 118 KBD patients,the average calcaneus length was 7.4 cm,height was 4.3 cm,and the length-height ratio was 1.7.The calcaneus tuber angle was 28.2°,front angle was 38.0° and the plantar angle was 74.2°.The distal tibia anteroposterior length was 4.05 cm.Compared with 50 normal adults (control group),significant differences were found for the calcaneus length,the calcaneus length-height ratio,and the distal tibia AP length.Conclusions Patients with KBD have characteristic abnormalities on ankle radiographs; talus depression and deformity,calcaneus shortening deformity,and distal tibia deformity with AP length widening were the most typical changes.

  9. 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 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.

  10. The Use of the String of Pearls Locking Plate System in the Stabilisation of a Comminuted Calcaneal Fracture in a Giant Breed Dog

    Directory of Open Access Journals (Sweden)

    A. B. Scrimgeour

    2011-01-01

    Full Text Available An eight-year-old male Pyrenean mountain dog was presented with a comminuted fracture of the right calcaneus following motor vehicle trauma. The fracture was stabilised with a plate-rod construct, using the String of Pearls locking plate system and an intramedullary pin. Healing was uncomplicated.

  11. [Excessively long calcaneal spur. A rudimentary form of calcaneo-navicular synostosis].

    Science.gov (United States)

    Hardy, J; Pouliquen, J C

    1983-01-01

    The authors have seen 5 children aged between 12 and 16 years suffering from a painful foot described as a recurrent sprain. Movements of the subtalar joint were limited and radiographs showed a hypertrophic calcaneal spur projecting towards the navicular but without fusion between the calcaneus and navicular. The calcaneal spurs were resected with good results and with an immediate symptomatic improvement.

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

    DEFF Research Database (Denmark)

    Nielsen, Rasmus G; Rathleff, Michael S; Simonsen, Ole H;

    2009-01-01

    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...

  13. 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.

  14. Management of Paget's Disease of the Calcaneum.

    Science.gov (United States)

    Humphrey, Joel; Pervez, Anum; Walker, Roland; Abbasian, Ali; Singh, Sam

    The calcaneum is not the most common site for Paget's disease of bone, with only a few reports of monostotic involvement. We present 2 cases of Paget's disease of bone affecting the calcaneus, present an overview of the published data, and describe our management of these interesting cases.

  15. 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.

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

    NARCIS (Netherlands)

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

    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

  17. RECONSTRUCTIVE MICROSURGERY IN THE TREATMENT OF SURFACE FORMS OF CALCANEal OSTEOMYELITIS

    Directory of Open Access Journals (Sweden)

    E. S. Tsybul’

    2016-01-01

    Full Text Available One of the most common complications associated with the treatment of calcaneus fracturesis, a necrosis of the edges of the surgical wound and as a result – chronic nonhealing ulcers of the heel region and osteomyelitis of the calcaneus. In the structure of skeletal lesions osteomyelitic chronic osteomyelitis of the calcaneus occurs in 3.1–14.8% of cases, and in relation to the bones of the foot – up to 51%. At the same time after open fractures of the total incidence of deep infection from soft tissue even higher than that for the surface (12.2% vs. 9.6%. The traditional approach to the treatment of osteomyelitis of the calcaneus is often accompanied by poor performance with recurrent osteomyelitis process and highsubsequent disability of working age.Objective: to identify opportunities and assess the effectiveness of the use of reconstructive microsurgery techniques in the treatment of patients with superficial forms of osteomyelitis of the calcaneus, accompanied by the presence of soft tissue defect.Materials and мethods.The results of treatment of 28 patients with superficial forms of osteomyelitis of the calcaneus, which in the period from 2006 to 2013 in RNIITO them. R.R.Vredena were performed reconstructive plastic surgery using microsurgical techniques. Defects covering tissues were located on the sole (20 and back-side surfaces (8 of the calcaneus. Scope of interventions included the radical surgical treatment of osteomyelitis focus, marginal resection of the affected heel bone and tissue replacement of defect cover flap with axial blood supply.Results. With the localization of the defect cover tissues to non-reference surface of the heel region was carried out free plastic ray skin-fascial flap (9 cases. When the location of the defect on the plantar surface of the heel region favored medial plantar flap (10 cases. However, the presence of scarring and damage to the medial plantar artery was performed

  18. The Haglund painful heel syndrome. Experimental investigation of cause and therapeutic implications.

    Science.gov (United States)

    Heneghan, M A; Pavlov, H

    1984-01-01

    Haglund syndrome, a common cause of pain in the posterior heel, consists of a painful swelling of the local soft tissues (the so-called pump bump) and prominence of the calcaneal bursal projection. The condition is caused by compression of the distal Achilles tendon and surrounding soft tissue between the os calcis and the posterior shoe counter. Osseous plantar projections appear to be a critical etiologic factor in Haglund syndrome. With an experimental model, it has been demonstrated that osseous projections on the plantar surface of the calcaneus adversely influence the bone-soft tissue relation of the posterior heel. Shoe heel elevation has been shown to be clinically effective in alleviating symptoms. It is demonstrated with an experimental model that elevation of the shoe heel decreases the pitch angle. This diminishes the prominence of the bursal projection and allows the foot to slip forward, displacing the posterior calcaneus away from the shoe counter.

  19. “Don Juan-Fracture” as a Hint to Aortic Isthmus Rupture

    Directory of Open Access Journals (Sweden)

    Sirilak Suksompong

    2014-01-01

    Full Text Available We report a case of thoracic aortic rupture after blunt trauma in a 23-year-old male patient. The initial investigation found no external injury or bleeding, only a slightly widened mediastinum and a broken left calcaneus. Abdominal lavage was negative, biochemistry was normal, and breathing and oxygenation were not compromised. When changing his position during diagnostics, the patient all of a sudden developed cardiac arrest and typical signs of hypovolemic shock. An immediate sternotomy was done without any further diagnostics on suspicion of aortic isthmus injury. A circular avulsion at the ligamentum arteriosum was found as assumed and repaired under cardiopulmonary bypass. The patient left the hospital for rehabilitation after 12 days in adequate health status. Biodynamics of blunt trauma after high-speed frontal impact and the relationship between calcaneus fracture, called “Don-Juan fracture,” and aortic rupture at the site of ligamentum arteriosum are discussed.

  20. "Don juan-fracture" as a hint to aortic isthmus rupture.

    Science.gov (United States)

    Suksompong, Sirilak; von Bormann, Benno

    2014-01-01

    We report a case of thoracic aortic rupture after blunt trauma in a 23-year-old male patient. The initial investigation found no external injury or bleeding, only a slightly widened mediastinum and a broken left calcaneus. Abdominal lavage was negative, biochemistry was normal, and breathing and oxygenation were not compromised. When changing his position during diagnostics, the patient all of a sudden developed cardiac arrest and typical signs of hypovolemic shock. An immediate sternotomy was done without any further diagnostics on suspicion of aortic isthmus injury. A circular avulsion at the ligamentum arteriosum was found as assumed and repaired under cardiopulmonary bypass. The patient left the hospital for rehabilitation after 12 days in adequate health status. Biodynamics of blunt trauma after high-speed frontal impact and the relationship between calcaneus fracture, called "Don-Juan fracture," and aortic rupture at the site of ligamentum arteriosum are discussed.

  1. “Don Juan-Fracture” as a Hint to Aortic Isthmus Rupture

    Science.gov (United States)

    Suksompong, Sirilak; von Bormann, Benno

    2014-01-01

    We report a case of thoracic aortic rupture after blunt trauma in a 23-year-old male patient. The initial investigation found no external injury or bleeding, only a slightly widened mediastinum and a broken left calcaneus. Abdominal lavage was negative, biochemistry was normal, and breathing and oxygenation were not compromised. When changing his position during diagnostics, the patient all of a sudden developed cardiac arrest and typical signs of hypovolemic shock. An immediate sternotomy was done without any further diagnostics on suspicion of aortic isthmus injury. A circular avulsion at the ligamentum arteriosum was found as assumed and repaired under cardiopulmonary bypass. The patient left the hospital for rehabilitation after 12 days in adequate health status. Biodynamics of blunt trauma after high-speed frontal impact and the relationship between calcaneus fracture, called “Don-Juan fracture,” and aortic rupture at the site of ligamentum arteriosum are discussed. PMID:25478249

  2. Dependence of ultrasonic scattering on frequency and microarchitecture in trabecular bone: Theory and experiment

    Science.gov (United States)

    Wear, Keith A.

    2002-05-01

    Measurements of ultrasonic properties of calcaneus (heel bone) have been shown to be effective for the diagnosis of osteoporosis. However, the mechanisms underlying the interaction between ultrasound and bone are currently not well understood. A model that predicts backscatter from trabecular bone has been developed. Scattering is assumed to originate from the surfaces of trabeculae, which are modeled as long, thin, elastic cylinders with radii small compared with the ultrasonic wavelength. Experimental measurements of backscatter using broadband ultrasound centered at 500 kHz from 43 trabecular bone samples (from human calcaneus) in vitro have been performed. Microcomputed tomography has been performed on all 43 samples in order to measure microarchitectural features. The theory correctly predicts the measured dependences of backscatter on ultrasonic frequency and trabecular thickness. [Funding from the FDA Office of Womens Health is gratefully acknowledged.

  3. 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.

  4. Calcaneal ostectomy for Haglund disease.

    Science.gov (United States)

    Pauker, M; Katz, K; Yosipovitch, Z

    1992-01-01

    From 1967 to 1987, operative treatment was performed on 28 feet in 22 patients with retrocalcaneal bursitis due to prominent posterior superior margin of the calcaneus (Haglund disease). Through a lateral or medial approach, the prominent bone was removed. The results indicated that excision of the retrocalcaneal bursa was not necessary. Preoperative planning and intraoperative examination was necessary in order to remove an adequate amount of bone, which was the key for a successful result.

  5. [Complex injuries associated with somnambulism].

    Science.gov (United States)

    Sillesen, Nanna Hylleholt; Nielsen, Lisa Toft; Bonde, Christian

    2010-12-13

    Up to 3% of adults walk in their sleep and some perform complex behaviours. Treatment recommendations for sleepwalking are inconsistent. This case report describes a 64-year-old man who climbed out of a 2nd floor toilet window during somnambulism. He fell 6-8 meters and fractured the tibia, fibula, cervical columna, lumbal columna, calcaneus, costae and suffered a pneumothorax. Evidence to support sleepwalking treatment is lacking and besides benzodiazepines, prevention is the preferred treatment choice according to the literature.

  6. 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.

  7. Deployment After Limb Salvage for High-Energy Lower-Extremity Trauma

    Science.gov (United States)

    2012-01-01

    vs. Ped 3 33 Open tibia/fibula fracture GSW 4 35 Compartment syndrome IED 5 30 Open ankle fracture MVC 6 40 Open ankle fracture-dislocation, talus...fracture IED 12 26 Calcaneus fracture GSW 13 26 Open ankle fracture MVC 14 33 Open tibia/fibula fracture, ankle fracture, multiple midfoot fractures IED...MV, motor vehicle; MVC , motor vehicle collision; Ped, pedestrian. Figure 1. Wear of a military uniform with the IDEO. J Trauma Acute Care Surg Volume

  8. Management of Posttraumatic Osteoarthritis with an Integrated Orthotic and Rehabilitation Initiative

    Science.gov (United States)

    2012-08-01

    Latencya (mo) 1 24 Open talar body and ankle fracture MCC TT 18 2 29 Ankle fracture Explosion/ MVC ST 9 3 31 Bilateral tibia fracture, pilon fracture...Gunshot TT, ST 4 4 22 Tibia fracture, multiple midfoot fractures, talonavicular dislocation, T12 burst fracture Explosion/ MVC TT 11 5 26 Calcaneus...fracture Explosion/ MVC ST 7 6 40 Open ankle fracture-dislocation, talus fracture Plane crash TT 6 7 24 Bilateral ankle fracture, both-bone fore- arm fracture

  9. Ecomorphological analysis of the astragalo-calcaneal complex in rodents and inferences of locomotor behaviours in extinct rodent species

    OpenAIRE

    Ginot, Samuel; Hautier, Lionel; Marivaux, Laurent; Vianey-Liaud, Monique

    2016-01-01

    Studies linking postcranial morphology with locomotion in mammals are common. However, such studies are mostly restricted to caviomorphs in rodents. We present here data from various families, belonging to the three main groups of rodents (Sciuroidea, Myodonta, and Ctenohystrica). The aim of this study is to define morphological indicators for the astragalus and calcaneus, which allow for inferences to be made about the locomotor behaviours in rodents. Several specimens were dissected and des...

  10. The landmine foot: its description and management.

    Science.gov (United States)

    Jacobs, L G

    1991-11-01

    The injuries of 54 patients involved in landmine explosions are described. In 72 per cent the injuries affected the mid- and hindfoot. Of these injuries, 67 per cent were open fractures involving the calcaneus. The injury resulted in the 'landmine foot', an entity not previously described. Its clinical features and orthotic management are described. The prognosis of 'landmine foot' was generally favourable in this Third World setting, with adequate rehabilitation provided by a customized surgical boot.

  11. Treatment of arthralgia syndrome with point through point acupuncture in 222 cases%透穴针刺法治疗痹症222例

    Institute of Scientific and Technical Information of China (English)

    袁国庆; 关宝建

    2002-01-01

    Background:It is considered that arthralgia syndrome includes cervical spondylopathy,scapulohumeral periarthritis, knee joint retrograde degeneration,calcaneus pain etc..Point through point acupuncture means a treatment with one needle penetrating two points once resulting in separating adhesion, dredging the channel, relieving pain quickly. In traditional Chinese medicine pain occurs when the channel is not dredged.We observed this in our study.

  12. Role of the plantar fascia in digital stabilization. A case report.

    Science.gov (United States)

    Pontious, J; Flanigan, K P; Hillstrom, H J

    1996-01-01

    The plantar aponeurosis is a ligamentous structure that extends from the calcaneus to the proximal phalanges. Under tension, it functions to support the longitudinal arch, supinate the rearfoot, and stabilize the digits against the ground. The anatomy and biomechanics of the plantar fascia and plantar aponeurosis, particularly their role in digital stabilization, are reviewed. A case is presented showing a patient who developed hammer toes as a postoperative complication after having a portion of the plantar aponeurosis removed.

  13. Progress in Finite Element Modeling of the Lower Extremities

    Science.gov (United States)

    2015-06-01

    of the calcaneus (left) is replaced with a refined mesh (right) by changing a single line of code . The 1-D structural elements are automatically...considerably larger time step as well as fewer elements . The current version of the assembler program lets the user switch between representing the...surface by shell elements or a uniform thickness by changing one line of code . This is done within Gargamel by taking the input mesh of the entire part

  14. Major Extremity Trauma Research Consortium (METRC) 2011 Annual Report

    Science.gov (United States)

    2011-01-01

    ages of 18 and 84 who were admitted with fractures requiring surgery of the upper or lower extremity, pelvis or acetabulum , and foot (calcaneus...Contribute to the science of fracture and soft tissue repair; 6. Contribute to the science of conducting clinical trials in a challenging...talus or crush injuries only). Excluded from the registry are hip fractures in patients 60 years or older and fractures to the wrist, hand, ankle

  15. Characteristics of calcaneal bone infarction: an MR imaging investigation

    Energy Technology Data Exchange (ETDEWEB)

    Abrahim-Zadeh, R.; Klein, R.M.; Leslie, D.; Norman, A. [Department of Radiology, New York Medical College, Macy Pavillion, Valhalla, NY 10595 (United States)

    1998-06-01

    Objective. Bone infarction (BI) of the calcaneus is an uncommon entity which has received little mention in the recent literature. In this paper, we review the MR images of six calcanei with BI, which demonstrate a pattern of presentation that may explain the etiology of BI at this unusual location. Design. A retrospective review was performed of the transcribed reports of the foot or ankle MR examinations at our institution. MR images of examinations with any marrow signal abnormality were reviewed for presence of BI and its distribution. Patients. Based on MRI criteria, four patients had calcaneal BI (none biopsy proven); they ranged in age from 37 to 51 years old. Two patients were diagnosed with systemic lupus erythematosus, one with fibrositis, and another with polymyositis. All were treated with corticosteroids. Results. Six calcanei (in four patients) contained a region of calcaneal BI. In five of the six, the lesions were entirely or predominantly located in the posterior half of the calcaneus. Conclusion. Two theories are proposed which may explain why BI predominantly occurs in the posterior half of the calcaneus. First, the convergence of the recurrent intraosseous calcaneal vessels may occasionally produce the equivalent of a single dominant vessel that is more prone to vascular accidents. Secondly, the region between the recurrent and the epiphyseal vessels may act as a watershed zone, increasing its susceptibility to ischemia. (orig.) With 4 figs., 1 tab., 8 refs.

  16. Comparison of in vivo segmental foot motion during walking and step descent in patients with midfoot arthritis and matched asymptomatic control subjects.

    Science.gov (United States)

    Rao, Smita; Baumhauer, Judith F; Tome, Josh; Nawoczenski, Deborah A

    2009-05-29

    The purpose of this study was to compare in vivo segmental foot motion during walking and step descent in patients with midfoot arthritis and asymptomatic control subjects. Segmental foot motion during walking and step descent was assessed using a multi-segment foot model in 30 patients with midfoot arthritis and 20 age, gender and BMI matched controls. Peak and total range of motion (ROM), referenced to subtalar neutral, were examined for each of the following dependent variables: 1st metatarso-phalangeal (MTP1) dorsiflexion, 1st metatarsal (MT1) plantarflexion, ankle dorsiflexion, calcaneal eversion and forefoot abduction. The results showed that, compared to level walking, step descent required greater MTP1 dorsiflexion (pwalking. Patients with midfoot arthritis responded differently to the step task compared to control subjects in terms of MT1 and calcaneus eversion excursion. During walking, patients with midfoot arthritis showed significantly less MT1 plantarflexion excursion compared to control subjects (p=0.03). However, during step descent, both groups showed similar MT1 plantarflexion excursion. During walking, patients with midfoot arthritis showed similar calcaneus eversion excursion compared to control subjects. However, during step descent, patients with midfoot arthritis showed significantly greater calcaneus eversion excursion compared to control subjects (p=0.03). Independently or in combination, these motions may contribute to articular stress and consequently to symptoms in patients with midfoot arthritis.

  17. Multi-segment foot kinematics after total ankle replacement and ankle arthrodesis during relatively long-distance gait.

    Science.gov (United States)

    Rouhani, H; Favre, J; Aminian, K; Crevoisier, X

    2012-07-01

    This study aimed to investigate the influence of ankle osteoarthritis (AOA) treatments, i.e., ankle arthrodesis (AA) and total ankle replacement (TAR), on the kinematics of multi-segment foot and ankle complex during relatively long-distance gait. Forty-five subjects in four groups (AOA, AA, TAR, and control) were equipped with a wearable system consisting of inertial sensors installed on the tibia, calcaneus, and medial metatarsals. The subjects walked 50-m twice while the system measured the kinematic parameters of their multi-segment foot: the range of motion of joints between tibia, calcaneus, and medial metatarsals in three anatomical planes, and the peaks of angular velocity of these segments in the sagittal plane. These parameters were then compared among the four groups. It was observed that the range of motion and peak of angular velocities generally improved after TAR and were similar to the control subjects. However, unlike AOA and TAR, AA imposed impairments in the range of motion in the coronal plane for both the tibia-calcaneus and tibia-metatarsals joints. In general, the kinematic parameters showed significant correlation with established clinical scales (FFI and AOFAS), which shows their convergent validity. Based on the kinematic parameters of multi-segment foot during 50-m gait, this study showed significant improvements in foot mobility after TAR, but several significant impairments remained after AA.

  18. Three-dimensional finite element analysis of calcaneal fractures%跟骨三维有限元模型的建立及其骨折发生机制

    Institute of Scientific and Technical Information of China (English)

    黄诸侯; 李俊; 陈日齐; 杜景文; 张建新

    2012-01-01

    目的:建立跟骨三维有限元模型,探讨跟骨骨折发生机制.方法:通过扫描正常人跟骨螺旋CT,精确模拟边界条件,并运用Sap 93计算软件运算建立跟骨有限元模型,模型由1 959个节点,1 496个单元组成.在跟骨有限元模型上模拟踝关节在中立位和背伸20°时的状况后对模型施以500N的垂直轴向载荷,观察模型应力分布和位移情况.结果:跟骨在踝关节中立位时通过跟距外侧的关节面,并且由内后斜向前外方向的跟骨处遭受应力最大.背伸20°受力时除上述位置遭受应力最大外,从跟骨体部走向后距关节面与跟腱之间的部位遭受应力也比较大.结论:高处坠落踝关节中立位时跟骨骨折的发生将从跟距关节面的外侧向内后方向走行;当坠落时踝关节处于背伸位时除产生上述骨折线外,跟骨体部走向后距关节面方向也将发生骨折,同时跟腱附着点附近也会形成撕脱性骨折.%Objective :To establish the three-dimensional finite element model of calcaneus,and to discuss mechanism of calcaneal fracture. Methods:The calcaneus of normal person was scanned with spinal CT.and the finite element model was established with the Sap 93 software. The node and element number of this model was 1 959 and 1 496 respectively. After establishing the finite element model of the calcaneus, the axial load of 500 N was applied on the model in neutral position and back stretches 20° position. The stress distribution and the displacement of the models were observed. Results:The fracture line passed through the lateral articular facet of talocalcaneal joint when the ankle joint was in neutral position,and the stress distribution was maximal at calcaneus from posteromedial to anterolateral aspect. In addition, the stress distribution was maximal from calcaneus to position between posterior talar articular surface and calcaneal tendon when the ankle joint was in back stretch position of 20 degree

  19. Canine tarsal architecture as revealed by high-resolution computed tomography.

    Science.gov (United States)

    Galateanu, G; Apelt, D; Aizenberg, I; Saragusty, J; Hildebrandt, T B

    2013-06-01

    Central tarsal bone (CTB) fractures are well documented and are a subject of increasing importance in human, equine and canine athletes although the mechanism of these fractures in dogs is not fully understood and an extrapolation from human medicine may not be accurate. This study reports the use of high-resolution computed tomography (CT) of 91 tarsal joints from 47 dogs to generate a more detailed in situ anatomical description of the CTB architecture in order to obtain a better understanding of the pathogenesis of CTB fractures in this species. The dogs studied represented a wide range of ages, breeds and levels of habitual physical activity and the angles of the tarsal joints studied ranged between maximal flexion (16.4°) and maximal extension (159.1°). Regardless of tarsal angle, the CTB articulated with the calcaneus exclusively at the level of its plantar process (PPCTB) in all dogs. The PPCTB presented two distinct parts in all dogs, a head and a neck. The calcaneus tended to rely on the PPCTB neck during flexion and on the PPCTB head during extension. This study describes new tarsal elements for the first time, including the calcaneal articular process, the fourth tarsal bone plantar articular process and the talar plantar prominence of the CTB. Based on calcaneo-PPCTB architecture, it is postulated that the PPCTB is a keystone structure and that at least some of CTB fractures in dogs could either commence at or are induced at this level due to the impingement forces exercised by the calcaneus.

  20. Primary subtalar arthrodesis for the treatment of comminuted intra-articular calcaneal fractures.

    Science.gov (United States)

    Potenza, V; Caterini, R; Farsetti, P; Bisicchia, S; Ippolito, E

    2010-07-01

    We report the short- and mid-term results in six patients (seven feet) affected by markedly comminuted intra-articular calcaneal fractures (Sanders type IV), treated by primary subtalar arthrodesis. The average age at surgery was 40 years. In all patients, arthrodesis of the subtalar joint was performed using a limited lateral approach to the calcaneus; it was stabilised with two or three cannulated screws. No patient had a preliminary reduction and internal fixation of the fracture. The time from injury to surgery averaged 20 days because all of the patients had associated visceral and/or other skeletal injuries. All of the patients were followed up clinically and radiographically 2 times, at an average of 12 months and 53 months after surgery. At the short-term follow-up, the mean AOFAS score was 70 points; the X-rays showed a complete fusion of the subtalar joint in all seven feet, without any sign of osteoarthritis of the calcaneo-cuboid and the talo-navicular joints. In all cases, an altered shape of the calcaneus was present. At the mid-term follow-up, the mean AOFAS score increased to 85 points; in one patient, radiographic signs of osteoarthritis of the calcaneo-cuboid and the talo-navicular joints were present and, in another patient, only talo-navicular joint was present, although both patients were free from pain. The difference between the two AOFAS scores was statistically significant. We believe that primary subtalar arthrodesis performed for markedly comminuted Sanders type IV calcaneal fractures yielded good mid-term results, and it is especially indicated when surgical treatment is delayed for whatever reason. A preliminary open reduction and internal fixation to restore the normal height of the calcaneus before performing the subtalar arthrodesis, as suggested by several authors, does not seem indispensable to obtain good clinical results.

  1. 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)

  2. Assessment of bone microarchitecture in chronic kidney disease: a comparison of 2D bone texture analysis and high-resolution peripheral quantitative computed tomography at the radius and tibia.

    Science.gov (United States)

    Bacchetta, Justine; Boutroy, Stéphanie; Vilayphiou, Nicolas; Fouque-Aubert, Anne; Delmas, Pierre D; Lespessailles, Eric; Fouque, Denis; Chapurlat, Roland

    2010-11-01

    Bone microarchitecture can be studied noninvasively using high-resolution peripheral quantitative computed tomography (HR-pQCT). However, this technique is not widely available, so more simple techniques may be useful. BMA is a new 2D high-resolution digital X-ray device, allowing for bone texture analysis with a fractal parameter (H(mean)). The aims of this study were (1) to evaluate the reproducibility of BMA at two novel sites (radius and tibia) in addition to the conventional site (calcaneus), (2) to compare the results obtained with BMA at all of those sites, and (3) to study the relationship between H(mean) and trabecular microarchitecture measured with an in vivo 3D device (HR-pQCT) at the distal tibia and radius. BMA measurements were performed at three sites (calcaneus, distal tibia, and radius) in 14 healthy volunteers to measure the short-term reproducibility and in a group of 77 patients with chronic kidney disease to compare BMA results to HR-pQCT results. The coefficient of variation of H(mean) was 1.2, 2.1, and 4.7% at the calcaneus, radius, and tibia, respectively. We found significant associations between trabecular volumetric bone mineral density and microarchitectural variables measured by HR-pQCT and H(mean) at the three sites (e.g., Pearson correlation between radial trabecular number and radial H(mean) r = 0.472, P technique with few technical constraints. Thus, it may represent an interesting tool for evaluating bone structure, in association with biological parameters and DXA.

  3. Calcaneal fillet flap: a new osteocutaneous free tissue transfer for emergency salvage of traumatic below-knee amputation stumps.

    Science.gov (United States)

    Januszkiewicz, J S; Mehrotra, O N; Brown, G E

    1996-09-01

    Traumatic below-knee amputations do not always leave enough soft tissue of bone with which to fashion a stump of sufficient length and durability to support a prosthesis. Composite free flaps can often be harvested from the amputated limb to provide immediate one-stage stump salvage and to preserve knee function. We report a new technique to increase stump length by incorporating the calcaneus into a foot fillet flap as a vascularized bone transfer. The calcaneal fillet flap is a useful addition to the inventory of available composite flaps. It is recommended for knee joint salvage when there is less than 11 cm of tibial remnant length.

  4. Calcaneo-valgus deformity.

    Science.gov (United States)

    Evans, D

    1975-08-01

    A discussion of the essential deformity in calcaneo-valgus feet develops a theme originally put forward in 1961 on the relapsed club foot (Evans 1961). Whereas in the normal foot the medial and lateral columns are about equal in length, in talipes equino-varus the lateral column is longer and in calcaneo-valgus shorter than the medial column. The suggestion is that in the treatment of both deformities the length of the columns be made equal. A method is described of treating calcaneo-valgus deformity by inserting cortical bone grafts taken from the tibia to elongate the anterior end of the calcaneus.

  5. Normal osseous variants presenting as cystic or lucent areas on radiography and CT imaging: a pictorial overview

    Energy Technology Data Exchange (ETDEWEB)

    Wilde, Vally de; Maeseneer, Michel de E-mail: midema@village.uunet.be; Lenchik, Leon; Roy, Peter van; Beeckman, Paul; Osteaux, Michel

    2004-07-01

    We present a number of commonly encountered pseudolesions. These represent areas of the skeleton that are relatively radiolucent simulating an osteolytic or cystic lesion. Such areas discussed in this article include the superolateral humeral head, rhomboid fossa of the clavicle, scapular defect, supratrochlear foramen, biceps tendon insertion, vascular channel of the ulna, distal condylar area of the knee, 'bone in bone' disturbance, dorsal defect of the patella, metadiaphyseal area, 'Wards' triangle', inframalleolar fossa of the fibula, and anterior lytic defect of the calcaneus. We provide an overview of commonly encountered pseudolesions, that may lead to false positive diagnosis of an osteolytic or cystic lesion.

  6. [Heel involvement in rheumatoid polyarthritis].

    Science.gov (United States)

    Bouysset, M; Tebib, J G; Vianey, J C; Berthier, M; Nemoz, J C; Chaumentin, G; Schnepp, J; Llorca, G; Bouvier, M

    1990-11-01

    Calcaneus involvement during the course of RA is poorly known. A clinical and radiological study of 408 consecutive rheumatoid feet are then reported. If talalgia was seldomly noted (3.7 p. cent), plantar calcaneitis was found in 29.7 p. cent as plantar spur. Similarly, posterior exostosis was displayed in 30.5 p. cent of patients. These radiological abnormalities are increased in RA but appeared more as a consequence of the statical modification of the foot secondary to RA process than as a direct involvement. Logical orthopedic therapeutics are then proposed.

  7. Calcaneal osteosarcoma: a rare cause of heel pain in the paediatric population.

    Science.gov (United States)

    Taslakian, Bedros; Issa, Ghada; Saab, Raya; Jabbour, Mark N; Khoury, Nabil J

    2013-02-04

    Osteosarcoma is the most common primary non-haemopoietic malignant bone tumour in children and adolescents. However, it rarely occurs in the calcaneus with only a few case reports in the literature. We report a case of a 14-year-old boy with calcaneal osteosarcoma, who presented with heel pain followed by swelling. The pain was initially thought to be related to a benign process and treated with analgesics, delaying the diagnosis. We discuss the clinical presentation, the differential diagnosis, multi-imaging and pathological findings of a calcaneal osteosarcoma, its clinical outcome and the importance of early diagnosis to improve outcome.

  8. Combined total ankle replacement and modified bridle tendon transfer for end-stage ankle joint arthrosis with paralytic dropfoot: report of an unusual case.

    Science.gov (United States)

    Bibbo, Christopher; Baronofsky, Hyim J; Jaffe, Leland

    2011-01-01

    In recent years, total ankle replacement has become a reasonable option for many patients with end-stage ankle arthrosis. In order to be successful, total ankle replacement requires a relatively balanced alignment of the foot in relation to the leg. Such alignment is traditionally achieved surgically by means of stabilization of the hindfoot in conjunction with relocation osteotomy of the calcaneus and/or tibia. In this report, we describe the unconventional combination of total ankle replacement in an adult patient with concomitant paralysis that was addressed by means of tendon transfer.

  9. Test Methodology for Protection of Vehicle Occupants against Anti-Vehicular Landmine Effects (Methodologie d’essais pour la protection des occupants de vehicules contre les effets des mines terrestres anti-vehicules)

    Science.gov (United States)

    2007-04-01

    Figure 3.5: The Lower Limb [ Tortora , 2003]. Figure 3.6 shows the medial view of the right foot. The tarsal bones (in the ankle) are the calcaneus...Anatomy (Modified from [ Tortora , 1984]). When a landmine detonates under a vehicle, the movement of the structure on which the foot rests (floor...referred to [ Tortora , 2003]. 3.6.1.1 The Auditory System The auditory system (ear), shown in Figure 3.18, is the most susceptible body region to

  10. 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.

  11. Finite element analysis of heel pad with insoles.

    Science.gov (United States)

    Luo, Gangming; Houston, Vern L; Garbarini, Mary Anne; Beattie, Aaron C; Thongpop, Chaiya

    2011-05-17

    To design optimal insoles for reduction of pedal tissue trauma, experimental measurements and computational analyses were performed. To characterize the mechanical properties of the tissues, indentation tests were performed. Pedal tissue geometry and morphology were obtained from magnetic resonance scan of the subject's foot. Axisymmetrical finite element models of the heel of the foot were created with 1/4 of body weight load applied. The stress, strain and strain energy density (SED) fields produced in the pedal tissues were computed. The effects of various insole designs and materials on the resulting stress, strain, and SED in the soft pedal tissues were analyzed. The results showed: (a) Flat insoles made of soft material provide some reductions in the maximum stress, strain and SED produced in the pedal tissues. These maximum values were computed near the calcaneus. (b) Flat insoles, with conical/cylindrical reliefs, provided more reductions in these maximum values than without reliefs. (c) Custom insoles, contoured to match the pedal geometry provide most reductions in the maximum stress, strain and SED. Also note, the maximum stress, strain and SED computed near the calcaneus were found to be about 10 times the corresponding peak values computed on the skin surface. Based on the FEA analysis, it can be concluded that changing insole design and using different material can significantly redistribute the stress/strain inside the heel pad as well as on the skin surface.

  12. Using an optimization approach to design an insole for lowering plantar fascia stress--a finite element study.

    Science.gov (United States)

    Hsu, Yu-Chun; Gung, Yih-Wen; Shih, Shih-Liang; Feng, Chi-Kuang; Wei, Shun-Hwa; Yu, Chung-Huang; Chen, Chen-Sheng

    2008-08-01

    Plantar heel pain is a commonly encountered orthopedic problem and is most often caused by plantar fasciitis. In recent years, different shapes of insole have been used to treat plantar fasciitis. However, little research has been focused on the junction stress between the plantar fascia and the calcaneus when wearing different shapes of insole. Therefore, this study aimed to employ a finite element (FE) method to investigate the relationship between different shapes of insole and the junction stress, and accordingly design an optimal insole to lower fascia stress.A detailed 3D foot FE model was created using ANSYS 9.0 software. The FE model calculation was compared to the Pedar device measurements to validate the FE model. After the FE model validation, this study conducted parametric analysis of six different insoles and used optimization analysis to determine the optimal insole which minimized the junction stress between plantar fascia and calcaneus. This FE analysis found that the plantar fascia stress and peak pressure when using the optimal insole were lower by 14% and 38.9%, respectively, than those when using the flat insole. In addition, the stress variation in plantar fascia was associated with the different shapes of insole.

  13. 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

  14. 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.

  15. [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.

  16. Neurovascular calcaneo-cutaneus pedicle graft for stump capping in congenital pseudarthrosis of the tibia: preliminary report of a new technique.

    Science.gov (United States)

    Weber, Michael

    2002-01-01

    The operative treatment of congenital pseudarthrosis of the tibia, especially when associated with neurofibromatosis type I (Recklinghausen's disease), often leads to failure. Frequently, regardless of the type of deformity, multiple operative procedures end in the amputation of the affected limb. Soft tissue coverage of the amputation stump may confront the surgeon with new problems. Secondary perforation of the soft tissue envelope of the stump owing to terminal overgrowth is not a rare complication. A new technique of stump capping is demonstrated in a 10-year-old boy and a 14-year old girl, both with congenital pseudarthrosis of the tibia of the right leg and neurofibromatosis. During this procedure, a radical resection of the pseudarthrotic tissue is performed although all neurovascular structures supplying the calcaneus are carefully maintained (Arteria, vena et nervus tibialis posterior et peronealis). Subsequently, the tibia and fibula are inserted into the calcaneus. This construct is stabilized with two crossed Kirschner wires. Afterwards, the skin of the lower limb and the hindfoot are sutured together covering the neurovascular bundles, which are arranged in a loop-like fashion. The documented active range of motion was similar to that of the unaffected knee joint. Twelve weeks after operation in both patients, full weight bearing was achieved with a lower-leg prosthesis. This new procedure leads to a durable, full weight-bearing stump with complete sensitive innervation without the risk of future soft tissue perforation caused by the growing bone. The stump fits with an end-bearing lower-leg prosthesis.

  17. Calcaneo-stop procedure in the treatment of the juvenile symptomatic flatfoot.

    Science.gov (United States)

    Pavone, Vito; Costarella, Luciano; Testa, Gianluca; Conte, Giorgio; Riccioli, Maria; Sessa, Giuseppe

    2013-01-01

    Flexible flatfoot is the most prevalent condition seen in pediatric orthopedic clinics. It is characterized by an absence of the medial arch and a valgus position of the calcaneus. The purpose of the present study was to report on the results obtained in children treated using the calcaneo-stop procedure. A total of 410 flatfeet in 242 consecutive patients were treated using the calcaneo-stop procedure from January 1999 to March 2010 (10 years, 3 months) and were followed up to February 2012. The mean age at surgery was 11 (range 7 to 14) years, and the mean follow-up duration was 88 (range 14 to 157) months. A clinical evaluation, podoscopic examination, and radiologic assessment were performed in the participating patients preoperatively and at 6 months postoperatively. Of the 242 patients, 168 (69.42%) underwent bilateral foot surgery and 74 (30.58%) unilateral intervention, involving 33 right (44.6%) and 41 left (55.4%) feet. At follow-up, the outcome was satisfactory in 397 feet (96.83%); heel valgus was observed in only 12 feet (2.92%), and the footprint was normalized in 328 feet (80%). The calcaneo-stop procedure is a simple, reliable, and minimally invasive procedure for the treatment of pediatric flexible flatfoot. It allows alignment of the talus and calcaneus, restoring a proper foot arch.

  18. Treatment of Chopart Fracture-Dislocations.

    Science.gov (United States)

    Klaue, Kaj

    2010-06-01

    The Chopart articular space was used by François Chopart (1743-1795) as a practical space for amputation in cases of distal foot tumor. It corresponds to the center of the foot and allows for essential articulation by means of the talo-calcaneo-navicular joint (coxa pedis). Chopart fracture-dislocations may therefore include fractures of the navicular, the cuboid, the talus, and calcaneus. The treatment priorities should therefore include addressing all of the injured soft tissues by immediate joint reduction or restoring bony alignment, including the avoidance of threatening compartment syndromes. Subsequent anatomical bone and joint reconstruction, if possible, should first address the talar head and the navicular. The anterior process of the calcaneus and the cuboid should be aligned to preserve foot alignment in the sagittal and horizontal planes. In severe joint destructions, isolated fusion of the calcaneo-cuboidal joint may help preserve functional mobility of the foot. Isolated or associated talo-navicular fusion considerably limits functional mobility of the foot.

  19. 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)

  20. 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.

  1. Foot pressure distribution during walking in young and old adults

    Directory of Open Access Journals (Sweden)

    Lipsitz Lewis A

    2005-05-01

    Full Text Available Abstract Background Measurement of foot pressure distribution (FPD is clinically useful for evaluation of foot and gait pathologies. The effects of healthy aging on FPD during walking are not well known. This study evaluated FPD during normal walking in healthy young and elderly subjects. Methods We studied 9 young (30 ± 5.2 years, and 6 elderly subjects (68.7 ± 4.8 years. FPD was measured during normal walking speed using shoe insoles with 99 capacitive sensors. Measured parameters included gait phase characteristics, mean and maximum pressure and force, and relative load. Time-series measurements of each variable for all sensors were grouped into 9 anatomical masks. Results Elderly subjects had lower normalized maximum pressure for the medial and lateral calcaneal masks, and for all medial masks combined. In the medial calcaneus mask, the elderly group also had a lower absolute maximum and lower mean and normalized mean pressures and forces, compared to young subjects. Elderly subjects had lower maximum force and normalized maximum force and lower mean force and normalized mean forces in the medial masks as well. Conclusion FPD differences between the young and elderly groups were confined to the calcaneus and hallux regions and to the medial side of the foot. In elderly subjects, weight bearing on the lateral side of the foot during heel touch and toe-off phases may affect stability during walking.

  2. A multifocal angiosarcoma involving bones of foot: A case report

    Directory of Open Access Journals (Sweden)

    Başak DOĞAN AVŞARGİL

    2008-05-01

    Full Text Available Angiosarcomas of bone are rare tumors constituting 1% of all malignant bone tumors. They can be either solitary or multifocal and can easily be misinterpreted as multiple myeloma or metastasis radiologically. We present a case of multifocal angiosarcoma arrising in foot bones, the diagnosis of which was difficult clinically, radiologically and pathologically. The histologic findings observed in both bioptic and amputation specimens were provided.The patient was a 56 years-old man who has undergone coronary by-pass and saphenous vein surgery 3 months ago. He has been suffering from pain and swelling on left foot since then. The lesion was suspicious for atypical fungal infection, metastasis or lymphoma radiologically. “Tru-cut” biopsy revealed extensive necrosis and the lesion resembled an inflammatory and reactive process at first glance. Morphologic mimickers of the lesion like lymphoma, metastasis and small round cell tumors were excluded immunohistochemically and the diagnosis of “malignant vasculary tumor” was made upon CD- 31 positivity of tumor cells, presence of erytrocytes, cells with intracytoplasmic lumina and increased mitotic activity. In amputation specimen a multifocal tumor having areas of necrosis and hemorrhages was observed involving predominantly calcaneus but also infiltrating talus, distal tibia and achilles tendon. The maximum diameter of tumor was 5 cm in calcaneus. Adjuvant chemotherapy could not be given because of cardiac problems.The case was presented to increase awareness on this rare, diagnostically problematic issue, the classification of which is controversial.

  3. A dynamic model of the windlass mechanism of the foot: evidence for early stance phase preloading of the plantar aponeurosis.

    Science.gov (United States)

    Caravaggi, Paolo; Pataky, Todd; Goulermas, John Y; Savage, Russel; Crompton, Robin

    2009-08-01

    In the present study we have estimated the temporal elongation of the plantar aponeurosis (PA) during normal walking using a subject-specific multi-segment rigid-body model of the foot. As previous studies have suggested that muscular forces at the ankle can pre-load the PA prior to heel-strike, the main purpose of the current study was to test, through modelling, whether there is any tension present in the PA during early stance phase. Reflective markers were attached to bony landmarks to track the kinematics of the calcaneus, metatarsus and toes during barefoot walking. Ultrasonography measurements were performed on three subjects to determine both the location of the origin of the PA on the plantar aspect of the calcaneus, and the radii of the metatarsal heads. Starting with the foot in a neutral, unloaded position, inverse kinematics allowed calculation of the tension in the five slips of the PA during the whole duration of the stance phase. The results show that the PA experienced tension significantly above rest during early stance phase in all subjects (P<0.01), thus providing support for the PA-preloading hypothesis. The amount of preloading and the maximum elongation of the slips of the PA decreased from medial to lateral. The mean maximum tension exerted by the PA was 1.5 BW (body weight) over the three subjects.

  4. Adult calcaneal osteitis: incidence, etiology, diagnostics and therapy

    Directory of Open Access Journals (Sweden)

    Tiemann, A. H.

    2012-07-01

    Full Text Available Calcaneal osteomyelitis presents a complicated situation. The specific anatomy of the os calcis and its surrounding soft tissues plays an important role in the planning and realization of the procedures needed in order to eradicate the osteomyelitic focus. The calcaneus represents a spongious bone; a fact that supports the developement of an osteomyelitis. It is the strongest bone of the foot and is highly important for the biomechanical features of physiological walking. The surrounding soft tissues are thin and contain various important anatomical structures. These might be damaged during the treatment of the osteomyelitis. In addition the vascularization of the os calcis is delicate and may be compromized during the surgical osteomyelitis treatment. Calcaneus osteomyelitis may be classified based on the routes of infection into exogenous and endogenous forms. Additionally from the clinical point of view acute and chronic forms may be distinguished from an early and a late infection. Exogenous calcaneal osteomyelitis mostly is the result of an infection with S. aureus. The treatment is equal to the therapy in other locations and based on: •Eradication of the bone infection •Sanitation of the soft tissue infection •Reconstruction of bone and soft tissue Especially the preservation and restoration of the soft tissue is important. Thus plastic surgical procedures play an essential role. The main object of treatment is the preservation of a biomechanical functioning foot. This may be impossible due to the local situation. Calcanectomy or even below knee amputation may be needed in those cases.

  5. 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.

  6. Cancellous bone fast and slow waves obtained with Bayesian probability theory correlate with porosity from computed tomography.

    Science.gov (United States)

    Hoffman, Joseph J; Nelson, Amber M; Holland, Mark R; Miller, James G

    2012-09-01

    A Bayesian probability theory approach for separating overlapping ultrasonic fast and slow waves in cancellous bone has been previously introduced. The goals of this study were to investigate whether the fast and slow waves obtained from Bayesian separation of an apparently single mode signal individually correlate with porosity and to isolate the fast and slow waves from medial-lateral insonification of the calcaneus. The Bayesian technique was applied to trabecular bone data from eight human calcanei insonified in the medial-lateral direction. The phase velocity, slope of attenuation (nBUA), and amplitude were determined for both the fast and slow waves. The porosity was assessed by micro-computed tomography (microCT) and ranged from 78.7% to 94.1%. The method successfully separated the fast and slow waves from medial-lateral insonification of the calcaneus. The phase velocity for both the fast and slow wave modes showed an inverse correlation with porosity (R(2) = 0.73 and R(2) = 0.86, respectively). The slope of attenuation for both wave modes also had a negative correlation with porosity (fast wave: R(2) = 0.73, slow wave: R(2) = 0.53). The fast wave amplitude decreased with increasing porosity (R(2) = 0.66). Conversely, the slow wave amplitude modestly increased with increasing porosity (R(2) = 0.39).

  7. In Vivo, Non-Invasive Characterization of Human Bone by Hybrid Broadband (600-1200 nm) Diffuse Optical and Correlation Spectroscopies

    Science.gov (United States)

    Pagliazzi, Marco; Negredo, Eugènia; Martelli, Fabrizio; Farina, Andrea; Dalla Mora, Alberto; Lindner, Claus; Farzam, Parisa; Pérez-Álvarez, Núria; Puig, Jordi; Taroni, Paola; Pifferi, Antonio; Durduran, Turgut

    2016-01-01

    Non-invasive in vivo diffuse optical characterization of human bone opens a new possibility of diagnosing bone related pathologies. We present an in vivo characterization performed on seventeen healthy subjects at six different superficial bone locations: radius distal, radius proximal, ulna distal, ulna proximal, trochanter and calcaneus. A tailored diffuse optical protocol for high penetration depth combined with the rather superficial nature of considered tissues ensured the effective probing of the bone tissue. Measurements were performed using a broadband system for Time-Resolved Diffuse Optical Spectroscopy (TRS) to assess mean absorption and reduced scattering spectra in the 600–1200 nm range and Diffuse Correlation Spectroscopy (DCS) to monitor microvascular blood flow. Significant variations among tissue constituents were found between different locations; with radius distal rich of collagen, suggesting it as a prominent location for bone related measurements, and calcaneus bone having highest blood flow among the body locations being considered. By using TRS and DCS together, we are able to probe the perfusion and oxygen consumption of the tissue without any contrast agents. Therefore, we predict that these methods will be able to evaluate the impairment of the oxygen metabolism of the bone at the point-of-care. PMID:27997565

  8. Relationship between ankle-hind foot function and calcaneal three-dimensional morphological parameters%跟骨三维形态学参数与踝后足功能的关系

    Institute of Scientific and Technical Information of China (English)

    许灿; 李明清; 李康华; 刘华

    2016-01-01

    背景:跟骨整体形态与后距下关节面解剖对位都是跟骨关节内骨折手术治疗的重要预后因素,但当前仍缺少系统的生物力学实验证实跟骨三维形态学参数对于踝-后足功能的重要性。目的:综合利用实体实验与数值分析方法,明确跟骨三维形态学参数与踝后足功能的相关性。方法:首先使用人体踝足尸体标本构建跟骨高度、宽度和长度异常模型,通过生物力学加载支架对各组模型进行加载,分析跟骨高度丢失、宽度增加和长度短缩模型的动力学数据。进而构建正常人体踝后足有限元模型,在其基础上建立跟骨高度丢失、宽度增加和长度短缩数值模型,计算后距下关节面的接触特征。结果与结论:①跟骨宽度增加和长度短缩会部分限制踝后足的活动度,跟骨高度丢失则会引起距下关节活动度增加;②跟骨宽度增加会增加距下关节的接触面积,高度丢失会减少距下关节的接触面积,并使关节应力中心向关节面前下方移动;③跟骨三维形态学参数的改变会导致踝后足生物力学异常,因此跟骨骨折修复治疗中应当细致恢复跟骨的整体形态。%BACKGROUND:Both the overal appearance of the calcaneus and anatomical reduction of posterior subtalar joint are important prognostic factors of calcaneal intra-articular fracture repair. However, there is a lack of biomechanical data supporting the clinical importance of calcaneus height, length and heel width for the ankle-hind foot function. OBJECTIVE:To determine the correlation of the three-dimensional morphological parameters with the ankle-hind foot biomechanics as determined by the entity experiment and numerical analysis. METHODS:Models of abnormal calcaneus height, length and width were constructed in the human cadaveric feet and underwent a biomechanical load. The kinematics of the ankle-hind foot were compared between normal and

  9. Bone lead (Pb) content at the tibia is associated with thinner distal tibia cortices and lower volumetric bone density in postmenopausal women.

    Science.gov (United States)

    Wong, Andy K O; Beattie, Karen A; Bhargava, Aakash; Cheung, Marco; Webber, Colin E; Chettle, David R; Papaioannou, Alexandra; Adachi, Jonathan D

    2015-10-01

    Conflicting evidence suggests that bone lead or blood lead may reduce areal bone mineral density (BMD). Little is known about how lead at either compartment affects bone structure. This study examined postmenopausal women (N=38, mean age 76 ± 8, body mass index (BMI): 26.74 ± 4.26 kg/m(2)) within the Hamilton cohort of the Canadian Multicentre Osteoporosis Study (CaMos), measuring bone lead at 66% of the non-dominant leg and at the calcaneus using (109)Cadmium X-ray fluorescence. Volumetric BMD and structural parameters were obtained from peripheral quantitative computed tomography images (200 μm in-plane resolution, 2.3 ± 0.5mm slice thickness) of the same 66% site and of the distal 4% site of the tibia length. Blood lead was measured using atomic absorption spectrometry and blood-to-bone lead partition coefficients (PBB, log ratio) were computed. Multivariable linear regression examined each of bone lead at the 66% tibia, calcaneus, blood lead and PBB as related to each of volumetric BMD and structural parameters, adjusting for age and BMI, diabetes or antiresorptive therapy. Regression coefficients were reported along with 95% confidence intervals. Higher amounts of bone lead at the tibia were associated with thinner distal tibia cortices (-0.972 (-1.882, -0.061) per 100 μg Pb/g of bone mineral) and integral volumetric BMD (-3.05 (-6.05, -0.05) per μg Pb/g of bone mineral). A higher PBB was associated with larger trabecular separation (0.115 (0.053, 0.178)), lower trabecular volumetric BMD (-26.83 (-50.37, -3.29)) and trabecular number (-0.08 (-0.14, -0.02)), per 100 μg Pb/g of bone mineral after adjusting for age and BMI, and remained significant while accounting for diabetes or use of antiresorptives. Total lead exposure activities related to bone lead at the calcaneus (8.29 (0.11, 16.48)) and remained significant after age and antiresorptives-adjustment. Lead accumulated in bone can have a mild insult on bone structure; but greater partitioning of lead

  10. Imaging findings of tarsal chondroblastoma%跗骨成软骨细胞瘤的影像表现

    Institute of Scientific and Technical Information of China (English)

    张泽坤; 吴文娟; 李玉清; 张伟; 高静; 孙锋; 王冬梅; 丁建平; 王泽静

    2010-01-01

    目的 探讨跗骨成软骨细胞瘤的影像表现.方法 回顾分析经病理证实的134例成软骨细胞瘤的部位分布情况,对其中11例跗骨成软骨细胞瘤的X线和5例CT表现进行分析.结果 11例跗骨成软骨细胞瘤患者中,病变位于距骨6例、跟骨3例、足舟骨2例.距骨体后部及跟骨后结节为好发部位,X线表现以膨胀性骨质破坏为主(10/11),局部边缘轻度硬化(11/11),骨嵴常见(9/11),关节面破坏常见(7/11),可见斑点状钙化(6/11);CT对关节面破坏(5/5)、小的骨嵴(5/5)以及细小钙化(2/5)的显示更明显.结论 距骨、跟骨是跗骨成软骨细胞瘤好发部位,影像表现具有一定特点,但应结合其发病部位与其他疾病鉴别.%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.

  11. 外固定支架结合关节镜治疗跟骨 Sanders II~IV 型骨折41例%Treatment of Sanders II~IV calcaneal fracture with external fixation bracket combined with arthroscopic (41 cases)

    Institute of Scientific and Technical Information of China (English)

    杜中兴; 岳发翔; 朱贤久; 唐方科; 朱怡; 陈勇

    2013-01-01

    Objective To estimate the clinical efficacy of prying reduction and external fixation support+joint surface with mandibular reconstruction under arthroscopy (or bone graft) simple gram needle fixation on calcaneus comminuted fracture, and to explore the treatment's advantages and disadvantages. Methods 41 cases (46 feet) with bone comminuted fracture patients were treated by prying reduction and external fixation support+joint surface with mandibular reconstruc-tion under arthroscopy (or bone graft) simple gram needle fixation. Results According to the Maryland foot rating Score, excellent in 31 feet, good in 11, fair in 4, and the excellent and good rate was 90.1%. Conclusion The treatment on calcaneus comminuted fracture has the advantages of curative effect with small surgical trauma, fewer complications, does not destroy the blood supply, joint surface reduct well, and it is more suitable choice for the calcaneus fracture patients accompanying with soft tissue injuries needing several operations.%  目的观察撬拨复位外固定支架+关节镜下跟骨关节面撬拨整复(植骨)克氏针简单内固定治疗跟骨粉碎性骨折的临床疗效,探讨该方法治疗跟骨粉碎性骨折的优点和不足.方法对41例(46足)跟骨粉碎性骨折病人接受撬拨复位外固定支架+关节镜下跟骨关节面撬拨整复(或植骨)克氏针简单内固定治疗跟骨粉碎性骨折.结果术后其疗效按Maryland足部评分标准,优31足,良11足,可4足,优良率90.1%.结论利撬拨复位外固定支架+关节镜下跟骨关节面撬拨整复(植骨)克氏针简单内固定治疗跟骨粉碎性骨折疗效满意,有手术创伤小、并发症少,不破坏骨折血运,对骨折愈合影响小,跟骨关节面复位理想等优点,且对伴有软组织损伤需多次手术治疗的患者更适合该方法.

  12. Kingella kingae-Associated Pediatric Osteoarticular Infections: An Overview of 566 Reported Cases.

    Science.gov (United States)

    Al-Qwbani, Mohammed; Jiang, Nan; Yu, Bin

    2016-02-10

    This study aimed to summarize clinical experience with Kingella kingae-associated pediatric osteoarticular infections (OAIs). We reviewed 566 cases in the English literature from 2000 to June 2014. More than 80% of the patients were diagnosed between 4 months and 4 years of age, and the male to female ratio was 1.14:1. The most frequent preceding illness was upper respiratory tract infections (82%). The top 3 OAIs types were septic arthritis (73.1%), osteomyelitis (15.7%), and spondylodiscitis (5.4%), and the most affected sites of these types were knee (46%), calcaneus (20%), and L4/5 disc (70%). All cases where polymerase chain reaction (PCR) technique was used were PCR positive, no reported cases of positive cultures for K kingae with negative PCR. The duration of antibiotics use ranged from 2 to 4 weeks. Beta-lactam antibiotics were the most frequently used intravenously and orally. The clinical efficacy was favorable.

  13. Five cases of Kingella kingae skeletal infection in a French hospital.

    Science.gov (United States)

    La Scola, B; Iorgulescu, I; Bollini, G

    1998-07-01

    Five cases of Kingella kingae skeletal infections were diagnosed in children admitted to La Timone Hospital between 1992 and 1997. Patients were between 6 and 31 months old and presented with septic spondylodiskitis, calcaneus osteomyelitis, and hip-joint arthritis. All displayed either an upper respiratory tract infection or eczema during the month prior to their admission. Laboratory findings included an elevated leukocyte count and an elevated erythrocyte sedimentation rate. Standard radiography was unrevealing, but 99mTc bone scans and magnetic resonance imaging showed significant abnormalities. Isolation of Kingella kingae was achieved in all cases by culture of fluid aspirates using the Bactec blood culture system. This bacterium was sensitive to the most common antibiotics tested, and the outcome was favourable in all cases.

  14. Survey on the occurrence of flatfoot and the kinesis of feet amone this children with spastic cerebral palsy%痉挛性脑性瘫痪患儿扁平足及足运动情况调查

    Institute of Scientific and Technical Information of China (English)

    王玉霞; 张进华; 兰爱芳

    2011-01-01

    [Objective] To explore the growth of instep and the incidence rate of flatfoot and the kinesis of feet in 2~6 years old children with spastic cerebral palsy. [Methods] The study involved 56 in 2~6 years old children with spastic cerebral palsy from the Tianjin Children's Hospital. Footprint was used to observe and classify the insteps, and then counted the incidence rate of flatfoot. Visual method was used to observe the calcaneus and toes, and then counted the incidence rate of calcaneus varus or valgus, hallux varus or valgus,toe plantar flexion or dorsiflexion. [Results] Among 56 children,106 feet were observed. The incidence rate was as follows: 100% for flatfoot, 0% For slight、2. 83% for medium、97.17%for maximum,0% for calcaneus varus、0. 94% for nomal.99.06% for calcaneus valgus, 100% for ankle plantar flexion,0.94% for ankle dorsiflexion,100% for toe plantar flexion, 16.98% for toe dorsiflexion, the difference among age wasn't worth(P>0. 05); 0. 94 % for hallux varus, 5.66% for normal, 93.40% for hallux valgus, the difference among age was worth(P<0.05). [Conclusions] In 2~6 years old children with spastic cerebral palsy, the incidence rate of flatfoot is high, the kinesis of feet is poor. We should pay more attention to it.%[目的]调查痉挛性脑性瘫痪患儿扁平足患病率及足部运动情况.[方法]采用足印法、目测法,对天津儿童医院康复科治疗的56例2~6岁痉挛性脑性瘫痪患儿进行检查,对扁平足罹患率及程度、足跟骨内外翻及足拇趾内外翻、足踝及足趾能否跖屈和背屈情况进行统计分析.[结果]56名2~6岁痉挛性脑性瘫痪患儿共获得106个患足足印、目测检查106只患足.扁平足发病率为100%,扁平足程度轻度0.00%、中度2.83%、重度97.17%,足跟骨内翻0%、正位0.94%、外翻99.06%,足踝能跖屈100%,足踝能背屈0.94%,足趾能跖屈100%,足趾能背屈16.98%,不同年龄组

  15. 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.)

  16. 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)

  17. On the comparison between MRI and US imaging for human heel pad thickness measurements

    DEFF Research Database (Denmark)

    Matteoli, Sara; Corbin, Nadège Corbin; Wilhjelm, Jens E.;

    2011-01-01

    The human heel pad thickness, defined as the shortest distance between the calcaneus and heel skin, is one of the intrinsic factor which must be taken into account when investigating the biomechanics of the heel pad. US and MRI are the preferable imaging modalities used to measure the heel pad...... thickness as they are both ionizing-free radiations. The aim of this paper is to measure the bone to skin distance of nine heel pad phantoms from MRI and US images, and to compare the results with a true value (TV) in order to find the errors. Paired sample t-test was used to compare the measurements......1530 (P-value=0.402). Results confirm the necessity to investigate on the real speed of sound for the heel pad tissues, in order to have realistic measurements when dealing with human heel pads. __________________________________________________________________________________________________________...

  18. Bone mineral density in patients with destructive arthrosis of the hip joint.

    Science.gov (United States)

    Okano, Kunihiko; Aoyagi, Kiyoshi; Enomoto, Hiroshi; Osaki, Makoto; Chiba, Ko; Yamaguchi, Kazumasa

    2014-05-01

    Recent reports have shown the existence of subchondral insufficiency fracture in rapidly destructive arthrosis of the hip joint (RDA), and the findings suggest that osteopenia is related to the pathogenesis of the rapid progression of this disease. Therefore, we measured bone mineral density (BMD) in RDA patients. We measured BMD of the lumbar spine, radius, and calcaneus using dual-energy X-ray absorptiometry in 19 patients with RDA and 75 with osteoarthritis of the hip (OA) and compared BMD at different skeletal sites between RDA and OA patients. No significant differences were observed in BMD of the lumbar spine, ultradistal radius, mid-radius, and calcaneous between the RDA and OA groups. Our data suggest that RDA is not accompanied by generalized osteoporosis. Factors other than generalized bone status, for example, BMD around the affected hip joint before destruction, need to be analyzed to elucidate the pathophysiological mechanism of RDA.

  19. Intramedullary foot fixation for midfoot Charcot neuroarthropathy.

    Science.gov (United States)

    Lamm, Bradley M; Siddiqui, Noman A; Nair, Ajitha K; LaPorta, Guido

    2012-01-01

    Midfoot Charcot collapse commonly occurs through the tarsometatarsal and/or midtarsal joints, which creates the characteristic "rocker bottom" deformity. Intramedullary metatarsal fixation spanning the tarsus into the talus and/or calcaneus is a recently developed method for addressing unstable midfoot Charcot deformity. The intramedullary foot fixation technique has various advantages when addressing midfoot Charcot deformity in the neuropathic patient. These advantages include anatomical realignment, minimally invasive fixation technique, formal multiple joint fusion, adjacent joint fixation beyond the level of Charcot collapse, rigid interosseus fixation, and preservation of foot length. The goals of the intramedullary foot fixation procedure are to create a stable, plantigrade, and ulcer-free foot, which allows the patient to ambulate with custom-molded orthotics and shoes.

  20. 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.)

  1. Sex determination using discriminant analysis of upper and lower extremity bones: New approach using the volume and surface area of digital model.

    Science.gov (United States)

    Lee, U-Young; Kim, In-Beom; Kwak, Dai-Soon

    2015-08-01

    This study used 110 CT images taken from donated Korean cadavers to create 3-D models of the following upper and lower limb bones: the clavicle, scapula, humerus, radius, ulna, hip bone (os coxa), femur, patella (knee cap), tibia, talus, and calcaneus. In addition, the bone volume and surface area were calculated to determine sex differences using discriminant analysis. Significant sex differences were found in all bones with respect to volume and surface area (phip bone>tibia>humerus>scapula), although the order of surface area was different. The largest surface area in men was the femur and in women was the hip bone (psex determination (94%). When using the surface area of multiple bones, the maximum accuracy (99.4%) was achieved. The equation was as follows: (discriminant equation of surface area; femalesex determination.

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

    Directory of Open Access Journals (Sweden)

    Anne-Carolin Döring

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  4. Peripheral bone mineral density and different intensities of physical activity in children 6-8 years old: the Copenhagen School Child Intervention study

    DEFF Research Database (Denmark)

    Hasselstrøm, H; Karlsson, K M; Hansen, S E

    2007-01-01

    This study aimed to evaluate the association between objectively measured habitual physical activity and calcaneal and forearm bone mineral density (BMD, g/cm(2)), one mechanically more loaded and one less loaded skeletal region, in children aged 6-8 years. BMD was measured in 297 boys and 265...... girls by peripheral dual-energy X-ray absorptiometry in the forearm and calcaneus. An accelerometer registered the level of physical activity during 4 days (2 weekdays and the weekend). Weight, height, and skinfold thickness were measured. In order to establish thresholds (count . min(-1)) for bone......-stimulating physical activity, we evaluated different definitions of vigorous physical activity. The boys had 3.2% higher distal forearm bone mineral content (BMC, P physical activity and spent 14.6-19.0% more...

  5. Validation of a novel ultrasound measurement of achilles tendon length

    DEFF Research Database (Denmark)

    Barfod, Kristoffer Weisskirchner; Riecke, Anja Falk; Boesen, Anders;

    2014-01-01

    PURPOSE: A clinically applicable and accurate method for measuring Achilles tendon length is needed to investigate the influence of elongation of the Achilles tendon after acute rupture. The purpose of this study was to develop and validate an ultrasonographic (US) length measurement...... of the Achilles tendon-aponeurosis complex. METHODS: Both legs of 19 non-injured subjects were examined by magnetic resonance imaging (MRI) and US. The length from calcaneus to the medial head of m. Gastrocnemius was measured by three independent US examiners. Repeated US measurements were performed and compared...... to be further assessed in the setting of acute Achilles tendon rupture. CLINICAL RELEVANCE: This new ultrasound measurement might allow for length measurement of ruptured Achilles tendons in the acute and chronic state after rupture. LEVEL OF EVIDENCE: II....

  6. Prevention of bone mineral changes induced by bed rest: Modification by static compression simulating weight bearing, combined supplementation of oral calcium and phosphate, calcitonin injections, oscillating compression, the oral diophosphonatedisodium etidronate, and lower body negative pressure

    Science.gov (United States)

    Schneider, V. S.; Hulley, S. B.; Donaldson, C. L.; Vogel, J. M.; Rosen, S. N.; Hantman, D. A.; Lockwood, D. R.; Seid, D.; Hyatt, K. H.; Jacobson, L. B.

    1974-01-01

    The phenomenon of calcium loss during bed rest was found to be analogous to the loss of bone material which occurs in the hypogravic environment of space flight. Ways of preventing this occurrence are investigated. A group of healthy adult males underwent 24-30 weeks of continuous bed rest. Some of them were given an exercise program designed to resemble normal ambulatory activity; another subgroup was fed supplemental potassium phosphate. The results from a 12-week period of treatment were compared with those untreated bed rest periods. The potassium phosphate supplements prevented the hypercalciuria of bed rest, but fecal calcium tended to increase. The exercise program did not diminish the negative calcium balance. Neither treatment affected the heavy loss of mineral from the calcaneus. Several additional studies are developed to examine the problem further.

  7. 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.)

  8. Osteoporosis and Osteopathy Markers in Patients with Mastocytosis

    Directory of Open Access Journals (Sweden)

    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.

  9. 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

  10. Foot kinematics during walking measured using bone and surface mounted markers.

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    Nester, C; Jones, R K; Liu, A; Howard, D; Lundberg, A; Arndt, A; Lundgren, P; Stacoff, A; Wolf, P

    2007-01-01

    The aim was to compare kinematic data from an experimental foot model comprising four segments ((i) heel, (ii) navicular/cuboid (iii) medial forefoot, (iv) lateral forefoot), to the kinematics of the individual bones comprising each segment. The foot model was represented using two different marker attachment protocols: (a) markers attached directly to the skin; (b) markers attached to rigid plates mounted on the skin. Bone data were collected for the tibia, talus, calcaneus, navicular, cuboid, medial cuneiform and first and fifth metatarsals (n=6). Based on the mean differences between the three data sets during stance, the differences between any two of the three kinematic protocols (i.e. bone vs skin, bone vs plate, skin vs plate) were >3 degrees in only 35% of the data and >5 degrees in only 3.5% of the data. However, the maximum difference between any two of the three protocols during stance was >3 degrees in 100% of the data, >5 degrees in 73% of the data and >8 degrees in 23% of the data. Differences were greatest for motion of the combined navicular/cuboid relative to the calcaneus and the medial forefoot segment relative to the navicular/cuboid. The differences between the data from the skin and plate protocols were consistently smaller than differences between either protocol and the kinematic data for each bone comprising the segment. The pattern of differences between skin and plate protocols and the actual bone motion showed no systematic pattern. It is unlikely that one rigid body foot model and marker attachment approach is always preferable over another.

  11. Bone mineral density, bone turnover markers and fractures in patients with systemic sclerosis: a case control study.

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    Marco Atteritano

    Full Text Available OBJECTIVE: The aim of our study was to elucidate the pathophysiology of systemic sclerosis-related osteoporosis and the prevalence of vertebral fragility fracture in postmenopausal women with systemic sclerosis (SSc. METHODOLOGY: Fifty-four postmenopausal women with scleroderma and 54 postmenopausal controls matched for age, BMI, and smoking habits were studied. BMD was measured by dual energy-x-ray absorptiometry at spine and femur, and by ultrasonography at calcaneus The markers of bone turnover included serum osteocalcin and urinary deoxypyridinoline. All subjects had a spine X-ray to ascertain the presence of vertebral fractures. RESULTS: bone mineral density at lumbar spine (BMD 0.78±0.08 vs 0.88±0.07; p<0,001, femoral neck (BMD: 0.56±0.04 vs 0.72±0.07; p<0,001 and total femur (BMD: 0.57±0.04 vs 0.71±0.06; p<0,001 and ultrasound parameter at calcaneus (SI: 80.10±5.10 vs 94.80±6.10 p<0,001 were significantly lower in scleroderma compared with controls; bone turnover markers and parathyroid hormone level were significantly higher in scleroderma compared with controls, while serum of 25(OHD3 was significantly lower. In scleroderma group the serum levels of 25(OHD3 significantly correlated with PTH levels, BMD, stiffness index and bone turnover markers. One or more moderate or severe vertebral fractures were found in 13 patients with scleroderma, wherease in control group only one patient had a mild vertebral fracture. CONCLUSION: Our data shows, for the first time, that vertebral fractures are frequent in subjects with scleroderma, and suggest that lower levels of 25(OHD3 may play a role in the risk of osteoporosis and vertebral fractures.

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

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    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.].

  13. A Three-Dimensional Finite Element Analysis of Displaced Intra-Articular Calcaneal Fractures.

    Science.gov (United States)

    Xu, Can; Liu, Hua; Li, Mingqing; Wang, Chenggong; Li, Kanghua

    A better understanding of displaced intra-articular calcaneal fractures, their effect on joint mechanics, and the relationship between altered mechanics and osteoarthritis could aid in the development or refinement of treatment methods. Finite element modeling is accepted as the reference standard for evaluating joint contact stresses. The objective of the present study was to analyze the in vivo joint mechanical data from finite element modeling for normal and injured subtalar joints. A 3-dimensional model of the ankle-hindfoot was developed and validated. Both height loss and width increases in the calcaneus were simulated. Next, they were used to investigate the relationship between calcaneal height or width and the contact mechanics of the posterior facet of the subtalar joint. The contact area/joint area ratio increased in the subtalar joint with injury when the calcaneal width increased. Moreover, the peak contact pressure and the proportion of the area under high contact pressure (>6 MPa) increased. The contact area/joint area ratio decreased with reduced calcaneal height, but the peak contact pressure remained almost constant. The width increases of the calcaneus somewhat limited the subtalar joint motion, especially for eversion; however, the height loss mostly resulted in subtalar rotatory instability. The height loss diminished the subtalar joint's stability in eversion, internal rotation, and external rotation. The results of the present study support the advisability of surgery for these complex injuries. Reestablishing the calcaneal height and width could restore the normal kinematics and contact stress distribution in the subtalar joint, improve the tibiotalar position, and diminish long-term degeneration in the ankle.

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

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    Kim, S. H.; Chung, S. K.; Park, Y. H.; Lee, S. Y.; Sohn, H. S.; Han, B. H.; Bahk, Y. W. [College of Medicine, Catholic Univ., Seoul (Korea, Republic of)

    1998-07-01

    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.

  15. Foundation and static analysis of calcaneal three-dimensional finite element model%跟骨三维有限元模型的建立与静态分析

    Institute of Scientific and Technical Information of China (English)

    黄海晶; 王捷; 马建雄; 张清功; 王志彬; 金鸿宾

    2010-01-01

    目的 建立一个基于健康人体的跟骨三维有限元模型,静态分析双足站立相时跟骨内部的生物力学特性,探讨跟骨骨折疼痛的内外侧应力不均衡因素.方法 选取1名健康男性志愿者,年龄28岁,体重64kg.采用16排螺旋CT对足部沿横断面连续扫描,将符合DICOM 3.0标准的CT断层图像导入MIMICS10.1中,设定阈值为226~3071 Houfield unit,确定方位后经手动编辑、区域增长、形态学操作及空洞处理等,生成足部的三维模型,从整个足部模型中提取跟骨模型.对跟骨进行面网格的优化处理后,导入ANSYS10.0中得到体网格模型.根据CT断层图像的灰度值完成模型材质的添加,生成最终的三维有限元模型.模拟研究对象双足静止站立的状态,距下关节面在整个分析过程中被全约束,自足跟及跟腱附着点处对模型分别施加垂直向上的320 N和160 N载荷,观察跟骨的Vonmises应力分布.结果 MIMICS软件能够迅速建立更为精确的有限元模型,当垂直载荷作用于跟骨后,跟骨内、外侧存在一定的应力不均衡因素.跟骨的外侧结构是明显的薄弱区域,随着跟骨外侧壁的应力增加,导致继发外侧畸形,压迫腓骨长短肌及跟骰关节产生疼痛.结论 创建的跟骨三维有限元模型,经验证是一个较为精确的正常跟骨三维模型,可用于理解跟骨内部的应力分布变化.%Objective To establish a more rapid and precise calcaneal three-dimensional (3D) finite element model based on the healthy human foot, to analyze the internal biomechanical properties of calcaneus, and to explore the relationship between caleaneal fracture pain with the stress imbalance factors in medial and lateral side of calcaneus. Methods One healthy male volunteer (28 years old, 64 kg) was selected. Input DICOM 3.0 standard CT sectional images into MIMICS10.1 software, set the threshold of 226-3071 Houfield unit, generate foot 3D model, extract caleaneus

  16. 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

  17. Early decrements in bone density after completion of neoadjuvant chemotherapy in pediatric bone sarcoma patients

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    Hardes Jendrik

    2010-12-01

    Full Text Available Abstract Background Bone mineral density (BMD accrual during childhood and adolescence is important for attaining peak bone mass. BMD decrements have been reported in survivors of childhood bone sarcomas. However, little is known about the onset and development of bone loss during cancer treatment. The objective of this cross-sectional study was to evaluate BMD in newly diagnosed Ewing's and osteosarcoma patients by means of dual-energy x-ray absorptiometry (DXA after completion of neoadjuvant chemotherapy. Methods DXA measurements of the lumbar spine (L2-4, both femora and calcanei were performed perioperatively in 46 children and adolescents (mean age: 14.3 years, range: 8.6-21.5 years. Mean Z-scores, areal BMD (g/cm2, calculated volumetric BMD (g/cm3 and bone mineral content (BMC, g were determined. Results Lumbar spine mean Z-score was -0.14 (95% CI: -0.46 to 0.18, areal BMD was 1.016 g/cm2 (95% CI: 0.950 to 1.082 and volumetric BMD was 0.330 g/cm3 (95% CI: 0.314 to 0.347 which is comparable to healthy peers. For patients with a lower extremity tumor (n = 36, the difference between the affected and non-affected femoral neck was 12.1% (95% CI: -16.3 to -7.9 in areal BMD. The reduction of BMD was more pronounced in the calcaneus with a difference between the affected and contralateral side of 21.7% (95% CI: -29.3 to -14.0 for areal BMD. Furthermore, significant correlations for femoral and calcaneal DXA measurements were found with Spearman-rho coefficients ranging from ρ = 0.55 to ρ = 0.80. Conclusions The tumor disease located in the lower extremity in combination with offloading recommendations induced diminished BMD values, indicating local osteopenia conditions. However, the results revealed no significant decrements of lumbar spine BMD in pediatric sarcoma patients after completion of neoadjuvant chemotherapy. Nevertheless, it has to be taken into account that bone tumor patients may experience BMD decrements or secondary osteoporosis

  18. 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

  19. Dietary Silicon Intake of Korean Young Adult Males and Its Relation to their Bone Status.

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    Choi, Mi-Kyeong; Kim, Mi-Hyun

    2017-03-01

    Accumulated data suggests a positive effect of silicon on bone health; however, limited research exists on the silicon content of foods. To further the understanding of the relationship between dietary silicon intake and bone health, a food composition database of commonly consumed foods in Korea is required. For quantitative data on the intake levels of silicon, we analyzed the silicon content of 365 food items commonly consumed in Korea using inductively coupled plasma-atomic emission spectrometry following microwave-assisted digestion. To investigate the dietary silicon intake status and to examine the potential role of dietary silicon intake in the bone status of men, a total of 400 healthy Korean adult males aged 19-25 were observed for their diet intake and calcaneus bone density using the 24-h recall method and quantitative ultrasound, respectively. Clinical markers reflecting bone metabolism such as serum total alkaline phosphatase, N-mid osteocalcin, and type 1 collagen C-terminal telopeptide concentrations were also analyzed. Silicon intake of the subjects was estimated as 37.5 ± 22.2 mg/day. Major food sources of dietary silicon in the Korean male were cereal and cereal products (25.6 % of total silicon intake), vegetables (22.7 %), beverages and liquors (21.2 %), and milk and milk products (7.0 %). Silicon intake correlated positively with age, weight, energy intake, protein intake, calcium intake, and alcohol intake. After adjusted for age, weight, energy intake, protein intake, calcium intake, alcohol intake, smoking cigarettes, and regular exercise status, daily total silicon intake had no correlation with calcaneus bone density and the bone metabolism markers, but silicon intake from vegetables had a positive correlation with serum total alkaline phosphatase activity, a bone formation maker. These findings show the possible positive relationship between dietary silicon intake from vegetables and the bone formation of young adult males. Further

  20. 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

  1. 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

  2. 跟骨肿瘤及肿瘤样病变的影像学诊断价值%Imaging diagnosis and differential diagnosis of calcaneal tumor and tumor-like diseases

    Institute of Scientific and Technical Information of China (English)

    陈凯; 刘军泉; 袁君君

    2011-01-01

    目的:探讨跟骨肿瘤及肿瘤样病变的影像学特征,提高跟骨病变的影像诊断水平.方法:回顾性分析经手术和病理确诊的30例跟骨病变的影像学表现,其中30例行X射线平片检查,19例平片后不能确诊再行CT检查,3例仍然诊断困难再行MR检查.结果:良性肿瘤10例,恶性肿瘤7例,肿瘤样病变13例;骨囊肿在跟骨体部与前部交界处发生率最高,且有特征性.动脉瘤样骨囊肿有分隔,可有钙化.恶性骨肿瘤骨质破坏明显,往往为全跟骨骨质破坏.硬化缘、骨嵴及破坏区密度对鉴别诊断有意义.结论:X射线平片、CT及MR综合表现结合病变部位,可以对跟骨肿瘤及肿瘤样病变提出准确的影像学诊断和鉴别诊断.%OBJECTIVE: To discuss the radiologic features of cal-caneal tumor and tumor-like diseases so as to level up imaging diagnosis. METHODS: A retrospective analysis was done for the radiological representations of 30 cases who were verified by pathological results of surgical excision. Thirsty cases first had routine X-ray check, 19 of which who could not be definitely diagnosed had a CT check later on, and there were 3 cases still with difficulties in diagnosing and were added with MR checking. RESULTS: Among those cases, 10 were benign, 7 were malignant, and 13 were tumor-like diseases. The incidence rate of bone cyst occurred on the border of the central part and forepart of the calcaneus was the highest and was characteristic. Malignant bone tumors accompanied with significant bone destruction and frequently spread to the whole calcaneus. Sclerotic border, bone crest and the the density of the destruction region were meaningful to differential diagnosis. CONCLUSION: Via combining the X-ray, CT and MR images of the diseased region can give the exact imaging diagnosis and differential diagnosis of calcaneal tumor and tumor-like diseases.

  3. Factors influencing uncertainties of in vivo bone lead measurement using a (109)Cd K X-ray fluorescence clover leaf geometry detector system.

    Science.gov (United States)

    Behinaein, Sepideh; Chettle, David R; Marro, Leonora; Malowany, Morie; Fisher, Mandy; Fleming, David E B; Healey, Norm; Inskip, Mike; Arbuckle, Tye E; McNeill, Fiona E

    2014-12-01

    A (109)Cd K X-ray fluorescence (KXRF) measurement system consisting of four detectors in clover-leaf geometry is a non-invasive, low-radiation-dose method of measuring bone lead concentration. Its high precision in estimating the bone lead content makes it a promising tool for the determination of the low levels of lead currently found in the general population. After developing the clover-leaf geometry system, the system was used for the first time in a major survey in 2008 to measure the lead levels of 497 smelter employees (an occupationally exposed group with high lead levels). Since the delivered effective dose of the bone lead system in clover-leaf geometry is small (on the order of nSv), the technique can be used to measure the bone lead of sensitive populations such as the elderly and children. This detector system was used from 2009 to 2011, in a pilot study that measured the bone lead concentration of 263 environmentally exposed individuals (termed the EG group) residing in Toronto, Ontario, Canada. In this paper, the factors that influence uncertainties in lead content in tibia (cortical bone) and calcaneus (trabecular bone) are discussed based on gender, age, and body mass index (BMI) by using analysis of variance (ANOVA) and multiple linear regression models. Results from the two study groups (the EG group versus the occupationally exposed smelter employees) are compared where appropriate (i.e. for males older than 20). Results from univariate analyses showed that females have higher tibia uncertainty compared to males. We observed significant differences for both calcaneus and tibia uncertainty measures (p < 0.0005) among different age groups, where the uncertainties were highest in the lowest age group (<11 years). Lastly, and perhaps most significantly, we found that the product of source activity and measurement time influenced the precision of measurements greatly, and that this factor alone could account for the higher uncertainties observed for

  4. MRI characteristics of enthesitis in peripheral ankylosing spondylitis%外周型强直性脊柱炎中附着点相关炎症的MRI表现

    Institute of Scientific and Technical Information of China (English)

    李国; 李建军; 詹峰; 陈峰

    2016-01-01

    Objective To explore the MRI findings of enthesitis in peripheral ankylosing spondylitis (AS). Methods We retrospectively reviewed the MRI obtained from 13 patients with clinically-diagnosed peripheral AS. MRI finding attributable to enthesitis could be visualized as tendon or ligament enthesitis, bone marrow edema (BME), synovitis, bursitis, tenosynovitis. Results MRI findings of knee showed enthesitis in 8 knees, mainly involved in the insertions of the quadriceps tendon at the upper patellar pole , the patellar ligament at the lower patellar pole and the tibial tubercle, BME in 8 knees, synovitis in 5 knees, bursitis in 3 knees, and tenosynovitis in 4 knees. MRI findings of ankle showed enthesitis in 3 ankles, involved in plantar insertion into calcaneus and Achilles tendon insertion into the calcaneus, BME in 1 ankle, and tenosynovitis in 3 ankles. Conclusion The lower extremities are more often involved in peripheral AS than the upper extremities. MRI characteristic of enthesitis may contribute to the diagnosis of peripheral AS early combined with HLA-B27.%目的:探讨外周型强直性脊柱炎的MRI表现。方法:收集我院经临床确诊为外周型强直性脊柱炎13例患者的MRI图像行回顾性分析,将MRI表现分为肌腱或韧带附着点炎、骨髓水肿、滑膜炎、滑囊炎、腱鞘炎五种。结果:膝关节MRI表现:附着点炎8膝,主要位于髌韧带髌骨附着点、髌韧带胫骨附着点、股四头肌肌腱髌骨端附着点;骨髓水肿8膝;滑膜炎5膝;滑囊炎3膝;腱鞘炎4膝。踝关节MRI表现:附着点炎3踝,位于足底筋膜跟骨附着点、跟腱跟骨附着点;骨髓水肿1踝;腱鞘炎4踝。结论:外周型强直性脊柱炎好发于下肢关节,结合HLA-B27检查,MRI的附着点相关炎症可对其早期诊断。

  5. Modeling and stress analyses of a normal foot-ankle and a prosthetic foot-ankle complex.

    Science.gov (United States)

    Ozen, Mustafa; Sayman, Onur; Havitcioglu, Hasan

    2013-01-01

    Total ankle replacement (TAR) is a relatively new concept and is becoming more popular for treatment of ankle arthritis and fractures. Because of the high costs and difficulties of experimental studies, the developments of TAR prostheses are progressing very slowly. For this reason, the medical imaging techniques such as CT, and MR have become more and more useful. The finite element method (FEM) is a widely used technique to estimate the mechanical behaviors of materials and structures in engineering applications. FEM has also been increasingly applied to biomechanical analyses of human bones, tissues and organs, thanks to the development of both the computing capabilities and the medical imaging techniques. 3-D finite element models of the human foot and ankle from reconstruction of MR and CT images have been investigated by some authors. In this study, data of geometries (used in modeling) of a normal and a prosthetic foot and ankle were obtained from a 3D reconstruction of CT images. The segmentation software, MIMICS was used to generate the 3D images of the bony structures, soft tissues and components of prosthesis of normal and prosthetic ankle-foot complex. Except the spaces between the adjacent surface of the phalanges fused, metatarsals, cuneiforms, cuboid, navicular, talus and calcaneus bones, soft tissues and components of prosthesis were independently developed to form foot and ankle complex. SOLIDWORKS program was used to form the boundary surfaces of all model components and then the solid models were obtained from these boundary surfaces. Finite element analyses software, ABAQUS was used to perform the numerical stress analyses of these models for balanced standing position. Plantar pressure and von Mises stress distributions of the normal and prosthetic ankles were compared with each other. There was a peak pressure increase at the 4th metatarsal, first metatarsal and talus bones and a decrease at the intermediate cuneiform and calcaneus bones, in

  6. Bone mineral density, quantitative ultrasound parameters and bone metabolism in postmenopausal women with depression.

    Science.gov (United States)

    Atteritano, Marco; Lasco, Antonino; Mazzaferro, Susanna; Macrì, Ida; Catalano, Antonino; Santangelo, Antonino; Bagnato, Gianluca; Bagnato, Gianfilippo; Frisina, Nicola

    2013-09-01

    Low bone mineral density, which increases the risk of stress fragility fractures, is a frequent, often persistent finding in patients with major depressive disorder (MDD). The clinical association between major depressive disorder and osteopenia is still unclear, although several factors are associated with a loss of bone mass. The aim of our study, therefore, was to evaluate bone mineral density and bone metabolism in patients with MDD. Bone mineral density was evaluated in fifty postmenopausal women with MDD, and in 50 matched postmenopausal control women by dual-energy X-ray absorptiometry of the lumbar spine and femur, and by ultrasonography of the calcaneus and phalanges. Serum levels of 25-hydroxivitamin D, parathyroid hormone, Osteoprotegerin/Receptor Activator for Nuclear Factor κB Ligand ratio, bone turnover markers, serum and urinary cortisol were examined. Bone mineral density of the lumbar spine (BMD: 0.72 ± 0.06 vs. 0.82 ± 0.09 g/cm(2), p < 0.001), femoral neck (BMD: 0.58 ± 0.04 vs. 0.71 ± 0.07 g/cm(2), p < 0.001) and total femur (BMD 0.66 ± 0.09 vs. 0.54 ± 0.06 g/cm(2), p < 0.001); and ultrasound parameters at calcaneus (SI: 81.30 ± 6.10 vs. 93.80 ± 7.10, p < 0.001) and phalanges (AD-SOS: 1915.00 ± 37.70 vs. 2020.88 ± 39.46, p < 0.001; BTT : 1.30 ± 0.8 vs. 1.45 ± 0.9, p < 0.001) are significantly lower in patients with MDD compared with controls. Moreover bone turnover markers, parathyroid hormone levels and Receptor Activator for Nuclear Factor κB Ligand are significantly higher in MDD patients compared with controls, while serum levels of 25-hydroxivitamin D and osteoprotegerin are significantly lower. There are no differences in urinary excretion and serum cortisol between groups. Postmenopausal women with depressive disorder have an elevated risk for osteoporosis. Our data suggest that a high level of parathyroid hormone may play a role in the pathogenetic process underlying osteopenia in these patients.

  7. Grizzly bears (Ursus arctos horribilis) and black bears (Ursus americanus) prevent trabecular bone loss during disuse (hibernation).

    Science.gov (United States)

    McGee-Lawrence, Meghan E; Wojda, Samantha J; Barlow, Lindsay N; Drummer, Thomas D; Castillo, Alesha B; Kennedy, Oran; Condon, Keith W; Auger, Janene; Black, Hal L; Nelson, O Lynne; Robbins, Charles T; Donahue, Seth W

    2009-12-01

    Disuse typically causes an imbalance in bone formation and bone resorption, leading to losses of cortical and trabecular bone. In contrast, bears maintain balanced intracortical remodeling and prevent cortical bone loss during disuse (hibernation). Trabecular bone, however, is more detrimentally affected than cortical bone in other animal models of disuse. Here we investigated the effects of hibernation on bone remodeling, architectural properties, and mineral density of grizzly bear (Ursus arctos horribilis) and black bear (Ursus americanus) trabecular bone in several skeletal locations. There were no differences in bone volume fraction or tissue mineral density between hibernating and active bears or between pre- and post-hibernation bears in the ilium, distal femur, or calcaneus. Though indices of cellular activity level (mineral apposition rate, osteoid thickness) decreased, trabecular bone resorption and formation indices remained balanced in hibernating grizzly bears. These data suggest that bears prevent bone loss during disuse by maintaining a balance between bone formation and bone resorption, which consequently preserves bone structure and strength. Further investigation of bone metabolism in hibernating bears may lead to the translation of mechanisms preventing disuse-induced bone loss in bears into novel treatments for osteoporosis.

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

    Energy Technology Data Exchange (ETDEWEB)

    Behinaein, Sepideh; Chettle, David R; Egden, Lesley M [Department of Medical Physics and Applied Radiation Sciences, McMaster University, Hamilton, Ontario, L8S 4K1 (Canada); Atanackovic, Jovica [AECL, Chalk River Laboratories, Dosimetry Services, K0J 1J0, Ontario (Canada); Fleming, David E B [Department of Physics, Mount Allison University, Sackville, New Brunswick, E4L 1E6 (Canada); Nie, Linda H [School of Health Sciences, Purdue University, West Lafayette, IN 47907 (United States); Richard, Norbert; Stever, Susan, E-mail: behinas@mcmaster.ca [Occupational Health Services, Xstrata Zinc, Brunswick Smelter, Belledune, New Brunswick, E8G 2M1 (Canada)

    2011-02-07

    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 K{sub {alpha}} and K{sub {beta}} 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.

  9. 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.

  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.

  11. Mineral distribution in rat skeletons after exposure to a microgravity model

    Science.gov (United States)

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

    1995-01-01

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

  12. 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.

  13. Heel pain--operative results.

    Science.gov (United States)

    Baxter, D E; Thigpen, C M

    1984-01-01

    In 6 years through 1982, the authors performed 34 operative cases in 26 patients with recalcitrant heel pain. The operative procedure involves an isolated neurolysis of the mixed nerve supplying the abductor digiti quinti muscle as it passes beneath the abductor hallucis muscle and beneath the medial ridge of the calcaneus. The deep fascia of the abductor hallucis muscle is released routinely, and an impinging heel spur or tight plantar fascia is partially removed or released if it is causing entrapment of the nerve. The biomechanical pathogenesis of heel pain in relation to pes planus and pes cavus predisposing to an entrapment neuropathy is described, and the anatomy of the heel in relation to the nerve distribution is clarified and well illustrated. Of the 34 operated heels, 32 had good results and two had poor results. Heel pain can cause total disability in the working population and may jeopardize one's employment or professional athletic career. The authors believe operative treatment has a place in the care of recalcitrant heel pain and that an entrapment neuropathy is an etiological factor in heel pain.

  14. 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%.

  15. Template-based automatic extraction of the joint space of foot bones from CT scan

    Science.gov (United States)

    Park, Eunbi; Kim, Taeho; Park, Jinah

    2016-03-01

    Clean bone segmentation is critical in studying the joint anatomy for measuring the spacing between the bones. However, separation of the coupled bones in CT images is sometimes difficult due to ambiguous gray values coming from the noise and the heterogeneity of bone materials as well as narrowing of the joint space. For fine reconstruction of the individual local boundaries, manual operation is a common practice where the segmentation remains to be a bottleneck. In this paper, we present an automatic method for extracting the joint space by applying graph cut on Markov random field model to the region of interest (ROI) which is identified by a template of 3D bone structures. The template includes encoded articular surface which identifies the tight region of the high-intensity bone boundaries together with the fuzzy joint area of interest. The localized shape information from the template model within the ROI effectively separates the bones nearby. By narrowing the ROI down to the region including two types of tissue, the object extraction problem was reduced to binary segmentation and solved via graph cut. Based on the shape of a joint space marked by the template, the hard constraint was set by the initial seeds which were automatically generated from thresholding and morphological operations. The performance and the robustness of the proposed method are evaluated on 12 volumes of ankle CT data, where each volume includes a set of 4 tarsal bones (calcaneus, talus, navicular and cuboid).

  16. 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.)

  17. Os Trigonum Syndrome: Two Case Reports Focusing On Possible Risk Factors

    Directory of Open Access Journals (Sweden)

    Senem Şaş

    2016-09-01

    Full Text Available An accessory bone, Os trigonum is placed at the poste­rior of talus. Os trigonum occurs as ossification center be­tween 7-13 years at the posterior of talus and combines with talus within a year. However, this combination does not occur in 7 % of population that results in Os trigonum syndrome. Os trigonum syndrome is a clinic disorders that can cause posterior foot pain. This bone causes back foot pain as a result of compression between talus and calcaneus. These symptoms are seen as a result of re­petitive strain or traumas that are frequently seen in balle­rinas and soccer players with the force of ankle to plantar flexion. People with Os trigonum are generally stated to be asymptomatic, however due to additional risk factors that cause posterior foot pain such as overuse or occupa­tional one can call this syndrome to be symptomatic. In this study two different cases with symptomatic Os trigo­num are reported one due to wearing of high heel shoes and other due to occupational overuse (farming. In this report we present two cases of an 18 years and a 65 years old who have back foot pain and diagnosed with os trigonum syndrome with the review of current lit­erature.

  18. Changes in response properties of nociceptive dorsal horn neurons in a murine model of cancer pain

    Institute of Scientific and Technical Information of China (English)

    Donald A. Simone; Sergey G. Khasabov; Darryl T. Hamamoto

    2008-01-01

    Pain associated with cancer that metastasizes to bone is often severe and debilitating. A better understanding of the neural mechanisms that mediate cancer pain is needed for the development of more effective treatments. In this study, we used an established model of cancer pain to characterize changes in response properties of dorsal horn neurons. Fibrosarcoma cells were implanted into and around the calcaneus bone in mice and extracellular electrophysiological recordings were made from wide dynamic range (WDR) and high threshold (HT) dorsal horn neurons. Responses of WDR and HT neurons evoked by mechanical, heat, and cold stimuli applied to the plantar surface of the hind paw were compared between tumor bearing mice and control mice. Mice exhibited hyperalgesia to mechanical and heat stimuli applied to their tumor-bearing hind paw. WDR neurons in tumor-beating mice exhibited an increase in spontaneous activity, and enhanced responses to mechanical, heat, and cold stimuli as compared to controls. Our findings show that sensitization of WDR neurons, but not HT neurons, contributes to tumor-evoked hyperalgesia.

  19. MR imaging findings of intraosseous lipoma

    Energy Technology Data Exchange (ETDEWEB)

    Park, Young Chan; Lee, Young Hwan; Jung, Kyung Jae; Sung, Nak kwan; Chung, Duck Soo; Kim, Ok Dong [School of Medicine, Catholic University of Taegu-Hyosung, Taegu (Korea, Republic of); Lee, Jongmin [School of Medicine, Kyungpllk National University, Taegu (Korea, Republic of); Cho, Kil Ho [College of Medicine, Yeungnam University, Taegu (Korea, Republic of)

    2000-09-01

    To evaluate the MR imaging findings of intraosseous lipoma. The MR imaging findings of 12 cases of intraosseous lipoma were retrospectively analyzed with regard to internal signal intensity, enhancement patterns, the presence of calcification and the status of the margin. The findings relating to these last two features were compared with those of plain films and CT. Six tumors were located in the calcaneus, three in the tibia, two in the ilium, and one in the carpal lunate. A fat component was clearly identified in all cases, but no lesion was purely fatty. Cyst formation was noted in four cases, and hyperintense portions different from the cystic area were seen on T2WI in ten. Contrast enhancement was observed in four patients, and although plain film and CT images revealed, in all cases, the presence of calcification, in two cases this was not demonstrated y MRI. In all cases, however, MRI showed well-defined tumoral margins. MRI clearly depicts fat and other components related to the involutional changes occurring in cases of intraosseous lipoma. The information these images provide is useful for the diagnosis and histologic classification of intraosseous lipoma. (author)

  20. Influence of Estrogen Receptor α Polymorphisms on Bone Density in Response to Habitual Exercise in Japanese Postmenopausal Women

    Directory of Open Access Journals (Sweden)

    Hiroyo Kondo

    2014-01-01

    Full Text Available Estrogen receptor α (ERα is one of candidate genes for osteoporosis. This study examined the influence of ERα gene, PvuII, and XbaI genotypes on bone density of calcaneus in response to habitual exercise. ERα polymorphisms were detected using PvuII and XbaI restriction enzymes in 316 Japanese postmenopausal women. The bone density was significantly lower in the women carrying PP, pp, or xx genotype without habitual exercise than in the age-matched women without those genotypes. The women carrying Pp genotype without habitual exercise had normal bone density compared to those without Pp genotype. The women carrying PPxx or ppxx polymorphism without habitual exercise had low bone density compared to those with habitual exercise. Thus, the reduction of bone density was attenuated in the women carrying PPxx or ppxx with habitual exercise. In addition, habitual exercise was highly effective for the bone density in the women carrying xx homozygote. These findings indicate that analyses of XbaI and PvuII polymorphisms of ERα may be useful to predict the effect of exercise on bone density, and habitual exercise attenuates the reduction of bone density in women with some genotypes.

  1. Clinical usefulness of calcaneal measurements using dual energy x-ray absorptiometry

    Energy Technology Data Exchange (ETDEWEB)

    Kohno, Jun [Nagasaki Saiseikai Hospital (Japan); Nakata, Tomoko; Ito, Masako

    1999-07-01

    To investigate the clinical usefulness of calcaneal measurement using dual-energy x-ray absorptiometry (DXA), the ability to detect bone loss and fracture risk were evaluated in comparison with spinal bone mineral density (BMD) measured using DXA and quantitative CT (QCT) and with calcaneal quantitative ultrasound (QUS). Furthermore, to investigate the region in calcaneus in which to detect bone change sensitively, the ability to detect bone loss and fracture risk were also evaluated using new regions of interest (ROIs) that were manually defined. The subjects were 165 healthy women, and 188 female patients with fracture, estrogen deficiency, and steroid-induced osteoporosis. Calcaneal BMD with some manually defined ROIs showed lower precision and less sensitivity in detecting bone loss than BMD measured with automatically defined ROIs. Calcaneal DXA, spinal DXA, and QCT demonstrated significant age-related bone loss, and all measurements could discriminate fracture cases from non-fracture cases. Calcaneal DXA could discriminate the bone loss associated with estrogen deficiency as well as spinal DXA. Furthermore, calcaneal measurements showed a greater ability to detect steroid-induced bone loss than spinal DXA, probably because this group included subjects of advanced age with spondylosis. In conclusion, calcaneal DXA is useful to assess BMD in subjects who are not suitable for spinal measurement, although the ability to detect age-related bone loss in calcaneal DXA is less than in spinal measurements. (author)

  2. An anatomic and clinical study of the adductor magnus tendon-descending genicular artery bone flap.

    Science.gov (United States)

    Huang, Dong; Wang, Hai-Wen; Xu, Da-Chuan; Wang, Hong-Gang; Wu, Wei-Zhi; Zhang, Hui-Ru

    2011-01-01

    The composite tissue flap of the descending genicular vessels with the adductor magnus tendon is a newly developed, reliable method to repair the Achilles tendon and relevant skin defects. The aim of this study was to evaluate the anatomy of the adductor magnus tendon-descending genicular artery bone flap, and the feasibility and value for the repair of the Achilles tendon and relevant skin defects. There were 34 adult specimens used for the anatomy of this flap. The descending genicular artery originates 10.5 ± 1.6 cm above the adductor tubercle, with a diameter of 1.8 ± 0.6 mm and a length of 1.2 ± 0.5 cm. Its articular branch is distributed in the adductor magnus tendon and the medial condyle of the femur. The saphenous branch has a diameter of 1.1 ± 0.3 mm and is distributed in the skin of the upper medial calf. A total of 16 cases of trauma-induced Achilles tendon damage and calcaneus and skin defects were repaired with the vascularized adductor magnus tendon bone flap, including the reconstruction of Achilles tendon insertion and repair of relevant skin defects. All of the composite tissue flaps were viable, the skin sensation of the flaps was recovered, and all patients walked with a normal gait. Our results suggested that the adductor magnus tendon-descending genicular artery bone flap is an alternative method to repair composite tissue defects of the Achilles tendon.

  3. Ecomorphological analysis of the astragalo-calcaneal complex in rodents and inferences of locomotor behaviours in extinct rodent species.

    Science.gov (United States)

    Ginot, Samuel; Hautier, Lionel; Marivaux, Laurent; Vianey-Liaud, Monique

    2016-01-01

    Studies linking postcranial morphology with locomotion in mammals are common. However, such studies are mostly restricted to caviomorphs in rodents. We present here data from various families, belonging to the three main groups of rodents (Sciuroidea, Myodonta, and Ctenohystrica). The aim of this study is to define morphological indicators for the astragalus and calcaneus, which allow for inferences to be made about the locomotor behaviours in rodents. Several specimens were dissected and described to bridge the myology of the leg with the morphology of the bones of interest. Osteological characters were described, compared, mechanically interpreted, and correlated with a "functional sequence" comprising six categories linked to the lifestyle and locomotion (jumping, cursorial, generalist, fossorial, climber and semi-aquatic). Some character states are typical of some of these categories, especially arboreal climbers, fossorial and "cursorial-jumping" taxa. Such reliable characters might be used to infer locomotor behaviours in extinct species. Linear discriminant analyses (LDAs) were used on a wider sample of species and show that astragalar and calcaneal characters can be used to discriminate the categories among extant species whereas a posteriori inferences on extinct species should be examined with caution.

  4. 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.

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

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    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.

  6. Chopart fractures.

    Science.gov (United States)

    Klaue, Kaj

    2004-09-01

    The Chopart articular space was described by François Chopart (1743-1795) as a practical space for amputations in cases of distal foot necrosis. It corresponds to the limit between the anatomical hind-foot and the mid-foot. The bones involved are the talus and the calcaneus proximally, and the navicular and the cuboid distally. This space thus holds two functionally distinct entities, the anterior part of the coxa pedis (an essential functional joint) and the calcaneo-cuboidal joint,which can be considered to be an "adaptive joint" within a normal foot. Trauma to this region may cause fractures and/or dislocations and, in high energy trauma,compartment syndromes. Principles of treatment are immediate reduction of dislocations and realignment of the medial and lateral column of the foot in length and orientation. Open reduction and internal fixation of talus and navicular fractures are often indicated to restore the "coxa pedis". Open reconstruction or fusion in correct length of the calcaneo-cuboidal joint is occasionally indicated. Salvage procedures in malunions include navicular osteotomies and calcaneo-cuboidal bone block fusions. Treatment of joint destructions, especially involving the talo-navicular joint, include triple arthrodesis.

  7. Endoscopic treatment of calcaneo-fibular impingement.

    Science.gov (United States)

    Bauer, T; Deranlot, J; Hardy, Ph

    2011-01-01

    The calcaneo-fibular impingement syndrome is frequent after calcaneal fracture and is linked to the decreased space between the tip of the fibula and the lateral wall of the calcaneus. The reasons for the painful symptoms are mixed with both bony and soft tissue involvement. The abnormal bony contact between the lateral calcaneal cortex and the tip of the fibula depends mainly on the size and localization of the lateral exostosis of the calcaneal wall. The soft tissue impingement is due to the fibrosis and scar tissues in the lateral gutter and to the compression of the peroneal tendons in the retromalleolar groove and under the tip of the malleolus. A 2-portal endoscopic technique is described for the treatment of calcaneo-fibular impingement with bone resection, soft tissue debridement and peroneal tendons release. One of the advantages of this endoscopic technique is the possibility of an assessment and treatment of associated lesions in the same procedure. A subtalar joint fusion can be done before if needed under arthroscopic control. As this endoscopic technique is very efficient to relieve symptoms of calcaneo-fibular impingement and is focused on the most relevant symptoms, it can thus be indicated for most of cases of calcaneal malunions, whatever the type of malunion and depending of the painful symptoms.

  8. [Variations in the calcaneo-fibular ligament (lig. calcaneofibulare). Application to the kinematics of the ankle].

    Science.gov (United States)

    Trouilloud, P; Dia, A; Grammont, P; Gelle, M C; Autissier, J M

    1988-03-01

    The authors observe variations in the calcaneo-fibular ligament because this ligament controls two articulations, the talo-crural and the subtalar. This study is based on the dissection of the ankle of 20 specimens. The calcaneo-fibular ligament is reinforced by the ventral and lateral talo-calcaneus ligaments with variations. 3 types of disposition have been described. Type A: A lateral talo-calcaneal ligament reinforces the calcaneo-fibular ligament. These two ligaments are divergent on the proximal, medial, or distal part. Type B: There is an independent lateral talo-calcaneal ligament forward of the calcaneo-fibular ligament. Type C: A ventral talo-calcaneal ligament is observed, parallel to the interosseous ligament. The authors consider the consequences of variation in the lateral ligaments of the ankle for the functioning of the tibio-tarsal articulation, the subtalar articulation and the astragalo-scaphoid articulation in order to propose specific radiographic examination of the kinematics of the ankle.

  9. Apparent density of the primate calcaneo-cuboid joint and its association with locomotor mode, foot posture, and the "midtarsal break".

    Science.gov (United States)

    Nowak, Matthew G; Carlson, Kristian J; Patel, Biren A

    2010-06-01

    Primates use a range of locomotor modes during which they incorporate various foot postures. Humans are unique compared with other primates in that humans lack a mobile fore- and midfoot. Rigidity in the human foot is often attributed to increased propulsive and stability requirements during bipedalism. Conversely, fore- and midfoot mobility in nonhuman primates facilitates locomotion in arboreal settings. Here, we evaluated apparent density (AD) in the subchondral bone of human, ape, and monkey calcanei exhibiting different types of foot loading. We used computed tomography osteoabsorptiometry and maximum intensity projection (MIP) maps to visualize AD in subchondral bone at the cuboid articular surface of calcanei. MIPs represent 3D volumes (of subchondral bone) condensed into 2D images by extracting AD maxima from columns of voxels comprising the volumes. False-color maps are assigned to MIPs by binning pixels in the 2D images according to brightness values. We compared quantities and distributions of AD pixels in the highest bin to test predictions relating AD patterns to habitual locomotor modes and foot posture categories of humans and several nonhuman primates. Nonhuman primates exhibit dorsally positioned high AD concentrations, where maximum compressive loading between the calcaneus and cuboid likely occurs during "midtarsal break" of support. Humans exhibit less widespread areas of high AD, which could reflect reduced fore- and midfoot mobility. Analysis of the internal morphology of the tarsus, such as subchondral bone AD, potentially offers new insights for evaluating primate foot function during locomotion.

  10. An Ultrasonic Backscatter Instrument for Cancellous Bone Evaluation in Neonates

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    Chengcheng Liu

    2015-09-01

    Full Text Available Ultrasonic backscatter technique has shown promise as a noninvasive cancellous bone assessment tool. A novel ultrasonic backscatter bone diagnostic (UBBD instrument and an in vivo application for neonatal bone evaluation are introduced in this study. The UBBD provides several advantages, including noninvasiveness, non-ionizing radiation, portability, and simplicity. In this study, the backscatter signal could be measured within 5 s using the UBBD. Ultrasonic backscatter measurements were performed on 467 neonates (268 males and 199 females at the left calcaneus. The backscatter signal was measured at a central frequency of 3.5 MHz. The delay (T1 and duration (T2 of the backscatter signal of interest (SOI were varied, and the apparent integrated backscatter (AIB, frequency slope of apparent backscatter (FSAB, zero frequency intercept of apparent backscatter (FIAB, and spectral centroid shift (SCS were calculated. The results showed that the SOI selection had a direct influence on cancellous bone evaluation. The AIB and FIAB were positively correlated with the gestational age (|R| up to 0.45, P10 µs. Moderate positive correlations (|R| up to 0.45, P10 µs. The T2 mainly introduced fluctuations in the observed correlation coefficients. The moderate correlations observed with UBBD demonstrate the feasibility of using the backscatter signal to evaluate neonatal bone status. This study also proposes an explicit standard for in vivo SOI selection and neonatal cancellous bone assessment.

  11. Ecomorphological analysis of the astragalo-calcaneal complex in rodents and inferences of locomotor behaviours in extinct rodent species

    Directory of Open Access Journals (Sweden)

    Samuel Ginot

    2016-10-01

    Full Text Available Studies linking postcranial morphology with locomotion in mammals are common. However, such studies are mostly restricted to caviomorphs in rodents. We present here data from various families, belonging to the three main groups of rodents (Sciuroidea, Myodonta, and Ctenohystrica. The aim of this study is to define morphological indicators for the astragalus and calcaneus, which allow for inferences to be made about the locomotor behaviours in rodents. Several specimens were dissected and described to bridge the myology of the leg with the morphology of the bones of interest. Osteological characters were described, compared, mechanically interpreted, and correlated with a “functional sequence” comprising six categories linked to the lifestyle and locomotion (jumping, cursorial, generalist, fossorial, climber and semi-aquatic. Some character states are typical of some of these categories, especially arboreal climbers, fossorial and “cursorial-jumping” taxa. Such reliable characters might be used to infer locomotor behaviours in extinct species. Linear discriminant analyses (LDAs were used on a wider sample of species and show that astragalar and calcaneal characters can be used to discriminate the categories among extant species whereas a posteriori inferences on extinct species should be examined with caution.

  12. Ecomorphological analysis of the astragalo-calcaneal complex in rodents and inferences of locomotor behaviours in extinct rodent species

    Science.gov (United States)

    Hautier, Lionel; Marivaux, Laurent; Vianey-Liaud, Monique

    2016-01-01

    Studies linking postcranial morphology with locomotion in mammals are common. However, such studies are mostly restricted to caviomorphs in rodents. We present here data from various families, belonging to the three main groups of rodents (Sciuroidea, Myodonta, and Ctenohystrica). The aim of this study is to define morphological indicators for the astragalus and calcaneus, which allow for inferences to be made about the locomotor behaviours in rodents. Several specimens were dissected and described to bridge the myology of the leg with the morphology of the bones of interest. Osteological characters were described, compared, mechanically interpreted, and correlated with a “functional sequence” comprising six categories linked to the lifestyle and locomotion (jumping, cursorial, generalist, fossorial, climber and semi-aquatic). Some character states are typical of some of these categories, especially arboreal climbers, fossorial and “cursorial-jumping” taxa. Such reliable characters might be used to infer locomotor behaviours in extinct species. Linear discriminant analyses (LDAs) were used on a wider sample of species and show that astragalar and calcaneal characters can be used to discriminate the categories among extant species whereas a posteriori inferences on extinct species should be examined with caution. PMID:27761303

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

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    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.

  14. Chondroblastoma: A clinical and radiological study of 104 cases

    Energy Technology Data Exchange (ETDEWEB)

    Bloem, J.L.; Mulder, J.D.

    1985-06-01

    The clinical and radiographic findings in 104 patients with chondroblastoma are presented. Pain was an almost constant presenting complaint, often accompanied in the case of para-articular lesions by impaired function of an adjacent joint. The majority (80%) were in long bones with a mean age of presentation of 16 years. The characteristic radiological image of these lesions was an eccentric radiolucency, having a sharply defined sclerotic margin and containing areas of calcification in approximately a third of cases. They were always related to a growth plate. Nearly half were confined to the affected epiphysis or apophysis itself, but most of the remainder had traversed the growth plate to involve also the adjacent metaphysis. The bones around the knee and the proximal ends of the humerus and femur were the sites of predilection. A minority (20%) affected flat bones and short tubular bones of the hand and foot, with a peculiar affinity for the calcaneus and talus. The mean age of presentation of these was 28 years. The radiological pattern was similar, except for a greater tendency to expand the affected bone. Complications included the formation of a secondary aneurysmal bone cyst in 16 cases (10 of them in long bones), one malignant chondroblastoma, and one fibrosarcoma developing after radiation of the original chondroblastoma.

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

    Energy Technology Data Exchange (ETDEWEB)

    Mennel, Emilie A. [University of Texas Southwestern Medical School, Dallas, Texas (United States); John, Susan D. [Department of Radiology, University of Texas-Houston Medical School, 6431 Fannin-MSB2.100, Houston, TX 77030 (United States)

    2003-01-01

    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.)

  16. Arthroscopic excision of bone fragments in a neglected fracture of the lateral process of the talus in a junior soccer player.

    Science.gov (United States)

    Funasaki, Hiroki; Kato, Soki; Hayashi, Hiroteru; Marumo, Keishi

    2014-06-01

    Fractures of the lateral process of the talus are uncommon and often overlooked. Typically, they are found in adult snowboarders. We report the case of an 11-year-old male soccer player who complained of lateral ankle pain after an inversion injury 6 months earlier. He did not respond to conservative treatment and thus underwent arthroscopic excision of fragments of the talar lateral process. The ankle was approached through standard medial and anterolateral portals. A 2.7-mm-diameter 30° arthroscope was used. Soft tissues around the talus were cleared with a motorized shaver, and the lateral aspect of the talar process was then visualized. The lateral process presented as an osseous overgrowth, and a loose body was impinged between the talus and the calcaneus. The osseous overgrowth was resected piece by piece with a punch, and the loose body was removed en block. The patient returned to soccer 5 weeks after the operation. This case exemplifies 2 important points: (1) This type of fracture can develop even in children and not only in snowboarders. (2) Arthroscopic excision of talar lateral process fragments can be accomplished easily, and return to sports can be achieved in a relatively short time.

  17. Talus measurements as a diagnostic tool for sexual dimorphism in Egyptian population.

    Science.gov (United States)

    Abd-elaleem, Shereen Abd-elhakim; Abd-elhameed, Mostafa; Ewis, Ashraf Abd-elazeem

    2012-02-01

    Measurements of talus have been shown to be sexually dimorphic in South African blacks and whites and Prehistoric New Zealand Polynesians. Since several studies have demonstrated that discriminant function equations used to determine the sex of a skeleton are population specific, the purpose of the present study was to derive similar equation for the tali of Egyptians. The sample consisted of 110 tali (67 male & 43 female) whose age at death ranged between 20 and 60 years. The tali were obtained from Anatomy departments of Minia and Cairo Universities and also from Forensic Medicine department of Justice Office in Minia governates - Egypt. Twelve measurements were taken for every talus. Data were analyzed by SPSS version 16. All measurements showed significant sexual differences (P < 0.05) except calcaneus articular surface width and navicular articular surfaced width. Talar length was found to be the most sexual dimorphic (90.9%). Combination of talar length, talar width and neck width gave a percentage of accuracy of 85.5%. Finally, it is concluded that the talus of Egyptian population is useful for sex estimation.

  18. Calcaneal loading during walking and running

    Science.gov (United States)

    Giddings, V. L.; Beaupre, G. S.; Whalen, R. T.; Carter, D. R.

    2000-01-01

    PURPOSE: This study of the foot uses experimentally measured kinematic and kinetic data with a numerical model to evaluate in vivo calcaneal stresses during walking and running. METHODS: External ground reaction forces (GRF) and kinematic data were measured during walking and running using cineradiography and force plate measurements. A contact-coupled finite element model of the foot was developed to assess the forces acting on the calcaneus during gait. RESULTS: We found that the calculated force-time profiles of the joint contact, ligament, and Achilles tendon forces varied with the time-history curve of the moment about the ankle joint. The model predicted peak talocalcaneal and calcaneocuboid joint loads of 5.4 and 4.2 body weights (BW) during walking and 11.1 and 7.9 BW during running. The maximum predicted Achilles tendon forces were 3.9 and 7.7 BW for walking and running. CONCLUSIONS: Large magnitude forces and calcaneal stresses are generated late in the stance phase, with maximum loads occurring at approximately 70% of the stance phase during walking and at approximately 60% of the stance phase during running, for the gait velocities analyzed. The trajectories of the principal stresses, during both walking and running, corresponded to each other and qualitatively to the calcaneal trabecular architecture.

  19. The Influence of Plantar Short Foot Muscle Exercises on Foot Posture and Fundamental Movement Patterns in Long-Distance Runners, a Non-Randomized, Non-Blinded Clinical Trial.

    Directory of Open Access Journals (Sweden)

    Iwona Sulowska

    Full Text Available The objective of this study was to evaluate the influence of two kinds of plantar short foot muscles exercise on foot posture and fundamental movement patterns in long-distance runners.A parallel group non-blinded trial with 6-week follow-up.Twenty five long-distance runners aged 22-35 years. They were divided into two groups. In group 1 (n = 13 subjects performed the exercise "Vele's Forward Lean" and "Reverse Tandem Gait" and in Group 2 (n = 12 the "Short Foot Exercise." The runners performed the exercises daily for 6 weeks. The Foot Posture Index (FPI-6 and The Functional Movement Screen (FMS tests were performed twice: at baseline and after 6 weeks of the exercise.A significant improvement was observed in FPI -6 (talar head palpation in Group 1, and inversion/eversion of the calcaneus in Group 2. Also in Group 1 a significant improvement was noted in FMS tests: deep squat, active straight leg raise and in total score.Short foot muscles strengthening exercises have beneficial effect on functional movement patterns and on foot posture, therefore they should be included as a part of daily training program of runners.Australian New Zealand Clinical Trials Registry ACTRN12615001200572.

  20. Partial calcanectomy and Ilizarov external fixation may reduce amputation need in severe diabetic calcaneal ulcers

    Science.gov (United States)

    Akkurt, Mehmet Orçun; Demirkale, Ismail; Öznur, Ali

    2017-01-01

    ABSTRACT Objective: The treatment of diabetic hindfoot ulcers is a challenging problem. In addition to serial surgical debridements, hyperbaric oxygen therapy and local wound care play important roles in the surgeon’s armamentarium, for both superficial infection and gangrene of the soft tissue, often complicated by osteomyelitis of the calcaneus. The purpose of this study was to evaluate the results of an aggressive approach from diagnosis to treatment of calcaneal osteomyelitis in foot-threatening diabetic calcaneal ulcers. Methods: The study included 23 patients with diabetic hindfoot ulcers who were treated with radical excision of the necrotic tissue and application of circular external fixation. The treatment protocol was a combination of magnetic resonance imaging (MRI)-guided debridement of the necrotic tissues and application of an Ilizarov external fixator in plantarflexion to decrease the soft-tissue defect. Primary outcome measures were total cure of infection and obvious healing of the osteomyelitis at 12 weeks determined by MRI, and clinical cure through objective assessment of the appearance of the wound. Results: The wounds healed in 18 of the 23 patients (78%), partial recovery occurred and subsequent flap operation was performed in three patients (13%), and below-the-knee amputation was performed in two patients (9%). Conclusions: This surgical protocol is effective in ameliorating diabetic hindfoot ulcers with concomitant calcaneal osteomyelitis, and satisfactorily reduces the need for amputation.

  1. [C-sign and talocalcaneal coalition].

    Science.gov (United States)

    Tomčovčík, L

    2011-01-01

    Talocalcaneal coalition is an abnormal bridge between talus and calcaneus, causing pain and restriction of subtalar movement; its incidence is less than 1 %. The signs and symptoms usually become manifest in the second decade of life with ossification of the lesion. They involve flat foot, peroneal muscle spasm, tarsal tunnel syndrome, or valgus tilt of the heel. The sings need not be noticeable and may appear only as tiredness and vague pain in the hind foot after exercise or an easily twisted ankle. The authors describe the case of talocalcaneal coalition in a 20-year-old man, incidentally diagnosed at ankle fracture. The presence of C-sign led to CT examination and the exact diagnosis. Radiological demonstration of this abnormality may be difficult because plain X-ray images in both projections may show normal findings. Literature data report, in addition to C-sign, further secondary signs of talocalcaneal coalition present on lateral radiographs of the ankle joint. Although these signs do not directly point to talocalcaneal coalition, they reveal abnormal anatomy or movement of the joint and may initiate more thorough examination by CT or MRI and the establishment of an exact diagnosis. Therefore, to know the secondary signs and pay attention to them is very useful.

  2. 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

  3. Effects of pathology dyes on Raman bone spectra

    Science.gov (United States)

    Esmonde-White, Karen A.; Esmonde-White, Francis W. L.; Morris, Michael D.; Roessler, Blake J.

    2013-05-01

    We report an overlooked source of artifacts for clinical specimens, where unexpected and normally negligible contaminants can skew the interpretation of results. During an ongoing study of bone fragments from diabetic osteomyelitis, strong Raman signatures were found, which did not correspond with normal bone mineral or matrix. In a bone biopsy from the calcaneus of a patient affected by diabetic osteomyelitis, Raman microspectroscopic analysis revealed regions with both abnormal mineral and degraded collagen in addition to normal bone. Additional bands indicated a pathological material. Stenotrophomonas maltophilia was identified in the wound culture by independent microbiologic examination. We initially assigned the unusual bands to xanthomonadin, a bacterial pigment from S. maltophilia. However, the same bands were also found more than a year later on a second specimen that had been noticeably contaminated with pathology marking dye. Drop deposition/Raman spectroscopy of commonly used pathology dyes revealed that a blue tissue-marking dye was responsible for the unusual bands in both specimens, even in the first specimen where there was no visible evidence of contamination.

  4. Sinobaatar gen. Nov.: First multituberculate from the Jehol Biota of Liaoning, Northeast China

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    A multituberculate skeleton from the Lower Cretaceous Yixian Formation at Dawangzhangzi, Lingyuan City, Liaoning Province, Northeast China, provides new morphological information for early multituberculates. The specimen is the holotype of Sinobaatar lingyuanensis gen. et sp. nov. It has a narrow skull that lacks the superorbital crest or postorbital process. The dental formula is 3·?·5·2/1·0·3·2. The dental morphology, especially that of cheek teeth, of S. lingyuanensis is similar to that of Eobaatar, which places it in the family Eobaataridae. The postcranial skeleton of Sinobaatar is similar to that of other multituberculates. As in Holotheria, Metatarsal V of Sinobaatar articulates only with the cuboid and has no contact with the calcaneus, which probably represents the primitive condition of multituberculates. Nine carpals of Sinobaatar resemble those of Zhangheotherium, except the centrale being larger than the trapezoid. The dental features of Sinobaatar show again that eobaatarids are obviously intermediate between Late Jurassic multituberculates and the later forms. Because eobaatarids are only known from the Early Cretaceous, the finding of Sinobaatar, therefore, supports that the age of the Jehol Biota is most likely Early Cretaceous.

  5. TALONAVICULAR JOINT ARTHRODESIS AND MEDIAL DISPLACEMENT CALCANEAL OSTEOTOMY FOR TREATMENT OF PATIENTS WITH PLANOVALGUS DEFORMITY

    Directory of Open Access Journals (Sweden)

    G. O. Dubovik

    2012-01-01

    Full Text Available The aim of this study was to assess the results of talonavicular joint arthrodesis and medial displacement calcaneal osteotomy for surgical correction of pes planovalgus. Fourteenth patients with a pes planovalgus deformity were underwent surgery from February 2008 to December 2011. The mean age was 45,5. In 90% of cases, operations were performed on one foot, and 10% of cases at two feet. All patients were assessed before the operation with the scale of the American Orthopaedic Foot and Ankle Society (AOFAS. According to the AOFAS scale, the average improvement was 41 before the operation had reached values of 84.2 after the operation. Radiography showed an average decrease in the angle of the longitudinal arch from 12 and an average decrease in the angle of deviation between the vehicle collision and the calcaneus to 38°, increasing the height of a set of 5 mm. This combination of procedures allows greater correction and stability than either procedure performed alone, and provides a viable alternative to triple arthrodesis.

  6. Chondroblastoma of the foot.

    Science.gov (United States)

    Fink, B R; Temple, H T; Chiricosta, F M; Mizel, M S; Murphey, M D

    1997-04-01

    A total of 322 cases of chondroblastoma were referred to the Armed Forces Institute of Pathology between 1960 and 1990. Ten additional cases of chondroblastoma were treated at Walter Reed Army Medical Center between 1985 and 1993. Forty-two of these involved the foot, two of which were treated at Walter Reed Army Medical Center. Patients with chondroblastoma of the foot were male in 35 (81%) cases, with a mean age of 25.5 years, which was significantly different from the mean age of 17.3 years in patients with chondroblastoma of the long bones (P Chondroblastoma of the foot is most commonly found in the posterior subchondral areas of the talus and calcaneus as well as in the calcaneal apophysis. Radiographically, the lesion was associated with an articular surface or apophyseal area in all cases and appeared radiolucent, with little to no matrix production. The margins were generally well defined. Cystic features were noted grossly and histologically in 24 (57%) specimens, a feature seen in only 21% of all chondroblastomas overall. Treatment consists of thorough curetting and bone grafting with good oncologic and functional results.

  7. Skeletal Adaptation to Daily Activity: A Biochemical Perspective

    Science.gov (United States)

    Whalen, Robert T.; Dalton, Bonnie (Technical Monitor)

    2002-01-01

    Musculoskeletal forces generated by normal daily activity on Earth maintain the functional and structural properties of muscle and bone throughout most of one's adult life. A reduction in the level of cumulative daily loading caused by space flight, bed rest or spinal cord injury induces rapid muscle atrophy, functional changes in muscle, and bone resorption in regions subjected to the reduced loading. Bone cells in culture and bone tissue reportedly respond to a wide variety of non-mechanical and mechanical stimuli ranging, from electromagnetic fields, and hormones to small amplitude, high frequency vibrations, fluid flow, strain rate, and stress/strain magnitude. However, neither the transduction mechanism that transforms the mechanical input into a muscle or bone metabolic response nor the characteristics, of the loading history that directly or indirectly stimulates the cell is known. Identifying the factors contributing to the input stimulus will have a major impact on the design of effective countermeasures for long duration space flight. This talk will present a brief overview of current theories of bone remodeling and functional adaptation to mechanical loading. Work from our lab will be presented from the perspective of daily cumulative loading on Earth and its relationship to bone density and structure. Our objective is to use the tibia and calcaneus as model bone sites of cortical and cancellous bone adaptation, loaded daily by musculoskeletal forces in equilibrium with the ground reaction force. All materials that will be discussed are in the open scientific literature.

  8. [Aponeurosis plantaris--phylogenetic development].

    Science.gov (United States)

    Dylevský, I

    1991-03-01

    The plantar aponeurosis is differentiated in its most primitive form in Marsupialia, where it is formed by a single connective tissue strip, a continuation of the tendon of the m. plantaris. The tendon is usually not fixed to the calacaneal tuberosity. The lateral tract (fibular) of the plantar aponeurosis takes a distal course and forms processes for the first to fifth toe. (The number of inserting strips is different and variable in different species of marsupials). A separate medial (tibial) strip of the aponeurosis is lacking. 2. In Insectivora the plantar aponeurosis is differentiated similarly as in marsupials. Again the medial (tibial) strip of the aponeurosis is absent and the tendon of the m. plantaris is more firmly fixed to the calcaneus. Scandentia (Tupalia) have a two-layer aponeurosis. The fibular (lateral) layer is in continuation of the tendon of the m. plantaris, the medial (tibial) layer starts at the calcaneal tuberosity. The plantar aponeurosis of Tupalia does not yet form two separable tracts, however, the forming layers of the aponeurosis indicate the future separation of the uniform connective tissue plate. 3. In prosimians and simians a separate medial (tibial) tract develops which is independent on the tendon of the m. plantaris, and in anthropoids and humans gradually the planta predominates.

  9. Biomechanical consequences of plantar fascial release or rupture during gait. Part II: alterations in forefoot loading.

    Science.gov (United States)

    Sharkey, N A; Donahue, S W; Ferris, L

    1999-02-01

    With a model using feet from cadavers, we tested the hypothesis that plantar fascial release or rupture alters the loading environment of the forefoot during the latter half of the stance phase of gait. The model simulated the position and loading environment of the foot at two instants: early in terminal stance immediately after heel-off and late in terminal stance just preceding contralateral heel strike. Eight feet were loaded at both positions by simulated plantar flexor contraction, and the distribution of plantar pressure was measured before and after progressive release of the plantar fascia. Strain in the diaphysis of the second metatarsal was also measured, from which the bending moments and axial force imposed on the metatarsal were calculated. Cutting the medial half of the central plantar fascial band significantly increased peak pressure under the metatarsal heads but had little effect on pressures in other regions of the forefoot or on second metatarsal strain and loading. Dividing the entire central band or completely releasing the plantar fascia from the calcaneus had a much greater effect and caused significant shifts in plantar pressure and force from the toes to beneath the metatarsal heads. These shifts were accompanied by significantly increased strain and bending in the second metatarsal. Complete fasciotomy increased the magnitude of strain in the dorsal aspect of the second metatarsal by more than 80%, suggesting that plantar fascial release or rupture accelerates the accumulation of fatigue damage in these bones. Altered forefoot loading may be a potential complication of plantar fasciotomy.

  10. Subcalcaneal bursitis with plantar fasciitis treated by arthroscopy.

    Science.gov (United States)

    Yamakado, Kotaro

    2013-05-01

    We report the successful arthroscopic treatment of a case of subcalcaneal bursitis with plantar fasciitis. To our knowledge, this is the first report on arthroscopic excision of a subcalcaneal bursa. Right heel pain developed in a 50-year-old woman, without any obvious cause. She reported that the heel pain occurred immediately after waking and that the heel ached when she walked. Magnetic resonance imaging showed an extra-articular, homogeneous, high-intensity lesion in the fat pad adjacent to the calcaneal tubercle on T2-weighted sagittal and coronal images and thickening of the plantar fascia on T2-weighted sagittal images. A diagnosis of a recalcitrant subcalcaneal bursitis with plantar fasciitis was made, and surgery was performed. The arthroscope was placed between the calcaneus and the plantar fascia. With the surgeon viewing from the lateral portal and working from the medial portal, the dorsal surface of the degenerative plantar fascia was debrided and the medial half of the plantar fascia was released, followed by debridement of the subcalcaneal bursal cavity through the incised plantar fascia. Full weight bearing and gait were allowed immediately after the operation. At the latest follow-up, the patient had achieved complete resolution of heel pain without a recurrence of the mass, confirmed by magnetic resonance imaging.

  11. Biomechanical principle of arcus plantaris and its clinical application

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: To analyze the principle mechanism of the arcus plantaris and its clinical application. Methods: The states of forces sustained by the arcus plantaris were analyzed and calculated according to the mechanism of the quadratic parabolic arch. Results: The aponeurosis plantaris corresponded to the pull rod of the arcus plantaris. The medial and lateral longitudinal arches formed by the pedal bones were stable with the rod, but unstable without the rod. In the latter condition, on loading, the force sustained by the parabolic arch became a force sustained by a simple beam, and the arcus plantaris tended to disappear and to be flattened.Clinically, 240 feet with talipes equinus were treated with triple arthrodesis. In 34 out of the reexamined 156 feet, the aponeurosis plantaris was cut in addition to the triple arthrodesis and was immobilized with cast for 3 months.One or two years later, their arcus plantaris disappeared,pain developed when walking, and some of them walked with the midtarsai joint against the ground. Then, the triple arthrodesis and shortening of the aponeurosis plantaris were applied on 18 cases, and osteotomy of the calcaneus and reconstruction of the aponeurosis plantaris were made on 10 cases and satisfactory effects were obtained. Conclusions: In order to achieve satisfactory therapeutic effects of the triple arthrodesis, we should reestablish the arcus plantaris and accurately treat the aponeurosis plantaris for the balance of the surrounding muscle force.

  12. Fetal development of the pulley for muscle insertion tendons: A review and new findings related to the tensor tympani tendon.

    Science.gov (United States)

    Rodríguez-Vázquez, Jose Francisco; Honkura, Yohei; Katori, Yukio; Murakami, Gen; Abe, Hiroshi

    2017-01-01

    The existence of hard tissue pulleys that act to change the direction of a muscle insertion tendon is well known in the human body. These include (1) the trochlea for the extraocular obliquus superior muscle, (2) the pterygoid hamulus for the tensor veli palatini muscle, (3) the deep sulcus on the plantar aspect of the cuboid bone for the peroneus longus tendon, (4) the lesser sciatic notch for the obturator internus muscle, and (5) the bony trochleariformis process for the tensor tympani muscle tendon. In addition, (6) the stapedius muscle tendon shows a lesser or greater angulation at the pyramidal eminence of the temporal bone. Our recent studies have shown that the development of pulleys Nos. 1 and 2 can be explained by a change in the topographical relationship between the pulley and the tendon, that of pulley No. 3 by the rapidly growing calcaneus pushing the tendon, and that of pulley No. 4 by migration of the insertion along the sciatic nerve and gluteus medius tendon. Therefore, in Nos. 1-4, an initially direct tendon curves secondarily and obtains an attachment to the pulley. In case No. 6, the terminal part of the stapedius tendon originates secondarily from the interzone mesenchymal tissue of the incudostapedial joint. In the case of pulley No. 5, we newly demonstrated that its initial phase of development was similar to No. 6, but the tensor tympani tendon achieved a right-angled turn under guidance by a specific fibrous tissue and it migrated along the growing malleus manubrium.

  13. [Étienne Destot (1864-1918): the first radioanatomist in Lyon, France].

    Science.gov (United States)

    Viard, B; Trost, O; Trouilloud, P; Salomon, C

    2014-03-01

    Destot was born in Dijon, France, in 1864. He began his education in Burgundy, then he started his preclinical curriculum in Lyon, France, from 1884. He had to leave Lyon, and spent some times in Algeria to treat a tuberculosis. He came back in Lyon as a resident in 1886. Destot worked as an assistant in the laboratory of anatomy of Leo Testut in 1880. His thesis, in 1892, analyzed mortality in the departments of surgery of the Lyon hospitals. The polemical results he presented compromised his surgical career. He went on as prosector by Leo Testut, and then became electrician-physician in 1895 (electrotherapy and galvanotherapy). Étienne Destot of Lyon, France, developed in 1895 the first radiography room ever at the Hôtel-Dieu of Lyon, France. Wilhelm Röntgen discovered the X-rays in the same year, and Destot felt his discovery could revolutionize the approach of anatomy and traumatology. He studied wrist, ankle and calcaneus fractures, and described a new anatomy: "traumatic anatomy". For example, he focused on the posterior talar surface hollow in posterior tarsus fractures. He proposed the term of "thalamus" for this articular surface; this term is nowadays widely used by the clinicians. He introduced the term of "third malleolus" to describe the posterior part of the distal extremity of the tibia. He was the first author to analyze the normal and pathological movements of the scaphoid bone and the lunatum in wrist extension.

  14. The Distribution of Elements in 48 Canine Compact Bone Types Using Handheld X-Ray Fluorescence.

    Science.gov (United States)

    Nganvongpanit, Korakot; Buddhachat, Kittisak; Piboon, Promporn; Klinhom, Sarisa

    2016-11-01

    A major question when we talk about the elements in the bone is whether all bones contain the same elements. To answer this question, this study was designed for determination of the elemental levels in 48 various canine compact bones using handheld X-ray fluorescence technique. From a total of 26 elements that could be detected, only 13 elements were found in all 48 bones. The sternum and os penis were significantly different from the other bones in that they contained the highest number of elements. The ratio of Ca and P was significantly different when comparing certain bones: there was a higher Ca/P ratio in the patella (right), calcaneus (right and left), and sternum compared with a lower ratio in the radius (left), rib (left), phalanx (left forelimb), and carpus (left). These results are the first to demonstrate that different types of bones have different elemental profiles, even for major elements such as Ca and P. Moreover, the Ca/P ratio was also different between bone types. This data is important for the selection of bones appropriate to the element studied. In addition, the results proved that the elements were not equally distributed in every bone in the body.

  15. QUS of phalanx, DXA, BMD, Osteoporosis

    Directory of Open Access Journals (Sweden)

    A Soltani

    2004-03-01

    Full Text Available DXL of calcaneus is a portable method for BMD. This study determined a cut off point for DXL in osteoporosis diagnosis. In 510 healthy postmenopausal women, BMD of axial regions with DXA (DPX-MD, GE,Lunar Corp, Madison, WI and heel with DXL (Demeteck- Sweden, measured. The agreement of two methods and cut off point for DXL in defining osteoporosis, obtained. DXA found osteoporosis in 34.3% and in DXL in 26.1% of cases. Agreement (Kappa was 0.407 for spine and 0.347 for femur. T-score = -1.8 for spine and T-score = -2.2 for femur were the cut off points of DXL in diagnosis of osteoporosis (sensitivity=84% specificity=60% and (sensitivity=84% and specificity=70%, respectively. Area under curve for regions were 0.807 (P=0.000 and 0.859 (P=0.000, respectively. These results mean DXL can not be used as a replacement for DXA, but it may can be used as a screening method for osteoporosis.

  16. QUS of phalanx, DXA, BMD, Osteoporosis

    Directory of Open Access Journals (Sweden)

    A Soltani

    2004-11-01

    Full Text Available DXL of calcaneus is a portable method for BMD. This study determined a cut off point for DXL in osteoporosis diagnosis. In 510 healthy postmenopausal women, BMD of axial regions with DXA (DPX-MD, GE,Lunar Corp, Madison, WI and heel with DXL (Demeteck- Sweden, measured. The agreement of two methods and cut off point for DXL in defining osteoporosis, obtained. DXA found osteoporosis in 34.3% and in DXL in 26.1% of cases. Agreement (Kappa was 0.407 for spine and 0.347 for femur. T-score = -1.8 for spine and T-score = -2.2 for femur were the cut off points of DXL in diagnosis of osteoporosis (sensitivity=84% specificity=60% and (sensitivity=84% and specificity=70%, respectively. Area under curve for regions were 0.807 (P=0.000 and 0.859 (P=0.000, respectively. These results mean DXL can not be used as a replacement for DXA, but it may can be used as a screening method for osteoporosis.

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

    Directory of Open Access Journals (Sweden)

    B Larijani

    2004-03-01

    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.

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

    Science.gov (United States)

    Martinkevich, P.; Rahbek, O.; Møller-Madsen, B.; Søballe, K.; Stilling, M.

    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 osteotomy (LCLO). Methods LCLO was performed in six fixed adult cadaver feet. Tantalum markers were inserted on each side of the osteotomy and in the cuboideum. Lengthening was done with a plexiglas wedge. A total of 24 radiological double examinations were obtained. Two feet were excluded due to loose and 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 evaluation of stability in LCLO. Cite this article: Bone Joint Res 2015;4:78–83. PMID:25957380

  19. Medial displacement calcaneal osteotomy with posterior tibial tendon reconstruction for the flexible flatfoot with symptomatic accessory navicular.

    Science.gov (United States)

    Cao, Hong-Hui; Tang, Kang-Lai; Lu, Wei-Zhong; Xu, Jian-Zhong

    2014-01-01

    We investigated the clinical outcomes after medial displacement calcaneal osteotomy with reconstruction of the posterior tibial tendon insertion on the navicular, in patients with flexible flatfoot with accessory navicular symptoms. From December 2008 to July 2011, 16 patients (21 feet) with a flexible flatfoot, symptomatic accessory navicular, and obvious heel valgus underwent medial displacement calcaneal osteotomy and reconstruction with posterior tibial tendon insertion on the navicular bone. The patients were evaluated preoperatively, 6 weeks and 3, 6, and 12 months postoperatively, and every 6 months thereafter. The clinical examination was undertaken using the American Orthopaedic Foot and Ankle Society ankle and midfoot scores. The radiologic assessments included the arch height, calcaneus inclination angle, talocalcaneal angle, and talar first metatarsal angle on the lateral weightbearing radiograph. The talocalcaneal angle and talar first metatarsal angle was assessed on the anteroposterior view of the weightbearing foot. Heel valgus alignment was assessed on the axial hindfoot radiographs. The mean follow-up duration was 28.5 months (range 18 to 48). All patients were satisfied with the clinical results and were pain free 6 months postoperatively. No cases of wound infection or nerve injury developed. The mean American Orthopaedic Foot and Ankle Society score improved from 53.3 ± 6.5 to 90.8 ± 1.4 at the last follow-up visit (p flatfoot with symptomatic accessory navicular, associated with excellent clinical outcomes and correction of the deformity.

  20. Automatic Detection of Calcaneal-Fifth Metatarsal Angle Using Radiograph: A Computer-Aided Diagnosis of Flat Foot for Military New Recruits in Taiwan.

    Directory of Open Access Journals (Sweden)

    Chin-Hua Yang

    Full Text Available Flatfoot (pes planus is one of the most important physical examination items for military new recruits in Taiwan. Currently, the diagnosis of flatfoot is mainly based on radiographic examination of the calcaneal-fifth metatarsal (CA-MT5 angle, also known as the arch angle. However, manual measurement of the arch angle is time-consuming and often inconsistent between different examiners. In this study, seventy male military new recruits were studied. Lateral radiographic images of their right and left feet were obtained, and mutual information (MI registration was used to automatically calculate the arch angle. Images of two critical bones, the calcaneus and the fifth metatarsal bone, were isolated from the lateral radiographs to form reference images, and were then compared with template images to calculate the arch angle. The result of this computer-calculated arch angle was compared with manual measurement results from two radiologists, which showed that our automatic arch angle measurement method had a high consistency. In addition, this method had a high accuracy of 97% and 96% as compared with the measurements of radiologists A and B, respectively. The findings indicated that our MI registration measurement method cannot only accurately measure the CA-MT5 angle, but also saves time and reduces human error. This method can increase the consistency of arch angle measurement and has potential clinical application for the diagnosis of flatfoot.

  1. Automatic Detection of Calcaneal-Fifth Metatarsal Angle Using Radiograph: A Computer-Aided Diagnosis of Flat Foot for Military New Recruits in Taiwan

    Science.gov (United States)

    Yang, Chin-Hua; Chou, Kuei-Ting; Chung, Mu-Bai; Chuang, K. S.; Huang, Tzung-Chi

    2015-01-01

    Flatfoot (pes planus) is one of the most important physical examination items for military new recruits in Taiwan. Currently, the diagnosis of flatfoot is mainly based on radiographic examination of the calcaneal-fifth metatarsal (CA–MT5) angle, also known as the arch angle. However, manual measurement of the arch angle is time-consuming and often inconsistent between different examiners. In this study, seventy male military new recruits were studied. Lateral radiographic images of their right and left feet were obtained, and mutual information (MI) registration was used to automatically calculate the arch angle. Images of two critical bones, the calcaneus and the fifth metatarsal bone, were isolated from the lateral radiographs to form reference images, and were then compared with template images to calculate the arch angle. The result of this computer-calculated arch angle was compared with manual measurement results from two radiologists, which showed that our automatic arch angle measurement method had a high consistency. In addition, this method had a high accuracy of 97% and 96% as compared with the measurements of radiologists A and B, respectively. The findings indicated that our MI registration measurement method cannot only accurately measure the CA–MT5 angle, but also saves time and reduces human error. This method can increase the consistency of arch angle measurement and has potential clinical application for the diagnosis of flatfoot. PMID:26126115

  2. The Effect of Physical Activity on Bone Density in Military Personnel

    Directory of Open Access Journals (Sweden)

    Iman Mokhtari Garakani

    2016-12-01

    Full Text Available Objective: The aim of this study was to assess the effect of life style factors including physical activity, calcium intake, and smoking on bone mineral density (BMD. Materials and Methods: From January 2012 to May 2013, calcaneal BMD of 335 male military personnel (aged between 35-55 years in two equal separate groups; operative (active field soldiers and non-operative (official army staff were evaluated with dual X-ray and laser Calscan. Information about lifestyle factors including smoking, calcium intake and physical activity were collected through a questionnaire. Operative personnel had daily regular physical activity. Operatives were compared with non-operative personnel who did not perform the regular active field training maneuvers. Results: The mean age of participant was 44.7±0.5 years and all were male. The rate of osteopenia and osteoporosis was lower in operative group than in non-operative group. Linear regression revealed that BMD is significantly associated with job (p<0.001, age (p<0.001, smoking (p<0.01, calcium intake (p<0.05, and years of physical activity (p<0.001. Conclusion: Based on the findings of the study, years of regular physical activity and mechanical loading were the strongest predictors of calcaneus BMD.

  3. Differences in foot kinematics between young and older adults during walking.

    Science.gov (United States)

    Arnold, John B; Mackintosh, Shylie; Jones, Sara; Thewlis, Dominic

    2014-02-01

    Our understanding of age-related changes to foot function during walking has mainly been based on plantar pressure measurements, with little information on differences in foot kinematics between young and older adults. The purpose of this study was to investigate the differences in foot kinematics between young and older adults during walking using a multi-segment foot model. Joint kinematics of the foot and ankle for 20 young (mean age 23.2 years, standard deviation (SD) 3.0) and 20 older adults (mean age 73.2 years, SD 5.1) were quantified during walking with a 12 camera Vicon motion analysis system using a five segment kinematic model. Differences in kinematics were compared between older adults and young adults (preferred and slow walking speeds) using Student's t-tests or if indicated, Mann-Whitney U tests. Effect sizes (Cohen's d) for the differences were also computed. The older adults had a less plantarflexed calcaneus at toe-off (-9.6° vs. -16.1°, d = 1.0, p = Walking speed did not influence these differences, as they remained present when groups walked at comparable speeds. The findings of this study indicate that independent of walking speed, older adults exhibit significant differences in foot kinematics compared to younger adults, characterised by less propulsion and reduced mobility of multiple foot segments.

  4. Individual metatarsal and forefoot kinematics during walking in people with diabetes mellitus and peripheral neuropathy.

    Science.gov (United States)

    DiLiberto, Frank E; Tome, Josh; Baumhauer, Judith F; Houck, Jeff; Nawoczenski, Deborah A

    2015-10-01

    The purpose of this study was to compare in-vivo kinematic angular excursions of individual metatarsal segments and a unified forefoot segment in people with Diabetes Mellitus and peripheral neuropathy (DMPN) without deformity or ulceration to a healthy matched control group. Thirty subjects were recruited. A five- segment foot model (1st, 3rd, and 5th metatarsals, calcaneus, tibia) was used to examine relative 3D angular excursions during the terminal stance phase of walking. Student t-tests were used to assess group differences in kinematics. Pearson correlations and cross-correlations were used to assess relationships between the motion of the individual metatarsals and the unified forefoot. Significant reductions of DMPN group sagittal plane angular excursions were detected in all individual metatarsals and the unified forefoot (p study illustrates that multiple individual metatarsals have reduced motion in people with DMPN. Differences in the magnitude and coupling between individual metatarsal motion and unified forefoot motion supports the use of a two segment forefoot modeling approach in future kinematic analyses. Further study is recommended to determine if the observed kinematic profile is related to the development and location of deformity and tissue breakdown in people with DMPN.

  5. Foot bone kinematics as measured in a cadaveric robotic gait simulator.

    Science.gov (United States)

    Whittaker, Eric C; Aubin, Patrick M; Ledoux, William R

    2011-04-01

    The bony motion of the foot during the stance phase of gait is useful to further our understanding of joint function, disease etiology, injury prevention and surgical intervention. In this study, we used a 10-segment in vitro foot model with anatomical coordinate systems and a robotic gait simulator (RGS) to measure the kinematics of the tibia, talus, calcaneus, cuboid, navicular, medial cuneiform, first metatarsal, hallux, third metatarsal, and fifth metatarsal from six cadaveric feet. The RGS accurately reproduced in vivo vertical ground reaction force (5.9% body weight RMS error) and tibia to ground kinematics. The kinematic data from the foot model generally agree with invasive in vivo descriptions of bony motion and provides the most realistic description of bony motion currently available for an in vitro model. These data help to clarify the function of several joints that are difficult to study in vivo; for example, the combined range of motion of the talonavicular, naviculocuneiform, metatarsocuneiform joints provided more sagittal plane mobility (27.4°) than the talotibial joint alone (23.2°). Additionally, the anatomical coordinate systems made it easier to meaningfully determine bone-to-bone motion, describing uniplanar motion as rotation about a single axis rather than about three. The data provided in this study allow for many kinematic interpretations to be made about dynamic foot bone motion, and the methodology presents a means to explore many invasive foot biomechanics questions under near-physiologic conditions.

  6. Correlates between kinematics and baropodometric measurements for an integrated in-vivo assessment of the segmental foot function in gait.

    Science.gov (United States)

    Giacomozzi, Claudia; Leardini, Alberto; Caravaggi, Paolo

    2014-08-22

    Baropodometry and multi-segmental foot kinematics are frequently employed to obtain insight into the mechanics of the foot-ground interaction in both basic research and clinical settings. However, nothing hitherto has been reported on the full integration of kinematics with baropodometric parameters, and only a few studies have addressed the association between intersegmental kinematics and plantar loading within specific foot regions. The aim of this study was to understanding the relationships between foot joint mobility and plantar loading by focusing on the correlation between these two measures. An integrated pressure-force-kinematics system was used to measure plantar pressure and rotations between foot segments during the stance phase of walking in 10 healthy subjects. An anatomically-based mask was applied to each footprint to obtain six regions according to the position of the markers; hence each kinematic segment was paired with a corresponding area of the plantar surface. Relationships between segmental motion and relevant baropodometric data were explored by means of correlation analysis. Negative, weak-to-moderate correlations (R(2)segmental range of motion across all foot joints except the Calcaneus-Midfoot. Temporal profiles of sagittal-plane kinematics and baropodometric parameters were well correlated, particularly at the ankle joint. Larger motion in the foot joints during walking was associated with lower plantar pressure in almost all regions. The study helps improve our understanding of the relationship between joint mobility and plantar loading in the healthy foot and represents a critical preliminary analysis before addressing possible clinical applications.

  7. 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.

  8. A comparison of bone mineral densities and body composition between Southeast Asia college students and Chinese college students.

    Science.gov (United States)

    Liu, Peng; Ye, Ziliang; Lu, Jingjing; Lu, Haili; Guan, Liping; Teng, Zhihai; Gao, Shangzhi; Li, Mingyi

    2016-09-01

    The aim of this study was to compare bone mineral densities (BMDs) and body composition between Southeast Asia college students and Chinese college students, in order to provide a certain reference enhancing college students' physical fitness.A total of 1694 Chinese college students (294 men and 1400 women, aged 18-22 years) and 250 Southeast Asia college students (148 men and 102 women, aged 19-22 years) were included in the study. Weight, height, and body mass index were measured anthropometrically. BMD values were determined by ultrasound bone densitometer and body composition was determined by body composition analyzer.Southeast Asia college students were overweight than Chinese college students (250 vs 1694) (P college students had a significantly lower body weight, fat mass, lean tissue mass, lean body weight, estimation of bone mass, protein, and metabolic rate but higher BMD at the calcaneus compared with Southeast Asia college students (P college students and Southeast Asia college students (P > 0.01 for all parameters).The results of this cross-sectional study suggest that Chinese college students had a higher BMD but lower body composition than Southeast Asia college students, which may be associated with genes, diet, exercise, and other factors.

  9. Tendon Graft and Platelet Concentrate for Chronic Achilles Tendon Rupture. A Case Report

    Directory of Open Access Journals (Sweden)

    Yovanny Ferrer Lozano

    2015-12-01

    Full Text Available Achilles tendon is third most common tendon torn, following the rotator cuff and the quadriceps extensor mechanism. Ruptures can be partial or complete and their etiology is multifactorial. We present the case of a 63-year-old woman who attended the Orthopedics service because of discomfort when walking that had been present for several months and persistent pain in his right heel related to an acetonide triamcinolone injection into the back of the calcaneus. The gap in the tendon (hatchet strike defect and a Thompson test confirmed the Achilles tendon rupture. The tendon was repaired using a peroneus brevis tendon graft and the repair was reinforced with gastrocnemius aponeurosis. The skin flap necrosis led to conservative debridement, graft exposure, and daily application of a platelet lysate, which was subsequently alternated due to the successful formation of the scar tissue. Epithelialization was reached in the fourth postoperative week. Twelve weeks after surgery, the patient began to resume her normal life. The use of platelet concentrates as adjuvant therapy is rare in these patients. For this reason, we decided to publish this case.

  10. 足部生物力学模拟的有限元方法%Finite Element Method on Foot-biomechanics Simulation

    Institute of Scientific and Technical Information of China (English)

    石俊; 姜寿山; 张欣; 陈翔

    2006-01-01

    针对1999年以来的研究,从足部疾病、步态分析、踝关节生物力学、跟骨应力分布、鞋垫对足底影响等方面的应用研究以及足部有限元建模方面进行综述.提出未来研究的重点.分析当前研究的困难和不足.指出困难在于足部结构的合理定义和适用的有限元方法,不足是缺乏多学科的协同工作和足部结构动态模拟时没有应用柔性多体系统动力学.%Researches were summarized from 1999 including application-researches on foot-disorders, gait-analysis, ankle-biomechanics, calcaneus-stress distribution and insole-effects on plantar, and finite element (FE) modeling for foot. Research-emphases are proposed in the future. Research difficulties are analyzed including model properly defined and applicable finite element method (FEM) for foot-structures, and research deficiencies are pointed out including without collaborative works of multi-subjects and on dynamic simulation for foot-structures without application of flexible multibody-systems dynamics.

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

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    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.

  12. Syringing method as an alternative to Śṛṇga therapy in Vātakaṇṭaka

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    Suma Joshi

    2014-01-01

    Full Text Available Calcaneus forms the bone of the foot. Due to abnormal pressures, foot muscles and ligaments are stretched beyond their normal limits that lead to chronic plantar heel pain, among which calcaneal spur tops the list. In Ayurveda, it can be correlated to "Vātakaṇṭaka" (pricking sensation in the foot-a painful condition of heel caused by its improper placement on the ground. To assess the effect of syringing method (modified Śṛṅga in the treatment of Vātakaṇṭaka. A 10 ml syringe was for ease, hygiene, and to enable the case to be managed in the outpatient department. A diagnosed case of calcaneal spurs with pain, tenderness, and swelling visited KLE University′s Shri BMK Ayurveda Hospital and Research Centre, Belgaum, Karnataka, India. After Snigdha Patrapoṭṭali sveda (a form of sudation therapy, bloodletting was performed by syringing method. In total procedure was performed for 4 times on the patient. Marked subjective relief was observed. Pain from 8 visual analog scale (VAS came to 2 visual analog scale (VAS and tenderness and swelling relived completely.

  13. Preditores espaço-temporais do andar para testes de capacidade funcional em pacientes com doença de Parkinson Gait spatial and temporal predictors for functional capacity tests in Parkinson's disease patients

    Directory of Open Access Journals (Sweden)

    MDR Sánchez-Arias

    2008-10-01

    Full Text Available OBJETIVOS: Determinar quais parâmetros espaço-temporais são preditores do andar de indivíduos com doença de Parkinson idiopática para os testes de resistência aeróbia e agilidade, propostos pela bateria de testes da American Alliance for Health, Physical Education, Recreation and Dance (AAHPERD. MATERIAIS E MÉTODOS: Foram selecionados seis homens e seis mulheres com comprometimento e estágio da doença em níveis leve e moderado, que realizaram os testes de agilidade e resistência aeróbia, conforme o protocolo da AAHPERD, e andaram 8m sobre uma passarela. Uma câmera digital registrou uma passada central. Marcadores foram fixados no quinto metatarso e na face lateral do calcâneo do membro inferior direito e no primeiro metatarso e na face medial do calcâneo do membro inferior esquerdo. As variáveis dependentes selecionadas foram: tempo nos testes de agilidade e resistência e as variáveis cinemáticas (comprimento da passada - CP, cadência - CAD, duração da passada - DP, duração da fase de duplo suporte - DDS, duração do suporte simples - SS, duração da fase de balanço - DB e velocidade da passada - VP. RESULTADOS: Para agilidade, o teste de Pearson apontou correlação estatisticamente significativa entre as variáveis CP (r=-0,70; pOBJECTIVE: To determine which spatial and temporal parameters are predictors of the gait pattern of individuals with idiopathic Parkinson's disease, for the aerobic endurance and agility tests included in the battery of tests of the AAHPERD protocol. METHODS: Six men and six women with mild and moderate impairment and disease stage were selected. They performed agility and aerobic endurance test in accordance with the AAHPERD protocol, and walked 8 m on a walkway. A digital video camera recorded one central stride. Markers were attached to the fifth metatarsal and lateral face of the calcaneus of the right leg and to the first metatarsal and medial face of the calcaneus of the left leg. The

  14. 老年糖尿病女性骨质健康状况及干预情况分析%Analysis of bone health status and intervention in elderly women with type 2 diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    马艳芬; 刘薇

    2012-01-01

    目的 探讨60岁以上老年女性2型糖尿病(type 2 diabetes mellitus,T2DM)患者与非糖尿病患者骨量、骨代谢标志物骨钙素和骨碱性磷酸酶和血清钙、血清磷及其他骨量相关指标的差异,对糖尿病骨病目前的治疗状况进行分析,为糖尿病骨量异常的治疗提供依据.方法 用超声测量40例60岁以上老年女性非糖尿病患者及46例老年女性糖尿病患者的跟骨骨密度,并检测两组人群的血清钙、血清无机磷、骨质疏松生化标志物骨钙素和骨碱性磷酸酶.结果 糖尿病组的跟骨骨密度,血清钙均低于非糖尿病人群,骨钙素和骨碱性磷酸酶高于非糖尿病组,二者比较有统计学意义.结论 60岁以上老年女性糖尿病患者骨量丢失显著重于同龄非糖尿病人群,对糖尿病性骨量减低的干预和治疗应给予足够重视,以期尽量减少和避免骨折等严重并发症的发生.%Objective To explore the differences of bone quality, bone Gla protein, bone alkaline phosphatase ( BALP ), serum calcium, and serum phosphorus among elderly women who were more than 60 years old with or without type 2 diabetes mellitus. To analyze current treatment of diabetic bone diseases, in order to provide basis for the treatment of aberrant bone mass due to diabetes mellitus. Methods Bone mineral density ( BMD ) of calcaneus in 40 elderly women without diabetes mellitus and 46 elderly women with type 2 diabetes mellitus was measured using ultrasound. The concentrations of serum calcium, serum phosphorus, and osteoporotic biomarkers such as bone Gla protein and BALP were tested in both groups. Results BMD of calcaneus and serum calcium in diabetes group was lower than that in non-diabetes group. But bone Gla protein and BALP in diabetes group were higher than those in non-diabetes group ( P <0. 05 ). Conclusion The bone mass loss in elderly patients who were more than 60 years old with diabetes mellitus was significantly severer than that

  15. 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

  16. Seventeen Cases of Calcaneal Tumors and Tumor-like Lesions%跟骨肿瘤与瘤样病变17例

    Institute of Scientific and Technical Information of China (English)

    张智长; 杨庆诚; 董扬; 曾炳芳

    2011-01-01

    目的 足踝部肿瘤尤其是跟骨肿瘤非常少见,多数临床医师对跟骨肿瘤认识较少,延误诊断和治疗不当很常见.总结并回顾我院治疗的跟骨肿瘤病例及相关文献,评价其诊断及治疗方法.方法 自2003年1月至2007年12月共收治17 例跟骨原发肿瘤,其中男性13 例,女性4 例;年龄13~67 岁,平均年龄31.5 岁.均行病灶刮除植骨术.结果 术后病理证实,跟骨脂肪瘤7 例(8足),软骨母细胞瘤6 例(6足,其中5 例继发动脉瘤样骨囊肿),单纯性骨囊肿2 例(2足),骨内腱鞘囊肿2 例(2足).17 例均获随访,随访时间29~76个月,平均52个月.术后均无复发病例.结论 跟骨肿瘤少见,多为良性,原发或转移性恶性肿瘤罕见.诊断依赖于临床表现、影像学检查和病理检查,多数肿瘤通过临床表现、影像学检查可以明确性质.对良性肿瘤可以随访观察,常规手术方案为经外侧入路行病灶刮除植骨.恶性肿瘤多采取膝下截肢.%Objective Tumors occurred in foot and ankle especially in heel are rare, most clinicians know little of the calcaneal tumors,delayed diagnosis and improper treatment are common. So,review to our hospital for treatment of calcaneal tumor cases,review and summarize the literature and evaluate its diagnostic and treatment methods. Methods Sinccan 2003 to Dec2007,17 cases of primary calcaneal tumors,including 13 males and 4 females,average age 31.5 years,underwent curettage and bone graft. Results Pathologically confirmed,calcaneus lipoma in 7 patients (8 feet), 6 cases of chondroblastoma (6 feet), 5 patients with secondary aneurysmal bone cyst,simple bone cyst in 2cases(2 feet),bone Ganglion cyst in 2 patients (2 feet). 17 cases were followed up for 29-76 months (mean 52 months). There was no recurrence. Conclusion Tumors occurred in calcaneus are rare,most are benign,primary or metastatic malignancy are rare. Diagnosis depends on clinical manifestations,imaging and pathological

  17. 足底主要韧带损伤对足纵弓应力分布的影响%Longitudinal arch stress distribution of the foot following plantar ligament injury

    Institute of Scientific and Technical Information of China (English)

    杨云峰; 俞光荣; 周家钤; 陈雁西; 袁锋; 贾永伟; 牛文鑫; 丁祖泉

    2008-01-01

    目的 测量尸体足纵弓主要骨结构的应力分布,分析韧带损伤对其应力的影响.方法 7例正常成人新鲜尸体足标本,解剖显露足底跖筋膜、弹簧韧带、跖长韧带、跖短韧带,标记足纵弓主要骨结构.经电子万能试验机逐级加载至700 N,利用静态电阻应变测试仪和微型箔式电阻应变片,测量足底韧带损伤情况下足纵弓骨结构的表面应力,对结果进行统计学分析.结果 在足底韧带损伤前,最大应力值出现在跟骨,其次是第三跖骨、第二跖骨,均为压应力;而舟骨、腓骨、胫骨主要表现为拉应力.不同足底韧带损伤情况下骨结构表面应力差异有统计学意义(P<0.05).结论 足底韧带损伤后,足纵弓骨结构的表面应力分布将发生改变.%Objective To measure stress distribution of the main bone architecture of the normal adult cadaveric foot and discuss the effect of plantar ligament injury on stress distribution. Methods Seven fresh adult cadaveric feet were used and 10 strain gauges attached to the bones of the longitudinal foot arch,including the calcaneus,navicular,medial cuneiform,1-5 metatarsal trunk,the distal part of the tibia and fibular,respectively.After the loading Was added to 700 N by almighty test machine,resistance strainmeter was used to measure surface strain of these bones.The results were processed statistically. Results The strain was varied based on different bone segments attached and increased with loading.Tensile force was always found at the medial part of the navicular,the distal part of the tibia and fibular,while the others showed compression all the time.Peak strain was found at calcaneus.followed by the second and third metatarsal.Strain on the surface of the bone segments changed greatly with different ligament injury(P<0.05).Conclusion The bone surface stress of the longitudinal foot arch changes significantly when the plantar ligament is injured.

  18. 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.

  19. Medially posted insoles consistently influence foot pronation in runners with and without anterior knee pain.

    Science.gov (United States)

    Rodrigues, Pedro; Chang, Ryan; TenBroek, Trampas; Hamill, Joseph

    2013-04-01

    Anterior knee pain (AKP) is a common injury among runners and effectively treated with posted insoles and foot orthotics. While clinically effective, the underlying biomechanical mechanisms that bring about these improvements remain debatable. Several methodological factors contribute to the inconsistent biomechanical findings, including errors associated with removing and reattaching markers, inferring foot motion from markers placed externally on a shoe, and redefining segmental coordinate systems between conditions. Therefore, the purpose of this study was to evaluate the influence of medially posted insoles on lower extremity kinematics in runners with and without AKP while trying to limit the influence of these methodological factors. Kinematics of 16 asymptomatic and 17 runners with AKP were collected while running with and without insoles. Reflective markers were attached to the surface of the calcaneus and kept in place (as opposed to detached) between conditions, eliminating the error associated with reattaching markers and redefining segmental coordinate systems. Using these methods, no significant interactions between insole and injury and the main effect of injury were detected (p>0.05); therefore, means were pooled across injury. Insoles, on average, reduced peak eversion by 3.6° (95% confidence interval -2.9° to -4.3°), peak eversion velocity by 53.2°/s (95% confidence interval -32.9 to -73.4) and eversion range of motion by 1.33 (95% confidence interval -0.8 to -1.9). However, while insoles systematically reduced eversion variables, they had small influences on the transverse plane kinematics of the tibia or knee, indicating that they may bring about their clinical effect by influencing other variables.

  20. Achilles Impingement Tendinopathy on Magnetic Resonance Imaging.

    Science.gov (United States)

    Bullock, Mark J; Mourelatos, Jan; Mar, Alice

    2017-02-28

    Haglund's syndrome is impingement of the retrocalcaneal bursa and Achilles tendon caused by a prominence of the posterosuperior calcaneus. Radiographic measurements are not sensitive or specific for diagnosing Haglund's deformity. Localization of a bone deformity and tendinopathy in the same sagittal section of a magnetic resonance imaging scan can assist with the diagnosis in equivocal cases. The aim of the present cross-sectional study was to determine the prevalence of Haglund's syndrome in patients presenting with Achilles tendinopathy and note any associated findings to determine the criteria for a diagnosis of Haglund's syndrome. We reviewed 40 magnetic resonance imaging scans with Achilles tendinopathy and 19 magnetic resonance imaging scans with Achilles high-grade tears and/or ruptures. Achilles tendinopathy was often in close proximity to the superior aspect of the calcaneal tuberosity, consistent with impingement (67.5%). Patients with Achilles impingement tendinopathy were more often female (p < .04) and were significantly heavier than patients presenting with noninsertional Achilles tendinopathy (p = .014) or Achilles tendon rupture (p = .010). Impingement tendinopathy occurred medially (8 of 20) and centrally (10 of 20) more often than laterally (2 of 20) and was associated with a posterior prominence or hyperconvexity with a loss of calcaneal recess more often than a superior projection (22 of 27 versus 8 of 27; p < .001). Haglund's deformity should be reserved for defining a posterior prominence or hyperconvexity with loss of calcaneal recess because this corresponds with impingement. Achilles impingement tendinopathy might be more appropriate terminology for Haglund's syndrome, because the bone deformity is often subtle. Of the 27 images with Achilles impingement tendinopathy, 10 (37.0%) extended to a location prone to Achilles tendon rupture. Given these findings, insertional and noninsertional Achilles tendinopathy are not mutually

  1. AN INVESTIGATION OF A REFERENCE POSTURE USED IN DETERMINING REARFOOT KINEMATICS FOR BOTH HEALTHY AND PATELLOFEMORAL PAIN SYNDROME INDIVIDUALS

    Directory of Open Access Journals (Sweden)

    Pazit Levinger

    2005-09-01

    Full Text Available The choice of a reference posture is important when investigating rearfoot motion in clinical populations. The reference posture used may affect the magnitude of the peak angles and therefore may not enable comparison of the rearfoot kinematics across different populations. This study examined the relationship between the rearfoot frontal plane pattern of motion and three reference postures during the stance phase of walking in healthy and patellofemoral pain syndrome (PFPS subjects. The three reference postures investigated were: Relaxed Standing posture, subtalar joint neutral position (STJN and when the calcaneus and the lower leg were vertically aligned (Vertical Alignment. The rearfoot inversion/eversion during the stance phase was measured in 14 healthy subjects and 13 subjects with diagnosed PFPS using three dimensional motion analysis with the three different reference postures. The graphs of rearfoot inversion/eversion motion were overlaid with the angle at the rearfoot in the static posture and any intersection between the static angle and rearfoot motion was noted. An ANOVA showed significant differences in static posture between the groups for Relaxed Standing (p = 0.01, and STJN (p = 0.02. For both groups, with Relaxed Standing as a reference posture, the mean rearfoot pattern of motion did not intersect the Relaxed Standing static angle during the stance phase. The use of Vertical Alignment reference posture, however, showed an intersection of this reference posture through the rearfoot pattern of motion. The use of the Vertical Alignment reference posture also generated a typical rearfoot motion pattern for both groups and therefore it may be an appropriate reference posture for both healthy and PFPS individuals

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

    Directory of Open Access Journals (Sweden)

    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.

  3. 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.

  4. 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.)

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

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    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.

  6. Types of subtalar joint facets.

    Science.gov (United States)

    Jung, Min-Ho; Choi, Byoung Young; Lee, Ji Yong; Han, Chang Sung; Lee, Jin Suk; Yang, Young Chul; Cho, Byung Pil

    2015-08-01

    Articular facets of the clinical subtalar joint (CSTJ) were analyzed using a total of 118 (right 57, left 61) dry, paired calcanei and tali from 68 Korean adult cadavers. The CSTJ facets were classified into the following three types depending on their continuity: type A, all three facets are separated; type B, the anterior and middle facets are partially connected; and type C, the anterior and middle facets are fused to form a single facet. The continuity between the anterior and middle facets was represented by the degree of separation (DS), which ranged between 2.00 (type A) and 1.00 (type C). Type A was most common (39.0 %) in calcanei and rarest (11.0 %) in tali. Matching of calcaneus-talus pairs yielded five combined types: A-A (11.0 %), A-B (28.0 %), B-B (18.6 %), B-C (13.6 %), and C-C (28.8 %). The mean DS was slightly greater in calcanei (1.53) than in tali (1.32), and decreased in the order of types A-A, A-B, B-B, B-C, and C-C. The intersecting angles between the anterior and middle facets, which are related to the mobility of the CSTJ, were inversely related to the DS. These findings indicate that the anterior and middle facets are fused more frequently in tali than in calcanei, and combinations of different CSTJ facet types (A-B, B-C) exist over 40 % of feet. Our results indicate that types with a smaller DS (such as B-C and C-C) are relatively mobile but less stable compared to those with a greater DS (such as A-A and A-B).

  7. RESULTS FROM CLINICAL AND RADIOLOGICAL FOLLOW-UP, AFTER SURGICAL TREATMENT OF CHONDROBLASTOMA

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    Penna, Valter; Toller, Eduardo Areas; Ferreira, Adriano Jander; Dias, Dante Palloni Costa

    2015-01-01

    Objectives: To evaluate the long-term clinical and radiological results from patients who underwent surgical treatment of chondroblastoma, between 2003 and 2009, by the same surgical team, using the same operative technique. Methods: A retrospective study was conducted on 12 patients with histological diagnoses of chondroblastoma, who were attended between 2003 and 2009 at the Pius XII Foundation (Barretos Cancer Hospital, Barretos, State of São Paulo). These patients underwent surgical treatment with intralesional resection of the tumor, adjuvant electrocauterization and replacement with methyl methacrylate (11 cases) or an autologous graft from the iliac crest (one case). The preoperative evaluation included physical examination, plain radiographs of the site, magnetic resonance imaging, computed axial tomography and bone scintigraphy. The patients were assessed clinically and radiologically according to a predefined protocol, with a series of plain radiographs, and a functional assessment in accordance with the Enneking functional score. Results: The average age at the time of diagnosis was 14 years and 4 months. The most frequent location affected was the distal femoral epiphysis (75%), followed by the proximal tibial epiphysis (16.6%) and the calcaneus (8.4%). There was higher prevalence among the female patients than among the male patients (3:1). In three cases, preoperative biopsy was necessary. During the follow-up, there was no evidence of local tumor recurrence, and all the patients presented an excellent functional result from the surgical technique used, with Enneking scores ranging from 20 to 30. Conclusion: Surgical treatment of chondroblastoma, using intralesional resection, adjuvant electrocauterization and replacement with methyl methacrylate or bone graft produced good results. PMID:27027054

  8. Chondroblastoma of the hands and feet

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    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.)

  9. [Ankle joint prosthesis for bone defects].

    Science.gov (United States)

    Lampert, C

    2011-11-01

    Large defects of the talus, i.e. due to tumors, large areas of osteolysis in total ankle replacement (TAR) and posttraumatic talus body necrosis are difficult to manage. The gold standard in these circumstances is still tibiocalcaneal arthrodesis with all the negative aspects of a completely rigid hindfoot. We started 10 years ago to replace the talus by a custom-made, all cobalt-chrome implant (laser sintering). The first patient with a giant cell tumor did very well but the following patients showed all subsidence of the metal talus into the tibia due to missing bony edges. Therefore, we constructed a custom-made talus (mirrored from the healthy side) and combined it with a well functioning total ankle prosthesis (Hintegra). So far we have implanted this custom-made implant into 3 patients: the first had a chondrosarcoma of the talus (1 year follow-up), the second had massive osteolysis/necrosis of unknown origin (6 months follow-up) and the third massive osteolysis following a correct TAR (2 months follow-up). The results are very encouraging as all of the patients are practically pain free and have a good range of movement (ROM): D-P flexion 15°-0-20° but less motion in the lower ankle joint: ROM P-S 5°-0-5°. No subsidence was detected in the tibia or the calcaneus. The custom-made talus combined with the Hintegra total ankle replacement will probably be an interesting alternative to a tibiocalcaneal arthrodesis in selected cases with massive defects of the talus.

  10. Polyunsaturated fatty acids and calcaneal ultrasound parameters among Inuit women from Nuuk (Greenland: a longitudinal study

    Directory of Open Access Journals (Sweden)

    Alexandra-Cristina Paunescu

    2013-06-01

    Full Text Available Background. The traditional diet of Inuit people comprises large amounts of fish and marine mammals that are rich in omega-3 polyunsaturated fatty acids (PUFAs. Results from in vitro studies, laboratory animal experiments and population studies suggest that omega-3 PUFA intake and a high omega-3/omega-6 ratio exert a positive effect on bone health. Objective. This longitudinal study was conducted to examine the relationship between omega-3 and omega-6 PUFA status and quantitative ultrasound (QUS parameters in Greenlandic Inuit women. Methods. The study included 118 Inuit women from Nuuk (Greenland, aged 49–64 years, whose QUS parameters measured at baseline (year 2000, along with PUFA status and covariates, and follow-up QUS measurements 2 years later (year 2002. QUS parameters [speed of sound (SOS; broadband ultrasound attenuation (BUA] were measured at the right calcaneus with a water-bath Lunar Achilles instrument. Omega-3 and omega-6 PUFA contents of erythrocyte membrane phospholipids were measured after transmethylation by gas chromatography coupled with a flame ionization detector. Relationships between QUS parameters and different PUFAs were studied in multiple linear regression models. Results. Increasing values of EPA, DHA and the omega-3/omega-6 PUFA ratio were associated with increased BUA values measured at follow-up (year 2002. These associations were still present in models adjusted for several confounders and covariates. We found little evidence of associations between PUFAs and SOS values. Conclusion. The omega-3 PUFA intake from marine food consumption seems to have a positive effect on bone intrinsic quality and strength, as revealed by higher BUA values in this group of Greenlandic Inuit women.

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

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    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.

  12. Osseous manifestations of SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis) syndrome.

    Science.gov (United States)

    Reith, J D; Bauer, T W; Schils, J P

    1996-11-01

    The SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome includes a complex group of disorders characterized by peculiar bone lesions, most commonly involving the anterior chest wall, and sometimes accompanied by dermatologic manifestations. The clinical and radiographic features of this syndrome are well described, but few studies have examined the histologic features of the bone lesions. We describe the clinical, radiographic, and histologic features of the osseous lesions encountered in eight patients with a clinical diagnosis of SAPHO syndrome. The patients included five female and three male patients ranging in age from 5 to 63 years (mean, 35.3 years). The most common clinical presentation was pain related to the sites of osseous involvement. Two patients also had some form of pustular dermatosis. The radiographic features of the osseous lesions varied but often suggested the possibility of a neoplasm. Nine pathologic specimens were available for review, five from the clavicle, two from the first rib, one from the calcaneus/cuboid, and one from the tibia. The histologic features varied but seemed related to the duration of the patients' musculoskeletal symptoms. Early lesions contained acute inflammation, edema, and prominent periosteal bone formation, histologically indistinguishable from ordinary bacterial osteomyelitis, whereas late lesions demonstrated markedly sclerotic bone trabeculae with prominent marrow fibrosis and only mild chronic inflammation; one of these biopsies appeared virtually identical to Paget's disease. One biopsy was performed after an intermediate duration of symptoms and contained prominent chronic inflammation only. The histologic findings in SAPHO are variable and nonspecific and may depend on the duration of disease, but it is important to recognize the spectrum of histologic changes possible in the syndrome and to realize that clinicopathologic correlation is necessary to avoid misdiagnosis and unnecessary

  13. Lactose intolerance among Malay and Orang Asli female children in selected rural Selangor and its effect on bone mineral density

    Science.gov (United States)

    Makbul, Ika Aida Aprilini; Daud, Norlida Mat; Aziz, Nurul Azrianti Abdul; Yahya, Noor Fairuzi Suhana

    2016-11-01

    Sufficient intake of calcium during childhood is very important to ensure an optimal growth and strong bones development. However, lactose intolerance (LI) may limit the intake of milk and dairy products due to the inability of the body to digest lactose to its constituents, glucose and galactose. Children in rural area were a major concern as they are commonly associated with an inadequate intake of nutrients. Hence, the objectives of this study are to determine the prevalence of LI among Malay and Orang Asli female children in rural Selangor and its association with bone mineral density (BMD). A total of 65 (39 Malay, 26 Orang Asli) female primary school students with a mean age of 10.4 ± 0.6 years old underwent hydrogen breath test and lactose tolerance test (LTT) during fasting and after ingestion of 25g lactose solution. A Wong Baker Face Pain Rating Scale (WBFPRS) was used to assess the presence of gastrointestinal (GI) symptoms during the study. LI symptoms are defined when breath H2 levels exceed 20 ppm above baseline values, an increase of postprandial blood glucose (PBG) levels of less than 1.1 mmol/L and GI symptom score is more or equal than score 2. BMD was measured in the calcaneus using QUS-2 Ultrasonometer. The result showed that 35 subjects (15 Malay, 20 Orang Asli) had a positive breath test (>20ppm). A total of 74.4% Malay and 88.5% Orang Asli children had an increase of PBG of less than 1.1 mmol/L. Both groups have low percentage (35.9 % Malay, 34.6 % Orang Asli) of GI symptoms. A total of 20.0% children (n=13, Malay=4, Orang Asli=9) was found to experience LI. Orang Asli children showed a significantly higher (pcalcium can affect bone health development needed throughout their entire life.

  14. Comparison of the Calcaneal Pitch Angle and Modified Projection Area Per Length Squared Method for Medial Longitudinal Arch Evaluation of the Foot

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    Esat Kıter2

    2012-12-01

    Full Text Available Objective: To compare the calcaneal pitch angle (CPA values measured on direct lateral radiographs of feet, and the modified projection area per length squared (PAL, which was calculated as a new method for the evaluation of the medial longitudinal arch (MLA of the foot.Material and Methods: Direct lateral radiographs of patients who had weightbearing feet radiographies for any reason except trauma were retrospectively obtained from the archives. Direct lateral radiographs of the feet were printed and a transparent sheet was placed on it. A straight line was drawn between the most plantar process of the calcaneus and the head of the first metatarsal bone for the calculation of the PAL of the MLA. Two semilunar arcs were drawn upon this straight line. PAL1 and PAL2 were estimated using a point-counting technique. The CPA, lateral talo-calcaneal angles (LTCA, and talo-first metatarsal angles (TFMA were measured. The correlations between PAL1, PAL2 of right and left feet and CPA, LTCA, and TFMA were explored.Results: Fifty patients (27 females, 23 males with a mean age of 40.12 (4-78 years were evaluated. Significant correlations were detected between PAL1, PAL2 and CPA, and TFMA for both right and left feet (p<0.05. Conclusion: A significant correlation was detected between the modified PAL method as a new technique and the standard CPA method for MLA evaluation. The PAL method is suggested as a simple and practical method for MLA evaluation.

  15. Shock wave therapy for chronic proximal plantar fasciitis.

    Science.gov (United States)

    Ogden, J A; Alvarez, R; Levitt, R; Cross, G L; Marlow, M

    2001-06-01

    Three hundred two patients with chronic heel pain caused by proximal plantar fasciitis were enrolled in a study to assess the treatment effects consequent to administration of electrohydraulicall-generated extracorporeal shock waves. Symptoms had been present from 6 months to 18 years. Each treated patient satisfied numerous inclusion and exclusion criteria before he or she was accepted into this study, which was approved by the Food and Drug Administration as a randomized, double-blind evaluation of the efficacy of shock wave therapy for this disorder. Overall, at the predetermined evaluation period 3 months after one treatment, 56% more of the treated patients had a successful result by all four of the evaluation criteria when compared with the patients treated with a placebo. This difference was significant and corroborated the fact that this difference in the results was specifically attributable to the shock wave treatment, rather than any natural improvement caused by the natural history of the condition. The current study showed that the directed application of electrohydraulic-generated shock waves to the insertion of the plantar fascia onto the calcaneus is a safe and effective nonsurgical method for treating chronic, recalcitrant heel pain syndrome that has been present for at least 6 months and has been refractory to other commonly used nonoperative therapies. This technology, when delivered using the OssaTron (High Medical Technology, Kreuz-lingen, Switzerland), has been approved by the Food and Drug Administration specifically for the treatment of chronic proximal plantar fasciitis. The results suggest that this therapeutic modality should be considered before any surgical options, and even may be preferable to cortisone injection, which has a recognized risk of rupture of the plantar fascia and recurrence of symptoms.

  16. [Surgical treatment of rupture of the plantar fascia].

    Science.gov (United States)

    Christel, P; Rigal, S; Poux, D; Roger, B; Witvoët, J

    1993-01-01

    Among the various lesions of the hindfoot in athletes, plantar fascia ruptures are not well documented and their surgical treatment is not often reported in the literature. The purpose of the current work was to more precisely define therapeutic indications and to evaluate the results of the surgical treatment based on the excision-release of the plantar fascia. Between 1986 and 1991, 19 patients (5 females, 14 males, average age 32 years) were operated on by one surgeon. All patients were either recreational or competitive athletes. The plantar fascia rupture occurred 18 times during sports activity. Surgical treatment was indicated when pain persisted despite a well conducted conservative treatment. In 17 cases, MRI allowed to plan the operative strategy by showing the fascia lesion. The patients were operated after an average of 8 months following the initial injury (6-16 months). One patient was lost for follow-up, 2 had a follow-up below 6 months, thus 16 patients were available for analysis. The clinical outcome was evaluated through persistence of pain, return to sports, and functional activity. With a 16-month average follow-up (6-51 months) it was observed that pain constantly disappeared and that 11 patients over 16 returned to the same level of sports activity after 6 months with a time-stable result. After failure of a well conducted conservative treatment, surgical treatment of plantar fascia rupture must be proposed. Surgical technique is based not only on fascia release but also on the excision of the pathological scar tissue in order to avoid the restoration of the continuity of the fascia with the calcaneus.

  17. [Achilles tendon rupture--early functional and surgical options with special emphasis on rehabilitation issues].

    Science.gov (United States)

    Knobloch, K; Thermann, H; Hüfner, T

    2007-03-01

    Achilles tendon ruptures are one end of a continuum starting with the healthy Achilles tendon via the thickened and painful tendinopathic Achilles tendon with neovascularisation to the complete tendon rupture. Often times chinolone antibiotics, cortisone therapy and valgus foot axis are associated risk factors. Incidence of Achilles tendon ruptures is estimated to be 10/100 000 per year with a mean age of 35-40 years. Physical activity is encountered in 75 % cases of Achilles tendon ruptures. Running is associated with Achilles tendinopathy as the predominant overuse injury in an analysis among 291 athletes with 10 million kilometers exposure. The Achilles tendinopathic rate was 0.016/1000 km differentiated in 0.008/1000 km mid-portion tendinopathy and 0.005/1000 km insertional tendinopathy. Achilles tendinopathy in running overuse injuries is followed by runner's knee (0.013/1000 km), shin splint (0.0104/1000 km) and plantar fasciitis (0.0054/1000 km). Dynamic ultrasound in 20 degrees plantar flexion is of utmost importance for therapeutic decision making. With an adaptation rate of 75 % or more of the ruptured tendon in 20 degrees plantar flexion and a high patient's compliance we perform an early functional conservative treatment regimen in Achilles tendon ruptures. In almost all other cases the percutaneous Achilles tendon repair is indicated, where nervus suralis lesions have to be appreciated. The vulnerable zone is 10-12 cm proximal to the calcaneus at the lateral border of the Achilles tendon with the sural nerve in close proximity with the tendon. Early functional rehabilitation is not associated with a higher risk of rerupture but with improved subjective assessments and should therefore be advocated.

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

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    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.

  19. 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

  20. Reliable measurement of 3D foot bone angles based on the frame-of-reference derived from a sole of the foot

    Science.gov (United States)

    Kim, Taeho; Lee, Dong Yeon; Park, Jinah

    2016-03-01

    Clinical management of foot pathology requires accurate and robust measurement of the anatomical angles. In order to measure a 3D angle, recent approaches have adopted a landmark-based local coordinate system to establish bone angles used in orthopedics. These measurement methods mainly assess the relative angle between bones using a representative axis derived from the morphological feature of the bone and therefore, the results can be affected by bone deformities. In this study, we propose a method of deriving a global frame-of-reference to acquire consistent direction of the foot by extracting the undersurface of the foot from the CT image data. The two lowest positions of the foot skin are identified from the surface to define the base plane, and the direction from the hallux to the fourth toe is defined together to construct the global coordinate system. We performed the experiment on 10 volumes of foot CT images of healthy subjects to verify that the proposed method provides reliable measurements. We measured 3D angles for talus-calcaneus and talus-navicular using facing articular surfaces of paired bones. The angle was reported in 3 projection angles based on both coordinate systems defined by proposed global frame-of-reference and by CT image planes (saggital, frontal, and transverse). The result shows that the quantified angle using the proposed method considerably reduced the standard deviation (SD) against the angle using the conventional projection planes, and it was also comparable with the measured angles obtained from local coordinate systems of the bones. Since our method is independent from any individual local shape of a bone, unlike the measurement method using the local coordinate system, it is suitable for inter-subject comparison studies.

  1. 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

  2. Status of bone mineral content and body composition in boys engaged in intensive physical activity

    Directory of Open Access Journals (Sweden)

    Madić Dejan

    2010-01-01

    Full Text Available Background/Aim. It is well known that physical activity has an anabolic effect on bone tissue. But there is a lack of information about the effect of intensive physical activity in childhood, particularly at the prepubertal stage. To examine the influence of training on body composition and bone mineral density we have studied a group of prepubertal soccer players as well as a group of inactive prepubertal boys at the starting phase of their peak bone mass acquisition. Methods. A total of 62 healthy prepubertal boys took part in this study. They were divided into two groups. The first one consisted of 32 soccer players (aged 10.7 ± 0.5 years, who had been playing football for at least 1 year (10-15 h per week. The second group a control group 30 boys (aged 11.2 ± 0.7 years doing 1.5 h per week physical activity at school. Body composition was assessed by a Body Fat Analyzer 'BES 200 Z'. Bone mineral density measurements of the left and the right calcaneus were done by using ultrasound densitometer 'Sahara' (Hologic, Inc., MA, USA. Results. There were significant differences between soccer players and the control group in fat mass (p = 0.01. Besides, a significant difference was determined between the group of athletes and the control group in bone mineral density of both calcaneal bones (p = 0.01. Conclusion. The results of this study confirm the significant effects of physical activity on reducing body mass and increasing bone density. Considering that football training can be very easily implemented in the broader population of children and young people, which does not apply to many other sports, it should be used more in the prevention of obesity and osteoporosis.

  3. MRI signal changes of the bone marrow in HIV-infected patients with lipodystrophy: correlation with clinical parameters

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    Garcia, Ana I.; Tomas, Xavier; Pomes, Jaume; Amo, Montserrat del [Hospital Clinic, Department of Radiology, Barcelona (Spain); Milinkovic, Ana; Perez, Inaki; Mallolas, Josep [IDIBAPS-Hospital Clinic, Department of Infectious Diseases, Barcelona (Spain); Rios, Jose [Hospital Clinic, Department of Biostatistics, Barcelona (Spain); Vidal-Sicart, Sergi [Hospital Clinic, Department of Nuclear Medicine, Barcelona (Spain)

    2011-10-15

    To assess the prevalence, imaging appearance, and clinical significance, of bone marrow MR signal changes in a group of human immunodeficiency virus (HIV)-infected patients with lipodystrophy syndrome. Twenty-eight HIV-infected patients with lipodystrophy syndrome treated with highly active antiretroviral therapy, and 12 HIV-negative controls underwent MRI of the legs. Whole-body MRI, SPECT/CT, and a complete radiographic skeletal survey were obtained in subjects with signal changes in bone marrow. MRI and clinical evaluations were reviewed 6 months after baseline to determine changes after switching from thymidine analogs (TA) to tenofovir-DF (TDF). MRI results correlated with clinical parameters. We observed foci of a serous-like pattern (low signal and no enhancement on T1-weighted, high signal on T2-weighted images) in 4 out of 28 patients (14.3%) and an intermediate signal on T1-weighted images in 4 out of 28 patients (14.3%). Serous-like lesions were located in the lower limbs and scattered in the talus, calcaneus, femurs, and humeral bones; they showed slight uptake on SPECT bone scans and were normal on CT and radiographs. Patients with serous-like lesions had significantly lower peripheral and total fat at baseline than other groups (P < 0.05). No changes at 6 months were observed on MRI, and the serous-like lesion group showed good peripheral fat recovery after changing drug treatment. A serous-like MRI pattern is observed in the peripheral skeletons of HIV-infected patients with lipodystrophy, which correlates with peripheral lipoatrophy, and should not be misdiagnosed as malignant or infectious diseases. Although the MR lesions did not improve after switching the treatment, there was evidence of lipoatrophy recovery. (orig.)

  4. RELATIONSHIP BETWEEN TRAINING VOLUME AND BONE MINERAL DENSITY CHANGES IN ELDERLY WOMEN

    Directory of Open Access Journals (Sweden)

    Juan José Rábade Espinosa

    Full Text Available ABSTRACT Introduction: Several studies have analyzed the relationship between physical activity and bone density. However, the prescription of exercise is not entirely clear as to the type, quantity and intensity. Objective: The objective of this study was to determine if there is a relationship between the amount of exercise and changes in bone mineral density. Methods: Fifty-two women, members of the Municipal Program of Physical Activity for Seniors, voluntarily underwent two ultrasonographies of the calcaneus within a 6-month interval. During this period, all physical activity was recorded. Afterwards, a lineal correlation study was carried out between the amount of exercise and bone changes, expressed as T-Score variation, first in total number of participants and then in groups. Considering the average body weight obtained for all women, two groups were created ("light" 69 kg. Later, women who had participated in less than 72% of the targeted program were excluded from both groups, and the differences between the groups "light and trained" and "heavy and trained" were analyzed. To do so, the nonparametric Mann-Whitney U test was used. Results: A significant relationship of r= -0.59 was found between the total amount of exercise and the T-Score variation in the group of women above 69 kg. Significant differences were found between the "light and trained" group and the "heavy and trained" group with respect to the variation of T-Score. Conclusion: The effect of exercise on bone mineral density is determined, somehow, by body weight. This interaction is due, possibly, to mechanical demands difference.

  5. Imaging features of foot osteoid osteoma

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    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. Association between bone stiffness and nutritional biomarkers combined with weight-bearing exercise, physical activity, and sedentary time in preadolescent children. A case-control study.

    Science.gov (United States)

    Herrmann, Diana; Pohlabeln, Hermann; Gianfagna, Francesco; Konstabel, Kenn; Lissner, Lauren; Mårild, Staffan; Molnar, Dénes; Moreno, Luis A; Siani, Alfonso; Sioen, Isabelle; Veidebaum, Toomas; Ahrens, Wolfgang

    2015-09-01

    Physical activity (PA) and micronutrients such as calcium (Ca), vitamin D (25OHD), and phosphate (PO) are important determinants of skeletal development. This case-control study examined the association of these nutritional biomarkers and different PA behaviours, such as habitual PA, weight-bearing exercise (WBE) and sedentary time (SED) with bone stiffness (SI) in 1819 2-9-year-old children from the IDEFICS study (2007-2008). SI was measured on the calcaneus using quantitative ultrasound. Serum and urine Ca and PO and serum 25OHD were determined. Children's sports activities were reported by parents using a standardised questionnaire. A subsample of 1089 children had accelerometer-based PA data (counts per minute, cpm). Moderate-to-vigorous PA (MVPA) and SED were estimated. Children with poor SI (below the 15th age-/sex-/height-specific percentile) were defined as cases (N=603). Randomly selected controls (N=1216) were matched by age, sex, and country. Odds ratios (OR) for poor SI were calculated by conditional logistic regression for all biomarkers and PA behaviour variables separately and combined (expressed as tertiles and dichotomised variables, respectively). ORs were adjusted for fat-free mass, dairy product consumption, and daylight duration. We observed increased ORs for no sports (OR=1.39, pnutritional biomarkers appear to play a minor role compared to the osteogenic effect of PA and WBE, it is noteworthy that the highest risk for poor SI was observed for no sports or low MVPA combined with lower serum Ca (<2.5 mmol/l) or lower 25OHD (<43.0 nmol/l).

  7. A method to investigate the effect of shoe-hole size on surface marker movement when describing in-shoe joint kinematics using a multi-segment foot model.

    Science.gov (United States)

    Bishop, Chris; Arnold, John B; Fraysse, Francois; Thewlis, Dominic

    2015-01-01

    To investigate in-shoe foot kinematics, holes are often cut in the shoe upper to allow markers to be placed on the skin surface. However, there is currently a lack of understanding as to what is an appropriate size. This study aimed to demonstrate a method to assess whether different diameter holes were large enough to allow free motion of marker wands mounted on the skin surface during walking using a multi-segment foot model. Eighteen participants underwent an analysis of foot kinematics whilst walking barefoot and wearing shoes with different size holes (15 mm, 20mm and 25 mm). The analysis was conducted in two parts; firstly the trajectory of the individual skin-mounted markers were analysed in a 2D ellipse to investigate total displacement of each marker during stance. Secondly, a geometrical analysis was conducted to assess cluster deformation of the hindfoot and midfoot-forefoot segments. Where movement of the markers in the 15 and 20mm conditions were restricted, the marker movement in the 25 mm condition did not exceed the radius at any anatomical location. Despite significant differences in the isotropy index of the medial and lateral calcaneus markers between the 25 mm and barefoot conditions, the differences were due to the effect of footwear on the foot and not a result of the marker wands hitting the shoe upper. In conclusion, the method proposed and results can be used to increase confidence in the representativeness of joint kinematics with respect to in-shoe multi-segment foot motion during walking.

  8. Three-dimensional finite element analysis of the foot during standing--a material sensitivity study.

    Science.gov (United States)

    Cheung, Jason Tak-Man; Zhang, Ming; Leung, Aaron Kam-Lun; Fan, Yu-Bo

    2005-05-01

    Information on the internal stresses/strains in the human foot and the pressure distribution at the plantar support interface under loading is useful in enhancing knowledge on the biomechanics of the ankle-foot complex. While techniques for plantar pressure measurements are well established, direct measurement of the internal stresses/strains is difficult. A three-dimensional (3D) finite element model of the human foot and ankle was developed using the actual geometry of the foot skeleton and soft tissues, which were obtained from 3D reconstruction of MR images. Except the phalanges that were fused, the interaction among the metatarsals, cuneiforms, cuboid, navicular, talus, calcaneus, tibia and fibula were defined as contact surfaces, which allow relative articulating movement. The plantar fascia and 72 major ligaments were simulated using tension-only truss elements by connecting the corresponding attachment points on the bone surfaces. The bony and ligamentous structures were embedded in a volume of soft tissues. The encapsulated soft tissue was defined as hyperelastic, while the bony and ligamentous structures were assumed to be linearly elastic. The effects of soft tissue stiffening on the stress distribution of the plantar surface and bony structures during balanced standing were investigated. Increases of soft tissue stiffness from 2 and up to 5 times the normal values were used to approximate the pathologically stiffened tissue behaviour with increasing stages of diabetic neuropathy. The results showed that a five-fold increase in soft tissue stiffness led to about 35% and 33% increase in the peak plantar pressure at the forefoot and rearfoot regions, respectively. This corresponded to about 47% decrease in the total contact area between the plantar foot and the horizontal support surface. Peak bone stress was found at the third metatarsal in all calculated cases with a minimal increase of about 7% with soft tissue stiffening.

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

    Directory of Open Access Journals (Sweden)

    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.

  10. Multiple bony lesions other than femoral heads on {sup 99m}Tc-MDP bone scan in patients with avascular necrosis of the femoral head

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Yun Young; Yang, Seoung Oh; Moon, Dae Hyuk; Ryu, Jin Sook; Weon, Young Cheol; Shin, Myung Jin; Lee, Soo Ho; Lee, Hee Kyung [Asan Medical Center, Ulsan Univ. College of Medicine, Ulsan (Korea, Republic of); Chun, Hae Kyung [St. Francisco Hospital, Seoul (Korea, Republic of)

    1997-03-01

    To evaluate the clinical significance of the multiple increased uptake lesions other than in femoral heads as seen on whole body bone scan in patients with avascular necrosis of femoral heads. One hundred and seventy three patients with clinical diagnosis of avascular necrosis of the emoral head underwent a bone scan using Tc-99m MDP. Increased uptake lesions other than in femoral heads were evaluated, including frequency and common sites of in volvement, and correlated with clinical information and plain radiographic findings. Two hundred patients without AVN, who had undergone a bone scan, were included as a control group. Increased uptake lesions in extrafemoral head locations were found in 36 of 173 patients(20.8%); the location of 79 lesions was other than the femoral head. This result is statistically different from patients without avascular necrosis of femoral head(p<0.0001). The most common site of involvement was the knee joint area(62.5%). Other lesions were located in the mid-shafts of the long bones of the lower extremities, calcaneus, proximal humerus, etc., in order of decreasing frequency. Plain radiographs of 17 lesions were nonspecific, except for three lesions showing definite changes associated with avascular necrosis. The risk factors included alcoholism, the prolonged use of steroids, renal transplantation, herbal medication and working as a working as deep-sea diver. Most patients did not complain of pain, except for two with irreversible osteonecrotic changes as seen on plain radiograph. in patients with avascular necrosis of the femur, increased uptake lesions other than in the femoral head as seen on bone scan, may represent the early stage of osteonecrosis, which shows a characteristic appearance on bone scan. In order to aveid possible misdiagnoses of multiple extrafemoral lesions as bony metastasis or traumatic lesions, in patients with avascular necrosis of the femur these should be carefully evaluated.

  11. Rabbit Achilles tendon full transection model – wound healing, adhesion formation and biomechanics at 3, 6 and 12 weeks post-surgery

    Science.gov (United States)

    Meier Bürgisser, Gabriella; Calcagni, Maurizio; Bachmann, Elias; Fessel, Gion; Snedeker, Jess G.; Giovanoli, Pietro

    2016-01-01

    ABSTRACT After tendon rupture repair, two main problems may occur: re-rupture and adhesion formation. Suitable non-murine animal models are needed to study the healing tendon in terms of biomechanical properties and extent of adhesion formation. In this study 24 New Zealand White rabbits received a full transection of the Achilles tendon 2 cm above the calcaneus, sutured with a 4-strand Becker suture. Post-surgical analysis was performed at 3, 6 and 12 weeks. In the 6-week group, animals received a cast either in a 180 deg stretched position during 6 weeks (adhesion provoking immobilization), or were re-casted with a 150 deg position after 3 weeks (adhesion inhibiting immobilization), while in the other groups (3 and 12 weeks) a 180 deg position cast was applied for 3 weeks. Adhesion extent was analyzed by histology and ultrasound. Histopathological scoring was performed according to a method by Stoll et al. (2011), and the main biomechanical properties were assessed. Histopathological scores increased as a function of time, but did not reach values of healthy tendons after 12 weeks (only around 15 out of 20 points). Adhesion provoking immobilization led to an adhesion extent of 82.7±9.7%, while adhesion inhibiting immobilization led to 31.9±9.8% after 6 weeks. Biomechanical properties increased over time, however, they did not reach full strength nor elastic modulus at 12 weeks post-operation. Furthermore, the rabbit Achilles tendon model can be modulated in terms of adhesion formation to the surrounding tissue. It clearly shows the different healing stages in terms of histopathology and offers a suitable model regarding biomechanics because it exhibits similar biomechanics as the human flexor tendons of the hand. PMID:27635037

  12. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Factors influencing the operative results of displaced intra-articular calcaneal fracture%影响移位关节内跟骨骨折手术疗效的因素

    Institute of Scientific and Technical Information of China (English)

    宋兵华; 孙俊英; 倪增良; 何斌; 成文; 童舜谊

    2015-01-01

    Objective To determine the factors influencing the results of open reduction and internal fixation for displaced intra-articular calcaneal fracture (DIACF).Methods From May 2009 to June 2013, 80 patients with DIACF involving in 91 feet were treated by open reduction and internal fixation.Mean age was 38.7 years (range, 18-72 years).Patients were grouped according to the possible factors related to the operative results, including the Sanders classification of fracture, quality of fracture reduction, postoperative B(o)hler angle, width of postoperative calcaneus, and time to surgery after injury.Clinical result was evaluated and compared within each group.Results Mean duration of follow-up was 18.3 months (range, 14-26 months).The clinical results were excellent for 67 feet (74%), good for 12 feet (13%), fair for 7 feet (8%) and poor for 5 feet (5%), which yielded 87% good to excellent results.Good to excellent results in Sanders Ⅱ , Ⅲ and Ⅳ groups reached 94%, 85% and 53% respectively, in quality of fracture reduction ≤ 2 mm and > 2 mm groups reached 93% and 30% respectively, in postoperative B(o)hler angle < 15° and ≥15° groups reached 33% and 90% respectively;in broadening of postoperative calcaneus < 1 cm and ≥ 1 cm groups reached 92% and 17% respectively, in time to surgery after injury ≤14 days and > 14 days groups reached 91% and 43% respectively, in age ≤60 years old and > 60 years old groups reached 85% and 88% respectively.Except for the age group, the clinical result differed significantly within group (P < 0.05).Conclusions Fracture type, reduction quality, postoperative B(o)hler angle, width of postoperative calcaneus, time to surgery after injury are the factors influencing on the operative results of patients with displaced intra-articular calcaneal fracture.Thereupon the unfavorable influences should be avoided to improve the operative results.%目的 探讨影响移位关节内跟

  15. Effect Research of Comprehensive Nursing on the Rehabilitation of Achilles Tendon Haglund Disease after Arthroscopic Debridement and Radiofrequency Ablation%综合护理对跟腱Haglund病关节镜下清理射频消融术后康复的影响研究

    Institute of Scientific and Technical Information of China (English)

    段莉香; 易红; 罗彩虹

    2015-01-01

    Objective: To investigate the effect of comprehensive nursing on the rehabilitation of achilles tendon haglund disease after arthroscopic debridement and radiofrequency ablation.Method:71 patients with achilles tendon haglund disease after arthroscopic debridement and radiofrequency ablation in our hospital were selected and randomly divided into two groups. 35 cases in the control group were given conventional nursing,36 cases in the observation group were given comprehensive nursing on the basis of conventional nursing.The effects of postoperative rehabilitation were compared between the two groups. Result: The excellent recovery rate of the observation group was significantly higher than that of the control group,the difference was statistically significant(P0.05).After nursing,Fowler-Philip angle of the observation group was significantly lower than pre-nursing, the spout height of calcaneus posterior superior and VAS scores of the two groups were significantly lower than pre-nursing,Tengner scores of the two groups were significantly higher than pre-nursing,the differences between pre-nursing and post-nursing were statistically significant(P0.05);护理后,观察组患者Fowler-Philip角明显低于护理前,全部患者跟骨后上突突起高度和VAS评分均明显低于护理前,Tengner评分明显高于护理前,护理前后比较差异均有统计学意义(P<0.05),观察组患者Fowler-Philip角、跟骨后上突突起高度和VAS评分均明显低于对照组,Tengner评分明显高于对照组,两组比较差异均有统计学意义(P<0.05),观察组护理满意率明显高于对照组,两组比较差异有统计学意义(P<0.05)。结论:综合护理有助于显著改善跟腱Haglund病关节镜下清理射频消融术后患者踝关节活动程度,降低疼痛程度,提高康复护理效果。

  16. 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.

  17. [Arthroscopic treatment for calcaneal spur syndrome].

    Science.gov (United States)

    Stropek, S; Dvorák, M

    2008-10-01

    PURPOSE OF THE STUDY Arthroscopic treatment of calcaneal spur syndrome is a tissue-sparing and effective approach when conservative therapy has failed. This method, its results and our experience with the treatment of this syndrome are presented here. MATERIAL Between January 2003 and November 2007, 26 patients underwent an arthroscopic procedure for calcaneal spur syndrome; of these, 20 were women with an average age of 49 years, and six were men with an average age of 45 years. Four, three women and one man, were lost to follow-up, therefore 22 patients with 24 heels were eventually evaluated. All had conservative therapy for 3 to 6 monts. METHODS The arthroscopic method used was developed by the arthroscopic group of the Orthopaedic Service of Hospital Hermanos Ameijeiras in Havana, Cuba. The surgical technique insolves treatment of the spur and plantar fasciitis commonly found in calcaneal spur syndrome, but it also addresses adjacent calcaneal periostitis. RESULTS The results were evaluated on the scale that is part of the foot function index developed by Budiman-Mak for measuring rheumatoid arthritis pain. The patients were asked mine questions on pain intensity during various activities before and after surgery. Pain was evaluated on a scale with grades from 0 to 9. The average value was 5.9 before surgery and 1.4 after surgery. A 0-1 pain range was reported by 25 %, 1-2 by 26 % and 2-4 by 22 % of the patients. All patients reported improvement. DISCUSSION The orthopaedic group in Havana led by Carlos achieved 85 % excellent outcomes (pain range, 0-2) at one-year followup; this was 79 % in our study, in which no problems with foot arches or wound infection were recorded. CONCLUSIONS The heel spur syndrome is a result of an inflamed ligament (plantar fascia) due to repeated microtrauma. It is not a traction osteophyte,but a reaction of the tissue where it attaches to the calcaneus. Adjacent calcaneal periostitis is usually present as well. Therefore, this

  18. Clinical research of the effect of invigorating the kidney and strengthening the bone method on primary osteoporosis%益肾健骨法对原发性骨质疏松症的临床研究

    Institute of Scientific and Technical Information of China (English)

    张春凤; 戴芳芳

    2012-01-01

    目的 了解近3年来就诊于江苏省中医院内分泌科患者骨质疏松、骨量减少发生情况,制定预防措施.验证中医益肾健骨法在治疗骨质疏松中的疗效.方法 通过对南京地区骨质疏松症及骨量减少的筛选,设定对照组(阿法骨化醇0.5 μg,qd)、治疗组(阿法骨化醇0.5 μg,qd+健骨丸5 g,bid),观察患者临床表现,监测血钙、磷及骨密度两年.结果 治疗1年时,中药治疗组临床症状缓解明显;第2年时中药治疗组的跟骨骨密度增加明显优于对照组,血钙、血磷由于自身代谢及合理饮食改变不明显.结论 中药制剂健骨丸对骨质疏松有明显的疗效.%Objective To investigate the incidence of osteoporosis and osteopenia in the patients who came to the Department of Endocrinology in Jiangsu Provincial Hospital in the past 3 years, to verify the effect of invigorating the kidney and strengthening the bone method on primary osteoporosis , and to formulate the prophylactic method. Methods Patients with osteoporosis and osteopenia in Nanjing area were screened and divided into 2 groups; the control group and the treatment group. Patients in control group were treated with 0. 5 ug Alfacalcidol once a day. While patients in treatment group were treated with 0. 5 ug Alfacalcidol once a day, and 5 g Jiangu pill twice a day. The clinical manifestations were observed . Bone mineral density (BMD) and the serum levels of calcium and phosphorus were examined for 2 years. Results After 1-year treatment, clinical symptoms of patients in the treatment group were relieved obviously . After 2-year treatment, the increase of BMD of the calcaneus in the treatment group was significantly higher than that in the control group. The serum levels of calcium and phosphorus did not show an obvious change due to self -metabolism and balanced diet. Conclusion The traditional Chinese medicine Jiangu pill has an obvious effect on primary osteoporosis.

  19. 金乌骨胶囊联合雷尼酸锶治疗绝经后妇女骨质疏松症的临床观察%Clinical observation of the combined therapy of Jinwugu capsules and strontium ranelate for the treatment of postmenopausal osteoporosis

    Institute of Scientific and Technical Information of China (English)

    马文兰; 文灵芝

    2012-01-01

    Objective To evaluate the efficacy and safety of the combined therapy of Jinwugu capsules and strontium ranelate for the treatment of postmenopausal osteoporosis. Methods Seventy patients with postmenopausal osteoporosis were selected and randomly divided into treatment group and control group. Patients in the control group were treated with Jinwugu capsules orally, 3 times a day and 3 capsules a time. Patients in the treatment group were added with strontium ranelate, 2 mg/day for 14 weeks on basis of the treatment in the control group. Bone mass of the left calcaneus bone was measured using ultrasonic bone mineral density instrument before and after treatment. Results Clinical symptoms of patients in both groups were obviously alleviated after the treatment. BMD of patients in both groups significantly increased after the treatment and the risk for fractures significantly decreased ( P < 0. 05 ). The clinical efficacy of patients in the treatment group was superior to that in the control group and the rate of the clinical symptoms alleviation was more than 97. 14%(P < 0. 05). Conclusion The efficacy and safety of the combined therapy of Jinwugu capsules and strontium ranelate are definitive than Jinwugu capsules usage alone.%目的 评价金乌骨胶囊联合雷尼酸锶治疗绝经后骨质疏松症有效性和安全性.方法 选70例绝经后妇女骨质疏松患者随机分治疗组与对照组各35例;对照组给金乌骨胶囊,口服,3次/d,3粒/次;治疗组在对照组基础上加用雷尼酸锶2mg/d,疗程14周;治疗前后检测采用超声骨密度仪测左侧跟骨低骨量.结果 两组绝经后妇女治疗后症状均有所减轻,骨密度较治疗前明显增加,骨折风险减少(P<0.05);临床疗效优于单用金乌骨胶囊组(P<0.05),临床症状好转达97.14%.结论 金乌骨胶囊联合雷尼酸锶治疗骨质疏松疗效比单一用药治疗效果及安全性更确切.

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

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    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

  1. 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.

  2. Polymorphisms in genes involved in the NF-κB signalling pathway are associated with bone mineral density, geometry and turnover in men.

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    Delnaz Roshandel

    Full Text Available INTRODUCTION: In this study, we aimed to investigate the association between single nucleotide polymorphisms (SNPs within two genes involved in the NF-κB cascade (GPR177 and MAP3K14 and bone mineral density (BMD assessed at different skeletal sites, radial geometric parameters and bone turnover. METHODS: Ten GPR177 SNPs previously associated with BMD with genome-wide significance and twelve tag SNPs (r(2≥0.8 within MAP3K14 (±10 kb were genotyped in 2359 men aged 40-79 years recruited from 8 centres for participation in the European Male Aging Study (EMAS. Measurement of bone turnover markers (PINP and CTX-I in the serum and quantitative ultrasound (QUS at the calcaneus were performed in all centres. Dual energy X-ray absorptiometry (DXA, at the lumbar spine and hip, and peripheral quantitative computed tomography (pQCT, at the distal and midshaft radius, were performed in a subsample (2 centres. Linear regression was used to test for association between the SNPs and bone measures under an additive genetic model adjusting for study centre. RESULTS: We validated the associations between SNPs in GPR177 and BMD(a previously reported and also observed evidence of pleiotrophic effects on density and geometry. Rs2772300 in GPR177 was associated with increased total hip and LS BMD(a, increased total and cortical vBMD at the radius and increased cortical area, thickness and stress strain index. We also found evidence of association with BMD(a, vBMD, geometric parameters and CTX-I for SNPs in MAP3K14. None of the GPR177 and MAP3K14 SNPs were associated with calcaneal estimated BMD measured by QUS. CONCLUSION: Our findings suggest that SNPs in GPR177 and MAP3K14 involved in the NF-κB signalling pathway influence bone mineral density, geometry and turnover in a population-based cohort of middle aged and elderly men. This adds to the understanding of the role of genetic variation in this pathway in determining bone health.

  3. Prevalence of lactose intolerance and its relation with bone mineral density among Malay students of Universiti Kebangsaan Malaysia, Malaysia

    Science.gov (United States)

    Yahya, Noor Fairuzi Suhana; Daud, Norlida Mat; Makbul, Ika Aida Aprilini; Aziz, Qurratul Aini Salma Abdul

    2016-11-01

    Lactose intolerance (LI), a risk factor for low bone mineral density (BMD), is the most common type of carbohydrate intolerance, which predominantly affects Southeast Asian populations. However, data on the prevalence of LI and its association with BMD among Malaysian adults are still lacking as not much research has been done on this matter. Thus, the aims of this study are to determine the prevalence of LI and to evaluate its association with BMD among students of Universiti Kebangsaan Malaysia. A total of 100 Malay students (50 males and 50 females) with mean age of 23.9 ± 4.7 years old and body mass index of 24.5 ± 5.8 kg/m2 were selected to involve in this preliminary study. After an overnight fast, subjects were asked to perform hydrogen breath test (HBT) and lactose tolerance test (LTT) after an intake of 300 ml lactose drink (50g lactose). HBT measurements were recorded at every 30 minutes intervals while LTT results were recorded at fasting and 30 minutes after lactose consumption. Visual analogue scales were used to measure gastrointestinal symptoms. BMD was measured at calcaneus bone using quantitative ultrasound and expressed as T-score. A consistent rise by >20 ppm for HBT and failure of blood sugar to rise by >1.10 mmol/L above basal level were considered as abnormal HBT and LTT. Lactose malabsorption (LM) is defined by abnormal HBT and LTT whilst LI is characterized by having abnormal HBT, LTT and gastrointestinal symptoms. The result showed that 86% male and 90% female subjects exhaled breath hydrogen >20 ppm but there was no significant difference (p>0.05) between them. LTT results showed that 86% male subjects failed to rise their blood sugar level >1.10 mmol/L compared to 60% in female subjects. Both male and female subjects had high percentage occurrence of gastrointestinal symptom (82 % and 80% respectively) although no significant difference (p>0.05) was demonstrated. The prevalence of LI and LM among all subjects was 77% and 18

  4. 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

  5. 少见部位软骨母细胞瘤的影像学表现%Radiologic feactures of chondroblastoma in unusual sites

    Institute of Scientific and Technical Information of China (English)

    王岩; 陈国栋; 于爱红; 程晓光

    2012-01-01

    Objective:To investigate radiological features of chondroblastoma in unusual sites. Methods:We retrospectively re viewed the radiological features of 20 cases with pathologically proved chondroblastoma in unusual sites. The location,shape,density and enhancement characteristics of the lesions were assessed. Results:The bones involved were the talus (n=6) ,the calcaneus (n= 5) ,the patella (n=4) ,the scapula (n=2) ,the ilium (n = 2) and the ischium (n=l). The characteristic imaging features include round to oval,irregular osteolytic expansive bone destruction with or without septum and slight sclerotic margin on CT and plain ra diography. Spotty or patchy calcification might occasionally be encountered. Typically, chondroblastoma in unusual sites appeared heterogeneously hypointense on T1WI and heterogeneously hyperintense on T2 WI. Conclusion: Chondroblastoma in unusual sites is rare and has varied appearances. Some specific imaging features of the chondroblastoma in unusual sites still exist. Imaging combined with clinical and pathological manifestations is helpful for most accurate diagnosis of the chondroblastoma in unusual sites.%目的:探讨少见部位软骨母细胞瘤(CB)的影像学表现.方法:回顾性分析经病理证实的20例少见部位CB的影像学资料,分析其病灶位置、形态、密度及增强表现等特征.结果:20例中病灶位于距骨6例,跟骨5例,髌骨4例,肩胛骨2例,髂骨2例,坐骨1例.病灶在X线和CT上主要表现为类圆形或不规则形,以膨胀性溶骨性骨破坏为主,周围可见硬化边,其内有或无分隔,边缘可见骨嵴,病灶内偶尔可见点状及片状钙化,痛灶在MRI上表现为不均匀的长T1、长T2信号.结论:少见部位软骨母细胞瘤发病率低,影像学表现具有相对特征性和多样性,应结合临床、影像学和病理学特征进行综合诊断,避免误诊.

  6. Reflex pathways connect receptors in the human lower leg to the erector spinae muscles of the lower back.

    Science.gov (United States)

    Clair, J M; Okuma, Y; Misiaszek, J E; Collins, D F

    2009-06-01

    Reflex pathways connect all four limbs in humans. Presently, we tested the hypothesis that reflexes also link sensory receptors in the lower leg with muscles of the lower back (erector spinae; ES). Taps were applied to the right Achilles' tendon and electromyographic activity was recorded from the right soleus and bilaterally from ES. Reflexes were compared between sitting and standing and between standing with the eyes open versus closed. Reflexes were evoked bilaterally in ES and consisted of an early latency excitation, a medium latency inhibition, and a longer latency excitation. During sitting but not standing, the early excitation was larger in the ES muscle ipsilateral to the stimulation (iES) than in the contralateral ES (cES). During standing but not sitting, the longer latency excitation in cES was larger than in iES. This response in cES was also larger during standing compared to sitting. Responses were not significantly different between the eyes open and eyes closed conditions. Taps applied to the lateral calcaneus (heel taps) evoked responses in ES that were not significantly different in amplitude or latency than those evoked by tendon taps, despite a 75-94% reduction in the amplitude of the soleus stretch reflex evoked by the heel taps. Electrical stimulation of the sural nerve, a purely cutaneous nerve at the ankle, evoked ES reflexes that were not significantly different in amplitude but had significantly longer latencies than those evoked by the tendon and heel taps. These results support the hypothesis that reflex pathways connect receptors in the lower leg with muscles of the lower back and show that that the amplitude of these reflexes is modulated by task. Responses evoked by stimulation of the sural nerve establish that reflex pathways connect the ES muscles with cutaneous receptors of the foot. In contrast, the large volley in muscle spindle afferents induced by the tendon taps compared to the heel taps did not alter the ES responses

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

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    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

  8. Biomechanical podiatric evaluation in an Italian cohort of patients with systemic sclerosis: A pilot study

    Science.gov (United States)

    Maddali Bongi, Susanna; Ravenni, Giovanni; Ciampi, Benedetta; Del Rosso, Angela; El Aoufy, Khadija

    2016-01-01

    Objective Foot problems are often present in Systemic Sclerosis (SSc) patients, however studies regarding podiatric problems related to SSc are lacking and there are no data evaluating the foot biomechanical changes. The aim of the present pilot study was to evaluate podiatric problems in an Italian cohort of SSc patients by assessing received podiatric services, foot pain and disability and biomechanical foot deformity. Material and Methods 25 consecutive SSc patients were enrolled from the Division of Rheumatology, University of Florence. All SSc patients were assessed by: Standards of Care for People with Foot Musculoskeletal Health problems: Audit Tool, Foot Function Index (FFI), Weight and non-weight bearing foot joint assessment, (Foot Posture Index (FPI) and Gait Cycle), Health Assessment Questionnaire (HAQ) and Medical Outcomes Survey Short Form 36 (SF-36). Results Audit Tool - Only 7 (28%) out of the 25 patients with SSc had a specific podiatric assessment and treatment: no patient received a foot health assessment within the first 6 months of disease diagnosis and no patient received information about foot involvement. 1 patient (4%) received foot assessment every year; 1 patient (4%) received specific information about the disease and 5 patients (20%) received information about the benefits of using adapted footwear and insoles. FFI - Values of pain, disability and activity limitations, reported in FFI, are 4.7±5.1, 5.1±3.2 and 3.2±3.1 (M±DS), respectively. Non-weight bearing foot joint assessment shows a rearfoot varus deformity in 64% of patients, forefoot varus deformity in 42% and 6% forefoot valgus deformity. Weight bearing foot joint assessment, through FPI shows a pronated foot 20% of patients with and 34% with highly pronated overall foot posture. Gait analysis shows that 64% of patients has a contact of the calcaneus in invertion while 36% in eversion. In the midstance, 78% have the foot in pronation and 22% in supination, while in

  9. Indication, surgical technique and results of endoscopic fascial release in plantar fasciitis (E FRPF).

    Science.gov (United States)

    Jerosch, Jörg; Schunck, Jochem; Liebsch, Dietrich; Filler, Tim

    2004-09-01

    The purpose of the present study is to present the surgical technique for, and review our indications and results after, endoscopic fascial release in patients with plantar fasciitis. In five thiel-embalmed human specimens, a biportal technique for endoscopic release of the plantar fascia was established. The aim was here to evaluate the relation between the plantar fascia and the heel spur and to perform a release that would not exceed 50-70% of the diameter of the calcaneoplantar fascia. The endoscopic technique was performed within the last 5 years in ten male and seven female patients. All patients with the clinical entity of plantar fasciitis underwent conservative treatment for at least 6 months. The average age at surgery was 35 years (24-56 years). In the first five patients, surgery was performed under c-arm control. In all patients the operation could be finished endoscopically. The endoscopic portals healed without complications. The time for surgery during the learning curve ranged between 21 and 74 min (average 41 min) and was still longer compared to the open technique. The clinical follow-up ranged between 4 and 48 months (average 18.5 months). Out of 17 patients, 13 improved clinically, and they would choose the treatment option again. In the Ogilvie-Harris score, seven patients showed good and six excellent results. In two patients, the initial results were not satisfactory, because of a bony stress reaction of the calcaneus. This complication was treated by 6 weeks of partial weight bearing, without any further problems. Two other patients developed secondary pain in the lateral column. In spite of the minimal invasive approach it seems to be important to be careful in increasing the weight bearing in early rehabilitation. The technique of the endoscopic plantar fascia release (E FRPF) can be performed in a standardised and reproducible procedure. The follow-up examination showed good midterm results, but a loss of stability of the plantar arch

  10. 19例异体跟腱关节镜下重建膝后交叉韧带临床分析%Posterior cruciate ligament reconstruction with allogenic achilles tendon under arthroscopy in 19 cases

    Institute of Scientific and Technical Information of China (English)

    孙英华; 王莉; 范晓华; 焦兆德

    2009-01-01

    目的 探讨关节镜下应用同种异体跟腱重建膝后交叉韧带(PCL)的方法及疗效.方法 回顾2004年1月至2008年1月在关节镜下应用同种异体跟腱重建PCL 19例,术中切取标准化的柱状跟骨,确保移植物在股骨及胫骨骨道内紧密固定,术前及术后12个月时用Lysholm评分评定膝关节功能.结果 随访19例患者术前平均评分61分(54~69分),术后12个月时92分(76~95分),总优良率89%.结论 关节镜下应用同种异体跟腱重建PCL可有效改善膝关节稳定性.术中股骨及胫骨骨道精确定位、术后系统康复治疗是确保手术疗效的关键.%Objective To evaluate the method and its effect of posterior cruciate ligament (PCL) reconstruction with allogenic achilles tendon under arthroscopy.Methods We reviewed ninteen patients who were underwent arthroscopic PCL reconstruction using the allogenic achilles tendon from January 2004 to January 2008.A special technique was allowed for the standardized harvest of cylindrical calcaneus bone,ensuring adequate press-fit fixation within the femoral and tibial tunnels,and the function of the knee joint was assessed according to the Lysholm score.Results Ninteen patients were followed up.Before operation,the mean Lysholm score was 61 points (54~69 points).Twelve months later after operation,the score was 92 points (76~95 points).The excellent and good results were obtained in 89%.Conclusion Our study indicates that arthroscopic PCL reconstruction with allogenic achilles tendon can effectively improve the stability of the knee joint.It is important to achieve favorable result that the precise position is taken in the femoral and tibial tunnels in operation,and systematic rehabilitation training is performed after operation.

  11. 3D-MRI rendering of the anatomical structures related to acupuncture points of the Dai mai, Yin qiao mai and Yang qiao mai meridians within the context of the WOMED concept of lateral tension: implications for musculoskeletal disease

    Directory of Open Access Journals (Sweden)

    Kremser Christian

    2007-04-01

    Full Text Available Abstract Background A conceptual model of lateral muscular tension in patients presenting thyroid associated ophthalmopathy (TAO has been recently described. Clinical improvement has been achieved by using acupuncture on points belonging to the so-called extraordinary meridians. The aim of this study was to characterize the anatomical structures related to these acupuncture points by means of 3D MRI image rendering relying on external markers. Methods The investigation was carried out the index case patient of the lateral tension model. A licensed medical acupuncture practitioner located the following acupuncture points: 1 Yin qiao mai meridian (medial ankle: Kidney 3, Kidney 6, the plantar Kidney 6 (Nan jing description; 2 Yang qiao mai meridian (lateral ankle: Bladder 62, Bladder 59, Bladder 61, and the plantar Bladder 62 (Nan jing description; 3 Dai mai meridian (wait: Liver 13, Gall bladder 26, Gall bladder 27, Gall bladder 28, and Gall bladder 29. The points were marked by taping a nitro-glycerin capsule on the skin. Imaging was done on a Siemens Magnetom Avanto MR scanner using an array head and body coil. Mainly T1-weighted imaging sequences, as routinely used for patient exams, were used to obtain multi-slice images. The image data were rendered in 3D modus using dedicated software (Leonardo, Siemens. Results Points of the Dai mai meridian – at the level of the waist – corresponded to the obliquus externus abdominis and the obliquus internus abdominis. Points of the Yin qiao mai meridian – at the medial side of the ankle – corresponded to tendinous structures of the flexor digitorum longus as well as to muscular structures of the abductor hallucis on the foot sole. Points of the Yang qiao mai meridian – at the lateral side of the ankle – corresponded to tendinous structures of the peroneus brevis, the peroneous longus, and the lateral surface of the calcaneus and close to the foot sole to the abductor digiti minimi

  12. Clinical Characteristics and Treatment of Extremity Chronic Osteomyelitis in Southern China: A Retrospective Analysis of 394 Consecutive Patients.

    Science.gov (United States)

    Jiang, Nan; Ma, Yun-Fei; Jiang, Yi; Zhao, Xing-Qi; Xie, Guo-Ping; Hu, Yan-Jun; Qin, Cheng-He; Yu, Bin

    2015-10-01

    Although extremity chronic osteomyelitis is common in China, updated data were still limited regarding its characterizations. The present study aimed to review clinical features of extremity chronic osteomyelitis in Southern China.A retrospective analysis was conducted in the patients who had sought medical attention from January 2010 to April 2015 for extremity chronic osteomyelitis in Nanfang Hospital in Southern China. Clinical data were collected and analyzed.A total of 394 patients (307 males and 87 females) were included, giving a gender ratio of 3.53. The median age at first diagnosis was 42 years for all. The most frequent type was traumatic osteomyelitis (262 cases, 66.50%), which was mainly caused by open injury (166 cases, 63.36%) and during a road accident (91 cases, 34.73%). Single-site infection accounted for 81.98% (323 cases), with tibia (126 cases), femur (79 cases), calcaneus (37 cases), and toes (37 cases) as the top sites. The positive rate of intraoperative culture was 70.63% (214/303), 78.97% (169/214) of which was monomicrobial infection. Staphylococcus aureus (59 cases) was the most frequent bacteria for monomicrobial infection, followed by Pseudomonas aeruginosa (29 cases) and Escherichia coli (11 cases). The positive ratios of preoperative serum white blood cell (WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNF-α) were 21.63%, 64.92%, 53.27%, 42.25%, 72.82%, and 66.67%, respectively. The most frequently used intravenous antibiotic was cephalosporins. The overall cure rate was 77.74%, with a total amputation rate of 16.75%.In this representative Chinese cohort, extremity chronic osteomyelitis was mostly caused by open injury and during a road accident, predominated in males and favored the tibia. S. aureus was the most frequent pathogenic organism. Preoperative elevated levels of serum IL-6, TNF-α, and ESR may be helpful diagnostic

  13. Time and dose-effect relationship of lateral pressure of Calcaneal tension band splint fixation%跟骨张力带夹板固定侧方压力的时效、量效关系研究

    Institute of Scientific and Technical Information of China (English)

    李引刚; 孟祥东; 刘艳平; 杨锋; 陈明光

    2012-01-01

    Objective;To investigate time and dose-effect relationship of lateral pressure at different intensities on the injury of skin after the calcaneal fracture with percutaneous poking postoperative tension band splint fixation and obtain a suitable pressure range. Methods:20 patients with 20 feet in healthy subjects and 20 patients with 20 feet with intra-articular fractures of the calcaneus prying postoperative patients were included , we used self-made balloon tension band fixation, and observed and recorded the local pain, numbness, skin color changes at different pressure and time. Results: Evaluating pressure ulcers by Shea staging standard, according to skin color, pain, numbness and other autonomic manifestations, healthy subjects pressure should be<40 kPa, patients should be< 35kPa. Conclusion:Calcaneal lateral pressure pad can effectively prevent calcaneal diameter width and calcaneal ever-sion, but needed regulating pressure and action time according to the swelling degree, to avoid the formation of pressure ulcers.%目的:探讨跟骨骨折经皮撬拨术后张力带夹板固定法中侧方压力在不同强度下对皮肤损伤时效、量效之间的关系.方法:20例20足健康受试者及20例20足符合跟骨关节内骨折撬拨术后的患者纳入试验,采用自制带气囊的张力带夹板固定,观察并记录跟骨内外侧皮肤在不同压强、时间下局部疼痛、麻木、皮肤颜色的改变.结果:压疮以shea分期作为标准,根据皮肤颜色、疼痛、麻木等自主表现,健康受试者压强应<40kPa,患者应<35kPa.结论:跟骨内外侧压力垫有效防止跟骨横径变宽及跟骨外翻,但要根据肿胀的程度注意调节压强大小及作用时间,避免压疮形成.

  14. Finite element analysis of a pseudoelastic compression-generating intramedullary ankle arthrodesis nail.

    Science.gov (United States)

    Anderson, Ryan T; Pacaccio, Douglas J; Yakacki, Christopher M; Carpenter, R Dana

    2016-09-01

    Tibio-talo-calcaneal (TTC) arthrodesis is an end-stage treatment for patients with severe degeneration of the ankle joint. This treatment consists of using an intramedullary nail (IM) to fuse the calcaneus, talus, and tibia bones together into one construct. Poor bone quality within the joint prior to surgery is common and thus the procedure has shown complications due to non-union. However, a new FDA-approved IM nail has been released that houses a nickel titanium (NiTi) rod that uses its inherent pseudoelastic material properties to apply active compression across the fusion site. Finite element analysis was performed to model the mechanical response of the NiTi within the device. A bone model was then developed based on a quantitative computed tomography (QCT) image for anatomical geometry and bone material properties. A total bone and device system was modeled to investigate the effect of bone quality change and gather load-sharing properties during gait loading. It was found that during the highest magnitude loading of gait, the load taken by the bone was more than 50% higher than the load taken by the nail. When comparing the load distribution during gait, results from this study would suggest that the device helps to prevent stress shielding by allowing a more even distribution of load between bone and nail. In conditions where bone quality may vary patient-to-patient, the model indicates that a 10% decrease in overall bone modulus (i.e. material stiffness) due to reduced bone mineral density would result in higher stresses in the nail (3.4%) and a marginal decrease in stress for the bone (0.5%). The finite element model presented in this study can be used as a quantitative tool to further understand the stress environment of both bone and device for a TTC fusion. Furthermore, the methodology presented gives insight on how to computationally program and use the unique material properties of NiTi in an active compression state useful for bone fracture healing

  15. The Imaging Diagnosis of Osteochondroma in Uncommon Locations%少见部位骨软骨瘤的影像学分析

    Institute of Scientific and Technical Information of China (English)

    唐浩; 胡桂周; 陈卫国; 蔡裕兴

    2012-01-01

    Objective To analyse imaging findings of osteochondroma in uncommon locations on plain film.CT and MR1. Methods Seventeen cases with histologically confirmed osteochondroma in uncommon locations were reviewed. Radiography was performed in 7 cases, CT in 6 patients and MRI in 5 cases. Results Osteochondroma located at parietal bone, temporal bone, malar bone, sella turcica, clavicalis and calcaneus in each one case, at pubis in 2 cases , cervical vertebra in 4 cases and huckle bone in 5 cases. Cartilage cap could be found on plain film and CT. 9 cases showed spongy bone in osteochondroma centre move to pulp cavity of source bone. Soft tissue around tumor became swollen in one case. On MRI, lesions presented iso or hypointenBity signal on T, WI and T2 WI, and spotted hyperintensity signal on T2 WI. All cases showed heterogeneous enhancement on MRI. Conclusion Osteochondroma in uncommon locations could be accurately diagnosed with synthetically applying various imaging methods, and judged malignant in some extent.%目的 探讨X线平片、CT及MRI对少见部位骨软骨瘤的诊断价值.方法 回顾性分析17例经手术病理证实的少见部位骨软骨瘤的X线平片、CT及MRI表现.其中7例行X线平片检查,6例行CT检查,5例行MRI检查.结果 顶骨、颞骨、颧骨、鞍底、锁骨及跟骨各1例,耻骨2例,颈椎4例,距骨5例.X线平片及CT像上均可见软骨帽,9例可见肿瘤中心松质骨与母骨髓腔相互移行,1例肿瘤周缘软组织出现肿胀.在MRI上,肿瘤在T1WI上呈等、低信号,T2WI上以等低信号为主,其间夹杂斑点状高信号;增强扫描肿瘤呈不同程度的不均匀强化.结论 综合运用多种影像检查方法可准确诊断少见部位的骨软骨瘤,并能在一定程度上判定肿瘤是否发生恶变.

  16. QUANTITATIVE EVALUATION OF POSTOPERATIVE EFFECT OF CALCANEAL FRACTURES USING FOOTSCAN SYSTEM%Footscan足底压力分析系统对跟骨骨折术后疗效的定量评价

    Institute of Scientific and Technical Information of China (English)

    陈占法; 张英泽; 郑占乐; 郭明珂

    2009-01-01

    Objective To investigate the value of using Footscan system to evaluate the therapeutic effect of two internal fixation methods on calcaneus fractures. Methods From February 2006 to September 2006, 64 patients with fresh unilateral closed calcaneus fractures were randomly divided into two groups. The experimental group: 32 patients underwent minimally invasive open reduction and internal fixation with improved compressing plate and screw, including 28 males and 4 females aged 20-53 years old (average 36.7 years old); the course of disease was 3-14 days; there were 19 cases of type Ⅱ, 11 of type Ⅲ, and 2 of type Ⅳaccording to Sanders fracture classification system. The control group: 32 patients underwent internal fixation of standard AO plate via L-shaped incision, including 29 males and 3 females aged 18-56 years old (average 37.1 years old); the course of disease was 4-15 days; there were 18 cases of type Ⅱ, 11 of type Ⅲ and 23 of type Ⅳ according to Sanders fracture classification system. No significant difference was noted between two groups in the general information (P > 0.05). At 1 and 2 years after operation, dynamic plantar pressure was measured using Footscan system, Maryland foot scores of two groups was compared, and statistical analysis was performed. Results All patients were followed up for 2 years. No infection, cuticular border necrosis, and sural nerve distal end injury occurred in the experimental group, whereas in the control group, 3 patients suffered from cuticular border necrosis and recovered after dressing, and 1 patient had sural nerve distal end injury with decreased sensation in local skin. At 1 and 2 years after operation, in the control group, there were significant differences between the injured foot and the normal foot in terms of impulse, instep index, motion range of subtalar joint, lateral displacement of footplate pressure center, and calcaneal width when patients stood on both feet (P 0.05).Significant differences

  17. Pathogenesis of foot blisters caused by weight-bearing march%负重徒步致足部水疱的发病机制研究

    Institute of Scientific and Technical Information of China (English)

    陈聪; 周维均; 刘明华; 曾凡杰; 田铸; 郭国宁

    2016-01-01

    Objective To analyze the related factors of foot blisters caused by long-distance weight-bearing march and to explore the pathogenesis of foot blisters to provide a useful way for the prevention and treatment.Methods After the 300 km march,counted the number who had accomplished the march,and then recorded the number of foot blisters,location of blisters,and abrasion of sole.Collected the data of gender,age,body mass index (BMI),hand dominance,and whether had bliters before the march through questionnaire.And the data were coded for analysis with SPSS 13.0 statistical package.Results The 7 cases who complete the whole march and 17 cases who already had foot blisters before the march were ruled out of the final statistics.Among the remaining 590 cases,there were 554 cases (93.9%)suffered from foot blisters.And there were 1 282 blisters in total,among which the plantar blisters occupied 98% (1 257 cases).The analysis showed that the incidence of foot blisters had no significant correlation with gender,left/right foot,hand dominance,BMI and age.The predilection sites of blisters were the second and third metatarsals (28.2%),the hallux (21.3%),the fifth metatarsal (18.1%),and the calcaneus (15.8%)of the left foot.The predilection sites of blisters were the second and third metatarsals (33.3%),the hallux (22.4%),the fifth metatarsal (18.6%),and the calcaneus (14.5%)of the right foot.In terms of the abrasion of sole,the lateral heel was worn out the most (34.6% on the left and 34.2% on the right).Conclusion The study confirmed that the incidence of foot blisters had no significant correla-tion with gender,left/right foot,hand dominance,BMI and age,which may be affected by the particularity of this march.Most of the foot blisters occurred in the planta,and the predilection sites of blisters were in accord with sites of of the abrasion of sole and the distribution of plantar shear force,which demonstrated the shear force is the most critical factor on the pathogenesis of

  18. 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

  19. COPD合并骨质疏松患者血清17β-雌二醇、骨保护素在证型间的差异

    Institute of Scientific and Technical Information of China (English)

    朱际平; 张静莹; 李磊; 吴刚

    2016-01-01

    目的::观察COPD合并骨质疏松的患者血清17β-雌二醇,和骨保护素(osteoprotegerin OPG)与非 COPD骨质疏松患者的差异,并观察COPD不同本虚证型间是否存在差异.方法:观察82例经跟骨超声骨密度检测确诊的骨质疏松患者(T≤-2.5),其中COPD患者62例,非 COPD患者20例.采用ELISA法检测血清中17β-雌二醇,和OPG浓度.对62例COPD患者进行中医辨证.根据中医证型进行分层分析.观察各证型间血清17β-雌二醇,和 OPG浓度的差异.结果:COPD和非 COPD患者血清17β-雌二醇未见显著性差异,COPD患者血清 OPG浓度低于非 COPD患者,且存在显著性差异.COPD不同中医证型(肾虚,脾虚,肺虚)间血清17β-雌二醇未见显著性差异,OPG 在三个证型间组间存在显著性差异.结论:COPD合并骨质疏松患者的血清 OPG显著降低,可能是导致骨质疏松的原因.COPD本虚证型间的血清 OPG水平存在差异.%ObjectiveTo observe the difference between osteoporosis patients with COPD and those without COPD in E2 and OPG,as well as in their TCM pat-tern types.Method:82 osteoporosis patients were observed which were diagnosed by ultrasonic bone density measurement via calcaneus (T≤-2.5),a-mong which 62 cases were COPD patients,and 20 cases were non-COPD patients.Then ELISA was used to determine the concentration of E2 and OPG.TCM syndrome differentiation was employed to the 62 patients with COPD,and stratified analysis was conducted according to their TCM syn-drome types.The differences between their syndrome types in the concentration of E2 and OPG were closely observed.Results:There was no significant difference between COPD and non-COPD patients in their E2,while the concentration of OPG of COPD patients was lower than non-COPD patients, and there was significant difference between the two groups.There was no significant difference in E2 between the two groups in their TCM pattern types,but there was significant

  20. 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

  1. 骨内脂肪瘤的X线及CT表现(附6例报告并文献复习)%Appearance of intraosseous lipoma with X-ray and CT:A report of 6 cases and review of the literature

    Institute of Scientific and Technical Information of China (English)

    谈瑞生; 黄文杰; 许宜选; 施付强; 刘校生; 蔡顺达

    2011-01-01

    Objective:To expore the X-ray and CT features of the intraosseous lipoma and to improve the accuracy of diagnosis. Methods:The X-ray and CT features of intraosseous lipoma confirmed by surgical pathlogy in 6 cases were retrospectively studied and the literatures with intraosseous lipoma of domestic and abroad were reviewed. Results: Single lesions were showed in 6 patients of the six cases with intraosseous lipomas, one located in the scapular spine one in the inferior articular process of fourth lumbar vertebra, three in the femoral head, and one in the calcaneus, respectively. All foci of infection were spherical shape, ova-shape or irregular radiolucent area on X-ray and adipose tissue area with thin or thick sclerotic rim on CT images. The fat attenuation values within the lesion were in the range from -35 HU to -110 HU. Focal intralesional calcification in the center was present in 1 focus. Their longest diameter ranged from 1. 8 cm to 2. 6 cm. Conclusion:The X-ray manifestations of intraosseous lipoma were helpful for diagnosing location, CT could be provided the qualitative diagnosis for the intraosseous lipoma before operation, and CT provides the imaging gist to establish the treatment project as soon as possible.%目的:探讨骨内脂肪瘤的X线及CT表现,提高其诊断准确率.方法:收集6例经病理证实的骨内脂肪瘤的X线及CT影像资料,结合文献对其临床、病理及影像表现进行回顾性分析.结果:6例均为单发病灶,其中1个病灶位于肩胛冈、1个病灶位于第四腰椎下关节突、3个病灶位于股骨头、1个病灶位于跟骨.X线平片表现为边界清或不清的圆形、类圆形或不规则形透亮区,可伴硬化缘.CT图像上病灶表现为圆形、类椭圆形或不规则形脂性密度区,CT值为-35~-110HU,其中1例病灶中央见结节状钙化,病灶最大径为1.8~2.6cm.边缘不规整,伴有厚薄不等的硬化边.结论:X线平片有助于显示骨

  2. 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

  3. Arthroscopic treatment of osteoid osteoma in hind-foot%关节镜手术治疗后足骨样骨瘤疗效分析

    Institute of Scientific and Technical Information of China (English)

    何能斌; 胡涂; 宋国勋; 许同龙; 施忠民

    2015-01-01

    Objective To evaluate clinical outcome of arthroscopic treatment of osteoid osteoma in hind‐foot . Methods From February 2013 to July 2014 ,8 cases of osteoid osteoma in hind‐foot were treated by arthroscopic manner .There were 5 males and 3 females with a mean age of 21 .25 years .The calcaneus was implicated in 5 cases and the talus was implicated in 3 cases .Overall functional evaluation was carried out according to Visual Analogue Scale (VAS) ,American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hind‐foot score .Results Eight cases were followed up for 4‐22 months (mean ,16 months) .There was no wound infection and neoplasm recurrence . The average VAS score reduced significantly from 8 .375 preoperatively to 0 .375 postoperatively ,and the average AOFAS ankle and hind‐foot score improved significantly from 40 .375 preoperatively to 92 .500 postoperatively . Conclusion The arthroscopic treatment of osteoid osteoma in hind‐foot is a safe and reliable treatment ,because it can resect the tumor completely ,and also limited the soft tissue complications .%目的探讨关节镜手术治疗后足骨样骨瘤临床疗效。方法2013年2月至2014年7月,采用关节镜手术治疗后足骨样骨瘤患者8例,其中男性5例,女性3例,平均年龄21.25岁。受累部位为跟骨5例,距骨3例。采用疼痛视觉模拟评分(VAS)、美国足踝骨科学会(AOFAS)踝‐后足评分综合评估临床疗效。结果术后随访4~22个月,平均16个月。所有患者术后均无伤口感染、肿瘤复发等并发症发生。末次随访时 VAS评分由术前平均8.375分改善至术后平均0.375分,差异有统计学意义;AOFAS踝‐后足评分由术前平均40.375分改善至术后平均92.500分,差异有统计学意义。结论关节镜手术治疗后足骨样骨瘤在完整切除肿瘤的同时,可减少软组织并发症,是一种安全、可靠的治疗技术。

  4. Fluid Shifts

    Science.gov (United States)

    Stenger, M. B.; Hargens, A. R.; Dulchavsky, S. A.; Arbeille, P.; Danielson, R. W.; Ebert, D. J.; Garcia, K. M.; Johnston, S. L.; Laurie, S. S.; Lee, S. M. C.; Liu, J.; Macias, B.; Martin, D. S.; Minkoff, L.; Ploutz-Snyder, R.; Ribeiro, L. C.; Sargsyan, A.; Smith, S. M.

    2017-01-01

    Introduction. NASA's Human Research Program is focused on addressing health risks associated with 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 now more than 50 percent of ISS astronauts have experienced more profound, chronic changes with objective structural findings such as optic disc edema, globe flattening and choroidal folds. These structural and functional changes are referred to as the visual impairment and intracranial pressure (VIIP) syndrome. Development of VIIP symptoms may be related to elevated intracranial pressure (ICP) secondary to 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 determine if a relation exists 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 any VIIP-related effects of those shifts, are predicted by the crewmember's pre-flight status and responses to acute hemodynamic manipulations, specifically posture changes and lower body negative pressure. 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, and calcaneus tissue thickness (by ultrasound); (3) vascular dimensions by ultrasound (jugular veins, cerebral and carotid arteries, vertebral arteries and veins, portal vein); (4) vascular dynamics by MRI (head/neck blood flow, cerebrospinal fluid

  5. Clinical effects of in situ microwave treatment for giant cell tumor%原位微波灭活瘤段+重建治疗骨巨细胞瘤的临床观察

    Institute of Scientific and Technical Information of China (English)

    王进; 吴晔; 杨国华; 曾祥

    2012-01-01

    Objective To investigale the clinical effects, including the limb and joint function after microwave treatment for giant cell tumor. Methods From March 2004 Lo April 2011, 32 patients were treated by in-situ microwave in our hospital. Primary sites were as follows; pelvis of one patient, distal femur of 12 patients, proximal tibia of 10 patients, distal radius of four patients, proximal humerus of three patients, distal humerus of one patients, and calcaneus of one patient. Pathologic grades were; grade Ⅰ in four patients; grade Ⅱ in 11 patients; grade Ⅲ in 17 patients. The tumor was separated with safe margin, and microwave probes were inserted in situ, which produced controllable hyperthermia lo inactivate tumor. The effects and function were investigated in follow-up. Results Among the 32 patienls who were followed up for 2. 8 years in average, there was one recurred case and one infecled case. 28 patients had excellent limb and joint function, and four patients had fair function. Conclusions The clinical results of controllable thermotherapy produced by microwave were excellent for the treatment of giant cell tumor, and this method provides low recurrence and good joint function.%目的 应用微波原位灭活瘤段+重建技术治疗骨巨细胞瘤,观察临床疗效和肢体功能.方法 2004年3月至2011年4月本组共应用此方法治疗32例骨巨细胞瘤患者,其中骨盆1例,股骨远端12例,胫骨近端10例,桡骨远端4例,肱骨近端3例,肱骨远端1例,跟骨1例.病理分级:Ⅰ级4例,Ⅱ级11例,Ⅲ级17例.术中边缘外分离肿瘤,原位插入微波针,控制性高温灭活瘤体,自体骨粒或骨水泥填充病灶腔隙,填充骨水泥和异体骨混合物,部分需行内固定,观察术后肿瘤复发和肢体功能评分.结果 32例患者皆得到随访,平均随访2年8个月.发现1例复发,1例感染,肢体关节功能评定:好者28例,可者4例,差者0例.结论 原位微波灭活瘤段+重建技术治疗骨巨细

  6. Pain, lower limb strength and physical function in patients with primary osteoporosis%骨质疏松患者疼痛与下肢肌力及生理功能间的相关性分析

    Institute of Scientific and Technical Information of China (English)

    杨延砚; 陈亚平; 李涛; 李玳; 赵炳楠; 左宁; 王威

    2010-01-01

    Objective To study the correlation between pain, lower limb strength and physical function in patients with primary osteoporosis. Methods Fifty-seven female patients diagnosed with menopause-related low bone mass or primary osteoporosis using a GE calcaneus bone density detector were involved in this study. The muscle strength of their lower limbs was tested with a Biodex system 4 machine. Pain was assessed with a visual analogue scale, and physical function (PF) with the SF-36 instrument. Results Low back pain was significantly correlated with PF, and so was leg pain. Leg pain was also significantly correlated with the strength of the extensors of the dominant leg during low velocity and medium velocity movement. Leg pain was not, however, significantly correlated with the strength of the flexors of the dominant leg during low and medium velocity movement. Conclusions Pain predicts poor physical function in patients with primary osteoporosis or low bone density. During low and medium velocity movement, leg pain significantly predicts poor muscle strength in the extensors of the dominant lower leg, but it has no correlation with the muscle strength of the flexors.%目的 研究原发性骨质疏松或骨量低下患者疼痛与下肢肌力、生理功能间的相关性,为制订科学康复方案提供参考依据.方法 共选取57例绝经期骨量低下或原发性骨质疏松患者,采用多关节等速测试系统检测患者下肢肌力,采用视觉模拟评分法(VAS)评定下肢及腰背部疼痛,选用汉化版SF-36健康调查问卷对患者生理功能进行评定.结果 经相关性分析发现,入选患者腰痛及腿痛均与生理功能具有显著负相关性(P<0.05);且腿痛与生理功能的相关性大于腰痛;下肢在慢速及中速运动时,腿痛与优势腿伸肌群肌力均具有显著负相关性(均P<0.05);与优势腿屈肌群肌力均无明显相关性(均P>0.05).结论 原发性骨质疏松或骨量低下患者疼痛与其生

  7. Radiography and sonography of clubfoot: A comparative study

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    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

  8. DXA测量BMD与超声测量SOS的比较%Comparison between SOS of quantitative ultrasound and BMD meas ured by DXA in diagnostic value of osteoporosis

    Institute of Scientific and Technical Information of China (English)

    安珍; 杨定焯; 王文志; 张祖君; 姜光瑶

    2001-01-01

    目的 本文通过对同一个人的跟骨超声声速(SOS)测量与双能X线吸收法测量腰2- 4,股骨近端骨密度(BMD)的临床对比来评价超声骨密度仪测量跟骨的SOS对诊断骨质疏松症 的敏感性和与DXA测量BMD的相关性。方法 对523名8~87岁健康人群同时采用DXA测量L2-4,股骨近端(N eck,Ward三角,Troch)BMD和超声骨密度仪测量左跟骨SOS值并进行相关分析。对1006名3~8 7岁健康人群测量左右跟骨的SOS值。结果 SOS与DXA测量BMD的骨峰值(PBM)均出现在20~39岁,SOS的PBM男性 为(1542.83±27.44)m/s,女性为(1531.02±29.96)m/s。40岁以后随着年龄的增加,二 者均逐渐下降。健康成人中BMD与SOS的相关系数为0.3~0.6,骨质疏松患者BMD与SOS的相 关系数(r=0.16~0.39)较健康人(r=0.33~0.61)低。左右足跟SOS无显著差异 ,DXA的BMD与SOS诊断骨质疏松症(OP)的符合率为60%。结论 DXA测量BMD与超声SOS为中等相关。建议在单独使用超声骨密度仪测 量SOS来诊断OP时,应当参照临床症状和X线的检查全面考虑,以免造成漏诊或误诊。%Dual energy x-ray absorptiometry(DXA) is a method o f measur ing the material properties of bone, that is, bone mineral density(BMD), whereas the quantitative ultrasound(QUS) is a method of assessing the mechanical proper ties of bone by the reflection and attenuation of ultrasound. We evaluated the s ensitivity of ultrasound in measuring bone mass by comparing with dual energy x -ray absorptiometry. BMD at lumbar spine and proximal part of the femur was mea sured by DXA and SOS at calcaneus by QUS in 892 subjects of 3 to 87 years in Chengdu. The results showed that SOS peaked at the age of 20 and declined with aging. The peak SOS was (1542.83±27.44)m/s in males and (1531.02±28.96)m/s in females. The correlation coefficients between SOS and BMD were 0.12~0.21 in children and 0.3~0.6 in adults, respectively. The homogeneity rate of the

  9. Evaluation of the results of bone mineral density measurement in adult women in longevity region%长寿地区成年女性骨密度测量结果评估

    Institute of Scientific and Technical Information of China (English)

    刘鹏; 徐世民; 李春燕; 冯哲; 贺韩臻

    2013-01-01

    目的 检测广西巴马地区20岁~60岁成年女性的骨密度,探讨其骨密度变化的规律.方法 随机选取当地268位20岁~60岁成年女性,按不同年龄分组,每组5岁,共8组.应用韩国生产跟骨超声骨密度测定仪,测定跟骨骨密度.采用SPSS16.0对数据进行分析.结果 268例全部进入分析.(1)女性的峰值骨密度处于36岁~40岁年龄组,峰值组的骨密度高于绝经后组(P<0.05),且随年龄的增加呈现先升高后下降的趋势.(2)女性的骨密度随年龄的增加而减少,导致骨质疏松症的发病率升高.(3)Pearson相关分析显示,女性的SI和年龄呈现出负相关(r=-0.193,P<0.01),和身高有显著关系(r=0.157,P<0.05),并未发现与体重和BMI有关系.结论 广西巴马地区20岁~60岁女性SI值与年龄和身高均有显著相关性,本研究获得的SI值为进一步探讨长寿地区成年女性的骨密度状况提供参考依据.%Objective To investigate the changing pattern of bone mineral density (BMD) by testing BMD in adult women aging from 20 to 60 years old in Bama, Guangxi. Methods Two hundred and sixty-eight adult women aging from 20 to 60 years old were randomly selected. All subjects were divided into 8 groups according to a 5-year-age division. BMD of the calcaneus was tested with ultrasound BMD detector ( Korea). A SPSS 16. 0 software was used to analyze the data. Results The data of all 268 women were analyzed. The peak BMD of the women occurred in 36-40-year-old group. Peak BMD was higher than that in postmenopausal group (P < 0. 05 ) , with a tendency of increasing first then decreasing along with the increase of age. BMD of women decreased along with the increase of age , leading to a high incidence of osteoporosis. SI of BMD was negatively correlated with age ( r = - 0. 193, P < 0. 01 ) while it was significantly correlated with height ( r = 0. 157 , P < 0. 05 ) , according to Pearson correlation analysis . However, no correlation with

  10. 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

  11. One-center bone tumors in the foot:an epidemiological analysis of 258 cases%单中心足部骨肿瘤258例临床流行病学分析

    Institute of Scientific and Technical Information of China (English)

    廖锋; 徐海荣; 牛晓辉

    2015-01-01

    目的:探究足部骨肿瘤流行病学特点。方法回顾1957年8月至2014年7月,北京积水潭医院骨肿瘤科诊治的258例足部骨肿瘤患者资料,分析其性别、年龄、病理诊断、发病部位及影像特点。结果男174例,女84例,年龄7~76岁,平均27.9岁。病变多位于跟骨、趾骨、距骨、跖骨,少见于足舟骨、楔骨和骰骨。恶性骨肿瘤38例,包括软骨肉瘤13例、骨肉瘤8例、Ewing 肉瘤6例、转移性肿瘤5例;中间型肿瘤81例,包括软骨母细胞瘤36例、骨巨细胞瘤29例、动脉瘤样骨囊肿10例、软骨粘液样纤维瘤3例;良性肿瘤139例,包括内生软骨瘤37例、甲下外生性骨疣27例、单纯性骨囊肿26例、骨软骨瘤19例、骨样骨瘤12例、骨脂肪瘤10例。结论足部骨肿瘤好发于中青年男性,多为良性或中间型。%Objective To explore epidemiological features of bone tumors in the foot and further to guide clinical diagnosis.Methods From August 1957 to July 2014, 258 patients were included. Gender, age, location, pathological and radiological data were reviewed.Results There were 174 males and 84 females, with a mean age of 27.9 years ( range: 7-76 years ). Bone tumors of the foot had particular predilections in the calcaneus, talus, phalanx and metatarsal bones. Thirty-eight cases of malignant tumors included chondrosarcoma ( 13 cases ), osteosarcoma ( 8 cases ), Ewing sarcoma ( 6 cases ) and metastatic tumors ( 5 cases ). Eighty-one cases of intermediate bone tumors included chondroblastoma ( 36 cases ), giant cell tumors of bone ( 29 cases ), aneurysmal bone cysts ( 10 cases ) and chondromyxoid ifbroma ( 3 cases ). One hundred and thirty-nine benign bone tumors included enchondroma ( 37 cases ), subungual exostosis ( 27 cases ), simple bone cyst ( 26 cases ), osteochondroma ( 19 cases ), osteoid osteoma ( 12 cases ) and lipoma of bone ( 10 cases ).Conclusions Benign and intermediate tumors are most common in

  12. The imaging features of the chondroblastoma in the tarsal bone%足跗骨软骨母细胞瘤的影像学表现

    Institute of Scientific and Technical Information of China (English)

    彭俊红; 周利华; 黄利华; 王慧明; 阮学广

    2012-01-01

    目的:总结分析足跗骨软骨母细胞瘤的影像学表现.方法:回顾性分析经临床病理证实的发生于足跗骨的5例软骨母细胞瘤的X线、CT及MRI表现.结果:5例均单发,2例位于跟骨,2例位于距骨,1例位于舟骨.X线主要表现为圆形或卵圆形透亮影,边界清楚,5例均可见病灶边缘硬化带形成,病灶内未见明显钙化.CT扫描显示肿瘤呈膨胀性生长,骨质破坏区边界锐利、硬化,灶周软组织肿胀,未见骨膜反应及软组织肿块,增强扫描呈轻度不均匀强化.MRI可见病灶形态呈分叶状,呈长、稍长T1信号,混杂T2信号,伴有灶周骨髓水肿及关节腔积液,灶周软组织水肿,增强扫描亦呈轻度不均匀强化.结论:足跗骨软骨母细胞瘤较少见,其影像学表现具有一定特征性.%Objective:To analyze the imaging features of the chondroblastoma in the tarsal bone,and enhance the com petence of diagnosis. Methods:The X ray,CT and MRI imaging of 5 cases with pathology proved chondroblastoma which were located in the tarsal bone were retrospectively analyzed. Results:Of all the 5 cases,the locations of tumors were as fol forws:calcaneus(n=2),talus(n=2),navicular bone (n=1).The main radiographic manifestations were round or oval translucent area witn well delined margin, sclerotic rim,and no calcilications in all lesions. On CT scan,thee tumor demon strated expansive growth patterns,by showing well defined bone destruction with sclerosis rim. The adjacent soft tissue ede ma,without periosteal reaction and soft tissue masses were observed. The contrast enhancement was mild. Lesions demon strated heterogeneous MR signal intensity on T1WI and T2 WI. Lobular margins,adjacent bone marrow edema and joint ef fusion were found. The contrast enhancement was mild too. Conclusion: Characteristic imaging features could be revealed in the uncommon cnondroblastoma of the tarsal bone,which were helpful in the diagnosis.

  13. 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

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    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.

  14. 广西仫佬族女性定量超声骨量峰值%Peak bone density of women of Mulam nationality in Guangxi province*

    Institute of Scientific and Technical Information of China (English)

    黄秀峰; 周庆辉; 浦洪琴; 黄昌盛; 李松良

    2011-01-01

    Objective: To obtain the value of catcaneal broadband ultrasonic attenuation (BUA) in women of Mulam nationality in Luocheng in Guangxi province, and establish the peak bone mineral density of Mulam women, and then to provide data for prevention, screening, diagnosis and evaluation of the theraputic effects of osteoporosis. Methods: 697 Mulam women (ranging from 25 to 75 years) were divided into ten groups according to the age. The bone density was evaluated with quantitative ultrasound instrument, and the height, body mass, the length of foot as well as the broadband ultrasound attenuation (BUA) of the left calcaneus were measured. Results: (1) The peak values of BUA of women in Mulam nationality appeared in 45- to 49years age group. The peak bone density of women in Mulam nationality was 70. 79 ± 13.46 db/MHz. (2) The body mass of Mulam female increased with age,and at the peak in the 45- to 49-year age group, and gradually decreased, which was consistent with the change the value of calcaneal BUA. Conclusion: The research show that the value of BUA in Mulam female changed with age, and identify the value and the age of the peak bone density in Mulam female. The correlation between bone mineral density and the body mass is also verified, which will provide foundation for the study of the correlation analysis between human body composition and osteoporosis.%目的:通过获取广西罗城仫佬族女性骨定量超声值,建立仫佬族女性定量超声骨量峰值,为骨质疏松症的预防、初步筛查、诊断和评估治疗效果提供依据.方法: 用定量超声骨密度仪对697名仫佬族女性(年龄≥25岁,按年龄分为10组,以5岁作为1个年龄段),进行骨定量超声测定和分析,测量其身高、体质量、足长和左侧跟骨超声振幅衰减(BUA).结果: 仫佬族女性的BUA峰值年龄在45~岁组;仫佬族女性BUA峰值为(70.79±13.46)db/MHz;仫佬族女性25~45岁组平均体质量随年龄增大而增高,45~岁达

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

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    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

  16. Anatomical observation and MRI analysis of the spring ligament%弹簧韧带的解剖观测和MRI分析研究

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    喻永新; 刘凯; 邵红岩; 尚如国

    2014-01-01

    Objective To observe the anatomical characteristics and explore the function of the spring ligament by anatomical study, and to observe morphology of the spring ligament in MRI images. Methods The spring ligament was dissected;its origin, distribution and morphological characteristics were recorded. Meanwhile, analysis of the spring ligament in different scanning planes of the MRI images were carried out. Results The spring ligament is made up of the superomedial calcaneonavicular ligament, the medioplantar oblique calcaneonavicular ligament and the inferoplantar longitudinal calcaneonavicular ligament, which originated from the sustentaculum tali of the calcaneus, and attached to the superomedial aspect of the navicular bone,the bottom of the navicular tuberosity and the navicular beak, respectively. The spring ligament could be displayed clearly on MRI, which was a low signal on T1 and T2 weighted images, and it is better displayed on the sagittal and transverse planes. Conclusion Spring ligament is an important complex of ligamentaneous structures in bearing the head of talus, which has a great significance in maintaining the longitudinal arch of the foot. MR can be used as a diagnostic tool when the spring ligament is injured.%目的:通过解剖学研究了解弹簧韧带的解剖特点并探讨其功能作用,同时应用MR观察弹簧韧带,分析其在MRI上的显示情况。方法解剖并观察弹簧韧带,了解其起止、走形及形态特征等情况,测量相关数据。同时对弹簧韧带不同扫描平面的MRI进行分析研究。结果弹簧韧带起于跟骨的载距突,由上内跟舟韧带,内下斜行跟舟韧带和下跟舟韧带3部分组成,分别止于舟骨的上内侧面,舟骨粗隆下和舟骨喙突。MR可以清楚的显示弹簧韧带的各部分结构,在T1及T2加权图像上呈中低信号表现,以矢状面和横断面显示较佳。结论弹簧韧带是足底部承载距骨头的一

  17. Changes in bone mineral density in pregnant women and their contributing factors%孕期女性骨密度变化及影响因素研究

    Institute of Scientific and Technical Information of China (English)

    张红; 郑彦; 白云; 燕美琴; 王芳芳; 贾艳芳; 赵敏

    2013-01-01

    目的 探讨孕期女性骨密度变化及影响因素,为预防骨质疏松提供依据.方法 采用美国Hologic公司生产的SAHARA临床超声骨密度仪,对2012年6月至12月在山西省妇幼保健院进行产前检查的304名健康孕期女性进行跟骨骨密度超声测量及生活习惯的调查.所得数据计量资料比较采用t检验或方差分析,相关分析采用Pearson相关,多因素分析采用多重线性回归模型.结果 ①孕期女性低骨量发生率为29.9%,骨质疏松发生率为18.8%,各孕期低骨量及骨质疏松发生率差异无统计学意义;②孕晚期与孕早期相比QUI、Z-Score值有所降低;③孕期女性跟骨骨密度与孕周、体质量、吃饭时间规律有关.结论 对孕期女性进行骨密度测量,完善围产期保健,对预防骨质疏松具有重要意义.%Objective To investigate the changes in bone mineral density in pregnant women and their influencing factors for prevention of osteoporosis.Methods The SAHARA clinical ultrasound bone densitometer (Hologic company,United States) was used to measure the calcaneal bone density in 304 healthy pregnant women who had come to Shanxi Provincial Maternal and Child Health Hospital from June 2012 to December 2012 for prenatal examination.Their living habits were also investigated.All data were analyzed statistically.Measurement data were compared with t test or analysis of variance,correlation analysis was done with Pearson's correlation,and multivariate analysis with the multiple linear regression model.Results ① The rate of low bone mass in the pregnant women was 29.9% and the incidence of osteoporosis was 18.8%.There were no significant differences regarding the low bone mass and the incidence of osteoporosis among all periods of pregnancy.②The quantitative ultrasound index (QUI) and Z-Score at the late pregnancy decreased compared with the early pregnancy.③The calcaneus bone mineral density in pregnant women was related to

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

    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

  19. 非特种职业者疲劳性骨折的误诊原因分析%Causes of misdiagnosis of fatigue fracture in nonspecific occupation

    Institute of Scientific and Technical Information of China (English)

    高振华; 张朝晖; 黄兆民; 孟悛非

    2011-01-01

    Objective To explore the causes of misdiagnosis of fatigue fracture on nonspecific occupational patients and look for diagnostic strategies.Methods Retrospective analysis was done on clinical imaging data of misdiagnosed fatigue fracture from 13 cases of nonspecific occupation.A11 of the 13 patients underwent X-ray examination, at the same time, some of the patients received CT scans (n=l0), MRI examination (n=8), and bone isotope scan (n=4).Results Among 13 cases of fatigue fracture, 7 cases occurred in the tibia, 2 in fibula, 1 in calcaneus, 2 in rib, and I in ischial tuberosity.llof 13 cases were unilateral fractures and 2 were bilateral fractures.Of all initial X-ray examination of the 13 cases, 6 were missed diagnosis, 1 was unclear diagnosis and 6 were misdiagnosis.While among all initial CT scans of the 10 cases, 2 were missed and 3 were wrongly diagnosed.5 of 8 cases' initial MRI examination were misdiagnosed.Of 4 cases examined with bone isotope scan, 2 cases were misdiagnosed and 2 were diagnosed unclearly.Causes of misdiagnosis could be composed of insufficient knowledge and attention towards the disease, non detailed medical history, improper choice of examination method and failure to carry out imaging signs.Conclusions Close correlation with clinical history, appropriate examination methods and accurate imaging identification contribute to a correct and timely diagnosis of fatigue fracture in nonspecific professionals.%目的 分析非特种职业者疲劳骨折的误诊原因,寻找诊断策略.方法 回顾分析13例误诊的非特种职业者疲劳骨折的临床影像学资料.13例均行X线平片检查,其中CT检查10例,MRI检查8例,同位素骨扫描4例.结果 13例疲劳性骨折发生于胫骨7例,腓骨2例,跟骨1例,肋骨2例,坐骨结节1例;单侧11例,双侧2例.13例首次X线平片检查,漏诊6例,诊断不清1例,误诊6例;10例首次CT检查,漏诊2例,误诊3例.8例首次MRI检查中,误诊5例.4例同位素骨扫描检

  20. 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

  1. 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.

  2. 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.

  3. 切开复位内固定治疗SandersⅢ型及Ⅳ型跟骨骨折%Treatment of Sanders type Ⅲ and Ⅳ calcaneal fractures with open reduction and internal fixation

    Institute of Scientific and Technical Information of China (English)

    陈志伟; 杨乐忠; 吴文特; 刘春磊

    2011-01-01

    , shoes 10,stairs 4, terrain 4, cosmesis 10 ,motion 5 ). Results:All 58 feet in 51 patients were followed up, and the duration ranged from 6 to 24 months,with an average of 13 months. The incidence of complications was 13.8% (8/58). Incision superficial necrosis in 2 feet,choronicity pain in 4 feet,subtalar joint arthrositis of advanced stage in 2 feet. According to Maryland foot score,the results were excellent in 23 feet, good in 27, fair in 5, poor in 3. Conclusion:The surgical techniques and results of internal fixation to fractures are related to anatomic features of calcaneus and their injury mechanism. It is an effective method for the treatment of calcaneal fractures with Sanders type Ⅲ, Ⅳ.

  4. 开放性跟骨关节内骨折的手术治疗%Surgical treatment of open intraarticular calcaneal fracture

    Institute of Scientific and Technical Information of China (English)

    孙洋; 曲家富; 曹利海; 闫荣亮

    2013-01-01

    Objective To investigate effect of surgical treatment for open intraarticular calcaneal fracture.Methods A total of 128 patients (141 feet) with open intraarticular calcaneal fracture combined with severe soft tissue injury were treated,in the early stage of treatment,the primary purposes were to achieve soft tissue coverage for wound healing,and to reduce calcaneal fracture for avoiding increase of skin tension and contracture of Achilles tendon.In the first stage operation,the fractures were reduced by drawing,prying or manual reduction to restore the width,height and length of calcaneus,and then fixed with screws or Kirschner wires.Finally vacuum sealing drainage(VSD) was used to cover wound according to degree of injury.In the second stage operation,open reduction and internal fixation or reconstruction of calcaneal thalamus combined with subtalar arthrodesis were used according to Sanders classification.Results All patients werefollowed up for 18 months to 6 years (average,40 months).The average wound healing time was 16 days,and the first rate healing rate was 90.8%.The total infection rate was 9.2%,including superficial infection rate of 7.8% and deep infection rate of 1.4%.According to AOFAS classification,functional recovery was excellent in 58 feet,good in 70 feet,fair in 10 feet and poor in 3 feet,the excellent and good rate was 90.8%.Conclusion For open intraarticular calcaneal fracture combined with severe soft tissue injury,different methods should be used according to degree of injury and fracture style.Usually,the VSD should be used for patients with severe soft tissue injury,which can significantly reduce infection rate and improve effect.%目的 探讨开放性跟骨关节内骨折手术治疗的有效方法.方法 对Gustilo Ⅱ型以上128例(141足)跟骨关节内骨折,早期解决软组织覆盖及伤口愈合问题,尽量恢复跟骨正常骨性结构,用螺钉或克氏针临时固定骨折,均采用VSD技术治疗为后期处理

  5. 跟骨骨折术后并发症的分析及预防策略%Analysis of postoperative complications of calcaneal fractures and prevention strategies

    Institute of Scientific and Technical Information of China (English)

    刘彦

    2012-01-01

    Objective To investigate the intra-articular calcaneal fracture fixation complications, causes, prevention and policy. Methods For intra-articular calcaneal fractures in 82 feet for an open reduction and internal fixation and treatment, routine use of perioperative antibiotics to prevent infection, follow-up time of 5 to 35 months, an average of 10 months. Results In accordance with Marryland Foot Score were evaluated, the affected foot function fine 27 feet, good 42 feet, 13 feet. Early complications occurred in this group of 16 feet, the rate was 19. 5% , of which 9 feet cut edge of skin necrosis, wound infection in 4 foot, 2 foot wound rejection, sural nerve injury in 1 foot. Later stage of the subtalar joint chronic pain, significantly affect walking 6 feet, the rate was 7%. Conclusion Intra-articular calcaneal fracture fixation complications and anatomical characteristics of the calcaneus and calcaneal fracture mechanisms, but through effective measures to reduce the incidence of complications, complications after the treatment according to the situation accordingly.%目的 探讨跟骨关节内骨折内固定手术并发症的原因、预防和策略.方法 对77例82足跟骨关节内骨折进行了切开复位内固定治疗,围手术期常规应用抗生素预防感染,随访时间5 ~35个月,平均10个月.结果 按照Marryland足部评分系统(Marrryland Foot Score)评价术后功能,患足功能优27足,良42足,可13足.本组发生早期并发症16足,发生率为19.5%,其中切口边缘皮肤坏死9足,伤口感染4足,伤口排异反应2足,腓肠神经损伤1足.晚期出现距下关节慢性疼痛、明显影响行走6足,发生率为7%.结论 跟骨关节内骨折内固定手术并发症与跟骨解剖特点、跟骨骨折机制、手术方式、手术切口的选择、复位效果以及固定方式有关,但可以通过有效的措施减少并发症的发生,出现并发症后可根据情况作出相应的处理.

  6. 自固化磷酸钙人工骨植骨联合可塑形钛板内固定治疗 Sanders Ⅲ,Ⅳ型跟骨骨折%Autosetting Calcium Phosphate Cement Bone-Grafting and Internal Fixation with Shaping Titanium Plate for Treatment of SandersⅢ,ⅣCalcaneal Fractures

    Institute of Scientific and Technical Information of China (English)

    韩振学; 李志仙

    2014-01-01

    [ ABSTRACT] Objective To investigate the curative effect of Sanders Ⅲ,Ⅳ calcaneal fractures by autosetting calcium phosphate cement bone-grafting and internal fixation with shaping titanium plate.Methods Twenty-eight cases(28 feet) SandersⅢ,Ⅳcalcaneal frac-tures adopted open reduction with shaping titanium plate internal fixation combined with autosetting calcium phosphate cement bone-grafting, the shaping titanium plate were placed at the outward of calcaneus,reset evaluation of calcaneal fractures by measuring Bohler's Angle,Gis-sane's Angle in postoperation.Results All patients were followed up,postoperative skin necrosis in 2 cases and sural nerve injury in 1 case. After 6 months,Bohler's Angle in 20 foot≥35°,in 8 foot≥30°,Gissane Angle fully recovered to normal range and calcaneal varus deformity on axial were not seen.Fracture healing time was 2~3 months,according to Maryland foot scoring system,treatment effects of all patients were as follows:excellent in 15 feet,good in 5 feet,normal in 3 feet and poor in 2 feet,the total excellent and good rate was 83.7%,the excel-lent and good rate ofⅣtype was 56.2%.Conclusion The treatment of SandersⅢ,Ⅳcalcaneal fractures by autosetting calcium phosphate cement bone-grafting and internal fixation with shaping titanium plate is simple and its curative effect is satisfied.%目的:探讨自固化磷酸钙人工骨植骨联合可塑形钛板内固定治疗Sanders Ⅲ,Ⅳ型跟骨骨折的疗效。方法对28例(28足) SandersⅢ,Ⅳ型跟骨骨折均采用切开复位可塑形钛板固定联合自固化磷酸钙人工骨治疗,跟骨外侧放置可塑形钛板,术后测量Bohler's 角、Gissane's角,评价跟骨骨折的复位情况。结果所有患者均得到随访,术后皮缘坏死2例,腓肠神经损伤1例。术后6个月Bohler's 角20足≥35°,8足≥30°,Gissane角全部恢复至正常范围,轴位片上未见跟骨内翻畸形。骨折愈合时间2~3个月,

  7. 外侧切口治疗跟骨骨折%Treatment of calcaneal fracture with the lateral incision

    Institute of Scientific and Technical Information of China (English)

    王树金; 孔丹辉; 张华俊; 陈建红; 蒋波逸

    2013-01-01

    Objective To explore the effects of lateral incision surgical in treatment of calcaneal fractures. Methods From September of 2009 to December of 2011 using the lateral incision surgical treatment of calcaneal fractures in 21 patients:15 males and 6 females;ages 31~65 years old, with an average of 48. 3 years old. Unilateral calcaneus in 19 cases, bilateral in 2 cases, fall injury in 17 feet, crush injury in 4 feet. According to Sanders type: type II 9 feet, type III 11 feet, type IV 3 feet. The surgery time was 5~12 days after injury. Results Follow-up of 10~24 months, with an average of 16 months. 3 feet with superficial necrosis of skin flap, scar healing after changing dressing;2 feet with lateral edge of the skin is numb. 17 feet postoperative X-ray films showed that the articular surface reset good, calcaneal height and width satisfactory recovery;6 feet postoperative Bohler angle and Gissane angle than before surgery significantly improved, but not completely back to normal. Conclusion The efficacy by Maryland scoring criteria:excellent in 13 feet, good in 6 feet, general in 4 feet, good rate of 82.6%. Lateral incision treat calcaneal fractures have such advantages:fracture lines revealed clear, subtalar articular surface and formation calcaneocuboid articular surface can recoverable to normal arch form and calcaneal width, and have enough space to place plates and screws, which will properly protected Soft tissue. Sanders II fractures and articular surface crushed Sanders III fractures is applicable.%目的:探讨外侧切口手术治疗跟骨骨折的效果。方法2009年9月~2011年12月采用外侧切口治疗跟骨骨折21例,男15例,女6例;年龄31~65岁,平均48.3岁。单侧足19例,双侧足2例。坠落伤17例,压砸伤4例。按Sanders分型:Ⅱ型9足、Ⅲ型11足、Ⅳ型3足。手术时间为伤后5~12 d。结果随访10~24个月,平均16个月。术后3足出现皮缘浅表坏死,经换药后瘢痕愈合;2足出

  8. 跟骨关节内骨折内固定手术临床报告%The Clinical Report of Inter-articular Calcaneal Fracture Fixation Surgery

    Institute of Scientific and Technical Information of China (English)

    陈家麟

    2011-01-01

    Objective Through inter-articular calcaneal fracture fixation surgery and complications study to evaluated the results of surgical technique with open reduction and internal fixation of the inter-articular calcaneal fractures,and controlled complications. Methods From February 2004 to October 2010,45 sides of calcaneal in 42 patients were treated with open reduction and plastic calcaneus titanium plate fixation Sanders Ⅰ~Ⅳ type fractures through lateral approach with lateral “L” shaped incision,part of cases supplemented by autogenous bone grafting when necessary. According to Sanders classification,3 sides were accounted for type Ⅰ ,20 for type Ⅱ , 17 for type Ⅲ ,5 for type Ⅳ. During operation,intraoperative lateral X-ray observation Bohlers and Gissanes angle,Broden view was made to evaluate the recovery of articular surface. Results Incision necrosis infection in 3 cases,sural nerve injury in one foot. X-axis and lateral radiography ,and patients were Maryland foot score standard evaluation results of operations,45 sides of calcaneal fractures in 42 patients were followed up for 2~36 months,average of 18 months. Excellent in 27,good in12 feet,fair in 4 feet,poor in 2,excellent and good rate was 86.7%. Conclusion Lateral “L” shaped incision,open reduction and internal fixation of calcaneal fractures,can be more satisfactory anatomical reduction and rigid fixation of calcaneal fractures. It is an effective way. Intraoperative flap incision must be carefully protected to prevent postoperative wound necrosis or infection.%目的 通过对跟骨关节内骨折内固定手术和并发症研究,探讨跟骨关节内骨折内固定手术方法和治疗效果,防治并发症.方法 2004年2月至2010年10月我科采用外侧"L"型切口、可塑形跟骨解剖钢板进行开放复位内固定,手术治疗Sanders分型Ⅰ~Ⅳ型跟骨骨折42 例45足,必要时行植骨.根据Sanders分型,Ⅰ型3足,Ⅱ型20足,Ⅲ型17足,Ⅳ型5足.术中

  9. Imaging diagnosis of metastatic tumors of short bones of limbs%手足短骨转移瘤的影像学诊断

    Institute of Scientific and Technical Information of China (English)

    周长友; 陈久尊; 何家维; 刘琨; 陈伟

    2013-01-01

    目的:探讨手足短骨转移瘤的影像学表现.方法:回顾性分析16例手足短骨转移瘤患者的临床及影像学资料.结果:16例中病灶位于手部6例(指骨4例,掌骨1例,腕舟骨1例),位于足部10例(跟骨3例,跖骨5例,趾骨2例),其中11例为手部或足部单发,5例多发.13例能明确原发肿瘤,分别为肺癌7例,乳腺癌2例,肾癌、宫颈癌、甲状腺癌、结直肠癌各1例,3例原发肿瘤不明.影像学主要表现为溶骨性骨质破坏,9例在病灶部位可见软组织肿块,2例出现轻微骨膜反应,2例合并病理性骨折.结论:手足短骨转移瘤罕见,容易误诊、漏诊,尤其是单发病灶或原发肿瘤不明的患者,结合患者病史和多种影像学表现有助于早期明确诊断.%Objeetive:To investigate the clinical symptoms and imaging manifestations of limb os breve metastases.Methods:Imaging data of 16 cases who were diagnosed as limb os breve metastases were analyzed retrospectively.Results:In all 16 cases,6 cases were in bones of hands and 10 cases in bones of feet,among which 11 cases were single in hands or feet,5 cases were multiple and accompanied by involvement of other bones.In the 16 cases,phalanges were involved in 4 cases,metacarpals in 1 case,scaphoid bone in 1 case,calcaneus in 3 cases,metatarsal bones in 5 cases,and phalanges of toe in 2 cases.The primary tumors were determinable in 13 cases:7 lung cancers,2 breast cancers,1 renal cancer,1 cancer of cervix,1 cancer,and 1 colorectal cancer;whereas there were 3 cases with indeterminable primary tumors.The main imaging manifestations were lytic bone destructions:9 cases with soft-tissue mass adjacent to the lesions,2 cases with mild periosteal reaction,and 2 cases with pathological fractures.Conclusion:Since metastatic tumors of short bones of limbs are rare,diagnosis is likely to be missed or delayed,especially in those cases whose lesions are single or the primary tumors are indeterminable.A combination of medical

  10. Exploration of digital technology in traumatic orthopedic clinical teaching for eight-year program medical students%数字骨科技术在八年制医学生创伤骨科临床教学中的应用

    Institute of Scientific and Technical Information of China (English)

    金丹; 付苏; 刘军; 王尚冲; 相大勇; 余斌

    2014-01-01

    结合本科室教学实践,对数字骨科技术在八年制医学生创伤骨科临床教学中的应用进行初步探索。通过数字骨科技术重建骨与关节损伤三维模型、结合具体病例进行立体展示、个人计算机上动态复习回顾、三维打印骨折实物模型展示等,加深学生对创伤骨科基础知识的理解,加快其融入临床实践的进程;利用相关软件实现骨折复位、固定的虚拟设计,在此基础上引导学生亲自参与制定并在个人计算机上模拟实现手术计划,有助于其提高病例诊疗分析能力、养成正确的临床工作思维;积极指导学生利用数字骨科技术,开展后踝、跟骨骨折的有限分析,制作足踝部骨折分型与功能评分等移动设备APP软件,较好地激发了其临床科研创新兴趣。%A preliminary exploration of the application and effects of digital orthopaedic technique combined with the clinical practice in our clinical teaching of orthopaedics and trauma for 8-year program medical students has been made. Construction of 3D-model of bone and joint with the digital reconstruction technology, combination of 3D-display with detailed clinical cases, individual studying of knowledge, and fracture models performed by three dimensional printing, all have enhanced the students' understanding of the basics knowledge of orthopaedic trauma and accelerated the process of its joining into clinical practice. Related software has been used to realize the virtual design of fracture reduction and fixation and based on it, students have been guided to personally involve in the development and realization of surgical simulation program on a personal computer, thus improving students' capabilities of analysis, diagnosis and treatment of illness. Besides, students have been actively guided to use digital technology to conduct the finite ele-ment analysis of posterior malleolar fractures and calcaneus fractures , and to produce

  11. 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

  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. 婴幼儿距骨畸形性扁平外翻足的治疗%Experience in the treatment of infantile talus deformity lfatfoot

    Institute of Scientific and Technical Information of China (English)

    蔡豪祺; 王志刚; 蔡海清; 葛翼华

    2015-01-01

    patients ( 28 feet ). Through the physical examination ( for example, the Achilles tendon ) and X-ray measurement of TCA & CPA & T1MT, type and severity of the disease could be evaluated. In vertical talus of max plantar lfexion in lateral radiograph, there were talo-navicular and calcaneo-cuboid dislocations. In oblique talus of max plantar lfexion in lateral radiograph, there were no talo-navicular or calcaneo-cuboid dislocations. Six vertical talus feet were all inflexible flatfeet, which had to be treated by extensive soft tissue release and open reduction even with a calcaneus lengthening. Twenty-two oblique talus feet were flexible flatfeet with Achilles tendon contracture, accepting the Achilles tendon lengthening and reduction of the talus. In the follow-up, the X-ray was measured again and the Maryland foot score was used for evaluation.Results The mean follow-up period was 31 months. The 6 vertical talus feet gained more than 9 points by Walker system. And the 22 oblique talus feet were all excellent or ifne by Maryland system. For 5 vertical talus on lateral radiograph: TCA was reduced from 83.1° to 51.3°, CPA was from-20.1° to 1.3°, and T1MT was from 85.3° to 30.6°. And in Maryland system: 2 excellent, 1 good, 2 fair. For 17 oblique talus on lateral radiograph: TCA was reduced from 58.2° to 35.3°, CPA was from-5.3° to 15.6°, T1MT was from 42.3° to 9.7°. And in Maryland system, 15 excellent, 2 good.Conclusions Accurate identiifcation and proper treatment are critical to obtain good results. Oblique talus is lfexible lfatfoot with contracture of Achilles tendon, and vertical talus is rigid lfatfoot. Both of them can be identiifed by physical and imaging examination. Early active treatment are needed. Series cast, Achilles tendon lengthening, closed reduction and internal ifxation are mainly used in the treatment of children with oblique talus. The treatment of vertical talus varies according to the age of the children, including series cast, Achilles

  14. Subtalar Joint Fusion through Modified Lateral Approach in Treatment of Severe Calcaneal Mal-union%改良外侧入路距下关节植骨融合治疗严重跟骨骨折畸形愈合

    Institute of Scientific and Technical Information of China (English)

    石国栋; 李波; 杨兴华; 张驰; 张海林; 马辉

    2016-01-01

    Objective To evaluate the efficacy of the subtalar joint fusion through the modified lateral approach for the treatment of severe calcaneal.Methods A total of 31 patients(22 males and 9 females)with complete follow-up of calcane-alⅡ,Ⅲ type Malunion Stephen were enrolled in the present study from January 2 0 1 0 to December 2011 . Median age was 45. 2 years with a range of 23 to 68 years. At time of the study,21 patients had the hind foot varus deformity,and 10 had valgus deformity. 31 cases of patients were treated with a modified lateral approach,intraoperative lateral wall of the calcaneus resec-tion of osteophytes and peroneal tendon release,distraction the subtalar joint joint and scaling surface of cartilage,implanting tricortical iliac crest autograft;then 2 to 3 cannulated screw were fixed in the subtalar joint. Regular outpatient follow-up were done with talus and first metatarsal angle,talus calcaneal angle. American Association of Foot and Ankle Surgery( AOFAS) ankle and hindfoot score and visual analogue scale( VAS)were used. Moreover,the subtalar joint fusion and stability of the implant were observed after operation.Results The operation time was70~110(85±15)min.Follow-up time was15~28 (19 ± 6)months. All the incision healed well,and there was no plant loosening and cutting out. Foot pain of 29 cases signifi-cantly reduced. The Calcaneal valgus deformity and the calcaneal varus deformity of 30 cases significantly improved. There was no fusion failure. The talus first metatarsal angle improved from(16. 8 ± 2. 3)° pre-operatively to(5. 6 ± 1. 2)° post-opera-tively,the talus calcaneus angle from(15. 8 ± 2. 1)° pre-operatively to(26. 1 ± 2. 3)° post-operatively,AOFAS ankle and hindfoot angle improved from(33. 2 ± 6. 2)° pre-operatively to(84. 7 ± 5. 6)post-operatively. Pain scores decreased from (8.1±0.8)pre-operatively to(2.2±1.1)post-operatively.Statistically significant difference was found(P<0.05).The last follow-up conducted

  15. Open Achilles tendon defects:reconstructive surgeries and long term follow-up%开放性跟腱缺损一期重建的远期随访

    Institute of Scientific and Technical Information of China (English)

    朱跃良; 徐永清; 王家祥; 殷作明; 张西正; 吕乾; 浦绍全; 吴一芃; 赵泽雨

    2016-01-01

    Objective To explore the reconstructive surgeries for open Achilles tendon defects and their long term outcomes.Methods A retrospective review was performed on 31 patients with open Achilles tendon defects treated at our center.There were 19 males and 12 females with an average age of 23.1 years (range,4-55 years).There were 7 cases on left side and 24 on right.The injury causes included spoke injuries (18 cases),crash injuries (6 cases),machine injuries (6 cases),and cut injuries (1 case).The defect lengths of the Achilles tendons in the study ranged from 1 to 1 1cm and the soft tissue defects ranged from 3 cm×3 cm to 12 cm× 10 cm.There were 10 cases with calcaneus fractures.Surgeries for Achilles tendon defects included sliding the Achilles tendon stump down with the sliding gastrocnemius musculocutaneous flap (15 cases),suture at the plantar flexion (10 cases),tendon flap turndown (1 case),hamstring tendon autograft (1 case),fascia lata muscle reconstruction (1 case) and tendon allograft (3 cases).Free flaps (7 cases) and non-free flaps (24 cases) were used for the coverage of concomitant skin defects.The calcaneus fractures were fixed with screws (6 cases) or K-wires (4 cases).The treatment protocols were based on the defect length of the Achilles tendon.Results The follow up period was 1-6 years (average,1.8 years).There was no total flap failure or tendon re -rupture,while 7 cases who had partial flap loss 2-4 days after the surgeries.In the latest follow-up,all the cases had regained full walking abilities:19 cases (61.3%,19/31) even had regained the heel raising by the reconstructed foot while 12 cases (38.7%) cannot.Compared with the contralateral side,31 cases' (100.0%)reconstructed ankles had the maximum plantar flexion,while 21 cases (67.7%) had the maximum dorsal extention.Ten cases (32.2%) lost their maximum dorsal extension ranging from 5° to 25°.Conclusion There are many reconstructive surgeries available for open Achilles tendon

  16. 副舟骨切除胫后肌腱止点重建跟骨内移截骨术治疗与副舟骨相关的平足症%The medial displacement calcaneal osteotomy with reconstruction of posterior tibial tendon insertion on navicular for the flatfoot related with accessory navicular

    Institute of Scientific and Technical Information of China (English)

    陈成; 唐康来; 胡超; 刘俊鹏; 袁成松

    2013-01-01

    目的 探讨副舟骨切除胫后肌腱止点重建跟骨内移截骨术治疗与副舟骨相关的平足症的临床疗效.方法 2009年3月至201 1年10月,采用副舟骨切除胫后肌腱止点重建跟骨内移截骨术治疗与副舟骨相关的平足症13例(16足),男4例,女9例;年龄18~64岁,平均41.3岁.单足10例,双足3例;均有明显的跟骨外翻.术后以美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)踝与后足评分评估后足功能,于X线片上测量足弓高度、跟骨倾斜角(CI)、距跟角(TC)、距骨-第一跖骨角(TMT).结果 13例均获得随访,随访时间12~31个月,平均16.8个月.术后6个月时11例(13足)无任何疼痛,2例(3足)有长距离行走后足部疼痛.术后随访时AOFAS评分从术前(52.4±6.4)分提高至(88.1±2.8)分;负重侧位X线片上足弓高度从(3.8±0.3) mm提高至(12.0±1.1) mm,CI从9.5°±1.1 °提高至20.1°±1.5°,TC从47.3°±2.5°改善至32.3°±2.5°,TMT从17.6°±1.6°改善至6.8°±1.0°;负重正位X线片上TC从39.5°±2.3°改善至26.2°±2.0°,TMT从15.2°±1.7°改善至6.3°±1.0°;轴位X线片上跟骨外翻角从11.3°±1.4°改善至4.2°±2.0°.结论 对与副舟骨相关的平足症的治疗,当存在后足外翻畸形时,副舟骨切除胫后肌腱止点重建跟骨内移截骨术可以明显缓解疼痛,有效矫正畸形,近期疗效良好.%Objective To investigate the clinical outcomes of the medial displacement calcaneal osteotomy with reconstruction of posterior tibial tendon insertion on navicular for the flatfoot related with accessory navicular.Methods From March 2009 to October 2011,13 patients (16 feet) with flatfoot related with accessory navicular received treatment by the medial displacement calcaneal osteotomy with reconstruction of posterior tibial tendon insertion on navicular.There were 4 males and 9 females,with an average age of 41.3 years (range,18-64 years).All patients had obvious valgus calcaneus

  17. Treatment of Haglund deformity by means of arthroscopic minimally invasive%关节镜辅助Haglund畸形矫正术

    Institute of Scientific and Technical Information of China (English)

    彭旭; 段小军; 杨柳

    2013-01-01

    Achilles tendon.Use the C-arm X-ray fluoroscopy observed calcaneus orthopedic during the operation.From the posteromedial approach to the posterolateral approach to alternately use the shaver and ArthroCare to clean up the front of the inflammation of the Achilles tendon bursa,by which could form arthroscopic operations "security zone".All operating equipment was on the back toward the Achilles tendon,which could maximize the protection Achilles tendon.Postoperative plaster or brace short brake was used for two weeks.16 cases of postoperative patients were followed up; the mean follow-up time was 13 months (9-18 months).According pain visual analogue scale (VAS) and the American Orthopaedic Foot and Ankle (AOFAS),the clinic effects were evaluated.Results At the last follow-up,the AOFAS hindfoot score of 91.5±2.8 was significantly higher than the preoperative 71.0±3.7 (t=17.38,P=0.014),postoperative VAS score 1.3±0.6 was significantly lower than the preoperative 5.10±0.44 (t=19.20,P=0.022).Conclusion The treatment of Haglund deformity by means of arthroscopic minimally invasive,with smaller trauma,faster recovery and lower complications,is effective and safe in clinical practice.However,dues to its steep learning curve,this method requires doctors to carry out who had relatively large arthroscopic surgery experience.

  18. 老年高血压患者骨密度减低的风险因素分析%Analysisof the Risk Factors of Low Bone Mineral Density of Elderly Hypertensive Pa-tients

    Institute of Scientific and Technical Information of China (English)

    赵星球; 杜玉开

    2015-01-01

    目的:研究高血压老年患者发生骨质疏松或骨量减低的危险因素.方法对1620例50岁以上高血压患者进行问卷调查和跟骨超声骨密度检查,收集服用钙通道阻滞剂(CCB)或钙离子拮抗剂(CA)等药物情况以及饮食嗜好和生活习惯等信息,采用χ2检验和多因素 Logistic回归分析,分析影响骨密度的危险因素.结果1620例高血压老年患者中,骨密度正常566例(34.9%)、骨量减低860例(53.1%)、骨质疏松194例(12.0%).服用CCB/CA、嗜好咖啡、可乐、巧克力以及吸烟的研究对象骨密度减低发生率较高(P 均<0.001);嗜好牛奶者的骨密度降低的发生率较低(P<0.001).骨量减低的多因素 Logistic 回归分析结果显示,长期服用 CCB/CA 的OR=59.36(95%CI:49.56~99.70)、嗜好咖啡OR=29.74(95%CI:15.70~59.40)、嗜好可乐OR=25.65(95%CI:12.86~53.28)、嗜好巧克力的OR=23.77(95%CI:12.00~53.15)、吸烟的OR=3.26(95%CI:1.95~5.95),嗜好牛奶对骨密度降低具有保护作用,OR=0.42(95%CI:0.21~0.83).结论高血压老年患者应该注意饮食的健康管理,服用钙离子拮抗剂或阻滞剂的患者,应同时监测骨密度的变化,预防骨量减低和骨质疏松.%Objectives To explore the risk factors of osteoporosis or osteopenia of elderly hypertensive pa-tients.Methods Questionnaire survey and ultrasound bone scanner via calcaneus was used to collected data of 1 620 elderly patients with hypertension,and the data collected including living habits,diet hobbies and the use of calcium channel blockers (CCB)or calcium antagonists (CA)and so on. Chi-square analysis and multivariate Logistic re-gression were used to analyze the data. Results 566 (34.9%)patients were with normal bone mineral density (BMD),860 (53.1%)were with osteopenia and 194 (12.0%)were with osteoporosis. The rates of low BMD were higher in groups of taking CCB or CA (OR=59.36,95%CI:49.56~99.70),and being like to drink

  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. 高血压与中老年女性骨密度的关系%The relationship of hypertension to bone mineral density in mid-elderly women

    Institute of Scientific and Technical Information of China (English)

    徐君翔; 刘晨; 张鹏; 徐又佳

    2015-01-01

    measurement.Bone mineral density was detected by calcaneus absorptiometry.Results ①The average BMD in hypertension group with antihypertensive was(0.416±0.098 )g/cm2,and without antihypertensive was (0.401±0.121) g/cm2,ei-ther of which was lower than that of non-hypertensive group.After adjustment for cofounders, the difference remained significant.②Among the hypertensive women, the average BMD was higher in group with antihypertensive, the difference was significant after adjustment for other factors.The group with single drug had higher average BMD than those with joint use of drugs.③Comparing the average BMD among four groups with each kind of single-used antihypertensive medication, the order was:ACEI/ARB>Thiazide diuretics>calcium channel blockers>βreceptor inhibitors.After adjustment for other factors, the average BMD in the group with use of ACEI/ARB or Thiazide diuretics was sig-nificant higher than that of hypertensive group without antihypertensive, and had no difference with the non-hypertensive group.The average BMD in the group with use of calcium channel blockers was higher than that of hypertensive group without antihypertensive, and lower than that of non-hypertensive group.The average BMD in the group with βreceptor inhibitors was significant lower than that of the groups with other three kinds of antihypertensive.Conclusions Hypertension is associated with reduced BMD in mid-elderly women.Divergence of BMD exists among women with different antihypertensive drugs.

  1. An analysis of imaging characteristics of X-ray, computed tomography and magnetic resonance imaging of intraosseous lipoma%骨内脂肪瘤的X线、CT和MRI影像学特点分析

    Institute of Scientific and Technical Information of China (English)

    李春爱; 栾贻新; 程晓光; 李相龙

    2014-01-01

    Objective To investigate the imaging characteristics of X-ray, computed tomography ( CT ) and magnetic resonance imaging ( MRI ) of intraosseous lipoma and to improve the accuracy of diagnosis and differential diagnosis.Methods The imaging characteristics of X-ray, CT and MRI in 38 cases of intraosseous lipoma conifrmed by percutaneous puncture biopsy and pathological test were analyzed retrospectively, which was compared with pathological outcomes.Results Intraosseous lipoma was noticed in the calcaneus (n=11 ), in the femur (n=8 ), in the tibia (n=5 ), in the ilium (n=6 ), in the humerus (n=6 ), in the radius ( n=1 ) and in the talus (n=1 ) respectively. There were 38 cases of single cystic type in all. Based on the X-ray and CT, calciifcation was found in 11 cases, bone crest in 19 cases, double sclerotic band in 4 cases, sclerotic border in 21 cases and bone expansion in 16 cases. Lipo density could be determined by CT in all the cases. The CT value was -40HU - -133HU. The MRI showed there was fat component in all the cases. Among them, cyst formation was detected in 9 cases, and inhomogeneous signal in 20 cases. According to Milgram’s stage, 4 cases were at stage I, 4 cases at stage II and 30 cases at stage III. Conclusions The X-ray and CT can show the lesion site, morphology, calcification, bone crest, sclerotic border, bone expansion and with or without boundary. The MRI can make clear fat component, fat necrosis, cyst formation, myxoid change, inlfammation, range and border of the lesion. The X-ray, CT and MRI relfect imaging characteristics of intraosseous lipoma from different aspects.%目的:探讨骨内脂肪瘤(intraosseouslipoma,IOL)的X线、CT和MRI的影像学特点及诊断价值,提高诊断及鉴别诊断的准确性。方法回顾性分析38例经皮穿刺活检和手术病理证实的IOLX线、CT和MRI影像学特点,并与病理结果进行对照。结果38例IOL发生部位分别为:跟骨11例,股骨8例,胫骨5

  2. Combination of plate screw and Steinmann pin in repair of comminuted calcaneal intra-articular and posterosuperior fractures%钢板螺钉结合斯氏针内固定修复粉碎性跟骨关节内伴后上方骨折

    Institute of Scientific and Technical Information of China (English)

    李广峰; 张鑫; 彭勇; 吴献民; 王思成; 杨国庆; 张友忠; 曹中华; 何国云; 尹志峰; 杨笑宇

    2014-01-01

    fractures. METHODS:From December 2009 to December 2013, forty patients with fractures of comminuted calcaneal posterosuperior fractures were randomly divided into two groups. In the control group, patients were treated by open reduction and internal fixation by plate screw only. In the experimental group, patients were treated by open reduction and internal fixation by combination of plate screw and Steinmann pin. The Gissane and Bohler angles of the calcaneus were measured from lateral radiograph before and 4 weeks after surgery, and the MARYLAND score was assessed at the last fol ow-up. Gissane and Bohler angle and MARYLAND score were compared in each group and among different groups. RESULTS AND CONCLUSION:Al patients were fol owed up for 9-23 months. BOHLER and GISSANE angles were significantly bigger at 4 weeks after surgery compared with pre-treatment in both groups (P<0.05). BOHLER and GISSANE angles were significantly bigger in the experimental group than in the control group at 4 weeks after surgery (P<0.05). During final fol ow-up, the average score by MARYLAND Foot Score was 78 in the experimental group and 67 in control group, with their excellent and good rate of 80%and 73%. The excellent and good rate was significantly higher in the experimental group than in the control group (P<0.05). These data indicated that open reduction and internal fixation with combination of plate screw and Steinmann pin has better efficacy in treatment of the comminuted calcaneal intra-articular and posterosuperior fractures compared with plate and screw fixation alone. Their fixation is firm. Functional exercise can be performed earlier. Postoperative recovery of function of the affected limbs is better than plate and screw fixation alone.

  3. 局部注射肝素钠免跟腱系统生物力学性质的变化%Effects of heparin with local injection on the biomechanical properties of Achilles tendon system in rabbits

    Institute of Scientific and Technical Information of China (English)

    刘波

    2008-01-01

    Sichuan Province Orthopaedic Hospital between March and December 2005. MATERIALS: Fifty Achilles tendon samples from Japanese White rabbits weighing (4.10±0.23) kg were used in this study. METHODS: Rabbits were divided into a control group (n=20), an exercise group (n=12) and a heparin treatment group (n= 18) at random. The rabbits were exercised for 3 weeks, simultaneously the heparin solution were injected into the peritendineum around the insertion of Achilles-calcaneus from the 4th week to the 6th week, twice a week. Then the cyclic stretching on the Achilles tendon was performed for 25 cycles and the tendon was stretched to the constant load to determine the stress relaxation vs, time. Finally the preparation was loaded to failure to measure the biomechanical characteristics of the tendon. MAIN OUTCOME MEARES: The cross-sectional area of the tendon, the cyclic creep lengths versus time, hysteresis loop, the stress relaxation versus time, the strength properties and the stress versus strain characteristics. RESULTS: The normalized area of hysteresis from exercise and heparin groups were significantly reduced in the most cycles, and the stress relaxation reduced more quickly in the exercise and heparin groups. The mean values for yield load and failure energy, yield energy, and yield stress, strain energies from the exercised preparations were higher than those of the controls. All of the mechanical properties from the heparin treated preparations were improved significantly. CONCLUSION: The results showed that the tensile strength and viscoelastic properties of tendon were improved by the management of heparin. It is indicated that the local injections of heparin at the location of peritendineum and tendon-bone insertions are beneficial to viscoelastic and tensile behaviors of the Achilles tendon system.

  4. Computer navigation-guided percutaneous radiofrequency ablation of the osteoid osteomas:13-case report%计算机导航辅助经皮射频消融治疗骨样骨瘤13例报告

    Institute of Scientific and Technical Information of China (English)

    鱼锋; 张清; 赵海涛; 徐立辉; 牛晓辉

    2014-01-01

    common site involved ( n=4 ), followed by the femoral trochanter ( n=2 ), the femoral neck ( n=2 ), the femoral condyle ( n=2 ), the tibial diaphysis ( n=2 ) and the calcaneus ( n=1 ). The intraoperative scanning with the C-arm Iso-C three-dimensional ( 3-D ) system ( Siemens ) was performed and the spine navigation system ( Stryker ) was used in all the cases. The core needle biopsy ( 9G ) which was guided by the navigation system was performed in the nidus, and the the outer sleeve was reserved as an access for the radiofrequency needle. The RFA was performed at 90℃for 6 minutes. All the patients were followed up postoperatively. The Visual Analogue Scale (VAS) was used before and after the surgery, and the X-ray and CT examinations were performed after the surgery to evaluate the results. Results All the 13 patients were followed up for 11.2 months on average ( range;4-20 months ), and they all underwent computer navigation-guided RFA successfully. Histopathological examination revealed 11 cases of osteoid osteomas and 2 cases of no diagnosis, and the pathological diagnosis rate was 85%. The postoperative pain got relieved instantly. The VAS scores were signiifcantly reduced, which were 4.7 points, 1.3 points and 0.1 points on average preoperatively and at 3 days and 3 months after the operation respectively, and the differences were statistically signiifcant ( P<0.05 ). Neither tumor recurrence nor pain relapse was found in all the patients during the follow-up. Conclusions Percutaneous RFA is a feasible, safe and effective method in the treatment of osteoid osteomas, with the advantages of more accurate positioning when inserting the needle in the nidus and minimally invasiveness under the guidance of computer navigation.

  5. 7例足踝部骨样骨瘤的诊断与治疗分析%Diagonosis and treatment of osteoid osteoma in foot and ankle in 7 cases

    Institute of Scientific and Technical Information of China (English)

    洪源; 徐向阳

    2014-01-01

    背景:骨样骨瘤是于1935年由Jaffe首次报道的一种良性成骨性疾患,具有界限清晰的局限性病灶。最常见的部位为股骨、胫骨等长干骨,而足踝部的骨样骨瘤较为少见。目的:研究足踝部骨样骨瘤的临床特点以及外科治疗效果。方法:回顾性分析2010年1月至2013年10月在我院足踝中心确诊的7例足踝部骨样骨瘤的临床资料,其中男5例,女2例,平均发病年龄21.5岁。受累部位:距骨5例,跟骨2例。发病至确诊时间平均为16个月(8~25个月),症状为疼痛,服用非甾体抗炎药可缓解。2例发病之前有相关部位的外伤史。3例曾于我院或外院诊断为其他疾病,并行相关手术治疗。1例外院确诊骨样骨瘤,手术切除后1年复发。所有患者均接受肿瘤刮除+植骨治疗。结果:术后平均随访14个月(2~24个月),患者疼痛症状均消失,未见病灶复发,无植骨反应,无病理性骨折。结论:足踝部骨样骨瘤发病少见,其临床表现容易与其他疾病相混淆。所以,需要密切结合患病部位的临床表现、完善的影像学检查和准确的组织活检做出明确诊断,并给以相应治疗。%Background:Osteoid osteoma is first reported in 1935 by Jaffe. It is a kind of benign bone disease with the limitation of well-defined lesions. The most common involved site is femur, tibia and other long bones. It is rarely seen in the foot and ankle. Objective:To research the clinical characteristics and surgical treatment effect of osteoid osteoma in the foot and ankle. Methods:Seven patients diagnosed as osteoid osteoma in the foot and ankle in our hospital between January 2010 and Octo-ber 2013 were enrolled in the retrospective study. There were 5 males and 2 females with a mean age of 21.5 years. The ta-lus was involved in 5 cases and the calcaneus was in 2 cases. It took 8-25 months (average 16 months) from onset to final di-agnosis. The

  6. The morphogenesis of the arteries of the pelvic extremity. A comparative study of mammals with special reference to the tree shrew Tupaia belangeri (Tupaiidae, Scandentia, Mammalia).

    Science.gov (United States)

    Funke, C; Kuhn, H J

    1998-01-01

    springs directly from the lateral wall of the aorta. In the 20-day embryo, the a. iliaca externa gives rise to an a. circumflexa ilium profunda towards the lateral pelvic wall, and in 23-day embryos, to the a. profunda femoris. The main branches of the a. profunda femoris develop until day 24. At the same time, the aa. circumflexa femoris lateralis and nutricia ossis femoris arise from the a. femoralis. The a. saphena, which is already recognizable in the 23-day embryo, gives rise to the a. genus descendens, and as an a. plantaris medialis, to four aa. digitales plantares communes (I-IV) at the planta pedis. The development of the a. tibialis cranialis on day 25 takes place independently and without any topographic relation to the a. saphena, which functionally replaces the a. tibialis cranialis in some other mammals. In the 26-day embryo, the aa. peronea and tibialis cranialis extend to the dorsum of the foot where they continue as the aa. dorsales pedis profunda and superficialis. The fourth main artery of the lower leg, the a. caudalis femoris, which is first observed in the 20-day embryo, reaches the lateral aspect of the foot on day 24. Its r. calcaneus runs to the planta pedis. In 30-day embryos, the aa. digitales plantares propriae have differentiated. The corresponding dorsal arteries and the superficial plantar vascular are develop until day 35, so that all important arteries of the pelvic extremity, which are seen in the corrosion cast of the adult, are recognizable. Among the embryos and the adult Tupaia studied, individual variation is minimal. The developmental stage at which the arteries of the leg acquired a secondary vascular wall was ascertained. Only a vessel with a primary vascular wall can dissolve into a capillary plexus later on (e.g., a. interossea). In contrast, the course of an artery which has acquired a secondary vascular wall is determined, because modifications of the course of a vessel often need a capillary plexus as an intermediate st

  7. 骨化三醇联合钙尔奇D对老年女性2型糖尿病患者骨代谢的影响%Effect of calcitriol combined with Caltrate D on bone metabolism in senile female patients with type 2 diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    李洁; 郑婧; 任利群

    2014-01-01

    , equivalent calcium to 600 mg with vitamin D3 125IU.Twenty-two patients in the treatment group took an oral medication of 0.25μg calcitriol combined with 1 tablet of Caltrate D for 6 months.The basic drug treatment in both groups had no significant difference, showing comparability.The differences of body weight, waist circumference, body mass index (BMI), kidney function, quantitative of urinary albumin, glycosylated hemoglobin (HbA1c), serum levels of glucose, lipid, calcium ( Ca), phosphorus (P), alkali phosphatase ( AKP), C-telopeptide of type I collagen (CTx), procollagen I N-terminal propeptide (PINP), and the bone mineral density (BMD) of the right calcaneal were compared and analyzed.Results No significant difference of weight, waist circumference, BMI, kidney function, quantitative of urinary albumin, HbA1c, and serum levels of glucose and lipid between both groups was observed.However, the serum level of calcium in the treatment group was significantly higher than that in the control group (2.51 ±0.16 vs.2.08 ±0.15, P<0.05).And the serum level of CTx was significantly lower than that in the control group (0.385 ±0.28 vs.0.644 ±0.31, P<0.01).BMD of the calcaneus in the treatment group was significantly higher than that in the control group (0.618 ±0.108 vs.0.402 ±0.133, P<0.05).Conclusion The application of calcitriol combined with Caltrate D can significantly reduce bone resorption, improve bone metabolism, and increase BMD in senile female patients with T2DM.

  8. Analysis of image findings in forty-one patients with primary lymphoma of the bone%骨原发性淋巴瘤影像分析

    Institute of Scientific and Technical Information of China (English)

    于宝海; 刘杰; 钟志伟; 赵静品; 彭志刚; 刘记存; 吴文娟

    2011-01-01

    Objective To analyze the imaging features of primary lymphoma of the bone,and discuss the special feature of the "floating ice sign". Methods Forty-one cases of primary lymphoma of the bone in our unit from 1963.1-2009.6 were retrospectively studied. All 41 patients underwent X-ray examination, and 20 patients underwent CT examination, 12 patients underwent MR examination (3 cases simultaneously with enhancement).Results Involvement of the flat bone was seen in 12 cases. Vertebral column was affected in 8 cases, and 17 cases showed lesions in long bones and irregular bones were involved in 4 cases. The most common location was the femur(10, 24.4%), followed by the ilium(8, 19.5%). Lesions were found in the metaphyses of the long bone in 11 cases (64.7%). "Floating ice sign" was showed in the calcaneus of 2 patients and in the lumbar vertebra of 2 cases respectively, accounted for 9.8% of all cases. Slight bone destruction with soft tissue mass on CT image could be found in 12 cases, while obvious soft tissue mass was found in 9 cases. No periosteal reaction was found in 37 cases (90.2%). MRI examinations of 12 patients revealed soft tissue mass in 10 patients, and the extent of the lesion was larger in MR than CT. One case showed extensive bone destruction on MR but inconspicuous bone destruction on X-ray plain film and CT scan. Conclusion Slight bone destruction with conspicuous soft tissue mass, conspicuous bone destruction on MR but slight or inconspicuous bone destruction on X-ray film and CT,could strongly imply the diagnosis of primary lymphoma of the bone. "Floating ice sign" was a special imaging feature of primary lymphoma of the bone, which could be used as a clue for the diagnosis of lymphoma.%目的 分析原发性骨淋巴瘤(PLB)及"浮冰征"的影像表现和病理基础.方法 回顾性分析经病理证实且临床资料齐全的41例PLB患者的临床与影像特征.41例全部行X线检查,20例行CT检查,12例行MR检查(3

  9. Influência de diferentes comprimentos de onda da laserterapia de baixa intensidade na regeneração tendínea do rato após tenotomia Influence of different low-intensity laser therapy wavelengths for rat tendon regeneration following tenotomy

    Directory of Open Access Journals (Sweden)

    ERB Arruda

    2007-08-01

    wavelengths (670nm and 904nm and in the combination of both on the tissue repair of the calcaneus tendon. METHODS: We used 37 female Wistar rats divided in 5 groups which had been submitted to the total tenotomy. Group GA (n= 8 was submitted to the laser irradiation in lambda= 904nm, GaAS diode, pulsated emission, peak power 15W and dose of 3J/cm², group GB (n= 8 was submitted to laser irradiation lambda= 670nm AlGaInP diode, continuous emission, power 30 mW and dose 3J/cm², group GAB (n= 8 was submitted to association of both of lasers and group GCL (n= 7 which the calcaneum tendon was submitted to placebo treatment. The group GP (n= 6 was a standard group without lesion and treatment. The animals received 12 sessions of lasertherapy and submitted to euthanasia on 14th day after surgery. The tendons were submitted to histological procedure and were analyzed to evaluate the optic retardation (in nm for the birefringence measurement. RESULTS: The statistic analysis showed that the irradiated groups have higher values of optic retardation statistically significant than placebo group (p= 0,00001. It indicates that all the treated groups show better organization of collagen fibers in the longitudinal axis of the tendon, evidencing better quality in the tissue repair. The group GAB was that shown best results (p= 0,00001 when compared to another groups.

  10. 软骨母细胞瘤67例临床病理分析%Chondroblastoma of bone: a clinicopathological analysis of 67 cases

    Institute of Scientific and Technical Information of China (English)

    方三高; 肖蔚; 周航波; 周晓军

    2011-01-01

    Objective To analyze the morphological characteristics, image features, treatments and diagnosis of chondroblastotna. Methods The pathological features were explored with HE and immunohistochemical staining in 67 cases of chondroblastoma. The image manifestations were studied with plain X-ray film, CT and MRI. Results It occurred predominantly in adolescents (mean age, 19 years), more commonly in males (male/female =3. 2; 1.0). Preferred sites were the epiphyses or apophyses of the long bones, especially in the femoral great trochantere (22/67, 32. 84% ). In this group, lesions were located at femurs in 37 patients (55. 22% ) ; tibia in 12 ( 17. 91% ) ; talus and pelvis each in 3; humeri, costae, vertebrae, calcaneus and patella each in 2 and sacrum and infraturbinal each in 1. On plain radiograph, it depicted as an ovoid lesion with well defined osteolytic destruction and thin sclerotic margin. CT was optimal to detect the tumors that appeared as low density area of bone with patchy and stippled calcification, periosteal reaction, soft tissue swelling and cystic changes. MRI imaging demonstrated iso-and hypo-intense on T1WI and heterogeneous signals on T2WI. Histologically, one of the most characteristic findings in chondroblastomas was so called "chicken-wire-like calcification" that assuming a grid pattern of tiny calcific bodies which enveloped the cells. However, it was only 31 cases (46. 27% ) in this group, compared with polygonally-shaped mononuclear cell with a grooved nuclei intermixed by eosinophilical chondroid matrixes and local narcoses. Immunohistochemically, among 45 cases, the strong positive case for S-100 protein was 45. Meanwhile, modest positive case for D2-40 was 9 and weak positive case was 11 in another 26 cases. And few tumor cells were high level expression for Ki-67 except for cases of 5 (the positive rate <5% ). Conclusion Chondroblastoma of bone is a rare, benign cartilaginous neoplasm. Apart from chicken-wire-like calcification, more

  11. Diagnosis and treatment for primary bone tumor of the talus%距骨原发肿瘤的诊断与治疗

    Institute of Scientific and Technical Information of China (English)

    杨发军; 刘巍峰; 牛晓辉; 丁易

    2011-01-01

    Objective To analyze the clinical feature, surgical treatment and prognosis of primary bone tumor of the talus.Methods From January 1993 to December 2008, 21 patients of primary bone tumor and tumor-like lesion in the talus were retrospectively analyzed.The feature of bone tumor of the talus was analyzed from clinical, imaging and pathological aspects.All patients underwent surgical treatment.During postoperative follow-up, the function of patients was evaluated according to the criteria of musculoskeletal tumor society (MSTS).Results In all 21 patients,there were chondroblastoma (10 cases), giant cell tumor of bone (7 cases), osteoid osteoma (1 case), aneurysmal bone cysts (1 case), simple bone cysts (1 case), and osteofibrous dysplasia (1 case).Among 10 patients with chondroblastoma,the mean age was 22 years old (range; 10-35years).All 10 patients were performed curettage.1 patient was performed curettage and filled with bone cement.9 patients were performed curettage and bone grafting.No recurrence appeared among 9 patients with complete follow-up.The follow-up lasted for 15-87 months, and the median follow-up was 36 months.The function score (MSTS) was all 30.The mean age of onset of 7 patients with giant cell tumor of bone was 24 years old (range; 20-33years).Through image text, all cases suffered osteolytic damage.No calcification existed in ground substance.4 patients were primary cases and conducted curettage.3 cases relapsed.2 cases were performed astragalectomy and fusion of calcaneus and tibia.1 patient was applied crus amputation.3 patients had complete followup, and 2 patients were primary cases.Postoperatively, no recurrence happened within 10 and 32 months respectively.Recurrence happened in 1 case.No recurrence happened in follow-up lasting for 36 months.The function scores were respectively 26, 29 and 24.For other four patients with diagnosis, 1 patient with osteoid osteoma received lesion resection and bone grafting and 3 patients received

  12. 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.

  13. 软组织损伤评估处理对跟骨骨折术后感染的意义%Classified Treatments of Soft-tissue Injury in Preventing Postoperative Infection in Patients with Calca-neal Fracture

    Institute of Scientific and Technical Information of China (English)

    徐生根; 肖坚; 吴维剑

    2016-01-01

    Objective To study the clinical significance of soft tissue assessment and classification treat⁃ment for the prevention of postoperative infection in the patients with calcaneal fractures. Methods We re⁃cruited 91 patients who underwent open reduction and reconstruction plate internal fixation operation for closed calcaneal fractures (103 feet). All patients were randomly divided into a control group and an evaluation group. In the control group, there were 36 men (40 feet) and 7 women (8 feet). They aged from 18 to 72 years (average 38.5 years). By Sanders classification, 11 feet were of type Ⅱ, 21 feet of type Ⅲ and 8 feet of type IV. All con⁃trol patients with preoperative soft tissue injury underwent the conventional preparation processing, and preopera⁃tive assessment of soft tissue and classification treatment was not carried out. In the evaluation group, there were 39 men (44 feet) and 9 women (11 feet). They aged from 19 to 71 years(average 39.6 years). By Sanders classifi⁃cation,12 feet were of type Ⅱ, 23 feet of type Ⅲ, and 9 feet of type IV. They underwent soft tissue assessment using criteria for preoperative assessment and also underwent classification treatment. Results The control group of 43 patients were followed up for 13~17 months (average 14.5 months). There were 5 cases of postopera⁃tive wound infection, and the infection rate was 16.3%. In the evaluation group, 48 cases were followed up for 14-22 months (average 16.1 months), and only 2 cases had wound infection after surgery, and the infection rate was 4.17%. The infection rates in the two groups were different significantly (P<0.05). Conclusion It is im⁃portant to conduct preoperative skin and soft tissue assessments and classification treatment, as an intervention strategy for calcaneal fractures. It can significantly reduce the rate of wound infection after fracture of calcaneus.%目的:探讨皮肤软组织损伤评估及分级处理对预防跟骨骨折术后切

  14. External fixation and gradual limb lengthening for complicated delayed calcaneal fractures: report of 12 cases%距下关节截骨缓慢延长治疗陈旧性跟骨骨折

    Institute of Scientific and Technical Information of China (English)

    范伟力; 王子明; 赵玉峰; 吴思宇; 王雨; 孙红振; 王爱民

    2011-01-01

    目的 伴有距下关节损伤的陈旧性跟骨骨折,目前主要是采用距下关节原位融合术和距下关节牵伸骨块植入融合术治疗,在此介绍一种新手术方式,距下关节截骨外固定支架缓慢延长手术,并评估其疗效.方法 12例15足(单足9例,双足3例)陈旧性跟距关节骨折脱位,年龄16~53岁,平均33.6岁.闭合性7例(10足),开放型性5例(5足).开放性损伤中3例严重多发伤病人手术时伤口已愈合2个月以上,2例伤口仍未愈合.均采用距下关节截骨牵伸融合新方法治疗,术中行内、外侧骨突切除、距下关节截骨与植骨、Orthofix外固定支架固定,术后7~10天延长,至距下关节间隙牵开1~2cm、跟骨高度和Bohler角基本恢复正常时结束延长,2~3个月后距下关节骨性融合后取出外固定支架开始负重行走.结果 12例(15足)得到了6~50个月的随访,伤口均愈合,无皮肤坏死.距下关节在3~6个月(平均3.7个月)得到骨性融合.采用美国骨科足踝外科学会(AOFAS)评分标准,平均由术前的24.2分提高到术后随访时的76.8分.结论 距下关节截骨缓慢延长治疗陈旧性跟骨骨折是一种新的有效治疗方法;无皮肤坏死、无需植骨和内固定;用于开放性陈旧性跟骨骨折的治疗可明显缩短疗程.%Objective For delayed calcaneal fractures accompanied by subtalar joint injury, the most common treatment is the use of in situ subtalar arthrodesis and subtalar distraction bone-hlock arthrodesis. In this study,we introduced a novel surgical treatment, subtalar osteotomy with external fixation and limb lengthening, and assessed its efficacy. Methods Totally 12 cases ( 15 feet) of delayed calcaneal fractures accompanied by severe subtalar joint injury were treated with this method. The patients ranged in age from 16 to 54 years, with an average age of 33. 6 years. And seven cases were closed injury, others were opened injury. The protruding lateral calcaneus was

  15. Resultado do acompanhamento clínico-radiológico pós-cirúrgico do condroblastoma Results from clinical and radiological follow-up, after surgical treatment of chondroblastoma

    Directory of Open Access Journals (Sweden)

    Valter Penna

    2011-10-01

    technique. METHODS: A retrospective study was conducted on 12 patients with histological diagnoses of chondroblastoma, who were attended between 2003 and 2009 at the Pius XII Foundation (Barretos Cancer Hospital, Barretos, State of São Paulo. These patients underwent surgical treatment with intralesional resection of the tumor, adjuvant electrocauterization and replacement with methyl methacrylate (11 cases or an autologous graft from the iliac crest (one case. The preoperative evaluation included physical examination, plain radiographs of the site, magnetic resonance imaging, computed axial tomography and bone scintigraphy. The patients were assessed clinically and radiologically according to a predefined protocol, with a series of plain radiographs, and a functional assessment in accordance with the Enneking functional score. RESULTS: The average age at the time of diagnosis was 14 years and 4 months. The most frequent location affected was the distal femoral epiphysis (75%, followed by the proximal tibial epiphysis (16.6% and the calcaneus (8.4%. There was higher prevalence among the female patients than among the male patients (3:1. In three cases, preoperative biopsy was necessary. During the follow-up, there was no evidence of local tumor recurrence, and all the patients presented an excellent functional result from the surgical technique used, with Enneking scores ranging from 20 to 30. CONCLUSION: Surgical treatment of chondroblastoma, using intralesional resection, adjuvant electrocauterization and replacement with methyl methacrylate or bone graft produced good results.

  16. Repair of lower extremity soft tissue defect with free musculo-cutaneous flaps bridging with healthy contralateral posterior tibial vessel%游离肌皮瓣桥接胫后血管修复对侧下肢软组织缺损

    Institute of Scientific and Technical Information of China (English)

    夏成德; 狄海萍; 薛继东; 赵耀华; 李晓亮; 李强; 牛希华; 李永林; 连鸿凯

    2015-01-01

    Objective To observe the clinical effects of free musculo-cutaneous flap bridging with contralateral posterior tibial vessel on repair of lower extremity soft tissue defect.Methods From February 2006 to June 2013,10 patients with soft tissue defect on lower shank and foot were included.The posterior tibial vessel on healthy lower extremity was chosen as recipient vessel and anastomosed with free latissimus dorsi musculo-cutaneous flap,or free latissimus dorsi musculo-cutaneous flap combined with thoracic-umbilical skin flap or anterolateral femoral musculo-cutaneous flap.The retrograde bridged flap was transposed to repair defect on contralateral lower shank and foot.The wound area ranged from 40 cm × 21 cm to 22 cm×15 cm,with flap size from 48 cm×26 cm to 25 cm×18 cm.Meanwhile the defects on donor sites were covered with skin graft and both lower extremities were fixed with kirschner wires at middle tibia and calcaneus.The kirschner wires were removed at 4 weeks and pedicles were cut off 5 ~ 8 weeks postoperatively.Six patients received posterior tibial vessel reanastomosis at the same time of pedicle cutting.Results All the 10 flaps survived and 3 patients received thinning of flaps due to excessive thickness.During the follow-up period of 3 months to 2 years follow up,the ambulatory function of injured legs recovered gradually with satisfactory appearance.The reanastomosed posterior tibial vessel on the healthy side was recovered.Conclusions Appropriate bridged musculo-cutaneous flaps is suitable for extensive soft tissue defect of lower shank and foot.It is a safe and effective method for limb salvage.%目的 观察游离肌皮瓣与健肢胫后血管桥接修复对侧下肢软组织缺损的临床效果.方法 2006年2月至2013年6月,对10例小腿下段及足部软组织缺损患者,应用健肢胫后血管与游离背阔肌肌皮瓣、背阔肌肌皮瓣联合胸脐皮瓣、股前外侧肌肌皮瓣的血管吻合,形成以健肢

  17. Fatores associados à úlcera por pressão em pacientes internados nos Centros de Terapia Intensiva de Adultos Factores asociados a la úlcera por presión en pacientes internados en Unidades de Terapia Intensiva de Adultos Factors associated to pressure ulcers in patients at Adult Intensive Care Units

    Directory of Open Access Journals (Sweden)

    Flávia Sampaio Latini Gomes

    2010-12-01

    asociados a la presencia de úlcera por presión. Se concluye en que la sepsis, tiempo de internación y riesgo alto y elevado en la clasificación de la escala de Braden son factores potencialmente asociados a la formación de úlceras en pacientes acostados.The objective of this a cross-sectional analytical study was to estimate the occurrence of pressure ulcers and their associated factors in adult ICUs in the city of Belo Horizonte, Brazil. The sample consisted of 142 patients aged 18 or older, admitted before midnight of the day prior to data collection, from a total of 316 beds distributed in 22 ICUs. Presence of at least one pressure ulcer per patient was 35.2% (CI 95% = 27.4-47.7. Of the 99 ulcers identified, the ones in the sacral region were most frequent (36.0%, followed by those in the calcaneus (22.0%. We observed that the presence of sepsis (OR = 6.04, CI 95% = 1.09-33.53, period of stay > 10 days (OR = 7.61, CI 95% = 2.92-19.82 and being high risk and very high-risk in the Braden scale (OR = 4.96, CI 95% = 1.50-16.50 were independent factors significantly associated with the presence of pressure ulcers. Results suggest that sepsis, length of stay, and having high and very high risk" in the Braden scale are factors potentially associated to the development of ulcers in bedridden patients.

  18. The Digital Astronaut Project Computational Bone Remodeling Model (Beta Version) Bone Summit Summary Report

    Science.gov (United States)

    Pennline, James; Mulugeta, Lealem

    2013-01-01

    Under the conditions of microgravity, astronauts lose bone mass at a rate of 1% to 2% a month, particularly in the lower extremities such as the proximal femur [1-3]. The most commonly used countermeasure against bone loss in microgravity has been prescribed exercise [4]. However, data has shown that existing exercise countermeasures are not as effective as desired for preventing bone loss in long duration, 4 to 6 months, spaceflight [1,3,5,6]. This spaceflight related bone loss may cause early onset of osteoporosis to place the astronauts at greater risk of fracture later in their lives. Consequently, NASA seeks to have improved understanding of the mechanisms of bone demineralization in microgravity in order to appropriately quantify this risk, and to establish appropriate countermeasures [7]. In this light, NASA's Digital Astronaut Project (DAP) is working with the NASA Bone Discipline Lead to implement well-validated computational models to help predict and assess bone loss during spaceflight, and enhance exercise countermeasure development. More specifically, computational modeling is proposed as a way to augment bone research and exercise countermeasure development to target weight-bearing skeletal sites that are most susceptible to bone loss in microgravity, and thus at higher risk for fracture. Given that hip fractures can be debilitating, the initial model development focused on the femoral neck. Future efforts will focus on including other key load bearing bone sites such as the greater trochanter, lower lumbar, proximal femur and calcaneus. The DAP has currently established an initial model (Beta Version) of bone loss due to skeletal unloading in femoral neck region. The model calculates changes in mineralized volume fraction of bone in this segment and relates it to changes in bone mineral density (vBMD) measured by Quantitative Computed Tomography (QCT). The model is governed by equations describing changes in bone volume fraction (BVF), and rates of

  19. 合肥市大学新生膳食模式及其与骨密度的关系%Dietary patterns in college freshmen and its relation to bone mineral density

    Institute of Scientific and Technical Information of China (English)

    王素芳; 穆敏; 赵艳; 王晓琴; 束龙; 李青艳; 李迎春

    2012-01-01

    目的 了解合肥市大学新生的骨密度现状,并分析膳食模式与其骨密度的关系.方法 采用分层整群随机抽样的方法抽取1414名大学新生,最终收集到有效问卷1319份.检测人群的超声骨密度值.采用因子分析法判断大学新生的膳食模式,采用协方差分析,控制混杂因素后,比较不同膳食模式组间的骨SOS修正均数.结果 (1)4种膳食模式较为有意义:“西方食物”型(摄入较多的汉堡包及油炸食品、腌制食品、坚果类、零食、可乐、雪碧、咖啡、糖类);“动物性食物”型(摄入较多的猪肉、羊肉、牛肉、禽肉、动物肝脏、鱼虾类、海带/海鱼/紫菜等海制品、坚果类);“钙类食物”型(摄入较多新鲜水果、鸡蛋、鱼虾类、海带/海鱼/紫菜等海制品、奶及奶制品、豆类及豆制品、坚果类);“传统中国”型(摄入较多的粮谷类、新鲜蔬菜、新鲜水果、猪肉).(2)高“动物性食物”型膳食模式的骨密度(SOS值)低于低“动物性食物”型(P<0.05);高“钙类食物”型膳食模式的骨密度(SOS值)高于低“钙类食物”型(P<0.05);高“传统中国”型膳食模式的骨密度(SOS值)高于低“传统中国”型膳食模式(P<0.05).结论 合肥市大学新生的膳食模式和骨密度关系密切.%Objective In order to investigate the bone density of freshmen, and to analyze the association between dietary pattern and bone mineral density ( BMD). Methods A questionnaire survey on the situation of dietary pattern was conducted in 1414 freshmen. Effective dietary survey questionnaires and bone mineral density measurements were completed for 1319 participants. Bone mass was assessed by using an Ultrasound Bone Densitometer on the right calcaneus ( CM-200, Furuno Electric Corporation, Japan) , and the speed of sound ( SOS, m/s) was used as an indicator for bone density. Factor analysis with varimax rotation was used to identify the dietary patterns

  20. 小腿穿支皮瓣修复踝周皮肤软组织缺损%Using lower leg perforator flaps to repair soft tissue defect on ankle

    Institute of Scientific and Technical Information of China (English)

    丰波; 张志; 呼和; 庞有明; 张澜; 王永军; 牛克成

    2014-01-01

    目的 探讨小腿穿支血管皮瓣修复踝周皮肤软组织缺损的应用价值. 方法 2007年1月至2012年12月,应用不同类型的小腿穿支皮瓣逆行转移修复踝周皮肤软组织缺损62例,均合并肌腱和(或)骨外露,其中7例跟腱断裂术后外露或窦道形成,8例合并踝关节、跗骨间关节破损外露,24例伴胫骨远端、内踝、外踝、跟骨骨折,11例合并不同程度感染.一期修复15例,延期或二期修复47例.胫后动脉内踝上穿支皮瓣10例,腓动脉外踝上前穿支皮瓣12例,腓动脉外踝上后穿支皮瓣40例;皮瓣切取面积为4.0 cm×5.5 cm~9.0 cm×15.0 cm.供区直接缝合10例,余采用植皮修复创面. 结果 术后56例皮瓣完全成活,3例腓动脉外踝上前穿支皮瓣、1例胫后动脉内踝上前穿支皮瓣、2例腓动脉外踝上后穿支皮瓣出现远端部分坏死,经换药后痊愈;所有病例经随访3~12个月,皮瓣质地柔软、弹性好.供区植皮全部成活. 结论 小腿穿支皮瓣修复踝周皮肤软组织缺损具有手术操作简单、不损伤主干血管、皮瓣成活可靠、供区破坏少等优点,针对不同部位进行“个性化”皮瓣选择非常重要.%Objective To explore the application value of the lower leg perforator flaps in repairing soft tissue defect on ankle.Methods From January 2007 to December 2012,62 cases of soft tissue defect on ankles have been repaired.The defects were combined with tendon and/or bone exposure for all the cases,among them 7 cases were exposure or sinus tract after achilles tendon rupture surgery,8 cases with ankle or intertarsal joint defect and exposure,24 cases with distal tibia fracture,or medial malleolus fracture,or lateral malleolus fracture,or calcaneus fracture,11 cases with different level of infection.Fifteen cases were primarily repair,and 47 cases were secondly repair or extended phase.The cases were repaired by applying different types retrograde transferred perforator pedicle

  1. 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.

  2. 跟骨内移截骨治疗获得性扁平足临床分析%Acquired flat foot medial displacement calcaneal osteotomy

    Institute of Scientific and Technical Information of China (English)

    张奉琪; 王慧娟; 张奇; 赵海涛; 李智勇; 高巍; 张英泽

    2011-01-01

    [ Objective] To study the c haracteristic and clinic curative effect of the acquired flatfoot treated by a medial displacement calcaneal osteotomy. [ Methods] From Jan. 2006 ~ Dec. 2008, 31 patients with an average age of 26. 7 years (range, 19 ~50 years), were treated by a medial displacement calcaneal osteotomy together with other technique. Seventeen of them were male and 14 were female. The lateral position, calcaneal axial and CT of calcaneal were taken preoperatively. The mean first talocalcaneal angle was 22.3° ( range, 5° ~ 32°) . All patients had contracture of achilles tendon, posterior tibial tendon dysfunction, calcaneovalgus, forefoot pronation and abduction ( weight bearing ) and pains. The American Orthopaedic Foot and Ankle Society (AOFAS) Hindfoot Scale was 45.8. Posterior tibial tendon irsufficiency (PTTI) were stageⅡ. Thirteen feet were treated by a medial displacement calcaneal osteotomy, 4 feet by a medial displacement calcaneal osteotomy and tendocalcaneus lengthening, 14 feet by a medial displacement calcaneal osteotomy , tendo calcaneus lengthening and flexor digitorum longus tendon transfer. [ Results] After a mean follow up of 18. 8 months (range, 6 ~ 26 months), the medial longitudinal arch improved postoperatively, 10 feets pain disappeared, 15 foot reliefed and 6 foot remained. The mean first talocalcaneal angle was 3.2° (range, 0° ~7°) (t = 22. 57, P≤0. 001 ), strephexopodia and the abduction of foot obviously improved . The rating of clinic curative effect was 80. 6% (25/31) . The American Orthopaedic Foot and Ankle Society (AOFAS) Hindfoot Scale was 84. 5. [ Conclusion ] Medial displacement calcaneal osteotomy treating the flexible flatfoot can reliablely correct calcaneovalgus , partly resume the medial longitudinal arch, improve weight bearing and biomechanical characteristic of foot and ankle. We can combine with other technique to improve curativeeffect of the acquired flat foot. The operative indication

  3. Clinical Application of Sural Neurocutaneous Flap Retained Perforating Branch to Repair Soft Tissues Defect of Lower Leg, Ankle and Foot%腓肠神经营养血管皮瓣修复下肢远端软组织缺损的疗效评价

    Institute of Scientific and Technical Information of China (English)

    谢昀; 郑力峰; 方心俞; 曾锦源; 叶君健

    2012-01-01

    with sinus tract of distal tibia .2 cases were soft connective tissue tumor in distal end of lower leg , and 11 cases were osteomyelitis of calcaneus with exposed plate postoperatively . 6 cases were prosthesis of rupture of achilles tendon with exposed tendon , and 15 cases were soft tissue defect of foot with exposed bone (n=12) and muscle tendon(n=3) . 4 cases were chronic ulcer of heel, and one case was keratosis seborrheica of heel . Resits The clinical outcome was satisfactory : 45 flaps survived completely ;partial distal superficial necrosis took place in 11 flaps ; wound healing delayed in 6 cases ; distal superficial necrosis took place partially in 9 cases by changing dressings in 7 cases and secondary suturing in 2 cases and achieved healing at last . Mass necrosis in 3 cases showed operation failure . The size of flaps ranged from 7 cm 5 cm to 22 cm 12 cm . All weight area repaired by flap retained sensory recovery so that none ulcer took place after weight loading . Conclusion The perforating branch should be reserved to enlarge the size of the flap and combi -ning part of gastrocnemius muscle could be used to repair a deep defect . In the research , the applied range of the flap was enlarged and it can be used to repair soft tissue defect easily .

  4. 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

  5. Clinical features and correlation between radiographic parameters and incidence of calcaneal spur%跟骨骨刺的临床特征及其影像学参数与发病的相关性研究

    Institute of Scientific and Technical Information of China (English)

    张庆; 姜楠; 胡巍然; 虞泽伟; 张翔; 余斌

    2016-01-01

    目的 探讨跟骨骨刺的临床特征,以及足部影像学参数与发病的相关性,为研究跟骨骨刺产生机制提供参考. 方法 对2014年7月至2015年12月在南方医科大学南方医院行负重位跟骨侧位、轴位X线片和踝关节侧位X线片检查跟骨骨刺者的影像学资料进行回顾性研究,根据性别、侧别、年龄分组分别进行骨刺部位、形态、长度的分析,并测量患者足部的B(o)hler角、Gissane角、距跟角、距骨水平角、跟骨倾斜角、后距关节面倾斜角、后距关节面高度、绝对足高、跟骨长度、跟骨宽度,进行跟骨骨刺发病的相关性研究. 结果 本研究共纳入200例骨刺患者,女性多于男性,单纯足底骨刺多于单纯跟腱,B型多于A型,跟腱骨刺长度大于足底,女性足底骨刺多于男性,右足足底骨刺长度大于左足,差异均有统计学意义(P<0.05);<60岁组与≥60岁组骨刺部位、形态、长度差异均无统计学意义(P>0.05).骨刺的发病与Gissane角(P=0.000,OR=0.944,95% CI 0.917-0.973)、后距关节面倾斜角(P=0.017,OR=0.957,95% CI 0.924-0.992)及后距关节面高度(P=0.007,OR=0.933,95% CI0.886-0.981)相关. 结论 跟骨骨刺患者女性多于男性,足底多于跟腱,B型多于A型,跟腱骨刺长度大于足底.女性比男性好发于足底,右足足底骨刺比左足长,骨刺特征无明显年龄差异.跟骨骨刺的发病可能与Gissane角、后距关节面倾斜角、后距关节面高度有关.%Objective To analyze the clinical features and the correlation between radiographic parameters and incidence of calcaneal spur in the patients from Nanfang Hospital,Southern Medical University,China.Methods Three experienced observers independently used the image acquisition and transmission system (PACS) to collect the data of lateral and axial X-ray images of calcaneus or ankle joint in neutral position from the patients with calcaneal spur and normal controls who had undergone

  6. 澳门地区中老年人骨质疏松情况调查分析%Investigation and analysis of osteoporosis among middle-aged and elderly people in Macau

    Institute of Scientific and Technical Information of China (English)

    郑力恒; 谭文成; 张锦辉; 吴昊; 刘宁; 查振刚

    2016-01-01

    Objective To investigate the prevalence of osteoporosis (OP) among middle-aged and elderly people in Macau.Methods A total of 7 209 middle-aged and elderly persons living in 30 nursing homes in Macau from February 2012 to January 2014 were studied in this prevalence survey. The informed consents of all participants were obtained and the ethical committee approval from the Macau Association of Medical Science and Technology Research had been received. Among the 7 209 participants, 1 312 were males and 5 897 were females with an average age of (74±10) years old. These participants were divided into groups according to different purposes of the research: (1) divided into 50- to 59-year-old age group, 60- to 69-year-old age group, 70- to 79-year-old age group, 80- to 89-year-old age group, 90- to 99-year-old group and 100- year-old age group according to age. (2) divided into male group and female group according to gender. Calcaneus bone mineral density was measured in 7 209 participants by GE Insight ultrasonic bone mineral density meter and a questionnaire survey was also performed. Bone mineral density, prevalence rate of OP and fracture occurrence in different age or gender groups were compared. Data between groups were compared usingt test orχ2 test.Results (1) The degree of decline of bone mineral density tended to increase with age; in the 60- to 99-year-old age group, bone mineral density of women participants was significantly lower than that of men participants. (2) The prevalence rate of OP in middle-aged and elderly men participants was 18.8% (247/1 312), which was significantly lower than 39.5%(2 327/5 897) in middle-aged and elderly women participants (χ2=196.80,P0.05). (4) Among the 2 327 OP participants, 400 took calcium tablets combined with other prescription, 713 took single calcium tablet, and the other patients took other prescription or no treatment.Conclusions The treatment rate for OP among middle-aged and elderly people in Macau is low. To

  7. EFFECTIVENESS OF IN SITU SUBTALAR ARTHRODESIS WITH BONE GRAFT FOR SUBTALAR TRAUMATIC ARTHRITIS AND GAIT ANALYSIS%距下关节创伤性关节炎原位植骨融合术后疗效与步态分析的临床研究

    Institute of Scientific and Technical Information of China (English)

    吴战坡; 陈伟; 张奇; 殷兵; 李明; 王海立; 张英泽

    2011-01-01

    Objective To evaluate the effects of in situ subtalar arthrodesis with bone graft for subtalar traumatic arthritis, and to analyse the plantar pressure distribution so as to provide the evidence for effectiveness evaluation. Methods Between March 2004 and December 2008, 26 patients with unilateral subtalar arthrodesis undergoing bone graft fusion were enrolled (test group). After operation, the imageology diversity and the effect of subtalar arthrodesis on adjacent joint were observed. American Orthopaedic Foot and Ankel Society (AOFAS) ankle and hindfoot score and radiographs were used to assess the foot function before and after operation. Twenty-six normal subjects served as controls. Footscan system was used to test the distribution of maximum plantar pressure and the change of gravity center curve. No significant difference was found in gender, age, height, and weight between 2 groups (P > 0.05). Results All patients were followed up 18.2 months on average (range, 14-71 months). The mean subtalar arthrodesis time was 5.6 months (range, 4 months and 15 days to 11 months). The mean AOFAS ankle and hindfoot score improved from 35.18 ± 8.16 preoperatively to 76.36 ± 6.90 postoperatively (t=13.910, P=0.000). Nine (34.6%) patients had satisfactory functional effects, and 13 (50.0%) patients basically satisfactory. The talocalcaneal height, talocalcaneal angle, talar declination angle, and calcaneus patch angle were 87.04% ± 6.17%, 76.73% ± 5.13%, 65.86% ± 7.01%, and 70.19% ± 8.33% of the contralateral side, respectively. Osteoarthritis of the adjacent joints occurred in 7 cases. The maximum plantar pressure increased in the third to fifth metatarsal bones and decreased in the first to second metatarsal bones, showing significant differences when compared with normal controls (P < 0.05). No significant difference was found in the plantar pressure between arthrodesis foot and contralateral foot of the test group (P > 0.05). The plantar pressure was well

  8. 临夏盆地晚中新世维氏大唇犀(奇蹄目,犀科)肢骨化石%LIMB BONES OF CHILOTHERIUM WIMANI (PERISSODACTYLA, RHINOCEROTIDAE) FROM THE LATE MIOCENE OF THE LINXIA BASIN IN GANSU, CHINA

    Institute of Scientific and Technical Information of China (English)

    邓涛

    2002-01-01

    他的大唇犀种更原始.Ch.wimani的肢骨尺寸也与产自保德和新安的Acerorhinus palaeosinensis接近,且后者的距骨对跟骨的关节面也是愈合的,但后者肢骨的粗壮程度小于CH.wimani.Ch.wimani的肢骨更远比产自通古尔的Acerorhirmszernowi短粗.尽管Ch.wimani的前肢长于产自西班牙的Alicomops simorrense,但在欧洲发现的大多数A.simotrense的肢骨都比Ch.wimani细长.所有Aceratherium incisivum的肢骨也都比Ch.wimani细长,而Hoploaceratheriumtetradactylum的肢骨更是远远长于Ch.wimani,相应地也更为纤细.在可以对比的肢骨中,Plesiaceratherium gracile的掌、踱骨比Ch.wimani细长得多,同时前者距骨对跟骨的关节面也分得相当开.所以,在无角犀亚科中,大多数属种的肢骨都比大唇犀细长,这与它们的系统发育地位是吻合的.%The genus Chilotherium was dominant among the Hipparion fauna of the Late Miocene in China, and it also appeared in other regions of Asia and South Europe widely. However, studies for the postcranial skeletons of Chilotherium are scarce. Although rich fossils of Chilotherium were discovered in Baode, Shanxi and Fugu, Shaanxi, only some postcranial bones of Ch. anderssoni were described. Recently, very abundant fossils of Ch. wimani were discovered from the Late Miocene of the Linxia Basin in Gansu, China, including a lot of skulls as well as postcranial skeletons. In this paper, limb bones of Ch.wimani are studied. The fore and hind feet of Ch. wimani are tridactyle, and limb bones are as short and robust as those of Ch. anderssoni discovered from Baode. Facets Ⅱ and Ⅲ for calcaneus on the posterior face of astragalus of Ch. wimani are connected to each other or separated by a narrow groove. In the subfamily Acemtheriinae, limb bones of most genera and species are longer and slenderer than those of Chilotherium, such as Plesiaceratherium gracile , Alicornops simorrense , Aceratherium incisivum

  9. 组合生物重建用于四肢骨肿瘤切除后骨缺损修复%The combinative biological reconstruction of bony defect following limb bone tumor resections

    Institute of Scientific and Technical Information of China (English)

    李靖; 王臻; 郭征; 陈国景; 石磊

    2016-01-01

    -bearing bone and vascularized fibular flap for the reconstruction of bony defects following tumor resection,guiding clinical practice.Methods From March 2007 to June 2013,we enrolled 63 patients who had combinative biological reconstruction after bone tumor resection (11 in humerus,22 in femur,21 in tibia,4 in calcaneus).There were 36 male and 27 female in this series.The average age at time of operation was 20 years,ranging from 9 to 48 years.The follow-up ranged from 16 to 102 months with average of 48 months.We investigated the X-ray and CT images for all patients and histological findings of two patients.Patients were assessed functionally with the Musculoskeletal Tumor Society 93 score.Results Three patients with local soft tissue recurrence and one patient with infection underwent amputation.The survival of construct was 93.6%.Bone union achieved in all cases with the average MSTS score of 92.8%.Bone union ranged from 11 to 28 months in allograft group and 9 to 14 months in devitalized tumor bearing bone group.Significant difference of bone union time was found between two groups (Z=-3.638,P=0.000).Viability of the fibular grafts was verified in 58 of 63 patients (92%).Three types of images were observed in complex.Osteopenia and spongy change in fibula were found in 51 patients (81%) with stable fixation of the complex.Five complexes with failed blood supply of fibula and stable fixation revealed no density change of fibula,small amount of callous formation and relative delayed union.In seven complexes (11%) with unstable complex due to patients' incompliance,fibula reacted with dense hypertrophy and microfracture.Fusion of grafts with amount of callus was obviously observed.Union at allograft-host bone junctions occurred by residual host bone-derived external callus and fibular-derived internal callus that bridged the junction and filled the gap between abutting cortices.Callus from fibular graft was mature than that from periosteum of residual host bone

  10. 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