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Sample records for calcaneus

  1. Fractures on the calcaneus

    OpenAIRE

    Tanke, Gerhardus Marinus Henricus

    1982-01-01

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

  2. Anterior process fractures of the calcaneus

    Energy Technology Data Exchange (ETDEWEB)

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

    1985-07-01

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

  3. Aneurysmal bone cyst of the calcaneus.

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    Kaplanoğlu, Veysel; Ciliz, Deniz Sözmen; Kaplanoğlu, Hatice; Elverici, Eda

    2014-01-01

    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. PMID:25396076

  4. 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.

  5. Open Calcaneus Fractures and Associated Injuries.

    Science.gov (United States)

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

    2016-01-01

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

  6. Open Calcaneus Fractures and Associated Injuries.

    Science.gov (United States)

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

    2016-01-01

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

  7. 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 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. PMID:24875966

  8. 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.

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

    OpenAIRE

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

    2016-01-01

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

  10. 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).

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

    Directory of Open Access Journals (Sweden)

    Duo Wai-Chi Wong

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

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

    International Nuclear Information System (INIS)

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

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

    OpenAIRE

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

    2015-01-01

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

  14. 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.

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

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

    2016-03-01

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

  16. 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.

  17. 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.

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

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

    2014-01-01

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

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

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

    2016-07-01

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

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

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

    2016-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Xu J

    2013-06-01

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

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

    Science.gov (United States)

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

    2000-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Xu J

    2013-06-01

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

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

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

    2006-11-15

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

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

    International Nuclear Information System (INIS)

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

  6. 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.

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

    Science.gov (United States)

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

    1996-01-01

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

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

    International Nuclear Information System (INIS)

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

  9. 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

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

    Science.gov (United States)

    Chaminade, B; Zographos, S; Uthéza, G

    2001-11-01

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

  11. 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.

  12. 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.

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

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    Hadžiavdić Aleksandra

    2015-01-01

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

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

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    Ugur A. Bingol

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    杨敏; 范茂丹; 周磊; 孙国栋; 陆鸣

    2011-01-01

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

  16. 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.

  17. 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.

  18. 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.

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

    International Nuclear Information System (INIS)

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

  20. 内外侧联合入路治疗严重跟骨关节内骨折%The combined medial and lateral operative approach for the serious intra -articular fractures of calcaneus

    Institute of Scientific and Technical Information of China (English)

    潘杨; 谭云; 冉隆万; 朱政炜; 刘小林

    2016-01-01

    Objective To study the effect of the combined medial and lateral operative approach for the serious intra -articular fractures of calcaneus.Methods The lateral and medial approach for the treatment of the serious intra -articular fractures of calcaneus 22 cases (26 feet),fully exposed in the medial and lateral subtalar joint surface,reduct subtalar joint surface,drill into Kirschner nails for reduction of the calcaneus angle,then graft bones fully in the defect left after reduction,used calcaneus anatomic plate and screws to fix the fracture on the lateral. Results The patients were followed up for 10 -22 months.According to the American Orthopaedic Foot and Ankle association ankle scoring system,the averange score was 87 points.Normal union of 22 feet,4 feet delayed union,skin necrosis no incision,no infections,no cases of neurovascular injury.Conclusion The combined medial and lateral operative approach for the serious intra -articular fractures of calcaneus is an effective method,and can fully expose the lateral and medial fracture,and is conducive to reduction of the lateral and medial articular surface,and restoration of calcaneus shape,reduce malunion and the foot -pain with walking.%目的:探讨内外侧联合手术入路治疗严重跟骨关节内骨折的疗效。方法选择内外侧联合入路治疗的严重跟骨关节内骨折患者22例(26足),充分暴露内外侧距下关节面,恢复距下关节面,钻入克氏针恢复跟骨角,行充分植骨填充复位后遗留的缺损,外侧使用跟骨解剖钢板及螺钉固定。结果术后随访10~22个月,参照美国骨科足与踝关节协会的足踝临床评分系统评定,平均87分。22足正常愈合,4足延迟愈合,无切口皮肤坏死,无感染患者,无血管神经损伤患者。结论内外侧联合手术入路治疗严重跟骨关节内骨折是一种有效方法,能充分暴露内外侧骨折,且有利于内外侧关节面及跟骨外形的复位,

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

    Institute of Scientific and Technical Information of China (English)

    黄海晶; 马信龙; 马剑雄; 金鸿宾

    2013-01-01

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

  2. 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

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

    Directory of Open Access Journals (Sweden)

    Pedro José Labronici

    2012-01-01

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

  4. 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

  5. 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

  6. 跟骨超声背散射系数与新生儿相关参数的相关性%Correlations between ultrasonic backscattering coefficient in calcaneus and parameters of neonates

    Institute of Scientific and Technical Information of China (English)

    张蓉; 刘成成; 他得安; 陈超

    2013-01-01

      采用超声背散射法检测新生儿跟骨的超声背散射系数(Ultrasonic Backscatter Coefficient, BSC),并分析BSC与出生胎龄、体重、身长和头围等因素之间的关系,从而评估BSC在评价新生儿松质骨状况中的作用。对122例新生儿的临床测试分析结果表明新生儿跟骨中的BSC与出生时的胎龄、体重和身长有良好的相关性。说明超声背散射信号及其BSC可用于评价新生儿的骨质量。%  Using ultrasonic backscattering method to detect backscattering signals in the calcaneus of neonates, and analyzing the relationships between backscattering coefficient (BSC) and gestational age, birthweight, length, head cir-cumference and gender, the aim is to estimate the performance of BSC in bone status assessment of neonates. A total of 122 neonates participated in the study. The results show a significant correlation between the BSC and gestational age, birthweight and length at birth. This study suggests that the use of ultrasonic backscattering and the BSC is feasible for assessing the bone status of neonates.

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

    Institute of Scientific and Technical Information of China (English)

    马东弟; 杨振建; 宋锦旭; 高志峰; 孙立恒; 潘学文

    2015-01-01

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

  8. [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.

  9. 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

  10. 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

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

    Directory of Open Access Journals (Sweden)

    Marco Túlio Costa

    2007-01-01

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

  12. 黑龙江省体育院校大学生运动专项与骨密度的相关性研究%Analysis of Correlation of Special Sports and Calcaneus Ultrasound Bone Mass for the Students Majored in P.E. in Heilongjiang Province

    Institute of Scientific and Technical Information of China (English)

    魏亚茹; 赵文艳; 杜唯; 常凤; 陈景嵩; 杨中华; 张田田

    2011-01-01

    采用文献资料法、测试法、问卷调查法、数理统计法对哈尔滨体育学院11个不同运动专项男大学生跟骨超声骨量进行研究,为黑龙江省体育院校大学生科学运动训练提供骨密度方面的资料。结果显示:田径、游泳、羽毛球、网球专项大学生跟骨超声骨量STI值高于同性别青年组平均值,且与对照组相比差异显著(P〈0.05);体操、篮球、乒乓球、排球、足球、跆拳道、柔道专项大学生跟骨超声骨量STI值低于同性别青年组平均值,与对照组相比差异不显著(P〉0.05)。得出不同运动专项、运动强度对我省体育院校男大学生跟骨超声骨量的影响不同。%With the methods of document, test, questionnaire and mathematical statistic, the author investigated correlation of special sports and Calcaneus Ultrasound Bone Mass, to provide the new evidence and indicators of Bone metabolic for Science training. The result show that Athletics, swimming,badminton, tennis majors in STI is higher than the mean values of the same gender youth group, and have significant difference with the control group (P 〈 0.05), Gymnastics, Basketball, Table tennis, Volleyball, Football, Taekwondo, Judo in STI is lower than the mean values of the same gender youth group, and there is no significant difference with the control group (P 〉 0.05). The conclusion show that the different sports, exercise intensity have had different effects in STI to the students majored in P.E.

  13. 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

  14. [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.

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

    Directory of Open Access Journals (Sweden)

    Rodrigo Bezerra de Menezes Reiff

    2007-01-01

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

  16. 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

  17. 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.)

  18. 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.

  19. 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

  20. 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.

  1. 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

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

    Science.gov (United States)

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

    1995-10-01

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

  3. 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.

  4. 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

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

    International Nuclear Information System (INIS)

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

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    Muschitz Ch

    2013-01-01

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

  8. 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. PMID:20350821

  9. 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.

  10. 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

    surgery and age-matched controls from the population register. The APOE genotypes of 327 women were studied: 73 with lower forearm fractures, 43 with hip fractures and 211 age-matched controls. The participants were not receiving antiosteoporotic treatment. Polymerase chain reaction restriction fragment...

  11. 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.

  12. 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)

  13. 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。

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. Gait Analysis by Multi Video Sequence Analysis

    DEFF Research Database (Denmark)

    Jensen, Karsten; Juhl, Jens

    2009-01-01

    and the calcaneus angle during gait. In the introductory phase of the project the task has been to select, purchase and draw up hardware, select and purchase software concerning video streaming and to develop special software concerning automated registration of the position of the foot during gait by Multi Video...

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

    Science.gov (United States)

    Kuntz, Martin; Seidl, Maximilian; Henneke, Philipp

    2016-01-01

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

  20. 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...

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

    NARCIS (Netherlands)

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

    2010-01-01

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

  2. 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.

  3. Bone status in rheumatoid arthritis assessed at peripheral sites by three different quantitative ultrasound devices

    DEFF Research Database (Denmark)

    Madsen, O R; Suetta, C; Egsmose, C;

    2004-01-01

    sites in 27 women with RA (mean disease duration 15 years) and in 36 healthy women matched for age, height and weight. Speed of sound (SOS, m/s), broadband ultrasound attenuation (BUA, dB/MHz) and stiffness of the calcaneus were assessed by a Lunar Achilles device. Amplitude-dependent SOS (Ad-SOS, m...

  4. 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.

  5. Disease: H00903 [KEGG MEDICUS

    Lifescience Database Archive (English)

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

  6. 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.

  7. 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.

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

    Science.gov (United States)

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

    2015-06-01

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

  9. Calcaneal Ossoscopy.

    Science.gov (United States)

    Toepfer, Andreas; Lenze, Ulrich; Harrasser, Norbert

    2016-06-01

    Both unicameral bone cysts and intraosseous lipoma of the calcaneus are rare entities that are mostly diagnosed because of unspecific heel pain, pathologic fracture, or as incidental finding. Minimally invasive ossoscopy with endoscopic resection of the tumor followed by grafting can potentially minimize risks of open surgery and speed up convalescence. We present our modifications to previously described techniques of endoscopic curettage with a particular focus on intraosseous lipoma and allogenic grafting. The key point for grafting is the use of a funnel-shaped ear speculum facilitating the plombage with allogenic cancellous bone chips. Compared with its alternatives, grafting with allogenic cancellous bone might prove favorable in this localization for several reasons: osteointegration, handling, availability, and costs. The objective of this technical note is to present a simple, safe, and cost-effective surgical technique for endoscopic surgical treatment of benign osteolytic lesions of the calcaneus. PMID:27656388

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2000-03-01

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

  11. Tuberculosis of the foot: An osteolytic variety

    OpenAIRE

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

    2012-01-01

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

  12. Form and function in the hominoid tarsal skeleton.

    OpenAIRE

    Harcourt-Smith, W. E. H.

    2003-01-01

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

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

    OpenAIRE

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

    2012-01-01

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

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

    OpenAIRE

    Curto, Ana; Fernandes, Teresa

    2016-01-01

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

  15. The Congenital Radiouinar Synostcsis by a Rare Tarsal Callition

    OpenAIRE

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

    2004-01-01

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

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

    OpenAIRE

    Deepinder Kaur Gandhi; Maninder Singh; Anupama Mahajan; Seema

    2012-01-01

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

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

    OpenAIRE

    Pascual Huerta, Javier; Alarcón García, Juan María

    2007-01-01

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

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

    OpenAIRE

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

    2010-01-01

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

  19. Primary Care Management of Plantar Fasciitis.

    Science.gov (United States)

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

    2015-01-01

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

  20. 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.

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

    OpenAIRE

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

    2011-01-01

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

  2. Case report:Calcaneal fractures in a cat

    OpenAIRE

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

    2016-01-01

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

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

    OpenAIRE

    Korpelainen, R.

    2005-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1989-01-01

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

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

    OpenAIRE

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

    2012-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-11-15

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

  9. 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.

  10. 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.

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

    Science.gov (United States)

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

    2001-01-01

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

  12. 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.

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

    Institute of Scientific and Technical Information of China (English)

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

    2009-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Patrícia Maria de Moraes Barros Fucs

    2007-12-01

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

  15. 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

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-06-15

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

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

    OpenAIRE

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

    2004-01-01

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

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

    Science.gov (United States)

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

    2016-06-01

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

  20. 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.

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

    Science.gov (United States)

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

    2015-01-01

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

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

    OpenAIRE

    高畑,陽子; 穴井,孝信

    2011-01-01

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

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

    Science.gov (United States)

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

    2000-01-01

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

  4. 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.

  5. A thorny question: the taxonomic identity of the Pirro Nord cervical vertebrae revisited.

    Science.gov (United States)

    Alba, David M; Colombero, Simone; Delfino, Massimo; Martínez-Navarro, Bienvenido; Pavia, Marco; Rook, Lorenzo

    2014-11-01

    The past geographic distribution of the genus Theropithecus (Primates: Cercopithecidae) is mainly restricted to Africa. Outside that continent, the earliest reported records of this genus consist of a calcaneus of cf. Theropithecus sp. from 'Ubeidiya (Israel, 1.6-1.2 Ma [millions of years ago]), as well as three associated cervical vertebrae from Pirro Nord (Italy, 1.7-1.3 Ma) attributed to Theropithecus sp. The attribution of the Pirro Nord vertebrae to this genus has been disputed on morphometric grounds, although their assignment to a large-bodied cercopithecid has remained undisputed. Here we report unpublished cervical vertebral specimens with a similar morphology and, given their significance for the paleobiogeography of Theropithecus (purportedly representing its earliest European record), we re-evaluate their taxonomic attribution. In particular, we reconsider the possibility that they belong to another non-primate mammal recorded at this site. Based on both qualitative and metric morphological comparisons, we strongly favor an alternative attribution of the cervical vertebrae from Pirro Nord to the large porcupine Hystrix refossa, which is widely documented at the site by both dentognathic and other postcranial remains. We therefore conclude that the dispersal of Theropithecus out of Africa before ca. 1 Ma (when it is recorded by dental remains from Cueva Victoria, Spain) is currently based only on the calcaneus from 'Ubeidiya tentatively attributed to this genus.

  6. 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.

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

    Science.gov (United States)

    Faroug, Radwane; Stirling, Paul; Ali, Farhan

    2013-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Radwane Faroug

    2013-01-01

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

  9. 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.

  10. 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.

  11. 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)

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

    Directory of Open Access Journals (Sweden)

    M. Bueschges

    2013-01-01

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

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

    Science.gov (United States)

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

    2014-11-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2009-01-01

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

  17. 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.

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

    Directory of Open Access Journals (Sweden)

    Pedro José Labronici

    2016-04-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-01-01

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

  20. 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.

  1. 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...

  2. Clinical and radiological findings of myocetoma

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-07-01

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

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  7. Bone density determination using I125 densitometry with idiopathic scoliosis

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-04-01

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

  9. 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.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2014-01-15

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

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

    Science.gov (United States)

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

    2015-04-18

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

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

    Directory of Open Access Journals (Sweden)

    Дмитрий Степанович Буклаев

    2013-03-01

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

  13. 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

  14. Compartments of the foot: topographic anatomy.

    Science.gov (United States)

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

    2012-12-01

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

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

    Science.gov (United States)

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

    1995-09-01

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

  16. 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. __________________________________________________________________________________________________________...

  17. 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.)

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

    Directory of Open Access Journals (Sweden)

    Sejda František

    2015-12-01

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

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Kawamoto, Sadahisa

    1964-01-01

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

  1. Apophysitis of the lower limbs: imaging findings

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2001-04-01

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

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

    Science.gov (United States)

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

    2016-10-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-06-15

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

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

    Science.gov (United States)

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

    2016-07-01

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

  6. EFFECT OF ORTHOTICS AND FOOTWEAR ON STATIC REARFOOT KINEMATICS

    Directory of Open Access Journals (Sweden)

    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

  7. Complete encasement of the peroneal tendons by the peroneal tubercle.

    Science.gov (United States)

    Lalli, Trapper A J; King, Jonathan C; Santrock, Robert D

    2014-07-01

    The peroneal tubercle is an osseous structure on the lateral side of the calcaneus present in 90% of individuals. Hypertrophy of the peroneal tubercle resulting in stenosing peroneal tenosynovitis has been well described in the literature. Repair of this condition involves operative treatment to remove the hypertrophied peroneal tubercle and repair any resulting tendon pathology. The authors report a unique case of a hypertrophied peroneal tubercle with an associated tarsal coalition, resulting in complete bony encasement of the peroneal tendons. In this case, a 50-year-old white man presented with worsening bilateral foot and ankle pain for several years. On examination, he had fixed hindfoot varus and bilateral equinocavovarus feet. Magnetic resonance imaging and weight-bearing radiographs showed a calcaneonavicular coalition. Intraoperatively, the authors discovered complete bony encasement of the peroneal longus and brevis tendons. On examination, the peroneal longus and brevis were severely stenotic, with the peroneal brevis to the point of near laceration. This painful condition was repaired by takedown of the calcaneonavicular coalition, the peroneal tubercle was resected, and the peroneal tendons were freed from their bony encasement. Tenodesis of the peroneus brevis to longus was performed and the hindfoot varus was corrected with wedge osteotomy of the calcaneus. The patient reported excellent postoperative results. At 3 months postoperatively, he was pain-free and his calcaneal osteotomy was well healed. This case appears to be the first of its type to be reported in the literature. The details of the case are presented along with a review of the relevant literature. PMID:24992061

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

    International Nuclear Information System (INIS)

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

  9. Congenital vascular malformations in scintigraphic evaluation

    International Nuclear Information System (INIS)

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

  10. 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.

  11. 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

  12. 儿童足跟部严重损伤的骨及软组织修复%Repair of soft tissue and bone in children with badly damaged heel

    Institute of Scientific and Technical Information of China (English)

    胡长青; 王顺义; 马战备; 张志桐; 李辉; 史占雷; 孙建涛; 马伟松; 于涛

    2013-01-01

    目的 探讨儿童足跟部严重损伤的骨及软组织修复方法.方法 对9例(11侧患肢)儿童新鲜的足跟部严重损伤患儿急诊实施跟骨皮质包埋跟腱法修复跟骨及跟腱,腓动脉穿支蒂皮瓣逆行转移修复软组织缺损,伴有足底皮肤缺损的患儿同时行腓肠外侧皮神经移位后用于感觉恢复,术后随访1年.结果 临床9例(11侧患肢)手术均顺利完成,所有跟骨及跟腱均愈合良好,皮瓣均成活,随访1年,皮瓣血运良好,质地柔软.踝关节屈伸平均达48°,接近健侧.修复足底的皮瓣共4例,感觉恢复达S3+,两点分辨率为7~10 mm.结论 儿童足跟部严重损伤采用跟骨皮质包埋跟腱法修复跟骨及跟腱,腓动脉穿支蒂皮瓣逆行转移修复软组织缺损,其手术方式安全、可靠,腓肠外侧皮神经用于修复足底感觉时效果良好.%Objective To discuss a new surgical procedure for repairing of soft tissue and bone defect in badly damaged heels of children.Methods Nine cases (11 limbs) of badly damaged heels were performed as emergency operations.The Achilles's tendon was embedded in the cortical bone of calcaneus and the pedicled flap with perforating branch of the peroneal artery was used for repairing the soft tissue defect of the heel.Lateral sural nerve was transferred for the recovery of the thenar sensation.All cases were followed up for one year.Results All operations were performed with no complications.Calcaneus and Achilles's tendon had reunited well.At 12 months postoperatively,the flap had good blood supply and soft texture.Ankle function was similar to the normal side,with an average arc of motion of 48°.The sensitivity of the flaps with nerve transferring (4 cases of plantar defect) reaches S3+,2-PD was 7 mm to 10 mm.Conclusions The technique of Achilles's tendon embedded in cortical bone of calcaneus,with calf flap is safe,and reliable for repairing badly damaged heels in children.

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

    Institute of Scientific and Technical Information of China (English)

    孔建中; 郑立程; 水小龙; 郭晓山; 李士

    2009-01-01

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

  14. 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

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

    Institute of Scientific and Technical Information of China (English)

    丁亮; 薛锋; 肖海军; 何志敏; 张东

    2013-01-01

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

  16. 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.

  17. 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

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

    Directory of Open Access Journals (Sweden)

    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. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  1. Os trigonum syndrome.

    Science.gov (United States)

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

    2014-09-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1988-09-01

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

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

    Science.gov (United States)

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

    2015-07-01

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

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

    International Nuclear Information System (INIS)

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

  5. 3D morphology of the rear foot from MRI data: technical validation and clinical description

    Science.gov (United States)

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

    1998-06-01

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

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

    Jia, Zhiheng; Du, Zhijiang; Wang, Monan

    2006-01-01

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

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

    Science.gov (United States)

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

    2015-05-01

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

  9. 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.

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2016-06-01

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

  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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-06-01

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

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

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    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.

  15. 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

  16. 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.

  17. 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.

  18. 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

  19. 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

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

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    B Larijani

    2004-11-01

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

  1. 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.)

  2. 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.

  3. 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.

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

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    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.

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

    International Nuclear Information System (INIS)

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

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

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    Hafte Assefa Beyene

    2016-02-01

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

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

    Institute of Scientific and Technical Information of China (English)

    王庆贤; 张英泽; 潘进社; 吴希瑞; 彭阿钦; 王鹏程

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Singh R

    2010-10-01

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

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

    Science.gov (United States)

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

    2014-08-15

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

  10. 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.

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

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Mari Vainionpää

    2012-01-01

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

  14. 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.

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

    International Nuclear Information System (INIS)

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

  16. 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.

  17. 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.

  18. 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.

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

    Science.gov (United States)

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

    2008-01-01

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

  20. 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).

  1. 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.

  2. 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.

  3. 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.

  4. 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%.

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Correa-Muñoz Elsa

    2007-12-01

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

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

    Science.gov (United States)

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

    2007-01-01

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

  8. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-04-15

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

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2013-12-01

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

  12. 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.

  13. 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.

  14. 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.

  15. 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.

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

    Science.gov (United States)

    McKay, Brian J; Bir, Cynthia A

    2009-11-01

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

  17. 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.

  18. 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.

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

    Science.gov (United States)

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

    2016-01-01

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

  1. Exploring Eucladoceros ecomorphology using geometric morphometrics.

    Science.gov (United States)

    Curran, Sabrina C

    2015-01-01

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

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

    Science.gov (United States)

    Choi, Mi-Kyeong; Kim, Mi-Hyun

    2016-07-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

  4. 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

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

    Institute of Scientific and Technical Information of China (English)

    王杰; 倪朝民; 陈焱焱; 马祖长; 孙怡宁; 金艳; 张勤良

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    王庆贤; 张英泽; 潘进社; 吴希瑞; 张国川; 李衡; 焦振清

    2011-01-01

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

  7. 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

  8. 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

  9. Chondroblastoma of the hands and feet

    International Nuclear Information System (INIS)

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

  10. Tuberculosis of the foot: An osteolytic variety

    Directory of Open Access Journals (Sweden)

    Mandeep S Dhillon

    2012-01-01

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

  11. 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

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

    Science.gov (United States)

    Klaue, K

    2004-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Ryder JH

    2013-04-01

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

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

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    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.

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

    Science.gov (United States)

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

    2013-01-01

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

  16. 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

  17. 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.

  18. 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.

  19. 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.)

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

    Directory of Open Access Journals (Sweden)

    Kienast B

    2010-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Ioannis A. Ignatiadis

    2011-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-07-15

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

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

    Institute of Scientific and Technical Information of China (English)

    许灿; 张明彦; 李康华

    2011-01-01

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

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

    International Nuclear Information System (INIS)

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

  5. 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.

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

    International Nuclear Information System (INIS)

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

  7. 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

  8. Reconstruction of Chopart's Amputation Stump Using Artificial Dermis Combined with Free Anterolateral Thigh Flap.

    Science.gov (United States)

    Shimizu, Mari; Matsumine, Hajime; Takeuchi, Masaki

    2015-11-01

    A 63-year-old man dropped a metal chunk onto his left foot during his work and suffered a crush injury of the left forefoot. He underwent Chopart's amputation followed by stump coverage with sole skin at the orthopedic department on the same day. He was referred to our department for reconstruction because of poor vascularization and subsequent necrosis of tissue at the stump. After the necrotic tissue was debrided, exposure of the talus bone was noted. An artificial dermis was then applied to the stump wound, followed by local negative pressure wound therapy. After 3 weeks, the generation of a strong dermis-like tissue was observed at the site of artificial dermis grafting. We then performed flow-through free anterolateral thigh flap grafting to reconstruct the stump wound. This procedure involved suturing of the peroneal muscle group and tibialis anterior muscle, which were cut off during Chopart's amputation, and suturing the soft tissue surrounding the calcaneus firmly to the fascia lata of the anterolateral thigh flap, followed by suturing of the flap to the skin defect of the left foot. There were neither postoperative complications, such as skin ulcer and equinus/varus deformity, nor need for secondary repair of the grafted flap, so the patient was able to smoothly enter a rehabilitation program including gait training. The current reconstruction technique for the tissue defect following Chopart's amputation, consisting of artificial dermis grafting, negative pressure wound therapy, and flow-through free anterolateral thigh flap grafting, enabled safe and smooth gait rehabilitation with a forefoot prosthesis. PMID:26893983

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

    Institute of Scientific and Technical Information of China (English)

    杨新宇; 吴海华

    2012-01-01

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

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

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    Prashanth

    2015-10-01

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

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

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

    2016-05-01

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

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

    Science.gov (United States)

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

    2016-08-01

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

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

    Science.gov (United States)

    Ojah, Rani C I; Welch, Jo M

    2012-05-01

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

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

    Directory of Open Access Journals (Sweden)

    Jo M. Welch

    2012-05-01

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

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

    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

  18. Chondroblastoma of the hands and feet

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-10-01

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

  19. 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; Buschmann, Johanna

    2016-01-01

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

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

    International Nuclear Information System (INIS)

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

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

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    W. X. Niu

    2013-01-01

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

  3. Hybrid III Lower Leg Injury Assessment Reference Curves Under Axial Impacts Using Matched-Pair Tests.

    Science.gov (United States)

    Yoganandan, Narayan; Pintar, Frank; Banerjee, Anjishnu; Schlick, Michael; Chirvi, Sajal; Uppal, Hermeeth; Merkle, Andrew; Voo, Liming; Kleinberg, Michael

    2015-01-01

    The objective of the present study was to derive injury probability curves applicable to the Hybrid III dummy (also termed the Anthropomorphic Test Device, ATD) lower leg under axial impacts for military applications. A matched-pair approach was used. Axial impacts were delivered to below knee foot-ankle complex preparations of the lower leg of the ATD using pendulum and custom vertical accelerator devices. Military boot was used in some tests. Post mortem human surrogate (PMHS) preparations were used as matched-pair tests for injury outcomes. The alignment was such that the foot-ankle complex was orthogonal to the leg (below knee tibia-fibula complex), termed as the normal 90-90 posture. Injury outcomes from the biological surrogate focused on calcaneus and or distal tibia fractures with or without the involvement of articular surfaces. Peak lower tibia load cell forces were obtained from matched-pair dummy tests. Injury and force data were paired, censoring was assigned based on injury outcomes and survival analysis was done using the Weibull distribution to derive dummy-based probability curves. Mean peak forces were extracted at 5, 10, 20 and 50% probability levels. Normalized confidence interval sizes (NCIS) at ± 95% level were computed to determine the tightness-of-fit of the confidence bands. The NCIS data ranged from 0.34 to 0.78 and a peak force of 8.2 kN was associated at the ten percent injury probability level. Other data and curves are given in the body of the paper. The present Injury Assessment Reference Curves and Values (IARC and IARV) may be used in future tests for advancing safety in military environments. These survival analysis processes and IARC and IARV data may also be used in other applications. PMID:25996722

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

    Directory of Open Access Journals (Sweden)

    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.

  5. 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.

  6. 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.

  7. 手术治疗96例跟骨骨折的体会%Experience of surgical treatment for 96 cases with calcaneal fractures

    Institute of Scientific and Technical Information of China (English)

    徐健; 董涛

    2015-01-01

    Objective:To discuss the curative effect and the precautions of the treatment for patients with calcaneal fracture. Methods:96 patients with calcaneal fracture were selected,all patients were treated with open reduction and internal fixation. Results:In 96 patients,84 patients healed by first intention,12 cases of skin necrosis of incision and exposed plate.All patients were followed up,and all of them with fractures healed for long-term follow up.The clinical effect was excellent and good in 86 cases,the excellent and good rate was 89.65%.Conclusion:Patients with calcaneus fracture involving the articular surface treated by reasonable open reduction and internal fixation can obtain satisfactory clinical curative effect.%目的:探讨跟骨骨折手术的疗效与注意事项。方法:收治跟骨骨折患者96例,均采用切开复位内固定治疗。结果:术后切口Ⅰ期愈合84例,12例出现切口皮肤部分坏死、钢板外露。患者均获随访,远期随访骨折均愈合。临床疗效优良86例,优良率89.58%。结论:累及关节面的跟骨骨折合理进行切开复位内固定手术治疗可获得满意的临床疗效。

  8. 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.

  9. Imaging features of foot osteoid osteoma

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-07-15

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

  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. A PROSPECTIVE STUDY OF SURGICAL CORRECTION OF CTEV BY CINCINNATI APPROACH

    Directory of Open Access Journals (Sweden)

    Gopalakrishna

    2014-08-01

    Full Text Available BACKGROUND: Surgical correction of congenital talipes equino varus (ctev is to address adequately all aspects of this complex foot deformity. Various exposures have been elucidated with varying results and complications. This prospective study discusses the cincinnati approach advocated by Mackay to address the various aspects of clubfoot correction. Objective: To study the adequacy of exposure, wound healing and problems related to Cincinnati approach. To study the effectiveness of primary surgical correction. METHODS: The present prospective study includes treatment of 24 feet in 21 patients with clubfoot treated with posteromedial and lateral soft tissue release by Cincinnati approach and followed up with an average follow up of 6.9 months. 3 (12.5% were followed up for 1 year and 3 (12.5% lost for the follow up. 18 (75% were followed up to 6 months. All were resistant to correction by conservative method. Age at operation averaged 1.6 year, ranged from 9 months to 3 years. RESULTS: Results were evaluated using Laaveg and Ponseti functional rating system of clubfoot. Postoperatively the average arc of movement in ankle joint was 370, which was 50% of normal limb. Inversion, eversion movement of subtalar joint was 230, bimalleolar angle was 770.The functional results were excellent in 6 feet (25%, good in 12 feet (50%, fair in 5 feet (20.83% and poor in 1 foot (4.17%. In our series complications encountered were post-operative focal necrosis in 3 feet (12.5% and marginal necrosis in 3 feet (12.5%. CONCLUSION: Cincinnati incision provides an adequate exposure for extensive surgical release under direct vision, there by bony realignment of talus over calcaneus was restored and hence the restoration of normal bimalleolar angle. Skin closure is not found to be a problem in achieving a primary closure. Wound healing leaves only a thin and cosmetically acceptable scar.

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

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    A. Loi

    2013-07-01

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

  13. 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

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

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    Sugawara Norio

    2012-02-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

  16. Sonographic evaluation of acute osteomyelitis in infants

    International Nuclear Information System (INIS)

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

  17. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-06-15

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

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

    Directory of Open Access Journals (Sweden)

    Jain Saurabh

    2013-12-01

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

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

    Institute of Scientific and Technical Information of China (English)

    王春辉; 吴兵; 盛文辉; 王自钢

    2011-01-01

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

  1. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    Francesco Gianfagna

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

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

    Science.gov (United States)

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

    2013-01-01

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

  5. 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

  6. 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

  7. Radiography and sonography of clubfoot: A comparative study

    Directory of Open Access Journals (Sweden)

    Satish Kumar Bhargava

    2012-01-01

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

  8. 3D automatic anatomy segmentation based on iterative graph-cut-ASM

    International Nuclear Information System (INIS)

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

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

    Institute of Scientific and Technical Information of China (English)

    郑慧琳; 余旭辉; 段清萍; 张弘; 饶绮

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Marcus Castro Ferreira

    2004-01-01

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

  11. 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.

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

    Directory of Open Access Journals (Sweden)

    Rahel Abebe

    2012-03-01

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

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

    Institute of Scientific and Technical Information of China (English)

    赵春琪

    2014-01-01

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

  14. 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.

  15. 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

  16. 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

  17. 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

  18. The Surgical Safe Zone of the Medial Displacement Calcaneal Osteotomy the Surgry for the Treatment of Flatfoot%跟骨内移截骨术中跟骨内侧的截骨安全区

    Institute of Scientific and Technical Information of China (English)

    杨蕾; 杨茂伟; 李元州; 王振鹏

    2011-01-01

    目的 探讨跟骨内移截骨术中跟骨内侧的截骨安全区.方法 10具防腐成人尸体的20只足部标本上,取跟骨结节内缘最低点为A点,内踝尖最低点为B点,足舟骨结节为C点.显露跟骨内侧各神经血管结构后,用游标卡尺测量AB、AC长度,以及各神经血管结构与AB、AC线段交点与A点间的长度.经统计学检验,各组长度符合正态分布,所以可以用后者的长度均值除以AB、AC长度的均值,计算出各神经血管结构在AB、AC上的分布比例.结果 跟骨内侧神经、足底外侧神经、足底内侧神经、胫后动脉在AB线上分别位于A点后的:29%、57%、66%、60%;而在AC线上跟骨内侧神经、足底外侧动脉、足底外侧神经、足底内侧动脉、足底内侧神经分别位于A点后的:20%、45%、50%、60%、66%.结论 AB线上A点后29%~57%,AC线上A点后20%~45%的区域无重要神经血管走行,满足跟骨内移截骨术在跟骨中后部截骨的要求,可作为跟骨内移截骨术的手术安全区.%Objective To explore the surgical safe zone of the medial displacement calcaneal osteotomy(MDCO).Methods 20 adult cadaveric feet were dissected. On the medial surface of each foot,three palpable anatomic landmarks were choosen and labeled as Point A(the lowest point on the inner margin of calcaneal tuberosity),Point B(the lowest point of inferior medial malleolus),and Point C (navicular tuberosity). The medial neurovascular structures were carefully dissected, then marked. The length of line AB and AC and the distance between the points at which neurovascular structures intersect line AB and AC and the point A were measured by vernier caliper. And then calculate the percentage of these distances respectively on the line AB and AC to mark off the relative safe zone at medial calcaneus to reduce the neurovascular injuries in MDCO. Results On the AB line,MCN,LPN,MPN and PTA were located at 29%、57%、66%、60% away from point A respectively

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

    Institute of Scientific and Technical Information of China (English)

    李海源; 李小满; 高莉丽; 林秀琼; 蔡映红; 梁玉英

    2015-01-01

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

  20. 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

  1. 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

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

    Institute of Scientific and Technical Information of China (English)

    孙德政; 杨青; 胡亚彬; 段峰; 于华龙

    2014-01-01

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

  3. 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

  4. 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

  5. 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

  6. 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.

  7. 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

  8. 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

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

    Directory of Open Access Journals (Sweden)

    Maira Sayuri Sakay Bortoletto

    2010-07-01

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

  10. 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。

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

    Science.gov (United States)

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

    1998-12-01

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

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

    Institute of Scientific and Technical Information of China (English)

    张英琪; 张世民

    2011-01-01

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

  13. 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.

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

    Institute of Scientific and Technical Information of China (English)

    章玉玲; 王晨秀; 刘精东; 霍亚南; 林安华; 程丽红

    2013-01-01

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

  15. 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.

  16. 芦山地震中主动性高处坠落伤的伤情分析%A retrospective analysis of intentional free-fall injury in Lushan earthquake

    Institute of Scientific and Technical Information of China (English)

    韩培; 杨庆诚; 龚伟华; 干耀恺; 孙玉强; 曾炳芳

    2013-01-01

    目的 探讨芦山地震中主动性高处坠落伤的损伤情况和临床特点. 方法 对芦山地震中早期收治的74例伤员资料进行回顾性分析,筛选出20例主动性高处坠落伤伤员,均为男性;年龄14 ~57岁,平均29.4岁.分析此20例伤员的坠落高度、骨折部位及损伤严重程度等资料,并应用简明创伤分度和损伤严重度评分(ISS)进行创伤评分.根据ISS评分分为轻度伤组和中重度伤组,分析年龄、坠落高度与损伤严重程度是否存在关联. 结果 20例伤员坠落高度为2~6m,平均3.7m.骨折部位:跟骨骨折10例,其中双侧5例,单侧5例;胸腰椎骨折9例,其中简单骨折5例,爆裂骨折4例(不全瘫2例);上肢骨折3例;下肢骨折3例.ISS评分为4~16分,平均9.0分,以轻、中度损伤为主.轻度伤组与中重度伤组伤员的年龄、坠落高度比较差异均无统计学意义(P>0.05),年龄、坠落高度与损伤严重程度间无明显相关性. 结论 芦山地震中主动坠落伤有着与自杀性主动坠落伤及被动坠落伤明显不同的伤情特点,应根据其特点采取相应的救治措施.%Objective To analyze the clinical characteristics of intentional free-fall injury in the Lushan earthquake.Methods Twenty patients who had got injured after an intentional free-fall were screened from the 74 victims who were treated in our hospital for their injuries caused in the Lushan earthquake.They were all males,aged from 14 to 57 years (average,29.4 years).After their injuries were graded by the abbreviated injury score (AIS) and injury severity score (ISS) systems,they were classified into 2groups according to their ISS:a mild injury group and a moderate-to-serious group.Associations among falling height,flacture site and injury severity were explored using SPSS19.0.Results The falling heights of the 20 patients ranged from 2 to 6 meters,averaging 3.7 meters.Calcaneus fracture occurred in 10 cases,including 5 bilateral ones and

  17. 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

  18. 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.

  19. 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

  20. 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.

  1. 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

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

    Institute of Scientific and Technical Information of China (English)

    李海峰; 季伟; 白雪东; 贾治伟

    2011-01-01

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

  3. 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

  4. 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

  5. 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.

  6. 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、

  7. Reconstruction of the lateral ankle ligaments with autograft of semitendinosus & bio-interference screws in chronic lateral instability of the ankle%自体半腱肌肌腱结合界面螺钉修复慢性踝关节外侧副韧带损伤

    Institute of Scientific and Technical Information of China (English)

    赵立来; 徐向阳; 刘津浩

    2011-01-01

    drilled on the lateral ankle, where the tendon of semitendinosus was permeated through, both ends of semitendinosus tendons were fixed with bio-interference screws on talus of at the end of anterior talofibular ligament and calcaneus of at the end of calcaneofibular ligament, maintaining ankle neutral and moderate valgus position. Following operation, the ankle was fixed in neutral position and slightly valgus position with plaster cast. The wound healing, the outcomes of American Orthopaedic Foot and Ankle Society (AOFAS) score, Foot and Ankle Outcome Score (FAOS), and stress radiographic evaluation were assessed at the follow-up. Results All 12 patients showed no infection and the wound healed well at the primary stage. At 3, 6, 12, 24 months after operation, all patients were followed-up. According to AOFAS and FAOS of preoperation and final follow-up postoperation, function of ankle in all patients was significantly improved (P<0.01), the scores of Chrisman-Snook group were more lower than this approach. No patients complained of instability of the ankle, and stress radiograph confirmed this improvement. Conclusion Reconstruction of lateral ligaments of the ankle with autograft of semilendinosus & biointerference screws is a practical and reliable treatment, which restores stability and function of the ankle.

  8. 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

  9. 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.

  10. 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

  11. Anatomical reconstruction of ligaments with chronic lateral ankle instability%自体肌腱移植解剖重建慢性踝关节外侧不稳定

    Institute of Scientific and Technical Information of China (English)

    王雪松; 冯华; 王满宜

    2010-01-01

    Objective To evaluate the clinical results of an anatomical reconstruction technique for the lateral ligaments with semitendinosus autografts in treatment of chronic lateral ankle instability.Methods From October 2008 to October 2009, 16 patients with lateral instability of the ankle underwent surgery using the proposed methods. They were 8 men and 8 women, with a mean age of 28.2 years (range,19 to 47 years) . Nine patients received only the anterior talofibular ligament reconstruction. Seven patients received both the anterior talofibular ligament and the calcaneofibular ligament reconstruction. Standard stress radiographs under anesthesia were taken to determine which ligament would be reconstructed. The semitendinosus autografts were secured to the fibular insertion site with suture anchors and to the talar or calcaneus insertion site with interference screws. The American Orthopaedic Foot and Ankle Society (AOFAS) scores and standard stress radiographs were used to assess the patients preoperation and at the last follow-up.Results We had a mean follow-up of 12. 1 months (range, 6 to 18 months). In the 16 patients, the average preoperative AOFAS score was 70. 50 ± 3.98, and the final average AOFAS score increased to 93.06 ± 4. 78 ( t = - 24. 010, P = 0. 000). Their average anterior drawer sign improved from 8. 75 ± 3.38 mm to 3.51 ±1.63 mm ( t = 7. 028, P = 0. 000). In the 7 patients who had received both lateral ligaments reconstruction,their average talar tilt improved from 16. 18° ± 7.30° to 5.57° ± 2. 99° ( t = 5. 661, P = 0. 001 ). No significant complications were found in all but one patient who had a 10° limitation of dorsal flexion of the ankle.Conclusions Our short-term results reveal that anatomical reconstruction of the ligaments with chronic lateral ankle instability using the above-mentioned methods may be effective and have the advantages of precise anatomical reconstruction, firm fixation of the grafts, mini-invasive procedure for the

  12. 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.

  13. 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

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

    Institute of Scientific and Technical Information of China (English)

    宋卫东; 李德; 刘尚礼; 黄建荣; 沈慧勇; 黄东生; 马若凡

    2010-01-01

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

  15. 自体与异体肌腱微创重建踝关节外侧韧带的临床对比研究%Comparison of semitendinosus tendon autograft and tendon allograft for reconstruction of the ligaments of the lateral ankle via minimally invasive method

    Institute of Scientific and Technical Information of China (English)

    胡牧; 徐向阳; 刘津浩; 朱渊; 王碧波; 郭常军

    2014-01-01

    Objective To study on the different results of a minimally invasive method to reconstruct the ligaments of the lateral ankle using semitendinosus tendon autograft and tendon allograft.Methods Data of 68 patients with chronic ankle instability who had undergone lateral ligament reconstruction from September 2006 to June 2011 were retrospectively analyzed.In the group of semitendinosus autograft,there were 32 patients (19 males,13 females) with an average age of 32.4 years old.Semitendinosus was harvested through 2 small knee incisions.While in the group of tendon allograft,there were 36 patients (22 males,14 females) with an average age of 34.2 years old.For the ankle reconstruction,4 small incisions of 5 mm each were made at the medial and lateral side of the fibular tip,the talar neck,and the middle of the calcaneus.Anatomical reconstruction of the anterior talofibular ligament and calcaneofibular ligament was then performed through these small incisions.AOFAS questionnaires were used to measure clinical outcomes,donor site morbidity and patients' satisfaction.Preoperative and postoperative stress tests were performed and radiographic parameters were measured.Results The average operation time of the autograft group 85.5 ± 11.5 min was significantly longer than that in the allograft group 58.1±10.2 min,but the fever days in the latter 5.5±1.5 d was significantly longer than in the former 2.5±1.2 d.In autograft group,23 patients got followed up,and the mean period of follow-up was 33.5±6.7 months.The mean AOFAS score increased from 62.3±8.2 to 95.1 ±7.5.In allograft group,26 patients got followed up,and the mean period of follow-up was 28.5±6.7 months.The mean AOFAS score increased from 60.2±8.4 to 94.8±5.5.There were 5 patients (3 of autugraft group and 2 of allograft group) with residual instability on uneven ground.One case of the autologous group had instability in daily life.No patient presented weakness or disability in the donor site

  16. 自体半腱肌肌腱微创重建踝关节外侧韧带的中期随访研究%Mid-term follow-up study of minimally invasive reconstruction of ankle joint lateral ligament with autologous semitendinosus tendon

    Institute of Scientific and Technical Information of China (English)

    胡牧; 徐向阳; 葛文涛; 李星辰; 刘津浩; 朱渊; 王碧波; 郭常军

    2014-01-01

    Objective To assess the results of a minimally invasive method for reconstructing the lateral ligaments of the ankle using a semitendinosus tendon autograft .Methods From September 2006 to June 2012, 58 patients ( 34 males, 24 females ) with chronic ankle instability underwent the lateral ligament reconstruction by a minimally invasive method with the semitendinosus autograft .The average age was 58.5 ( range, 17 to 62 ) years old.The semitendinosus tendon was harvested through two small incisions at the knee .For the ankle reconstruction , four small incisions of 5 mm each were made at the medial and lateral sides of the fibular tip , the talar neck, and the middle of the calcaneus .The anatomical reconstructions of the anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL) were then performed through these small incisions .The mean follow-up time was (58.5 ±7.4) months, (range, 25 to 86 months ) .AOFAS, VAS questionnaires were used to evaluate the clinical outcomes , donor site morbidity and the patient satisfaction .The preoperative and postoperative stress tests were performed and the radiographic parameters were measured .Results The average opereation time of the autograft group was 75-98 min, (85.5 ±11.5) min in average, and the lasting time of the postoperative fever were 1.5-4 days, (2.5 ±1.2) days in average.In the autograft group, 46 patient were followed up, the follow-up time ranged from 25 to 86 months, (58.5 ±7.4) months in average.The average AOFAS score increased from (62.3 ±8.2) to (95.1 ±7.5) ( P <0.01).Six patients reported the residual instability on the uneven ground .Three patients of the autologous group reported the instability in daily life .No patient reported weakness or disability in the donor site .The satisfaction level of the autograft group was excellent in 31 patients and good in nine patients .Significant improvement of the talar tilt angle according to the stress radiographic parameters was noticed

  17. 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

  18. 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