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American Journal of Biological... Dec 2022This study investigates patterns of bone functional adaptations in extant apes through comparing hindlimb to forelimb bone rigidity ratios in groups with varying levels...
OBJECTIVES
This study investigates patterns of bone functional adaptations in extant apes through comparing hindlimb to forelimb bone rigidity ratios in groups with varying levels of arboreality.
MATERIALS AND METHODS
Using CT scans, bone rigidity (J) was calculated at three regions of interest (ROI) along femoral and humeral diaphyses in Homo, Pongo, Pan, and Gorilla with further comparisons made between species and subspecies divisions within Pan and Gorilla.
RESULTS
Consistent with previous work on extant hominoids, species exhibited differences in midshaft femoral to humeral (F/H) rigidity ratios. Results of the present study confirm that these midshaft differences extend to 35% and 65% diaphyseal ROIs. Modern humans, exhibiting larger ratios, and orangutans, exhibiting smaller ratios, bracketed the intermediate African apes in comparisons. Within some African apes, limb rigidity ratios varied significantly between taxonomic groups. Eastern gorillas exhibited the highest mean ratios and chimpanzees the lowest at all three ROIs. In posthoc comparisons, chimpanzees and bonobos did not differ in relative limb rigidity ratios at any of the three ROIs. However, western gorillas were more similar to bonobos than eastern gorillas at 50% and 35% ROIs, but not at the 65% ROI.
CONCLUSION
Species, and to a lesser extent subspecies, can be distinguished by F/H limb rigidity ratios according to broad positional behavior patterns at multiple regions of interest along the diaphyses. Similarity of bonobos and western gorillas is in line with behavioral data of bonobos being the most terrestrial of Pan species, and western gorillas the most arboreal of the Gorilla groups.
Topics: Humans; Animals; Hominidae; Gorilla gorilla; Pan troglodytes; Pan paniscus; Trees; Locomotion; Pongo; Humerus; Pongo pygmaeus
PubMed: 36790629
DOI: 10.1002/ajpa.24632 -
Canadian Association of Radiologists... May 2015This article provides an overview of atypical femoral fractures with a highlight on their radiographic findings. Potent antiresorptive agents such as bisphosphonates or... (Review)
Review
This article provides an overview of atypical femoral fractures with a highlight on their radiographic findings. Potent antiresorptive agents such as bisphosphonates or denosumab have been associated with the development of such fractures. However, at this time, a causal association has not been conclusively established. Atypical femoral fractures are insufficiency fractures, which frequently present with bone pain. Early identification of characteristic radiographic features and withdrawal of antiresorptive therapy may prevent the development of completed atypical femoral fractures.
Topics: Antibodies, Monoclonal, Humanized; Bone Density Conservation Agents; Denosumab; Diaphyses; Diphosphonates; Femoral Fractures; Fractures, Spontaneous; Humans; Radiography
PubMed: 25051904
DOI: 10.1016/j.carj.2014.01.002 -
Medicine and Science in Sports and... Dec 2022Female runners have high rates of bone stress injuries (BSIs), including stress reactions and fractures. The current study explored multidirectional sports (MDS) played...
PURPOSE
Female runners have high rates of bone stress injuries (BSIs), including stress reactions and fractures. The current study explored multidirectional sports (MDS) played when younger as a potential means of building stronger bones to reduce BSI risk in these athletes.
METHODS
Female collegiate-level cross-country runners were recruited into groups: 1) RUN, history of training and/or competing in cross-country, recreational running/jogging, swimming, and/or cycling only, and 2) RUN + MDS, additional history of training and/or competing in soccer or basketball. High-resolution peripheral quantitative computed tomography was used to assess the distal tibia, common BSI sites (diaphysis of the tibia, fibula, and second metatarsal), and high-risk BSI sites (base of the second metatarsal, navicular, and proximal diaphysis of the fifth metatarsal). Scans of the radius were used as control sites.
RESULTS
At the distal tibia, RUN + MDS ( n = 18) had enhanced cortical area (+17.1%) and thickness (+15.8%), and greater trabecular bone volume fraction (+14.6%) and thickness (+8.3%) compared with RUN ( n = 14; all P < 0.005). Failure load was 19.5% higher in RUN + MDS ( P < 0.001). The fibula diaphysis in RUN + MDS had an 11.6% greater total area and a 11.1% greater failure load (all P ≤ 0.03). At the second metatarsal diaphysis, total area in RUN + MDS was 10.4% larger with greater cortical area and thickness and 18.6% greater failure load (all P < 0.05). RUN + MDS had greater trabecular thickness at the base of the second metatarsal and navicular and greater cortical area and thickness at the proximal diaphysis of the fifth metatarsal (all P ≤ 0.02). No differences were observed at the tibial diaphysis or radius.
CONCLUSIONS
These findings support recommendations that athletes delay specialization in running and play MDS when younger to build a more robust skeleton and potentially prevent BSIs.
Topics: Humans; Female; Bone Density; Bone and Bones; Radius; Tibia; Running
PubMed: 35941520
DOI: 10.1249/MSS.0000000000003016 -
Scientific Reports Oct 2022The current prognosis for successful return to function in koalas with appendicular fractures is poor despite being the most common fracture type to result in successful...
The current prognosis for successful return to function in koalas with appendicular fractures is poor despite being the most common fracture type to result in successful rehabilitation. The forelimb, particularly the humerus, plays a critical role in stabilisation and support while climbing trees. Successful rehabilitation therefore requires adequate internal stabilisation to promote bone healing and faster return to function. Current knowledge of koala limb bone morphometry is lacking and would provide useful clinical insight for future orthopaedic research, particularly with regards to recommendations regarding implant size and type. In this study microcomputed tomography (micro-CT) was used to describe bone length, internal and external diameters, and cortical thickness at five transverse levels along the humerus of skeletally mature koala cadavers. Qualitative descriptions were also made regarding bone features deemed clinically relevant to potential fracture repair techniques. Mean humeral length was 114.3 mm (95% CI 107.29-121.31 mm). Mediolateral diameters were greater than craniocaudal diameters at each measurement level, and the diaphysis has a distally tapering medullary cavity. Diaphyseal cortices were relatively homogenous with slight distal thickening, and medial cortices were thickest along the entire bone. The bone protuberances of the deltoid and supinator ridges projected most of the way down the lateral surface of the bone while the medial surface remained relatively uniform. Distal to the deltoid ridge the humerus curved caudally, terminating at a craniocaudally flattened distal epiphysis. Morphometric descriptions provided in this study will serve as a useful reference for future research, guiding orthopaedic surgery and improving prognosis of koala humeral fractures.
Topics: Animals; Humans; X-Ray Microtomography; Phascolarctidae; Humerus; Humeral Fractures; Diaphyses
PubMed: 36302878
DOI: 10.1038/s41598-022-22944-0 -
Orthopaedic Surgery Jun 2021Measure and systematically evaluate the distribution of microhardness in the human skeleton.
OBJECTIVES
Measure and systematically evaluate the distribution of microhardness in the human skeleton.
METHODS
Three fresh corpses were obtained, aged 62 (male), 45 (female), and 58 years (male). Soft tissues were removed, and all axial and unilateral appendicular bones were freshly harvested. All three skeletons were examined by X-ray and computed tomography (CT) to exclude skeletal pathology. Only bones from donors with no known skeletal pathology were included in the study. Axial and unilateral appendicular skeleton bones from each of the three donors were obtained, except for ear ossicles, hyoid bone, tailbone, and 14 phalanges of the foot, for which samples were difficult to obtain. Precision bone specimens with a thickness of 3 mm, which were cut with a Buehler IsoMet 11-1280-250 low-speed diamond saw (Buehler, USA), were obtained from all important anatomic sites in a direction perpendicular to the mechanical axis of each bone. Micro-indentation (the Vickers hardness test) was performed on the surface of each specimen using a microhardness tester with a diamond indenter. Hardness value (HV) was computed for each indentation. Each bone specimen was divided into several regions of interest. Indentations were carefully made and computed. Then we analyzed the data to identify hardness distribution rules at different anatomic sites.
RESULTS
In total, 5360 indentations were made in 1072 regions of interest in each donor. Hardness of the axial and appendicular bones were all inhomogeneous depending on the anatomic sites, but the distribution of microhardness followed certain rules. The mean hardness value ranged from 24.46 HV (HV = hardness value, kgf/mm ) for the sacrum to 53.20 HV for the shaft of the tibia. The diaphysis was harder than the metaphysis, and the proximal and distal epiphysis had lower values (8.85%- 40.39%) than the diaphysis. Among the long bone diaphyses, the tibia cortical bone (51.20 HV) was the hardest, harder than the humerus (47.25 HV), the ulna (43.26 HV), the radius (42.54 HV), and the femur (47.53 HV). However, in some anatomic sites such as the lumbar vertebra (cortical bone 32.86 HV, cancellous bone 31.25 HV), the cortical shells were sometimes not harder than the internal cancellous bones. The lumbar vertebra (32.86 HV) was harder than the cervical vertebra (28.51 HV) and the thoracic vertebra (29.01 HV).
CONCLUSIONS
The distribution of microhardness in the human skeleton follows certain rules. These distribution rules could be used to predict the mechanical properties of bone and progress in this field could provide data for the basis of a new three-dimensional printing technique, which may lead to new perspectives for custom-made implants.
Topics: Biomechanical Phenomena; Bone and Bones; Cadaver; Female; Hardness; Humans; Male; Middle Aged
PubMed: 33973714
DOI: 10.1111/os.12841 -
PloS One 2023Cortical bone thickness is important for the mechanical function of bone. Ontogeny, aging, sex, body size, hormone levels, diet, behavior, and genetics potentially cause...
Cortical bone thickness is important for the mechanical function of bone. Ontogeny, aging, sex, body size, hormone levels, diet, behavior, and genetics potentially cause variations in postcranial cortical robusticity. However, the factors associated with cranial cortical robusticity remain poorly understood. Few studies have examined cortical robusticity in both cranial and postcranial bones jointly. In the present study, we used computed tomography (CT) images to measure cortical bone thicknesses in the cranial vault and humeral diaphysis. This study clearly showed that females have a greater cranial vault thickness and greater age-related increase in cranial vault thickness than males. We found an age-related increase in the full thickness of the temporal cranial vault and the width of the humeral diaphysis, as well as an age-related decrease in the cortical thickness of the frontal cranial vault and the cortical thickness of the humeral diaphysis, suggesting that the mechanisms of bone modeling in cranial and long bones are similar. A positive correlation between cortical indices in the cranial vault and humeral diaphysis also suggested that common factors affect cortical robusticity. We also examined the association of polymorphisms in the WNT16 and TNFSF11 genes with bone thickness. However, no significant associations were observed. The present study provides fundamental knowledge about similarities and differences in the mechanisms of bone modeling between cranial and postcranial bones.
Topics: Male; Female; Humans; Skull; Cortical Bone; Diaphyses; Humerus
PubMed: 36989318
DOI: 10.1371/journal.pone.0283636 -
Acta Radiologica (Stockholm, Sweden :... Apr 2018Background Ribbing disease, or multiple diaphyseal sclerosis, is a rare benign bone dysplasia. Purpose To systematically review the literature to determine the clinical...
Background Ribbing disease, or multiple diaphyseal sclerosis, is a rare benign bone dysplasia. Purpose To systematically review the literature to determine the clinical and radiological presentation of patients with Ribbing disease as well as the effects of attempted treatments. Material and Methods We considered individual patient data of patients diagnosed with Ribbing disease derived from patient reports and patient series. All stages of the review were performed by two reviewers independently. Standard descriptive statistics were used for quantitative analyses and mixed model analyses were used when appropriate Results The literature search yielded 420 unique hits of which 23 studies were included, covering a total of 40 patients of whom 29 had bilateral involvement. The mean age at diagnosis was 35 years and the mean time between diagnosis and onset of symptoms, mostly pain, was five years (range = 1-16 years). The tibial diaphysis was the most commonly involved bone in 35 of 36 patients. Non-surgical treatment consisted of non-steroidal anti-inflammatory drugs (NSAIDs), prednisone, and bisphophonates with mixed results. Surgical treatment consisted of intramedullary reaming and fenestration and was very effective to reduce pain. Conclusion The clinical presentation and imaging findings of patients with Ribbing disease are becoming more apparent. However, there is paucity of evidence on the natural disease progression and effectiveness of treatment modalities.
Topics: Adult; Anti-Inflammatory Agents, Non-Steroidal; Camurati-Engelmann Syndrome; Female; Glucocorticoids; Humans; Magnetic Resonance Imaging; Male; Osteoma, Osteoid; Prednisone; Tibia; Tomography, X-Ray Computed; X-Rays
PubMed: 28691528
DOI: 10.1177/0284185117719575 -
Bone Dec 2019Marrow adipose tissue (MAT) is increasingly recognized as an active and dynamic endocrine organ that responds to changes in nutrition and environmental milieu. Compared...
BACKGROUND
Marrow adipose tissue (MAT) is increasingly recognized as an active and dynamic endocrine organ that responds to changes in nutrition and environmental milieu. Compared to normal weight controls, adolescent girls with anorexia nervosa have higher MAT content, which is associated with impaired skeletal integrity, but data are limited regarding MAT content in adolescents with obesity and how this interacts with bone endpoints.
OBJECTIVE
To evaluate (i) MAT content in adolescents with obesity compared to normal-weight controls, (ii) the association of MAT with bone endpoints, and (iii) whether these associations of MAT are affected by body weight.
METHODS
We assessed MAT, bone endpoints, and body composition in 60 adolescent girls 14-21 years old: 45 with obesity (OB) and 15 normal-weight controls (NW-C). We used (i) DXA to assess areal bone mineral density (aBMD) at the lumbar spine and total hip, and total body fat and lean mass, (ii) proton magnetic resonance spectroscopy (1H-MRS) to assess MAT at the 4th lumbar vertebra and femur, and MRI to assess visceral (VAT) and subcutaneous adipose tissue (SAT), (iii) high resolution peripheral quantitative CT (HR-pQCT) to assess volumetric BMD (vBMD), (iv) individual trabeculae segmentation to evaluate trabecular bone (plate-rod morphology), and (v) finite element analysis to assess stiffness (a strength estimate) at the distal radius and tibia.
RESULTS
Groups did not differ for age or height. Weight, BMI, and areal BMD Z-scores at all sites were higher in the OB group (p<0.0001). MAT was lower in OB at the femoral diaphysis (p= <0.0001) and the lumbar spine (p=0.0039). For the whole group, MAT at the lumbar spine and femoral diaphysis was inversely associated with BMI, total fat mass, lean mass, and VAT. Even after controlling for body weight, independent inverse associations were observed of femoral diaphyseal and lumbar MAT with total tibial vBMD, and of lumbar MAT with radial trabecular vBMD.
CONCLUSION
Adolescent girls with obesity have lower MAT than normal-weight controls despite having an excess of total body fat. These findings confirm that MAT is regulated uniquely from other adipose depots in obesity. MAT was inversely associated with vBMD, emphasizing an inverse relationship between MAT and bone even in adolescent girls with obesity.
Topics: Adipose Tissue; Adolescent; Body Composition; Bone Density; Bone Marrow; Bone and Bones; Diaphyses; Female; Humans; Obesity; Proton Magnetic Resonance Spectroscopy; Young Adult
PubMed: 31622774
DOI: 10.1016/j.bone.2019.115103 -
Orthopaedics & Traumatology, Surgery &... May 2019Intra-medullary osteosclerosis of the tibia is a rare condition characterised by chronic pain due to diaphyseal hyperostosis with no detectable triggering factor. The...
BACKGROUND
Intra-medullary osteosclerosis of the tibia is a rare condition characterised by chronic pain due to diaphyseal hyperostosis with no detectable triggering factor. The main differential diagnoses are stress fracture and osteoid osteoma. Of the few cases reported to date, most were in adults. The objective of this study was to assess paediatric patients with intra-medullary osteosclerosis to determine whether the first visit provides sufficient information to establish the diagnosis and rule out both osteoid osteoma and stress fracture, whether a biopsy is required, and which treatment is optimal.
HYPOTHESIS
The diagnosis of intra-medullary osteosclerosis of the tibia can be made at the first visit.
PATIENTS AND METHODS
Seven paediatric patients, 4 males and 3 females, with a mean age of 11 years, were included in this retrospective study. We evaluated the clinical features, findings from imaging studies (standard radiographs, computed tomography, magnetic resonance imaging, and bone scintigraphy), and treatment outcomes.
RESULTS
At the first visit, all patients had a painful swelling at the middle of the shin and imaging study evidence of antero-lateral tibial cortical thickening extending into the medullary cavity; in 5 patients, a linear lucency was visible. No other bone abnormalities were seen. Treatments included non-operative measures, pinning, and nailing. None of these treatments provided permanent bone healing or pain relief, although transitory freedom from pain with or without radiological bone healing was achieved.
DISCUSSION
Intra-medullary osteosclerosis of the tibia is rarely reported and therefore probably underdiagnosed. Distinctive characteristics of the cortical and endosteal thickening include location at the antero-lateral mid-diaphysis and, in some cases, the concomitant presence of a linear lucency that can provide the early diagnosis. The distinctive radiological features allow differentiation from a stress fracture. The management is challenging.
LEVEL OF EVIDENCE
IV, retrospective observational study.
Topics: Adolescent; Biopsy; Bone Neoplasms; Child; Child, Preschool; Diagnosis, Differential; Diaphyses; Edema; Female; Fractures, Stress; Humans; Magnetic Resonance Imaging; Male; Musculoskeletal Pain; Osteoma, Osteoid; Osteosclerosis; Retrospective Studies; Tibia; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 30975636
DOI: 10.1016/j.otsr.2018.10.026 -
Journal of Wrist Surgery Jun 2020Volar plating for distal radius fractures has become common. Screw prominence on the dorsal side from long screws can lead to tendon injury. Methods for detecting...
Volar plating for distal radius fractures has become common. Screw prominence on the dorsal side from long screws can lead to tendon injury. Methods for detecting screws that penetrate the far cortex involve X-ray or ultrasound. These have focused on the distal row of screws. No studies have addressed screw penetration in the diaphysis. We describe two cases where diaphyseal screws caused symptoms. We then insert screws in the diaphysis of synbones 2 mm longer than measured and determine what angle of pronation or supination was best to detect this on X-ray. Three synbones were plated using Synthes volar plate. The three diaphyseal screws were drilled perpendicular to the plate, and the depth measured. Cortical 2.4-mm screws were inserted, 2 mm longer than measured. The three synbones were then placed in a custom clamp to measure rotation. Lateral X-rays were taken at 0 degree rotation, and 5, 10, and 15 degrees of supination and pronation. The prominence of each screw was measured using the synapse digital ruler. For the screws that were placed at a neutral angle (perpendicular to the plate) the maximum visualization of the prominent tips occurred around 0 degree rotation. With screws angled 15 degrees ulna, maximum visualization was between 5 and 10 degrees of pronation. With screws angled 15 degrees radial, maximum visualization was between 5 and 10 degrees of supination. Every 5 degrees of rotation changes the profile of the screw by 0.4 mm. The diaphysis of the radius becomes approximately trapezoidal distally. Prominent screws that are placed below the "peak" of the trapezoid may appear to be the correct length. Rotating the wrist into pronation or supination to bring the relevant cortex as parallel to the X-ray beam as possible will help to identify if screws are of the correct length. Screws that are prominent in the second compartment may be particularly symptomatic as the tendons here are closely opposed to the bone. We recommend screening for 2 mm diaphyseal screw prominence in neutral, with 10 degrees of pronation and supination.
PubMed: 32509425
DOI: 10.1055/s-0040-1702930