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Tierarztliche Praxis. Ausgabe G,... Oct 2023Fractures of the splint bones are the most common fractures in horses. Various treatment options for splint bone fractures (MC/MT II and IV), including conservative and...
Fractures of the splint bones are the most common fractures in horses. Various treatment options for splint bone fractures (MC/MT II and IV), including conservative and surgical management, have been described. This report describes an acute splint bone fracture due to external trauma in a 17-year-old Icelandic mare. The fracture was diagnosed as an open multifragment fracture of the proximal third of the fourth metacarpal bone (MCIV) in the right front limb. Surgery was performed with the horse under general anaesthesia. The distal fragments were removed, and the distal part of the proximal remnant splint bone was cut with an osteotome. During the postoperative period, a routine x-ray-control two days after surgery showed a dislocated fracture of the remaining proximal part of the fourth metacarpal bone. In a second surgery, the proximal part of MCIV was entirely removed. After a reconvalescence period of 5 month, the horse reached her previous level of performance as a leisure horse. The mare is still free of lameness 6 years after the incident.
Topics: Horses; Animals; Female; Metacarpal Bones; Iceland; Fractures, Bone; Radiography; Horse Diseases
PubMed: 37956675
DOI: 10.1055/a-2180-2981 -
Journal of Dentistry (Shiraz, Iran) Mar 2024Bone age is a more accurate assessment for biologic development than chronological age. The most common method for bone age estimation is using Pyle and Greulich Atlas....
STATEMENT OF THE PROBLEM
Bone age is a more accurate assessment for biologic development than chronological age. The most common method for bone age estimation is using Pyle and Greulich Atlas. Today, computer-based techniques are becoming more favorable among investigators. However, the morphological features in Greulich and Pyle method are difficult to be converted into quantitative measures. During recent years, metacarpal bones and metacarpophalangeal joints dimensions were shown to be highly correlated with skeletal age.
PURPOSE
In this study, we have evaluated the accuracy and reliability of a trained neural network for bone age estimation with quantitative and recently introduced related data, including chronological age, height, trunk height, weight, metacarpal bones, and metacarpophalangeal joints dimensions.
MATERIALS AND METHOD
In this cross sectional retrospective study, aneural network, using MATLAB, was utilized to determine bone age by employing quantitative features for 304 subjects. To evaluate the accuracy of age estimation software, paired t-test, and inter-class correlation was used.
RESULTS
The difference between the mean bone ages determined by the radiologists and the mean bone ages assessed by the age estimation software was not significant ( Value= 0.119 in male subjects and = 0.922 in female subjects). The results from the software and radiologists showed a strong correlation -ICC=0.990 in male subjects and ICC=0.986 in female subjects (< 0.001).
CONCLUSION
The results have shown an acceptable accuracy in bone age estimation with training neural network and using dimensions of bones and joints.
PubMed: 38544775
DOI: 10.30476/dentjods.2023.95629.1882 -
Veterinary Surgery : VS Nov 2023To compare (1) performance of compact versus standard flute drill bits, (2) screw insertion properties and (3) pullout variables between interlocking thread (ITS) and...
Biomechanical comparison of compact versus standard flute drill bits, and interlocking versus buttress thread self-tapping cortical bone screws in cadaveric equine third metacarpal condyle.
OBJECTIVES
To compare (1) performance of compact versus standard flute drill bits, (2) screw insertion properties and (3) pullout variables between interlocking thread (ITS) and buttress thread (BTS) self-tapping screws in third metacarpi.
STUDY DESIGN
In vitro experimental study.
SAMPLE POPULATION
Paired third metacarpi from 11 Thoroughbreds aged 2-4 years.
METHODS
Screws were inserted into the lateral condylar fossae following bone preparation using the respective drill bit for each screw type. Screw pullout was achieved using a mechanical testing system. Density and porosity of bone surrounding screw holes was measured with microcomputed tomography following each pullout test. Drilling, screw insertion and pullout variables were compared between drill bit and screw types using repeated measures ANOVA. Linear regression analyses were used to characterize relationships between bone tissue properties and drill bit and screw outcomes.
RESULTS
Maximum torque power spectral density (PSD) was lower for compact flute drill bits. Insertion torque was 50% higher for ITS. BTS had 33% greater preyield stiffness and 7% greater mean yield force. Bone tissue properties affected measured variables similarly for both screw and drill bit types.
CONCLUSIONS
Lower torque PSD may increase durability of the compact flute drill bit. ITS had greater insertional torque, which may reflect greater bone engagement. BTS had greater resistance to axial pullout forces.
CLINICAL SIGNIFICANCE
Metacarpal bone provides a simple model for comparison of drill bit and screw designs. Use of ITS to repair equine fractures subject to predominantly tensile forces is not justified based on the results of this study.
Topics: Animals; Horses; Metacarpal Bones; X-Ray Microtomography; Biomechanical Phenomena; Bone Screws; Cortical Bone; Torque; Cadaver; Horse Diseases
PubMed: 37302003
DOI: 10.1111/vsu.13965 -
Animals : An Open Access Journal From... Sep 2023Fissure in the third metacarpal/tarsal parasagittal groove and proximal phalanx sagittal groove is a potential prodromal pathology of fracture; therefore, early...
Three-Dimensional Imaging and Histopathological Features of Third Metacarpal/Tarsal Parasagittal Groove and Proximal Phalanx Sagittal Groove Fissures in Thoroughbred Horses.
Fissure in the third metacarpal/tarsal parasagittal groove and proximal phalanx sagittal groove is a potential prodromal pathology of fracture; therefore, early identification and characterisation of fissures using non-invasive imaging could be of clinical value. Thirty-three equine cadaver limbs underwent standing cone-beam (CB) computed tomography (CT), fan-beam (FB) CT, low-field magnetic resonance imaging (MRI), and macro/histo-pathological examination. Imaging diagnoses of fissures were compared to microscopic examination. Imaging features of fissures were described. Histopathological findings were scored and compared between locations with and without fissures on CT. Microscopic examination identified 114/291 locations with fissures. The diagnostic sensitivity and specificity were 88.5% and 61.3% for CBCT, 84.1% and 72.3% for FBCT, and 43.6% and 85.2% for MRI. Four types of imaging features of fissures were characterised on CT: (1) CBCT/FBCT hypoattenuating linear defects, (2) CBCT/FBCT striated hypoattenuated lines, (3) CBCT/FBCT subchondral irregularity, and (4) CBCT striated hypoattenuating lines and FBCT subchondral irregularity. Fissures on MRI appeared as subchondral bone hypo-/hyperintense defects. Microscopic scores of subchondral bone sclerosis, microcracks, and collapse were significantly higher in locations with CT-identified fissures. All imaging modalities were able to identify fissures. Fissures identified on CT were associated with histopathology of fatigue injuries.
PubMed: 37760312
DOI: 10.3390/ani13182912 -
Journal of Visualized Experiments : JoVE Apr 2024Endoscopic carpal tunnel release (ECTR) techniques have been established as a successful treatment for carpal tunnel syndrome and have proven equally effective as...
Endoscopic carpal tunnel release (ECTR) techniques have been established as a successful treatment for carpal tunnel syndrome and have proven equally effective as traditional open carpal tunnel release (OCTR) techniques in relieving pain and numbness. However, patients who undergo OCTR are more likely to experience scar tenderness and pillar pain and take longer to return to work. We present here a method of metacarpal small incision for carpal tunnel release (MSICTR) as a safe, reliable, cost-effective alternative surgical decompression of the median nerve of the wrist. This technique utilizes a metacarpal small incision and direct visualization of the median nerve and carpal tunnel contents, reducing the risk of permanent injury and neurasthenia when compared to traditional OCTR. MSICTR is also suitable for the examination of the median nerve, surrounding tendon sheath, or space-occupying lesions. MSICTR is associated with shorter operation times, less postoperative pain, faster recovery, and improved cosmetic results when compared to traditional OCTR. Therefore, MSICTR is an effective surgical decompression of the median nerve for the treatment of carpal tunnel syndrome.
Topics: Carpal Tunnel Syndrome; Humans; Decompression, Surgical; Median Nerve; Endoscopy; Metacarpal Bones
PubMed: 38647277
DOI: 10.3791/65808 -
The Journal of Hand Surgery Nov 2023The objective of this study was to investigate whether the base of the third metacarpal can predict the location of the thenar branch (TB) of the median nerve and the...
PURPOSE
The objective of this study was to investigate whether the base of the third metacarpal can predict the location of the thenar branch (TB) of the median nerve and the accuracy of palpating the base of the third metacarpal.
METHODS
In 15 patients with ulnar nerve lesions around the elbow, we transferred the opponens motor branch to repair the deep terminal division of the ulnar nerve (DTDUN). Before surgery, we located the TB by palpating the base of the third metacarpal volarly. During surgery, we placed three needles at the following places: one at the entrance of the TB into the abductor pollicis brevis, another at the point where the TB contacted the thenar muscles, and third at the DTDUN's trajectory over the third metacarpal. We obtained fluoroscopic images and measured distances between the needles and structures with image software. We also examined the relationship between the TB, DTDUN, and the volar tubercle of the base of the third metacarpal in cadaver hands. Finally, we invited 22 surgeons to palpate the base of the third metacarpal on volunteer hands and verified their accuracy using fluoroscopy.
RESULTS
During surgery, after dissection and palpation of the TB, under fluoroscopy, we confirmed that the palpable bone prominence was the base of the third metacarpal. In cadaver dissections, we observed the TB crossing the volar tubercle of the base of the third metacarpal superficially from proximal to distal and from ulnar to radial. The DTDUN was, on average, 14 mm distal to the base of the third metacarpal distal limit. In total, 19 of the 22 surgeons correctly identified the base of the third metacarpal and consequently the trajectory of the TB.
CONCLUSIONS
The palpable base of the third metacarpal can be used to determine the trajectory of both the TB and DTDUN.
TYPE OF STUDY/LEVEL OF EVIDENCE
Diagnostic II.
Topics: Humans; Median Nerve; Metacarpal Bones; Hand; Thumb; Cadaver
PubMed: 37480915
DOI: 10.1016/j.jhsa.2023.05.022 -
Eplasty 2023Gunshot wounds of the hand are challenging, as these injuries include bones, tendons neurovascular structures, and soft tissue. The osteocutaneous fibula flap has shown...
BACKGROUND
Gunshot wounds of the hand are challenging, as these injuries include bones, tendons neurovascular structures, and soft tissue. The osteocutaneous fibula flap has shown to be an excellent option for treating the composite defects, including bone and soft tissue. In this study, reconstructions of gunshot injuries of the metacarpal bones with a fibular flap are presented.
METHODS
Six patients with gunshot injuries to the hand were treated with free fibula flap. All patients had composite defects reconstructed with osteocutaneous fibula flap. Because of the size mismatch between fibula and metacarpal bone, a longitudinally split fibula was used in 2 patients. In 1 patient, the flap was used in a double-barrel fashion to reconstruct 2 metacarpal bone losses. Tendon repairs were performed either primarily or with tendon graft. All patients received hand rehabilitation. Hand function of the patients was evaluated by grip and pinch strength tests and Jebsen hand function test.
RESULTS
All flaps survived with no major postoperative complications. The mean follow-up period was 18 months. Web releasing and an arthrodesis procedure was performed in 1 patient, and tenolysis was performed in 2 others. All flaps adapted well to the recipient area. With respect to routine daily activities, overall hand function measured by grip and pinch strength tests and Jebsen hand function test was considered satisfactory in all patients.
CONCLUSIONS
The fibular flap is a good alternative for reconstruction of the injured hand with composite defects, including metacarpal bone and soft tissue. It can be used longitudinally or transversely. Osteotomies can be performed to obtain split fibular flap or double-barrel fibular flap according to the bone defect.
PubMed: 38229968
DOI: No ID Found -
European Journal of Orthopaedic Surgery... Apr 2024The photodynamic bone stabilization system (PBSS) was was developed in 2010, and in 2018 gained FDA approval in the United States. Given its relative novelty, our... (Review)
Review
INTRODUCTION
The photodynamic bone stabilization system (PBSS) was was developed in 2010, and in 2018 gained FDA approval in the United States. Given its relative novelty, our analysis sought to analyze the available literature exploring the indications, outcomes, and complications of the PBSS.
METHODS
We performed a systematic review (PROSPERO registration of study protocol: CRD42022363065, October 8th, 2022). PubMed, EBSCOHost, and Google Scholar electronic databases were queried to identify articles evaluating PBSS in the treatment of pathologic or traumatic fractures between January 1 2010 and 15 October 2022. The quality of the included studies was assessed using the Methodological Index for Nonrandomized Studies tool.
RESULTS
Our initial search yielded 326 publications, which were then screened for appropriate studies that aligned with the purpose of our review. A total of thirteen studies, comprising seven case series, four case reports, and two cohort studies. The total sample size of the included studies consisted of 345 patients, with 242 females (70%) and 103 males (30%). The implants were most commonly utilized in the humerus (41%), radius (12%), and metacarpal (12%). The most common complications were related to broken implants (5%) and dislocation (1%). Most studies reported complete fracture healing and return of full strength and range of motion.
CONCLUSION
Despite being a relatively novel technology, PBSS appears to be a viable option for fracture stabilization. Most studies included in our analysis reported complete fracture healing and return of function with minimal complications.
Topics: Male; Female; Humans; Fractures, Spontaneous; Fractures, Bone; Fracture Healing; Joint Dislocations; Patient Reported Outcome Measures
PubMed: 38376586
DOI: 10.1007/s00590-024-03833-w -
American Journal of Biological... Mar 2024Recent studies have associated subarticular trabecular bone distribution in the extant hominid first metacarpal (Mc1) with observed thumb use, to infer fossil hominin...
OBJECTIVES
Recent studies have associated subarticular trabecular bone distribution in the extant hominid first metacarpal (Mc1) with observed thumb use, to infer fossil hominin thumb use. Here, we analyze the entire Mc1 to test for interspecific differences in: (1) the absolute volume of trabecular volume fraction, (2) the distribution of the deeper trabecular network, and (3) the distribution of trabeculae in the medullary cavity, especially beneath the Mc1 disto-radial flange.
MATERIALS AND METHODS
Trabecular bone was imaged using micro-computed tomography in a sample of Homo sapiens (n = 11), Pan paniscus (n = 10), Pan troglodytes (n = 11), Gorilla gorilla (n = 10) and Pongo sp., (n = 7). Using Canonical Holistic Morphometric Analysis (cHMA), we tested for interspecific differences in the trabecular bone volume fraction (BV/TV) and its relative distribution (rBV/TV) throughout the Mc1, including within the head, medullary cavity, and base.
RESULTS
P. paniscus had the highest, and H. sapiens the lowest, BV/TV relative to other species. rBV/TV distribution statistically distinguished the radial concentrations and lack of medullary trabecular bone in the H. sapiens Mc1 from all other hominids. H. sapiens and, to a lesser extent, G. gorilla also had a significantly higher trabecular volume beneath the disto-radial flange relative to other hominids.
DISCUSSION
These results are consistent with differences in observed thumb use in these species and may also reflect systemic differences in bone volume fraction. The trabecular bone extension into the medullary cavity and concentrations beneath the disto-radial flange may represent crucial biomechanical signals that will aid in the inference of fossil hominin thumb use.
Topics: Humans; Animals; Hominidae; Metacarpal Bones; Thumb; X-Ray Microtomography; Pan troglodytes; Gorilla gorilla; Pongo; Pan paniscus
PubMed: 36790736
DOI: 10.1002/ajpa.24695