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Evolution; International Journal of... Mar 2021Long bones comprise articular ends (epiphyses) joined by transitional metaphyses and a diaphysis (shaft). The structure of the latter is often viewed as regularly... (Comparative Study)
Comparative Study
Long bones comprise articular ends (epiphyses) joined by transitional metaphyses and a diaphysis (shaft). The structure of the latter is often viewed as regularly tubular across tetrapods (limbed vertebrates). However, assessments of the bone structure along the whole diaphysis are rare. Here, I assess whole-diaphysis profiles of global compactness (bone fraction) of 164 species of extant and extinct therian mammals (marsupials + placentals) in a phylogenetically informed context. Generally terrestrial, mammals have acquired multiple times the highly specialized aerial, fully aquatic, and subterranean lifestyles, allowing to potentially associate specific traits with these lifestyles. I show that there is a consistent increase in global compactness along the diaphysis in most mammals. This pattern is modified in a limited number of specialized species: all aerial clades (gliders and bats) have rather uniform and low values, while cetaceans' humeral diaphysis is marked by a slightly more compact mid-diaphyseal region. Among subterranean clades, structure alterations are most obvious in fossorial talpids (true moles) and their highly modified humerus. These results call for the investigation of bone structure in whole skeletal elements of key fossils in order to reconstruct the patterns of evolutionary modifications associated with lifestyle transitions.
Topics: Animals; Diaphyses; Ecosystem; Fossils; Humerus; Mammals; Phylogeny
PubMed: 33433007
DOI: 10.1111/evo.14170 -
International Journal of... 2018Diaphyseal tuberculosis (TB) is a rare case of the skeletal TB. The following report documents the case of a 52-year-old Moroccan woman with a swelling over the right... (Review)
Review
Diaphyseal tuberculosis (TB) is a rare case of the skeletal TB. The following report documents the case of a 52-year-old Moroccan woman with a swelling over the right forearm followed by pulmonary TB under treatment for 3 months. The radiographs of the forearm show a lytic image located at the radius mid-diaphysis. The histopathology confirmed the diagnosis. The patient received surgical drainage with trepanation of the bone. The antibacillary chemotherapy was administered for 6 months. It is, therefore, indispensable to bear in mind the possibility of such atypical presentations of TB when making a rapid and pertinent diagnosis and prescribing the appropriate treatment.
Topics: Antitubercular Agents; Diaphyses; Female; Forearm; Humans; Middle Aged; Radiography; Radius; Tuberculosis; Tuberculosis, Osteoarticular; Tuberculosis, Pulmonary
PubMed: 30198514
DOI: 10.4103/ijmy.ijmy_81_18 -
International Journal of Molecular... Aug 2021The process of fracture healing varies depending upon internal and external factors, such as the fracture site, mode of injury, and mechanical environment. This review... (Comparative Study)
Comparative Study Review
The process of fracture healing varies depending upon internal and external factors, such as the fracture site, mode of injury, and mechanical environment. This review focuses on site-specific fracture healing, particularly diaphyseal and metaphyseal healing in mouse long bones. Diaphyseal fractures heal by forming the periosteal and medullary callus, whereas metaphyseal fractures heal by forming the medullary callus. Bone healing in ovariectomized mice is accompanied by a decrease in the medullary callus formation both in the diaphysis and metaphysis. Administration of estrogen after fracture significantly recovers the decrease in diaphyseal healing but fails to recover the metaphyseal healing. Thus, the two bones show different osteogenic potentials after fracture in ovariectomized mice. This difference may be attributed to the heterogeneity of the skeletal stem cells (SSCs)/osteoblast progenitors of the two bones. The genes that specify the patterning of the mammalian skeleton during embryogenesis are upregulated during the diaphyseal healing. genes positively regulate the differentiation of osteoblasts from SSCs in vitro. During bone grafting, the SSCs in the donor's bone express with adaptability in the heterologous bone. These novel functions of the genes are discussed herein with reference to the site-specificity of fracture healing.
Topics: Animals; Diaphyses; Fracture Healing; Fractures, Bone; Mice; Osteogenesis
PubMed: 34502206
DOI: 10.3390/ijms22179299 -
JBJS Reviews Feb 2017
Review
Topics: Bone Neoplasms; Diagnosis, Differential; Diaphyses; Femur; Humans; Tomography, X-Ray Computed
PubMed: 28248740
DOI: 10.2106/JBJS.RVW.16.00012 -
American Journal of Orthopedics (Belle... Oct 2014In reviewing the literature, we found few cases of Salmonella osteomyelitis of the femoral diaphysis in a healthy patient. Most are typically associated with sickle cell... (Review)
Review
In reviewing the literature, we found few cases of Salmonella osteomyelitis of the femoral diaphysis in a healthy patient. Most are typically associated with sickle cell anemia or immunosuppressed patients. We report on the successful treatment of Salmonella osteomyelitis in the mid-diaphyseal region of the femur caused by Salmonella species in a healthy individual.
Topics: Diaphyses; Femur; Humans; Male; Middle Aged; Osteomyelitis; Radiography; Salmonella; Salmonella Infections
PubMed: 25303451
DOI: No ID Found -
Chinese Journal of Cancer May 2012To investigate the clinical characteristics of chondroblastoma with an emphasis on lesions located in the long bone diaphysis, we reviewed the clinical data of 7... (Review)
Review
To investigate the clinical characteristics of chondroblastoma with an emphasis on lesions located in the long bone diaphysis, we reviewed the clinical data of 7 patients with histologically proven chondroblastoma treated in Tianjin Medical University Cancer Hospital and Fudan University Cancer Hospital between January 1995 and May 2009. There were two rare cases of chondroblastoma in the long bone diaphysis. One patient with a lesion in the tibial diaphysis underwent intralesional curettage and bone grafting, and the postoperative bone function was measured as excellent according to the Enneking scoring system. The patient was still alive upon follow-up at 60 months. The other patient with a lesion in the humeral diaphysis underwent resection, and the postoperative bone function was excellent at 48 months, at which there was no evidence of recurrence or metastasis. Thus, except for the distinctive site of the long bone diaphysis, which made diagnosis difficult, the patients' ages, symptoms, X-ray and CT images, treatment, and prognosis were in accordance with typical lesions in the epiphysis and metaphysis. The diagnosis of chondroblastoma in the long bone diaphysis significantly depends on histopathologic characteristics.
Topics: Adolescent; Adult; Bone Neoplasms; Bone Transplantation; Chondroblastoma; Curettage; Diaphyses; Female; Follow-Up Studies; Humans; Humerus; Magnetic Resonance Imaging; Male; Tibia; Tomography, X-Ray Computed; Young Adult
PubMed: 22464651
DOI: 10.5732/cjc.011.10402 -
Journal of Bone and Mineral Research :... Jan 2014Bisphosphonates (BPs) and denosumab reduce the risk of spine and nonspine fractures. Atypical femur fractures (AFFs) located in the subtrochanteric region and diaphysis... (Review)
Review
Bisphosphonates (BPs) and denosumab reduce the risk of spine and nonspine fractures. Atypical femur fractures (AFFs) located in the subtrochanteric region and diaphysis of the femur have been reported in patients taking BPs and in patients on denosumab, but they also occur in patients with no exposure to these drugs. In this report, we review studies on the epidemiology, pathogenesis, and medical management of AFFs, published since 2010. This newer evidence suggests that AFFs are stress or insufficiency fractures. The original case definition was revised to highlight radiographic features that distinguish AFFs from ordinary osteoporotic femoral diaphyseal fractures and to provide guidance on the importance of their transverse orientation. The requirement that fractures be noncomminuted was relaxed to include minimal comminution. The periosteal stress reaction at the fracture site was changed from a minor to a major feature. The association with specific diseases and drug exposures was removed from the minor features, because it was considered that these associations should be sought rather than be included in the case definition. Studies with radiographic review consistently report significant associations between AFFs and BP use, although the strength of associations and magnitude of effect vary. Although the relative risk of patients with AFFs taking BPs is high, the absolute risk of AFFs in patients on BPs is low, ranging from 3.2 to 50 cases per 100,000 person-years. However, long-term use may be associated with higher risk (∼100 per 100,000 person-years). BPs localize in areas that are developing stress fractures; suppression of targeted intracortical remodeling at the site of an AFF could impair the processes by which stress fractures normally heal. When BPs are stopped, risk of an AFF may decline. Lower limb geometry and Asian ethnicity may contribute to the risk of AFFs. There is inconsistent evidence that teriparatide may advance healing of AFFs.
Topics: Aged; Antibodies, Monoclonal, Humanized; Bone Density Conservation Agents; Denosumab; Diaphyses; Diphosphonates; Female; Femoral Fractures; Fractures, Stress; Humans; Male; Middle Aged; Radiography; Risk Factors
PubMed: 23712442
DOI: 10.1002/jbmr.1998 -
British Medical Bulletin Jun 2015This review aims to provide information on the time taken to resume sport following tibial diaphyseal stress fractures (TDSFs). (Review)
Review
INTRODUCTION
This review aims to provide information on the time taken to resume sport following tibial diaphyseal stress fractures (TDSFs).
SOURCES OF DATA
A systematic search of Medline, EMBASE, CINHAL, Cochrane, Web of Science, PEDro, Sports Discus, Scopus and Google Scholar was performed using the keywords 'tibial', 'tibia', 'stress', 'fractures', 'athletes', 'sports', 'non-operative', 'conservative', 'operative' and 'return to sport'.
AREAS OF AGREEMENT
Twenty-seven studies were included: 16 reported specifically on anterior TDSFs and 5 on posterior TDSFs. The general principles were to primarily attempt non-operative management for all TDSFs and to consider operative intervention for anterior TDSFs that remained symptomatic after 3-6 months. Anterior TDSFs showed a prolonged return to sport.
AREAS OF CONTROVERSY
The best time to return to sport and the optimal management modalities for TDSFs remain undefined.
GROWING POINTS
Management of TDSFs should include a full assessment of training methods, equipment and diet to modify pre-disposing factors.
AREAS TIMELY FOR DEVELOPING RESEARCH
Future prospective studies should aim to establish the optimal treatment modalities for TDSFs.
Topics: Athletic Injuries; Diaphyses; Fractures, Stress; Humans; Recovery of Function; Return to Sport; Tibial Fractures; Time Factors
PubMed: 25712999
DOI: 10.1093/bmb/ldv006 -
Injury Oct 2006PubMed and Ovid Medline were searched to investigate the role of intramedullary nailing in the treatment of diaphyseal humeral non-union. Of 474 abstracts, 9 retrieved... (Review)
Review
PubMed and Ovid Medline were searched to investigate the role of intramedullary nailing in the treatment of diaphyseal humeral non-union. Of 474 abstracts, 9 retrieved articles fulfilled our inclusion criteria and described management in 166 cases of humeral shaft non-union using several types of intramedullary nails. Union ranged from 40 to 100%; part of the variation could be explained by the quality index of the selected articles. Exchange nailing alone was not effective. Exposure of the fracture site and use of bone grafting were key to successful treatment. The total incidence of severe complications, including radial nerve damage, was very low. Thus, intramedullary nailing in the treatment of humeral shaft non-unions can lead to successful outcomes when associated with autologous bone grafting.
Topics: Adolescent; Adult; Aged; Bone Nails; Databases, Bibliographic; Diaphyses; Female; Fracture Fixation, Intramedullary; Fractures, Malunited; Humans; Humeral Fractures; Male; Middle Aged; Range of Motion, Articular; Recovery of Function; Treatment Outcome
PubMed: 16777105
DOI: 10.1016/j.injury.2006.02.050 -
Hand Clinics Feb 2002In summary, treatment of diaphyseal fractures requires accurate assessment of the injury to rule out concomitant ligamentous injury at the wrist or the elbow. Minimally... (Review)
Review
In summary, treatment of diaphyseal fractures requires accurate assessment of the injury to rule out concomitant ligamentous injury at the wrist or the elbow. Minimally displaced ulnar fractures can be managed with bracing. Displaced diaphyseal fractures of the radius and ulna should be plated, usually with 3.5-mm compression plates using AO technique. Complications may still occur but can be minimized if strict attention to technique is followed.
Topics: Device Removal; Diaphyses; Humans; Orthopedic Procedures; Radius; Radius Fractures; Treatment Outcome; Ulna; Ulna Fractures
PubMed: 12143414
DOI: 10.1016/s0749-0712(02)00014-8