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Journal of Bone and Mineral Research :... Sep 2017To monitor the drift of the periosteal and endocortical surfaces during metacarpal growth longitudinally, radiogrammetry was carried out on hand-wrist X-rays of 572... (Clinical Trial)
Clinical Trial
To monitor the drift of the periosteal and endocortical surfaces during metacarpal growth longitudinally, radiogrammetry was carried out on hand-wrist X-rays of 572 children from the Birth to Twenty Bone Health Cohort annually from ages 9 to 21 years. This is the largest collection of longitudinal X-rays in African children. The second metacarpal bone length, bone width, and medullary width were measured using digital vernier calipers on a total of 4730 X-rays. Superimposition by Translation and Rotation (SITAR) was used to obtain age at peak metacarpal length velocity (PLV). Bone width and medullary width were modeled using SITAR against both chronological age and age from PLV. In black and white females, tempo and velocity of metacarpal length growth was synchronized. Black males, however, attained PLV 7 months later than white males (p < 0.0001). Compared to white males, black males had a longer second metacarpal (p < 0.05), and greater bone width size (p < 0.02), tempo (p < 0.0009), and velocity (p < 0.0001). Medullary width growth velocity in black participants peaked 2 years prior to attainment of PLV and exceeded that of their white peers (p < 0.0001) in whom it peaked 6 to 12 months post-PLV attainment. Black adolescents therefore had wider bones with relatively thinner cortices and wider medullary cavities than their white peers. Ethnic and sex differences also occurred in the timing of medullary width contraction that accompanied expansion in bone width and cortical thickness. In black males, medullary width contraction commenced approximately 3 years later than in black females, whereas in white males this occurred a year later than in white females. The ethnic and sex differences in bone acquisition reported in this study may differentially affect bone mass in later life. © 2017 American Society for Bone and Mineral Research.
Topics: Adolescent; Adolescent Development; Adult; Child; Female; Follow-Up Studies; Humans; Longitudinal Studies; Male; Metacarpal Bones; Sex Characteristics; South Africa
PubMed: 28548290
DOI: 10.1002/jbmr.3179 -
Joint Diseases and Related Surgery Apr 2023A floating metacarpal is defined as the simultaneous dislocation of the metacarpophalangeal (MCP) and carpometacarpal (CMC) joints. Metacarpal dislocations are rare, and...
A floating metacarpal is defined as the simultaneous dislocation of the metacarpophalangeal (MCP) and carpometacarpal (CMC) joints. Metacarpal dislocations are rare, and floating metacarpals with double dislocations are extremely rare. In this article, we present a very rare case of floating metacarpal in which the first MCP and CMC dislocations were found simultaneously and successfully treated with closed reduction, open reduction, and Kirschner wire fixation methods.
Topics: Humans; Metacarpal Bones; Joint Dislocations; Thumb; Carpometacarpal Joints; Open Fracture Reduction
PubMed: 37462655
DOI: 10.52312/jdrs.2023.922 -
Anatomical Record (Hoboken, N.J. : 2007) Apr 2021The elongated, distally tapered limbs of horses are adapted for high-speed locomotion. Because these traits are artificially selected for in modern racehorses, they...
The elongated, distally tapered limbs of horses are adapted for high-speed locomotion. Because these traits are artificially selected for in modern racehorses, they operate at a morphological extreme with a high risk of fracture. Racehorses are subject to different training and racing regimes depending on their breed and gait, and are therefore an interesting model to examine bone functional adaptation under variable biomechanically intense conditions. This study compares bone structural properties in the third metacarpal (MCIII) of Thoroughbred (n = 9) and Quarter Horse (n = 11) racehorses, using feral Assateague Island ponies (n = 6) as an untrained/unraced outgroup, to determine whether structural properties reflect variable racing and training regimes. Geometric section properties and bone mineral densities were determined using peripheral quantitative CT at two diaphyseal sites and through the distal epiphysis. Diaphyseal strength of the MCIII in all three breeds does not differ relative to body size, but in the mid-diaphyseal region Thoroughbreds have higher antero-posterior relative to medio-lateral bending strength than Quarter Horses, as well as higher bone mineral densities in left MCIII epiphyses (particularly in the lateral condyle). Interestingly, all breeds have lower bone mineral densities in the lateral versus medial condyle, an inherent structural feature that may influence predisposition to fracture when running around turns. Our results suggest that despite subtle differences in bone structure between different racehorse breeds, basic morphology of the third metacarpus is relatively similar among racing and non-racing horses, possibly reflecting intense selection (natural and artificial) across domestic equids for similar structural features within distal limb elements.
Topics: Adaptation, Physiological; Animals; Bone Density; Horses; Locomotion; Metacarpal Bones; Physical Conditioning, Animal
PubMed: 32805766
DOI: 10.1002/ar.24485 -
In Vivo (Athens, Greece) 2019Although some patients with enchondroma have multiple lesions, no study has investigated the distribution of lesions in patients with multiple enchondromas.
BACKGROUND/AIM
Although some patients with enchondroma have multiple lesions, no study has investigated the distribution of lesions in patients with multiple enchondromas.
PATIENTS AND METHODS
This retrospective study included 118 patients with enchondroma of the hand. The incidence and characteristic feature of multiple enchondromas of the hand were investigated.
RESULTS
Four patients (3.4%) had multiple enchondromas. In all the patients with multiple enchondromas, the lesions occurred in the middle phalanx, proximal phalanx, and metacarpal bone in the same digital ray.
CONCLUSION
The development of the hand rapidly progresses from intrauterine day 33 to day 54. The digital rays are evident on intrauterine day 41, and separation of the distal phalanx, middle phalanx, proximal phalanx, and metacarpal bone is completed until intrauterine day 54. The successive occurrence of multiple enchondroma lesions in the same digital ray in all four cases suggests that the occurrence of lesions preceded the separation of the hand bones and the lesions were divided during the development of these bones.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Chondromatosis; Female; Hand; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Radiographic Image Enhancement; Retrospective Studies; Tumor Burden; Young Adult
PubMed: 31662562
DOI: 10.21873/invivo.11728 -
Journal of Musculoskeletal & Neuronal... Dec 2000The response of equine bone to training has not been quantified in racetrack trained horses, only in treadmill exercised horses. Seven two-year-old thoroughbred fillies...
The response of equine bone to training has not been quantified in racetrack trained horses, only in treadmill exercised horses. Seven two-year-old thoroughbred fillies were trained on sand and grass at a racetrack, in a typical New Zealand flatrace training regime. The horses were exercised 6 days per week for up to 13 weeks. During the day the horses were confined in 4 x 4m sand yards, and were stalled at night. Another 7 fillies of the same age were allowed free exercise in grass yards. The bones of the animals were available after the 13 week experimental period, and were examined using a Siemens Somatom AR CT scanner. To quantify the response of epiphyseal bone, 3mm thick sagittal plane images of the carpus (through the middle of the medial condyle of distal radius) and the distal third metacarpal bone (Mc3) (immediately lateral and medial to the junction of the condyle and the median sagittal ridge) were studied. Appropriate areas of interest were chosen, and the mean tissue density equivalent (Houndsfield Units) was determined. In the carpus, there was a significant effect of exercise in the dorso-distal aspect of the radius (p<0.01), dorsal aspect of radial and third carpal bones (p<0.01 and p<0.001 respectively). In palmaro-distal subchondral bone of Mc3, there was a significant effect on the medial/lateral site (p<0.01), which differed between right and left legs, probably due to the effect of the horses having been trained in one direction around the training track. The mean tissue density of the Mc3 epiphysis of the exercised group was 36.8% greater than that of the non-exercised group (p<0.001). The study demonstrates that bone response is both rapid and substantial, which should prompt the use of non-invasive diagnostic aids to determine the stage of training in which tissue density changes occur.
PubMed: 15758509
DOI: No ID Found -
Folia Morphologica 2021Five-fingered hand (5-FH) with completely developed phalanges is a rare phenotype observed so far only in humans and characterised by three phalanges of the 1st ray. A...
BACKGROUND
Five-fingered hand (5-FH) with completely developed phalanges is a rare phenotype observed so far only in humans and characterised by three phalanges of the 1st ray. A long-lasting, debated question is if the missing element of the normal hand 1st ray is the metacarpal or the phalanx. In this study, comparative X-rays morphometry of long bones in normal and 5-FH is carried out with the aim to face this question through homology analysis of long bone segments in the transverse and longitudinal line of normal hand and 5-FH.
MATERIALS AND METHODS
In the normal hand X-rays (n =20) and in a 5-FH X-rays series (n = 9) the relative length of each segment on the ray total length and the index of growth rate (IGR) were assessed. The calculation of the first parameter in normal hand bi-phalangeal thumb was carried out on the 3rd ray total length in the same hand.
RESULTS
The parameters of relative length and the proximal/distal growth rate asymmetry in the post-natal period (assessed through the IGR) confirmed in 5-FH the homology of all the five segment on the transverse line. In the normal control hand, the relative length assessment methodology was biased by the missing segment of the thumb, therefore, the reference to the 3rd ray total length in the same hand (instead of the 1st), allowed the homology analysis of the thumb metacarpal and 1st phalanx with the lateral segments (2nd-5th ray) of the same hand. The 5-FH analysis was used to choose the more appropriate reference ray for the normal hand group.
CONCLUSIONS
The comparative analysis of relative lengths and IGRs in the two groups suggested homology of the (anatomical) 1st metacarpal with the 2nd-5th proximal phalanges in the same hand and that of the (anatomical) 1st proximal phalanx with the 2nd-5th mid phalanges. These data suggest that the missing segment of the normal hand thumb is the metacarpal.
Topics: Fingers; Hand; Humans; Metacarpal Bones; Thumb; X-Rays
PubMed: 32644183
DOI: 10.5603/FM.a2020.0074 -
Journal of Bone and Mineral Research :... Apr 2017The objective of this cross-sectional study was to define normal sex- and age-dependent values of intra-articular bone mass and microstructures in the metacarpal heads...
The objective of this cross-sectional study was to define normal sex- and age-dependent values of intra-articular bone mass and microstructures in the metacarpal heads of healthy individuals by high-resolution peripheral quantitative computed tomography (HR-pQCT) and test the effect of rheumatoid arthritis (RA) on these parameters. Human cadaveric metacarpal heads were used to exactly define intra-articular bone. Healthy individuals of different sex and age categories and RA patients with similar age and sex distribution received HR-pQCT scans of the second metacarpal head and the radius. Total, cortical, and trabecular bone densities as well as microstructural parameters were compared between 1) the different ages and sexes in healthy individuals; 2) between metacarpal heads and the radius; and 3) between healthy individuals and RA patients. The cadaveric study allowed exact definition of the intra-articular (intracapsular) bone margins. These data were applied in measuring intra-articular and radial bone parameters in 214 women and men (108 healthy individuals, 106 RA patients). Correlations between intra-articular and radial bone parameters were good (r = 0.51 to 0.62, p < 0.001). In contrast to radial bone, intra-articular bone remained stable until age 60 years (between 297 and 312 mg HA/cm ) but decreased significantly (p < 0.001) in women thereafter (237.5 ± 44.3) with loss of both cortical and trabecular bone. Similarly, RA patients showed significant (p < 0.001) loss of intra-articular total (263.0 ± 44.8), trabecular (171.2 ± 35.6), and cortical bone (610.2 ± 62.0) compared with sex- and age-adjusted controls. Standard sex- and age-dependent values for physiological intra-articular bone were defined. Postmenopausal state and RA led to significant decrease of intra-articular bone. © 2016 American Society for Bone and Mineral Research.
Topics: Adult; Age Factors; Aged; Aging; Arthritis, Rheumatoid; Bone Density; Female; Humans; Male; Metacarpal Bones; Middle Aged; Radius; Sex Characteristics; Sex Factors; Tomography, X-Ray Computed
PubMed: 27787923
DOI: 10.1002/jbmr.3025 -
BMC Veterinary Research Aug 2022Treatment options for metacarpal/metatarsal fractures include conservative and surgical management. The aim of this study is to determine whether there is any...
BACKFROUND
Treatment options for metacarpal/metatarsal fractures include conservative and surgical management. The aim of this study is to determine whether there is any significant difference in healing and complication rates, between open and closed treatment. Medical records of dogs and cats with metacarpal/metatarsal fractures with complete follow-up were retrospectively reviewed. Patients were allocated in two groups: open or closed stabilization. Minor and major complications were recorded and compared. Fracture healing was classified as good, delayed and non-union, and it was statistically compared.
RESULTS
Sixty-three patients (35 dogs and 28 cats) were included. Thirty-one were treated with an open approach and 32 by a closed stabilization. Regarding fracture healing a significantly higher proportion of delayed healing/non-union was found in the closed group (12/32 vs 2/31). Regarding postoperative complications, a significantly higher number of animals in the open group did not develop any complications (12/31 vs 3/32). A significantly higher proportion of minor complications were reported in the closed group (27/32 vs 12/31). However, a higher number of major complications was reported in the open group (7/31 vs 2/32) although this was not statistically significant. Fracture malalignment was significantly more prevalent in patients undergoing closed stabilization (11/32 vs 2/31).
CONCLUSION
According to the results, better healing, fracture alignment and a lower complication rate are found when fractures are stabilised with an open technique. However, other factors such as configuration of the fracture, soft tissue involvement, patient´s character and client´s situation would also need to be taken into account in the decision of stabilization technique.
Topics: Animals; Ankle Injuries; Cat Diseases; Cats; Dog Diseases; Dogs; Fracture Fixation, Internal; Fracture Healing; Fractures, Bone; Metacarpal Bones; Metatarsal Bones; Retrospective Studies; Treatment Outcome
PubMed: 35927668
DOI: 10.1186/s12917-022-03404-3 -
Hand (New York, N.Y.) Jan 2022The frequency, pattern, and treatment of pediatric hand fractures are rarely reported. We sought to review our institution's experience in the management of pediatric... (Review)
Review
The frequency, pattern, and treatment of pediatric hand fractures are rarely reported. We sought to review our institution's experience in the management of pediatric hand fractures. : A retrospective review of children and adolescents (younger than 18 years) treated for hand fractures between January 1990 and June 2017 was preformed. Fractures were categorized into metacarpal, proximal/middle phalanx, distal phalanx, or intra-articular metacarpophalangeal (MCP)/proximal interphalangeal (PIP)/distal interphalangeal (DIP) fractures. Patients were categorized into 3 age groups (0-5, 6-11, and 12-17 years). A total of 4356 patients were treated for hand fractures at a mean ± SD age of 12.2 ± 3.5 years. Most fractures occurred in patients aged 12 to 17 years (n = 2775, 64%), followed by patients aged 6 to 11 years (n = 1347, 31%). Only 234 (5%) fractures occurred in children younger than 5 years. Most fractures occurred in the proximal/middle phalanx (48%), followed by metacarpal (33%), distal phalangeal (12%), and intra-articular MCP/PIP/DIP joints (7%). Proximal/middle phalangeal fractures were the most common in all age groups. About 58% of intra-articular MCP/PIP/DIP fractures in patients aged between 0 and 5 years required open reduction ± fixation, and the remaining 42% fractures were amenable to closed reduction. In patients older than 5 years, about 70% of these fractures were amenable to closed reduction. All age groups included, most metacarpal (93%), proximal/middle phalangeal (92%), and distal phalangeal (86%) fractures were amenable to closed reduction alone. The frequency, pattern, and treatment of hand fractures vary among different age groups. Understanding the pattern of these fractures helps making the right diagnosis and guides choosing the appropriate treatment.
Topics: Adolescent; Child; Child, Preschool; Finger Phalanges; Fractures, Bone; Hand Injuries; Humans; Infant; Infant, Newborn; Metacarpal Bones; Range of Motion, Articular
PubMed: 32036680
DOI: 10.1177/1558944719900565 -
The Journal of Hand Surgery Feb 2013In thumb carpometacarpal osteoarthritis, current evidence suggests that degenerative, bony remodeling primarily occurs within the trapezium. Nevertheless, the...
PURPOSE
In thumb carpometacarpal osteoarthritis, current evidence suggests that degenerative, bony remodeling primarily occurs within the trapezium. Nevertheless, the pathomechanics involved and the most common sites of wear remain controversial. Quantifying structural bone morphology characteristics with high-resolution computed tomography CT (micro-CT) infer regions of load transmission. Using micro-CT, we investigated whether predominant trabecular patterns exist in arthritic versus normal trapeziums.
METHODS
We performed micro-CT analysis on 13 normal cadaveric trapeziums and 16 Eaton stage III to IV trapeziums. We computationally divided each specimen into 4 quadrants: volar-ulnar, volar-radial, dorsal-radial, and dorsal-ulnar. Measurements of trabecular bone morphologic parameters included bone volume ratio, connectivity, trabecular number, and trabecular thickness. Using analysis of variance with post hoc Bonferroni/Dunn correction, we compared osteoarthritic and normal specimen quadrant measurements.
RESULTS
No significant difference existed in bone volume fraction between the osteoarthritic and normal specimens. Osteoarthritic trapeziums, however, demonstrated significantly higher trabecular number and connectivity than nonosteoarthritic trapeziums. Comparing the volar-ulnar quadrant of osteoarthritis and normal specimens collectively, this quadrant in both consistently possessed significantly higher bone volume fraction, trabecular number, and connectivity than the dorsal-radial and volar-radial quadrants.
CONCLUSIONS
The significantly greater trabecular bone volume, thickness, and connectivity in the volar-ulnar quadrant compared with the dorsal-radial and dorsal-ulnar quadrants provides evidence that the greatest compressive loads at the first carpometacarpal joint occur at the volar-ulnar quadrant of the trapezium, representing a consistently affected region of wear in both normal and arthritic states.
CLINICAL RELEVANCE
These findings suggest that trapezial trabecular morphology undergoes pathologic alteration. This provides indirect evidence that changes in load transmission occur with thumb carpometacarpal joint arthritis development.
Topics: Adult; Aged; Aged, 80 and over; Bone Density; Female; Humans; Image Interpretation, Computer-Assisted; Imaging, Three-Dimensional; Male; Metacarpal Bones; Middle Aged; Osteoarthritis; Reference Values; Trapezium Bone; Wrist Joint; X-Ray Microtomography
PubMed: 23267754
DOI: 10.1016/j.jhsa.2012.10.038