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Open Veterinary Journal 2022It is vital to understand the gross anatomy and dimensions of the metacarpal and metatarsal bones in camels in order for veterinarians to identify fraud cases between...
BACKGROUND
It is vital to understand the gross anatomy and dimensions of the metacarpal and metatarsal bones in camels in order for veterinarians to identify fraud cases between males and females by carefully distinguishing between them.
AIM
It is to make comparisons of the morphological characteristics and measurements of the metacarpus and metatarsus bones of male and female camels.
METHODS
Forty metacarpus and metatarsus of adult camels of both sexes were collected from a typical Burydah slaughterhouse in KSA. The bones were treated according to the established methods of boiling, drying, and bleaching to study morphology. The measurement of the bones in this study has been taken by using digital vernier calipers.
RESULTS
The metacarpus and metatarsus consisted of two large and two small bones. The large metacarpal and metatarsal bones consisted of fused III and IV. Except for the distal side in which the two bones diverge more from each other. The metacarpal bone is similar to the metatarsus, except that it is smaller in measurement majority. The small Mc-Mt II and Mc-Mt V were smaller and present on the palmo-lateral or planto-lateral aspect of the large bones, respectively. The length of the metacarpus and metatarsus is almost equal nearly in camels unlike the rest of the animals as well as the metacarpus bone was unlike the metatarsus in form and measurements generally.
CONCLUSION
The large metacarpus and metatarsus bones are distinguished by the fusion of the third and fourth bones along the length of the bone. Except for the distal side in which the two bones diverge more from each other like the rest of the animals. The morphologically characterized majority of the metacarpal bone was similar to the metatarsus, except that it was proximal extremity, cross-section, and measurement.
Topics: Male; Female; Animals; Metatarsal Bones; Metacarpal Bones; Camelus; Metatarsus; Metacarpus
PubMed: 36589408
DOI: 10.5455/OVJ.2022.v12.i5.9 -
Journal of Orthopaedic Surgery and... Nov 2018The Lisfranc joint has complex structures, and articular surfaces overlap on conventional X-ray radiographs. Hence, there is no available auxiliary examination for...
BACKGROUND
The Lisfranc joint has complex structures, and articular surfaces overlap on conventional X-ray radiographs. Hence, there is no available auxiliary examination for diagnosing related injuries. At present, few studies on the imaging of Lisfranc ligaments have been reported, and related imaging data are rare. Therefore, no imaging reference can be used for related diagnosis and repair operations. This study aims to observe and describe the morphology and structure of Lisfranc ligaments using magnetic resonance imaging (MRI), in order to provide imaging reference for the diagnosis and repair of Lisfranc joint injuries.
METHODS
MRI scanning was performed on 60 sides of normal feet of 30 healthy adult volunteers. In the MRI scanning on the Lisfranc joint, sagittal scanning was focused on the area between the lateral margin and medial margin of the Lisfranc joint, while oblique coronal scanning was focused on the area parallel to the Lisfranc joint clearance. After acquisition of MRI images, data were burned into a CD, and the morphology and structure of the Lisfranc ligament on the MRI image were observed and described. Hence, the imaging parameters of the Lisfranc ligament were acquired, providing an imaging reference for the diagnosis and repair of Lisfranc joint injuries.
RESULTS
By observing the obtained images of the Lisfranc ligament through appropriate MRI scanning, it was found that the Lisfranc ligament originates at the site 12.63 ± 1.20 mm from the lateral side of the base of the medial cuneiform bone, with a length of 8.02 ± 1.5 mm, a width of 2.53 ± 0.61 mm, a height of 6.96 ± 1.01 mm, forms an included angle of 46.79 ± 3.47° with the long axis of the first metatarsal bone, and finally ends at the base of the second phalanx. Detailed imaging parameters of the Lisfranc joint and ligament were obtained from the present imaging experiment, providing an imaging reference for the diagnosis and repair of Lisfranc joint injuries.
CONCLUSIONS
On the MRI images, the sagittal section can clearly display the corresponding situation of the Lisfranc joint bone and longitudinal arch of the foot, tolerably display the Lisfranc joint dorsal ligaments and metatarsal ligaments, and poorly display the Lisfranc ligament. The oblique coronal section can clearly display the transverse arch of the foot and clearly display the cross-section of the Lisfranc ligament. The oblique crosssection can clearly display the horizontal arch of the Lisfranc joint and more clearly display its surrounding ligaments and tendons, especially the entire Lisfranc ligament and its attachment points. This is an important section for the diagnosis of Lisfranc ligament injuries. This study provides a certain imaging reference for the MRI scanning, diagnosis, and repair of Lisfranc joint injuries. Further research with large sample size is still needed to confirm the conclusions.
Topics: Adult; Female; Foot; Humans; Ligaments, Articular; Magnetic Resonance Imaging; Male; Metatarsal Bones; Young Adult
PubMed: 30419938
DOI: 10.1186/s13018-018-0968-x -
Medicina (Kaunas, Lithuania) Jun 2023Contrary to Lisfranc joint fracture-dislocation, ligamentous Lisfranc injury can lead to additional instability and arthritis and is difficult to diagnose. Appropriate... (Review)
Review
Contrary to Lisfranc joint fracture-dislocation, ligamentous Lisfranc injury can lead to additional instability and arthritis and is difficult to diagnose. Appropriate procedure selection is necessary for a better prognosis. Several surgical methods have recently been introduced. Here, we present three distinct surgical techniques for treating ligamentous Lisfranc employing flexible fixation. First is the "Single Tightrope procedure", which involves reduction and fixation between the second metatarsal base and the medial cuneiform via making a bone tunnel and inserting Tightrope. Second is the "Dual Tightrope Technique", which is similar to the "Single Tightrope technique", with additional fixation of an intercuneiform joint using one MiniLok Quick Anchor Plus. Last but not least, the "internal brace approach" uses the SwiveLock anchor, particularly when intercueniform instability is seen. Each approach has its own advantages and disadvantages in terms of surgical complexity and stability. These flexible fixation methods, on the other hand, are more physiologic and have the potential to lessen the difficulties that have been linked to the use of conventional screws in the past.
Topics: Humans; Ligaments, Articular; Fractures, Bone; Fracture Fixation, Internal; Metatarsal Bones; Sutures
PubMed: 37374337
DOI: 10.3390/medicina59061134 -
Foot & Ankle International Jan 2023The plantar plate is a major stabilizing structure of the metatarsophalangeal (MTP) joint with instability frequently occurring after a tear or attenuation of this...
BACKGROUND
The plantar plate is a major stabilizing structure of the metatarsophalangeal (MTP) joint with instability frequently occurring after a tear or attenuation of this structure. Commonly, a McGlamry elevator is used to strip the plantar plate from the plantar surface of the metatarsal to improve exposure of the MTP joint. The anatomy of the proximal plantar plate and vascular consequence of stripping the plantar plate from the metatarsal is not yet well understood. The purpose of this study is to describe the proximal attachment of the plantar plate anatomically and quantify the relative contribution of blood supply to the proximal plantar plate from both the metatarsal and the plantar fascia.
METHODS
For anatomic evaluation, 6 lower extremity cadaver specimens without any gross evidence of foot and ankle deformity were utilized. For imaging analysis, 16 fresh frozen human adult cadaveric lower extremity specimens were used for this study, resulting in 35 MTP joints without deformity and 11 lesser MTP joints with cockup and/or crossover deformities. The specimens were prepared as described previously by Finney et al..
RESULTS
From gross anatomic dissection, the plantar plate origin consists of a stout fibrous pedicle distinct from the surrounding synovial-type tissue that firmly anchors the plantar plate to the metatarsal. Based on nano-computed tomographic imaging, an average of 63.5% of the vascular supply to the proximal portion of the plantar plate entered from the metatarsal pedicle. The remaining 36.5% of the vascular supply entered from the plantar fascia.
CONCLUSION
The proximal attachment of the plantar plate includes a stout fibrous pedicle anchoring the proximal portion of the plantar plate to the notch between the medial and lateral plantar condyles of the metatarsal head. The vascular supply of the proximal plantar plate is supplied from both the metatarsal pedicle and plantar fascia.
LEVEL OF EVIDENCE
Level III, retrospective comparative study.
Topics: Adult; Humans; Plantar Plate; Retrospective Studies; Metatarsophalangeal Joint; Metatarsal Bones; Toes
PubMed: 36539967
DOI: 10.1177/10711007221140043 -
American Family Physician Sep 2007Patients with metatarsal fractures often present to primary care settings. Initial evaluation should focus on identifying any conditions that require emergent referral,... (Review)
Review
Patients with metatarsal fractures often present to primary care settings. Initial evaluation should focus on identifying any conditions that require emergent referral, such as neurovascular compromise and open fractures. The fracture should then be characterized and treatment initiated. Referral is generally indicated for intra-articular or displaced metatarsal fractures, as well as most fractures that involve the first metatarsal or multiple metatarsals. If the midfoot is injured, care should be taken to evaluate the Lisfranc ligament. Injuries to this ligament require referral or specific treatment based on severity. Nondisplaced fractures of the metatarsal shaft usually require only a soft dressing followed by a firm, supportive shoe and progressive weight bearing. Stress fractures of the first to fourth metatarsal shafts typically heal well with rest alone and usually do not require immobilization. Avulsion fractures of the proximal fifth metatarsal tuberosity can usually be managed with a soft dressing. Proximal fifth metatarsal fractures that are distal to the tuberosity have a poorer prognosis. Radiographs should be carefully examined to distinguish these fractures from tuberosity fractures. Treatment of fractures distal to the tuberosity should be individualized based on the characteristics of the fracture and patient preference. Nondisplaced fractures of the proximal portion of metatarsals 1 through 4 can be managed acutely with a posterior splint followed by a molded, non-weight-bearing, short leg cast. If radiography reveals a normal position seven to 10 days after injury, progressive weight bearing may be started, and the cast may be removed three to four weeks later.
Topics: Foot Injuries; Fractures, Bone; Humans; Metatarsal Bones; Orthopedic Fixation Devices; Prognosis; Radiography; Trauma Severity Indices
PubMed: 17910296
DOI: No ID Found -
BMC Musculoskeletal Disorders Aug 2021Intramedullary screw fixation is considered the standard treatment for proximal fifth metatarsal stress fractures. Low-intensity pulsed ultrasound (LIPUS) is a...
Can low-intensity pulsed ultrasound (LIPUS) accelerate bone healing after intramedullary screw fixation for proximal fifth metatarsal stress fractures? A retrospective study.
BACKGROUND
Intramedullary screw fixation is considered the standard treatment for proximal fifth metatarsal stress fractures. Low-intensity pulsed ultrasound (LIPUS) is a well-known bone-healing enhancement device. However, to the best of our knowledge, no clinical study has focused on the effect of LIPUS for postoperative bone union in proximal fifth metatarsal stress fractures. This study aimed to investigate the effect of LIPUS treatment after intramedullary screw fixation for proximal fifth metatarsal stress fractures.
METHODS
Between January 2015 and March 2020, patients who underwent intramedullary screw fixation for proximal fifth metatarsal stress fractures were investigated retrospectively. All patients underwent intramedullary screw fixation using a headless compression screw with autologous bone grafts from the base of the fifth metatarsal. The time to restart running and return to sports, as well as that for radiographic bone union, were compared between groups with or without LIPUS treatment. LIPUS treatment was initiated within 3 weeks of surgery in all cases.
RESULTS
Of the 101 ft analyzed, 57 ft were assigned to the LIPUS treatment group, and 44 ft were assigned to the non-LIPUS treatment group. The mean time to restart running and return to sports was 6.8 and 13.7 weeks in the LIPUS treatment group and was 6.2 and 13.2 weeks in the non-LIPUS treatment group, respectively. There were no significant differences in these parameters between groups. In addition, the mean time to radiographic bone union was not significantly different between the LIPUS treatment group (11.9 weeks) and the non-LIPUS treatment group (12.0 weeks). The rate of postoperative nonunion in the LIPUS treatment group was 0% (0/57), while that in the non-LIPUS treatment group was 4.5% (2/44). However, this difference was not statistically significant.
CONCLUSIONS
There were no statistically significant differences regarding the time to start running, return to sports, and radiographic bone union in patients with or without LIPUS treatment after intramedullary screw fixation for proximal fifth metatarsal stress fractures. Therefore, we cannot recommend the routine use of LIPUS to shorten the time to bone union after intramedullary screw fixation for proximal fifth metatarsal stress fractures.
Topics: Bone Screws; Fracture Fixation, Internal; Fractures, Stress; Humans; Metatarsal Bones; Retrospective Studies; Ultrasonic Waves
PubMed: 34425817
DOI: 10.1186/s12891-021-04611-z -
Journal of Orthopaedic Surgery and... Feb 2021This study was performed to investigate the change in the bony alignment of the foot after tendo-Achilles lengthening (TAL) and the factors that affect these changes in...
BACKGROUND
This study was performed to investigate the change in the bony alignment of the foot after tendo-Achilles lengthening (TAL) and the factors that affect these changes in patients with planovalgus foot deformity.
METHODS
Consecutive 97 patients (150 feet; mean age 10 years; range 5.1-35.7) with Achilles tendon contracture (ATC) and planovalgus foot deformity who underwent TAL were included. All patients underwent preoperative and postoperative weight-bearing anteroposterior (AP) or lateral (LAT) foot radiographics. Changes in AP talo-1st metatarsal angle, AP talo-2nd metatarsal angle, LAT talo-1st metatarsal angle, and calcaneal pitch angle and the factors affecting such changes after TAL were analyzed using lineal mixed model.
RESULTS
There were no significant change in AP talo-1st metatarsal angle and AP talo-2nd metatarsal angle after TAL in patients with cerebral palsy (CP) (p = 0.236 and 0.212). However, LAT talo-1st metatarsal angle and calcaneal pitch angle were significantly improved after TAL (13.0°, p < 0.001 and 4.5°, p < 0.001). Age was significantly associated with the change in LAT talo-1st metatarsal angle after TAL (p = 0.028). The changes in AP talo-1st metatarsal angle, AP talo-2nd metatarsal angle, and calcaneal pitch angle after TAL were not significantly associated with the diagnosis (p = 0.879, 0.903, and 0.056). However, patients with CP showed more improvement in LAT talo-1st metatarsal angle (- 5.0°, p = 0.034) than those with idiopathic cause.
CONCLUSION
This study showed that TAL can improve the bony alignment of the foot in patients with planovalgus and ATC. We recommend that physicians should consider this study's findings when planning operative treatment for such patients.
Topics: Achilles Tendon; Adolescent; Adult; Age Factors; Calcaneus; Child; Child, Preschool; Female; Flatfoot; Humans; Male; Metatarsal Bones; Tenotomy; Young Adult
PubMed: 33557891
DOI: 10.1186/s13018-021-02272-1 -
Sports Health 2022Stress fractures are caused by micro-trauma due to repetitive stress on bone, common in active individuals and athletes. Previous studies demonstrate that the...
BACKGROUND
Stress fractures are caused by micro-trauma due to repetitive stress on bone, common in active individuals and athletes. Previous studies demonstrate that the weightbearing bones of the lower extremities incur stress fractures most often, especially in women and older adults.
HYPOTHESIS
Prior literature does not quantify the difference in frequency of stress fractures among different genders, age groups, or body mass indices (BMIs). We hypothesized that older female patients would have higher rates of lower extremity stress fractures than male patients.
STUDY DESIGN
Epidemiological research.
LEVEL OF EVIDENCE
Level 3.
METHODS
Records of female and male patients with lower extremity stress fractures from 2010 to 2018 were identified from the PearlDiver administrative claims database using the International Classification of Diseases (ICD)-9/ICD-10 codes. Stress fractures were classified by ICD-10 diagnosis codes to the tibial bone, proximal femur, phalanges, and other foot bones. Comorbidities were incorporated into a regression analysis.
RESULTS
Of 41,257 stress fractures identified, 30,555 (70.1%) were in women and 10,702 (25.9%) were in men. Our sample was older (>60 years old) (37.3%) and not obese (BMI <30 kg/m, 37.1%). A greater proportion of female patients with stress fracture were older ( < 0.001) and had foot stress fractures ( < 0.001), while a greater proportion of male patients with stress fracture were younger than 19 years ( < 0.001) and had metatarsal ( < 0.001), hip ( = 0.002), and tibia stress fractures ( < 0.001).
CONCLUSION
Stress fractures commonly occur in women and older adults with low BMIs. Metatarsal and tibia stress fractures were the most common, and a greater proportion of women had foot stress fractures.
CLINICAL RELEVANCE
Our study examined the large-scale prevalence of different lower extremity stress fractures among a wide patient population sample of varying ages and BMIs. These findings can help clinicians identify active populations at greater risk for stress fracture injuries.
Topics: Female; Humans; Male; Aged; Middle Aged; Fractures, Stress; Risk Factors; Metatarsal Bones; Femur; Tibia
PubMed: 35243941
DOI: 10.1177/19417381221080440 -
Journal of Foot and Ankle Research 2018The relationship between metatarsal length and various forefoot pathologies is a topic of contention in Orthopaedics. The results of such investigations have been shown...
BACKGROUND
The relationship between metatarsal length and various forefoot pathologies is a topic of contention in Orthopaedics. The results of such investigations have been shown to depend on the method of metatarsal length measurement used. The aim of this study was to assess the inter- and intra-rater reliability of the Maestro and Barroco metatarsal length measurement techniques.
METHODS
A retrospective and quantitative study was performed on 15 randomly selected radiographs to determine the reliability of the two measurement techniques across all five metatarsals (M1 to M5). This was done at one week apart for three weeks by three raters. The intraclass correlation coefficient (ICC), and the 95% lower confidence limit (95% LCL) were calculated.
RESULTS
The Maestro and Barroco techniques produced high to very high ICC vlaues for length measurements across all metatarsals. The 95% lower confidence limit for inter-rater measurements ranged between 0.92-0.98 for Maestro's and 0.86-0.99 for Barroco's technique. For intra-rater measurements the 95% LCL ranged between 0.83-0.99 for Maestro's and 0.75-0.99 for Barroco's technique.
CONCLUSIONS
Our study found that both the Maestro and Barroco methods of measurements produced high to very high inter- and intra-rater reliability. Both methods may be suitable for the use of peri-operative planning and clinical research relating metatarsal length and forefoot pathology. Besides having a more simplistic method of application, the novel Barroco technique is comparable to the more established Maestro method in both repeatability and reproducibility.
Topics: Adult; Aged; Female; Humans; Male; Metatarsal Bones; Middle Aged; Observer Variation; Organ Size; Retrospective Studies; Young Adult
PubMed: 30127858
DOI: 10.1186/s13047-018-0289-7 -
Medical Engineering & Physics Sep 2021A thorough understanding of the influence of the foot skeletal structure on hallux valgus (HV) is required for HV prevention. We developed a system using a 3D foot...
BACKGROUND
A thorough understanding of the influence of the foot skeletal structure on hallux valgus (HV) is required for HV prevention. We developed a system using a 3D foot scanner on a smartphone to clarify the relationships between foot features and HV risk.
METHODS
Two-dimensional video images were recorded on a smartphone, sent to a computer or cloud server, and used to construct a 3D foot-feature model, considering 10 foot features associated with HV. The participants (419 individuals, aged 40-89 years) stood with their toes 12 cm apart and heels 8 cm apart during video recording. The height and weight were measured for body-mass index calculation.
RESULTS
Age-dependent foot-feature variations were observed slightly for males and distinctively for females. For females, the great toe-first metatarsal head-heel (GFH) angle associated with HV increased with age, i.e., the GFH angle increased with age, suggesting that HV increased with age. Multiple regression analysis revealed that the features determining the GFH angle are the second toe-heel-navicular angle, bone distance axis, and transverse arch length and height. The adjusted coefficients of determination were 0.54 and 0.52 for males and females, respectively.
CONCLUSION
This approach enables simple foot structure assessment for HV risk evaluation.
Topics: Female; Foot; Hallux Valgus; Humans; Male; Metatarsal Bones; Regression Analysis; Smartphone
PubMed: 34479698
DOI: 10.1016/j.medengphy.2021.08.001