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The American Journal of Dental Science Nov 1878
PubMed: 30756590
DOI: No ID Found -
Journal of Bone and Mineral Research :... Feb 2003Bone characteristics of the humeral shaft and distal radius were measured from 64 female tennis and squash players and their 27 age-, height-, and weight-matched...
Effect of long-term impact-loading on mass, size, and estimated strength of humerus and radius of female racquet-sports players: a peripheral quantitative computed tomography study between young and old starters and controls.
Bone characteristics of the humeral shaft and distal radius were measured from 64 female tennis and squash players and their 27 age-, height-, and weight-matched controls with peripheral quantitative tomography (pQCT) and dual energy X-ray absorptiometry (DXA). The players were divided into two groups according to the starting age of their tennis or squash training (either before or after menarche) to examine the possible differences in the loading-induced changes in bone structure and volumetric density. The following pQCT variables were used: bone mineral content, total cross-sectional area of bone (TotA), cross-sectional area of the marrow cavity (CavA) and that of the cortical bone (CoA), cortical wall thickness (CWT), volumetric density of the cortical bone (CoD) and trabecular bone (TrD), and torsional bone strength index for the shaft (BSIt) and compressional bone strength index for the bone end (BSIc). These bone strength indices were compared with the DXA-derived areal bone mineral density (aBMD) to assess how well the latter represents the effect of mechanical loading on apparent bone strength. At the humeral shaft, the loaded arm's greater bone mineral content (an average 19% side-to-side difference in young starters and 9% in old starters), was caused by an enlarged cortex (CoA; side-to-side differences 20% and 9%, respectively). The loaded humerus seemed to have grown periosteally (the CavA did not differ between the sites), leading to 26% and 11% side-to-side BSIt differences in the young and old starters, respectively. CoD was equal between the arms (-1% difference in both player groups). The side-to-side differences in the young starters' bone mineral content, CoA, TotA, CWT, and BSIt were 8-22% higher than those of the controls and 8-14% higher than those of the old starters. Old starters' bone mineral content, CoA, and BSIt side-to-side differences were 6-7% greater than those in the controls. The DXA-derived side-to-side aBMD difference was 7% greater in young starters compared with that of the old starters and 14% compared with that in controls, whereas the difference between old starters and controls was 6%, in favor of the former. All these between-group differences were statistically significant. At the distal radius, the player groups differed significantly from controls in the side-to-side bone mineral content, TrD, and aBMD differences only: the young starters' bone mineral content difference was 9% greater, TrD and aBMD differences were 5% greater than those in the controls, and the old starters' TrD and aBMD differences were both 7% greater than those in the controls. In summary, in both of the female player groups, the structural adaptation of the humeral shaft to long-term loading seemed to be achieved through periosteal enlargement of the bone cortex, although this adaptation was clearly better in the young starters. Exercise-induced cortical enlargement was not so clear at the distal radius (a trabecular bone site), and the study suggested that at long bone ends, the trabecular density could be a modifiable factor to built a stronger bone structure. Conventional DXA-based aBMD measurement detected the intergroup differences in the exercise-induced bone gains, although, because it measured two dimensions of bone only, it seemed to underestimate the effect of exercise on the apparent bone strength, especially if the playing had been started during the growing years.
Topics: Adult; Age Factors; Bone Density; Case-Control Studies; Female; Humans; Humerus; Osteoporosis; Racquet Sports; Radius; Time Factors; Tomography, X-Ray Computed
PubMed: 12568413
DOI: 10.1359/jbmr.2003.18.2.352 -
Journal of Bone and Mineral Research :... Dec 2002Bone characteristics of the humeral shaft and distal radius were measured from 64 female tennis and squash players and their 27 age-, height-, and weight-matched...
Effect of long-term impact-loading on mass, size, and estimated strength of humerus and radius of female racquet-sports players: a peripheral quantitative computed tomography study between young and old starters and controls.
Bone characteristics of the humeral shaft and distal radius were measured from 64 female tennis and squash players and their 27 age-, height-, and weight-matched controls with peripheral quantitative tomography (pQCT) and DXA. The players were divided into two groups according to the starting age of their tennis or squash training (either before or after menarche) to examine the possible differences in the loading-induced changes in bone structure and volumetric density. The used pQCT variables were bone mineral content (BMC), total cross-sectional area (TotA) of bone, cross-sectional area of the marrow cavity (CavA) and that of the cortical bone (CoA), cortical wall thickness (CWT), volumetric density of the cortical bone (CoD) and trabecular bone (TrD), and torsional bone strength index (BSIt) for the shaft, and compressional bone strength index (BSIc) for the bone end. These bone strength indices were compared with the DXA-derived areal bone mineral density (aBMD) to assess how well the latter represents the effect of mechanical loading on apparent bone strength. At the humeral shaft, the loaded arm's greater BMC (an average 19% side-to-side difference in young starters and 9% in old starters) was caused by an enlarged cortex (CoA; side-to-side differences 20% and 9%, respectively). The loaded humerus seemed to have grown periosteally (the CavA did not differ between the sites) leading to 26% and 11% side-to-side BSIt difference in the young and old starters, respectively. CoD was equal between the arms (-1% difference in both player groups). The side-to-side differences in the young starters' BMC, CoA, TotA, CWT, and BSIt were 8-22% higher than those of the controls and 8-14% higher than those of the old starters. Old starters' BMC, CoA, and BSIt side-to-side differences were 6-7% greater than those in the controls. The DXA-derived side-to-side aBMD difference was 7% greater in young starters compared with that of the old starters and 14% compared with that in controls, whereas the difference between old starters and controls was 6%, in favor of the former. All these between-group differences were statistically significant. At the distal radius, the player groups differed significantly from controls in the side-to-side BMC, TrD, and aBMD differences only; the young starters' BMC difference was 9% greater, TrD and aBMD differences were 5% greater than those in the controls, and the old starters' TrD and aBMD differences were both 7% greater than those in the controls. In summary, in both of the female player groups the structural adaptation of the humeral shaft to long-term loading seemed to be achievedthrough periosteal enlargement of the bone cortex although this adaptation was clearly better in the young starters. Exercise-induced cortical enlargement was not so clear at the distal radius (a trabecular bone site), and the study suggested that at long bone ends also the TrD could be a modifiable factor to build a stronger bone structure. The conventional DXA-based aBMD measurement detected the intergroup differences in the exercise-induced bone gains, although, measuring two dimensions of bone only, it seemed to underestimate the effect of exercise on the apparent bone strength, especially if the playing had been started during the growing years.
Topics: Absorptiometry, Photon; Adult; Bone Density; Case-Control Studies; Female; Humans; Humerus; Middle Aged; Racquet Sports; Radius; Tomography, X-Ray Computed
PubMed: 12469923
DOI: 10.1359/jbmr.2002.17.12.2281 -
Scientific Reports Mar 2016Dynamic processes modify bone micro-structure to adapt to external loading and avoid mechanical failure. Age-related cortical bone loss is thought to occur because of...
Dynamic processes modify bone micro-structure to adapt to external loading and avoid mechanical failure. Age-related cortical bone loss is thought to occur because of increased endocortical resorption and reduced periosteal formation. Differences in the (re)modeling response to loading on both surfaces, however, are poorly understood. Combining in-vivo tibial loading, in-vivo micro-tomography and finite element analysis, remodeling in C57Bl/6J mice of three ages (10, 26, 78 week old) was analyzed to identify differences in mechano-responsiveness and its age-related change on the two cortical surfaces. Mechanical stimulation enhanced endocortical and periosteal formation and reduced endocortical resorption; a reduction in periosteal resorption was hardly possible since it was low, even without additional loading. Endocortically a greater mechano-responsiveness was identified, evident by a larger bone-forming surface and enhanced thickness of formed bone packets, which was not detected periosteally. Endocortical mechano-responsiveness was better conserved with age, since here adaptive response declined continuously with aging, whereas periosteally the main decay in formation response occurred already before adulthood. Higher endocortical mechano-responsiveness is not due to higher endocortical strains. Although it is clear structural adaptation varies between different bones in the skeleton, this study demonstrates that adaptation varies even at different sites within the same bone.
Topics: Aging; Animals; Biomechanical Phenomena; Bone Resorption; Finite Element Analysis; Mice; Mice, Inbred BALB C; Periosteum; Stress, Mechanical; Tibia; X-Ray Microtomography
PubMed: 27004741
DOI: 10.1038/srep23480 -
The Indian Journal of Radiology &... Oct 2021Garré's sclerosing osteomyelitis is a form of chronic osteomyelitis that commonly affects children and young adults. Here, we report one such case of Garré's...
Garré's sclerosing osteomyelitis is a form of chronic osteomyelitis that commonly affects children and young adults. Here, we report one such case of Garré's sclerosing osteomyelitis in a 20-year-old female who presented with facial asymmetry and inability to open mouth. On clinical examination, it was bony hard swelling with trismus. History of infected second molar tooth extraction was present. Computed tomography scan showed thickening and sclerosis of the ramus and condylar process of mandible, on right side, with proliferative periostitis. Magnetic resonance imaging showed soft tissue edema and inflammation, in the form of enlargement of right masseter and pterygoid muscles with intramuscular fluid collection. On the basis of history, clinical signs, and imaging features, diagnosis of Garré's osteomyelitis with fascial space infection was made. To our knowledge, very few cases of Garré's osteomyelitis present with superimposed fascial space infection, as it is otherwise a nonsuppurative condition. Fistula formation is a very rare incidence as it is seen in our case.
PubMed: 35136519
DOI: 10.1055/s-0041-1741043 -
Journal of Current Ophthalmology Dec 2016To introduce a new modification of transposition flap technique for reconstruction of the medial canthal region.
PURPOSE
To introduce a new modification of transposition flap technique for reconstruction of the medial canthal region.
METHODS
This prospective study included 58 patients with the full thickness involvement of both upper and lower lid in the medial canthal area. Reconstruction of posterior lamella was performed by utilizing periosteal flaps and tarsoconjunctival grafts, and anterior lamellar reconstruction was performed using transposition of multiple full-thickness skin flaps, a modified form of rhomboid flap technique. Post-surgical outcomes, advantages, and drawbacks of this technique are discussed.
RESULTS
Between 2010 and 2014, 58 patients with basal cell carcinoma (BCC), proven by histopathologic study, underwent medial canthal reconstruction. The mean age was 72.8 ± 8.3 years. In 30 patients, the lacrimal apparatus was excised, and periosteal flaps or tarsoconjunctival grafts were prepared to reconstruct the posterior lamella. Anterior lamellar reconstruction was performed in all patients, and the mean number of transposition flaps was 3.63 in addition to the blepharoplasty flap. Patients were followed for 24 months. None of the patients developed flap necrosis or other intraoperative and postoperative complications, with acceptable aesthetic and functional outcomes.
CONCLUSION
Full-thickness reconstruction of the medial canthal area by utilizing periosteal flaps and modified transposition flap technique all in one session can be considered an alternative method in medial canthal reconstruction, with acceptable functional and aesthetic outcomes.
PubMed: 27830206
DOI: 10.1016/j.joco.2016.08.001 -
Nature Communications Jul 2017In mammals, megakaryocytes (MKs) in the bone marrow (BM) produce blood platelets, required for hemostasis and thrombosis. MKs originate from hematopoietic stem cells and...
In mammals, megakaryocytes (MKs) in the bone marrow (BM) produce blood platelets, required for hemostasis and thrombosis. MKs originate from hematopoietic stem cells and are thought to migrate from an endosteal niche towards the vascular sinusoids during their maturation. Through imaging of MKs in the intact BM, here we show that MKs can be found within the entire BM, without a bias towards bone-distant regions. By combining in vivo two-photon microscopy and in situ light-sheet fluorescence microscopy with computational simulations, we reveal surprisingly slow MK migration, limited intervascular space, and a vessel-biased MK pool. These data challenge the current thrombopoiesis model of MK migration and support a modified model, where MKs at sinusoids are replenished by sinusoidal precursors rather than cells from a distant periostic niche. As MKs do not need to migrate to reach the vessel, therapies to increase MK numbers might be sufficient to raise platelet counts.Megakaryocyte maturation is thought to occur as the cells migrate from a vessel-distant (endosteal) niche to the vessel within the bone. Here, the authors show that megakaryocytes represent largely sessile cells in close contact with the vasculature and homogeneously distributed in the bone marrow.
Topics: Animals; Blood Platelets; Blood Vessels; Bone Marrow; Cell Movement; Cells, Cultured; Intravital Microscopy; Megakaryocytes; Mice, Inbred C57BL; Mice, Knockout; Mice, Transgenic; Microscopy, Fluorescence, Multiphoton; Platelet Adhesiveness; Thrombopoiesis
PubMed: 28743899
DOI: 10.1038/s41467-017-00201-7 -
Postgraduate Medical Journal Nov 1963
Topics: Congenital Abnormalities; History; Humans; Hypertrophy; Lung Diseases; Osteoarthropathy, Secondary Hypertrophic; Periostitis; Thyroid Gland
PubMed: 14081154
DOI: 10.1136/pgmj.39.457.639 -
Children (Basel, Switzerland) Jun 2022Concerns surrounding osteolysis near and around the modular junction of a stainless-steel intramedullary lengthening rod prompted a manufacturer recall from the United...
Concerns surrounding osteolysis near and around the modular junction of a stainless-steel intramedullary lengthening rod prompted a manufacturer recall from the United States market in early 2021. These actions were preceded by similar steps taken in Europe. A concomitant review of stainless-steel lengthenings at our institution demonstrated signs of adverse tissue reaction including periosteal reaction and osteolysis at the modular junction and/or male-sided locking screws. Nearly half of our patients presented with these findings on radiographic images. At the time of the previous review, only half of the nearly 60 implanted stainless-steel devices met a 6-month follow-up. At this juncture, many patients have had their devices explanted. Given the suspected adverse tissue reactions caused by a component of the internal device, we sought to examine the rate of osteolysis post-explantation following removal of a stainless-steel nail. We reviewed a consecutive series of patients who underwent implantation of a stainless-steel limb lengthening device in the femur and/or tibia at a single institution between December 2018 and December 2020. Patients were included if their device was explanted. Periosteal reaction and osteolysis was classified according to a novel and validated classification system, as analyzed by five fellowship-trained surgeons. In addition, changes observed prior to explantation were tracked post-explantation to assess for resolution. The incidence of periosteal reaction and osteolysis prior to explantation was 22/57 (39%) and 15/57 (26%), respectively. Of the 15 patients with osteolysis pre-explantation, 14 patients' implants were explanted. Of these, eight patients had available follow-up films. Two patients were identified as having partial osteolysis resolution at mean 1-year follow-up, while six patients were identified as having complete osteolysis at mean 18-months follow-up. Periosteal tissue reaction and osteolysis largely resolved following explantation in a subset of patients. These results provide further support to the claim that the stainless-steel device contributed to the changes seen. Further follow-up is warranted to examine the longer-term effects of adverse tissue reaction in this patient population.
PubMed: 35740797
DOI: 10.3390/children9060860 -
Ulusal Travma Ve Acil Cerrahi Dergisi =... Sep 2022Recalcitrant fracture non-union is a condition that is difficult to treat and may require multiple surgeries, sometimes requiring treatment with periosteal flaps. The...
BACKGROUND
Recalcitrant fracture non-union is a condition that is difficult to treat and may require multiple surgeries, sometimes requiring treatment with periosteal flaps. The use of periosteal flaps can be preferred for the treatment of non-unions that do not yet have extensive bone defects. This study aims to share our experience with medial femoral condyle periosteal flap for the treatment of recalcitrant non-union in long bones of the upper limb.
METHODS
Seven patients who underwent treatment for upper limb non-union with a free medial femoral condyle periosteal flap between 2015 and 2019 were retrospectively evaluated. Patients who had previously underwent implant revision and non-vascular grafting procedures and with failed atrophic non-union were included in the study. Non-union was in the humerus in two patients, ulna in three, radius in one, and clavicula in one patient. Demographic data, non-union features, complications, and radiographic findings of the patients were evaluated. Functional results were evaluated according to Quick Disabilities of Arm, Shoulder, and Hand (Q-DASH) scores.
RESULTS
Mean patient age was 41 (23-60) years and the mean follow-up time was 33 months (16-56). Non-union time ranged from 9 to 24 months. Additional surgical procedures were not required. One patient developed a hematoma in the donor site and required surgical drainage. Medial collateral ligament injury of the knee occurred in one patient. Union was observed in all patients in an average of 3 (2-7) months. Mean pre-operative Quick Disabilities of Arm, Shoulder, and Hand (Q-DASH) score was 56 (33-95), while mean post-operative control Q-DASH score was 5 (0-33); the improvement was statistically significant (p=0.017). The functional outcomes of all patients improved, as confirmed by Q-DASH score.
CONCLUSION
The medial femoral condyle periosteal flap offers a viable treatment option for recalcitrant non-unions. This flap has low comorbidity compared to other flaps and is a feasible option for revascularization and bone formation in atrophic non-unions.
Topics: Adult; Bone Transplantation; Femur; Fractures, Ununited; Free Tissue Flaps; Humans; Middle Aged; Retrospective Studies; Upper Extremity
PubMed: 36043917
DOI: 10.14744/tjtes.2021.25032