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Surgical and Radiologic Anatomy : SRA Jun 2022In fracture and realignment surgery, the contralateral unaffected side is often used as a model or template for the injured bone even though clinically valuable...
PURPOSE
In fracture and realignment surgery, the contralateral unaffected side is often used as a model or template for the injured bone even though clinically valuable quantitative data of bilateral symmetry are often unavailable. Therefore, the objective of the present study was to quantify and present the bilateral symmetry of the tibia and fibula.
METHODS
Twenty bilateral lower-leg CT scans were acquired in healthy volunteers. The left and right tibia and fibula were segmented resulting in three-dimensional polygons for geometrical analyses (volume, surface and length). The distal and proximal segment of the right tibia of each individual was subsequently matched to the left tibia to quantify alignment differences (translation and rotation). Bone symmetry on group level was assessed using the Student's t test and intra-individual differences were assessed using mixed-models analyses.
RESULTS
Intra-individuals differences were found for tibia volume (5.2 ± 3.3 cm), tibia surface (5.2 ± 3.3 cm), translations in the lateral (X-axis; 9.3 ± 8.9 mm) and anterior direction (Y-axis; 7.1 ± 7.0 mm), for tibia length (translation along Z-axis: 3.1 ± 2.4 mm), varus/valgus (φ: 1.7 ± 1.4°), and endotorsion/exotorsion (φ: 4.0 ± 2.7°).
CONCLUSION
This study shows intra-individual tibia asymmetry in both geometric and alignment parameters of which the surgeon needs to be aware in pre-operative planning. The high correlation between tibia and fibula length allows the ipsilateral fibula to aid in estimating the original tibia length post-injury. Future studies need to establish whether the found asymmetry is clinically relevant when the contralateral side is used as reference in corrective surgery.
LEVEL OF EVIDENCE
III cohort study.
Topics: Cohort Studies; Humans; Leg; Lower Extremity; Tibia; Tomography, X-Ray Computed
PubMed: 35534775
DOI: 10.1007/s00276-022-02940-9 -
Deutsches Arzteblatt International Aug 2020
Topics: Humans; Imaging, Three-Dimensional; Tibia
PubMed: 33161945
DOI: 10.3238/arztebl.2020.0599a -
PloS One 2023The objective of this study was to provide an overarching description of the inter-subject variability of the equine femur and tibia morphology using statistical shape...
The objective of this study was to provide an overarching description of the inter-subject variability of the equine femur and tibia morphology using statistical shape modeling. Fifteen femora and fourteen tibiae were used for building the femur and tibia statistical shape models, respectively. Geometric variations in each mode were explained by biometrics measured on ±3 standard deviation instances generated by the shape models. Approximately 95% of shape variations within the population were described by 6 and 3 modes in the femur and tibia shape models, respectively. In the femur shape model, the first mode of variation was scaling, followed by notable variation in the femoral mechanical-anatomical angle and femoral neck angle in mode 2. Orientation of the femoral trochlear tubercle and femoral version angle were described in mode 3 and mode 4, respectively. In the tibia shape model, the main mode of variation was also scaling. In mode 2 and mode 3, the angles of the coronal tibial plateau and the medial and lateral caudal tibial slope were described, showing the lateral caudal tibial slope angle being significantly larger than the medial. The presented femur and tibia shape models with quantified biometrics, such as femoral version angle and posterior tibial slope, could serve as a baseline for future investigations on correlation between the equine stifle morphology and joint disorders due to altered biomechanics, as well as facilitate the development of novel surgical treatment and implant design. By generating instances matching patient-specific femorotibial joint anatomy with radiographs, the shape model could assist virtual surgical planning and provide clinicians with opportunities to practice on 3D printed models.
Topics: Animals; Horses; Tibia; Lower Extremity; Femur; Femur Neck; Biomechanical Phenomena
PubMed: 37390069
DOI: 10.1371/journal.pone.0287381 -
Cartilage Dec 2021The purposes of this study are to evaluate which growth plate parameters are associated with bone growth in mice and to compare the mouse results with those in humans.
OBJECTIVE
The purposes of this study are to evaluate which growth plate parameters are associated with bone growth in mice and to compare the mouse results with those in humans.
DESIGN
The sagittal sections of the proximal growth plate of the mouse tibia from neonate to young adult stages were subjected to histomorphometric and functional analyses. The radiographic images of tibias of human patients until puberty were analyzed to obtain the tibia length and the proximal growth plate height. It was found that a linear correlation best modeled the relationship between the growth plate variables with the tibia growth rate and length.
RESULTS
In mice, total height, resting zone height, combined height of the proliferation and prehypertrophic zones, proliferation activity, and the total width of tibia growth plate showed high linear correlation with tibia bone length and bone growth rate, but the hypertrophic zone height and the growth plate area did not. In both mice and humans, the total growth plate width of tibia was found to have the strongest correlation with tibia length and growth rate.
CONCLUSIONS
The results validated that growth plate total height, the height of the resting zone and cell proliferation activity are appropriate parameters to evaluate the balance between growth plate activity and bone growth in mice, consistent with previous reports. The study also provided a new growth plate parameter candidate, growth plate width for growth plate activity evaluation in both mouse and human tibia bone.
Topics: Animals; Bone Development; Bone and Bones; Growth Plate; Humans; Hypertrophy; Mice; Tibia
PubMed: 31997656
DOI: 10.1177/1947603519900800 -
The Bone & Joint Journal Feb 2019Double-level lengthening, bone transport, and bifocal compression-distraction are commonly undertaken using Ilizarov or other fixators. We performed double-level...
AIMS
Double-level lengthening, bone transport, and bifocal compression-distraction are commonly undertaken using Ilizarov or other fixators. We performed double-level fixator-assisted nailing, mainly for the correction of deformity and lengthening in the same segment, using a straight intramedullary nail to reduce the time in a fixator.
PATIENTS AND METHODS
A total of 23 patients underwent this surgery, involving 27 segments (23 femora and four tibiae), over a period of ten years. The most common indication was polio in ten segments and rickets in eight; 20 nails were inserted retrograde and seven antegrade. A total of 15 lengthenings were performed in 11 femora and four tibiae, and 12 double-level corrections of deformity without lengthening were performed in the femur. The mean follow-up was 4.9 years (1.1 to 11.4). Four patients with polio had tibial lengthening with arthrodesis of the ankle. We compared the length of time in a fixator and the external fixation index (EFI) with a control group of 27 patients (27 segments) who had double-level procedures with external fixation. The groups were matched for the gain in length, age, and level of difficulty score.
RESULTS
The mean gain in length was statistically similar in the two groups: 3.9 cm (1.5 to 9.0) in the study group and 4.2 cm (3.4 to 5.0) in the control group (p = 0.350). The mean time in a fixator was significantly less in the study group compared with the control group: 8.6 weeks (2.0 to 22.8) versus 30.2 weeks (25.0 to 35.4; p < 0.001). The mean EFI was significantly lower in the study group compared with the control group: 17.7 days/cm (10.6 to 35.6) versus 73.4 days/cm (44.5 to 102.3; p < 0.001). The ASAMI (Association for the Study and Application of the Method of Ilizarov) bone score was excellent in 22, good in four, and fair in one. The ASAMI functional score was excellent in 20 and good in seven. There were no infections, superficial or deep.
CONCLUSION
Double-level osteotomies or two procedures using a custom-made straight nail and external fixation can be used to correct deformities or to treat nonunion or malunion and may be combined with arthrodesis of the ankle with lengthening. It is a reasonably safe procedure that allows accurate and cost-effective treatment with a relatively short time in a fixator.
Topics: Adolescent; Adult; Bone Diseases, Developmental; Bone Lengthening; Bone Nails; External Fixators; Female; Femur; Fracture Fixation, Intramedullary; Humans; Male; Middle Aged; Osteotomy; Tibia; Young Adult
PubMed: 30700124
DOI: 10.1302/0301-620X.101B2.BJJ-2018-0622.R1 -
The Journal of Histochemistry and... Aug 2019Conventional bone decalcification is a time-consuming process and is therefore unsuitable for clinical applications and time-limited research projects. Consequently, we... (Comparative Study)
Comparative Study
Conventional bone decalcification is a time-consuming process and is therefore unsuitable for clinical applications and time-limited research projects. Consequently, we compared the effect of four different decalcification solutions applied at three different temperatures, and assessed the rate of decalcification and the implications on tissue morphology and antigenicity of mouse and rat tibiae. Bones were decalcified with 10% ethylenediaminetetraacetic acid (EDTA), 10% formic acid, 5% hydrochloric acid, and 5% nitric acid at 4C, 25C, and 37C. Decalcification in both species was fastest in nitric acid at 37C and slowest in EDTA at 4C. Histological and immunohistochemical staining confirmed that the conventional protocols of EDTA at 4C and 25C remain the best option regarding the quality of tissue preservation. Whereas formic acid at 4C is a good alternative saving about 90% of the decalcification time, hydrochloric and nitric acids should be avoided particularly in case of rat tibia. By contrast, due to their smaller size, mouse tibiae had shorter decalcification times and tolerated higher temperatures and exposure to acids much better. In conclusion, this study demonstrated that depending on the specific research question and sample size, alternative decalcification methods could be used to decrease the time of decalcification while maintaining histological accuracy.
Topics: Animals; Collagen Type I; Decalcification Technique; Male; Mice; Rats; Sp7 Transcription Factor; Tibia; von Willebrand Factor
PubMed: 31090479
DOI: 10.1369/0022155419850099 -
Wiener Klinische Wochenschrift Jun 2022Tuberculosis is among the leading causes of death from infectious diseases and affects many organ systems, including the skeleton. Skeletal tuberculosis is an...
Tuberculosis is among the leading causes of death from infectious diseases and affects many organ systems, including the skeleton. Skeletal tuberculosis is an extrapulmonary stage of tuberculosis, which occurs after the early and post-primary pulmonary stages of the disease. The aim of our study was to assess the microarchitecture of historic dry bone samples of subjects who have died of tuberculosis documented by post-mortem examinations. These preparations date to the pre-antibiotic era, and were provided by the Pathological-Anatomical Collection in the "Fools Tower" of the Natural History Museum Vienna (PASiN-NHM).We investigated macerated samples of 20 vertebral bodies, 19 femoral heads, and 20 tibiae of a total of 59 individuals diagnosed with tuberculosis from the nineteenth and early twentieth century. 10 femora and 10 tibiae from body donors that did not exhibit signs of infection and 10 (unaffected) vertebrae kept at the PASiN-NHM were studied as controls. The affected regions of the bone samples (and the corresponding regions of the control bones) were analyzed by microcomputed tomography using a Viscom X 8060 II system. Obtained images were analyzed semi-quantitatively. In samples with tuberculosis, independent of the investigated skeletal region, trabecular defects and decreased trabecular thickness were observed. Cortical porosity was seen in affected vertebrae and tibia; in tuberculous tibiae (but not in the femora) cortical thickness was decreased. In half of the individuals, cortical sclerosis was present; signs of ankylosis were observed mainly at the femoral heads affected with tuberculosis. We conclude that a combination of several alterations at the trabecular compartment could be suggestive of the presence of tuberculosis in historic skeletal remains.
Topics: Bone Density; Bone and Bones; Humans; Tibia; Tuberculosis; X-Ray Microtomography
PubMed: 35307770
DOI: 10.1007/s00508-022-02017-y -
Journal of Foot and Ankle Research Jul 2022Tibialis anterior (TA) muscle is the largest dorsiflexor of the ankle joint and plays an important role during gait movement. However, descriptions of the TA attachment...
BACKGROUND
Tibialis anterior (TA) muscle is the largest dorsiflexor of the ankle joint and plays an important role during gait movement. However, descriptions of the TA attachment site are inconsistent even among major anatomy textbooks, and its origin, especially the attachment site for the tibia, has not been reported in detail. This study is the first experimental attempt to investigate the origin of the TA in detail, paying particular attention to the relationship with the shape of the tibia, including sex differences.
METHODS
Forty legs (20 males, 20 females) from twenty Japanese cadavers were examined. Gross anatomical examination of the TA's attachment site to the tibia and the tibia's shape was performed.
RESULTS
The location of the distal end of the TA's attachment on tibia was significantly more distal in males than in females (p < 0.01). The anterior border of the tibia had a gentle S-like curve, with a medially convex curve in the proximal region and a laterally convex curve in the distal region in frontal plane. The most protruding point of the distal curve of the anterior border located significantly more proximal in females than in males (p = 0.02).
CONCLUSIONS
There were sex differences in the distal end of the attachment site on tibia of the TA and the shape of the tibia. Consequently, the variations in the attachment site of TA were considered to provide for differences in function of TA. In males, the TA may enable advantageous power exertion, whereas in females it may work efficiently for dorsiflexion of ankle, respectively. Sex differences in TA's attachment site and the shape of the tibia may be involved in gait movement as well as frequency of lower leg disorders such as chronic exertional compartment syndrome.
Topics: Ankle Joint; Cadaver; Female; Humans; Leg; Male; Muscle, Skeletal; Tibia
PubMed: 35821059
DOI: 10.1186/s13047-022-00559-y -
European Journal of Trauma and... Feb 2023This study aims to investigate the symmetry of the left and right tibial plateau in young healthy individuals to determine whether left-right mirroring can be reliably... (Review)
Review
PURPOSE
This study aims to investigate the symmetry of the left and right tibial plateau in young healthy individuals to determine whether left-right mirroring can be reliably used to optimize preoperative 3D virtual planning for patients with tibial plateau fractures.
METHODS
One hundred healthy subjects, without previous knee surgery, severe knee trauma, or signs of osteoarthritis were included for a previous dynamic imaging study of the knee. The subjects underwent a CT scan, scanning the left and right knee with a slice thickness of 0.8 mm. 3D surface models of the femur, patella, and tibia were created using a convolutional neural network. The 3D models of the left and right tibias were exported to MATLAB © and the tibias were mirrored. The mirrored tibias were superimposed on the contralateral tibia using a coherent point drift surface matching algorithm. Correspondence points on both surfaces were established, the mean root squared distance was calculated and visualized in a boxplot and heatmaps.
RESULTS
The overall mean difference between correspondence points on the left and right tibial plateau is 0.6276 ± 0.0343 mm. The greatest differences between correspondence points were seen around two specific surfaces on the outside of the tibial plateau; where the distal tibia was cut 15 mm below the tibial plateau and around the tibiofibular joint.
CONCLUSIONS
The differences between the left and right tibial plateau are small and therefore, we can be confident that the mirrored contralateral, unfractured, tibial plateau can be used as a template for 3D virtual preoperative planning for young patients without previous damage to the knee.
Topics: Humans; Tibia; Tibial Fractures; Knee Joint; Femur; Patella
PubMed: 35829733
DOI: 10.1007/s00068-022-02043-5 -
Journal of Medical Case Reports May 2023Osteomyelitis is a bone inflammation that can be related to various infectious agents. As with any other type of inflammation, the prevailing symptoms and signs may... (Review)
Review
INTRODUCTION
Osteomyelitis is a bone inflammation that can be related to various infectious agents. As with any other type of inflammation, the prevailing symptoms and signs may include redness, swelling, pain, and heat. Fungal osteomyelitis is rare and usually found in immune-compromised patients.
CASE PRESENTATION
A non-human immunodeficiency virus immunocompromised Greek female patient, 82 years old, visited the emergency department due to a 3 day pain located mainly over the left tibia's anterior surface, accompanied by swelling and redness. There was also a subcutaneous lesion of her left breast. Medical history revealed that the patient had an unmasked close contact with pigeons, a main host of the disease. Initial x-ray imaging showed an osteolytic area in the upper third of the tibial diaphysis. The patient was admitted and underwent a computed tomography-guided biopsy. The specimen revealed a Cryptococcus neoformans infection of the bone and the breast. She was treated with 400 mg fluconazole twice a day for 3 weeks while in hospital and 200 mg twice a day upon discharge for 9 months. After that, she underwent surgical debridement because of lasting local irritation. She was closely monitored in our outpatient office, and in her last visit, 1 year after the initial admission, inflammatory signs had regressed vastly.
CONCLUSIONS
To our knowledge, this is the ninth cryptococcal osteomyelitis of the tibia to be recorded since 1974, and the most unusual finding was the bifocal nature of the infection, affecting both the tibia and the breast.
Topics: Female; Humans; Cryptococcus neoformans; Tibia; Cryptococcosis; Fluconazole; Osteomyelitis; Inflammation
PubMed: 37149631
DOI: 10.1186/s13256-023-03925-x