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Veterinary Medicine and Science Nov 2021The forearms of dogs and cats do not only differ anatomically from each other, but there are also differences in prevalence of radius and ulna fractures between the two...
The forearms of dogs and cats do not only differ anatomically from each other, but there are also differences in prevalence of radius and ulna fractures between the two species. The prevalence of antebrachial fractures is 18.0% in dogs and 2.0-8.0% in cats. Many studies focus solely on the trabecular and cortical bone structure of dogs and the characteristics of the cat are often disregarded. The aim of this study was to evaluate the trabecular structure parameters [bone volume fraction per total volume (BV/TV), bone surface per total volume (BS/BV), trabecular number (Tb.N), trabecular thickness (Tb.Th), trabecular separation (Tb.Sp), connectivity density (Conn. D), degree of anisotropy (DA)] and the diaphyseal cortical bone density (Mean Density) of the antebrachium in cats and small dogs to visualise their differences. For this purpose, a total of 32 forearms of cats (n = 8) and small dogs (n = 8) were evaluated using microcomputed tomography and the findings were compared. The results of the study showed that cats had higher values for BV/TV, Tb.Th, Tb.Sp, DA and Mean Density and lower values for BS/BV, Tb.N and Conn.D at radius and ulna compared to dogs. According to the results of this study, the higher bone volume fraction (BV/TV), thicker trabeculae (Tb.Th), increased anisotropy (DA) and significantly higher diaphyseal cortical density (Mean Density) could contribute to the lower fracture risk of the antebrachium in cats compared to small dogs.
Topics: Animals; Cat Diseases; Cats; Cortical Bone; Dog Diseases; Dogs; Radius; Ulna; X-Ray Microtomography
PubMed: 34453415
DOI: 10.1002/vms3.619 -
The Journal of International Medical... Apr 2021As a pivotal part of the elbow joint structure, the coronoid process of the ulna plays a vital role in maintaining elbow joint stability. Loss of coronoid process height... (Review)
Review
As a pivotal part of the elbow joint structure, the coronoid process of the ulna plays a vital role in maintaining elbow joint stability. Loss of coronoid process height causes instability of the elbow joint depending on the fracture characteristics and size. The diagnosis and treatment of coronoid process fractures has gained widespread attention from orthopedic surgeons. Nevertheless, few reports have described reconstruction of coronoid process fractures and defects that affect elbow joint stability. Treatment of elbow joint instability induced by coronoid process defects is challenging because most cases are complicated by other elbow joint injuries. Moreover, the clinical efficacy remains unclear. The present narrative review was performed to examine the research progress on reconstruction of the coronoid process. The findings of this review provide evidence for clinical repair and reconstruction of coronoid process defects and contribute to the published literature on this topic.
Topics: Elbow Joint; Epiphyses; Humans; Joint Instability; Ulna; Ulna Fractures
PubMed: 33858252
DOI: 10.1177/03000605211008323 -
Orthopaedics & Traumatology, Surgery &... Apr 2023Ulnar fractures associated with long-term bisphosphonate (BPs) therapy are rare, and the nature and extent of this potential risk remains unknown. Although ulna is...
INTRODUCTION
Ulnar fractures associated with long-term bisphosphonate (BPs) therapy are rare, and the nature and extent of this potential risk remains unknown. Although ulna is generally considered a "straight bone", it actually features a bow anatomically. For this reason, we speculated that ulnar bow may have a role in the development of atypical ulnar fractures (AUFs). Therefore, we compared the location and depth of ulnar bow between AUF patients and patients with atypical fractures other than the ulna. We aimed to answer: (1) whether a correlation exists between the location of the ulna bow and the location of AUFs, (2) whether the degree of ulnar bow affects the occurrence of AUFs.
HYPOTHESIS
Ulnar bowing could play a critical role in the location and occurrence of AUFs.
METHODS
We retrospectively reviewed the radiographs and medical records of 64 patients with atypical fractures admitted to our department between May 2010 to July 2020. The bow of the ulna was measured using anteroposterior (AP) and lateral radiographs. Bone angulation was described as apex of deformity, with apex lateral bow designated as AP plane bowing and apex posterior bow marked as lateral plane bowing.
RESULTS
In all patients with atypical fractures, bow locations were measured at the proximal third level to the index line in 68% of AP plane and 72% of lateral plane. In patients with AUFs, fracture sites occurred in the range of 20% to<40%, except in one patient. Fracture site versus apex lateral bow location and fracture site versus apex posterior bow location showed a statistically significant correlation coefficient of 0.81 (p<0.001) and 0.69 (p=0.003), respectively. In lateral plane, there was a significant difference between AUF patients and patients with atypical fractures other than the ulna in ulnar bow depth (p=0.014). However, no statistically significant differences were found in AP plane (p=0.110).
DISCUSSION
In AUFs, fracture site was highly correlated with ulnar bowing location, and, as the degree of apex posterior bow increased, occurrence of AUFs increased. These findings are helpful in understanding the role of bowing as the ulnar geometry in the development of AUF and early identification of the location of suspicious AUF.
LEVEL OF EVIDENCE
IV.
Topics: Humans; Retrospective Studies; Ulna; Ulna Fractures; Upper Extremity; Diphosphonates; Genu Varum
PubMed: 36455865
DOI: 10.1016/j.otsr.2022.103492 -
Poultry Science Oct 2021We investigated the effect of photoperiod on eggshell quality, bone quality characteristics and bone metabolism related enzymes and factors in laying ducks. After...
We investigated the effect of photoperiod on eggshell quality, bone quality characteristics and bone metabolism related enzymes and factors in laying ducks. After adaption, 300 Jinding laying ducks (252-day-old) were randomly divided into 5 treatments, receiving 12L (hours of light):12D (hours of darkness), 14L:10D, 16L:8D, 18L:6D or 20L:4D, respectively. Each group had 6 replicates of 10 birds each. The feeding experiment lasted 8 wk. Compared with 12L:12D, the higher values of eggshell breaking strength occurred in ≥18 h photoperiods at the end of 6 wk, and in ≥16 h photoperiods at the end of 4 wk, with the common highest values in 18 h photoperiod (P ˂ 0.05). Besides, 18L:6D had higher values of ultimate load Fu and cortical cross-sectional area A in tibia, femur, and ulna (P ˂ 0.05), compared with 12L:12D. The higher values of proximal bone mineral content (BMC; tibia), distal BMC (ulna), total Ca (tibia), and cortical volumetric bone mineral density (vBMC; tibia and ulna) were observed in 16L:8D and 18L:6D treatments (P ˂ 0.05). Meanwhile, 18 h photoperiod group had the higher proximal BMC (femur) and total Ca in ulna (P ˂ 0.05). In serum, compared with 12L:12D group, the higher ALP activity occurred in ≥16 h photoperiods (0:00 and 18:00), with the highest values in 18L:6D treatment (P ˂ 0.05); the higher values of TGF-β (6:00) and OC (6:00 and 18:00) were simultaneously observed in 18 h photoperiod (P ˂ 0.05). Moreover, values of trACP activity, TNF-α and IL-6 contents decreased in ≥18 h photoperiods at 0:00 (P ˂ 0.05), compared with 12L:12D group. To sum up, an appropriate photoperiod could improve eggshell quality, bone strength and mineral content through increasing osteogenesis during the light time and decreasing resorption activity during the dark, and 18 h is an adequate photoperiod for the eggshell and bone quality of laying ducks.
Topics: Animals; Chickens; Ducks; Egg Shell; Femur; Ovum; Photoperiod; Tibia; Ulna
PubMed: 34391963
DOI: 10.1016/j.psj.2021.101376 -
British Medical Journal Jan 1978
Topics: Amputation Stumps; Amputees; Arm; Humans; Radius; Ulna
PubMed: 620220
DOI: No ID Found -
Clinical Orthopaedics and Related... Jan 2020Rotation of the forearm is a result of the complex interaction among the radius, ulna, and interosseous membrane. Although the radius is recognized as curved, the ulna...
BACKGROUND
Rotation of the forearm is a result of the complex interaction among the radius, ulna, and interosseous membrane. Although the radius is recognized as curved, the ulna is generally thought of as a "straight bone." To better describe normal anatomy, which may lead to more successful anatomic fixation of forearm fractures, we aimed to apply a method of measuring the normal ulnar bow and determine the mean ulnar bow in adults.
QUESTIONS/PURPOSES
(1) To what degree is the ulna bowed in the coronal and sagittal planes in normal adult forearms? (2) To what degree is the radius bowed in the coronal plane in normal adult forearms?
METHODS
Radiographs of the forearms of adults taken during a 1-year period were initially obtained retrospectively. These radiographs were performed for various reasons, including forearm pain and routine radiographic follow-up. Radiographs were excluded if evidence of a fracture or post-fracture fixation was found, if a patient had missing AP or lateral images, or if a suboptimal technique was used. The coronal and sagittal bow of the ulna was measured with a method adapted from previous studies that assessed radial bow using AP and lateral radiographs, respectively. Similar measurements were made in the coronal plane for the radius. All measurements were performed independently by the four authors. There was excellent interobserver reliability for ulnar bow in the coronal and sagittal planes (interclass correlation coefficient = 0.96 and 0.97, respectively) and for radial bow in the coronal plane (interclass correlation coefficient = 0.90).
RESULTS
The mean maximal coronal ulnar bow was 7 ± 2 mm and was located at 75% of the ulnar length, measured proximally to distally. The location of coronal bow was consistently distal to the radial bow location. The mean maximal sagittal ulnar bow was 6 ± 3 mm and was located at 39% of the ulnar length. The mean maximal coronal bow of the radius was 14 ± 2.0 mm and was 59% of the total length of the radius from proximal to distal.
CONCLUSIONS
The ulna is not a "straight bone," as is commonly thought, but rather has a bow in both the coronal and sagittal planes.
CLINICAL RELEVANCE
Knowledge of the standard ulnar bow may be pivotal to prevent malunion of the ulna during surgery. Future research using these data in preoperative planning may lead to changes in plate contouring and clinical outcomes in forearm fracture management.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Radiography; Radius; Reference Values; Reproducibility of Results; Retrospective Studies; Ulna; Young Adult
PubMed: 31663889
DOI: 10.1097/CORR.0000000000000999 -
Acta Orthopaedica Apr 2022Classification of fractures can be valuable for research purposes but also in clinical work. Especially with are fractures, such as distal ulna fractures, a treatment...
BACKGROUND AND PURPOSE
Classification of fractures can be valuable for research purposes but also in clinical work. Especially with are fractures, such as distal ulna fractures, a treatment algorithm based on a classification can be helpful. We compared 3 different classification systems of distal ulna fractures and investigated their reliability and reproducibility.
PATIENTS AND METHODS
patients with 97 fractures of the distal ulna, excluding the ulnar styloid, were included. All fractures were independently classified by 3 observers according to the classification by Biyani, AO/OTA 2007, and AO/OTA 2018. The classification process was repeated after a minimum of 3 weeks. We used Kappa value analysis to determine inter- and intra-rater agreement.
RESULTS
The inter-rater agreement of the AO/OTA 2007 classification was judged as fair, ĸ 0.40, whereas the agreement of AO/OTA 2018 and Biyani was moderate at ĸ 0.42 and 0.43 respectively. The intra-rater agreement was judged as moderate for all classifications.
INTERPRETATION
The differences between the classifications were small and the overall impression was that neither of them was good enough to be of substantial clinical value. The Biyani classification, being developed specifically for distal ulna fractures, was the easiest and most fitting for the fracture patterns seen in our material, but lacking options for fractures of the distal diaphysis. Standard radiographs were considered insufficient for an accurate classification. A better radiographic method combined with a revised classification might improve accuracy, reliability, and reproducibility.
Topics: Fractures, Bone; Humans; Observer Variation; Radiography; Reproducibility of Results; Ulna; Ulna Fractures
PubMed: 35438183
DOI: 10.2340/17453674.2022.2509 -
Clinical Orthopaedics and Related... Nov 2021Although Risser stages are visible on the same radiograph of the spine, Risser staging is criticized for its insensitivity in estimating the remaining growth potential...
BACKGROUND
Although Risser stages are visible on the same radiograph of the spine, Risser staging is criticized for its insensitivity in estimating the remaining growth potential and its weak correlation with curve progression in patients with adolescent idiopathic scoliosis. Risser staging is frequently accompanied by other skeletal maturity indices to increase its precision for assessing pubertal growth. However, it remains unknown whether there is any discrepancy between various maturity parameters and the extent of this discrepancy when these indices are used concurrently to assess pubertal growth landmarks, which are important for the timing of brace initiation and weaning.
QUESTIONS/PURPOSES
(1) What is the chronologic order of skeletal maturity grades based on the growth rate and curve progression rate in patients with adolescent idiopathic scoliosis? (2) What are the discrepancies among the grades of each maturity index for indicating the peak growth and start of the growth plateau, and how do these indices correspond to each other? (3) What is the effectiveness of Risser staging, Sanders staging, and the distal radius and ulna classification in assessing peak growth and the beginning of the growth plateau?
METHODS
Between 2014 and 2017, a total of 13,536 patients diagnosed with adolescent idiopathic scoliosis were treated at our tertiary clinic. Of those, 3864 patients with a radiograph of the left hand and wrist and a posteroanterior radiograph of the spine at the same visits including initial presentation were considered potentially eligible for this study. Minimum follow-up was defined as 6 months from the first visit, and the follow-up duration was defined as 2 years since initial consultation. In all, 48% (1867 of 3864) of patients were eligible, of which 26% (485 of 1867) were excluded because they were prescribed bracing at the first consultation. These patients visited the subsequent clinics wearing the brace, which might have affected body height measurement. Six percent (117 of 1867) of eligible patients were also excluded as their major coronal Cobb angle reached the surgical threshold of 50° and had undergone surgery before skeletal maturity. Another 21% (387 of 1867) of patients were lost before minimum follow-up or had incomplete data, leaving 47% (878) for analysis. These 878 patients with 1139 skeletal maturity assessments were studied; 74% (648 of 878) were girls. Standing body height was measured in a standardized manner by a wall-mounted stadiometer. Several surgeons measured curve magnitude as per routine clinical consultation, skeletal maturity was measured according to the distal radius and ulna classification, and two raters measured Risser and Sanders stages. Reliability tests were performed with satisfaction. Data were collected for the included patients at multiple points when skeletal maturity was assessed, and only up to when brace wear started for those who eventually had bracing. The growth rate and curve progression rate were calculated by the change of body height and major coronal Cobb angle over the number of months elapsed between the initial visit and next follow-up. At each skeletal maturity grading, we examined the growth rate (in centimeters per month) and curve progression rate (in degrees per month) since the skeletal maturity assessment, as well as the mean age at which this maturity grading occurred. Each patient was then individually assessed for whether he or she was experiencing peak growth and the beginning of growth plateau at each timepoint by comparing the calculated growth rate with the previously defined peak growth rate of ≥ 0.7 cm per month and the beginning of growth plateau rate of ≤ 0.15 cm per month in this adolescent idiopathic scoliosis population. Among the timepoints at which the peak growth and the beginning of growth plateau occurred, the median maturity grade of each maturity index was identified as the benchmark grade for comparison between indices. We used the McNemar test to investigate whether pubertal growth landmarks were identified by specific maturity grades concurrently. We assessed the effectiveness of these skeletal maturity indices by the difference in proportions (%) between two benchmark grades in indicating peak growth and the growth plateau.
RESULTS
For girls, the chronological order of maturity grades that indicated peak growth was the radius grade, ulna grade, Sanders stage, and Risser stage. Curve progression peaked between the age of 11.6 and 12.1 years at a similar timing by all maturity indices for girls but was inconsistent for boys. For both sexes, radius (R) grade 6, ulna (U) grade 5, Sanders stage (SS) 3, and Risser stage 0+ were the median grades for peak growth, whereas Risser stage 4, R8/9, U7/8, and SS6/7 indicated the beginning of the growth plateau. The largest discrepancy between maturity indices was represented by Risser stage 0+, which corresponded to six grades of the Sanders staging system (SS2 to SS7) and to R6 in only 41% (62 of 152) of girls in the whole cohort. Despite Risser stage 0+ corresponding to the wide range of Sanders and distal radius and ulna grades, none of the R6, U5, SS3, and Risser stage 0+ was found more effective than another grade in indicating the peak growth in girls. R6 most effectively indicated the peak growth in boys, and Risser stage 0+ was the least effective. For the beginning of the growth plateau in girls, SS6/7 was the most effective indicator, followed by U7/8. Risser stage 4 was the least effective because it indicated 29% (95% CI 21% to 36%; p < 0.001) fewer patients who reached the beginning of the growth plateau than did those with R8/9. Risser stage 4 also indicated 36% (95% CI 28% to 43%; p < 0.001) fewer patients who reached the beginning of the growth plateau than those indicated by U7/8, and it identified 39% fewer patients than SS6/7 (95% CI 32% to 47%; p < 0.001). For boys, similarly, R8/9, U7/8, and SS6/7 were all more effective than Risser stage 4 in identifying when the growth plateau began.
CONCLUSION
Risser stage 0+ corresponds to a wide range of Sanders and distal radius and ulna grades. Risser stage 0+ is least effective in indicating the peak growth in boys, and Risser stage 4 is the least effective maturity grade for indicating when the growth plateau starts in both sexes. The concurrent use of R6 and SS3 can be useful for detecting the peak growth, and SS6/7 in conjunction with U7/8 is most effective in indicating the beginning of the growth plateau. Using a combination of specific grades of Sanders staging and the distal radius and ulna classification can indicate pubertal growth landmarks with reduced risk of underestimating or overestimating skeletal maturity. These findings may aid in refining clinical decision-making of brace initiation and weaning at a more precise timing. Among Risser stage 0, the appearance of R6, U5, and SS3 provide the most effective assessment of peak growth that can indicate the most effective bracing period within which curve progression occurs. For initiation of the growth plateau, Risser 4 is not useful, and SS6/7, R8/9 and U7/8 should be used instead.
LEVEL OF EVIDENCE
Level III, diagnostic study.
Topics: Adolescent; Age Determination by Skeleton; Body Height; Braces; Child; Clinical Decision-Making; Disease Progression; Female; Humans; Male; Radiography; Radius; Reproducibility of Results; Scoliosis; Spine; Ulna; Wrist
PubMed: 34036944
DOI: 10.1097/CORR.0000000000001817 -
Hand (New York, N.Y.) Dec 2022Distal-ulna stump (DUS) instability often occurs when performing a distal radioulnar joint (DRUJ) arthroplasty. Recent studies suggest that the distal interosseous...
BACKGROUND
Distal-ulna stump (DUS) instability often occurs when performing a distal radioulnar joint (DRUJ) arthroplasty. Recent studies suggest that the distal interosseous membrane (DIOM) reinforces the triangular fibrocartilage complex, providing additional stability to the DRUJ. The aim of this study was to determine whether the DIOM stabilizes the ulnar stump.
METHODS
Twenty fresh-frozen random forearms were dissected. The presence of a distal oblique bundle (DOB) was recorded and measured. The radius was fixed to a vise and the ulna kept free. The DRUJ was fixed with a lag screw. A bone slice was removed by transverse ulna osteotomies 10 and 15 mm proximal to the DRUJ. A 10-N force was applied to the ulna in dorsal and volar directions. Displacements were measured. The DIOM was then transected, and maneuvers and measurements were repeated and compared.
RESULTS
A distinct distal membrane was present in 70% and a cord-like DOB in 30%. The mean length was 29 mm. Its origin was proximal to the sigmoid notch; its insertion was on the distal third of the ulna, at its lateral border. This attachment is comprised between 39 and 48 mm proximal to the ulnocarpal joint. Initial displacements averaged 22 mm dorsally and 13 mm volarly. After DIOM transection, ulnar translocation increased to 31 mm dorsally and 19 mm volarly.
CONCLUSION
In DRUJ arthroplasties, the DIOM does not appear to be a stabilizer of the DUS beneath a useful threshold. Its retaining effect occurs only after an initial 22-mm dorsal displacement, which we consider not clinically admissible. Therefore, in DRUJ arthroplasties, some augmentation might be advisable.
Topics: Humans; Interosseous Membrane; Joint Instability; Biomechanical Phenomena; Cadaver; Ulna
PubMed: 34144664
DOI: 10.1177/1558944721999728 -
Journal of Feline Medicine and Surgery Feb 2023The aim of this study was to describe the anatomy of the distal radioulnar ligament in the cat, using gross and histological sections from cadaveric feline carpi.
OBJECTIVES
The aim of this study was to describe the anatomy of the distal radioulnar ligament in the cat, using gross and histological sections from cadaveric feline carpi.
METHODS
Eight feline cadaveric distal radioulnar joints were included in the study, including six that were paraffin- and two that were polymethyl methacrylate-embedded. Each of the sections of the distal radioulnar joint and ligament were viewed macroscopically and microscopically using a dissection microscope and a standard light microscope with polarising capacity.
RESULTS
On gross examination, the distal radioulnar ligament could be seen as a triangular-shaped structure extending between the dorsal surface of the distal radius and ulna. The centre of the ligament had a greater density of tightly packed collagen fibres, while fibrocartilage was identified at the site of both the radial and ulnar entheses. Articular cartilage was noted to extend to the most proximal part of the bulbous portion of the distal ulna and corresponding axial aspect of the distal radius.
CONCLUSIONS AND RELEVANCE
In the cat, there appears to be a less extensive interosseous component of the distal radioulnar ligament compared with the dog and cheetah. Instead, the ligament follows the articular surfaces of the distal radius and ulna. These anatomical differences may account for increased rotation of the feline antebrachium and have clinical implications, particularly with regard to the management of antebrachiocarpal joint injuries.
Topics: Cats; Animals; Dogs; Biomechanical Phenomena; Cadaver; Ulna; Radius; Ligaments; Cat Diseases; Dog Diseases
PubMed: 36779780
DOI: 10.1177/1098612X221149382