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1.
Anat Histol Embryol ; 53(4): e13087, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38965910

RESUMEN

Scottish Fold cats (Felis catus, Linnaeus 1758) are one of the most well-known and popular cat breeds in the world, characterized by their folded ears attached to the head. Very frequently, cats fall prey of different trauma and accidents that can cause bone fractures especially in the metapodial bones. The method of radiometry is used in veterinary practice to visualize and measure different parts of the animal skeleton. The aim of this study was to assess the linear parameters derived from radiographic images of the metacarpals and metatarsals in Scottish Fold cats and additionally detecting potential sexual dimorphism. Radiographic images of 24 adult Scottish Fold cats (12 male and 12 females) of different ages and weights were analysed. Six linear measurements of the metapodial bones were evaluated to investigate any differences between the sexes. The linear radiometric measurements of the five metacarpals (MC1-5) and the four metatarsals (MT2-5) bones were larger in male metapodial bones than that of female cats. The maximum length (Ml) of the MC1 and MC2 was statistically different between sex, respectively, (p = 0.001) and (p = 0.05). The others metacarpal bones were different in mostly all linear parameters but not statistically significant. The most significant differences between sexes were observed in the parameter of width proximal end (Wp) of MC1-3 (p = 0.001) and MC4 (p = 0.05). More statistical different was MT2 and less MT3. The linear parameter of Bd of the MT4 was the most different statistically between sex (p = 0.001). The results of the study will be useful in function of comparative anatomy, in veterinary clinical practice, in zoo archaeology and in the veterinary forensic investigation.


Asunto(s)
Huesos del Metacarpo , Huesos Metatarsianos , Animales , Gatos/anatomía & histología , Masculino , Femenino , Huesos del Metacarpo/anatomía & histología , Huesos del Metacarpo/diagnóstico por imagen , Huesos Metatarsianos/anatomía & histología , Huesos Metatarsianos/diagnóstico por imagen , Radiografía/veterinaria , Caracteres Sexuales
2.
Med Sci Monit ; 30: e943537, 2024 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-38954596

RESUMEN

BACKGROUND The Lisfranc ligament is crucial for maintaining the transverse and longitudinal arch of the foot. Owing to the disruption between the medial cuneiform bone and the base of the second metatarsal bone, the currently preferred fixation method remains controversial. Our fixation technique involves screwing one anchor to the medial and intermediate cuneiform bones and using the anchor to carry the ligament to bind the Lisfranc joint and first and second metatarsal joints altogether for elastic fixation. This study evaluated the clinical and functional outcomes of InternalBrace fixation for Lisfranc injury. MATERIAL AND METHODS This retrospective study included 58 patients who underwent InternalBrace fixation for Lisfranc injury between January 2019 and September 2022 by an experienced surgeon. One-way analysis of variance or t test was used. Preoperative classification was performed according to the Myerson classification with imaging data. Postoperative follow-up was performed based on intraoperative blood loss, fracture healing time, visual analog scale (VAS) score, the American Orthopedic Foot and Ankle Society (AOFAS) score, Tegner score, and complications. RESULTS Surgery was completed in all patients, and follow-up was performed. The patients' ages ranged from 19 to 62 years (average: 34.6±9.4 years). The postoperative follow-up time was 12-24 months (average: 16.9±3.0 months). The average time for fracture healing was 12.8±3.0 (10-24) weeks. The VAS, AOFAS, and Tegner scores significantly improved postoperatively (from 5.33±1.0 (3-7) to 1.24±0.57 (0-2); 28.02±6.70 (18-51) to 91.59±4.76 (82-96); and 2.40±0.67 (1-4) to 6.53±0.54 (6-7), respectively), which was statistically significant (P<0.01), and the good rate of AOFAS was 91.4%. The postoperative complications were traumatic arthritis, incision infection, and temporary dorsal foot numbness, which gradually recovered. No other rejection reactions or Lisfranc fracture/dislocations recurrence occurred during the follow-up period. CONCLUSIONS InternalBrace fixation for Lisfranc injury is beneficial for restoring Lisfranc joint stability and function and allows for early and more aggressive rehabilitation for patients, with fewer surgical complications.


Asunto(s)
Fijación Interna de Fracturas , Huesos Metatarsianos , Humanos , Estudios Retrospectivos , Adulto , Femenino , Masculino , Persona de Mediana Edad , Fijación Interna de Fracturas/métodos , Huesos Metatarsianos/cirugía , Huesos Metatarsianos/lesiones , Adulto Joven , Traumatismos de los Pies/cirugía , Resultado del Tratamiento , Ligamentos Articulares/cirugía , Ligamentos Articulares/lesiones
3.
J Orthop Trauma ; 38(8S): S14-S15, 2024 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-39007635

RESUMEN

VIDEO AVAILABLE AT: https://ota.org/education/ota-online-resources/video-library-procedures-techniques/lisfranc-open-reduction-and.


Asunto(s)
Fijación Interna de Fracturas , Humanos , Fijación Interna de Fracturas/métodos , Fijación Interna de Fracturas/instrumentación , Reducción Abierta/métodos , Huesos Metatarsianos/cirugía
4.
Sci Rep ; 14(1): 15321, 2024 07 03.
Artículo en Inglés | MEDLINE | ID: mdl-38961097

RESUMEN

The forced turnout has a perceived risk of development of hallux valgus (HV) in ballet dancers. We determined how the forced turnout affects the sagittal mobility of the first tarsometatarsal (TMT) joint, which is one of the pathogenic factors of HV development. Seventeen female ballet dancers (body mass index: 18.2 ± 1.8 kg/m2) were included and performed demi-plié in control, functional turnout, and forced turnout conditions. Ultrasound imaging synchronized with a three-dimensional motion analysis system was used for measuring the vertical locations of the first metatarsal and medial cuneiform (MC) to evaluate the first TMT joint mobility. Plantar displacement of MC and the first TMT joint mobility in the forced turnout were the greatest among the 3 conditions. Multiple regression analysis indicated that the greater extent of the forcing angle might increase the displacement of MC and the first TMT joint mobility. Evaluating the sagittal mobility of the first TMT joint in the forced turnout can assist in understanding the association between inappropriate techniques including the forced turnout and HV development in ballet dancers. Since the excessive mobility of the first TMT joint is a factor in HV development, the acquirement of adequate active turnout may have the potential to prevent HV development in ballet dancers.


Asunto(s)
Baile , Rango del Movimiento Articular , Humanos , Femenino , Adulto Joven , Rango del Movimiento Articular/fisiología , Hallux Valgus/fisiopatología , Hallux Valgus/diagnóstico por imagen , Adulto , Huesos Metatarsianos/fisiología , Huesos Metatarsianos/diagnóstico por imagen , Fenómenos Biomecánicos , Ultrasonografía
5.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 38(7): 855-861, 2024 Jul 15.
Artículo en Chino | MEDLINE | ID: mdl-39013824

RESUMEN

Objective: To compare the effectiveness of small incision external articular minimally invasive osteotomy and traditional Chevron osteotomy in the treatment of hallux valgus. Methods: A retrospective analysis was conducted on the clinical data of 58 patients (58 feet) with hallux valgus who were admitted between April 2019 and June 2022 and met the selection criteria. Among them, 28 cases were treated with small incision external articular minimally invasive osteotomy (minimally invasive group), and 30 cases were treated with traditional Chevron osteotomy (traditional group). There was no significant difference in baseline data such as age, gender, disease duration, Mann classification, and preoperative inter metatarsal angle (IMA), hallux valgus angle (HVA), distal metatarsal articular angle (DMAA), forefoot width, tibial sesamoid position (TSP) score, American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score, visual analogue scale (VAS) score, psychological score (SF-12 MCS score) and physiological score (SF-12 PCS score) of short-form 12 health survey scale, and range of motion (ROM) of metatarsophalangeal joint between the two groups ( P>0.05). The incision length, operation time, intraoperative blood loss, intraoperative fluoroscopy frequency, weight-bearing walking time, fracture healing time, and incidence of complications were recorded and compared between the two groups; as well as the changes of imaging indexes at last follow-up, and the clinical function score and ROM of metatarsophalangeal joint before operation, at 6 weeks after operation, and at last follow-up. Results: All patients were followed up 11-31 months, with an average of 22 months. The incision length and intraoperative blood loss in the minimally invasive group were significantly less than those in the traditional group ( P<0.05), and the intraoperative fluoroscopy frequency and operation time in the minimally invasive group were significantly more than those in the traditional group ( P<0.05); but no significant difference was found in weight-bearing walking time and fracture healing time between the two groups ( P>0.05). There was 1 case of skin injury in the minimally invasive group and 3 cases of poor incision healing in the traditional group; all patients had good healing at the osteotomy site, and no complication such as infection, nerve injury, or metatarsal head necrosis occurred. At last follow-up, the imaging indexes of the two groups significantly improved when compared with those before operation ( P<0.05). The changes of DMAA and TSP score in the minimally invasive group were significantly better than those in the traditional group ( P<0.05), and there was no significant difference in the changes of IMA, HVA, and forefoot width between the two groups ( P>0.05). The clinical scores and ROM of metatarsophalangeal joint significantly improved in the two groups at 6 weeks after operation and at last follow-up when compared with preoperative ones ( P<0.05), and the indicators in the minimally invasive group were significantly better than those in the traditional group ( P<0.05). Conclusion: Compared with traditional Chevron osteotomy, small incision external articular minimally invasive osteotomy can effectively improve HVA, IMA, and forefoot width, correct foot deformities, and has less trauma. It can better correct the first metatarsal pronation deformity and restore the anatomical position of the sesamoid bone, resulting in better effectiveness.


Asunto(s)
Hallux Valgus , Procedimientos Quirúrgicos Mínimamente Invasivos , Osteotomía , Humanos , Osteotomía/métodos , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Hallux Valgus/cirugía , Resultado del Tratamiento , Rango del Movimiento Articular , Huesos Metatarsianos/cirugía , Masculino , Femenino , Estudios Retrospectivos
6.
Microcirculation ; 31(5): e12860, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38837938

RESUMEN

OBJECTIVE: Diabetic foot ulcer (DFU) is a severe complication with high mortality. High plantar pressure and poor microcirculation are considered main causes of DFU. The specific aims were to provide a novel technique for real-time measurement of plantar skin blood flow (SBF) under walking-like pressure stimulus and delineate the first plantar metatarsal head dynamic microcirculation characteristics because of life-like loading conditions in healthy individuals. METHODS: Twenty young healthy participants (14 male and 6 female) were recruited. The baseline (i.e., unloaded) SBF of soft tissue under the first metatarsal head were measured using laser Doppler flowmetry (LDF). A custom-made machine was utilized to replicate daily walking pressure exertion for 5 min. The exerted plantar force was adjusted from 10 N (127.3 kPa) to 40 N (509.3 kPa) at an increase of 5 N (63.7 kPa). Real-time SBF was acquired using the LDF. After each pressure exertion, postload SBF was measured for comparative purposes. Statistical analysis was performed using the R software. RESULTS: All levels of immediate-load and postload SBF increased significantly compared with baseline values. As the exerted load increased, the postload and immediate-load SBF tended to increase until the exerted load reached 35 N (445.6 kPa). However, in immediate-load data, the increasing trend tended to level off as the exerted pressure increased from 15 N (191.0 kPa) to 25 N (318.3 kPa). For postload and immediate-load SBF, they both peaked at 35 N (445.6 kPa). However, when the exerted force exceeds 35 N (445.6 kPa), both the immediate-load and postload SBF values started to decrease. CONCLUSIONS: Our study offered a novel real-time plantar soft tissue microcirculation measurement technique under dynamic conditions. For the first metatarsal head of healthy people, 20 N (254.6 kPa)-plantar pressure has a fair microcirculation stimulus compared with higher pressure. There might be a pressure threshold at 35 N (445.6 kPa) for the first metatarsal head, and soft tissue microcirculation may decrease when local pressure exceeds it.


Asunto(s)
Pie , Microcirculación , Piel , Humanos , Masculino , Femenino , Microcirculación/fisiología , Adulto , Piel/irrigación sanguínea , Piel/fisiopatología , Pie/irrigación sanguínea , Presión , Huesos Metatarsianos/irrigación sanguínea , Huesos Metatarsianos/fisiopatología , Flujometría por Láser-Doppler/métodos , Adulto Joven , Caminata/fisiología , Pie Diabético/fisiopatología
7.
Clin J Sport Med ; 34(4): 396-399, 2024 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-38914100

RESUMEN

ABSTRACT: A 21-year-old African American Division 1 female sprinter presented with 3-weeks history of right great toe and forefoot pain, fatigue, and a 30-day continuous menstrual cycle despite implanted etonogestrel (Nexplanon) inserted 3 years prior. An magnetic resonance imagine (MRI) identified likely stress fracture of the second metatarsal base with a diffusely low T1 signal indicating hyperactive red marrow. Due to persistent pain, a follow-up MRI was ordered 6 months later and indicated serous atrophy of the bone marrow, prompting a further metabolic workup notable for triglycerides exceeding 4000 mg/dL and a hemoglobin A1c of 10.9%. This case highlights the manifestation of a rare congenital lipodystrophy that initially presented as a relatively classic stress fracture and metrorrhagia in a female athlete.


Asunto(s)
Lipodistrofia Generalizada Congénita , Humanos , Femenino , Lipodistrofia Generalizada Congénita/diagnóstico , Adulto Joven , Imagen por Resonancia Magnética , Fracturas por Estrés/diagnóstico por imagen , Fracturas por Estrés/etiología , Carrera/lesiones , Huesos Metatarsianos/lesiones , Huesos Metatarsianos/anomalías , Huesos Metatarsianos/diagnóstico por imagen
8.
Sci Rep ; 14(1): 13547, 2024 06 12.
Artículo en Inglés | MEDLINE | ID: mdl-38866886

RESUMEN

This study aimed to elucidate the relationship between joint structures of the first tarsometatarsal and articular facet degeneration. A total of 100 feet from 50 cadavers were examined. The articular facets of the first metatarsal and medial cuneiform were categorized into four types based on the superior and inferior facets' separation, and the formation of the inferior lateral facet on the lateral plantar prominence: Type I, a single facet with no separation or inferior lateral facet; Type II-a, two facets with separation but no inferior lateral facet; Type II-b, two facets, no separation, but with an inferior lateral facet; Type III, three facets with separation and an inferior lateral facet. When both bone types matched, they were defined as Type I, Type II-a, Type II-b, and Type III joints, respectively; unmatched types were classified as Unpair joints. The severity of articular cartilage degeneration on both bones was assessed using a 5-point scale. The degeneration grade was compared among joint types. Type III joints exhibited significantly milder articular cartilage degeneration in medial cuneiform compared to Type II-a, II-b, Unpair joints. The formation of inferior lateral facet and separation of the superior and inferior facets might be crucial for the joint's stability.


Asunto(s)
Cadáver , Humanos , Femenino , Masculino , Anciano , Persona de Mediana Edad , Anciano de 80 o más Años , Cartílago Articular/patología , Huesos Metatarsianos/patología , Huesos Metatarsianos/anatomía & histología , Articulaciones Tarsianas/patología , Articulaciones Tarsianas/anatomía & histología , Articulaciones del Pie/patología
9.
Adv Skin Wound Care ; 37(6): 1-8, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38767428

RESUMEN

BACKGROUND: In the literature, there is no consensus regarding the surgical management of postaxial polydactyly, and few cases of polymetatarsia with polydactyly have been reported. Treatment of the complete deformity will prevent further foot and gait disorders. OBJECTIVE: To identify literature relevant to the operative management of Y-shaped metatarsal with biphalangeal sixth toe and related skin and wound care to improve surgical treatment protocols from a clinical experience perspective. DATA SOURCES: The authors searched several electronic databases in December 2022 for articles related to postaxial polysyndactyly in the feet and polymetatarsia. Databases searched included PubMed, SciELO, ScienceDirect, Cochrane Database of Systematic Reviews, and Google Scholar gray literature. STUDY SELECTION: Two independent researchers conducted the searches and read the article titles and abstracts. Studies were included if they were narrative reviews, case studies, or observational studies; written in English or Spanish; and published between 2012 and 2022. Nonhuman studies were excluded. Studies that met the inclusion criteria were fully evaluated. Disagreements between reviewers were resolved by consensus, and when there was no consensus, a senior researcher was consulted. DATA EXTRACTION: The following data were extracted from the included studies using a standardized form: author and year of publication, study type, number of participants, sex, polydactyly location, polymetatarsia, type of polydactyly, participants' history of hereditary associated diseases or malformations, treatment, removal criteria, and timing of surgery. DATA SYNTHESIS: Authors evaluated 11 studies of postaxial polydactyly that included a total of 153 participants (64 men, 89 women). They also document their clinical experience with a surgical technique used in cases of bilateral postaxial polydactyly of the foot with a Y-shaped metatarsal with biphalangeal sixth toe. CONCLUSIONS: Surgical correction with lateral removal of the sixth toe is a resolutive treatment to improve the functionality of the foot, its aesthetic appearance, and the patient's quality of life. Case-specific treatment should be applied and tailored to meet the individual needs. The biomechanics of gait and shoe problems in these patients improve with surgical treatment, without presenting secondary aesthetic problems in skin care.


Asunto(s)
Huesos Metatarsianos , Polidactilia , Humanos , Huesos Metatarsianos/anomalías , Huesos Metatarsianos/cirugía , Polidactilia/cirugía , Dedos del Pie/anomalías , Dedos del Pie/cirugía , Femenino , Masculino , Dedos/anomalías
10.
PLoS One ; 19(5): e0277582, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38743739

RESUMEN

Although a fifth metatarsal stress fracture is the most frequent stress fracture in soccer players, awareness of fifth metatarsal stress fractures among soccer coaches is unclear. Therefore, we performed an online survey of soccer coaches affiliated with the Japan Football Association to assess their awareness of fifth metatarsal stress fractures. A total of 150 soccer coaches were invited for an original online survey. Data on participants' age, sex, types of coaching licence, coaching category, types of training surface, awareness of fifth metatarsal stress fractures, and measures employed to prevent fifth metatarsal stress fractures were collected using the survey. Data from 117 coaches were analysed. Eighty-seven of the 117 coaches were aware of fifth metatarsal stress fractures; however, only 30% reported awareness of preventive and treatment measures for fifth metatarsal stress fractures. Licensed coaches (i.e., licensed higher than level C) were also more likely to be aware of fifth metatarsal stress fractures than unlicensed coaches were. Furthermore, although playing on artificial turf is an established risk factor for numerous sports injuries, soccer coaches who usually trained on artificial turf were more likely to be unaware of the risks associated with fifth metatarsal stress fractures than coaches who trained on other surfaces were (e.g., clay fields). Soccer coaches in the study population were generally aware of fifth metatarsal stress fractures; however, most were unaware of specific treatment or preventive training strategies for fifth metatarsal stress fractures. Additionally, coaches who practised on artificial turf were not well educated on fifth metatarsal stress fractures. Our findings suggest the need for increased awareness of fifth metatarsal stress fractures and improved education of soccer coaches regarding injury prevention strategies. .


Asunto(s)
Fracturas por Estrés , Huesos Metatarsianos , Fútbol , Humanos , Fútbol/lesiones , Fracturas por Estrés/prevención & control , Fracturas por Estrés/epidemiología , Japón/epidemiología , Estudios Transversales , Adulto , Masculino , Huesos Metatarsianos/lesiones , Femenino , Persona de Mediana Edad , Encuestas y Cuestionarios , Traumatismos en Atletas/prevención & control , Traumatismos en Atletas/epidemiología , Adulto Joven , Conocimientos, Actitudes y Práctica en Salud
11.
Clin Podiatr Med Surg ; 41(3): 379-389, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38789159

RESUMEN

Metatarsal fractures are some of the most common fractures reported in the human body. Recent advances in surgical techniques and fixation have helped facilitate healing and improved outcomes for our patients. The treatment goals of metatarsal fractures are to maintain the metatarsal parabola, sagittal position of the metatarsal heads, and a congruent metatarsophalangeal joint. Most of these injuries can be treated nonoperatively, but displaced fractures require surgical intervention to preserve normal gait biomechanics.


Asunto(s)
Fijación Interna de Fracturas , Fracturas Óseas , Huesos Metatarsianos , Humanos , Huesos Metatarsianos/lesiones , Huesos Metatarsianos/cirugía , Fracturas Óseas/cirugía , Fracturas Óseas/terapia , Fijación Interna de Fracturas/métodos , Curación de Fractura/fisiología , Masculino
12.
Clin Podiatr Med Surg ; 41(3): 391-405, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38789160

RESUMEN

Fifth metatarsal features are the most common fractures in the foot. They have a long history that has resulted in many classification systems and little consensus on appropriate treatment. Although there is some agreement among experts, there are also many questions yet to be answered. There is a general consensus that dancer's fractures and zone 1 fractures can generally be treated nonoperatively. There is much more debate about zone 2 and 3 fractures and appropriate treatment guidelines. The authors review the current literature and give the recommendation for treatment based on their experience in a community-based private practice.


Asunto(s)
Fracturas Óseas , Huesos Metatarsianos , Humanos , Huesos Metatarsianos/lesiones , Fracturas Óseas/terapia , Fracturas Óseas/clasificación , Fijación Interna de Fracturas/métodos , Traumatismos de los Pies/terapia
13.
Clin Podiatr Med Surg ; 41(3): 407-423, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38789161

RESUMEN

Lisfranc injuries were thought to primarily occur during high-energy events, leading to a preference for fusion treatment; however, recent data have shifted this perspective by highlighting a greater occurrence of low-energy injuries and reshaping the focus on open reduction internal fixation. This multifaceted process is guided by various factors, including the nature of the injury, specific anatomic considerations, and the involved joints. Our overarching goal remains to achieve anatomic reduction, with flexibility in hardware fixation methods. In cases of comminution, bridge plating may be warranted, potentially followed by arthrodesis in the future.


Asunto(s)
Traumatismos de los Pies , Fijación Interna de Fracturas , Humanos , Masculino , Artrodesis/métodos , Placas Óseas , Traumatismos de los Pies/cirugía , Traumatismos de los Pies/diagnóstico por imagen , Fijación Interna de Fracturas/métodos , Fracturas Óseas/cirugía , Fracturas Óseas/diagnóstico por imagen , Huesos Metatarsianos/lesiones , Huesos Metatarsianos/cirugía , Reducción Abierta/métodos
14.
Acta Ortop Mex ; 38(2): 109-112, 2024.
Artículo en Español | MEDLINE | ID: mdl-38782477

RESUMEN

Epiphyseal fractures of the metatarsal head are a rare entity specially as an isolated injury and is rarely seen in patients with skeletal immaturity. Due lack of documentation for this type of fracture, the treatment of choice is uncertain. The purpose of the present study is to present two cases and treatment of epiphyseal fracture of the second metatarsal head, to our knowledge there are no publications for this injury.


Las fracturas epifisarias de la cabeza metatarsiana son una entidad poco frecuente, principalmente cuando se presentan de forma aislada y en raras ocasiones se ven en pacientes con inmadurez esquelética. Debido a la escasez de documentación para este tipo de fractura, el tratamiento de elección es incierto. El motivo del presente estudio es presentar dos casos de fractura epifisaria de la cabeza del segundo metatarsiano y su tratamiento, ya que para nuestro conocimiento no hay publicaciones al respecto.


Asunto(s)
Epífisis , Fracturas Óseas , Huesos Metatarsianos , Humanos , Huesos Metatarsianos/lesiones , Huesos Metatarsianos/diagnóstico por imagen , Adolescente , Fracturas Óseas/cirugía , Fracturas Óseas/diagnóstico por imagen , Masculino , Epífisis/lesiones , Femenino
15.
Int Orthop ; 48(8): 2153-2163, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38705891

RESUMEN

PURPOSE: To date, the surgical treatment of severe hallux valgus deformity remains challenging despite the various methods presented. This study aimed to compare the effectiveness of minimally invasive distal chevron Akin osteotomies (d-MICA) and minimally invasive proximal chevron Akin osteotomies (p-MICA) in correcting severe hallux valgus deformities. METHODS: This prospective follow-up study included patients randomly assigned to undergo p-MICA or d-MICA for hallux valgus deformities with a preoperative hallux valgus angle (HVA) ≥ 40° and/or a first to second intermetatarsal angle (IMA) ≥ 16°. After a minimum follow-up period of two years, we compared various clinico-radiographic parameters of patients whose HVA exceeded 15° at the final follow-up. RESULTS: In the p-MICA and d-MICA groups, seven of 40 cases (17.5%) and 16 of 41 cases (39.0%), respectively, exhibited HVA > 15° at the final follow-up (P = 0.048). The preoperative parameters showed no significant differences. However, at the first weight-bearing assessment, the HVA, IMA, and relative second metatarsal length were significantly smaller, and the distal metatarsal articular angle (DMAA) was greater in the p-MICA group (all P < 0.05) compared with the d-MICA group. Postoperatively, both groups exhibited significant decreases in HVA and IMA at the final follow-up (P < 0.001 for all parameters). The p-MICA group showed no significant changes in DMAA and the relative length of the second metatarsal (P = 0.253 and 0.185, respectively). However, the d-MICA group showed a significant decrease in DMAA (P < 0.001) and an increase in the relative length of the second metatarsal at the final follow-up (P = 0.01). CONCLUSIONS: p-MICA and d-MICA procedures demonstrated effective correction potential for severe hallux valgus deformities; however, the d-MICA procedure exhibited a notably higher incidence of unsatisfactory correction at the final follow-up than p-MICA. Therefore, d-MICA may be less predictable in achieving successful outcomes than p-MICA in treating severe hallux valgus deformities.


Asunto(s)
Hallux Valgus , Procedimientos Quirúrgicos Mínimamente Invasivos , Osteotomía , Humanos , Hallux Valgus/cirugía , Hallux Valgus/diagnóstico por imagen , Osteotomía/métodos , Masculino , Femenino , Estudios Prospectivos , Persona de Mediana Edad , Resultado del Tratamiento , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Adulto , Estudios de Seguimiento , Radiografía/métodos , Anciano , Huesos Metatarsianos/cirugía
16.
Clin Orthop Surg ; 16(2): 335-341, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38562636

RESUMEN

Background: Jones fractures are common injuries that can be treated conservatively or surgically. However, the optimal treatment approach remains controversial. This study aimed to compare the clinical outcomes of conservative and operative treatments for Jones fractures and determine whether surgical treatment is necessary. Methods: A retrospective study was conducted on 69 patients with Jones fractures treated at our hospital. The patients were divided into 2 groups: conservative (C group; n = 46) and operative (O group; n = 23) treatments. Patients were followed up after 2, 6, and 12 weeks, and every 3 months thereafter. However, outpatient follow-ups were conducted between 8 and 10 weeks as needed. The mean follow-up period was 14.5 weeks (range, 12-24 weeks). In group C, the patients were treated with a non-weight-bearing cast for 4-6 weeks, followed by additional weight-bearing boot immobilization before returning to exercise. In group O, patients were treated surgically using a bicortical screw or intramedullary internal fixation. Time to radiologic union, clinical union, return to sports, visual analog scale (VAS), Foot Function Index-Revised Short Form (FFI-RS), and American Orthopedic Foot and Ankle Society (AOFAS) scores were evaluated. Results: Sixty-nine patients were included in the analysis. There were statistically significant differences in the time to radiologic union and return to sports, VAS score in the second week, and FFI-RS score in the 12th week. In group C, favorable outcomes were observed in terms of the time to return to sports, VAS score in the second week, and FFI-RS score in the 12th week. Contrastingly, in group O, better results were observed in time to radiologic union. The AOFAS score was excellent at the final follow-up, with no significant differences between groups. Complication rates were 10.8% and 13% in groups C and O, respectively. Conclusions: Surgical treatment is sometimes necessary for Jones fractures, but conservative treatment should also be considered because of the favorable outcomes. Conservative treatment can be a good option for patients who are risk-averse and place a high value on fracture healing without surgery.


Asunto(s)
Fracturas Óseas , Huesos Metatarsianos , Humanos , Estudios Retrospectivos , Resultado del Tratamiento , Huesos Metatarsianos/cirugía , Fracturas Óseas/diagnóstico por imagen , Fracturas Óseas/cirugía , Fijación Interna de Fracturas/métodos
17.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi ; 38(4): 444-447, 2024 Apr 15.
Artículo en Chino | MEDLINE | ID: mdl-38632064

RESUMEN

Objective: To explore the effectiveness of transverse double "8"-shaped tension band technique in the treatment of Lawrence zoneⅠfracture of the 5th metatarsal base. Methods: Between February 2019 and October 2021, 15 patients with Lawrence zoneⅠfracture of the 5th metatarsal base were treated with transverse double "8"-shaped tension band technique. There were 8 males and 7 females, with a median age of 40 years (range, 23-59 years). The fractures were caused by sprains. The time from injury to operation was 3-7 days (mean, 4.1 days). X-ray films were taken to observe the fracture healing and the anchor looseness and detachment. The foot function was evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) score, visual analogue scale (VAS) score, and the eversion angle of the calcaneal talus joint. Results: The incisions healed by first intention after operation in 14 cases and the incision healed poorly in 1 case. All patients were followed up 8-12 months (median, 10 months). The imaging examination showed that all fractures healed well, with a healing time of 10-14 weeks (mean, 11.7 weeks). At last follow-up, AOFAS score was 82-100 (median, 98); 13 cases were excellent and 2 cases were good, with an excellent and good rate of 100%. VAS score was 0-3 (median, 1). Three cases had mild limited ankle joint range of motion, while 12 cases had normal range of motion. The eversion angle of the calcaneal talus joint was 25°-32° (median, 30°). Conclusion: The application of transverse double "8"-shaped tension band technique for Lawrence zone Ⅰ fracture of the 5th metatarsal base has advantages such as simple operation, avoidance of secondary operation, and reduction of foreign body sensation, with definite effectiveness.


Asunto(s)
Fracturas Óseas , Huesos Metatarsianos , Herida Quirúrgica , Masculino , Femenino , Humanos , Adulto Joven , Adulto , Persona de Mediana Edad , Huesos Metatarsianos/cirugía , Fijación Interna de Fracturas/métodos , Resultado del Tratamiento , Fracturas Óseas/cirugía , Articulación del Tobillo/cirugía
18.
Animal ; 18(4): 101129, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38574453

RESUMEN

The growth and development of chicken bones have an enormous impact on the health and production performance of chickens. However, the development pattern and genetic regulation of the chicken skeleton are poorly understood. This study aimed to evaluate metatarsal bone growth and development patterns in chickens via non-linear models, and to identify the genetic determinants of metatarsal bone traits using a genome-wide association study (GWAS) based on growth curve parameters. Data on metatarsal length (MeL) and metatarsal circumference (MeC) were obtained from 471 F2 chickens (generated by crossing broiler sires, derived from a line selected for high abdominal fat, with Baier layer dams) at 4, 6, 8, 10, and 12 weeks of age. Four non-linear models (Gompertz, Logistic, von Bertalanffy, and Brody) were used to fit the MeL and MeC growth curves. Subsequently, the estimated growth curve parameters of the mature MeL or MeC (A), time-scale parameter (b), and maturity rate (K) from the non-linear models were utilized as substitutes for the original bone data in GWAS. The Logistic and Brody models displayed the best goodness-of-fit for MeL and MeC, respectively. Single-trait and multi-trait GWASs based on the growth curve parameters of the Logistic and Brody models revealed 4 618 significant single nucleotide polymorphisms (SNPs), annotated to 332 genes, associated with metatarsal bone traits. The majority of these significant SNPs were located on Gallus gallus chromosome (GGA) 1 (167.433-176.318 Mb), GGA2 (96.791-103.543 Mb), GGA4 (65.003-83.104 Mb) and GGA6 (64.685-95.285 Mb). Notably, we identified 12 novel GWAS loci associated with chicken metatarsal bone traits, encompassing 35 candidate genes. In summary, the combination of single-trait and multi-trait GWASs based on growth curve parameters uncovered numerous genomic regions and candidate genes associated with chicken bone traits. The findings benefit an in-depth understanding of the genetic architecture underlying metatarsal growth and development in chickens.


Asunto(s)
Estudio de Asociación del Genoma Completo , Huesos Metatarsianos , Animales , Estudio de Asociación del Genoma Completo/veterinaria , Pollos/genética , Sitios de Carácter Cuantitativo , Fenotipo , Genómica , Polimorfismo de Nucleótido Simple
19.
Vet Rec ; 194(8): e4069, 2024 04 20.
Artículo en Inglés | MEDLINE | ID: mdl-38578296

RESUMEN

BACKGROUND: Data regarding the lesion detection ability of different radiotracers are lacking in equine bone scintigraphy. METHODS: In this prospective study, hydroxymethylene diphosphonate (HMDP) and methylene diphosphonate (MDP) were compared in horses with increased radiopharmaceutical uptake either in the caudal cervical region (CS group) or in the proximal metacarpal/metatarsal region (PMR group). Region of interest analysis was used to determine normal bone-to-soft tissue ratios, lesion-to-normal bone ratios and lesion-to-soft tissue ratios. Qualitative scoring and total count rates were recorded for each image. RESULTS: A total of 213 scintigrams were included. Within the PMR group, there were significantly higher lesion-to-normal bone ratios for MDP compared with HMDP (p = 0.02). In the CS group, normal bone-to-soft tissue ratios were significantly higher for HMDP (p = 0.01). The interobserver agreement with regard to the qualitative assessment of the scintigrams was poor. LIMITATION: Paired studies, comparing the different radiotracers in the same patient, were not feasible. CONCLUSION: This study revealed minor differences between the two radiotracers, although these have no practical implications. Both radiopharmaceuticals are well suited for detecting lesions at the investigated sites using equine bone scintigraphy.


Asunto(s)
Huesos del Metacarpo , Huesos Metatarsianos , Animales , Caballos , Medronato de Tecnecio Tc 99m , Cintigrafía , Huesos del Metacarpo/diagnóstico por imagen , Estudios Prospectivos , Difosfonatos , Radiofármacos
20.
BMC Musculoskelet Disord ; 25(1): 275, 2024 Apr 09.
Artículo en Inglés | MEDLINE | ID: mdl-38589840

RESUMEN

BACKGROUND: Osteochondromas, classified as a new benign subtype of lipomas and characterised by chondroid and osseous differentiation, are rare lesions that have been infrequently reported in previous literature. The maxillofacial region was reported as the most frequent localization, with infrequent occurrence in the lower limb. This paper represents the first documented case report of osteochondrolipoma in the foot. CASE PRESENTATION: A 51-year-old male patient presented with a chief complaint of right foot pain at the plantar aspect, accompanied by the observation of swelling between the first and the second metatarsal shafts. His complaint of pain and swelling started 10 and 4 years prior, respectively. Since their onset, both symptoms have progressed in nature. Imaging revealved a large mass exhibiting a nonhomogenous composition of fibrous tissue and bony structures. Surgical intervention through total excision was indicated. CONCLUSION: Osteochodrolipoma is a benign lesion that can affect the foot leading to decreased functionality of the foot due to the pain and swelling. Surgical excision is the recommended approach for this lesion, providing both symptomatic relief and confirmation of the diagnosis through histopathological examination.


Asunto(s)
Neoplasias Óseas , Huesos Metatarsianos , Osteocondroma , Masculino , Humanos , Persona de Mediana Edad , Huesos Metatarsianos/patología , Osteocondroma/diagnóstico por imagen , Osteocondroma/cirugía , Osteocondroma/patología , Extremidad Inferior/patología , Neoplasias Óseas/diagnóstico por imagen , Neoplasias Óseas/cirugía , Dolor
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