A comparison of effectiveness of sex estimation from the calcaneus and talus in a Thai population / Comparación de la efectividad de la estimación del sexo a partir del calcáneo y el talus en una población tailandesa

SUMMARY: Sex estimation is an important aspect of skeletal identification. In addition, previous studies have found that the sex estimation of each race is different. Thus, it is necessary to develop discriminant function equations for the estimation of sex for the Thai population. This study aims to investigate the relationship between width, length and height of the calcaneus and talus with regards to sex and compare the effectiveness of sex estimation between the calcaneus alone, the talus alone, and between both the calcaneus and talus. A total of 200 individuals (100 males and 100 females) were used in this study; ages ranged from 19 to 94 years. Thirteen variables of calcaneus and ten variables of talus were measured. The authors created discriminant function equations for the estimation of sex and tested the efficiency of the equations obtained by using a test group of 40 individuals (20 males and 20 females). By analyzing the mean values of the variables in the calcaneus and the talus, it was shown that males were significantly different from females (p0.05). A stepwise method was used to create 6 equations for sex estimation. The equations were categorized from between the calcaneus alone, the talus alone, and between both the calcaneus and the talus, providing a sex estimation accuracy of between 88.5 and 93.0 %. Using the test group, it was shown that discriminant function equations from the calcaneus alone, the talus alone, and the calcaneus and the talus together, can estimate sex at a high level of accuracy. Sex estimation accuracy was greater than 85 % in all equations. Therefore, the discriminant function equations from the calcaneus alone, the talus alone, and between both the calcaneus and the talus, from this study can be applied to the Thai population.

La estimación del sexo es un aspecto importante de la identificación esquelética. Estudios previos han encontrado que la estimación del sexo de cada raza es diferente. Por lo tanto, es necesario desarrollar ecuaciones de funciones discriminantes para la estimación del sexo de la población tailandesa. Este estudio tuvo como objetivo investigar la relación entre el ancho, el largo y la altura de los huesos calcáneo y talus con respecto al sexo y comparar la efectividad de la estimación del sexo entre el calcáneo solo, el talus solo y entre el calcáneo y el talus. Se utilizaron un total de 200 huesos de individuos adultos (100 hombres y 100 mujeres), cuyas edades oscilaron entre 19 y 94 años. Se midieron trece variables del calcáneo y diez variables del talus. Los autores crearon ecuaciones de funciones discriminantes para la estimación del sexo y probaron la eficiencia de ellas usando un grupo de prueba de huesos de 40 individuos (20 hombres y 20 mujeres). Al analizar los valores medios de las variables en el calcáneo y el talus, se demostró que los huesos de los hombres eran significativamente diferentes al de las mujeres (p0.05). Se utilizó un método paso a paso para crear 6 ecuaciones para la estimación del sexo. Las ecuaciones se clasificaron entre el calcáneo solo, el talus solo y entre el calcáneo y el talus, lo que proporcionó una precisión de estimación del sexo de entre 88,5 y 93,0 %. Usando el grupo de prueba, se demostró que las ecuaciones de funciones discriminantes del calcáneo solo, el talus solo y el calcáneo y el talus juntos pueden estimar el sexo con un alto nivel de precisión. La precisión de la estimación del sexo fue superior al 85 % en todas las ecuaciones. Por lo tanto, las ecuaciones de la función discriminante del calcáneo solo, el talus solo y entre el calcáneo y el talus de este estudio se pueden aplicar a la población tailandesa.

Investigation of the relationship between foot deformities and radiographic measurements of the talus and calcaneus / Investigación de la relación entre las deformidades del pie y las mediciones radiográficas del talo y del calcáneo

SUMMARY: The weight of the body is transmitted to the foot through the subtalar joint and talus. Considering the important location of the talus and calcaneus, the morphological structures of these bones may affect the biomechanics of the subtalar joint. At the same time, the morphological structure of these bones is important in some common foot deformities. We aimed to investigate whether the various measurements of the talus and calcaneus are associated with different foot deformities in this study. In this study, radiography images of 158 (72 male and 86 female) patients within the mean age of 44 years were retrospectively examined. Eleven different measurements of the talus and calcaneus were obtained from the lateral and antero-posterior radiographs of the patients. A total of 158 patient's routine clinic radiographs were retrospectively assessed, which have calcaneal spur (n=63), hallux valgus (n=32) and control group (n=63). We determined that the body height of the calcaneus, maximum width of the head of the talus, minimum anterior width of the calcaneus were significantly different between calcaneal spur group and control group. Maximum length fibular malleolar facet of the talus was significantly different between age groups. And we determined that the calcaneal index was significantly different between hallux valgus group and control groups. Also all measurements were significantly different between males and females. As a result, some measurements that significantly determine the morphology of the talus and calcaneus were found to be significant between deformity groups and control groups. We think that our study will contribute to the literature as it is the first study in which the measurements obtained from the radiographic images of the talus and calcaneus are associated with foot deformities.

El peso del cuerpo se transmite al pie a través de la articulación subtalar y el talo. Teniendo en cuenta la importante ubicación del talo y el calcáneo, las estructuras morfológicas de estos huesos pueden afectar la biomecánica de la articulación subtalar. Al mismo tiempo, la estructura morfológica de estos huesos es importante en algunas deformidades comunes del pie. Nuestro objetivo fue investigar si las diversas medidas del talo y el calcáneo están asociadas con diferentes deformidades del pie en este estudio. Se examinaron retrospectivamente imágenes radiográficas de 158 pacientes (72 hombres y 86 mujeres) con una edad promedio de 44 años. Se obtuvieron once medidas diferentes del talo y el calcáneo a partir de las radiografías lateral y anteroposterior de los pacientes. Se evaluaron retrospectivamente un total de 158 radiografías clínicas de rutina de los pacientes, los cuales tenían espolón de calcáneo (n=63), hallux valgus (n=32) y grupo control (n=63). Determinamos que la altura del cuerpo del calcáneo, el ancho máximo de la cabeza del talo, el ancho anterior mínimo del calcáneo fueron significativamente diferentes entre el grupo con espolón calcáneo y el grupo control. La longitud máxima de la faceta maleolar fíbular del talo era significativamente diferente entre los grupos de edad. También determinamos que el índice calcáneo fue significativamente diferente entre el grupo de hallux valgus y los grupos controles. Además, todas las medidas fueron significativamente diferentes entre hombres y mujeres. Como resultado, algunas medidas que determinan la morfología del talo y el calcáneo resultaron significativas entre los grupos de deformidad y los grupos controles. Estimamos que nuestro estudio contribuirá a la literatura debido a que es el primer reporte en el que las medidas obtenidas de las imágenes radiográficas del talo y el calcáneo se asocian con deformidades del pie.

Estimating the stature of ancient high-altitude Andean populations from skeletal remains of the Chachapoya of Peru.

OBJECTIVES: Previous studies have demonstrated the need for regionally specific stature estimation formulae due to the geographical specificity of limb proportionality related to the effects of environmental pressures on growth and development. High-altitude Andean populations have often been neglected in the creation of these formulae. This study uses a hybrid approach to create linear regression formulae for stature estimation and test their accuracy when compared previously published formulae traditionally used in Andean bioarchaeology. MATERIALS AND METHODS: We studied a sample from a high-altitude Andean population to create linear regression formulae based on anatomical estimates of stature from the femur, tibia, and calcaneus and compare the newly created formulae with those traditionally employed in Andean bioarchaeology. We also examine the reliability of calcanei in stature estimation by creating and testing regression formulae based on metrics from that element. RESULTS: We include specific formulae accurate to within 1 cm of anatomical stature estimates using femoral, tibial, and calcaneal metrics. These formulae provide estimates that are closer to anatomical stature than those traditionally used in the Andes. ANOVA results were statistically significant for differences between Andean-derived and Mesoamerican-derived formulae. DISCUSSION: Although regionally proximate (mid-altitude) formulae provide estimates approximating population-specific formulae, those created from geographically distant populations from sites at or near sea-level are inappropriate in high-altitude studies. Like some previous studies on stature, we found that the most accurate estimates were based on the tibia rather than the femur and that the calcaneus can be used reliably in stature estimation when no other element is present or measurable.

Types and morphometric study of calcaneal articular facets on human tali of Thai population / Tipos y estudio morfométrico de las facetas articulares calcáneas en talus humano de la población tailandesa

Patterns and variant morphometries of calcaneal articular facets on talus are concerned before performing of joint ankle surgery, including used as a sex determination. Types of talar facets have been documented in many populations except in Thai race. Therefore, this study attempted to classify the types of talus facets and to measure the facet lengths on dried tali of Thais. The 372 dried tali (204 males, 168 females) from Khon Kaen University Bone Collection were observed for variant types and measured for their facet lengths. The facets were classified into 6 types: type I, tree facet are separated (1.88 %); type II (A), the anterior and middle facets are partially connected with predominant ridge (34.68 %); type II (B), the anterior and middle facets are partially connected with slight ridge (32.53 %); type III, the anterior and middle facets are fully fused to form a single facet (2.96 %); type IV, the anterior and middle facets are partially separated by a ridge and partly by a groove (27.42 %); type V, all facets are continuous fused to form a single facet (0.54 %). In addition, the morphometric lengths of AP (anterior to posterior process) and ML1&2 (medial to lateral process) in male are significantly greater than those of female. The AP, ML, and ML2 of male are 56.71±0.16, 41.63±0.18, and 37.85±0.36 mm, while of female are 51.21±0.12, 37.74±0.16, and 33.85±0.28 mm, respectively. This incidence can be used as ankle surgery consideration and an anthropological marker for sex determination of unidentified talus.

Los patrones y las variantes morfométricas de las facetas articulares calcáneas en el talus deben considerarse antes de la realización de la cirugía del tobillo a nivel articular, incluido su uso para la determinación del sexo. Se han documentado los tipos de facetas en el talus en muchas poblaciones, excepto en la raza tailandesa. Por lo tanto, este estudio clasificó los tipos de facetas del talus y se midieron las longitudes de las facetas del talus, en muestras secas de indiviuos tailandeses. Se analizaron 372 talus secos (204 de hombres, 168 de mujeres) de la colección de huesos de la Universidad Khon Kaen, se observaron distintos tipos de variantes y se midieron las longitudes de las facetas. Las facetas se clasificaron en 6 tipos: tipo I, faceta de árbol separadas (1,88 %); tipo II (A), facetas anterior y media parcialmente conectadas con la cresta predominante (34,68 %); tipo II (B), facetas anterior y media están parcialmente conectadas con una ligera cresta (32,53 %); tipo III, facetas anterior y media están completamente fusionadas para formar una sola faceta (2,96 %); tipo IV, facetas anterior y media están parcialmente separadas por una cresta y en parte por una ranura (27,42 %); tipo V, todas las facetas se fusionan continuamente para formar una sola faceta (0,54 %). Además, las longitudes morfométricas del proceso anterior o posterior (AP) y del proceso medial a lateral (ML1 y ML2) en el varón son significativamente mayores que las de la mujer. El AP, ML1 y ML2 de los hombres son 56,71 ± 0,16, 41,63 ± 0,18 y 37,85 ± 0,36 mm, mientras que las mujeres son 51,21 ± 0,12, 37,74 ± 0,16 y 33,85 ± 0,28 mm, respectivamente. Esta incidencia se puede utilizar como una consideración en la cirugía de tobillo y un marcador antropológico para determinar el sexo del talus no identificado.

Calcaneus quantitative ultrasound and body composition in preschool children: physical activity consideration / Ultrasonido cuantitativo de calcáneo y composición corporal en niños preescolares: consideración de actividad física

SUMMARY: The aim of this research was to determine the difference in Calcaneus quantitative ultrasound (QUS) and body composition according to physical activity in preschool children. We recruited 296 healthy children (112 girls and 184 boys) from different kindergartens in Vojvodina, Serbia. Children were evaluated for body composition. Quantitative ultrasound (QUS) measurements of the heel were performed using the Speed of sound, Broadband Ultrasound Attenuation, Quantitative Ultrasound Index and Estimated bone mineral density for further analysis. Furthermore, children were divided into three groups according to physical activity. Apart from the differences in Body fat % and body mass, there were no significant group differences for BMI, waist circumference and abdominal skinfold (p>0.05). The ANOVA showed significant differences (p<0.05) in all QUS measurements between three different intensities of physical activity. The results show that Body Mass and Body fat % were important predictors that discriminate children according to physical activity. Moreover, the results show that beside BMI and Body fat %, all calcaneus QUS measurements showed differences according to physical activity. In conclusion, our study showed differenses in all calcaneus QUS measurements according to physical activity level.

RESUMEN: El objetivo de esta investigación fue determinar la diferencia entre el ultrasonido cuantitativo (USC) de calcáneo y la composición corporal según la actividad física en niños en edad preescolar. Se estudiaron 296 niños sanos (112 niñas y 184 niños) de diferentes jardines infantiles en Vojvodina, Serbia. Se evaluó la composición corporal de los niños. Las medidas de USC del talón se realizaron utilizando la velocidad del sonido, atenuación de ultrasonido de banda ancha, el índice de ultrasonidos cuantitativos y la densidad mineral ósea estimada para un análisis posterior. Los niños se dividieron en tres grupos según actividad física. Además de las diferencias de porcentaje de grasa corporal y masa corporal, no se observaron diferencias significativas de grupo en el índice de masa corporal (IMC), circunferencia de cintura y el pliegue abdominal (p> 0,05). El test de ANOVA mostró diferencias significativas (p <0,05) en todas las mediciones USC entre tres diferentes intensidades de actividad física. Los resultados muestran que la masa corporal y la grasa corporal fueron indicadores importantes que permiten diferenciar a los niños según la actividad física. Por otra parte, los resultados muestran que además del IMC y el porcentaje de grasa corporal, todas las mediciones de USC del calcáneo mostraron diferencias según el nivel de actividad física. En conclusion, nuestro estudio mostró diferencias en el USC de acuerdo al nivel de actividad física.

Morphometric measurement and types of articular facets on the talus and calcaneus in an Anatolian population / Mediciones morfométricas y tipos de facetas articulares en el talus y calcáneo de una población Anatolia

Anatomical variations in terms of ligamentous attachments, articulations and bony morphology are common in the subtalar region. The shape of the articular facets of the talus and calcaneus and their relationship to each other are important for joint function and surgical procedures. In this study an assessment of the morphology of the articular facets of the talus and calcaneus, in an Anatolian population, was undertaken. 49 tali and 57 calcanei from Anatolian adults of unknown gender were examined. The types of articular facets on the talus and calcaneus were determined using the following classification: Type A1, the distance between the anterior and middle facets was less than 2 mm; Type A2, the distance between the anterior and middle facets was 2-5 mm; Type A3, the distance between the anterior and middle facets was more than 5 mm; Type A4, there was only one articular facet; Type B1, the separation between the anterior and middle facets was not complete; Type B2, separation of the anterior and middle facets was present; Type C, no separation between the anterior, middle and posterior facets was present, i.e. there was one articular facet. In addition, the anteroposterior length and width of the talus and calcaneus, together with the width, length and depth of sulcus tali and sulcus calcanei were determined. Left and right tali, respectively, displayed the folowing types of articular facet: A1, 0 %, 0 %; A2, 0 %, 3,4 %; A3, 0 %, 0 %; A4, 0 %, 0 %; B1, 60 %, 51,8 %; and B2, 40 %, 44.8 %. Articular facets on left and right calcanei, respectively, were: A1, 10 %, 7.4 %; A2, 10 %, 14.8 %; A3, 16.7 %, 11.1 %; A4, 3.3 %, 3.7 %; B1, 30 %, 22.2 %; B2, 30 %, 40.8 %. The length and width of left and right tali were 50.5±3.81 mm and 39.5±2.97 mm, and 53.1±4.38 mm and 39.3±3.66 mm, respectively. The width, length and depth of left and right sulcus tali were: 5.2±1.09 mm, 21.7±2.73 mm and 5.7±0.84 mm, and 6.1±2.05 mm, 21.1±3.66 mm and 5.7±1.52 mm, respectively. For left and right calcanei length and width were; 76.1±5.44 mm 44.0±3.97 mm, and 75.7±6.76 mm and 45.9±4.21 mm, respectively. The width, length and depth of left and right sulcus calcanei were: 6.4±1.19 mm, 31.9±2.76 mm and 4.0±0.81 mm, and 5.5±1.00 mm, 32.4±3.23 mm and 4.4±1.05 mm, respectively. The articular facets on both the talus and calcaneus in the Anatolian population studied was predominantly type B. This observations is similar to previous reports conducted in America, India and Africa, but differ from those undertaken in Europe. A knowledge of variations of the articular facets of the talus and calcaneus provides a valuable road map for orthopaedic surgeons, as well as others involved in foot rehabilitation.

Las variaciones anatómicas de ligamentos, articulaciones y morfología ósea son comunes en la región subtalar. La forma de las facetas articulares del talus y calcáneo y su relación mutua son importantes para la función articular y los procedimientos quirúrgicos. En este estudio se realizó una evaluación de la morfología de las facetas articulares del talus y del calcáneo en una población de Anatolia. Se examinaron 49 talus y 57 calcáneos de individuos adultos anatolios de sexo no conocido. Se clasificaron las facetas articulares del talus y el calcáneo de la siguiente manera: Tipo A1, la distancia entre las facetas anterior y media fue inferior a 2 mm; Tipo A2, la distancia entre las facetas anterior y media fue de 2-5 mm; Tipo A3, la distancia entre las facetas anterior y media fue de más de 5 mm; Tipo A4, sólo había una faceta articular; Tipo B1, la separación entre las facetas anterior y media no fue completa; Tipo B2, la separación de las facetas anterior y media estaba presente; Tipo C, no existía separación entre las facetas anterior, media y posterior, es decir, había una faceta articular. Además, se determinó la longitud anteroposterior y el ancho del talus y del calcáneo, junto con el ancho, la longitud y la profundidad del surco talar y del surco del calcáneo. Los talus izquierdo y derecho, respectivamente, mostraron los siguientes tipos de faceta articular: A1, 0 %, 0 %; A2, 0 %, 3,4 %; A3, 0 %, 0 %; A4, 0 %, 0 %; B1, 60 %, 51,8 %; B2, 40 %, 44,8 %. Las facetas articulares de los calcáneos izquierdo y derecho, respectivamente, fueron: A1, 10 %, 7,4 %; A2, 10 %, 14,8 %; A3, 16,7 %, 11,1 %; A4, 3,3 %, 3,7 %; B1, 30 %, 22,2 %; B2, 30 %, 40,8 %. La longitud y el ancho de talus izquierdo y derecho fueron 50,5±3,81 mm y 39,5±2,97 mm, y 53,1±4,38 mm y 39,3±3,66 mm, respectivamente. El ancho, la longitud y la profundidad del surco talar izquierdo y derecho fueron: 5,2±1,09 mm, 21,7 ± 2,73 mm y 5,7±0,84 mm, y 6,1±2,05 mm, 21,1±3,66 mm y 5,7±1,52 mm, respectivamente. Para el calcáneo izquierdo y derecho, la longitud y ancho fueron: 76,1±5,44 mm 44,0±3,97 mm y 75,7±6,76 mm y 45,9±4,21 mm, respectivamente. El ancho, longitud y profundidad del surco del calcáneo izquierdo y derecho fueron: 6,4±1,19 mm, 31,9±2,76 mm y 4,0±0,81 mm, y 5,5±1,00 mm, 32,4±3,23 mm y 4,4±1,05 mm, respectivamente. Las facetas articulares, tanto en el talus como en el calcáneo en la población de Anatolia estudiada, eran predominantemente de tipo B. Estas observaciones son similares a reportes previos realizados en América, India y África, pero difieren de los realizados en Europa. Un conocimiento de las variaciones de las facetas articulares del talus y del calcáneo proporciona una valiosa hoja de ruta para los cirujanos ortopédicos, así como otros involucrados en la rehabilitación de los pies.

Effects of Pilates-Interventional Program on Calcaneus-Bone Density Parameters of Adult Women / Efectos de un Programa de Intervención de Pilates Sobre Parámetros de Densidad Ósea en el Calcáneo de Mujeres Adultas

Physical exercise has a positive influence on bone tissue and therefore, is recommended in order to prevent the bone mass loss during the aging process. Similarly, normally practice of exercise potentially prevents the incidence of osteoporosis and bone fractures in adult women. In order to evaluate the differences of a Pilates-Interventional Program on parameters of bone density (right and left calcaneus) for six months, a total of 22 women (48.18±9.59) participated in the study. Bone mineral density (BMD) was estimated by the broadband ultrasonic attenuation (BUA) and the speed of sound signals (SOS), through "Sahara" sound device. The BUA showed significant difference in the right and the left leg (both, P< 0.01), the SOS of the right leg (P<0.05), whereas the BMD was not proved to be statistically significant at the end of the treatment. In conclusion, the bone mineral density by BUA increased, while the speed of sound of the right leg decreased. Thus, our findings might imply a better level of bone strength after a specific intervention focused on the Pilates method.

El ejercicio físico tiene una influencia positiva en el tejido óseo y por consiguiente, es recomendado a la hora de prevenir pérdida de masa ósea durante el envejecimiento. Igualmente, la práctica regular de ejercicio previene la osteoporosis y fractura de huesos en población adulta y mayor. Con el fin de evaluar las diferencias de parámetros en la densidad ósea (huesos calcáneos derecho e izquierdo) tras un programa de intervención Pilates de 6 meses, un total de 22 mujeres (48,18±9,59) participaron en el estudio. La densidad mineral ósea (DMO) fue estimada mediante la atenuación ultrasónica de banda ancha (AUBA) y la velocidad de las señales del sonido (VSS) a través del dispositivo de sonido "Sahara". La AUBA mostró diferencias significativas en ambos calcáneos (P<0,01), la VSS obtuvo diferencias significativas en el calcáneo derecho (P<0,5) y la DMO no mostró significancia alguna tras el programa de intervención. En conclusión, el calcáneo incrementó mediante medición AUBA mientras que VSS fue significativo en el calcáneo derecho. Nuestros resultados podrían implicar un mejor nivel de fuerza del calcáneo después de una intervención específica con Pilates.

Types of facets on the superior articular surface of Isan-Thai dried calcanei / Tipos de facetas de la superficie articular superior de calcáneos secos de tailandeses del nordeste

The patterns of talar articulating facets must be concerned in surgical procedure or the internal and external fixation in various diseases of the foot. The variant types of calcaneal facets on the superior articular surface have been reported in many races except in Thais. This study therefore was aimed to investigate the patterns of superior articulating facet of dried calcanei in Isan-Thais. The identified 396 Isan- Thai dried calcanei (202 males and 194 females) were carried out for variant superior facet observations. The results showed that types of facets observed could be classified into three major types (Type 1 [60.86%], Type 2 [38.64%], and Type 4 [0.51%], respectively). In sub-type classifications, there were Type 1A (24.75%), Type 1B (36.11%), Type 2A (12.88%), Type 2B (14.14%), Type 2C (2.78%), Type 2D (8.84%), and Type 4 (0.51%), respectively. Additionally, it was found that the percentage of Type 2A of male (15.84%) was much greater than that of female (9.79%) compared to those of other types. This incidence of facet types is valuable information for Thai orthologists to concern about treating in talocalcaneal joint area.

Los patrones de las facetas articulares del talus deben considerarse en los procedimientos quirúrgicos o en la fijación interna y externa en varias enfermedades del pie. Variaciones en las facetas articulares del calcáneo, correspondientes a la superficie articular superior, se han reportado en muchas razas y grupos étnicos, excepto en los tailandeses. Por tanto, este estudio tuvo como objetivo investigar los patrones de presentación de las carillas articulares de calcáneos secos en Tailandases-Isan. Se estudiaron 396 huesos calcáneos secos (202 de hombres y 194 de mujeres). Los resultados mostraron que los tipos de carillas observadas se pueden clasificar en tres tipos principales (tipo 1 [60,86%], tipo 2 [38,64%] y Tipo 4 0,51%, respectivamente). Las subclasificaciones se distribuyeron en los subtipos 1A (24,75%), 1B (36,11%), 2A (12,88%), 2B (14,14%), 2C (2,78%), 2D (8,84%), y 4 (0,51%), respectivamente. Adicionalmente, se encontró que el porcentaje del Tipo 2A de hombres (15,84%) fue mayor que en las mujeres (9,79%) en comparación con los otros tipos. Consideramos que la incidencia de aparición de los distintos tipos de facetas constituyen una información valiosa para ortopedistas tailandeses en relación a los tratamientos a desarrollar en el área de la articulación talocalcanea.

Mechanical and morphological aspects of the calcaneal tendon of mdx mice at 21 days of age.

A relationship between compromised muscles and other tissues has been demonstrated in mdx mouse, an animal model studied for understanding of Duchenne muscular dystrophy. The hypothesis is that changes in the calcaneal tendon of mdx mice occur previous to the onset of rigorous and most marked episodes of muscle degeneration, which start suddenly after 21 days of life. Thus, this study aimed to identify possible alterations in the calcaneal tendon of mdx mouse at 21 days of age. Control and mdx tendons were submitted to mechanical tensile testing, quantification of hydroxyproline, and staining with toluidine blue and picrosirius red. Hydroxyproline content was similar between mdx and control groups. The control tendon presented higher mechanical strength (load, stress, and elastic modulus) and its morphological analysis showed a larger number of round fibroblasts, nuclei with well-decondensed chromatin, and slightly metachromatic well-stained cytoplasmic material, different from that observed in mdx tendons. The results suggest that the absence of dystrophin in mdx mouse can provoke directly or indirectly alterations in the mechanical properties and morphology of the calcaneal tendon.

Calcaneal pitch and lateral talocalcaneal angle among nigerians / Inclinación calcáneo y ángulo talocalcáneo lateral en nigerianos

Various papers in the fields of Radiology, orthopaedics and radiographic anatomy have employed the use of angles measured on X-rays to make diagnoses, select treatment modalities in the management of foot disorders as well as predicting the outcome of interventions to these disorders. Calcaneal pitch (CP) and lateral talocalcaneal angle (L TCA) are angles that can be drawn on lateral standing radiographs of the foot and are used widely in the diagnosis, prognosis and choice of treatment modalities for various disorders of the foot. Data on these important radiological tools are lacking in Nigeria. Hence, the study is an attempt to bridge this gap. Using a hinge goniometer, the angles were measured from normal lateral standing radiographs of the foot. Mean CP was found to be 15.08 +/- 2.87 (n=63) and the mean L TCA was found to be 38.85°+/-8.20° (n=130). Differences in the means of the angles seen between the sexes were not statistically significant (CP, p=0.70; L TCA, p=0.60). No such significant difference was also observed in mean of the angles with respect to the sides of the body (CP, p=0.58; L TCA, p=0.13) or between ethnic groups (CP, p=0.30; L TCA, p=0.40).

Diversos trabajos en las áreas de la radiología, ortopedia y anatomía radiográfica han empleado los ángulos medidos en las radiografías para hacer diagnósticos, seleccionar las modalidades de tratamiento en el manejo de los trastornos del pie, así como para predecir el resultado de las intervenciones para estos trastornos. La inclinación calcánea (PC) y el ángulo talocalcáneo lateral (L TCA) son los ángulos que se pueden extraer desde las radiografías laterales de los pies y ser utilizados ampliamente en el diagnóstico, pronóstico y elección de modalidades de tratamiento para diversos trastornos del pie. Los datos sobre estos importantes instrumentos radiológicos no existen en Nigeria, y su estudio es un intento de obtener esta información. Usando un goniómetro bisagra, los ángulos se midieron a partir de radiografías normales permanentes lateral del pie. La media de CP se fue 15,08+/-2,87 (n = 63) y la media de TCA L fue 38,85°+/-8,20° (n = 130). Las diferencias en las medias de los ángulos observados entre los sexos no fueron estadísticamente significativas (CP, p = 0,70; L TCA, p = 0,60). No hubo diferencias significativas en la media de los ángulos con respecto al lado (CP, p = 0,58; L TCA, p = 0,13) o entre grupos étnicos (CP, p = 0,30; L TCA, p = 0,40).

Multidetector CT evaluation of calcaneal fractures.

As the largest tarsal bone and the most inferior bone in the body, the calcaneus is responsible for supporting the axial load from the weight of the body. It is most commonly fractured after a fall from a height in which axial loads exceed its support capacity. Calcaneal fractures account for 60% of all tarsal fractures. Conventional radiography is commonly used for initial evaluation of calcaneal injury but has the typical disadvantages of two-dimensional imaging. Modern assessment of calcaneal fractures relies heavily on multidetector computed tomography (CT), which allows better visualization and characterization of fracture lines and fragment displacement. Calcaneal fractures observed at CT have been divided into intra- and extraarticular fractures on the basis of subtalar joint involvement. The Sanders classification system for intraarticular fractures is the most commonly used system because it correlates with clinical outcomes and involves less interobserver variability. The classification of extraarticular fractures has been less controversial and makes use of anatomic landmarks on the calcaneus to divide the bone into anterior, middle, and posterior areas. Soft-tissue involvement is an important aspect of calcaneal fracture assessment because it has been linked with poor functional outcomes. Familiarity with the normal anatomy of the calcaneus, the classification of calcaneal fractures, and the various complications of these fractures is essential for treatment assessment, especially if surgical intervention is required.

Effects of passive stretching on the biochemical and biomechanical properties of calcaneal tendon of rats.

The role of physical activity in affecting the composition of extracellular matrix and mechanical properties of tendons has been well studied, but little is known about the role of passive stretching. The purpose of this study was to test the hypothesis that stimulation by passive stretching may change the composition and mechanical properties of tendons. Three-month-old Wistar rats were divided into three groups: the control, animals were not submitted to stretching procedures; groups that had their calcaneal tendons manually stretched three or five times a week, for 21 days. Afterward, the calcaneal tendons were removed and assayed for hydroxyproline content and biomechanical test. The hydroxyproline content in the stretched groups was higher, suggesting that more collagen was present in the tendons of these groups. These tendons also showed higher values of maximum stress and modulus of elasticity or Young's modulus. These results indicate that stretching leads to alterations in the synthesis of the extracellular matrix components and in the mechanical properties of tendons.

Desenvolvimento do núcleo de ossificação secundário do calcâneo: correlação morforradiográfica / Development of secondary ossification nucleus from the calcaneus: morphoradiographic correlation

O objetivo do presente estudo foi correlacionar os aspectos morfológicos da tuberosidade calcaneana com o perfil radiográfico do calcâneo. Material: Foram selecionadas três peças anatômicas de cadáveres humanos contendo a tuberosidade do calcâneo e três radiografias simples em perfil do calcâneo de indivíduos sadios. O estudo inclui a análise macroscópica e microscópica de cortes sagitais das peças anatômicas, correlacionando com os aspectos radiológicos do calcâneo dentro de três faixas etárias de zero a 16 anos de idade. Resultado: O sistema aquileu-calcâneo-plantar (SACP) está inserido inicialmente em modelo condral do núcleo secundário do calcâneo na faixa etária inicial, até seis anos de idade. Dessa faixa em diante, ocorre a ossiticação do núcleo através do sistema trabecular que une o tendão de Aquiles à fáscia plantar. O núcleo secundário do calcâneo desenvolve-se pelo modelo endomembranoso de ossificação, posiciona-se mais inferior no calcâneo, suas trabéculas são mais espessas e dispostas no sentido de tração do SACP, conferindo aspecto adiográfico de esclerose óssea, e funde-se ao calcâneo na adolescência na forma de uma apófise. Conclusão: Os aspectos morfológicos da tuberosidade calcaneana são compatíveis com a imagem do perfil radiológico do calcâneo de humanos em fase de crescimento

Validity of bone mineral density measurements in distal sites as an indicator of total bone mineral density in a group of pre-adolescent and adolescent women.

BACKGROUND: The study of bone mineral density (BMD) has received attention due to the importance of osteoporosis as a public health problem in Mexico. The objective of this study was to assess the validity of BMD measures in distal forearm and calcaneus with portable densitometers as indicators of BMD on other anatomic sites. METHODS: We conducted a cross-sectional study with 219 women from 9 to 22 years of age in Cuernavaca, Morelos, Mexico. We measured BMD in central sites (the entire skeleton, excluding head, proximal femur, and lumbar spine) using dual X-ray absorptiometry (DXA) and in peripheral sites (distal forearm and calcaneus) using a portable densitometer with DXA technology. Measurements of height, weight, body composition, physical activity, and demographic characteristics were collected. Agreement of measurements of BMD was assessed using correlation and regression analysis, and the method proposed by Bland and Altman. RESULTS: Higher levels of BMD were found in total skeleton (0.88 g/cm(2)) than in calcaneus (0.48 g/cm(2)) and distal forearm (0.38 g/cm(2)) (p <0.05). Moderate-to-high positive correlation coefficients (all significant) (p <0.05) were found between BMD in distal forearm and calcaneus vs. central anatomic sites, ranging from r = 0.49 to r = 0.78. BMD was higher in central sites compared with distal forearm and calcaneus. CONCLUSIONS: Measurement of BMD in distal forearm and calcaneus with portable densitometers provided valid indicators of BMD in central anatomic sites among pre-adolescent and adolescent women in Mexico.

Estudo dos ângulos talocalcaneanos em radiografias de frente e perfil dos pés normais de crianças / Study of talocalcaneal angles through anteroposterior and lateral views in X-rays of normal children feet

Radiografias nas incidências de frente e perfil foram realizadas nos pés direitos e esquerdos, considerados normais, de 140 crianças, igualmente divididas entre os sexos e na faixa etária de oito a 13 anos. Em suas imagens foram determinados os ângulos talocalcaneanos de frente (ATCF) e de perfil (ATCP), obtendo-se, respectivamente, os seguintes resultados: 26,0º + 4,7º para meninos e 28,2º + 5,2º para meninas e 43,9º + 4,2º para meninos e 41,1º + 4,4º para meninas. A análise estatística indicou para os dois ângulos diferenças significantes entre os sexos, sendo no ATCF os valores maiores para as meninas e no ATCP, o contrário. No que se refere à correlaçao deles com a idade, houve significância estatística somente no ATCP dos meninos, que diminui quando ela aumenta. Em conclusao, consideramos que os valores angulares aqui encontrados podem ser utilizados como critérios de normalidade podal de crianças, na faixa etária estudada.

Estudo radiológico da tuberosidade posterior do calcâneo / Radiological study of the calcis posterior tuberosity

Os autores apresentam estudo radiológico em 200 pés na projeçao em perfil, objetivando detectar alteraçoes na tuberosidade posterior do calcâneo. Os pés foram divididos em dois grupos, de acordo com o ângulo de Moreau Costa-Bertani: grupo I até 125 e grupo II acima de 125. Foram medidos nas radiografias os ângulos de inclinaçao do calcâneo, de Fowler & Philip, túbero-calcâneo e tubéro-plantar. Além desses ângulos, foram medidas as alturas da deformidade de Haglund e do tubérculo inferior. Concluiu-se nao haver correlaçao entre o ângulo Moreau Costa-Bertani e a posiçao da tuberosidade do calcâneo e que as alturas da deformidade de Haglund e do tubérculo inferior dependem da posiçao da apófise posterior.

O alongamento muscular no tratamento do esporäo calcanear / The muscular extension in the treatment of the calcanear spur

As algias causadas pelo esporäo de calcâneo acometem principalmente mulheres numa faixa etária de 40 a 60 anos, levando à claudicaçäo e, muitas vezes, ao afastamento da atividade profissional. A inclusäo da técnica de alongamento muscular regional em um programa de tratamento fisioterápico para o esporäo calcanear, reduz o número de sessöes e prolonga o período intercrítico

Angulo tuberoso-articular del calcáneo / Tuberous-articular angle of the calcaneus

Se realizó un estudio prospectivo longitudinal en 60 pacientes que acudieron al Servicio de Urgencias del Hospital ABC, midiendo el ángulo tuberoso articular del calcáneo, 29 del sexo femenino y 31 del masculino, con edades que variaron de 16 a 86 años, el promedio del ángulo en los masculinos fue de 25.9 grados y en los femeninos de 24.7 grados. Los resultados del estudio no mostraron diferencia significativa en las mediciones entre los grupos de edad y éstos concuerdan con lo reportado en la literatura

Ocorrência de padröes radiológicos da epifisite do calcâneo em crianças assintomáticas / Occurrence of radiologic patterns related to calcaneum epiphysitis in asymptomatic children

Através de estudo radiográfico realizado em 250 crianças normais de ambos os sexos e de idades compreendidas na faixa de sete a 13 anos, na incidência lateral e axial posterior, colhemos dados sobre os aspectos da apófise posterior do calcâneo no intuito de estabelecer os parâmetros anatômicos normais. Os resultados obtidos permitem concluir que há ampla variaçäo de imagens e formas evolutivas da apófise posterior do calcâneo e que as imagens relacionadas pela literatura como elementos de diagnóstico da apofisite do calcâneo (doença de Haglund-Sever) ocorreram em grande número de crianças sem qualquer sintoma de enfermidade