Relation between palm and finger cortical representations in primary somatosensory cortex: A 7T fMRI study.

Many studies focused on the cortical representations of fingers, while the palm is relatively neglected despite its importance for hand function. Here, we investigated palm representation (PR) and its relationship with finger representations (FRs) in primary somatosensory cortex (S1). Few studies in humans suggested that PR is located medially with respect to FRs in S1, yet to date, no study directly quantified the somatotopic organization of PR and the five FRs. Importantly, the link between the somatotopic organization of PR and FRs and their activation properties remains largely unexplored. Using 7T fMRI, we mapped PR and the five FRs at the single subject level. First, we analyzed the cortical distance between PR and FRs to determine their somatotopic organization. Results show that PR was located medially with respect to D5. Second, we tested whether the observed cortical distances would predict the relationship between PR and FRs activations. Using three complementary measures (cross-activations, pattern similarity and resting-state connectivity), we show that the relationship between PR and FRs activations were not determined by their somatotopic organization, that is, there was no gradient moving from D5 to D1, except for resting-state connectivity, which was predicted by the somatotopy. Instead, we show that the representational geometry of PR and FRs activations reflected the physical structure of the hand. Collectively, our findings suggest that the spatial proximity between topographically organized neuronal populations do not necessarily predicts their functional properties, rather the structure of the sensory space (e.g., the hand shape) better describes the observed results.

Human evolution. Human-like hand use in Australopithecus africanus.

The distinctly human ability for forceful precision and power "squeeze" gripping is linked to two key evolutionary transitions in hand use: a reduction in arboreal climbing and the manufacture and use of tools. However, it is unclear when these locomotory and manipulative transitions occurred. Here we show that Australopithecus africanus (~3 to 2 million years ago) and several Pleistocene hominins, traditionally considered not to have engaged in habitual tool manufacture, have a human-like trabecular bone pattern in the metacarpals consistent with forceful opposition of the thumb and fingers typically adopted during tool use. These results support archaeological evidence for stone tool use in australopiths and provide morphological evidence that Pliocene hominins achieved human-like hand postures much earlier and more frequently than previously considered.

Comparison of the anatomical dimensions and mechanical properties of the dorsoradial and anterior oblique ligaments of the trapeziometacarpal joint.

PURPOSE: The respective roles of the dorsoradial (DRL) and anterior oblique (AOL) ligaments in stability of the highly mobile trapeziometacarpal (TMC) joint remain disputed. Earlier publications have pointed to the AOL as the key stabilizing structure; yet, more recent publications have challenged the stabilizing role of the AOL, favoring the DRL as the main TMC joint stabilizer. We executed an anatomical study of the ligaments, including detailed dissection to quantify the length, width, and thickness of the AOL and DRL and tested the material properties of these ligaments. METHODS: Thirteen fresh frozen cadaveric thumbs from 9 specimens were used. Length, width, and thickness of the AOL and DRL were measured on magnetic resonance imaging and/or after dissection. Next, the first metacarpal and trapezium were isolated together with both ligaments, and both bones were cut sagittally to isolate a first metacarpal-AOL-trapezium and first metacarpal-DRL-trapezium complex from each thumb. These samples were subjected to cyclic loading in displacement-controlled tests. The obtained force-displacement curves were used to calculate stiffness and hysteresis of each sample. RESULTS: Our results showed that the DRL is significantly shorter and thicker than the AOL, which is thin and ill-defined. Our results also indicate that the DRL has a higher stiffness than the AOL, making it a more likely candidate to provide joint stability. CONCLUSIONS: Although the AOL has been asserted to be the primary restraint to dorsoradial subluxation, this view has been challenged over the past 10 years by several studies. These studies have shown the AOL to be relatively weak and compliant compared with the intermetacarpal and dorsoradial ligaments and have demonstrated that the DRL is the strongest and stiffest ligament of the TMC joint. Our studies confirm these findings. CLINICAL RELEVANCE: This study indicates that the DRL is relatively stiff and thick, suggesting it should be repaired or reconstructed when disrupted to restore stability of the TMC joint.

Effect of a bandage or tendon boot on skin temperature of the metacarpus at rest and after exercise in horses.

OBJECTIVE: To determine the skin temperature of the metacarpus in horses associated with the use of bandages and tendon boots, compared with the bare limb, at rest and after 20 minutes of lunging. ANIMALS: 10 adult horses. PROCEDURES: Skin temperature on the bare metacarpus of both forelimbs was measured at rest and after lunging. Subsequently, a bandage was applied to the left metacarpus and a tendon boot to the right metacarpus and skin temperature was measured at rest and after lunging. Skin temperature was measured with fixed sensors and thermographically. RESULTS: Mean ± SD skin temperatures of the bare metacarpi were 14.1 ± 2.4°C (left) and 14.1 ± 3.4°C (right) at rest, and 14.4 ± 1.8°C (left) and 13.6 ± 2.6°C (right) after exercise. Skin temperatures under the bandage were 15.3 ± 1.6°C at rest and 24.8 ± 3.6°C after exercise. Skin temperatures under the tendon boot were 15.3 ± 2.6°C at rest and 20.6 ± 2.9°C after exercise. Skin temperatures under the bandage and tendon boot were significantly higher after exercise than at rest. Skin temperatures at rest were not significantly different with a bare limb, bandage, or tendon boot. CONCLUSIONS AND CLINICAL RELEVANCE: Skin temperature of the metacarpus in horses increased significantly during exercise but not at rest when a bandage or tendon boot was used. The authors speculate that both a bandage and a tendon boot accelerate the warm up phase of exercise. Further research should focus on the effects of warm up and maximum exercise on the temperature of other anatomic structures such as tendons.

Extent of sympathectomy affects postoperative compensatory sweating and satisfaction in patients with palmar hyperhidrosis.

PURPOSE: Endoscopic thoracic sympathectomy (ETS) for the treatment of palmar hyperhidrosis is generally performed at one or two levels ranging between T2 and T4; however, compensatory sweating (CS) is an occasional bothersome side effect. The aim of our study was to evaluate the association between the extent of ETS and the degree of postoperative CS and palmar sweating, as well as patient satisfaction. METHODS: The participants represented a consecutive series of 76 patients who underwent bilateral ETS for palmar hyperhidrosis at level T2 and/or T3. Patients were interviewed by postal questionnaires to assess their self-reported degree of postoperative palmar sweating and CS and their outcome satisfaction. Of the 53 patients who replied to the postal questionnaire, 25 underwent bilateral ETS at one level (group A), and 27 underwent bilateral ETS at two levels (group B). One patient who underwent asymmetrical sympathectomy was excluded. RESULTS: The degree of postoperative palmar sweating was significantly lower in group B than in group A. The severity of CS was significantly higher in group B than in group A. The severity of CS was significantly inversely correlated with the degree of patient satisfaction. However, the degree of postoperative palmar sweating was not correlated with the degree of patient satisfaction. CONCLUSIONS: Compared to ETS at two levels, single-level ETS of T2 or T3 reduces postoperative palmar sweating to a milder degree, and causes CS to a less severe degree. The severity of CS is inversely correlated with the degree of patient satisfaction.

Effect of Clostridium botulinum toxin type A injections into the deep digital flexor muscle on the range of motion of the metacarpus and carpus, and the force distribution underneath the hooves, of sound horses at the walk.

In the treatment of laminitis, reducing deep digital flexor muscle (DDFM) activity might diminish its pull on the distal phalanx, thereby preventing displacement and providing pain relief. Injection of Clostridium botulinum toxin type A into the DDFM of horses is potentially therapeutic. However, the effects of C. botulinum toxin type A on the gait characteristics of sound horses at the walk are not known. The aim of this study was to test if a reduced DDFM activity would lead to (1) alterations of the sagittal range of motion of the metacarpus (SROM) and range of motion of the carpal joint (CROM); (2) changes in the force distribution underneath the hoof (toe vs. heel region: balance index); and (3) changes in the force distribution between the treated and untreated limb (symmetry index). The DDFMs of the left forelimbs of seven sound Royal Dutch Sport Horses were injected with 200 IU C. botulinum toxin type A using electromyography and ultrasound guidance. Measurements using an inertial sensor system and dynamically calibrated pressure plate were performed before and after injections. The SROM and CROM of the treated limb were significantly increased after C. botulinum toxin type A injections. No significant changes were detected in the balance index or in the symmetry index, indicating that no lameness was induced. C. botulinum toxin type A injections into the DDFM of sound horses do not appear to result in substantial gait alterations at the walk.

Índices numéricos Ebrí-metacarpofalángico y carpiano para el cálculo de la edad ósea y predicción de talla adulta / Metacarpophalangeal and carpal numeric indices to calculate bone age and predict adult size

Introducción: En este trabajo se presenta unos nuevos métodos numéricos a partir de los índices metacarpofalángico y carpiano para el cálculo de la edad ósea, así como poder predecir la talla adulta por medio de ecuaciones multiregresión. Material y métodos: La casuística longitudinal comprende a 160 niños zaragozanos sanos de ambos sexos, con edades comprendidas desde los 6meses hasta los 20años, estudiados anualmente, incluido el estudio radiológico. Para la labor estadística se ha utilizado el paquete estadístico «Statistix», así como el programa Excel. Resultados: Los nuevos índices se encuentran íntimamente correlacionados con la edad cronológica, dando por ello lugar a ecuaciones predictivas para el cálculo de la edad ósea de niños hasta 20 años, presentándose además ecuaciones propias hasta los cuatro, a efectos de poder afinar más el diagnóstico a estas cortas edades. Las edades óseas calculadas pueden ser llevadas tanto a tablas numéricas de desviación típica, como a una figura de equivalencias que nos dan el diagnóstico osificativo directamente. Las ecuaciones predictivas de talla adulta permiten una estimación fiable de la talla futura del niño a estudio. Estas estimaciones analizadas por el test de Student no han dado diferencias significativas respecto a la talla adulta que los niños de la casuística al final alcanzaron. Los resultados pueden obtenerse con una calculadora o a través de un programa informático a disposición gratuita del lector. Conclusiones: Son presentadas por vez primera, por métodos propios no foráneos, estándares de edad ósea, así como ecuaciones de predicción de talla adulta para el estudio de niños. Se invita al clínico a utilizar estos métodos metacarpofalángico y carpiano a fin de conseguir la experiencia necesaria para su idónea aplicación en población sana y con diversa patología(AU)

Introduction: This work presents new numerical methods from the meta-carpal-phalangeal and carpal indexes, for calculating bone age. In addition, these new methods enable the adult height to be predicted using multiple regression equations. Materials and Methods: The longitudinal case series studied included 160 healthy children from Zaragoza, of both genders, aged between 6months and 20 years, and studied annually, including the radiological study. For the statistical analysis the statistical package "Statistix", as well as the Excel program, was used. Results: The new indexes are closely co-related to the chronological age, thus leading to predictive equations for the calculation of the bone age of children up to 20 years of age. In addition, it presents particular equations for up to 4years of age, in order to optimise the diagnosis at these early ages. The resulting bones ages can be applied to numerical standard deviation tables, as well as to an equivalences chart, which directly gives us the ossification diagnosis. The predictive equations of adult height allow a reliable forecast of the future height of the studied child. These forecasts, analysed by the Student test did not show significant differences as regards the adult height that children of the case series finally achieved. The results can be obtained with a pocket calculator or through free software available for the reader. Conclusions: For the first time, and using a centre-developed and non-foreign methods, bones age standards and adult height predictive equations for the study of children, are presented. We invite the practitioner to use these meta-carpal-phalangeal and carpal methods in order to achieve the necessary experience to apply it to a healthy population and those with different disorders(AU)

All alone with sweaty palms--physiological arousal and ostracism.

Social exclusion, or ostracism, is universally perceived as a negative emotional experience and often leads to poor social outcomes for individuals and society. Although the experience of distress associated with being ostracized is innate, there has been very little investigation of the effects on the autonomic nervous system. This study provides objective evidence for the effects of ostracism on arousal (examined with skin conductance levels) while participants played an internet ball-tossing game (Cyberball). Forty-two healthy undergraduate students participated in both inclusion and ostracism conditions. When participants were included, there was a marked decrement in arousal over the course of the task, whereas there was no evidence of habituation when participants were ostracized. The implications of these results are discussed in terms of the potential of differential autonomic activity to predict the coping strategies that people engage in following ostracism.

The relation of near-infrared spectroscopy with changes in peripheral circulation in critically ill patients.

OBJECTIVE: We conducted this observational study to investigate tissue oxygen saturation during a vascular occlusion test in relationship with the condition of peripheral circulation and outcome in critically ill patients. DESIGN: Prospective observational study. SETTING: Multidisciplinary intensive care unit in a university hospital. PATIENTS: Seventy-three critically ill adult patients admitted to the intensive care unit. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Patients were followed every 24 hrs until day 3 after intensive care admission. Near-infrared spectroscopy was used to measure thenar tissue oxygen saturation, tissue oxygen saturation deoxygenation rate, and tissue oxygen saturation recovery rate after the vascular occlusion test. Measurements included heart rate, mean arterial pressure, forearm-to-fingertip skin-temperature gradient, and physical examination of peripheral perfusion with capillary refill time. Patients were stratified according to the condition of peripheral circulation (abnormal: forearm-to-fingertip skin-temperature gradient ≥4 and capillary refill time >4.5 secs). The outcome was defined based on the daily Sequential Organ Failure Assessment score and blood lactate levels. Upon intensive care unit admission, 35 (47.9%) patients had abnormal peripheral perfusion (forearm-to-fingertip skin-temperature gradient >4 or capillary refill time >4.5 secs). With the exception of the tissue oxygen saturation deoxygenation rate, tissue oxygen saturation baseline and tissue oxygen saturation recovery rate were statistically lower in patients who exhibited abnormal peripheral perfusion than in those with normal peripheral perfusion: 72 ± 9 vs. 81 ± 9; p = .001 and 1.9 ± 0.7 vs. 3.2 ± 0.9; p = .001, respectively. When a mixed-model analysis was performed over time for estimate (s) calculation, adjusted to the condition of disease, we did not find a significant clinical effect between vascular occlusion test-derived tissue oxygen saturation measurements (as response variables) and mean systemic hemodynamic variables (as independent variables): tissue oxygen saturation vs. heart rate: s (95% confidence interval) = 0.007 (-0.08; 0.09); tissue oxygen saturation vs. mean arterial pressure: s (95% confidence interval) = -0.02 (-0.12; 0.08); tissue oxygen saturation deoxygenation rate vs. heart rate: s (95% confidence interval) = 0.002 (-0.0004; 0.006); tissue oxygen saturation deoxygenation rate vs. mean arterial pressure: s (95% confidence interval) - 0.0007 (-0.003; 0.004); tissue oxygen saturation recovery rate vs. heart rate: s (95% confidence interval) = -0.009 (-0.02; -0.0015); tissue oxygen saturation recovery rate vs. mean arterial pressure: s (95% confidence interval) = 0.01 (0.002; 0.018). However, there was a strong association between tissue oxygen saturation baseline and tissue oxygen saturation recovery rate with abnormal peripheral perfusion: tissue oxygen saturation vs. abnormal peripheral perfusion: s (95% confidence interval) = -10.1 (-13.9; -6.2); tissue oxygen saturation recovery rate vs. abnormal peripheral perfusion: s (95% confidence interval) =-10.1 (-13.9; -6.2); tissue oxygen saturation recovery rate vs. abnormal peripheral perfusion: s (95% confidence interval) = -1.1 (-1.4; -0.81). Poor outcome was more closely related to abnormalities in peripheral perfusion than to tissue oxygen saturation-derived parameters. CONCLUSIONS: We found that the condition of peripheral circulation in critically ill patients strongly influences tissue oxygen saturation resting values and the tissue oxygen saturation reoxygenation rate but not the tissue oxygen saturation deoxygenation rate. In addition, changes in near-infrared spectroscopy-derived variables were independent of condition of disease and were not accompanied by any major differences in systemic hemodynamic variables.

Improved bioengineered cartilage tissue formation following cyclic compression is dependent on upregulation of MT1-MMP.

The generation of bioengineered cartilage tissue suitable for transplantation is a potential therapy to treat damaged cartilage. We have shown previously that the physical and biomechanical properties of bioengineered cartilage can be improved by the application of 30 min of cyclic compression by a mechanism involving sequential upregulation of gene and protein levels of membrane type-1 matrix metalloproteinase (MT1-MMP) and MMP-13. In the current study, we demonstrated that MT1-MMP is critical to this response, as blocking the upregulation of MT1-MMP prevented the improvement in tissue formation. MT1-MMP seems to act by inducing tissue remodeling as evidenced by the presence of aggrecan degradation products by Western blot analysis and increased release of matrix molecules into the media. Release of these molecules was diminished when MT1-MMP upregulation was prevented. This matrix degradation was likely due to MT1-MMP, as under conditions where MMP-13 expression is maintained (stimulation in the presence of MT1-MMP siRNA) the release of these matrix molecules into the media was still prevented. It also appears that MT1-MMP does not regulate MMP-13 gene expression, as MT1-MMP-siRNA pretreatment had no effect on MMP-13 expression following mechanical stimulation. Further analysis of the anabolic genes and proteins involved in mechanically stimulated cartilage will lead to better understanding of the mechanism(s) underlying tissue formation yielding improved bioengineered cartilage.

Changes in mineralised tissue at the site of origin of condylar fracture are present before athletic training in Thoroughbred horses.

AIM: To show that changes are present at the site of origin of metacarpal condylar fracture in young Thoroughbred horses before they enter race training. METHOD: Bone slices, 2 mm thick, in three mediolateral planes through the centre of rotation of the metacarpo-phalangeal joint (MCPJ) of both distal third metacarpal bones (Mc3) of 12 Thoroughbred horses aged 17 months, were imaged using point-projection digital X-ray imaging (muXR). RESULTS: In some horses, linear or ovoid radiolucency was found in articular calcified cartilage (ACC) and subchondral bone of the palmaro-distal aspect of the sagittal groove, exactly at the site of more advanced stages of condylar fatigue fracture. An incidental finding was ovoid radiolucency in the apex of the dorso-distal aspect of the sagittal ridge, with or without fragmentation or disturbance of the subchondral mineralised tissue line, resembling equine osteochondrosis. CONCLUSIONS AND CLINICAL RELEVANCE: The findings imply that the aetiology of condylar fatigue fracture in young Thoroughbred horses includes abnormality in development of the bone and joint that is present before athletic activity occurs.

Does harvesting of radial artery in the early postoperative period perturb the palmar blood supply and functions?

OBJECTIVE: The aim of this prospective study was to assess whether the removal of the radial artery (RA) caused any alteration in the function or power of hand on postoperative 15th day. METHODS: The study group included 25 patients with objective or subjective complaints on postoperative 15th day regarding harvest site following coronary bypass surgery by using RA. Patients were examined for bilateral forearm function (soft touch and pin-prick neural sensation, handgrip power). The ulnar artery and palmar arcus Doppler measurements such as peak systolic and end-diastolic velocity, and radius of the arteries have been measured both at rest and following handgrip test. The operated arm was evaluated and compared with the opposite arm. Wilcoxon test was used to compare continuous variables. RESULTS: Among 18 patients complained a loss of sense in the RA excised arm, the sensory defects were documented in 5. Among 7 patients presented with a feel of strength loss, handgrip power revealed a nonsignificant decrease of strength in the harvested arm. After squeezing test, ipsilateral ulnar artery peak systolic velocity increased from 86+/- 15 to 105+/- 15 cm/sec (<0.001), end-diastolic flow velocity from 28+/- 5 to 36+/- 8 cm/sec (<0.001) without any change in the ulnar artery radius. In contrast, no significant change in the flow velocity and the diameter of palmar arcus was noted before and after squeezing test. The comparison of the ulnar artery radius and blood flow velocity parameters in the RA excised arm to those of contralateral one after exercise test demonstrated no difference. CONCLUSIONS: With an assumption of appropriate selection, removal of RA does not change the forearm blood supply and functions with little sensory disturbances in the early postoperative period.

[Hands and feet of prosimians primates. Attempts of morphologic characterization]. / Mains et pieds des primates prosimiens. Essai de caractérisation morphologique.

The length of the carpus and tarsus, the metacarpus and metatarsus, the fingers and toes of 142 prosimian apes was measured. The relationship expressed as a percentage was drawn up for each individual between the length of each osseous part and that of its third metacarpal in order to eliminate the differences related to the size of the rest of the body. This ratio was compared with that of man. The characteristic variations appeared at the level of the subfamilies. CONCERNING THE HAND: The carpus presented the same values as that of man except for that of the indris, which was shorter. The thumb had proportionally the same length as that of man, sometimes longer and sometimes smaller as in the Eulemurs, Hapalidea, Megalapidea, Indrises, Daubentonia and Perodictus. The different metacarpals, including the fourth, were a little shorter than the third. In these subfamilies, the second ray was also often shorter and even much shorter in the Megalapidea and the Perodictus. The other rays were a little longer, in particular the fourth which could exceed the third in rather many subfamilies. CONCERNING THE FOOT: The length of the tarsus was extremely variable. It was twice larger in the Galagoidae, definitely larger in the tarsius and discreetly in the Hapalidae, a little smaller in the other Lemurs and much smaller in the other Prosimian apes, joining in that the near totality of the simians. The hallux was proportionally as long as that of man and sometimes even longer. The metatarsals were sometimes a little longer, sometimes less long, but always appreciably of the same length between them. The other toes were short at the aye aye (daubentonia), of which the foot appeared even smaller than that of man. The toes of the other prosimious resembled much to the fingers and in the propithecus and the perodictus, the fourth took gigantic proportions. There has been establishment of an anatomical relation and functional calculus between the length of the last three rays of the hands and the feet of prosimian apes and the biomechanics of their trapezometacarpal and their first cuneometacarpal joints.

Ice-water hand immersion causes a reflex decrease in skin temperature in the contralateral hand.

Cutaneous receptors stimulated by ice-water immersion of one hand will increase sympathetic nerve activity to the palm skin in the nonimmersed contralateral hand and reduce blood flow, reflecting on a decrease in skin surface temperature under a constant ambient environment. To test the hypothesis that gender might affect the contralateral vasoconstrictor response, we analyzed the spatiotemporal pattern of palm skin surface temperature during ice-water immersion for 10 min using thermography in eight males and eight females. As soon as the left hand was immersed in ice-water, palm skin temperature in the nonimmersed right hand quickly decreased in all subjects, particularly in the periphery of the digits and palm. The reduction in skin temperature was short-lasting in 63% of males and 38% of females, but it lasted throughout immersion in the remaining subjects. The average decrease in palm skin temperature was not significantly different between males and females, though it tended to be greater in males. The mean arterial blood pressure significantly increased and heart rate decreased during immersion in males, whereas no substantial cardiovascular changes were observed in females. Cold sensation was well coincident with the appearance of a reduction in the palm skin temperature. In consideration of all these results, we suggest that cutaneous cold stimuli increased skin sympathetic nerve activity in the nonimmersed hand and reduced skin blood flow. We also contend that gender difference in the contralateral vasoconstrictor response was denied because the time course and magnitude of the decrease in palm skin temperature were not different between males and females.

Microindentation in bone: hardness variation with five independent variables.

Microindentation is an investigational tool often used to determine hardness and other derived material properties of the material bone. This study explored the variation of microindentation hardness results with five independent variables. The variables were: applied mass, dwell time, drying time, time between indentation and measurement, and distance between the center of an indentation and the edge of other indentations and pores. These variables were selected because they represented a reasonable range of specimen investigational steps. We also investigated the cross sections of typical indentation residual impressions to determine the degree of material pile-up at the edges of the impressions. We found that microindentation hardness varied with applied mass and with distance between the indentation and neighboring indentations and pores but not with the other variables. Our recommended minimum applied mass is 0.10 kg versus a previously published value of 0.05 kg. We also found no discernable material pile-up at the residual impression edges, in contrast to reports of others.

Variations in articular calcified cartilage by site and exercise in the 18-month-old equine distal metacarpal condyle.

OBJECTIVES: To interrelate articular calcified cartilage thickness, mineralisation density, tidemark count and tidemark linear accretion rate by site in the equine third metacarpal distal condyle. To determine the effects of exercise during early life on articular calcified cartilage. METHOD: Six of 12 pasture-raised Thoroughbred horses were exercised from 10 days old. Calcein labels were given 19 and 8 days prior to euthanasia at 18 months old. Osteochondral specimens were cut from the distal third metacarpal condyle and imaged using confocal scanning light microscopy (CSLM) and quantitative backscattered electron scanning electron microscopy (qBSE). Articular calcified cartilage thickness and total thickness mineralisation density were measured on montaged qBSE image sets, and inter-label mineralisation density, tidemark count and linear accretion rate measured on registered CSLM-qBSE image pairs. RESULTS: Calcified cartilage thickness, mineralisation density, tidemark count and linear accretion rate varied significantly between sites. Regions with thinner calcified cartilage had greater linear accretion rates, hence rapid chondroclastic resorption. Mineralisation density was positively correlated with linear accretion rate. Fewer multiple tidemarks were counted in regions with greater linear accretion rates. Lag time between the tidemark and cement line was estimated (180 days; in the range of 0-648 days). Exercise had little effect on measured parameters. CONCLUSION: The major determinant of articular calcified cartilage thickness is the rate of chondroclastic resorption, not tidemark linear accretion rate. Our evidence supports coupled, mechanosensitive regulation of chondroclastic resorption and linear accretion rate in articular calcified cartilage. Exercising pasture-reared foals causes little additional adaptation in distal third metacarpal articular calcified cartilage.

Gender difference in metacarpal descent of fifth metacarpal.

OBJECTIVE: To determine the difference in metacarpal descent of fifth metacarpal between men and women. STUDY DESIGN: Descriptive study. PLACE AND DURATION: The outpatient department of plastic, reconstructive and hand surgery at Liaquat National Hospital, Karachi, from August 2005 to February 2006. PATIENTS AND METHODS: Skyline of the 2nd and 3rd metacarpals were used as reference line, from which the descent of the 5th metacarpal head was measured. The position of 5th metacarpal head was documented as angle X. Metacarpal descent was defined as the difference between angle "X" in relaxed and clenched fist position. The relaxed position was standardized by placing the forearm, wrist and palm on a shaped woodblock such that the wrist would be held in 25 - 30 degree in extension by a triangular spur, supported the 3rd metacarpal only. It was ensured that the movement of 4th and 5th metacarpals were not impaired. Analysis of variance was performed to compare the significance of means between genders at p<0.05 level of significance. RESULTS: Metacarpal descent of the 5th metacarpal of both hands was significantly greater for women, with a mean of 7 degree as compared with a mean of 4 degree for the men. This decrease in angle "X" was significant for the right 5th metacarpal relaxed and fist position and the fist position on the left. In contrast, women showed no significant differences between the various age groups for any of the variables tested. There was no relationship between metacarpal descent and hand dominance. CONCLUSION: Difference in metacarpal descent between men and women is significant and must be kept in mind when hand function is evaluated in both genders to assess the outcome of treatment and rehabilitation.

An in vitro analysis of ligament reconstruction or extension osteotomy on trapeziometacarpal joint stability and contact area.

PURPOSE: Painful instability of the minimally osteoarthritic thumb carpometacarpal (CMC) joint can be treated successfully by either ligament reconstruction or metacarpal extension osteotomy. The purpose of this study was to measure the laxity of cadaveric thumb CMC joints and to determine the influence of ligament reconstruction and metacarpal osteotomy on joint laxity and contact area. METHODS: The baseline laxity of CMC joints from 25 fresh-frozen human cadaveric specimens (average age, 42 y; range, 18-55 y) was measured in the position of lateral pinch on a custom-designed CMC joint laxity tester. Joint laxity was measured again after 2 surgical simulations consisting of either a metacarpal extension osteotomy (at 10 degrees and 15 degrees) or a simulated Eaton-Littler ligament reconstruction (including total, volar, and dorsal ligament reconstructions relative to the plane of the thumbnail). Contact area between the thumb metacarpal and trapezium during testing was determined using stereophotogrammetry. RESULTS: The 15 degrees extension osteotomy significantly reduced CMC joint laxity in the radial-ulnar, dorsal-volar, pronation-supination, and distraction directions in the position of lateral pinch. The 10 degrees osteotomy reduced laxity only in the dorsal-volar direction. The total ligament reconstruction significantly reduced joint laxity in the radial-ulnar, dorsal-volar, and pronation-supination directions. The dorsal ligament reconstruction reduced laxity in the dorsal-volar direction only; the volar ligament reconstruction reduced laxity in both dorsovolar and radioulnar directions. The 10 degrees and 15 degrees osteotomies produced a dorsal shift of the weighted centroid of contact on the metacarpal and trapezium, whereas the ligament reconstruction did not produce such an effect. CONCLUSIONS: In the position of lateral pinch the 15 degrees osteotomy and total ligament reconstruction significantly reduced laxity of the thumb CMC joint in all directions tested. The isolated dorsal or volar ligament reconstructions both reduced dorsal-volar laxity. Metacarpal extension osteotomy may stabilize the thumb CMC joint in lateral pinch to a degree similar to that of a standard ligament reconstruction.

Determination of mechanical loading components of the equine metacarpus from measurements of strain during walking.

REASONS FOR PERFORMING STUDY: The mechanical environment of the distal limb is thought to be involved in the pathogenesis of many injuries, but has not yet been thoroughly described. OBJECTIVES: To determine the forces and moments experienced by the metacarpus in vivo during walking and also to assess the effect of some simplifying assumptions used in analysis. METHODS: Strains from 8 gauges adhered to the left metacarpus of one horse were recorded in vivo during walking. Two different models - one based upon the mechanical theory of beams and shafts and, the other, based upon a finite element analysis (FEA) - were used to determine the external loads applied at the ends of the bone. RESULTS: Five orthogonal force and moment components were resolved by the analysis. In addition, 2 orthogonal bending moments were calculated near mid-shaft. Axial force was found to be the major loading component and displayed a bi-modal pattern during the stance phase of the stride. The shaft model of the bone showed good agreement with the FEA model, despite making many simplifying assumptions. CONCLUSIONS: A 3-dimensional loading scenario was observed in the metacarpus, with axial force being the major component. POTENTIAL RELEVANCE: These results provide an opportunity to validate mathematical (computer) models of the limb. The data may also assist in the formulation of hypotheses regarding the pathogenesis of injuries to the distal limb.