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1.
Oper Orthop Traumatol ; 33(6): 487-494, 2021 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-34709414

RESUMO

OBJECTIVE: Joint-preserving procedure with plantarization of the 1st metatarsal and improvement of range of motion. INDICATIONS: Mild and moderate arthrosis of the 1st metatarsophalangeal joint with pain and shoe discomfort due to elevation of 1st ray and failed conservative treatment. CONTRAINDICATIONS: Severe degenerative conditions 1st metatarsophalangeal joint with significant loss of range of motion preoperatively. General contraindications for surgical treatment/anesthesia. SURGICAL TECHNIQUE: Dorsomedial approach to 1st metatarsophalangeal joint, mild cheilectomy and arthrolysis, v­shaped osteotomy of metatarsal 1 from dorsal with plantarization of the metatarsal head, screw fixation from proximal dorsal to distal plantar. POSTOPERATIVE MANAGEMENT: Full weightbearing in rocker bottom shoe for 6 weeks. RESULTS: Improvement of range of motion from 35° dorsal extension to 50° in all cases after 6 months. Reduction of painful movement from VAS 6-7 to VAS 2-3 in 80% of patients.


Assuntos
Hallux Limitus , Hallux Valgus , Ossos do Metatarso , Articulação Metatarsofalângica , Humanos , Ossos do Metatarso/diagnóstico por imagem , Ossos do Metatarso/cirurgia , Articulação Metatarsofalângica/diagnóstico por imagem , Articulação Metatarsofalângica/cirurgia , Metatarso , Osteotomia , Resultado do Tratamento
2.
Vet Comp Orthop Traumatol ; 34(6): 401-410, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34488232

RESUMO

OBJECTIVE: The aim of this study was to create a feline reference database for the length, width and slenderness (length to width ratio) of metacarpal and metatarsal bones, radius and tibia. STUDY DESIGN: Radiographs of the radius, tibia, metacarpus and metatarsus were performed in domestic short hair cat cadavers (n = 40). Length and width of the aforementioned bones were measured in mature domestic shorthair cats and bone slenderness (length/width) and index ratios calculated. RESULTS: A significant skeletal sex dimorphism exists in cats, with bones of the metacarpus, metatarsus, radius and tibia generally longer and wider in male cats compared with female cats, with differences frequently significant. The most significant difference was identified for the width of Mc5 (p = 0.0008) and the length and width of Mt5 (p = 0.0005). Index ratios for length and width of radius to metacarpal bones, and tibia to metatarsal bones, were not significantly different between male and female cats, except for Mc5. The index ratio for Mc5 was significantly higher in male cats (p = 0.002). CONCLUSION: The present study provides insights into the normal length and width of distal forelimb and hind limb bones as well as bone index ratios in mature domestic shorthair cats. Using this information, it is now possible to quantitatively assess the relationship between these bones in domestic cats using radiography. This will assist not only with the diagnosis and categorization of skeletal abnormalities but can also guide surgical interventions of metacarpal and metatarsal bone fractures.


Assuntos
Doenças do Gato , Ossos Metacarpais , Ossos do Metatarso , Animais , Cadáver , Gatos , Extremidades , Feminino , Masculino , Ossos Metacarpais/diagnóstico por imagem , Ossos do Metatarso/diagnóstico por imagem , Metatarso
4.
J Foot Ankle Surg ; 60(5): 1048-1053, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34167887

RESUMO

The presence of metatarsus adductus (MTA) adds complexity to the diagnosis and treatment of hallux valgus (HV). Identification and careful analysis of these combined deformities is of paramount importance. The inability to completely correct HV and an increased incidence of recurrence has been established when MTA deformity is present. We present an option for correction of the combined deformities with multiplanar angular correction arthrodesis of the first, second, and third tarsometatarsal (TMT) joints.


Assuntos
Joanete , Hallux Valgus , Ossos do Metatarso , Metatarso Varo , Artrodese , Hallux Valgus/diagnóstico por imagem , Hallux Valgus/cirurgia , Humanos , Ossos do Metatarso/diagnóstico por imagem , Ossos do Metatarso/cirurgia , Metatarso
5.
Orthop Traumatol Surg Res ; 107(6): 102853, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-33578039

RESUMO

INTRODUCTION: The scarf osteotomy is a reliable surgical technique for treating hallux valgus. The aim of our study was to analyze the occurrence of transfer metatarsalgia after surgery on the first ray using a screwless Scarf osteotomy technique that we have been using in our department since 1995, which consists of stabilization by axial impaction without internal fixation. We hypothesized that the alleged shortening of the first metatarsal produced by this technique may be at the origin of postoperative metatarsalgia. PATIENTS AND METHODS: This was a case series of first ray metatarsal screwless Scarf osteotomies reviewed in the medium term. We did a clinical and radiological review of all patients operated using this technique between 2012 and 2017 who did not meet the following exclusion criteria: procedure on the other lateral metatarsals, concurrent hindfoot pathology, incomplete medical records. RESULTS: Of 114 feet, 96 were included in the study and 18 were excluded. The mean follow-up was 1 year and 8 months [1-4years]. The mean AOFAS score was 90.3 and 96% of patients were either satisfied or very satisfied with the outcome. All the parameters improved significantly: shoe wearing, pain, function, alignment. Fourteen feet had transfer metatarsalgia, which appeared during the first year postoperative (AOFAS 75/100). Ten other complications occurred: two Morton's neuromas, three cases of complex regional pain syndrome, one superficial infection, one paresthesia, two recurrences with surgical revision, one nonunion. No general complications were found. Based on radiographs, the mean M1 shortening was 3.3mm (6.3mm in metatarsalgia group versus 3.0 mm in the non-metatarsalgia group, P=0.2) and the mean angular correction was 16.2° (±6°). DISCUSSION: The overall results of screwless Scarf osteotomy are comparable and satisfactory, allowing large deformities to be corrected (28°±8° preoperatively in our cohort). M1 shortening and the transfer metatarsalgia rate appear to be higher than with other techniques. CONCLUSION: Screwless scarf osteotomy of M1 yields good functional and radiological outcomes in the medium term. However, it appears to cause more shortening and transfer metatarsalgia. LEVEL OF EVIDENCE: IV Retrospective, non-interventional in current practice (Recommendation grade C, low level of scientific proof).


Assuntos
Hallux Valgus , Ossos do Metatarso , Metatarsalgia , Hallux Valgus/diagnóstico por imagem , Hallux Valgus/cirurgia , Humanos , Ossos do Metatarso/diagnóstico por imagem , Ossos do Metatarso/cirurgia , Metatarsalgia/diagnóstico por imagem , Metatarsalgia/etiologia , Metatarsalgia/cirurgia , Metatarso , Osteotomia , Estudos Retrospectivos , Resultado do Tratamento
6.
Postgrad Med ; 133(3): 320-329, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33406375

RESUMO

Patients with foot pain commonly present to their primary care physicians for their initial management and treatment. These patients and their respective foot or lesser toe pain can present the physician with a complex problem with a long differential list. Depending on the timing of the pain and underlying pathology, these differentials can be divided into acute and acute exacerbation of chronic conditions. This review categorizes the history, physical exam, radiological findings, conservative treatment, and surgical management for each major cause of lesser toe pain, whether acute or chronic. The acute conditions surrounding lesser toe pain in the adult population discussed are toe fractures, toe dislocations, and metatarsal head and neck fractures. The chronic pathologies surrounding lesser toe pain in the adult population evaluated in this review include metatarsalgia, Morton's neuroma, Freiberg infraction, brachymetatarsia, bunionettes, and lesser toe disorders.


Assuntos
Metatarsalgia/patologia , Metatarsalgia/terapia , Dedos do Pé/patologia , Doença Aguda , Joanete do Alfaiate/patologia , Joanete do Alfaiate/terapia , Dor Crônica , Órtoses do Pé , Fraturas Ósseas/patologia , Fraturas Ósseas/terapia , Humanos , Imobilização/métodos , Luxações Articulares/patologia , Luxações Articulares/terapia , Metatarsalgia/etiologia , Metatarsalgia/cirurgia , Metatarso/anormalidades , Metatarso/patologia , Osteocondrite/congênito , Osteocondrite/patologia , Osteocondrite/terapia , Exame Físico
7.
J Med Primatol ; 50(1): 71-74, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33111351

RESUMO

Here we describe a successful surgical management of a distal fibular fracture combined with a tarsocrural luxation and multiple metatarsal fractures in the left foot of a southern brown howler monkey (Alouatta guariba clamitans). We achieved satisfactory outcome by applying intramedullary pinning for each of the bone fractures and closed reduction of joint luxation-kept in place only by bone alignment, without further ligament reconstruction. Bone healing occurred uneventfully within eight weeks and the monkey's foot regained its normal function. Therefore, we could properly release the patient back into the wild.


Assuntos
Alouatta/lesões , Fíbula/lesões , Consolidação da Fratura , Fraturas Ósseas/veterinária , Metatarso/lesões , Alouatta/fisiologia , Animais , Fíbula/fisiologia , Fíbula/cirurgia , Fraturas Ósseas/cirurgia , Masculino , Metatarso/fisiologia , Metatarso/cirurgia
8.
Foot Ankle Surg ; 27(6): 606-614, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32917526

RESUMO

BACKGROUND: Freiberg's disease is an osteonecrosis of the metatarsal head bone. Numerous surgical interventions can be provided; however, the literature is limited in systematic reviews discussing the various options. The study aimed to systematically review the quantity and quality of literatures exploring the surgical interventions. METHODS: Fifty articles were found to be relevant for assessing the efficacy of common surgical interventions. The articles were assigned a level of evidence (I-V) to assess their quality. Next, the studies were reviewed to provide a grade of recommendation (A-C, I). RESULTS: Two studies were found at level III that explored osteotomy and autologous transplantation; the other studies were level IV-V. There is poor evidence (grade C) in supporting of joint sparing and joint sacrificing for Freiberg's disease. CONCLUSION: Poor evidence exists to support the surgical interventions for Freiberg's disease, higher quality trials are needed to support the increasing application of these surgical techniques. LEVEL OF EVIDENCE: Level IV, Systematic review.


Assuntos
Ossos do Metatarso , Osteocondrite , Humanos , Ossos do Metatarso/cirurgia , Metatarso/anormalidades , Osteocondrite/congênito , Revisões Sistemáticas como Assunto
9.
Foot Ankle Int ; 41(9): 1092-1098, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32639166

RESUMO

BACKGROUND: Lesser toe metatarsophalangeal (MTP) joint pathology presents a challenge for surgical treatment. At our institution, arthroplasty using a polyvinyl alcohol (PVA) hydrogel implant has been utilized in the second and third MTP joints for advanced arthritis, failed management of Freiberg's infraction, and osteochondral defects. We present a case series describing the clinical outcomes of 13 patients following PVA implantation of the second or third MTP. METHODS: We retrospectively identified 13 patients (14 joints) who underwent PVA hydrogel implantation of the second (n = 12) or third (n = 2) metatarsal between 2017 and 2019. The average age was 49 (range, 20-67) years, with 100% females. Patient-Reported Outcomes Measurement Information System (PROMIS) scores were collected preoperatively and at an average of 21.1 (range, 8.3-29.2) months postoperatively. Clinical outcomes were also evaluated. The average time to clinical follow-up was 24.7 (range, 7-35.8) months. RESULTS: On average, patients demonstrated pre- to postoperative improvement in all PROMIS domains, with significant improvements in Pain Intensity (P = .01) and Pain Interference (P = .01). Five postoperative complications were observed: 1 case of persistent avascular necrosis, 1 revision with implant removal and bone grafting, 1 periprosthetic fracture, and 2 recurrences of pain requiring ultrasound-guided injection. CONCLUSION: This study represents the largest case series to date evaluating the use of PVA implant in the surgical correction of lesser toe MTP joint pathology. While the PVA implant presents a viable option in the setting of advanced arthritis, Freiberg's infraction, and certain osteochondral defects, it is not without complications. The specific indications for use of the PVA implant should be carefully considered. LEVEL OF EVIDENCE: Level IV, case series.


Assuntos
Artroplastia/métodos , Articulação Metatarsofalângica/cirurgia , Metatarso/anormalidades , Osteocondrite/congênito , Álcool de Polivinil/uso terapêutico , Próteses e Implantes , Adulto , Idoso , Feminino , Humanos , Metatarso/cirurgia , Pessoa de Meia-Idade , Osteocondrite/cirurgia , Medidas de Resultados Relatados pelo Paciente , Estudos Retrospectivos , Adulto Jovem
10.
Yonsei Med J ; 61(7): 635-639, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32608208

RESUMO

Cavovarus deformity is considered an anatomical risk factor for chronic lateral ankle instability (CLAI). However, subtle deformity can be difficult to detect, and its correction is controversial. The current study aimed to evaluate clinical and radiographic outcomes of a modified Broström procedure (MBP) with additional procedures for CLAI with subtle cavovarus deformity and a positive peek-a-boo heel sign. We reviewed the records of 15 patients who underwent MBP with additional procedures for CLAI with a positive peek-a-boo heel sign between August 2009 and April 2015. Consecutive physical and radiographic examinations were performed. The visual analog scale (VAS) for pain, the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, and the Karlsson-Peterson (KP) ankle score were applied to assess clinical outcomes. Weight bearing radiographs, hindfoot alignment view, and ankle stress radiographs were also examined. The mean follow-up period was 58.5 months. Calcaneal lateral closing wedge osteotomy was performed in seven patients to correct fixed hindfoot varus, and first metatarsal dorsiflexion osteotomy was performed in 11 patients to correct plantarflexion of the first ray. Three patients underwent both procedures. Mean VAS, AOFAS, and KP ankle scores improved significantly (p=0.001), and instability did not recur. Radiographically, all stress parameters improved significantly (p=0.007). Simultaneous correction of a positive peek-a-boo heel sign and cavovarus deformity with MBP for CLAI improves clinical outcomes and prevents recurrent instability. A comprehensive evaluation and cautious approach for subtle cavovarus deformity should be followed when treating patients with CLAI. This trial is registered on Clinical Research Information Service (CRiS, KCT0003287).


Assuntos
Articulação do Tornozelo/cirurgia , Instabilidade Articular/cirurgia , Osteotomia/métodos , Adulto , Tornozelo/diagnóstico por imagem , Tornozelo/fisiopatologia , Articulação do Tornozelo/diagnóstico por imagem , Feminino , , Calcanhar/diagnóstico por imagem , Calcanhar/fisiopatologia , Humanos , Instabilidade Articular/diagnóstico , Instabilidade Articular/diagnóstico por imagem , Masculino , Ossos do Metatarso , Metatarso/diagnóstico por imagem , Metatarso/cirurgia , Pessoa de Meia-Idade , Radiografia , Procedimentos Cirúrgicos Reconstrutivos , Recuperação de Função Fisiológica , Pé Cavo/diagnóstico por imagem , Pé Cavo/cirurgia , Resultado do Tratamento , Escala Visual Analógica
11.
J Foot Ankle Res ; 13(1): 46, 2020 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-32677989

RESUMO

BACKGROUND: This study aimed to clarify the morphological characteristics of the Lisfranc ligament and the cuneiform 1-metatarsal 2&3 plantar ligament (CMPL). METHODS: Forty legs from 20 cadavers were examined. Classification proceeded according to the number of fiber bundles in the Lisfranc ligament and the CMPL. Morphological features measured were fiber bundle length, width, thickness, and angle. RESULTS: In Type I-a, the Lisfranc ligament and the CMPL were a single fiber bundle; in Type I-b, the Lisfranc ligament was a single fiber bundle, and the CMPL was two fiber bundles; in Type II-a, the Lisfranc ligament was a two fiber bundle, and the CMPL was a single fiber bundle; in Type II-b, the Lisfranc ligament and the CMPL were two fiber bundles; in Type III-a, the Lisfranc ligament was three fiber bundles, and the CMPL was a single fiber bundle; in Type III-b, the Lisfranc ligament was three fiber bundles, and the CMPL was two fiber bundles; in Type IV, the Lisfranc ligament and the CMPL could not be separated. Type I-a was seen in 37.5%, Type I-b in 10%, Type II-a in 30%, Type II-b in 7.5%, Type III-a in 7.5%, Type III-b in 2.5%, and Type IV in 5%. The Lisfranc ligament was significantly larger than the CMPL in total fiber bundle width, total fiber bundle thickness, and total fiber bundle angle. CONCLUSION: The Lisfranc ligament had up to 3 fiber bundles and the CMPL had one or two fiber bundles; classifications were four types and two subgroups.


Assuntos
Pé/anatomia & histologia , Ligamentos Articulares/anatomia & histologia , Metatarso/anatomia & histologia , Placa Plantar/anatomia & histologia , Ossos do Tarso/anatomia & histologia , Cadáver , Feminino , Traumatismos do Pé/patologia , Humanos , Masculino
12.
J Am Podiatr Med Assoc ; 110(3)2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32730600

RESUMO

Midline metatarsal ray deficiencies, which occur in approximately half of congenital short limbs with fibular deficiency, provide the most distal and compelling manifestation of a fluid spectrum of human lower-extremity congenital long bone reductions; this spectrum syndromically affects the long bone triad of the proximal femur, fibula, and midline metatarsals. The bony deficiencies correspond to sites of rapid embryonic arterial transitioning. Long bones first begin to ossify because of vascular invasions of their respective mesenchymal/cartilage anlagen, proceeding in a proximal-to-distal sequence along the forming embryonic limb. A single-axis artery forms initially in the embryonic lower limb by means of vasculogenesis. Additional arteries evolve in overlapping transitional waves, in proximity to the various anlagen, during the sixth and seventh weeks after fertilization. An adult pattern of vessels presents by the eighth week. Arterial alterations, in the form of retained primitive embryonic vessels and/or reduced absent adult vessels, have been observed clinically at the aforementioned locations where skeletal reductions occur. Persistence of primitive vessels in association with the triad of long bone reductions allows a heuristic estimation of the time, place, and nature of such coupled vascular and bony dysgeneses. Arterial dysgenesis is postulated to have occurred when the developing arterial and skeletal structures were concurrently vulnerable to teratogenic insults because of embryonic arterial instability, a risk factor during arterial transition. It is herein hypothesized that flawed arterial transitions subject the prefigured long bone cartilage models of the rapidly growing limb to the risk of teratogenesis at one or more of the then most rapidly growing sites. Midline metatarsal deficiency forms the keystone of this developmental concept of an error of limb development, which occurs as a consequence of failed completion of the medial portion of the plantar arch. Therefore, the historical nomenclature of congenital long bone deficiencies will benefit from modification from a current reliance on empirical physical taxonomies to a developmental foundation.


Assuntos
Deformidades Congênitas do Pé , Ossos do Metatarso , Adulto , Fíbula , Humanos , Metatarso , Artérias da Tíbia
13.
J Foot Ankle Surg ; 59(5): 1109-1112, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32653393

RESUMO

Freiberg's disease is a form of osteochondrosis of a metatarsal head that often affects the second metatarsophalangeal joint, and that affects females more often than males. Repetitive microtrauma, osteonecrosis, and stress overload are the main factors in its pathophysiology. Surgical intervention is indicated in advanced cases wherein nonoperative treatment has failed. In this report, we describe the case of a young female who had Freiberg's disease localized to the third metatarsal head bilaterally and who was successfully treated with peroneus longus tendon transplantation.


Assuntos
Ossos do Metatarso , Osteocondrite , Autoenxertos , Feminino , Humanos , Masculino , Ossos do Metatarso/diagnóstico por imagem , Ossos do Metatarso/cirurgia , Metatarso/anormalidades , Metatarso/diagnóstico por imagem , Metatarso/cirurgia , Osteocondrite/congênito , Osteocondrite/diagnóstico por imagem , Osteocondrite/cirurgia , Tendões
14.
J Foot Ankle Surg ; 59(3): 484-490, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32354505

RESUMO

AIMS: The optimal level of lower-extremity amputation, particularly in diabetic patients with ulceration, is debated. Proximal amputations more greatly decrease function versus distal amputations, but healing and complication rates may differ between the 2 types. This study compares early postoperative outcomes after transmetatarsal and other partial foot amputations and major leg amputations. METHODS: Data were derived from National Surgical Quality Improvement Program datasets covering 2012 to 2014. Outcomes studied include 30-day rates of readmission to hospital for wound complications. We matched the 2 types of amputation patients by propensity score to fairly compare between levels of amputation when either type of amputation might be indicated. The same analysis was then performed with emphasis on diabetic patients. RESULTS: Major amputation patients were more likely to have dependent functional status, although their surgeries tended to be more complicated. Minor amputation patients had 2.5 times the odds of irrigation and debridement compared with major amputation patients, but only 0.49 and 0.47 times the odds of urinary tract infection or transfusion, respectively. CONCLUSIONS: Although short-term complications, readmissions, and reoperations were more common in distal amputation, UTI and the need for transfusion were higher in major amputation.


Assuntos
Amputação/efeitos adversos , Pé Diabético/cirurgia , Complicações Pós-Operatórias/epidemiologia , Idoso , Amputação/métodos , Estudos de Coortes , Feminino , Humanos , Joelho , Masculino , Metatarso , Pessoa de Meia-Idade , Readmissão do Paciente , Pontuação de Propensão , Reoperação , Fatores de Tempo
15.
Injury ; 51(7): 1457-1467, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32430197

RESUMO

INTRODUCTION: Large bone defects in long bone are not able to repair themselves and require grafts. Although autograft is the gold standard, it is associated with some disadvantages. Consequently, the application of tissue engineering (TE) techniques help with the use of allogenic biological and artificial scaffolds, cells and growth factors (GFs). Following 3Rs and in vitro testing strategies, animal models are required in preclinical in vivo studies to evaluate the therapeutic effects of the most promising TE techniques. MATERIALS AND METHODS: A systematic review was performed from 2000 to 2019 to evaluate bone regeneration sheep metatarsus defects. RESULTS: Eleven in vivo studies on sheep metatarsus defect were retrieved. The mid-diaphysis of metatarsus was the region most employed to perform critical size defects. Natural, synthetic and hybrid scaffolds were implanted, combined with bone marrow mesenchymal stem cells (BMSCs), GFs such as osteogenic protein 1 (OP1) and platelet rich plasma (PRP). The maximum follow-up period was 4 and 6 months in which radiography, histology, histomorphometry, computed tomography (CT) and biomechanics were performed to evaluate the healing status. CONCLUSIONS: the sheep metatarsus defect model seems to be a suitable environment with a good marriage of biological and biomechanical properties. Defects of 3 cm are treated with natural scaffolds (homologous graft or allografts), those of 2.5 cm with natural, synthetic or composite scaffolds, while little defects (0.5 × 0.5 cm) with composite scaffolds. No difference in results is found regardless of the defect size.


Assuntos
Fraturas Ósseas/terapia , Transplante de Células-Tronco Mesenquimais/métodos , Metatarso/lesões , Engenharia Tecidual , Animais , Fenômenos Biomecânicos , Proteína Morfogenética Óssea 7 , Regeneração Óssea , Humanos , Células-Tronco Mesenquimais/citologia , Modelos Animais , Plasma Rico em Plaquetas , Medicina Regenerativa , Ovinos , Transplante Homólogo
16.
Anat Histol Embryol ; 49(6): 695-707, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32319123

RESUMO

The objective of the present study was to model in 3D the detailed morphometric features of the thoracic and pelvic limb bones of the gazelle (Gazella subgutturosa), whose natural habitat is only in the Sanliurfa province, by using multidetector computerized tomography (MDCT) images. Materials from 14 (7 male and 7 female) dead gazelles were collected from the Harran University Veterinary Medicine Faculty clinics during or after treatment. MDCT images of the gazelles were taken and saved as DICOM (Digital Imaging and Communications in Medicine) files. MIMICS 20.1 software was used to generate a 3D reconstruction of the data, and morphological and morphometrical evaluation was performed. In respect of morphological features, the combined metacarpus (Mc) III and metacarpus Mc IV were the main weight-bearing metacarpal bone, while Mc II and Mc V were rudimentary. On the femur, the lateral condyle was bigger than the medial condyle at the caudodistal end and the medial wing of the trochlea femoris was larger than the lateral. As with the thoracic limb, the combined metatarsus (Mt) III and metatarsus Mt IV were the main weight-bearing metacarpal bone and they displayed a synostosis structure. There was no secondary metatarsus in the gazelles' pelvic limb. Based on digital measurements, the tibia was the longest bone of the gazelles' skeletal system, and there was a statistically significant sexual dimorphism throughout the skeleton at the levels of p < .05, p < .01 and p < .001. As a result, the present study's findings are useful as reference data for further studies on anatomy, surgery and archaezoology, while also being useful for classifying species and for forensic sciences.


Assuntos
Antílopes/anatomia & histologia , Extremidades/anatomia & histologia , Animais , Tornozelo/anatomia & histologia , Carpo Animal/anatomia & histologia , Feminino , Fêmur/anatomia & histologia , Quadril/anatomia & histologia , Úmero/anatomia & histologia , Imageamento Tridimensional/veterinária , Masculino , Ossos Metacarpais/anatomia & histologia , Metatarso/anatomia & histologia , Rádio (Anatomia)/anatomia & histologia , Escápula/anatomia & histologia , Caracteres Sexuais , Tíbia/anatomia & histologia , Dedos do Pé/anatomia & histologia , Ulna/anatomia & histologia
17.
Wounds ; 32(3): E14-E18, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32335521

RESUMO

INTRODUCTION: Diabetic foot ulcers may lead to nontraumatic amputations of the foot, leading to a decrease in patient quality of life. Transmetatarsal amputations (TMAs) represent an effective surgical procedure in cases of severe foot infection, but the tissue reconstruction is complicated and additional procedures should be considered. The present case report evaluates the wound closure of an open TMA in a patient with diabetes treated with a new aerogel composed of chitosan (ChS) and chondroitin sulphate (CS), without needing a skin graft. CASE REPORT: A 72-year-old man with diabetes and a history of successive amputations was admitted to a hospital in Valdivia, Chile, due to a severe infection of toes 2 and 4 of the right foot. After the diagnosis of gangrene and osteomyelitis, the patient underwent a TMA of his right forefoot. The surgeon proposed the incorporation of ChS and CS aerogels to accelerate wound healing to avoid another surgical procedure. The TMA surgical wound area closed 50% after day 28 from starting treatment with aerogels. Complete closure was achieved at day 94 of treatment with aerogels, with good epithelial tissue and favorable cosmetic results and without residual limb deformities. The patient experienced minimal physical and psychological impairment from the procedure. Other surgical procedures were not necessary. CONCLUSIONS: Due to the results of this patient, use of ChS and CS aerogels could represent an alternative treatment for forefoot TMA wound closure and prevent further surgical procedures, such as skin grafting. Future works should consider a larger number of cases.


Assuntos
Amputação , Quitosana/farmacologia , Sulfatos de Condroitina/farmacologia , Diabetes Mellitus Tipo 2/complicações , Pé Diabético/cirurgia , Metatarso/cirurgia , Cicatrização/efeitos dos fármacos , Idoso , Pé Diabético/etiologia , Gangrena/etiologia , Géis , Humanos , Masculino , Osteomielite/etiologia
18.
Sci Rep ; 10(1): 7068, 2020 04 27.
Artigo em Inglês | MEDLINE | ID: mdl-32341459

RESUMO

Although autografts are considered to be the gold standard treatment for reconstruction of large bone defects resulting from trauma or diseases, donor site morbidity and limited availability restrict their use. Successful bone repair also depends on sufficient vascularization and to address this challenge, novel strategies focus on the development of vascularized biomaterial scaffolds. This pilot study aimed to investigate the feasibility of regenerating large bone defects in sheep using 3D-printed customized calcium phosphate scaffolds with or without surgical vascularization. Pre-operative computed tomography scans were performed to visualize the metatarsus and vasculature and to fabricate customized scaffolds and surgical guides by 3D printing. Critical-sized segmental defects created in the mid-diaphyseal region of the metatarsus were either left empty or treated with the 3D scaffold alone or in combination with an axial vascular pedicle. Bone regeneration was evaluated 1, 2 and 3 months post-implantation. After 3 months, the untreated defect remained non-bridged while the 3D scaffold guided bone regeneration. The presence of the vascular pedicle further enhanced bone formation. Histology confirmed bone growth inside the porous 3D scaffolds with or without vascular pedicle inclusion. Taken together, this pilot study demonstrated the feasibility of precised pre-surgical planning and reconstruction of large bone defects with 3D-printed personalized scaffolds.


Assuntos
Fosfatos de Cálcio/química , Metatarso/cirurgia , Tecidos Suporte/química , Animais , Materiais Biocompatíveis/química , Regeneração Óssea/fisiologia , Projetos Piloto , Impressão Tridimensional , Ovinos
19.
Rev. esp. med. legal ; 46(1): 12-19, ene.-mar. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-193985

RESUMO

INTRODUCCIÓN: El objetivo de este estudio fue la obtención de funciones discriminantes para estimación del sexo a partir de mediciones directas en metacarpos y metatarsos para contribuir en la identificación de individuos desconocidos. MATERIAL Y MÉTODOS: Se analizaron métricamente los metacarpos y metatarsos de 112 esqueletos adultos contemporáneos (49 femeninos y 63 masculinos) de la Colección-UNAM del Laboratorio de Antropología Física, Facultad de Medicina, UNAM. Empleando un vernier digital se tomaron 5 medidas (longitud máxima y 4 anchuras) en cada uno de los huesos del metacarpo y del metatarso. RESULTADOS: Se desarrollaron 14 funciones discriminantes para los metacarpos, con porcentajes del 79,5% a 85,3% de asignación sexual correcta, siendo el segundo metacarpo el hueso más dimórfico de la muestra. Para el caso de los metatarsos se obtuvieron 5 funciones que van del 77,8% al 83,2% de certidumbre, siendo el primer metatarso el hueso más dimórfico. De manera general, las anchuras en ambas epífisis fueron las medidas más dimórficas. CONCLUSIONES: Las funciones discriminantes de metacarpos y metatarsos obtenidas presentan, de manera general, porcentajes por encima del 80%, lo cual concuerda con lo reportado para otras poblaciones; por lo tanto, pueden ser utilizadas en contextos forenses para la identificación humana, en restos completos o fragmentados, en el caso de no contar con otro elemento óseo, como la pelvis


INTRODUCTION: The aim of this study was to obtain discriminant functions for estimating gender from direct measurements of the metacarpal and metatarsal bones for identification of unknown individuals. MATERIAL AND METHODS: An analysis was performed on metacarpal and metatarsals bones of 112 adult contemporary skeletons (49 females and 63 males). The sample belongs to the Autonomous University of Mexico (UNAM) Collection from the Physical Anthropology Laboratory, UNAM Faculty of Medicine. Five measurements were taken (maximum length and four widths) of each metacarpal and metatarsal bones employing a digital calliper. RESULTS: Fourteen discriminant functions were developed for metacarpals with percentages from 79.5% to 85.3% of correct gender classification. The second metacarpal was the most dimorphic of the sample. For metatarsals, five discriminant functions were obtained, ranging from 77.8% to 83.2% of certainty. In this case the first metatarsal was the most dimorphic. In general terms, the widths of both epiphyses were the most dimorphic measurements. CONCLUSIONS: The discriminant functions of metacarpal and metatarsal bones obtained are generally above 80%, which is similar to reports from other populations. Therefore, it can be used in forensic contexts for human identification with complete or fragmented remains, in the cases where no other bone element is available, such as the pelvis


Assuntos
Humanos , Masculino , Feminino , Determinação do Sexo pelo Esqueleto/métodos , Metacarpo/anatomia & histologia , Metatarso/anatomia & histologia , Antropometria/métodos , Identificação Biométrica/métodos , Antropologia Forense/métodos , Tamanho do Órgão , México , Reprodutibilidade dos Testes
20.
Dev Genes Evol ; 230(2): 121-136, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32036445

RESUMO

Spiders are equipped with a large number of innervated cuticular specializations, which respond to various sensory stimuli. The physiological function of mechanosensory organs has been analysed in great detail in some model spider species (e.g. Cupiennius salei); however, much less is known about the distribution and function of chemosensory organs. Furthermore, our knowledge on how the sense organ pattern develops on the spider appendages is limited. Here we analyse the development of the pattern and distribution of six different external mechano- and chemosensory organs in all postembryonic stages and in adult male and female spiders of the species Parasteatoda tepidariorum. We show that except for small mechanosensory setae, external sense organs appear in fixed positions on the pedipalps and first walking legs, arranged in longitudinal rows along the proximal-distal axis or in invariable positions relative to morphological landmarks (joints, distal tarsal tip). A comparison to other Entelegynae spiders shows that these features are conserved. We hope that this study lays the foundation for future molecular analysis to address the question how this conserved pattern is generated.


Assuntos
Extremidades/crescimento & desenvolvimento , Órgãos dos Sentidos/crescimento & desenvolvimento , Sensilas/anatomia & histologia , Sensilas/crescimento & desenvolvimento , Aranhas/crescimento & desenvolvimento , Animais , Extremidades/anatomia & histologia , Feminino , Fêmur/anatomia & histologia , Fêmur/crescimento & desenvolvimento , Masculino , Metatarso/anatomia & histologia , Metatarso/crescimento & desenvolvimento , Microscopia Eletrônica de Varredura , Órgãos dos Sentidos/anatomia & histologia , Sensilas/ultraestrutura , Aranhas/anatomia & histologia , Tíbia/anatomia & histologia , Tíbia/crescimento & desenvolvimento
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