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2.
PLoS One ; 16(7): e0254788, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34297750

RESUMO

Despite the extreme morphological variability of the canine species, data on limb development are limited and the time windows for the appearance of the limb ossification centres (OCs) reported in veterinary textbooks, considered universally valid for all dogs, are based on dated studies. The aim of this study was to acquire up-to-date information regarding the arm, forearm and leg bone development in skeletally-immature large-sized dogs from 6 weeks to 16 weeks of age. Nine litters of 5 large-sized breeds (Boxer, German Shepherd, Labrador Retriever, Saarloos Wolfdog, White Swiss Shepherd Dog) were included, for a total of 54 dogs, which were subject to radiographic examination on a bi-weekly basis. The appearance of 18 limb OCs was recorded and 14 radiographic measurements were performed; their relationship with age and body weight was investigated and any breed differences were analysed using different statistical non-parametric tests. The number of OCs present was significantly different at 6 and 8 weeks of age between the investigated breeds. The appearance of the OCs occurred earlier in the Saarloos Wolfdog, while the Labrador Retriever was the later breed. In Boxers and Labrador Retrievers, various OCs showed a delayed appearance compared to the data reported in the literature. The number of OCs was strongly and positively correlated to body weight. Breed differences were also observed in the relative increase of the measured OCs and were not limited to dogs of different morphotypes. Statistically significant differences were most frequently observed between Saarloos Wolfdogs and the other breeds. The OCs that showed a greater variability in their development were the olecranon tuber, the patella and the tibial tuberosity. Their increase was more strongly correlated with the dog's age and body weight. Our data strongly suggest that differences in limb development exist in dog breeds of similar size and morphotype.


Assuntos
Desenvolvimento Ósseo , Cães/crescimento & desenvolvimento , Extremidades/crescimento & desenvolvimento , Animais , Ossos da Extremidade Inferior/diagnóstico por imagem , Ossos da Extremidade Inferior/crescimento & desenvolvimento , Ossos da Extremidade Superior/diagnóstico por imagem , Ossos da Extremidade Superior/crescimento & desenvolvimento , Cães/classificação , Extremidades/diagnóstico por imagem , Feminino , Masculino , Radiografia
3.
Medicine (Baltimore) ; 100(18): e25302, 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-33950919

RESUMO

ABSTRACT: Childhood obesity is a growing epidemic in the United States, and is associated with an increased risk of lower-extremity physeal fractures, and fractures requiring operative intervention. However, no study has assessed the risk upper extremity physeal fractures among overweight children. Our purpose was to compare the following upper-extremity fracture characteristics in overweight and obese children with those of normal-weight/underweight children (herein, "normal weight"): mechanism of injury, anatomical location, fracture pattern, physeal involvement, and treatment types. We hypothesized that overweight and obese children would be higher risk for physeal and complete fractures with low-energy mechanisms and would therefore more frequently require operative intervention compared with normal-weight children.We performed a cross-sectional review of our database of 608 patients aged 2 to 16 years, and included patients who sustained isolated upper-extremity fractures at our level-1 pediatric tertiary care center from January 2014 to August 2017. Excluded were patients who sustained pathologic fractures and those without basic demographic or radiologic information. Using body mass index percentile for age and sex, we categorized patients as obese (≥95th percentile), overweight (85th to <95th percentile), normal weight (5th to <85th percentile), or underweight (<5th percentile). The obese and overweight groups were analyzed both separately and as a combined overweight/obese group. Demographic data included age, sex, height, and weight. Fractures were classified based on fracture location, fracture pattern (transverse, comminuted, buckle, greenstick, avulsion, or oblique), physeal involvement, and treatment type. Of the 608 patients, 58% were normal weight, 23% were overweight, and 19% were obese. There were no differences in the mean ages or sex distributions among the 3 groups.Among patients with low-energy mechanisms of injury, overweight/obese patients had significantly greater proportions of complete fractures compared with normal-weight children (complete: 65% vs 55%, P = .001; transverse: 43% vs 27%, P = .006). In addition, the overweight/obese group sustained significantly more upper-extremity physeal fractures (37%) than did the normal-weight group (23%) (P = .007).Compared with those in normal-weight children, upper-extremity fracture patterns differ in overweight and obese children, who have higher risk of physeal injuries and complete fractures caused by low-energy mechanisms.Level of Evidence: Level III, retrospective comparative study.


Assuntos
Ossos da Extremidade Superior/lesões , Fraturas Ósseas/epidemiologia , Obesidade Pediátrica/epidemiologia , Distribuição por Idade , Criança , Pré-Escolar , Estudos Transversais , Feminino , Hospitais Pediátricos/estatística & dados numéricos , Humanos , Masculino , Estudos Retrospectivos , Fatores de Risco , Distribuição por Sexo , Centros de Atenção Terciária/estatística & dados numéricos , Estados Unidos/epidemiologia
4.
Sci Rep ; 10(1): 19070, 2020 11 04.
Artigo em Inglês | MEDLINE | ID: mdl-33149160

RESUMO

The lack of bone morphological markers associated with the human control of wild animals has prevented the documentation of incipient animal domestication in archaeology. Here, we assess whether direct environmental changes (i.e. mobility reduction) could immediately affect ontogenetic changes in long bone structure, providing a skeletal marker of early domestication. We relied on a wild boar experimental model, analysing 24 wild-born specimens raised in captivity from 6 months to 2 years old. The shaft cortical thickness of their humerus was measured using a 3D morphometric mapping approach and compared with 23 free-ranging wild boars and 22 pigs from different breeds, taking into account sex, mass and muscle force differences. In wild boars we found that captivity induced an increase in cortical bone volume and muscle force, and a topographic change of cortical thickness associated with muscular expression along a phenotypic trajectory that differed from the divergence induced by selective breeding. These results provide an experimental proof of concept that changes in locomotor behaviour and selective breeding might be inferred from long bones morphology in the fossil and archaeological record. These trends need to be explored in the archaeological record and further studies are required to explore the developmental changes behind these plastic responses.


Assuntos
Ossos da Extremidade Inferior/anatomia & histologia , Ossos da Extremidade Superior/anatomia & histologia , Domesticação , Suínos/anatomia & histologia , Animais , Animais Selvagens/anatomia & histologia , Animais Selvagens/genética , Evolução Biológica , Osso Cortical/anatomia & histologia , Feminino , Masculino , Suínos/genética
5.
Int J Mol Sci ; 20(23)2019 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-31757091

RESUMO

The longitudinal growth of long bone, regulated by an epiphyseal cartilaginous component known as the "growth plate", is generated by epiphyseal chondrocytes. The growth plate provides a continuous supply of chondrocytes for endochondral ossification, a sequential bone replacement of cartilaginous tissue, and any failure in this process causes a wide range of skeletal disorders. Therefore, the cellular and molecular characteristics of the growth plate are of interest to many researchers. Hedgehog (Hh), well known as a mitogen and morphogen during development, is one of the best known regulatory signals in the developmental regulation of the growth plate. Numerous animal studies have revealed that signaling through the Hh pathway plays multiple roles in regulating the proliferation, differentiation, and maintenance of growth plate chondrocytes throughout the skeletal growth period. Furthermore, over the past few years, a growing body of evidence has emerged demonstrating that a limited number of growth plate chondrocytes transdifferentiate directly into the full osteogenic and multiple mesenchymal lineages during postnatal bone development and reside in the bone marrow until late adulthood. Current studies with the genetic fate mapping approach have shown that the commitment of growth plate chondrocytes into the skeletal lineage occurs under the influence of epiphyseal chondrocyte-derived Hh signals during endochondral bone formation. Here, we discuss the valuable observations on the role of the Hh signaling pathway in the growth plate based on mouse genetic studies, with some emphasis on recent advances.


Assuntos
Desenvolvimento Ósseo , Ossos da Extremidade Inferior/metabolismo , Ossos da Extremidade Superior/metabolismo , Lâmina de Crescimento/metabolismo , Proteínas Hedgehog/metabolismo , Animais , Ossos da Extremidade Inferior/crescimento & desenvolvimento , Ossos da Extremidade Superior/crescimento & desenvolvimento , Regulação da Expressão Gênica no Desenvolvimento , Lâmina de Crescimento/crescimento & desenvolvimento , Proteínas Hedgehog/genética , Humanos , Transdução de Sinais
6.
Traffic Inj Prev ; 20(sup2): S63-S68, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31560215

RESUMO

Objective: The objective was to develop a disability-based metric for motor vehicle crash (MVC) upper and lower extremity injuries and compare functional outcomes between children and adults.Methods: Disability risk (DR) was quantified using Functional Independence Measure (FIM) scores within the National Trauma Data Bank-Research Data System for the top 95% most frequently occurring Abbreviated Injury Scale (AIS) 3 extremity injuries (22 unique injuries). Pediatric (7-18 years), young adult (19-45 years), middle-aged (46-65 years), and older adult (66+ years) MVC occupants with an FIM score and at least one of the 22 extremity injuries were included. DR was calculated for each injury as the proportion of occupants who were disabled of those sustaining the injury. A maximum AIS-adjusted disability risk (DRMAIS) was also calculated for each injury, excluding occupants with AIS 4+ co-injuries.Results: Locomotion impairment was the most frequent disability type across all ages. DR and DRMAIS of the extremity injuries ranged from 0.06 to 1.00 (6%-100% disability risk). Disability risk increased with age, with DRMAIS increasing from 25.9% ± 8.6% (mean ± SD) in pediatric subjects to 30.4% ± 6.3% in young adults, 39.5% ± 6.6% in middle-aged adults, and 60.5 ± 13.3% in older adults. DRMAIS for upper extremity fractures differed significantly between age groups, with higher disability in older adults, followed by middle-aged adults. DRMAIS for pelvis, hip, shaft, knee, and other lower extremity fractures differed significantly between age groups, with older adult DRMAIS being significantly higher for each fracture type. DRMAIS for hip and lower extremity shaft fractures was also significantly higher in middle-aged occupants compared to pediatric and young adult occupants. The maximum AIS-adjusted mortality risk (MRMAIS, proportion of fatalities among occupants sustaining an MAIS 3 injury) was not correlated with DRMAIS for extremity injuries in pediatric, young adult, middle-aged, and older adult occupants (all R2 < 0.01). Disability associated with each extremity injury was higher than mortality risk.Conclusions: Older adults had significantly greater disability for MVC extremity injuries. Lower disability rates in children may stem from their increased physiological capacity for bone healing and relative lack of bone disease. The disability metrics developed can supplement AIS and other severity-based metrics by accounting for the age-specific functional implications of MVC extremity injuries.


Assuntos
Acidentes de Trânsito , Ossos da Extremidade Inferior/lesões , Ossos da Extremidade Superior/lesões , Fraturas Ósseas/reabilitação , Escala Resumida de Ferimentos , Acidentes de Trânsito/mortalidade , Adolescente , Fatores Etários , Idoso , Criança , Avaliação da Deficiência , Pessoas com Deficiência , Feminino , Fraturas Ósseas/mortalidade , Humanos , Traumatismos do Joelho/mortalidade , Traumatismos do Joelho/reabilitação , Masculino , Pessoa de Meia-Idade , Ossos Pélvicos/lesões , Estados Unidos/epidemiologia , Adulto Jovem
7.
Int. j. morphol ; 37(3): 965-970, Sept. 2019. graf
Artigo em Espanhol | LILACS | ID: biblio-1012382

RESUMO

El tratamiento quirúrgico del cáncer de mama puede dejar secuelas tardías tales como escápula alada, pérdida de movilidad articular del hombro, sobrepeso, etc. Basado en lo anterior, el objetivo del presente estudio fue describir las secuelas morfofuncionales en mujeres operadas de cáncer de mama de las regiones de la Araucanía y del Bío-Bío, Chile, explorando también si el procedimiento quirúrgico conllevaría a la presencia de escápula alada. Para ello, se realizó un estudio cuantitativo, observacional y de corte transversal en treinta mujeres operadas de cáncer de mama, de edades comprendidas entre 28 y 76 años (55,67±11,60). Un profesional entrenado evaluó peso, estatura, índice de masa corporal (IMC), índice de cintura cadera (ICC), rangos articulares de hombro (ROM, Range of Movement) y fuerza prensil, aplicándose además la prueba de Hoppenfeld para identificar escápula alada. Los resultados mostraron diferencias significativas en el ROM a la abducción de hombro (p<0,05), correlación significativa positiva de leve (r=0,370) a moderada (r=0,514) entre el ROM del lado afectado tanto para la flexión como la abducción con la fuerza prensil. Destacan, un IMC de 28,91±5,31 kg/m2, un ICC de 0,86±0,06 cm y la presencia de escápula alada en el 36,7 % de las participantes. No se encontró asociación entre el abordaje quirúrgico y la presencia de escápula alada. Hubo secuelas morfo-funcionales en las mujeres en estudio, destacándose las alteraciones en el rango de movimiento del miembro superior, sobrepeso, riesgo cardiovascular y la presencia de escápula alada, sin asociarse al tipo de abordaje quirúrgico.


Surgical treatment of breast cancer can leave late sequelae such as winged scapula, loss of joint mobility of the shoulder, overweight, etc. Based on the above, the objective of the present study was to describe the morpho-functional sequelae in women operated on for breast cancer from the regions of Araucanía and Del BíoBío, Chile, also exploring whether the surgical procedure would lead to the presence of scapula winged. For this, a quantitative, observational and cross-sectional study was conducted in thirty women operated on for breast cancer, aged between 28 and 76 years (55.67 ± 11.60). A trained professional evaluated weight, height, body mass index (BMI), hip waist index (ICC), shoulder joint ranges(ROM, Range of Movement) and prehensile strength, and applied the Hoppenfeld test to identify the winged scapula. The results showed significant differences in the ROM to shoulder abduction (p <0.05), positive significant correlation of mild (r = 0.370) to moderate (r = 0.514) between the ROM of the affected side for both flexion and abduction with prehensile force. Highlights, a BMI of 28.91 ± 5.31 kg / m2, an ICC of 0.86 ± 0.06 cm and the presence of winged scapula in 36.7 % of the participants. No association was found between the surgical approach and the presence of the winged scapula. There were morphofunctional sequelae in the women under study, highlighting the alterations in the range of movement of the upper limb, overweight, cardiovascular risk and the presence of the winged scapula, without being associated with the type of surgical approach.


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Escápula/patologia , Neoplasias da Mama/cirurgia , Mastectomia/efeitos adversos , Ossos da Extremidade Superior/fisiopatologia , Ossos da Extremidade Superior/patologia , Complicações Pós-Operatórias , Escápula/fisiopatologia , Índice de Massa Corporal , Chile , Estudos Transversais , Amplitude de Movimento Articular , Relação Cintura-Quadril , Sobrepeso
8.
J Comput Assist Tomogr ; 43(3): 372-378, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30762657

RESUMO

OBJECTIVES: The aims of this study were to evaluate the agreement between cone-beam computed tomography (CBCT) and multislice computed tomography for the characterization of extremity fractures and to compare image quality, radiation dose, and patient tolerance. METHODS: Thirty-six patients with suspected fracture affecting distal extremities or who required preoperative fracture assessment were enrolled prospectively. Each patient underwent CBCT and multislice computed tomography the same day. Both examinations were evaluated independently twice by 2 trained radiologists using the Müller AO classification for fracture characterization. RESULTS: Cohen κ coefficient for agreement between the imaging techniques was almost perfect for fracture characterization, κ = 0.94 [95% confidence interval, 0.91-0.98]. There was substantial to almost perfect agreement for secondary findings. Cone-beam computed tomography was well tolerated and significantly less irradiant and had better subjective image. CONCLUSIONS: An excellent agreement between both imaging techniques was found. This confirms the ability of CBCT to assess fractures and its potential in the management of patients with distal limb trauma.


Assuntos
Tomografia Computadorizada de Feixe Cônico/métodos , Fraturas Ósseas/diagnóstico por imagem , Tomografia Computadorizada Multidetectores/métodos , Cooperação do Paciente/psicologia , Ossos da Extremidade Inferior/diagnóstico por imagem , Ossos da Extremidade Inferior/lesões , Ossos da Extremidade Superior/diagnóstico por imagem , Ossos da Extremidade Superior/lesões , Tomografia Computadorizada de Feixe Cônico/psicologia , Feminino , Humanos , Masculino , Tomografia Computadorizada Multidetectores/psicologia , Estudos Prospectivos , Doses de Radiação , Intensificação de Imagem Radiográfica/métodos , Radiologistas , Sensibilidade e Especificidade
9.
BMC Emerg Med ; 19(1): 17, 2019 01 28.
Artigo em Inglês | MEDLINE | ID: mdl-30691395

RESUMO

BACKGROUND: The aim of the present review is to assess the effectiveness of ultrasound (US) in the detection of upper and lower limb bone fractures in adults compared to a diagnostic gold standard available in secondary and tertiary care centres (e.g. radiography, CT scan or MRI). METHODS: The review followed PRISMA guidelines and used a database-specific search strategy with Medline, EMBASE and The Cochrane Library plus secondary sources (see supplementary material for completed PRISMA checklist). Diagnostic performance of ultrasound was assessed with a qualitative synthesis and a meta-analysis of two data subgroups. RESULTS: Twenty-six studies were included (n = 2360; fracture prevalence =5.3 % to 75.0%); data were organised into anatomical subgroups, two of which were subjected to meta-analysis. Sensitivity and specificity ranged from 42.11 - 100% and 65.0 - 100%, with the highest diagnostic accuracy in fractures of the foot and ankle. The pooled sensitivity and specificity of US was 0.93 and 0.92 for upper limb fractures (I2 = 54.7 % ; 66.3%), and 0.83 and 0.93 for lower limb fractures (I2 = 90.1 % ; 83.5%). CONCLUSION: Ultrasonography demonstrates good diagnostic accuracy in the detection of upper and lower limb bone fractures in adults, especially in fractures of the foot and ankle. This is supported by pooled analysis of upper and lower limb fracture subgroups. Further research in larger populations is necessary to validate and strengthen the quality of the available evidence prior to recommending US as a first-line imaging modality for prehospital use. TRIAL REGISTRATION: The protocol is registered with the PROSPERO International register of systematic reviews: ID = CRD42017053640 .


Assuntos
Ossos da Extremidade Inferior/diagnóstico por imagem , Ossos da Extremidade Inferior/lesões , Ossos da Extremidade Superior/diagnóstico por imagem , Ossos da Extremidade Superior/lesões , Fraturas Ósseas/diagnóstico por imagem , Ultrassonografia , Adulto , Humanos
10.
PLoS One ; 13(12): e0208033, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30566429

RESUMO

BACKGROUND: The aim of this study was to assess the incidence of fractures in infancy, overall and by type of fracture, its association with accidents, metabolic bone disease risk factors, and abuse diagnosis. METHODS: The design was a population-based register study in Sweden. Participants: Children born 1997-2014, 0-1 years of age diagnosed with fracture-diagnosis according to International Classification of Diseases (ICD10) were retrieved from the National Patient Register and linked to the Swedish Medical Birth Register and the Death Cause Register. Main outcome measures were fractures of the skull, long bone, clavicle and ribs, categorized by age (younger or older than 6 months), and accident or not. FINDINGS: The incidence of fractures during infancy was 251 per 100 000 infants (n = 4663). Major fracture localisations were long bone (44·9%), skull (31·7%), and clavicle (18·6%), while rib fractures were few (1·4%). Fall accidents were reported among 71·4%. One-third occurred during the first 6 months. Metabolic bone disease risk factors, such as maternal obesity, preterm birth, vitamin D deficiency, rickets, and calcium metabolic disturbances, had increased odds of fractures of long bones and ribs in early infancy (0-6 months): birth 32-36 weeks and long bone fracture [AOR 2·13 (95%CI 1·67-2·93)] and rib fracture [AOR 4·24 (95%CI 1·40-12·8)]. Diagnosis of vitamin D deficiency/rickets/disorders of calcium metabolism had increased odds of long bone fracture [AOR 49·5 (95%CI 18·3-134)] and rib fracture [AOR 617 (95%CI 162-2506)]. Fractures without a reported accident had higher odds of metabolic risk factors than those with reported accidents. Abuse diagnosis was registered in 105 infants, with overrepresentation of preterm births, multiple births and small-for-gestational age. INTERPRETATION: Metabolic bone disease risk factors are strongly associated with fractures of long bone and ribs in early infancy. Fracture cases with abuse diagnosis had a metabolic bone risk factor profile.


Assuntos
Doenças Ósseas Metabólicas/epidemiologia , Maus-Tratos Infantis/estatística & dados numéricos , Fraturas Ósseas/epidemiologia , Complicações na Gravidez/epidemiologia , Sistema de Registros/estatística & dados numéricos , Distribuição por Idade , Fatores Etários , Doenças Ósseas Metabólicas/etiologia , Doenças Ósseas Metabólicas/metabolismo , Ossos da Extremidade Inferior/lesões , Ossos da Extremidade Superior/lesões , Causas de Morte , Comorbidade , Feminino , Fraturas Ósseas/etiologia , Fraturas Ósseas/metabolismo , Humanos , Incidência , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Masculino , Exposição Materna/estatística & dados numéricos , Gravidez , Complicações na Gravidez/metabolismo , Costelas/lesões , Fatores de Risco , Fatores Sexuais , Crânio/lesões , Suécia/epidemiologia
11.
Am J Sports Med ; 46(14): 3495-3501, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30403369

RESUMO

BACKGROUND: The modified Jobe technique of ulnar collateral ligament (UCL) reconstruction has previously been biomechanically compared with primary repair augmented with internal bracing. However, the docking technique has not been compared with repair with internal bracing. HYPOTHESIS: Load to failure, gapping, and valgus opening angle are similar under valgus loading at 90° of flexion between repair with internal bracing and the docking technique for the UCL. STUDY DESIGN: Controlled laboratory study. METHODS: Nine matched pairs of fresh-frozen cadaveric elbows were potted with the forearm in neutral rotation. The palmaris longus tendon graft was harvested, and the bone was sectioned 14 cm proximal and distal to the elbow joint. First, native UCL testing was performed at 90° of flexion with 0.5 N·m preload, followed by a 5 N·m valgus moment to the elbow in cycles of 1, 10, 100, and 1000 at 1 Hz. The specimens were then loaded to failure at a rate of 0.2 mm/s. Next, the elbows were randomly divided into matched pairs to undergo either UCL reconstruction with docking technique or UCL repair augmented with internal bracing. Last, these specimens underwent testing as aforementioned. RESULTS: Load to failure, gapping, and valgus opening angle did not differ significantly between native ligaments that underwent reconstruction or repair with internal bracing, paired native ligaments and reconstructions, paired native ligaments and repairs augmented with internal bracing, or reconstructions and repairs augmented with internal bracing. CONCLUSION: UCL reconstruction with docking technique and repair augmented with internal bracing provides valgus stability to the medial elbow comparable to the native ligament at 90°. No significant differences were noted between docking reconstruction and repair techniques for load to failure, gapping, or valgus opening angle during cyclic loading at time zero. CLINICAL RELEVANCE: Our results suggest that UCL repair with internal bracing has a similar biomechanical profile at the time of initial fixation compared with the docking technique of UCL reconstruction.


Assuntos
Braquetes , Ligamentos Colaterais/cirurgia , Reconstrução do Ligamento Colateral Ulnar/métodos , Fenômenos Biomecânicos/fisiologia , Ossos da Extremidade Superior/fisiologia , Ossos da Extremidade Superior/cirurgia , Cadáver , Ligamentos Colaterais/fisiologia , Cotovelo/fisiologia , Cotovelo/cirurgia , Articulação do Cotovelo/fisiologia , Articulação do Cotovelo/cirurgia , Feminino , Antebraço/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Amplitude de Movimento Articular , Projetos de Pesquisa , Rotação , Tendões/transplante , Transplantes/cirurgia , Punho/fisiologia
12.
Hand Surg Rehabil ; 37(6): 337-341, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30266594

RESUMO

Rib cartilage grafts are widely used in maxillofacial surgery, but not in orthopedic surgery. The aim of this technical note is to describe the technique used to harvest this graft and to report on donor site complications in the 136 cases we have published on up to now. Harvesting is carried out at the osteochondral junction of the eighth rib. The osteochondral junction is located under the external oblique muscle and a perichondrium layer, which is retracted to allow safe harvesting. The amount of cartilage harvested depends on the size of the area being grafted. Harvesting of a rib osteochondral graft is easy to carry out, provides a considerable amount of hyaline cartilage for the reconstruction of degenerative and traumatic lesions on a joint surface and results in few donor site complications.


Assuntos
Ossos da Extremidade Superior/cirurgia , Cartilagem/transplante , Costelas/transplante , Coleta de Tecidos e Órgãos/métodos , Autoenxertos , Humanos , Manobra de Valsalva
13.
Am J Pathol ; 188(10): 2155-2163, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30031726

RESUMO

ß-Catenin-dependent Wnt signaling controls numerous aspects of skeletal development and postnatal bone repair. Currently available transgenic Wnt reporter mice allow for visualization of global canonical Wnt signaling activity within skeletal tissues, without delineation of cell type. This is particularly important in a bone repair context, in which the inflammatory phase can obscure the visualization of mesenchymal cell types of interest. To tackle the issue of tissue-specific Wnt signaling, we have generated and characterized a transgenic mouse strain [termed paired related homeobox 1 (Prx1)-Wnt-green fluorescent protein (GFP), by crossing a previously validated Prx1-Cre strain with a nuclear fluorescent reporter driven by T-cell factor/lymphoid enhancer factor activity (Rosa26-Tcf/Lef-LSL-H2B-GFP)]. Prx1-Wnt-GFP animals were subject to three models of long bone and membranous bone repair (displaced forelimb fracture, tibial cortical defect, and frontal bone defect). Results showed that, irrespective of bone type, locoregional mesenchymal cell activation of Wnt signaling occurs in a defined temporospatial pattern among Prx1-Wnt-GFP mice. In summary, Prx1-Wnt-GFP reporter animals allow for improved visualization, spatial discrimination, and facile quantification of Wnt-activated mesenchymal cells within models of adult bone repair.


Assuntos
Consolidação da Fratura/fisiologia , Via de Sinalização Wnt/fisiologia , Animais , Ossos da Extremidade Superior/fisiologia , Feminino , Osso Frontal/fisiologia , Genes Reporter/fisiologia , Proteínas de Homeodomínio/fisiologia , Masculino , Mesoderma/citologia , Camundongos Transgênicos , Osteogênese/fisiologia , Proteínas Wnt/genética , Proteínas Wnt/fisiologia , Microtomografia por Raio-X
14.
J Biomech ; 75: 154-158, 2018 06 25.
Artigo em Inglês | MEDLINE | ID: mdl-29752051

RESUMO

The golf swing is a complex full body movement during which the spine and shoulders are highly involved. In order to determine shoulder kinematics during this movement, multibody kinematics optimization (MKO) can be recommended to limit the effect of the soft tissue artifact and to avoid joint dislocations or bone penetration in reconstructed kinematics. Classically, in golf biomechanics research, the shoulder is represented by a 3 degrees-of-freedom model representing the glenohumeral joint. More complex and physiological models are already provided in the scientific literature. Particularly, the model used in this study was a full body model and also described motions of clavicles and scapulae. This study aimed at quantifying the effect of utilizing a more complex and physiological shoulder model when studying the golf swing. Results obtained on 20 golfers showed that a more complex and physiologically-accurate model can more efficiently track experimental markers, which resulted in differences in joint kinematics. Hence, the model with 3 degrees-of-freedom between the humerus and the thorax may be inadequate when combined with MKO and a more physiological model would be beneficial. Finally, results would also be improved through a subject-specific approach for the determination of the segment lengths.


Assuntos
Ossos da Extremidade Superior/fisiologia , Golfe/fisiologia , Modelos Biológicos , Articulação do Ombro/fisiologia , Adulto , Idoso , Fenômenos Biomecânicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Movimento , Tórax/fisiologia , Adulto Jovem
15.
Eur J Hum Genet ; 26(3): 350-358, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29330548

RESUMO

Haploinsufficiency of the transcription factor short stature homeobox (SHOX) manifests as a spectrum of clinical phenotypes, ranging from disproportionate short stature and Madelung deformity to isolated short stature. Here, we describe five infants with molecularly confirmed diagnoses of SHOX haploinsufficiency who presented in utero with short long bones during routine antenatal scanning from as early as 19 weeks gestation. Other foetal growth parameters were normal. The molecular basis of SHOX haploinsufficiency was distinct in each case. In four cases, SHOX haploinsufficiency was inherited from a previously undiagnosed parent. In our de novo case, SHOX haploinsufficiency reflected the formation of a derivative sex chromosome during paternal meiosis. Final adult height in the SHOX-deficient parents ranged from -1.9 to -1.2 SDS. All affected parents had disproportionately short limbs and two affected mothers had bilateral Madelung deformity. To our knowledge, SHOX haploinsufficiency has not previously been reported to present in utero. Our experience illustrates that SHOX deficiency should form part of the differential diagnosis of foetal short long bones and suggests a low threshold for genetic testing. This should be particularly targeted at, but not limited to, families with a history of features suggestive of SHOX deficiency. Data on the postnatal growth of our index cases is presented which demonstrates that antenatal presentation of SHOX haploinsufficiency is not indicative of severe postnatal growth restriction. Early identification of SHOX deficiency will enable accurate genetic counselling reflecting a good postnatal outcome and facilitate optimal initiation of growth hormone therapy.


Assuntos
Ossos da Extremidade Inferior/embriologia , Ossos da Extremidade Superior/embriologia , Doenças Fetais/diagnóstico , Transtornos do Crescimento/diagnóstico , Haploinsuficiência , Osteocondrodisplasias/diagnóstico , Fenótipo , Proteína de Homoeobox de Baixa Estatura/genética , Adulto , Ossos da Extremidade Inferior/diagnóstico por imagem , Ossos da Extremidade Superior/diagnóstico por imagem , Diagnóstico Diferencial , Feminino , Doenças Fetais/genética , Transtornos do Crescimento/genética , Humanos , Masculino , Osteocondrodisplasias/genética , Linhagem , Gravidez , Segundo Trimestre da Gravidez , Terceiro Trimestre da Gravidez , Ultrassonografia Pré-Natal
16.
J Orthop Surg Res ; 12(1): 157, 2017 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-29065899

RESUMO

BACKGROUND: Fractures in pediatrics show epidemiological characteristics which are different from fractures in adults. The objective of this study was to examine the injury profiles of open upper extremity fractures (UEFs) in all modes of injury related to road traffic accidents (RTAs) in adult and pediatric hospitalized patients. METHODS: Data on 103,465 RTA patients between 1997 and 2013 whose records were entered in a centralized country trauma database were reviewed. Data on open UEFs related to mode of injury (car, motorcycle, bicycle, and pedestrian) was compared between adult (18+ years) and pediatric (0-17 years) RTA patients. RESULTS: Of 103,465 RTA cases, 17,263 (16.7%) had UEFs. Of 73,087 adults, 13,237 (18.1%) included UEFs and of 30,378 pediatric cases, 4026 (13.2%) included UEFs (p < 0.0001). Of 17,263 cases with UEFs, we reviewed 22,132 fractures with 2, 743 (12.4%) open fractures. Adults had a greater risk for open fractures (2221, 13%) than the pediatric cases (522, 10.3%) (p < 0.0001). Overall, of a total of 22,132 UEFs, most of the fractures were in the radius (22.8%), humerus (20.3%), clavicle (17.5%), and ulna (15.4%). The adult pedestrian group had a significantly higher risk for open UEFs than the pediatric group (11 vs 8%, p = 0.0012). CONCLUSIONS: This study demonstrates the difference between adult and pediatric open fractures in hospitalized RTAs. We showed that adults had a greater risk for open UEFs compared to children, and the adult pedestrian group particularly had a significantly higher risk for open UEFs than the pediatric group.


Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Traumatismos do Braço/epidemiologia , Ossos da Extremidade Superior/lesões , Fraturas Expostas/epidemiologia , Sistema de Registros , Adolescente , Adulto , Fatores Etários , Criança , Pré-Escolar , Humanos , Lactente , Israel/epidemiologia , Estudos Retrospectivos , Adulto Jovem
17.
Ann Lab Med ; 37(6): 540-543, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-28840995

RESUMO

Osteopoikilosis is an autosomal dominant bone disorder characterized by symmetric multiple osteosclerotic lesions throughout the axial and appendicular skeleton. Pathogenic variants in the LEMD3 have been identified as the cause of osteopoikilosis. LEMD3 encodes an inner nuclear membrane protein that interacts with bone morphogenetic protein (BMP) and transforming growth factor (TGF)-ß pathways. We report the case of a 19-year-old man presenting with lower back pain and sciatica. His radiograph revealed bilateral and symmetrical multiple osteosclerotic bone lesions in both scapular areas. Sanger sequencing of LEMD3 revealed a four-base-pair deletion in intron 2 (c.1560+5_1560+8del), [corrected] which was inherited from his father. We found that this four-base-pair deletion in intron 2 causes aberrant splicing and consequent deletion of exon 2. To the best of our knowledge, this is the first report of genetically confirmed osteopoikilosis in Korea.


Assuntos
/genética , Proteínas de Membrana/genética , Proteínas Nucleares/genética , Osteopecilose/genética , Ossos da Extremidade Inferior/diagnóstico por imagem , Ossos da Extremidade Superior/diagnóstico por imagem , Análise Mutacional de DNA , Proteínas de Ligação a DNA , Éxons , Humanos , Íntrons , Masculino , Osteopecilose/diagnóstico , Sítios de Splice de RNA , República da Coreia , Deleção de Sequência , Adulto Jovem
19.
Hand Surg Rehabil ; 36(4): 233-243, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28624293

RESUMO

Soft tissue sarcoma of the forearm, wrist and hand are rare. Their benign appearance leads often to primary inadequate treatment. Due to the complex anatomy of the hand and forearm, they are challenging to treat. The two goals are to obtain wide resection of the primary tumor while preserving function. Limb-sparing surgery is now the cornerstone for the treatment of most sarcomas of the forearm, hand and wrist. To achieve optimal oncological and functional outcomes, the surgical excision should be associated with early reconstructive procedures and a multidisciplinary meeting to define the treatment strategy including adjuvant medical treatments. This article outlines the current principles and presents the results of the treatment of soft tissue sarcomas with emphasis on to particularities related to their forearm, wrist and hand location.


Assuntos
Sarcoma/terapia , Neoplasias de Tecidos Moles/terapia , Extremidade Superior/cirurgia , Algoritmos , Biópsia , Ossos da Extremidade Superior/cirurgia , Plexo Braquial/cirurgia , Quimioterapia Adjuvante , Continuidade da Assistência ao Paciente , Humanos , Salvamento de Membro , Estadiamento de Neoplasias , Radioterapia Adjuvante , Sarcoma/patologia , Neoplasias de Tecidos Moles/patologia , Retalhos Cirúrgicos , Tendões/cirurgia , Extremidade Superior/patologia
20.
J Morphol ; 278(3): 418-442, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-28176372

RESUMO

The head is considered the major novelty of the vertebrates and directly linked to their evolutionary success. Its form and development as well as its function, for example in feeding, is of major interest for evolutionary biologists. In this study, we describe the skeletal development of the cranium and pectoral girdle in Siberian (Acipenser baerii) and Russian sturgeon (A. gueldenstaedtii), two species that are commonly farmed in aquaculture and increasingly important in developmental studies. This study comprises the development of the neuro-, viscero- and dermatocranium and the dermal and chondral components of the pectoral girdle, from first condensation of chondrocytes in prehatchlings to the early juvenile stage and reveals a clear pattern in formation. The otic capsules, the parachordal cartilages, and the trabeculae cranii are the first centers of chondrification, at 8.4mm TL. These are followed by the mandibular, then the hyoid, and later the branchial arches. Teeth form early on the dentary, dermopalatine, and palatopterygoid, and then appear later in the buccal cavity as dorsal and ventral toothplates. With ongoing chondrification in the neurocranium a capsule around the brain and a strong rostrum are formed. Dermal ossifications start to form before closure of the dorsal neurocranial fenestrae. Perichondral ossification of cartilage bones occurs much later in ontogeny. Our results contribute data bearing on the homology of elements such as the lateral rostral canal bone that we regard homologous to the antorbital of other actinopterygians based on its sequence of formation, position and form. We further raise doubts on the homology of the posterior ceratobranchial among Actinopteri based on the formation of the hyoid arch elements. We also investigate the basibranchials and the closely associated unidentified gill-arch elements and show that they are not homologous. J. Morphol. 278:418-442, 2017. © 2017 Wiley Periodicals, Inc.


Assuntos
Ossos da Extremidade Superior/crescimento & desenvolvimento , Peixes/crescimento & desenvolvimento , Crânio/crescimento & desenvolvimento , Animais , Evolução Biológica , Ossos da Extremidade Superior/embriologia , Região Branquial/embriologia , Região Branquial/crescimento & desenvolvimento , Cartilagem/crescimento & desenvolvimento , Peixes/embriologia , Peixes/genética , Osso Hioide/embriologia , Osso Hioide/crescimento & desenvolvimento , Osteogênese , Crânio/embriologia
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