A three-dimensional axis for the study of femoral neck orientation.

A common problem in the quantification of the orientation of the femoral neck is the difficulty to determine its true axis; however, this axis is typically estimated visually only. Moreover, the orientation of the femoral neck is commonly analysed using angles that are dependent on anatomical planes of reference and only quantify the orientation in two dimensions. The purpose of this study is to establish a method to determine the three-dimensional orientation of the femoral neck using a three-dimensional model. An accurate determination of the femoral neck axis requires a reconsideration of the complex architecture of the proximal femur. The morphology of the femoral neck results from both the medial and arcuate trabecular systems, and the asymmetry of the cortical bone. Given these considerations, two alternative models, in addition to the cylindrical one frequently assumed, were tested. The surface geometry of the femoral neck was subsequently used to fit one cylinder, two cylinders and successive cross-sectional ellipses. The model based on successive ellipses provided a significantly smaller average deviation than the two other models (P < 0.001) and reduced the observer-induced measurement error. Comparisons with traditional measurements and analyses on a sample of 91 femora were also performed to assess the validity of the model based on successive ellipses. This study provides a semi-automatic and accurate method for the determination of the functional three-dimensional femoral neck orientation avoiding the use of a reference plane. This innovative method has important implications for future studies that aim to document and understand the change in the orientation of the femoral neck associated with the acquisition of a bipedal gait in humans. Moreover, the precise determination of the three-dimensional orientation has implications in current research involved in developing clinical applications in diagnosis, hip surgery and rehabilitation.

Technical note: Shape variability induced by reassembly of human pelvic bones.

In traditional as well as in geometric morphometric studies, the shape of the pelvis is often quantified after the reassembly of the two hip bones and the sacrum. However, on dry bones, the morphology of the cartilaginous tissues that form the two sacroiliac joints and the pubic symphysis before death remains unknown, leading to potential inaccuracies and errors during the reassembly process. A protocol was established to investigate the effects of reassembly on the quantification of pelvis shape. The shape of fresh pelves obtained after dissection, in which the three bones are in an anatomically relevant position, was compared with the shape of different reassemblies based on the individual dry bones of the same individuals. Our results demonstrated a significant effect of the reassembly. Variation in the reassembly process is likely related, first, to the complete absence of cartilaginous tissues on dry bones and, second, to the morphology of the sacroiliac joint which, in vivo, allows physiological movements, resulting in different potential positions of the two sacroiliac surfaces relative to one another. However, the artificial variation introduced by the reassembly process appears small compared with the biological variation between the different individuals.

Study of femoral torsion during prenatal growth: interpretations associated with the effects of intrauterine pressure.

The developing fetus is protected from external environmental influences by maternal tissues. However, these structures have a limited elasticity, such that the fetus must grow in a confined space, constraining its size at the end of pregnancy. Can these constraints modify the morphology of the fetal skeleton? The intensity of these constraints increases between 5 months and birth, making it the most appropriate period to address this question. A sample of 89 fetal femora was analyzed, and results provide evidence that during this period, the torsion of the femoral shaft (quantified by means of a new three-dimensional method) increases gradually. Two explanations were considered: this increase could signal effects of constraints induced by the intrauterine cavity, developmental patterning, or some combination of these two. Different arguments tend to support the biomechanical explanation, rather than a programming pattern formation. Indeed, the identification of the femur as a first degree lever, created by the hyperflexion of the fetal lower limbs on the pelvis, could explain the increase in femoral shaft torsion during prenatal life. A comparison with femora of infants is in accordance with this mechanical interpretation, which is possible through bone modeling/remodeling. Although genetic and epigenetic mechanisms may regulate timing of fetal development, our data suggest that at birth, the fetal skeleton also has an intrauterine mechanical history through adaptive bone plasticity.

Dopamine Modulates Motor Control in a Specific Plane Related to Support.

At the acute stage following unilateral labyrinthectomy (UL), rats, mice or guinea pigs exhibit a complex motor syndrome combining circling (HSCC lesion) and rolling (utricular lesion). At the chronic stage, they only display circling, because proprioceptive information related to the plane of support substitutes the missing utricular information to control posture in the frontal plane. Circling is also observed following unilateral lesion of the mesencephalic dopaminergic neurons by 6- hydroxydopamine hydrobromide (6-OHDA rats) and systemic injection of apomorphine (APO rats). The resemblance of behavior induced by unilateral vestibular and dopaminergic lesions at the chronic stage can be interpreted in two ways. One hypothesis is that the dopaminergic system exerts three-dimensional control over motricity, as the vestibular system does. If this hypothesis is correct, then a unilateral lesion of the nigro-striatal pathway should induce three-dimensional motor deficits, i.e., circling and at least some sort of barrel rolling at the acute stage of the lesion. Then, compensation could also take place very rapidly based on proprioception, which would explain the prevalence of circling. In addition, barrel rolling should reappear when the rodent is placed in water, as it occurs in UL vertebrates. Alternatively, the dopaminergic network, together with neurons processing the horizontal canal information, could control the homeostasis of posture and locomotion specifically in one and only one plane of space, i.e. the plane related to the basis of support. In that case, barrel rolling should never occur, whether at the acute or chronic stage on firm ground or in water. Moreover, circling should have the same characteristics following both types of lesions. Clearly, 6-OHDA and APO-rats never exhibited barrel rolling at the acute stage. They circled at the acute stage of the lesion and continued to do so three weeks later, including in water. In contrast, UL-rats, exhibited both circling and barrel rolling at the acute stage, and then only circled on the ground. Furthermore, barrel rolling instantaneously reappeared in water in UL rats, which was not the case in 6-OHDA and APO-rats. That is, the lesion of the dopaminergic system on one side did not compromise trim in the pitch and roll planes, even when proprioceptive information related to the basis of support was lacking as in water. Altogether, these results strongly suggest that dopamine does not exert three-dimensional control of the motor system but regulates postural control in one particular plane of space, the one related to the basis of support. In contrast, as previously shown, the vestibular system exerts three-dimensional control on posture. That is, we show here for the first time a relationship between a given neuromodulator and the spatial organization of motor control.