Journal articles on the topic 'Anatomical femur length'
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Lucak, T., S. Raju, A. Andrews, L. Igbokwe, and M. J. Heffernan. "Dimensions of the paediatric femur: anatomical limitations of flexible intramedullary nailing." Journal of Children's Orthopaedics 13, no. 2 (April 2, 2019): 220–25. http://dx.doi.org/10.1302/1863-2548.13.180194.
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Purpose Although spica casting remains the benchmark for treating diaphyseal femur fractures in preschool children, some authors advocate using flexible intramedullary nails in certain situations. The aim of the current study was to evaluate the anatomic feasibility of flexible nailing in young children. Methods Consecutive patients between the ages of zero and ten years with normal femurs who received femur radiographs at a tertiary paediatric hospital over a two-year period were included. Anteroposterior femur radiographs were evaluated for length and isthmus width measurements. Each femur was templated for flexible nail size. The proportions of each age group capable of accommodating two flexible nails up to 4.0 mm in size were determined and compared. Results A total of 381 full-length femur radiographs were reviewed. There was a strong, direct linear relationship between age and femoral length (R2 = 0.896) and a moderate correlation between age and femoral isthmus width (R2 = 0.417). Although the percentage of femurs able to accommodate flexible nails continued to increase with age, this increase did not represent a significant difference when comparing preschool-aged children with older age groups. Conclusions Age and femoral length demonstrated a strong, positive correlation while age and isthmus width had weaker correlation. The ability of femurs to accommodate flexible nails increased with age with most children age two years and older able to accommodate two flexible nails of at least 2.5 mm in size. Level of Evidence III
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Su, Xiu-Yun, Zhe Zhao, Jing-Xin Zhao, Li-Cheng Zhang, An-Hua Long, Li-Hai Zhang, and Pei-Fu Tang. "Three-Dimensional Analysis of the Curvature of the Femoral Canal in 426 Chinese Femurs." BioMed Research International 2015 (2015): 1–8. http://dx.doi.org/10.1155/2015/318391.
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Purpose. The human femur has long been considered to have an anatomical anterior curvature in the sagittal plane. We established a new method to evaluate the femoral curvature in three-dimensional (3D) space and reveal its influencing factors in Chinese population. Methods. 3D models of 426 femurs and the medullary canal were constructed using Mimics software. We standardized the positions of all femurs using 3ds Max software. After measuring the anatomical parameters, including the radius of femoral curvature (RFC) and banking angle, of the femurs using the established femur-specific coordinate system, we analyzed and determined the relationships between the anatomical parameters of the femur and the general characteristics of the population. Results. Pearson’s correlation analyses showed that there were positive correlations between the RFC and height (r=0.339, p<0.001) and the femoral length and RFC (r=0.369, p<0.001) and a negative correlation between the femoral length and banking angle (r=-0.223, p<0.001). Stepwise linear regression analyses showed that the most relevant factors for the RFC and banking angle were the femoral length and gender, respectively. Conclusions. This study concluded that the banking angle of the femur was significantly larger in female than in male.
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Ariana, Irma Padeta, Arvendi Rachma Jadi, Hery Wijayanto, Teguh Budipitojo, Slamet Raharjo, Amalia Rezeki, and Heri Budi Santoso. "The Correlation of Femur Length with The Body Length of Proboscis Monkey." BIO Web of Conferences 20 (2020): 04001. http://dx.doi.org/10.1051/bioconf/20202004001.
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The proboscis monkey is an endemic primate of Kalimantan Island, Indonesia. According to the International Union for Conservation of Nature (IUCN), proboscis monkey was classified as endangered species. Anatomical data of proboscis monkey has not been available yet. As endemic and endangered primate, morphology and morphometric data of proboscis monkey are important for forensic reference. The purpose of this study was to investigate the correlation between femur and body length of the proboscis monkey. The anatomical analysis used three proboscis monkey from the rehabilitation center, Sahabat Bekantan Indonesia (SBI), Banjarmasin, South Kalimantan. The femur and body length were measured by digital caliper in millimeter (mm). The result showed that there was a strong correlation between femur and body length of the proboscis monkey. The body length of proboscis monkey might be determined by femur length with linear regression y = 0.2682x + 347.85. In conclusion, there was a positive correlation between femur and body length of proboscis monkey in South Kalimantan.
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Stijak, Lazar, Vidosava Radonjic, Milan Aksic, B. Filipovic, M. Sladojevic, and G. Santrac-Stijak. "Correlation between femur's length and morphometric parameters of distal femur important in rupture anterior cruciate ligament." Acta chirurgica Iugoslavica 56, no. 2 (2009): 61–66. http://dx.doi.org/10.2298/aci0902061s.
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INTRODUCTION: Frequency of anterior cruciate ligament rupture depends of anatomical parameters of distal femur and intercondylar notch. PURPOSE: Purpose of this work is identification relation between femur length and morphometrical parameters intecondylar notch, measuring in two levels. METHOD: A hundred femur's (medley population of 48 right and 52 left femurs), from osteological collection Department of Anatomy 'dr. Niko Miljanic' in Belgrade measured. Measurement was in two levels. Epicondilar width, width of medial and lateral condyls and intercondylar width, had been measured in level of popliteal sulcus and on the widest place, after that notch width index had been determinated. RESULTS: Absolute values of morphometrical parameters distal femur's are in positive relation with her length (p <0.01), but notch width index is not, as in level of popliteal sulcus, as on the widest place (p>0.05). CONCLUSION: Femur's length increasing also produces increasing of absolute anatomical parameters of distal femur which can produce rupture of anterior cruciate ligament, while relative dimensions do not show femur's length increasing.
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Beutel, B. G., S. J. Girdler, J. A. Collins, N. Y. Otsuka, and A. Chu. "Characterization of proximal femoral anatomy in the skeletally-immature patient." Journal of Children's Orthopaedics 12, no. 2 (April 2018): 167–72. http://dx.doi.org/10.1302/1863-2548.12.180011.
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PurposeThe morphology of the proximal femur has been extensively studied in the adult population. However, no literature providing a comprehensive evaluation of the anatomy in paediatric patients exists. The current study aims to characterize such anatomy in skeletally-immature patients, examine potential differences between genders, and analyze how these anatomical parameters change with age.MethodsCadaveric femurs from the Hamann-Todd Osteological Collection were examined. Specimens with open physes and no skeletal disease or deformity were included for analysis. Age and gender were recorded for each specimen. Each femur was photographed in standardized modified axial and anteroposterior views. In all, 14 proximal femoral anatomical parameters were measured from these photographs. Comparisons between genders and age were calculated.ResultsA total of 43 femurs from ages four to 17 years met inclusion criteria. The majority were female (56%); no difference existed in age between genders (p = 0.62). The specimens had a neutral mean neck-shaft angle (130.7º) and anteversion (12.8º), and the sphericity of the ossified femoral heads was symmetrical. Male specimens had significantly higher alpha angles (p = 0.01), posterior offset (p = 0.02), neck width (p = 0.04) and head-neck length ratio (p = 0.02) values than female specimens. Strong positive correlations exist between length/size parameters and age, while negligible correlations were noted for angular measurements. Conclusions This study establishes reference values for a comprehensive list of anatomical parameters for the skeletally-immature ossified proximal femur. It highlights gender differences in morphology and demonstrates that angular characteristics remain relatively stable while length parameters generally increase with age. Level of Evidence Level III Diagnostic
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Taylor, M., and E. W. Abel. "Finite Element Analysis of Poor Distal Contact of the Femoral Component of a Cementless Hip Endoprosthesis." Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine 207, no. 4 (December 1993): 255–61. http://dx.doi.org/10.1243/pime_proc_1993_207_304_02.
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The difficulty of achieving good distal contact between a cementless hip endoprosthesis and the femur is well established. This finite element study investigates the effect on the stress distribution within the femur due to varying lengths of distal gap. Three-dimensional anatomical models of two different sized femurs were generated, based upon computer tomograph scans of two cadaveric specimens. A further six models were derived from each original model, with distal gaps varying from 10 to 60 mm in length. The resulting stress distributions within these were compared to the uniform contact models. The extent to which femoral geometry was an influencing factor on the stress distribution within the bone was also studied. Lack of distal contact with the prosthesis was found not to affect the proximal stress distribution within the femur, for distal gap lengths of up to 60 mm. In the region of no distal contact, the stress within the femur was at normal physiological levels associated with the applied loading and boundary conditions. The femoral geometry was found to have little influence on the stress distribution within the cortical bone. Although localized variations were noted, both femurs exhibited the same general stress distribution pattern.
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Kharbuja, Rabita, Rashmi Manjushree Adhikari, and Anupama Shrestha. "Bicondylar Angle and its Relation with Length and Neck Length of Human Femur." Journal of Lumbini Medical College 6, no. 1 (May 24, 2018): 17–20. http://dx.doi.org/10.22502/jlmc.v6i1.176.
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Introduction: Femoral bicondylar angle has immense importance from anatomical and clinical (forensic and anthropometric) point of view and is the characteristic feature of bipedal gait in humans. It is the angle between axis of femoral shaft and a line perpendicular to its transcondylar axis. The study was carried out to assess bicondylar angle and its relationship with femur length and neck length.
Methods: Bicondylar angle, length, and neck length of available dry human femurs of unknown sex and age were measured using osteometric board and vernier caliper. Bicondylar angle between two sides were compared. Similarly, relation between the angle and femoral length and length of femoral neck was studied.
Result: Bicondylar angle on right side was 8.65° (SD = 2.03) and on left side was 9.35° (SD = 2.05) and the different was not statistically significant (p = 0.08). On both sides, no significant correlation was found between bicondylar angle with femoral length and length of femoral neck.
Conclusion: Mean bicondylar angle of right femur was 8.65° and that of left was 9.35° and the difference was not statistically significant. There was no significant relation between the angle and other two parameters.
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Chethan, K. N., Shyamasunder N. Bhat, Mohammad Zuber, and Satish B. Shenoy. "Patient-Specific Static Structural Analysis of Femur Bone of different lengths." Open Biomedical Engineering Journal 12, no. 1 (December 31, 2018): 108–14. http://dx.doi.org/10.2174/1874120701812010108.
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Background:The femur bone is an essential part of human activity, providing stability and support in carrying out our day to day activities. The inter-human anatomical variation and load bearing ability of humans of different heights will provide the necessary understanding of their functional ability.Objective:In this study, femur bone of two humans of different lengths (tall femur and short femur) were subjected to static structural loading conditions to evaluate their load-bearing abilities using Finite Element Analysis.Methods:The 3D models of femur bones were developed using MIMICS from the CT scans which were then subjected to static structural analysis by varying the load from 1000N to 8000N. The von Mises stress and deformation were captured to compare the performance of each of the femur bones.Results:The tall femur resulted in reduced Von-Mises stress and total deformation when compared to the short femur. However, the maximum principle stresses showed an increase with an increase in the bone length. In both the femurs, the maximum stresses were observed in the medullary region.Conclusion:When the applied load exceeds 10 times the body weight of the person, the tall femur model exceeded 134 MPa stress value. The short femur model failed at 9 times the body weight, indicating that the tall femur had higher load-bearing abilities.
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Su, Xiu-yun, Jing-xin Zhao, Zhe Zhao, Li-cheng Zhang, Chen Li, Jian-tao Li, Jian-feng Zhou, Li-hai Zhang, and Pei-fu Tang. "Three-Dimensional Analysis of the Characteristics of the Femoral Canal Isthmus: An Anatomical Study." BioMed Research International 2015 (2015): 1–9. http://dx.doi.org/10.1155/2015/459612.
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Purpose. To establish a new approach for measuring and locating the femoral intramedullary canal isthmus in 3-dimensional (3D) space.Methods. Based on the computed tomography data from 204 Chinese patients, 3D models of the whole femur and the corresponding femoral isthmus tube were reconstructed using Mimics software (Materialise, Haasrode, Belgium). The anatomical parameters of the femur and the isthmus, including the femur length and radius, and the isthmus diameter and height, were measured accordingly.Results. The mean ratio of the isthmus height versus the femoral height was 55 ± 4.8%. The mean diameter of the isthmus was 10.49 ± 1.52 mm. The femoral length, the isthmus diameter, and the isthmus tube length were significantly larger in the male group. Significant correlations were observed between the femoral length and the isthmus diameter (r=0.24,p<0.01) and between the femoral length and the isthmus height (r=0.6,p<0.01). Stepwise linear regression analyses demonstrated that the femoral length and radius were the most important factors influencing the location and dimension of the femoral canal isthmus.Conclusion. The current study developed a new approach for measuring the femoral canal and for optimization of customer-specific femoral implants.
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Mehta, Suresh. "Gross anatomical studies on the femur, tibio-tarsus and fibula of emu (Dromaius novaehollandiae)." INTERNATIONAL JOURNAL OF AGRICULTURAL SCIENCES 17, no. 2 (June 15, 2021): 627–29. http://dx.doi.org/10.15740/has/ijas/17.2/627-629.
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The study was conducted on three adult emu birds of 2-3 years of age. The femur was a relatively short, but thickbone, measuring about 23±0.43 cm in length.The fovea capitiswas absent.The large trochanter major was at the same level as the head.A large pneumatic foramen was present on the caudal surface of the femur, medioventrally to the trochanter major. Distal extremity of femur showed a trochlea anteriorly and two condyles posteriorly.The tibio-tarsus waslongest and formed by the fusion of the tibia and proximal row of tarsalbones.The average length was 43±0.68 cm, was almost twice as long as the femur.The cranial part of the proximal end was greatly expanded which formed a large ridge, the proximal end of which was divided to form lateraland medial cranial ridges.The distal end showed lateral and medial condyles cranially and a trochlea with symmetrical ridges caudally. The fibula was shorter than the tibia, measuring about 29±0.23 cm in length with a prominent head.
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Rose, Ryan Hunter, Steven M. Cherney, Hanna K. Jensen, Saleema A. Karim, and Simon C. Mears. "Variations in Cost and Readmissions of Patients in the Bundled Payment for Care Improvement Bundle for Hip and Femur Fractures." Geriatric Orthopaedic Surgery & Rehabilitation 12 (January 2021): 215145932110496. http://dx.doi.org/10.1177/21514593211049664.
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Introduction The Bundled Payment for Care Improvement (BPCI) for hip and femur fractures is an effort to increase care quality and coordination at a lower cost. The bundle includes all patients undergoing an operative fixation of a hip or femur fracture (diagnosis-related group codes 480-482). This study aims to investigate variance in the hospital cost and readmission rates for patients within the bundle. Materials and Methods The study is a retrospective analysis of patients ≥65 years old billed for a diagnosis-related groups 480-482 in 2016 in the National Readmission Database. Cost of admission and length of stay were compared between patients who were or were not readmitted. Regression analysis was used to determine the effects of the primary procedure code and anatomical location of the femur fracture on costs, length of stay, and readmission rates. Results Patients that were readmitted within 90 days of surgery had an increased cost on initial admission ($18,427 vs $16,844, P < .0001), and an increased length of stay (6.24 vs 5.42, P < .0001). When stratified by procedure, patients varied in readmission rates (20.7% vs 19.6% vs 21.8%), initial cost, and length of stay (LOS). Stratification by anatomical location also led to variation in readmission rates (20.7% vs 18.3% vs 20.6%), initial cost, and LOS. Conclusion The hip and femur fractures bundle includes a great number of procedures with variance in cost, readmission, and length of stay. This amount of variation may make standardization difficult and may put the hospital at potential financial risk.
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Fonseca, R. L., A. R. Lobo-Jr, and M. I. S. Santana. "Measurements of femoral angles, femur length, and hip width in cat radiographs." Arquivo Brasileiro de Medicina Veterinária e Zootecnia 69, no. 6 (November 2017): 1513–20. http://dx.doi.org/10.1590/1678-4162-9583.
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ABSTRACT Femoral angle, femur length, and hip width were measured in radiographs of 92 intact domestic cats, males and females of mixed breed from the Center for Zoonosis Control of the Federal District. The animals showed no trauma, orthopedic diseases or angular deformities and had closed physeal lines. Accordingly, we measured aLPFA (anatomical lateral proximal femoral angle, aLDFA (anatomical lateral distal femoral angle), mLPFA (mechanical lateral proximal femoral angle), mLDFA (mechanical lateral distal femoral angle), IA (femoral inclination angle), FL (femur length) and HW (hip width) using ventrodorsal radiographs, with both hindlimbs in a single exposure to an X-ray beam centered on the hip. The mean values of the variables were: mLPFA: 82.5±3.62°; aLPFA: 80.1±4.29°; mLDFA: 96.1±3.51° (males) and 97.3±2.05° (females); aLDFA: 94,3±3.43°; IA: 136.6±3.86°; FL: 12.9±0.55cm (males) and 13.4±0.66cm (females); and HW: 3.1cm±0.23 (males) and 3.5±0.26cm (females). These values will serve as a reference for the diagnosis of angular deformities and as support for planning corrective osteotomies in domestic cats.
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B, Abdulrahman. "Anatomical Study of Some Selected Bones of the Hind Limb of Local Domestic Dog ( Canis lupus familiaris )." Cytology & Histology International Journal 5, no. 1 (2021): 1–9. http://dx.doi.org/10.23880/chij-16000127.
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This study was aimed at investigating the age related changes in the morphometry and biometry of some selected bones of the hind limb of Nigerian local dog ( canis lupus familiaris ). In this study a total of fifteen dogs were used as sample and were grouped into five age categories (group A-E). The dogs were aged by estimation using dentition eruption and wearing. The segment of the hind limb was identified and separated from the rest from other parts. The gross study of the hind limb revealed that the hind limb was composed of: ossa coxarum, femur, patella, tibia, fibula, tarsal and metatarsal bones. The biometric study revealed that the weight, length, width and circumference were found to be increasing with advancement in age. The result revealed that mean weight, length and circumference of various segments of the ossa coxarum, femur and the tibia tends to increase with age across the group that is from group A to group E. However, there is variation in the length of the fibula, width of the obturator foramen and length of the obturator foramen. Base on the above results, it was concluded that base line data was established with the aim of enhancing learning.
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Murakami, Sawako, Masakazu Shimada, Yasuji Harada, and Yasushi Hara. "Examination of the proximodistal patellar position in small dogs in relation to anatomical features of the distal femur and medial patellar luxation." PLOS ONE 16, no. 5 (May 28, 2021): e0252531. http://dx.doi.org/10.1371/journal.pone.0252531.
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Objective To determine the influence of anatomical features of the distal femur on the proximodistal patellar position and compare the proximodistal patellar position between dogs with and without medial patellar luxation (MPL). Study design Retrospective case series (n = 71). Methods Mediolateral-view radiographs of clinical cases of dogs weighing less than 15 kg were obtained. The stifle joint angle, patellar ligament length, patellar length, size of the femoral condyle, trochlear length, and trochlear angle were measured and included in multiple linear regression analyses to ascertain their effects on the proximodistal patellar position. Radiographs were divided into MPL and control groups. The effects of MPL on the proximodistal patellar position and morphological factors were also examined. Results The final model for the proximodistal patellar position revealed that the patella became distal as the ratio of the patellar ligament length to patellar length decreased, the trochlear angle relative to the femur increased, the trochlear length relative to the patellar length increased, or the trochlear length relative to the femoral condyle width decreased. The proximodistal patellar position in the MPL group was not significantly different from that in the control group despite the trend towards a distally positioned patella (p = 0.073). The MPL group showed a significantly shorter trochlea (p<0.001) and greater trochlear angle relative to the femur (p = 0.029) than the control group. Conclusion The proximodistal patellar position depends on multiple factors, and its determination based on PLL/PL alone may not be appropriate. Dogs with MPL did not have a proximally positioned patella compared with dogs without MPL. Although hindlimbs with MPL had a shorter trochlea than those without patellar luxation, this difference did not appear to be sufficient to displace the patellar position proximally in small dogs, possibly compensated by increased trochlear angle relative to the femur.
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Salim, Rodrigo, Mauricio Kfuri, and Fabricio Fogagnolo. "A Simple Technique to Prevent Early or Late EndoButton Deployment in Anterior Cruciate Ligament Reconstructions: A Technical Note." Journal of Knee Surgery 31, no. 01 (March 29, 2017): 075–77. http://dx.doi.org/10.1055/s-0037-1600090.
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AbstractThe use of suspensory graft fixation methods in arthroscopic reconstruction of the anterior cruciate ligament has become increasingly popular with the more frequent use of tendon grafts and anatomical techniques involving the creation of bone tunnels. An important technical step to ensure adequate fixation of the graft when using EndoButton-type implants, particularly in the femur, involves flipping the EndoButton plate at the correct length to avoid performing this maneuver before the appropriate time or leaving soft tissue between the plate and lateral cortex of the femur. In the present study, we describe a simple arthroscopic technique for indicating the correct time to flip/deploy the EndoButton plate.
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Mahat, Samyog, Shamsher Shrestha, and Prabhakar Yadav. "Anatomical study of nutrient foramen in lower limb dry long bones." International Journal of Research in Medical Sciences 9, no. 8 (July 28, 2021): 2246. http://dx.doi.org/10.18203/2320-6012.ijrms20213068.
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Background: Nutrient artery gain access through nutrient foramen and provide vascular supply to bone. Number, size and location of nutrient foramen has significant medical as well as surgical importance. Any insult to nutrient artery during surgical procedure or during trauma may lead to devascualarization or poor prognosis.Methods: The present study consist of 50 femurs, 50 tibia and 50 fibula, collected from department of anatomy, BPKIHS. Mean length of bone, number, position and size and foraminal index of nutrient foramen was observed and recorded accordingly.Results: In femur 62% bone shows single nutrient foramen. Nutrient foramen was commonly located in medial lip of linea aspera and in upper third of bone which was noted in 80% of bone. In tibia 82% of total bone shows single foramen with absent of foramen in 6% bone. Foramen was commonly located above the soleal line and middle third of bone which was noted in 56% of bone. In fibula 6% of total bone shows absent of nutrient foramen and majority of bone shows single nutrient foramen (82%). Foramen was commonly located in lower part of posterior surface (60%) and in middle third of bone.Conclusions: This study provides details topographic knowledge about nutrient foramen which is important clinically for proper planning of surgery and its outcome.
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Roy, Rajarshi, Prerana Aggarwal, and Shyamalendu Medda. "Variations in nutrient foramen in the long bones of lower limb." Indian Journal of Clinical Anatomy and Physiology 9, no. 1 (March 15, 2022): 35–41. http://dx.doi.org/10.18231/j.ijcap.2022.009.
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Morphology and morphometry of nutrient foramen of bones vary from country to country and from place to place. Objective was to study the number, position, location, directions, distance of nutrient foramen from the proximal end of femur, tibia and fibula in eastern Indian region. In a descriptive study, 393 bilateral lower limb long bones (138 femur, 132 tibia & 123 fibulae) were studied. Total nutrient foramen calculated; 178 in femur, 137 in tibia, 121 in fibula. Most had single foramen; femur (66%), tibia (96%) and fibula (94%). Number of foramina ranged from 0-3 in femur, 1-2 in tibia and 0-2 in fibula. Foramina were present mainly on the posterior surface of the bones [linea aspera in femur (96), below soleal line and lateral to the vertical line in tibia (90) and peroneal crest in fibula (74)]. The mean length, mean distance of nutrient foramen from the proximal end of the bones measured. Most foramina found on the middle third, with foraminal index ranging from 33% to 66%; though on tibia it’s not a common finding. The 't' test value of foraminal index was significant for tibia. Mean foraminal index was measured for femur 42.28%, tibia 35.91%, fibula 41.54%. The knowledge of anatomical variations of nutrient foramen is very important as preservation of vascularization of long bones is essential in fracture repair, tumor resection, bone grafting.
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Mahajan, Neetin Pralhad, Ved Ashish Ravesh, Prasanna Kumar G. S., Ajay Chandanwale, and Lalkar Gadod. "Assessment of functional outcome of distal femur intra-articular fractures treated with locking compression plate." International Journal of Research in Orthopaedics 6, no. 1 (December 24, 2019): 145. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20195814.
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<p class="abstract"><strong>Background:</strong> Intra-articular distal femoral fracture makes up to 6% of all femur fractures. Because they damage the cartilage surface of the bone, intra-articular fractures can be more difficult to treat. The locking compression plates have nowadays proven to be gold standard in treating both simple as well as complex intra-articular distal femur fractures. This study is to evaluate the complications, functional and anatomical outcome of distal femur fractures, treated by open reduction and internal fixation using distal femoral locking compression plate.</p><p class="abstract"><strong>Methods:</strong> This is<strong> </strong>a retrospective study of 30 patients with intra articular distal femur fractures operated with distal femur locking compression plate during the period of 2015 to 2018 in a tertiary care hospital with age range from 17 to 71 years and follow up till 2 years. Fractures were classified according to AO classification and functional outcome assessed by using Neer criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> 10 cases had excellent score (33%), 16 cases (52%) had satisfactory score, 3 cases (11%) had unsatisfactory score and only one case had poor score.<strong> </strong>85.1% of patients were in between satisfactory to excellent results. Complications observed were excessive bleeding, difficulty in reduction, superficial infections, knee stiffness, malalignment and limb length discrepancy.</p><p class="abstract"><strong>Conclusions:</strong> The distal femur locking compression plate is a good implant to be used for distal femur intra-articular fractures. Early surgery, anatomical reduction and early mobilisation are the prerequisites for good functional outcome. Comminution and bone defect on the medial side needs pillar reconstruction by fibular bone graft.</p>
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Pisharody, S., R. Phillips, and C. M. Langton. "Sensitivity of proximal femoral stiffness and areal bone mineral density to changes in bone geometry and density." Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine 222, no. 3 (March 1, 2008): 367–75. http://dx.doi.org/10.1243/09544119jeim307.
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Areal bone mineral density (aBMD) is the most common surrogate measurement for assessing the bone strength of the proximal femur associated with osteoporosis. Additional factors, however, contribute to the overall strength of the proximal femur, primarily the anatomical geometry. Finite element analysis (FEA) is an effective and widely used computer-based simulation technique for modelling mechanical loading of various engineering structures, providing predictions of displacement and induced stress distribution due to the applied load. FEA is therefore inherently dependent upon both density and anatomical geometry. FEA may be performed on both three-dimensional and two-dimensional models of the proximal femur derived from radiographic images, from which the mechanical stiffness may be predicted. It is examined whether the outcome measures of two-dimensional FEA, two-dimensional, finite element analysis of X-ray images (FEXI), and three-dimensional FEA computed stiffness values of the proximal femur are more sensitive than aBMD to changes in trabecular bone density and femur geometry. It is assumed that if an outcome measure follows known trends with changes in density and geometric parameters, then an increased sensitivity will be indicative of an improved prediction of bone strength. All three outcome measures increased non-linearly with trabecular bone density, increased linearly with cortical shell thickness and neck width, decreased linearly with neck length, and were relatively insensitive to neck-shaft angle. For femoral head radius, aBMD was relatively insensitive, with two-dimensional FEXI and three-dimensional FEA demonstrating a non-linear increase and decrease in sensitivity respectively. For neck anteversion, aBMD decreased non-linearly, whereas both two-dimensional FEXI and three-dimensional FEA demonstrated a parabolic-type relationship, with the maximum stiffness being achieved at an angle of approximately 15°. Multi-parameter analysis showed that all three outcome measures demonstrated their highest sensitivity to a change in cortical thickness. When changes in all input parameters were considered simultaneously, three and two-dimensional FEA had statistically equal sensitivities (0.41 ± 0.20 and 0.42 ± 0.16 respectively, p= ns) that were significantly higher than the sensitivity of aBMD (0.24 ± 0.07; p=0.014 and 0.002 for three-dimensional and two-dimensional FEA respectively). This simulation study suggests that since mechanical integrity and FEA are inherently dependent on anatomical geometry, FEXI stiffness, being derived from conventional two-dimensional radiographic images, may provide an improvement in the prediction of bone strength of the proximal femur than currently provided by aBMD.
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Anous, M. R. "A comparative study of muscle-bone relationships in the hind limb of goats and sheep." Animal Science 53, no. 1 (August 1991): 81–87. http://dx.doi.org/10.1017/s0003356100006000.
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ABSTRACTMuscle to bone weight relationships within anatomical regions (proximal-distal division into pelvic, thigh and lower leg groups) and subregions (division within regions into gluteal, intrinsic pelvic, cranial, caudal and medial thigh, and cranial and caudal lower leg groups) of the hind limb and also of its most important muscles (no. = 11) were compared between goats and sheep using the method of multivariate analysis of the centred data. In this comparison, a total of 39 animals was considered: 13 male kids of the Alpine breed (K) and a sample of 26 male lambs derived from different breeds or crossbreeds representing, in equal numbers, lambs having good conformation (LGC) and poor conformation (LPC). Lambs were chosen on the basis of the hindlimb length the means of which were 22·9 (s.e. 1·5), 29·3 (s.e. 1·8) and 29·1 (s.e. 2·5) cm for LGC, LPC, and K, respectively. Corresponding cold carcass weights were 19·71 (s.e. 347), 17·28 (s.e. 1·77) and 10·84 (s.e. 0·56) kg.In both comparisons (K-LGC and K-LPC) the two species were systematically distinguished by the size of the following ratios: (pelvic muscles/os coxae + leg muscles /tibia) relative to thigh muscles/femur (for regions), which was lower in lambs than in kids; intrinsic pelvic muscles/os coxae relative to caudal thigh muscles/femur (for subregions), which was higher in kids than in lambs. For individual muscles, they were distinguished by the size of the following ratios: rectus (emoris/femur relative to semimembranosus/femur (or gluteus medius/os coxae) in the comparison K-LGC, which was higher in lambs than in kids, and vastus lateralis/femur relative to sum of pectineus + gracilis/femur (or gastrocemius/tibia) in the comparison K-LPC, which was lower in kids than in lambs. The results show that the muscle-bone ratios of the anatomical regions, subregions and the most commercially important muscles in the hindlimb can be used as discriminant characteristics of species.
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Greatrex, Frederick, Erica Montefiori, Thomas Grupp, Josef Kozak, and Claudia Mazzà. "Reliability of an Integrated Ultrasound and Stereophotogrammetric System for Lower Limb Anatomical Characterisation." Applied Bionics and Biomechanics 2017 (2017): 1–8. http://dx.doi.org/10.1155/2017/4370649.
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Background. Lower extremity analysis for preoperative total knee and hip arthroplasty routines can increase surgery success rate and hence reduce associated costs. Current tools are limited by being invasive, limited to supine analysis, or too expensive. This study aimed to propose and validate a device, OrthoPilot®, based on the combined use of a stereophotogrammetric and ultrasound system which can in vivo and noninvasively measure varus/valgus, flexion/extension, femur and tibia torsion, and femur and tibia lengths.Methods. A phantom was measured by four operators to determine the resolution of the system. Interoperator variability was measured on three operators who measured the above six variables on both legs of three subjects in standing and supine positions. Intraoperator variability was assessed on data from three repeats from 9 subjects (18 legs).Results. All 6 variables were reliably detected on a phantom, with a resolution of 1 mm and 0.5°. Inter- and intraoperator consistency was observed for varus/valgus, flexion/extension, and length measurements on the healthy subjects in standing and supine positions (all ICC > 0.93). For torsion measurements, there was a considerable variation.Conclusion. The proposed system, when used on healthy subjects, allowed reliable measurements of key parameters for preoperative procedures in both supine and standing positions. Accuracy testing and further validation on patient populations will be the next step toward its clinical adoption.
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Ucpunar, H., S. K. Tas, Y. Camurcu, H. Sofu, M. Mert, and A. I. Bayhan. "The effects of residual hip deformity on coronal alignment of the lower extremity in patients with unilateral slipped capital femoral epiphysis." Journal of Children's Orthopaedics 12, no. 6 (December 2018): 599–605. http://dx.doi.org/10.1302/1863-2548.12.180137.
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Purpose The aim of our explorative study was to compare the differences in the coronal alignments of the hip, knee and ankle on the slip side and non-slip sides in patients with slipped capital femoral epiphysis (SCFE). Methods The study group consisted of 28 patients. On the full-length standing radiographs, measurements of articulo-trochanteric distance (ATD), neck-shaft angle (NSA), femoral offset, hip-knee-ankle axis, femur-tibial angle, mechanical axis deviation ratio (MAD-r), anatomical medial proximal femoral angle (aMPFA), mechanical lateral proximal femoral angle (mLPFA), anatomical lateral distal femoral angle (aLDFA), mechanical lateral distal femoral angle (mLDFA), knee joint line congruency angle, mechanical medial proximal tibial angle (mMPTA), mechanical lateral distal tibial angle (mLDTA), ankle joint line orientation angle (AJOA), and leg length discrepancy (LLD) were performed. The data from the slip side were compared with those from the non-slip side. Results At skeletal maturity, there were significant differences between the slip side and non-slip side in ATD (p <0.001), NSA (p <0.001), MAD-r (p <0.001), aMPFA (p <0.001), aLDFA (p = 0.03), mLDFA (p = 0.04), mLDTA (p = 0.02), AJOA (p <0.001) and LLD (p<0.001). Conclusion Residual deformity in the proximal femur after epiphyseal slip and premature epiphysiodesis could cause changes in the coronal alignment of the lower extremity. We can add lower extremity alignment examination to follow-up protocol to rule out secondary problems in patients with SCFE. Level of Evidence Level III, retrospective comparative study
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Moncrieff, Matthew J., and Lori A. Livingston. "Reliability of a Digital-Photographic-Goniometric Method for Coronal-Plane Lower Limb Measurements." Journal of Sport Rehabilitation 18, no. 2 (May 2009): 296–315. http://dx.doi.org/10.1123/jsr.18.2.296.
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Context:Structural and coronal-plane-alignment characteristics of the lower limb are frequently cited as factors contributing to knee pathologies.Objective:The purpose of this study was to determine the accuracy and reliability characteristics of a digital-photographic-goniometric method (DPGM) of measurement for 2-dimensional (2D) coronal-plane lower limb measurements of the quadriceps (Q) angle, tibiofemoral (TF) angle, and femur length in human participants adopting a self-selected- or Romberg-stance position.Design:Reliability study.Setting:University motion-analysis laboratory.Participants:A convenience sample of 20 healthy young adult men and women.Main Outcome Measures:Intraclass correlation coefficients (ICCs), 95% confidence intervals, and standard error of the measurements.Results:Intratester- and intertester-reliability coefficients for the Q angle (ICCs .458–845 and .257–737) were consistently lower than those for the TF angle (ICCs .627–.904 and .700–.839) or femur length (ICCs .867–.958 and .866–.944). Q angles were also significantly larger (13.4%) in the Romberg- vs self-selected-stance position (P < .001) and larger (20.2%) in the left limb than the right limb.Conclusions:The DPGM has the potential to produce accurate and reliable measurements of selected 2D lower limb measures. However, the reliability characteristics depend on the ability of the testers to correctly and repeatably landmark the anatomical sites used to define the measurements of interest and might be influenced by other factors such as the stance position adopted, the complexity of the variable (ie, number of anatomical landmarks and segments), and the size of the captured image. Further investigation of these latter factors is warranted.
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Al Aiyan, Ahmad, Kenneth Richardson, George Manchi, Johanna Plendl, and Leo Brunnberg. "Measurement of the femoral neck angle in medium and large dog breeds using computed tomography." Acta Veterinaria Hungarica 67, no. 1 (March 2019): 22–33. http://dx.doi.org/10.1556/004.2019.003.
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The aim of this study was to get precise normal values of the femoral neck angle (FNA) in support of developing an optimally functioning total hip prosthesis for medium and large dog breeds. Accordingly, two- and three-dimensional computed tomographic images of the anatomical structures of the proximal femora of 58, hip-dysplasia-free, mature dogs of medium and large breeds were studied. Based on the length of their femora the dogs were allocated to Group I (from 145 to 195 mm) and Group II (from 196 to 240 mm). The FNA was measured on each femur using multi-slice spiral computed tomography (CT). The two- and three-dimensional image data were processed as multi-planar and threedimensional reconstructions using Advantage Workstation software. The CT measurements revealed that Group I had an average femoral neck angle of 147.59° (min. 144.05°, max. 153.35°), while in Group II the average FNA was 147.46° (min. 141°, max. 154.35°). There was no significant correlation between the length of the femur and the FNA in either group. The optimal FNA for a total hip prosthesis is 147.5° for medium and large dog breeds.
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Keremu, Ajimu, Nuersimanguli Mijiti, Sirejiding Mijiti, Aikebaier Tuxun, and Abulikemu Abudurexiti. "Evaluation of the application value of a three-dimensional digital model of the knee in clinical practice." Journal of International Medical Research 48, no. 5 (May 2020): 030006051988974. http://dx.doi.org/10.1177/0300060519889742.
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Objective To compare the knee shape and bone parameters between knee prosthesis products from overseas companies and a Chinese patient’s knee, and to apply the anatomical basis for Chinese knee prosthesis design. Methods Three-dimensional digital models were built, including prosthesis products for a normal adult. The relevant anatomy index was measured, and physical parameter, radiographic, geometric, knee kinematic, and distal geometry data were collected on the femur and tibia. Results The width of the femoral condyle (WFC), width of the medial femoral condyle (WMFC), width of the lateral femoral condyle (WLFC), depth of the intercondylar fossa (DICF), sagittal length of the medial femoral condyle (SLMFC), sagittal length of the lateral femoral condyle (SLLFC), angle of the medial femoral condyle (AMFC), and angle of the lateral femoral condyle (ALFC) in the femur and the transverse diameter (ML) and anteroposterior diameter (AP) of the tibial bone were measured. These parameters were significantly lower in the normal group compared with the prosthesis product model group. Conclusion When using an imported knee prosthesis, the osteotomy angle may not fit perfectly. Use of an imported prosthesis may be an important factor in the increasing failure of knee arthroplasty in China.
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Cabassu, Julien. "Minimally Invasive Plate Osteosynthesis Using Fracture Reduction Under the Plate without Intraoperative Fluoroscopy to Stabilize Diaphyseal Fractures of the Tibia and Femur in Dogs and Cats." Veterinary and Comparative Orthopaedics and Traumatology 32, no. 06 (July 29, 2019): 475–82. http://dx.doi.org/10.1055/s-0039-1693413.
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Objective The aim of this study was to prospectively evaluate postoperative alignment when using fracture reduction under the plate (FRUP) during a minimally invasive plate osteosynthesis in tibial and femoral fractures, without intraoperative imaging, and report immediate postoperative complications. Materials and Methods After precise plate contouring and preoperative planning, FRUP was obtained with one cortical screw per fragment. Fractures were stabilized with a plate or plate rod. Tibial/femoral lengths, tibial plateau angles, mechanical medial proximal and distal tibial angles, anatomical lateral distal femoral angles, femoral curvatum and neck anteversion were evaluated on postoperative radiographs and contralateral bone. Tibial torsion was evaluated visually. Paired t-test were used to compare data. Immediate postoperative complications were recorded. Results Twenty-one tibial and 20 femoral fractures were stabilized (14 plate rod cases). Mean postoperative operated tibial length was 1.4% shorter (p = 0.001). Mean postoperative operated femoral length was 2% shorter (p = 0.04). Mean operated tibial plateau angle was 1.1° lower (p = 0.02). No difference in tibial torsion was noticed. No significant difference in mechanical medial proximal tibial angle, mechanical medial distal tibial angle, anatomical lateral distal femoral angle and femoral neck anteversion was observed. Mean operated femoral curvatum angle was 5.6° less (p = 0.01). Five cases (3 plate rod cases) required an immediate revision. Clinical Significance Minimally invasive plate osteosynthesis with FRUP leads to acceptable postoperative alignment. Correct pin placement should be evaluated.
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Laumonerie, P., M. Ollivier, S. LiArno, A. Faizan, E. Cavaignac, and J.-N. Argenson. "Which factors influence proximal femoral asymmetry?" Bone & Joint Journal 100-B, no. 7 (July 2018): 839–44. http://dx.doi.org/10.1302/0301-620x.100b7.bjj-2017-1601.r1.
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AimsIn patients where the proximal femur shows gross deformity due to degenerative changes or fracture, the contralateral femur is often used to perform preoperative templating for hip arthroplasty. However, femurs may not be symmetrical: the aim of this study was to determine the degree of variation between hips in healthy individuals and to determine whether it is affected by demographic parameters.Materials and MethodsCT-scan based modelling was used to examine the pelvis and bilateral femurs of 345 patients (211 males, 134 women; mean age 62 years (standard deviation (sd) 17), mean body mass index 27 kg/m2(sd 5)) representing a range of ethnicities. The femoral neck-shaft angle (NSA), femoral offset (FO), femoral neck version (FNV), femoral length (FL), femoral canal flare index (fCFI), and femoral head radius (FHr) were then determined for each patient. All measurements were constructed using algorithm-calculated landmarks, resulting in reproducible and consistent constructs for each specimen. We then analyzed femoral symmetry based on absolute differences (AD) and percentage asymmetry (%AS) following a previously validated method.ResultsWe found an asymmetry > 2% for NSA (mean AD 2.9°, mean %AS 2.3; p = 0.03), FO (AD 3.8 mm, %AS 9.1 ; p = 0.01), FNV (AD 5.1°, %AS 46.7 ; p = 0.001) and fCFI (AD 0.2 mm, %AS 5.4 ; p = 0.7). Significant relationships were found for AD regarding NSA and ethnicity (p = 0.037), FL and height (R2 = 0.22), and fCFI and gender (R2 = 0.34).ConclusionOur data confirm the presence of asymmetry of proximal femurs, which is mostly independent of demographic parameters. In cases where contralateral templating is used, such asymmetry may lead to inaccurate anatomical restoration of the hip if the templated sizes are routinely implanted. However, the clinical impact cannot be determined from our investigation. Cite this article: Bone Joint J 2018;100-B:839–44.
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Yasukawa, Shinji, Koji Tanegashima, Mamiko Seki, Kenji Teshima, Kazushi Asano, Tomohiro Nakayama, Kei Hayashi, and Kazuya Edamura. "Evaluation of bone deformities of the femur, tibia, and patella in Toy Poodles with medial patellar luxation using computed tomography." Veterinary and Comparative Orthopaedics and Traumatology 29, no. 01 (January 2016): 29–38. http://dx.doi.org/10.3415/vcot-15-05-0089.
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SummaryObjectives: To evaluate morphological parameters of the femur, tibia, and patella in Toy Poodles with medial patellar luxation (MPL) using three-dimensional (3D) computed tomography (CT) and to compare these parameters between radiography and CT.Methods: Thirty-five hindlimbs of Toy Poodles were divided into normal and grade 2 and 4 MPL groups. The anatomical and mechanical lateral proximal femoral angle, anatomical and mechanical lateral distal femoral angle (aLDFA, mLDFA), femoral varus angle (FVA), inclination of the femoral head angle, procurvation angle, anteversion angle (AA), frontal angle of the femoral neck, mechanical medial proximal or distal tibial angle, mechanical cranial proximal or distal tibial angle, tibial plateau angle, tibial torsion angle (TTA), Z angle, relative tibial tuberosity width, ratio of the medial distance of tibial tuberosity to the proximal tibial width (MDTT/PTW), patella size, and the patellar ligament length: patellar length (L:P) ratio were evaluated on radiography and 3D CT.Results: The aLDFA, mLDFA, FVA, and TTA were significantly larger and the AA, MDTT/ PTW, and patella were significantly smaller in the grade 4 MPL group. There were significant differences in many parameters between imaging tools, and CT was considered less susceptible to potential artefacts and rotational deformities.Clinical significance: Toy Poodles with grade 4 MPL had significant femoral varus deformity, medial displacement of the tibial tuberosity, internal torsion of the proximal tibia, and hypoplasia of the patella.
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Gogáin, Aodhán Ó., and Patrick N. Wyse Jackson. "Microcomputed tomography of the holotype of the early tetrapod Ichthyerpeton bradleyae (Huxley in Wright and Huxley, 1866) from the Pennsylvanian of Ireland." Journal of Paleontology 95, no. 5 (May 7, 2021): 1048–60. http://dx.doi.org/10.1017/jpa.2021.31.
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AbstractIchthyerpeton bradleyae (Huxley in Wright and Huxley, 1866) is one of the seven tetrapods originally described by Huxley from the Jarrow Assemblage (Pennsylvanian, Langsettian Regional Substage equated with the Bashkirian International Stage) in south-eastern Ireland. The holotype, one of only two specimens considered to represent the taxon, consists of the postcranial skeleton, which has been highly compressed and has undergone extensive replacement of bone by carbonaceous material. The holotype is studied using microcomputed tomography, which reveals that the vertebral column has at least 25 diplospondylous vertebrae with cylindrical centra. Neural arches and a haemal arch are described for the first time. Neural arches in the caudal region are paired and neural spines only contact one another dorsally. The hemal arch is fused and wraps around the ventral margin of the centrum. A stout femur and tibia are described. The morphology of the femur is unique for early tetrapods, with fibular and tibial condyles of similar length and lacking an adductor crest. The morphology of the femur, and its length relative to the tibia, suggests that the holotype of I. bradleyae preserves an immature individual. The tibia is a flat bone characteristic of stem tetrapods. Phalanges from the right and left pes are present. Because the phalanges are disarticulated, a phalangeal count cannot be determined. Despite the new anatomical information, the systematic position of I. bradleyae is still difficult to establish; however, it does not belong within the colosteids, temnospondyls, or embolomeres, to which it has previously been assigned.
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Pillai, Manju G. "Effect of early protected weight bearing in fractures of shaft of femur." International Journal of Research in Orthopaedics 5, no. 5 (August 26, 2019): 851. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20193591.
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<p class="abstract"><strong>Background: </strong>Fracture shaft of femur is a common and major musculoskeletal injury and in most of the cases the patients are immediately brought to hospitals for specialist orthopaedic management. The purpose of this study was to evaluate the effectiveness of early protected weight bearing in fractures of shaft of femur.</p><p class="abstract"><strong>Methods: </strong>This was observational study conducted on 35 patient’s hospital with transverse fracture mid-shaft of femur, between March 2007 and July 2011. Patients with high velocity trauma, with transverse fracture of mid shaft of femur amenable to closed reduction and interlocking intramedullary nailing and otherwise healthy individuals were included in this study. The preoperative parameters were recorded included age, gender, side of the fracture and medical history. All patients were operated on second day of admission.</p><p class="abstract"><strong>Results: </strong>A total of 35 consecutive cases were included, 34 patients were males and 1 was female. In 74% cases closed intramedullary nailing given excellent healing of fracture, in 14% cases healing was good, in 6% cases it was average and 6% cases poor healing was observed.</p><p class="abstract"><strong>Conclusions: </strong>Our study demonstrate that this method provides anatomical reduction and maintenance of femur length and early ambulation which promotes fracture healing by a stable internal fixation allowing micro motion at fracture site enhancing callous formation.</p>
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Craig, Jessica R., Frank R. Dunshea, Jeremy J. Cottrell, John B. Furness, Udani A. Wijesiriwardana, and John R. Pluske. "A comparison of the anatomical and gastrointestinal functional development between gilt and sow progeny around birth and weaning1." Journal of Animal Science 97, no. 9 (July 2, 2019): 3809–22. http://dx.doi.org/10.1093/jas/skz217.
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Abstract Gilt progeny (GP) often have restricted growth performance and health status in comparison to sow progeny (SP) from birth, with the underlying mechanisms responsible for this yet to be fully understood. The present study aimed to compare differences in growth and development between GP and SP in the first 24 h after birth and in the periweaning period. Two cohorts of pigs including 36 GP and 37 SP were euthanized at 1 of 4 time points: a birth cohort (at birth before suckling, 0 h; and 24 h after birth, 24 h; n = 33) and a weaning cohort (at approximately 29 d of age; “pre-weaning,” PrW; and 24 h after weaning; “post-weaning,” PoW; n = 40). Pigs were individually weighed at 0 h, 24 h, PrW, and PoW up until the point of euthanasia, at which time the weights of selected tissues and organs were recorded and analyzed relative to BW. The length of the small intestine (SI), femur, and body were also measured, and a serum sample was collected and analyzed for IgG concentration. Samples of jejunal and ileal mucosa were collected and analyzed for total protein and specific activity of lactase. Euthanized GP were lighter (P < 0.01) than SP at all time points. At all time points, the ratios of quadriceps weight to femur length, BW to body length, spleen to BW (all P < 0.05), and SI weight to length (P < 0.10) were lower in GP than in SP. There was no difference (P ≥ 0.05) in stomach or heart to BW ratios between GP and SP in either cohort. The brain to liver weight ratio was greater (P = 0.044) in GP than in SP in the birth cohort, and the brain to BW ratio was greater (P < 0.01) in GP in both the birth and weaning cohorts. The liver to BW ratio was similar (P = 0.35) at birth but greater (P = 0.014) in GP around weaning. Total mucosal protein content in the jejunum and ileum was lower (P = 0.007) in GP at 24 h compared with SP, and specific activity of lactase was greater (P = 0.022) in GP in the birth cohort, whereas there were no differences in the weaning cohort (P ≥ 0.10). Gilt progeny had lower (P < 0.001) serum IgG concentration compared with SP at 24 h, but there was no difference (P ≥ 0.10) in the weaning cohort. Collectively, these findings suggest that the early development of GP may be delayed compared with SP and that a number of the anatomical differences between GP and SP that exist after birth are also present at weaning.
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Shultz, Sandra J., William N. Dudley, and Yanfang Kong. "Identifying Multiplanar Knee Laxity Profiles and Associated Physical Characteristics." Journal of Athletic Training 47, no. 2 (March 1, 2012): 159–69. http://dx.doi.org/10.4085/1062-6050-47.2.159.
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Context: A single measure of knee laxity (ie, measurement of laxity in a single plane of motion) is probably inadequate to fully describe how knee joint laxity is associated with anterior cruciate ligament injury. Objective: To characterize interparticipant differences in the absolute and relative magnitudes of multiplanar knee laxity (ie, sagittal, frontal, and transverse planes) and examine physical characteristics that may contribute to these differences. Design: Descriptive laboratory study. Setting: University research laboratory. Patients or Other Participants: 140 participants (90 women, 50 men). Main Outcome Measure(s): Using cluster analysis, we grouped participants into distinct multiplanar knee laxity profiles based on the absolute and relative magnitudes of their anterior knee laxity (AKL), genu recurvatum (GR), and varusvalgus (VV) and internal-external rotation (IER) knee laxity. Using multinomial logistic regression, we then examined associations between the different laxity profile clusters and physical characteristics of sex, age, activity level, general joint laxity, body mass index, thigh strength, and 8 measures of lower extremity anatomical alignment. Results: Six clusters were identified: low (LOW), moderate (MOD) and high (HIGH) laxity overall and disproportionally higher VV/IER (MODVV/IER), GR (HIGHGR), and AKL (HIGHAKL) laxity. Once all other physical characteristics were accounted for, the LOW cluster was more likely to be older, with longer femur length. Clusters with greater magnitudes of VV and IER laxity were more likely to be younger and to have lower body mass index, smaller Q-angle, and shorter femur length (MOD, HIGH, MODVV/IER) and less thigh strength (HIGH). The HIGHGR cluster was more likely to be female and to have a smaller tibiofemoral angle and longer femur length. The HIGHAKL cluster was more likely to have greater hip anteversion and navicular drop. Conclusions: The absolute and relative magnitudes of a person's multiplanar knee laxity are not always uniform across planes of motion and can be influenced by age, body composition, thigh strength, and structural alignment. Except in HIGHGR, sex was not a significant predictor of cluster membership once other physical characteristics were taken into account.
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Zhao, Ran, Hong Cai, Hua Tian, and Ke Zhang. "Morphological consistency of bilateral hip joints in adults based on the X-ray and CT data." Surgical and Radiologic Anatomy 43, no. 7 (January 23, 2021): 1107–15. http://dx.doi.org/10.1007/s00276-020-02676-4.
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Abstract Purpose The application of the anatomical parameters of the contralateral hip joint to guide the preoperative template of the affected side relies on the bilateral hip symmetry. We investigated the bilateral hip symmetry and range of anatomical variations by measurement and comparison of bilateral hip anatomical parameters. Methods This study included 224 patients (448 hips) who were diagnosed with osteoarthritis (OA) and avascular necrosis (AVN) of the femur head, and underwent bilateral primary total hip arthroplasty (THA) in our hospital from January 2012 to August 2020. Imaging data included 224 patients X-ray and 30 CT data at the end of the cohort. Anatomical parameters, including the acetabular abduction angle and trochanteric height, were measured using the Noble method. Postoperative measurements included stem size, difference of leg length and offset. Results Except for the isthmus width, there were no significant differences in the anatomical morphology of the hip joint. Among the demographic factors, there was a correlation between body weight and NSA. Among various anatomical parameters, a correlation was present between medullary cavity widths of T + 20, T, and T − 20. The difference in the use of stem size is not due to the morphological difference of bilateral medullary cavity, but due to the different of 1- or 2-stage surgery. Conclusion Bilateral symmetry was present among the patients with normal morphology of the hip medullary cavity, theoretically confirming the feasibility of structural reconstruction of the hip joint using the hip joint on the uninjured side. Additionally, the difference in the morphology of the hip medullary cavity is not present in a single plane but is synergistically affected by multiple adjacent planes.
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Ravindra Mohan, Shailendra Singh, Arpit Singh, Deepak Kumar, Narendra Singh Kushwaha, and Sajiv Kumar. "Valgus inter-trochanteric osteotomy and fixation with double angle barrel plate and Richard screw for neglected fracture neck femur in young adults – A prospective clinico-radiological cohort study." Asian Journal of Medical Sciences 13, no. 7 (July 1, 2022): 176–81. http://dx.doi.org/10.3126/ajms.v13i7.34595.
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Background: Saving natural head is the primary aim of management in delayed presented intracapsular fracture neck of femur, especially in young population. Anatomical reduction of these fractures is a difficult task. Rather more difficult is to decide the method of fixation which might require additive procedure(s) and one such method is valgus osteotomy and fixation devices which are technically demanding. Aims and Objectives: Our aim is to evaluate the practicality and validity of valgus osteotomy and fixation with Richard screw and double angle barrel plate in delayed presented (more than 3 weeks) fracture neck of femur in young adults. Materials and Methods: We treated 18 patients with mean age of 39 years who presented late with valgus inter-trochanteric osteotomy and fixed with Richard screw and double angle barrel plate. The cases were evaluated radiologically and clinically for Harris hip score, limb length discrepancy, union time, neck-shaft angle and complications such as avascular necrosis and implant cut through. Results: 15 out of 18 patients (83%) united in an average period of 15 weeks (12–28 weeks) clinically as well as radiologically. In more than 70% of patients, the average Harris hip score was “Excellent to Good” (Harris hip score >80). Pre-operative Pauwel’s angle has been corrected from 72.5 to 33. All the patients with united fracture were able to walk with full weight bearing, sit cross legged, squat, and perform SLR and do one-leg stance. Conclusion: Fixation with Richard screw and120° double angle barrel plate provides rigid bony fixation and restore the limb length after valgus inter-trochanteric osteotomy. Valgus inter-trochanteric osteotomy is an effective method to achieve union in neglected fracture neck of femur, as it facilitates added compression at fracture site and stable internal fixation.
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Bogojevski, Ljubomir, and Milena Bogojevska Doksevska. "Optimizing the value of the posterior condylar offset, proximal tibial resection and slope in order to achieve the right balance of the posterior cruciate ligament - clinical application of the molding function of the two parts of the PCL." Orthopaedic Journal of Sports Medicine 5, no. 2_suppl2 (February 1, 2017): 2325967117S0005. http://dx.doi.org/10.1177/2325967117s00053.
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Introduction: In order to achieve the right balance of the posterior cruciate ligament using the skeletal method is very difficult, almost impossible (Mahoney). Our hypothesis for the right balance of the PCL by using the skeletal method is based on several defined facts: - PCL is a union based of two anatomically independent, but functionally synergic parts, posteromedial and anterolateral part. - The length of the posteromedial part of the PCL is determined by the belonging of the medial compartment and is shortest in varus and longest in valgus deformation. - The length of the anterolateral part of the PCL, placed centrally is unchangeable (cca 38 mm) in every knee and is independent from the anatomical appearance (deformation). - The cylindrical shape of the distal posterior part of the femur (Ficat) depends of the molding function of the PCL (Kapandji) and is a result of the proportion of the both parts of the PCL that is consisted of: shorter posteromedial part, less bone stock on the medial and more bone stock on the lateral condyle (varus knee) and vice versa, longer posteromedial part, more bone stock on the medial condyle and less on the lateral (valgus knee). According to that, the neutral bone stock is achieved by equalization of the lengths of the two parts (common radius of the cylinder) of the PCL, that is basis for the interligamentary balance of the posterior cruciate ligament. Methods: The basic characteristics of the interligamentary balance of the PCL that we started in 2008 are the following: 1. Posterior condylar offset is equal to the even length of the both part of the PCL. 2. Decrease of the values of proximal tibial resection from 10 in varus to 4-6 in valgus. 3. Femoral valgus cut from 6 in excessive varus deformity to 4 in valgus. Results: The clinical evaluation of the cases divided in groups excessive varus, mean varus, valgus type 1, 2 (Krakow) showed right distribution in the groups of the postoperative ROM and intraoperative tenacity of the PCL (POLO test and palpation test), as a confirmation to the hypothesis. Conclusions: The ligamentary apparatus of the knee by the molding function depends on the skeletal morphology of the distal posterior femur to the degree that there aren’t two identical knees (Kapandji). According to that, every PCL has its own knee.
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Woo, Savio L. Y., J. A. Weiss, M. A. Gomez, and D. A. Hawkins. "Measurement of Changes in Ligament Tension with Knee Motion and Skeletal Maturation." Journal of Biomechanical Engineering 112, no. 1 (February 1, 1990): 46–51. http://dx.doi.org/10.1115/1.2891125.
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This study was designed to determine the in situ strains, stresses, and loads in the medial collateral ligament (MCL) of skeletally immature and mature rabbits. Using a noncontact method, the magnitudes of the in situ strains were first determined as a function of knee flexion angle. The MCL was divided into three anatomical regions (anterior, middle, and posterior) across its width. For strain measurements, the variation of a gauge length in these regions was obtained in the intact knee at 60, 90, and 120 deg of flexion. Subsequently, all soft tissues around the knee were dissected away, leaving the femur-MCL-tibia (FMT) complex. The MCL was allowed to retract freely and the new length, called the zero length, was measured. From this, the in situ strains were determined. To obtain the stress-strain relationship of the FMT complex, the specimens were subjected to tensile testing. Knowing the in situ strains and the stress-strain relationship, the in situ stresses in the three anatomical regions of the MCL were determined as a function of knee flexion angle. Multiplying these stresses by 1/3 of the cross-sectional area and summing the loads thus calculated, the in situ loads of the MCL were obtained. Our data suggest that the in situ load in the MCL is not large within the range of knee flexion angles studied, i.e., 1.4 to 2.7 N for the skeletally immature animals and 3.0 to 5.8 N for the skeletally mature animals. An increase in the in situ load with skeletal maturation was demonstrated.
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Rim, Yong Hoon, Ahn Ryul Choi, Sang Sik Lee, and Joung H. Mun. "Non-Invasive Kinematic Analysis of the Triceps Surae Muscle-Tendon Complex during a Gait." Key Engineering Materials 321-323 (October 2006): 1090–93. http://dx.doi.org/10.4028/www.scientific.net/kem.321-323.1090.
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The purpose of this study is to calculate the length and velocity change of gastrocnemius and soleus muscle-tendon complex (MTC) for diagnosis and estimation of the rehabilitation procedure of the patient from non-invasive 3D markers. The previous method measuring the length of MTC has been dependant on the regression equation based on the rotation angle in the sagittal plane. However, in view of the fact that movement analysis is based on the human body having a variety of structure, the measurement using merely rotation angle and regression equation which not based on each subject shank and foot length might not be accurate. In order to overcome these limitations, the length change of MTC is calculated, employing 3D MTC model accompanied with the trajectory data of markers attached anatomical landmarks, each subject measurements and femur condyle radius. Basically, more accurate length change could be acquired through the 3D trajectory data of markers in comparing with 2D data based on the rotation angle. As our study, the difference of the gastrocnemius length change between 3D marker trajectory based method and the method using a 2-D angle was approximately 4% (2cm) at maximum contraction and 1% (0.5cm) at maximum relaxation. Similarly, the difference in terms of the soleus was approximately 0.7% (0.3cm) at maximum contraction and 0.5% (0.2cm) at maximum relaxation.
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Jeon, Anna, Ye-Gyung Kim, Youngjoo Sohn, and Je-Hun Lee. "Nerve and Arterial Supply Pattern of the Popliteus Muscle and Clinical Implications." BioMed Research International 2022 (January 10, 2022): 1–6. http://dx.doi.org/10.1155/2022/6980471.
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Introduction. The aim of this study was to investigate the nerve and artery supply and the tibial attachment of the popliteus muscle using anatomical methods. Methods. Forty-four nonembalmed and embalmed extremities were dissected for this study. To measure the attachment area of the popliteus, the most prominent points of the medial epicondyle of the femur and the medial malleolus of the tibia were identified before dissection. A line connecting these two prominent points was used as the reference line, with the most prominent point of the medial epicondyle of the femur as the starting point. This study also investigated the area where the popliteus attaches to the bone and the points where nerves and arteries enter the popliteus muscle when it is divided into three equal parts in the coronal plane. Results. The mean length of the reference line was 34.6 ± 2.1 cm . The origin of the popliteus was found to be at a distance of 16.6% to 35.2% on the tibial bone from the proximal region. The popliteus was innervated by only the tibial nerve in 90% of the cases and by the tibial and the sciatic nerves in the remaining 10% of the cases. The inferior medial genicular artery and the posterior tibial artery supplied blood to the popliteus in 90% and 65% of the cases, respectively. When the popliteus muscle was divided into three equal parts in the coronal plane, the nerve and the artery were found to enter the muscle belly in zones II and III and zones I and II in 92% and 98% of the specimens, respectively. Discussion. The anatomical investigation of the popliteus in this study will help identify patients with clinically relevant syndromes.
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Minh, Do Van, Tran Trung Dung, Ngo Van Toan, Nguyen Huy Phuong, Vo Sy Quyen Nang, and Thien Chu Dinh. "The Anatomical Numerical Measurement of Posterior Cruciate Ligament: A Vietnamese Cadaveric Study." Open Access Macedonian Journal of Medical Sciences 7, no. 24 (December 20, 2019): 4357–61. http://dx.doi.org/10.3889/oamjms.2019.835.
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BACKGROUND: The posterior cruciate ligament (PCL) is crucial to restrain the posterior translation of the tibia. Its anatomical structure is complex. A proper understanding of PCL anatomy may assist surgeon in reconstructing anatomically native PCL.
AIM: To describe the anatomical numerical measurement of the PCL in Vietnamese adults.
METHODS: Twenty-one fresh cadaveric knees were examined. The macroscopic details of the intra-articular PCL, the attachment of the anterolateral bundle (ALB), posteromedial bundles (PMB) to the femur and tibia were analysed. We used a digital camera to photograph the cadaveric specimens and used the ImageJ software to analyse the collected images.
RESULTS: The ALB and PMB length were 35.5 ± 2.78 and 32.6 ± 2.28 mm, respectively. The smallest and the biggest diameter of middle third of the PCL were 5.9 ± 0.71 and 10.0 ± 1.39 mm, respectively. The area of cross section of middle third of the PCL was 53.6 ± 12.37 mm2. The femoral insertion area of ALB and PMB were 88.4 ± 16.89 and 43.5 ± 8.83 mm2, respectively. The distance from the central point of femoral ALB, PMB, and total PCL insertion to the Blumensaat line were 5.5 ± 0.91, 11.5 ± 1.98, and 7.6 ± 1.42 mm, respectively. The shortest distance from medial femoral cartilage rim to the central point of femoral ALB, PMB, and total PCL insertion were 7.0 ± 0.79, 7.3 ± 0.95, and 7.8 ± 1.73 mm, respectively. The tibial insertion area of ALB and PMB were 84.5 ± 12.52 and 47.8 ± 6.20 mm2 respectively. The shortest distance from the posterior cartilage corner of the medial tibial plateau to the central point of ALB, PMB, and total PCL insertion to tibia were 8.5 ± 1.02, 9.4 ± 1.11, and 8.3 ± 1.1 mm, respectively. The central point of tibial PCL insertion was 9.7±1.08 mm below cartilage plane of the medial tibial plateau.
CONCLUSION: This study describes the detailed anatomical measurement of the PCL and its bundles in adults.
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Nabholz, Katrin, Antonio Pozzi, Philipp A. Schmierer, Lucas A. Smolders, and Sebastian C. Knell. "Safety and Accuracy of Minimally Invasive Long Bone Fracture Repair Using a 2.5-mm Interlocking Nail: A Cadaveric Feline Study." Veterinary and Comparative Orthopaedics and Traumatology 32, no. 05 (July 6, 2019): 351–61. http://dx.doi.org/10.1055/s-0039-1691828.
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Abstract Objectives The Targon Vet System (TVS) is a 2.5-mm interlocking nail that can be applied minimally invasively. The purpose of this study was to test if the TVS could be safely applied percutaneously to different feline long bones without fluoroscopic guidance. Methods A gap fracture was created in 96 feline humeri, femora and tibiae (n = 32/group). Paired bones were randomly assigned to two treatment groups: (1) TVS inserted percutaneously with fluoroscopy and (2) TVS inserted percutaneously without fluoroscopy. Intraoperative evaluation (complications, procedure time, attempts), radiographs (pre-/postoperative alignment, length) and anatomical dissection (neurovascular injury, rotational alignment) were compared between treatment groups. Results The use of fluoroscopy did not lead to significant differences in any of the outcome measures. Intraoperative complications predominantly occurred in the distal humerus (12/32) and the proximal femur (7/32). In total, 20/96 complications occurred with no complications for the tibia. Neurovascular structures were only damaged at the medial side of the distal humerus (10/32). Clinical Significance We conclude that the TVS can be safely applied percutaneously to the tibia and with limitations to the femur in normal cadaveric cats without fluoroscopy. Despite the limitations of a cadaveric study, the high number of complications is leading us to consider the humerus not safe for the TVS. A learning curve has to be expected and technical recommendations should be respected to decrease complications.
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Zelyanin, Dmitrii A., Vadim E. Dubrov, Aleksandr S. Zelyanin, Vladislav V. Filippov, Dmitrii V. Yashin, and Karen A. Petrosyan. "Features of the Extraction of the Anterior Tibial Vessels in the Formation of Vascularized Bone Grafts." Traumatology and Orthopedics of Russia 28, no. 1 (January 15, 2022): 89–99. http://dx.doi.org/10.17816/2311-2905-1719.
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Background. The currently existing techniques for dissection the anterior tibial vascular bundle in the proximal third of the lower leg do not provide sufficient length of the vascular pedicle to rotate the tibial bone graft to the level of the middle third of the thigh.
The aim of the study to substantiate the possibility of pedicled transfer to the level of the thigh middle third of two blood-supplied bone autografts on a common permanent pedicle, including the anterior tibial vascular bundle.
Material and Methods. The study was conducted on 62 lower limbs of non-fixed (native) corpses. We studied the topographic and anatomical relationship between the anterior tibial vascular bundle and the deep peroneal nerve at the level of the proximal third of the leg.
Results. The distance between the tip of the greater trochanter of the femur and the distal edge of the anterior tibial bone graft using a combination of grafts at the same level in men was Me 176.7 [173.7; 193.9] mm, in women Me = 151.6 [146.9; 159.9] mm. An analysis of limb lengths ratios in men and women indicates standard level that can be achieved with graft rotation in each person.
Conclusion. Dissection of the anterior tibial vascular bundle at the level of the proximal third of the lower leg allows rotation of the complex of the anterior tibial bone autograft and the autograft of the second metatarsal bone into the area of the middle third of the femur on a single vascular bundle. Prevention of injury to the deep peroneal nerve branches during dissection of the vascular pedicle requires the use of microsurgical techniques and preoperative preparation.
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Ilyas, Muhammad Saad, Uruj Zehra, Nimra Ijaz, and Amer Aziz. "Malunited and malrotated Salter-Harris type I fracture of distal femur managed with circular ring external Ilizarov fixator." BMJ Case Reports 14, no. 6 (June 2021): e240195. http://dx.doi.org/10.1136/bcr-2020-240195.
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A 9-year-old girl presented with malunited Salter-Harris type I fracture of distal femur treated by bone-setter (unreliable-practitioner). Assessment revealed 3 cm limb-length-discrepancy and affected leg was unable to bear weight, knee was stiff with no active-range of motion; radiographs showed displaced sagittally malunited femoral condyle with 163° posterior distal femoral angle (PDFA). Correction planned with circular-ring-external Ilizarov fixator using distraction-osteogenesis through supracondylar osteotomy and gradual anterior opening. Partial weight bearing allowed from first postoperative day on walker. Eight weeks follow-up showed restored anatomical position of femoral condyle and PDFA. During anterior-distraction and angulation correction, tibia subluxated posteriorly, for that assembly extended to tibia which gradually translated tibia anteriorly and reduced knee. Twenty weeks after removal of assembly patient was advised knee-ankle-foot-orthosis. At 40 weeks of frame removal, patient was walking without support and pain. Managing such rare injuries with distraction-osteogenesis technique allows gradual correction and monitoring, till desirable degree of correction is achieved.
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Fischer, Martin S., Nadja Schilling, Manuela Schmidt, Dieter Haarhaus, and Hartmut Witte. "Basic limb kinematics of small therian mammals." Journal of Experimental Biology 205, no. 9 (May 1, 2002): 1315–38. http://dx.doi.org/10.1242/jeb.205.9.1315.
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SUMMARYA comparative study of quantitative kinematic data of fore- and hindlimb movements of eight different mammalian species leads to the recognition of basic principles in the locomotion of small therians. The description of kinematics comprises fore- and hindlimb movements as well as sagittal spine movements including displacement patterns of limb segments, their contribution to step length, and joint movements. The comparison of the contributions of different segments to step length clearly shows the proximal parts (scapula,femur) to produce more than half of the propulsive movement of the whole limb at symmetrical gaits. Basically, a three-segmented limb with zigzag configuration of segments is mainly displaced at the scapular pivot or hip joint, both of which have the same vertical distance to the ground. Two segments operate in matched motion during retraction of the limb. While kinematic parameters of forelimbs are independent of speed and gait (with the scapula as the dominant element), fundamental changes occur in hindlimb kinematics with the change from symmetrical to in-phase gaits. Forward motion of the hindlimbs is now mainly due to sagittal lumbar spine movements contributing to half of the step length. Kinematics of small therian mammals are independent of their systematic position, their natural habitat, and also of specific anatomical dispositions (e.g. reduction of fingers, toes, or clavicle). In contrast, the possession of a tail influences `pelvic movements'.
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Jensen, Janni, Bo R. Mussmann, John Hjarbæk, Zaid Al-Aubaidi, Niels W. Pedersen, Oke Gerke, and Trine Torfing. "Microdose acquisition in adolescent leg length discrepancy using a low-dose biplane imaging system." Acta Radiologica 58, no. 9 (January 9, 2017): 1108–14. http://dx.doi.org/10.1177/0284185116682381.
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Background Children with leg length discrepancy often undergo repeat imaging. Therefore, every effort to reduce radiation dose is important. Using low dose preview images and noise reduction software rather than diagnostic images for length measurements might contribute to reducing dose. Purpose To compare leg length measurements performed on diagnostic images and low dose preview images both acquired using a low-dose bi-planar imaging system. Material and Methods Preview and diagnostic images from 22 patients were retrospectively collected (14 girls, 8 boys; mean age, 12.8 years; age range, 10–15 years). All images were anonymized and measured independently by two musculoskeletal radiologists. Three sets of measurements were performed on all images; the mechanical axis lines of the femur and the tibia as well as the anatomical line of the entire extremity. Statistical significance was tested with a paired t-test. Results No statistically significant difference was found between measurements performed on the preview and on the diagnostic image. The mean tibial length difference between the observers was −0.06 cm (95% confidence interval [CI], −0.12 to 0.01) and −0.08 cm (95% CI, −0.21 to 0.05), respectively; 0.10 cm (95% CI, 0.02–0.17) and 0.06 cm (95% CI, −0.02 to 0.14) for the femoral measurements and 0.12 cm (95% CI, −0.05 to 0.26) and 0.08 cm (95% CI, −0.02 to 0.19) for total leg length discrepancy. ICCs were >0.99 indicating excellent inter- and intra-rater reliability. Conclusion The data strongly imply that leg length measurements performed on preview images from a low-dose bi-planar imaging system are comparable to measurements performed on diagnostic images.
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Amin, Sheena J., Vince Lands, Rakesh P. Mashru, and Kenneth W. Graf. "Acute Correction of Leg Length Discrepancy and Severe Femoral Malalignment: A Case Report." Journal of Orthopaedic Case Reports 12, no. 5 (2022): 54–57. http://dx.doi.org/10.13107/jocr.2022.v12.i05.2814.
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Introduction: Approximately 70% of the population have a leg length discrepancy, with 2 cm being the threshold for surgical treatment. Although there are reports of patient outcomes after incremental leg-lengthening, there is a paucity of data regarding acute lengthening procedures. We present a unique case of acute leg lengthening and correction of severe malalignment in an adult patient after femoral malunion treated with multiple modified Sofield-Millar osteotomies and intramedullary nailing, a technique that has only previously been performed in pediatric long bone deformities. To the author’s knowledge, there have been no previous reports of acute lengthening in an adult patient to correct for such a severe deformity in a single operation. Case Report: A 48-year-old woman with a 35-year history of a right femur fracture malunion presented with a 5 cm leg length discrepancy and severe malalignment associated with pain and ambulatory dysfunction. Multiple modified Sofield-Millar osteotomies followed by placement of an intramedullary nail were performed and resulted in successful acute correction of limb length discrepancy and anatomical alignment. There was a complete union of bone with callus formation at osteotomy sites at 9 months postoperatively, and the patient reported minimal pain and improved ambulation. The patient was followed for 2 years postoperatively and experienced an improvement in ambulatory function with no pain. No post-operative complications were observed. Conclusion: Multiple modified Sofield-Millar osteotomies with intramedullary nailing were utilized for successful acute correction of limb length discrepancy and severe malalignment with improvement in pain and ambulatory function in this case of femoral leg length discrepancy in an adult patient.
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Zheleznov, L. M., O. A. Levanova, S. A. Nikiforova, and S. A. Sarenko. "Anatomical Basis for the Optimization of Ultrasound Screening Studies in Perinatology." Journal of Anatomy and Histopathology 7, no. 4 (January 11, 2019): 20–26. http://dx.doi.org/10.18499/2225-7357-2018-7-4-20-26.
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The article discusses the possibilities of expanding the effectiveness of ultrasound screening studies in perinatology based on the results of a study of 894 fetuses. It is established that the standardization of the study is facilitated by one specialist, on the scanner of one model, during a sufficiently short time interval. The range of the regional norm for quantitative intravital parameters of topographic and anatomical parameters of the thymus in the conditions of a large industrial city in healthy pregnant females has been determined and their dynamic changes – absolute growth and growth intensity at the screening inspection stages have been studied. For the first time to describe the quantitative topography of the thymus in fetuses, the shortest distances from the center of the vertebral body and also to the center of the ascending aorta, the pulmonary trunk and the superior vena cava, the thymic-thoracic index were studied, and the dynamics of their growth were traced. For the first time quantitative criteria and dynamic features of the change (biparietal, fronto-occipital dimensions and head circumference, abdominal circumference, femur length, thymus size) in fetuses of HIV-infected pregnant women were determined. For the first time, the fetometric parameters of the bearing fruit in low-, medium- and high-growth pregnant brachy-, meso- and dolichomorphic somatotypes at the stages of the second and third ultrasonic screening. Correlation relationships of fetometry indicators with anthropometric parameters in low-, medium- and tall pregnant brachy-, mezo- and dolichomorphic somatotypes at the stages of the second and third ultrasonic screening survey are shown. The possibilities of morphometric analysis, wide study not only of anatomy, but also of the topography of organs, the application of the laws of teachings on age anatomy, individual anatomical variability, and clinical anthropology are shown on the example of thymus research, features of fetuses of HIV-infected pregnant women, fetuses of women of different constitution and growth.
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Hardt, Sebastian, Robert Hube, and Carsten Perka. "Total Hip Arthroplasty for High Hip Dislocation." Zeitschrift für Orthopädie und Unfallchirurgie 158, no. 02 (March 4, 2020): 170–83. http://dx.doi.org/10.1055/a-0946-2750.
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Abstract Introduction Total hip arthroplasty in patients with high hip dislocation is a surgically demanding procedure. This is due to the congenital disorder of hip maturation and the resulting anatomical features. The aim of the arthroplasty is implantation of the cup prosthesis in the original centre of rotation, at the same time correcting femoral deformities and reducing the hip joint. Indications The indications include advanced osteoarthritis in the secondary acetabulum, existing instability, severe contractures and secondary changes in adjacent joints. Contraindications The contraindications include cerebrospinal dysfunction with impaired coordination, muscular dystrophies, overt metabolic bone disorders and complete or nearly complete absence of muscles that stabilise the hip/hip-stabilising musculature. Operation Technique The operation is preferably performed through an anterolateral approach with the patient supine or through a posterolateral approach with the patient on his side. Sparing the pelvitrochanteric muscles is crucial for the functional outcome. Exposure of the original acetabulum is essential for correct and secure placement of the cup component. We perform planned shortening femoral osteotomy above an increase in length of more than 3.0 cm in patients without previous surgery and depending on the operative findings in previously operated patients. As a rule of thumb, the bone fragment to be removed should be approximately 60% of the distance between the planned and the preoperative position of the trochanter tip. Additional fixation is necessary only in the absence of primary stability between the parts of the femur divided by the osteotomy. Postoperative Management In these patients, the postoperative management is determined individually depending on the stability of the prosthetic cup fixation, bone quality, rotational stability of the stem in both segments of the femur after the osteotomy, existing soft tissue contractures and the resulting postoperative leg length difference. Complications The most frequent complications are nerve injuries, femoral fractures, malpositioning of the components, absence of integration of the components (usually due to inadequate primary stability), joint instability due to damage to the pelvitrochanteric muscles and therefore an increased risk of dislocation, pseudarthrosis of the femoral osteotomy and increased perioperative blood loss due to the prolonged operation time. Results The currently published results show that subtrochanteric shortening osteotomy in patients with high hip dislocation with anatomic reconstruction of the original centre of rotation delivers good functional results with insignificantly increased 10-year loosening rates compared with standard management of primary hip osteoarthritis.
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Stracciolini, Andrea, Laura Boucher, Sarah Jackson, Naomi Brown, Danielle Magrini, Maxwell McKee-Proctor, Pierre d’Hemecourt, and Patricia Delzell. "FEASIBILITY AND RELIABILITY OF MUSCULOSKELETAL ULTRASOUND MEASUREMENT OF THE MEDIAL PATELLOFEMORAL LIGAMENT." Orthopaedic Journal of Sports Medicine 8, no. 4_suppl3 (April 1, 2020): 2325967120S0018. http://dx.doi.org/10.1177/2325967120s00185.
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Background The medial patellofemoral ligament (MPFL) is an important soft tissue constraint to preventing patellar dislocations in young athletes. The anatomy of the MPFL has been investigated in cadaveric studies and magnetic resonance studies. No studies to date have provided anatomical data of the MPFL on ultrasonography. Purpose To investigate the feasibility of musculoskeletal ultrasonography for the evaluation of the MPFL, and to determine interrater and intrarater reliability for MPFL ultrasound measures. Methods Ten control participants (20 knees) 20 to 50 years underwent ultrasonography performed by 3 researchers (musculoskeletal ultrasound radiologist, athletic trainer/biomechanist, primary care sports medicine physician) from 3 different institutions for interrater reliability testing. Intrarater reliability testing was performed at 2 separate institutions by 4 physicians, each performing the same knee ultrasound protocol on 20 knees in 10 study participants 2 to 3 weeks apart. In total, 180 images were created for interrater reliability, and 480 images for intrarater reliability. Examinations were performed with linear high-frequency transducers (10-18 MHz) with the participant in the supine position and the extremity flexed at 45°. Measurements included ligament length (long axis to ligament) from the patellar to the femoral attachment sites, ligament width (short axis to ligament) at the patellar attachment, and ligament thickness (long axis to ligament) midway between the patella and femur. Mean and SD were calculated for all measurements. Intraclass correlation coefficient (ICC) analysis was used to assess intrarater and interrater reliability. ICC values < 0.40 indicated poor reliability, whereas those between 0.40 and 0.75 indicated fair to good reliability, and those > 0.75 indicated excellent reliability. Results The mean US value for MPFL length was 44.83mm (SD 6.68), mean thickness 2.66mm (SD 0.85), and mean width 11.76mm (SD 2.99). The overall ICC values for interrater reliability testing indicated fair to good reliability for length measures (0.7) and poor reliability for thickness (–0.1) and width (0.3; Table 1.1). Overall ICC values for intrarater reliability indicated fair to good reliability for length (0.5), excellent for thickness (0.9), and poor reliability for width (–0.3; Table 1.2). Conclusions Musculoskeletal ultrasonography is a feasible and reliable office-based method of measuring MPFL length and thickness. These quantitative measures set the groundwork for establishing normative anatomical measures of the MPFL in athletes and establish a protocol for testing and measuring the MPFL using musculoskeletal ultrasonography. [Table: see text][Table: see text]
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Benton, Michael J., and Alick D. Walker. "Saltopus, a dinosauriform from the Upper Triassic of Scotland." Earth and Environmental Science Transactions of the Royal Society of Edinburgh 101, no. 3-4 (September 2010): 285–99. http://dx.doi.org/10.1017/s1755691011020081.
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ABSTRACTSaltopus elginensis, reported in 1910 from the yellow sandstones of the Lossiemouth Sandstone Formation (Late Triassic) of Morayshire, NE Scotland, has long been controversial. It was described first as a theropod dinosaur, but others disagreed. Reanalysis of the type, and only, specimen using casts from the natural rock moulds, as well as X-rays and CT scans, has revealed new anatomical data not available to previous researchers. Saltopus was a small, 800–1000 mm-long biped, whose tail made up more than half its length. It is an avemetatarsalian because it has elongated and tightly bunched metatarsals, the tibia is longer than the femur, the calcaneal tuber is rudimentary or absent, and metatarsal II is equal to or longer than metatarsal IV; a unique assemblage of characters diagnosing this clade. Saltopus is a dinosauromorph on the basis of the reduced fingers IV and V, the saddle-shaped dorsal margin of the iliac blade, and the articulation of sacral rib 1 close to the front of the iliac blade. Saltopus is a dinosauriform on the basis of the trochanteric shelf and lesser trochanter on the proximal end of the femur, the waisted sacral ribs, and perhaps the rod-like and straight pubis. However, it lacks all apomorphies of Dinosauria, retaining for example the primitive condition of two sacral vertebrae. Cladistic analyses place Saltopus within Dinosauromorpha and Dinosauriformes, and between the basal dinosauriform Pseudolagosuchus and the derived clade consisting of Silesauridae and Dinosauria, so making it one of a radiation of small pre-dinosaurian bipedal archosaurs in the Triassic found so far in North and South America and in Europe.
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Nishino, Tomofumi, Hajime Mishima, Haruo Kawamura, Tomohiro Yoshizawa, Shumpei Miyakawa, and Masashi Yamazaki. "Ten-year results of 55 dysplasia hips of hip offset and leg length reconstruction in total hip arthroplasty with cementless tapered stems having a high offset option designed for dysplastic femur." Journal of Orthopaedic Surgery 28, no. 1 (January 1, 2020): 230949902090949. http://dx.doi.org/10.1177/2309499020909499.
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Purpose: In developmental dysplasia of the hip (DDH), the centers of hip rotation move in the superior and lateral direction. In total hip arthroplasty for such cases, movement of the center of hip rotation is in the inferior and medial direction. It causes an increase in leg length and a decrease in acetabular offset. We therefore evaluated the change of hip offset and leg length before and after surgery with two stems having a high offset option. Patients and Methods: The preoperative diagnosis was secondary osteoarthritis due to DDH excluded Crowe IV. A stem selection was decided based on preoperative two-dimensional templating. Total 55 hips in 50 patients were followed up for minimum 10 years. Pre- and postoperative clinical evaluations were performed using a hip joint function scoring system. Radiographic evaluations were used for offset and leg length measurements and other associated factors. Results: Both stems showed excellent clinical results. A high offset option was used in 60% of all cases. No postoperative dislocations were observed. The biological fixation was stable in all cases. The hip offset was restored without excessive leg lengthening in most cases. Conclusion: Anatomical consistency could be maintained by using a stem which matched geometry of the proximal part and had offset option. These cementless tapered stems having a high offset option are suitable for Crowe I to III hip dysplasia if two-dimensional X-ray templates fit the shape of the proximal femurs. They were associated with excellent clinical results and biological fixation. The offset option may be useful to adjust leg length and offset in DDH patients.