Anatomical and Radiological Considerations of the Fifth Metatarsal Bone

2000 ◽  
Vol 21 (3) ◽  
pp. 212-215 ◽  
Author(s):  
Nabil A. Ebraheim ◽  
Steve P. Haman ◽  
Jike Lu ◽  
Thomas G. Padanilam ◽  
Richard A. Yeasting

Twenty cadaver fifth metatarsals were harvested from cadaver feet. They were then sectioned coronally in three locations. The cortical thickness (medial, lateral, dorsal, and plantar) and the intra-medullary canal diameter (dorsoplantar and mediolateral) were measured at the three sectional sites. The intra-medullary canal of six specimens was outlined with radiopaque solder wire. The canal was then examined radiographically with the lateral and dorsoplantar views. A lateral bow on the dorsoplantar view was observed in some specimens, which could contribute to surgical complications. On lateral view the intramedullary canal appeared straight in all specimens. The canal projects at least partially into the fifth metatarsal cuboid joint. When considering intra-medullary fixation a surgeon must take into account quality of bone stock and bowing of the canal. A bowed intra-medullary canal lends to vulnerability of the medial cortex at roughly mid-shaft of the fifth metatarsal. The canal has a narrower diameter in the dorsoplantar dimension than the mediolateral dimension. The cortical thickness was found to be less in the dorsal and plantar areas of the fifth metatarsal when compared to medial and lateral cortex. All of these findings lead to causes for complication in intra-medullary fixation of the fifth metatarsal.

Author(s):  
W Macdonald ◽  
L V Carlsson ◽  
N Gathercole ◽  
C M Jacobsson

The Gothenburg Osseointegrated Titanium (GOT) implant is a novel total hip replacement including a metaphyseal loading proximal femoral component fixed in the retained femoral neck. Endurance testing was performed under conditions analogous to ISO 7206–4: 1989. The cement-free implant is not fixed distally within the intramedullary canal, so distal embedding (as specified in the standard) would have been unrealistic. Instead glass-fibre-reinforced epoxy (GFRE) bushings were used to model reduced bone support mid-length at the medial cortex and distally at the lateral cortex. Such support simulated proximal bone loss, realistically reproducing the effect of osteolysis or fixation failure. Under such conditions the component survived unbroken for 10 million cycles at 3.0 kN peak load.


2021 ◽  
Vol 103 (4) ◽  
pp. 196-201
Author(s):  
N Sargazi ◽  
Y Oskrochi ◽  
J Houghton ◽  
B Rai ◽  
D Brown ◽  
...  

Introduction While the gold standard for simulation training in hand surgery is cadaveric hands, ethical issues and cost limit their use. Chicken thighbones have been utilised to replicate human metacarpals but there is a lack of literature to validate such a model. The aim of this study was to determine whether chicken femurs are morphologically similar to human metacarpal bones. Methods Computed tomography imaging was obtained of hands undertaken at our institute between 1 January and 31 December 2015. A total of 114 chicken thighs were also scanned. Bones with previous trauma or incomplete imaging were excluded. Bone length, distance to isthmus, radius of curvature, medullary canal diameter and cortical thickness were compared between the groups. Statistical analysis was conducted using Student’s t-test or the Mann-Whitney U test, with statistical significance implied with a p-value of < 0.05. Results A total of 146 human CT scans were identified, of which 36 were included in the study, resulting in 158 human metacarpals in 5 female and 31 male patients, with an average age of 39.5 years (range: 16–77 years). Of 114 chickens scanned, 101 were suitable for analysis. Mean length, distance to isthmus, radius of curvature, medullary canal diameter and cortical thickness were 57.3mm (standard deviation [SD]: 8.7mm), 32.9mm (SD: 8.2mm), 68.8mm (SD: 19.5mm), 9.3mm (SD: 1.6mm) and 1.7mm (SD: 0.4mm) respectively in human metacarpals, compared with 66.7mm (SD: 5.1mm), 34.1mm (SD: 6.4mm), 89.1mm (SD: 15.1mm), 6.4mm (SD: 0.6mm) and 1.6mm (SD: 0.1mm) respectively in chicken femurs. There was no significant difference in bone geometry between the groups, with p-values of >0.05 for all parameters described. Conclusions The chicken thigh model provides an anatomically suitable and more cost effective alternative to human cadaveric metacarpals in simulation training for hand surgery.


2016 ◽  
Vol 06 (03) ◽  
pp. 58-62
Author(s):  
Ahmed Elmorsy ◽  
Sarah Whitehouse ◽  
John Timperley ◽  
Stephen Veitch

BJPsych Open ◽  
2020 ◽  
Vol 6 (5) ◽  
Author(s):  
Flavia Venetucci Gouveia ◽  
Jürgen Germann ◽  
Gabriel A. Devenyi ◽  
Rosa M. C. B. Morais ◽  
Ana Paula M. Santos ◽  
...  

Aggressive behaviour is a highly prevalent and devastating condition in autism spectrum disorder resulting in impoverished quality of life. Gold-standard therapies are ineffective in about 30% of patients leading to greater suffering. We investigated cortical thickness in individuals with autism spectrum disorder with pharmacological-treatment-refractory aggressive behaviour compared with those with non-refractory aggressive behaviour and observed a brain-wide pattern of local increased thickness in key areas related to emotional control and overall decreased cortical thickness in those with refractory aggressive behaviour, suggesting refractoriness could be related to specific morphological patterns. Elucidating the neurobiology of refractory aggressive behaviour is crucial to provide insights and potential avenues for new interventions.


Author(s):  
F.S. Haddad ◽  
F. Rayan

♦ Periprosthetic fractures: intraoperative or postoperative femoral or acetabular fractures♦ Third commonest reason for reoperation after THA♦ Vancouver classification Type A, B, and C♦ Three most important factors that determine treatment are:• Site of the fracture• Stability of the implant• Quality of the surrounding bone stock.


2021 ◽  
Vol 103-B (1) ◽  
pp. 131-140
Author(s):  
Marcus Kin Long Lai ◽  
Prudence Wing Hang Cheung ◽  
Dino Samartzis ◽  
Jaro Karppinen ◽  
Kenneth Man Chee Cheung ◽  
...  

Aims To study the associations of lumbar developmental spinal stenosis (DSS) with low back pain (LBP), radicular leg pain, and disability. Methods This was a cross-sectional study of 2,206 subjects along with L1-S1 axial and sagittal MRI. Clinical and radiological information regarding their demographics, workload, smoking habits, anteroposterior (AP) vertebral canal diameter, spondylolisthesis, and MRI changes were evaluated. Mann-Whitney U tests and chi-squared tests were conducted to search for differences between subjects with and without DSS. Associations of LBP and radicular pain reported within one month (30 days) and one year (365 days) of the MRI, with clinical and radiological information, were also investigated by utilizing univariate and multivariate logistic regressions. Results Subjects with DSS had higher prevalence of radicular leg pain, more pain-related disability, and lower quality of life (all p < 0.05). Subjects with DSS had 1.5 (95% confidence interval (CI) 1.0 to 2.1; p = 0.027) and 1.8 (95% CI 1.3 to 2.6; p = 0.001) times higher odds of having radicular leg pain in the past month and the past year, respectively. However, DSS was not associated with LBP. Although, subjects with a spondylolisthesis had 1.7 (95% CI 1.1 to 2.5; p = 0.011) and 2.0 (95% CI 1.2 to 3.2; p = 0.008) times greater odds to experience LBP in the past month and the past year, respectively. Conclusion This large-scale study identified DSS as a risk factor of acute and chronic radicular leg pain. DSS was seen in 6.9% of the study cohort and these patients had narrower spinal canals. Subjects with DSS had earlier onset of symptoms, more severe radicular leg pain, which lasted for longer and were more likely to have worse disability and poorer quality of life. In these patients there is an increased likelihood of nerve root compression due to a pre-existing narrowed canal, which is important when planning surgery as patients are likely to require multi-level decompression surgery. Cite this article: Bone Joint J 2021;103-B(1):131–140.


2019 ◽  
Vol 71 (4) ◽  
pp. 1217-1226
Author(s):  
G.M. Bueno ◽  
A.M. Girardi ◽  
T.J.C. Módolo ◽  
A.F. Sabes ◽  
J.A. Oliveira ◽  
...  

ABSTRACT Due to the scarcity of myelogenous studies in cattle, the present study aimed to evaluate the efficacy and distribution of iopamidol and iohexol contrast agents in calves, in order to determine guidelines for obtaining diagnostic radiographs of spinal cord disorders in these animals. Ten healthy Holstein calves, seven days to two months of age, were divided into two groups, according to the contrast medium applied. Myelographic studies of the spine were performed with the calves in lateral recumbency, with radiographs repeated 20 times during a two-hour period. On the radiographs, the contrast medium was analyzed for opacity, detail of the image, distension of the medullary canal, and progression of the contrast line. After seven days, the myelographic studies were repeated, with the contrast media exchanged between the groups. There were no significant differences in the quality of the images and speed of the spinal column filling between the two contrast media. Furthermore, the best quality radiographic images were obtained six to eight minutes after injection of the contrast in the cervical spinal segment, 80 minutes in the thoracic, and 20 minutes in the lumbar, sacral, and cauda equina segments.


1970 ◽  
Vol 3 (2) ◽  
pp. 60-68
Author(s):  
Everson Renan Vilhena ◽  
Fernando Araújo Pires ◽  
Luciano Martins Alves Da Rosa

Introdução: Osteomielite é uma infecção óssea caracterizada pela destruiçãoprogressiva do osso cortical e canal medular e pode evoluir para tratamentosagressivos, como a amputação. O método de Ilizarov é um fixador externocircular, que possibilita uma osteossíntese estável e permite apoio de pesocorporal na marcha e mobilidade das articulações adjacentes. Casuística: Tratasede um caso de paciente jovem, maior de 18 anos, do sul de Minas Gerais,masculino, que após tratamento para fratura de maléolo medial com um fio deKirschner, evoluiu com extensa osteomielite e uma perda óssea de 10 cm detíbia distal incluindo a articulação tibiotalar. Ao recusar amputação, foi sugeridoao paciente o tratamento cirúrgico pelo método de Ilizarov e posteriormente,realização da artrodese tibiotalar com enxerto do ilíaco, cujo tratamento foiprolongado, com acompanhamento contínuo por um ano, com boa evolução eótimo prognóstico, tendo seu membro preservado. Discussão: O método deIlizarov permite tratar perdas ósseas extensas, evitando a perda do membro e adiminuição da qualidade de vida do paciente, mas necessita de profissionalcapacitado e o tratamento é longo, não possuindo bom resultado estético. Paraser efetivo, é necessário um acompanhamento contínuo e uma boa relaçãomédico-paciente. Conclusão: o método promove uma melhora substancial noprognóstico do paciente e qualidade de vida, tanto psicossocial, quantoeconômica e a satisfação de preservação do membro, que o torna uma boa opçãoem perdas ósseas extensas.Palavras chave: Osteomielite, Ilizarov, Fratura, Pilão tibial ABSTRACTIntroduction: Osteomyelitis is a bone infection characterized by progressivedestruction of cortical and medullary canal and may develop into aggressivetreatments, such as amputation. The Ilizarov method is a circular externalfixator, which allows stable fixation and body weight support gait and mobilityof adjacent joints. Reporting: This is about a young patient, over 18 years old,in the South of Minas, male, who after treatment for fracture of the medialmalleolus with a wire of Kirschner (bone wire) evolved with extensiveosteomyelitis and bone loss of 10 cm of the distal tibia including the tibiotalarjoint. By refusing amputation it was suggested to the patient surgical treatmentwith the Ilizarov method and subsequently implementation of tibiotalararthrodesis with iliac graft and prolonged treatment with continuous monitoringfor a year, with good performance and excellent prognosis member preserved. Discussion: This method allows to treat extensive bone loss, preventing limbloss and a decreased in the life quality of the patient, but requires skilledprofessional, the treatment is long and not having good cosmetic result and to beeffective requires a continuous monitoring and a good doctor-patientrelationship. Conclusion: The method brings a substantial improvement inpatient outcomes and quality of life, both psychosocial and economicsatisfaction and preservation member, which makes it a good choice forextensive bone loss.Keywords: Osteomyelitis, Ilizarov, Fracture, Tibialpestle


2012 ◽  
Vol 38 (6) ◽  
pp. 658-666 ◽  
Author(s):  
I. N. Sletten ◽  
L. Nordsletten ◽  
G. A. Hjorthaug ◽  
J. C. Hellund ◽  
I. Holme ◽  
...  

Four methods for measuring volar angulation in 5th metacarpal neck fractures were tested for validity and reliability. Mid-medullary canal measurement in the lateral view (method MC-90) has previously been proven valid in a cadaveric study, hence used as a reference to test validity of the latter three. These three yielded a significant different mean fracture angle compared with MC-90, with only minor enhancement in reliability. Therefore, none of these three methods is recommended as a better standard method than the MC-90, where reliability was found to be substantial (intraclass correlation coefficient 0.53–0.81). Two methods for measuring shortening in 5th metacarpal neck fractures were compared, and stipulation of shortening by drawing a line through the most distal point of the heads of the neighbouring 3rd and 4th metacarpals (method SH-Stip) is a simple method with excellent reliability (intraclass correlation coefficient 0.81–0.96) for estimating shortening, requiring only radiological examination of the injured hand.


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