Length of metacarpal and metatarsal bones in five Iranian sheep breeds and their associations with ungula measurements

Background This study aimed to measure the length of metacarpal and metatarsal bones in five Iranian sheep breeds and to correlate the length of the bones with ungula measurements. Thoracic and pelvic limbs of 2-year-old, previously untrimmed, pastured Afshari, Moghani, Kurdi, Makoui, and Lori–Bakhtiari ewes, (n = 20 ewes per breed) were collected after slaughter. The following lengths were recorded in the metacarpal and metatarsal bones: from the margo proximalis lateralis to the lateral (L1) and medial (D1) cartilago physialis; from the margo proximalis lateralis to the margo abaxialis of the lateral (L2) and medial (D2) caput; from the cartilago physialis lateralis to the margo abaxialis of the lateral caput (X1); from the cartilago physialis medialis to the margo distalis of the caput ridge (X2) and from the margo axialis of cartilago physialis to the margo axialis of the lateral caput (X3). Additionally, measurements of the ungula including pars dorsalis length, pars mobilis lateralis and medialis height, pars dorsalis height to the ground and to the solea cornea, thickness of the solea in the pars dorsalis, pars mobilis lateralis and medialis, solea cornea length and angulus dorsalis were recorded in the medial and lateral digits of the thoracic and pelvic limbs. Data on length of the metatarsal and metacarpal bones were analysed using mixed model equations while Pearson correlations were calculated between metacarpal and metatarsal bones and ungula measurements. Results Lori- Bakhtiari and Moghani ewes had greater L1, L2, and D1 and D2 while X1, X2 and X3 was greater in Kurdi ewes (P < 0.05). Measurements such as L1, L2, D1 and D2 were greater in the metatarsal than in metacarpal bones (P < 0.05) and the opposite was observed for X1, X2 and X3 (P < 0.05). No asymmetry was observed between the lateral and medial measurements (P > 0.05). Low to moderate correlations were observed between bone and ungula measurements (P < 0.05). Conclusion Under the conditions of this study, differences in metacarpal and metatarsal bone measurements were observed between breeds but no asymmetry was observed between lateral and medial bones. Results indicate an association between metacarpal and metatarsal bones ungula measurements. This could provide baseline information for the development and/or improvement of current ungula health protocols in the studied sheep breeds.

Study of Sexual Dimorphism in Metatarsal Bones: Geometric and Inertial Analysis of the Three-Dimensional Reconstructed Models

The aim of the present paper is to determine the sex of the individual using three-dimensional geometric and inertial analyses of metatarsal bones. Metatarsals of 60 adult Chinese subjects of both sexes were scanned using Aquilion One 320 Slice CT Scanner. The three-dimensional models of the metatarsals were reconstructed, and thereafter, a novel software using the center of mass set as the origin and the three principal axes of inertia was employed for model alignment. Eight geometric and inertial variables were assessed: the bone length, bone width, bone height, surface-area-to-volume ratio, bone density, and principal moments of inertia around the x, y, and z axes. Furthermore, the discriminant functions were established using stepwise discriminant function analysis. A cross-validation procedure was performed to evaluate the discriminant accuracy of functions. The results indicated that inertial variables exhibit significant sexual dimorphism, especially principal moments of inertia around the z axis. The highest dimorphic values were found in the surface-area-to-volume ratio, principal moments of inertia around the z axis, and bone height. The accuracy rate of the discriminant functions for sex determination ranged from 88.3% to 98.3% (88.3%–98.3% cross-validated). The highest accuracy of function was established based on the third metatarsal bone. This study showed for the first time that the principal moment of inertia of the human bone may be successfully implemented for sex estimation. In conclusion, the sex of the individual can be accurately estimated using a combination of geometric and inertial variables of the metatarsal bones. The accuracy should be further confirmed in a larger sample size and be tested or independently developed for distinct population/age groups before the functions are widely applied in unidentified skeletons in forensic and bioarcheological contexts.

PLANTAR FASCIITIS: A NOVEL CROWDSOURCING APPROACH TO DATA COLLECTION AND ANALYSIS

Plantar Fasciitis (PF) is a disorder of connective tissue that supports the longitudinal arch of the foot. The fascia runs along the sole with insertion to the heads of the metatarsal bones and origin in the calcaneus. It is one of the most frequent diagnoses for patients in general and foot clinics, and one of the common causes for heel pain which may develop into chronic heel pain, change the way we walk and lead to foot, knee, hip or back problems. PF is the most common type of plantar fascia injury. The purpose of this study is to describe the natural history of PF, including the ethnicity, early and main symptoms, aggravating factors, comorbidities and treatments for PF, based on the patient-reported data from active PF community in an online crowdsourcing platform, StuffThatWorks. Analyses were made in order to discover characteristics which have a clinical importance. Totally 3835 patients were included in this retrospective observational study. The results show that crowdsourcing is a valid approach for data collection, as expected results with regard to clinical aspects such as age-of-onset, early and main symptoms were witnessed. Furthermore, the patient-reported data show three characteristics which have a very high clinical relevance: high level of physical activity, being overweight and age. In addition, leads for future studies were established.

Feline Skeletal Reference Guide: A Cadaveric Radiographic Measurement on Lower Limb Extremities

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

Largazole Inhibits Ocular Angiogenesis by Modulating the Expression of VEGFR2 and p21

Ocular angiogenic diseases, characterized by abnormal blood vessel formation in the eye, are the leading cause of blindness. Although Anti-VEGF therapy is the first-line treatment in the market, a substantial number of patients are refractory to it or may develop resistance over time. As uncontrolled proliferation of vascular endothelial cells is one of the characteristic features of pathological neovascularization, we aimed to investigate the role of the class I histone deacetylase (HDAC) inhibitor Largazole, a cyclodepsipeptide from a marine cyanobacterium, in ocular angiogenesis. Our study showed that Largazole strongly inhibits retinal vascular endothelial cell viability, proliferation, and the ability to form tube-like structures. Largazole strongly inhibits the vessel outgrowth from choroidal explants in choroid sprouting assay while it does not affect the quiescent choroidal vasculature. Largazole also inhibits vessel outgrowth from metatarsal bones in metatarsal sprouting assay without affecting pericytes coverage. We further demonstrated a cooperative effect between Largazole and an approved anti-VEGF drug, Alflibercept. Mechanistically, Largazole strongly inhibits the expression of VEGFR2 and leads to an increased expression of cell cycle inhibitor, p21. Taken together, our study provides compelling evidence on the anti-angiogenic role of Largazole that exerts its function through mediating different signaling pathways.

Treatment of Cleft Foot Deformity using Fish Mouth Incision and Suture-Button in Paediatric Foot

Cleft foot is a congenital anomaly characterized by absence of the metatarsal bones and phalanges. It is commonly seen in children with Ectrodactyly-ectrodermal dysplasia and clefting syndrome (EEC) ranging from a median cleft up to the mid metatarsals to a deep cleft up to the tarsal bones. Surgical treatment in the form of cleft closure, excision of the rudimentary metatarsal bone and cross K-wire fixation of metatarsal bones have been tried for the management of such cases. Here, we report a case of one year old child with Type III cleft foot having four metatarsals, who was treated with suture-endobutton system using three transverse tunnels in the 2nd and 3rd metatarsal bones in order to bring them closer. We were able to achieve a satisfactory outcome with a normal fitting shoe wear. Keywords: Cleft foot; suture-button; fish mouth incision.

Conservative Treatment of the Fifth Metatarsal Bone Fractures in Professional Football Players Using Platelet-Rich Plasma

Injuries of the metatarsal bones in football are relatively rare and in most cases are localized in the fifth metatarsal. The gold standard of the diagnosis of fractures in this area can be X-rays, which in most cases allows verifying the diagnosis. The treatment tactics depend on the localization of the fracture according to Lawrence and Botte’s classification: 3 zones of localization are distinguished. Fractures located in zones 2 and 3 belong to a high-risk group due to delayed consolidation and nonunion and therefore athletes are most often treated with osteosynthesis using intramedullary screws. The minimal recovery time for this type of treatment is at least 8 weeks. This report describes 7 cases of the fifth metatarsal bone fractures, located in zones 2 and 3 in professional football players who were treated with an immobilization boot, cryotherapy, nutritional supplements of calcium and vitamin D, and local injections of platelet-rich plasma, which contains numerous growth factors. The deadline for returning to regular training activities was 43 to 50 days, and there was no relapse of damage within 6 months of follow-up. Levels of Evidence: Level of evidence 4: case report study

Analysis of Plantar Pressure Pattern after Metatarsal Head Resection. Can Plantar Pressure Predict Diabetic Foot Reulceration?

To evaluate the metatarsal head that was associated with the highest plantar pressure after metatarsal head resection (MHR) and the relations with reulceration at one year, a prospective was conducted with a total of sixty-five patients with diabetes who suffered from the first MHR and with an inactive ulcer at the moment of inclusion. Peak plantar pressure and pressure time integral were recorded at five specific locations in the forefoot: first, second, third, fourth, and fifth metatarsal heads. The highest value of the four remaining metatarsals was selected. After resection of the first metatarsal head, there is a displacement of the pressure beneath the second metatarsal head (p < 0.001). Following the resection of the minor metatarsal bones, there was a medial displacement of the plantar pressure. In this way, plantar pressure was displaced under the first metatarsal head following resection of the second or third head (p = 0.001) and under the central heads after resection of the fourth or fifth metatarsal head (p < 0.009 and p < 0.001 respectively). During the one-year follow-up, patients who underwent a metatarsal head resection in the first and second metatarsal heads suffered transfer lesion in the location with the highest pressure. Patients who underwent a minor metatarsal head resection (second–fifth metatarsal heads) showed a medial transference of pressure. Additionally, following the resection of the first metatarsal head there was a transference of pressure beneath the second metatarsal head. Increase of pressure was found to be a predictor of reulceration in cases of resection of the first and second metatarsal heads.

Conservative Treatment for Primary Metatarsalgia

Metatarsalgia is one of the most common causes of forefoot pain, and it is characterized by pain in the front part of the foot under the head of the metatarsal bones. Primary metatarsalgia is idiopathic, but it has been suggested to be related to forefoot plantar compression. Because of the various causes of metatarsalgia, there is the need to thoroughly consider the etiology of metatarsalgia to find novel, effective, and conservative treatments for metatarsalgia to avoid surgical treatment. Pressure reduction or redistribution can be achieved using toe exercise, flat shoe inserts, metatarsal pads, custom-molded inserts, and rockerbars. There was no need for one treatment. If toe function was poor, toe exercises were recommended. If dorsiflexion of the ankle joint was limited, the Achilles tendon was stretched. If the pain was localized to the plantar aspect of the 2nd MTP, a decompression insole was applied. If the pain was limited to the plantar aspect of the 2nd MTP, a decompression insole was worn. If swelling occurred, anti-inflammatory drugs were indicated to reduce inflammation. The combination of the two was appropriate for this condition. Toe exercises can improve balance and are worth trying. An in-depth understanding of the various etiologies of metatarsal and toe deformities is essential for successful treatment.

Culture Concordance in Different Sections of the Metatarsal Head: Interpretations of Microbiological Results

Microbiological cultures of per-wound bone biopsies have shown a lack of correlation and a high rate of false-negative results when compared with bone biopsy cultures in diabetic foot osteomyelitis. The selection of samples from the area of active osteomyelitis, which contains a complete census of the microorganisms responsible for the infection, is essential to properly guide antimicrobial treatment. We aimed to comparatively evaluate the quantitative and qualitative cultures taken from different areas, in metatarsal heads resected for osteomyelitis. For this purpose, we consecutively selected 13 metatarsal heads from 12 outpatients with plantar ulcers admitted to our diabetic foot unit. Metatarsal heads were divided transversally into 3 portions: plantar (A), central (B), and dorsal (C), and the 39 resulting samples were cultured. Qualitative and quantitative microbiological analysis was performed, and the isolated species and bacterial load, total and species specific, were compared between the 3 metatarsal bone segments. The primary outcome of the study was the bacterial diversity detected in the different bone sections. Cultures were positive in 12 of the 13 included metatarsal heads (92%). A total of 34 organisms were isolated from all specimens. Ten of the 12 cultures (83%) were polymicrobial. Ten of the 13 metatarsal heads (77%) had identical microbiological results in each of the 3 bone sections. The largest number of microorganisms was found in the central section. The overall concordance between sections was 91%. The predominant microorganisms were coagulase-negative staphylococci (41%). Statistical differences were not found in the bioburden between sections (range 3.25-3.41 log10 colony-forming unit/g for all sections; P = .511). The results of our study suggest that microorganisms exhibit a high tendency to spread along the metatarsal bone and that the degree of progression along the bone is species dependent. The central portions of metatarsal bones tend to accumulate a higher diversity of species. Thus, we recommend this area of bone for targeted biopsy in patients with suspected osteomyelitis.