Some allometric patterns of radiation diagnostics of the upper limb

A screening analysis of the parameters of the BMD of the forearm bones of more than 12,000 patients is presented. The dynamics of the median BMD was studied depending on gender and age parameters.

Morphological symmetry of the radius and ulna—Can contralateral forearm bones utilize as a reliable template for the opposite side?

The most important precondition for correction of the affected forearm using data from the contralateral side is that the left and right bone features must be similar, in order to develop patient-specific instruments (PSIs) and/or utilize computer-assisted orthopedic surgery (CAOS). The forearm has complex anatomical structure, and most people use their dominant hand more than their less dominant hand, sometimes resulting in asymmetry of the upper limbs. The aim of this study is to investigate differences of the bilateral forearm bones through a quantitative comparison of whole bone parameters including length, volume, bowing, and twisting parameters, and regional shape differences of the forearm bones. In total, 132 bilateral 3D radii and ulnae 3D models were obtained from CT images, whole bone parameters and regional shape were analyzed. Statistically significant differences in whole bone parameters were not shown. Regionally, the radius shows asymmetry in the upper section of the central part to the upper section of the distal part. The ulna shows asymmetry in the lower section of the proximal part to the lower section of the central part. Utilizing contralateral side forearm bones to correct the affected side may be feasible despite regional differences in the forearm bones of around 0.5 mm.

A Double-Barreled Fibular Graft for the Reconstruction of Both Forearm Bones and Humeroradial Joint after a Tumor Resection

A double-barreled fibular graft was used to reconstruct both forearm bones and the humeroradial joint after tumor resection. The patient had a tumor of radius that invaded the ulna and extensor groups. After a wide tumor resection, vascularized fibular autograft and soft tissue reconstruction was performed. A fibular graft were placed as a double barrel in the proximal ulnar and radial defects including the radial head and fixed using two locking plates. Simultaneously, reconstruction of the humeroradial joint and wrist dorsiflexion was performed. Two years postoperatively, the patient is satisfied with his elbow function while performing activities of daily living. Although amputation was one of the options considered during the preoperative planning in this case, the affected limb could be preserved by grafting a double-barreled fibula and tendon transfer, which could maintain the function of his upper left limb.

Comparative analysis of surgical treatments of non-union in forearm fractures

Objective To compare outcomes of non-union in forearm fractures treated with the use of a comprehensive surgical approach considering the injury pattern and localization. Material and methods Based on treatment approaches the cases were categorized into 3 groups with proximal forearm fractures (group I, n = 28; 33.8 %), mid-shaft and distal forearm fractures (group II, n = 32; 38.5 %), and controls (group III, n = 23; 27.7 %). Group I included patients with hypertrophic nonunion (HTNU) of the forearm bones treated with bone graft and plating. Group II consisted of atrophic nonunion, HTNU of the forearm bones repaired with the Ilizarov external fixation. A single 3 mL local injection of autologous bone marrow and a kukumazim solution of 50 PU were used to induce bone fusion in the patients of the two groups. The control group included non-unions with no considerations to the fracture pattern and localization. All patients underwent physical, radiological examinations and laboratory tests. Results The control group showed 8.7 % poor and 69.5 % good outcomes at a long term, whereas 3.6 % results were rated as poor and 82.1 % as good in group I, with 3.1 % poor and 87.6 % good outcomes in group II. The ratings can be associated with a differentiated surgical approach considering the injury pattern and localization, the use of kukumazim proteolytic enzymes and autologous bone marrow injection. Conclusion Optimization of surgical treatments and considerations for injury pattern and localization allowed for a 2.8-time (3.1 %) decrease in poor outcomes and a 30 % reduction in the limb immobilization period.

Effectiveness of the Influence of Physical Therapy on the Indicators of the Neurological and Functional Status of the Hand in People with Compression Neuropathy of the Median Nerve as a Postimmobilization Complication of Fractures of the Distal Forearm Bo

The social inconsistency of patients with hand injuries is due to the limitation of the possibilities of professional and labor activity (reduced qualifications, limited opportunities for training and retraining, inability to work in their specialty), which justifies the search for new methods of their rehabilitation. The purpose of the study was to determine the effectiveness of physical therapy on the indicators of the neurological and functional status of the hand in patients with compression neuropathy of the median nerve as a postimmobilization complication of fractures of the distal forearm bones. Material and methods. The study involved 56 people with postimmobilization contractures of the wrist joint, complicated by compression neuropathy of the median nerve, as a result of fracture of the bones of the distal forearm. They were divided into two groups: the control group (they practiced according to the principles of polyclinic rehabilitation with a predominance of passive means like manual techniques, preformed physical factors) and the main group (they were engaged in a developed physical therapy program based on the principles of International Classification of Functioning, Disability and Health with a predominance of active means like functional training; massage; warm wet compress combined with post-isometric muscle relaxation, posture treatment; kinesiological taping). The effectiveness of the program was assessed by the presence and degree of pain (VAS and DN4), goniometry results, signs of median nerve irritation (Phalen, Hoffmann-Tinel, Durkan), French Arm Test, ABILIHAND, DASH, Boston carpal tunnel questionnaire. Results and discussion. After the rehabilitation intervention, all examined patients showed a decrease in the intensity of pain at rest and during movement (according to VAS). Signs of compression neuropathy of the median nerve decreased (pain intensity according to the DN4 questionnaire, the prevalence of specific symptoms, the results of a quantitative assessment of the Boston carpal tunnel questionnaire). There was an improvement in the functioning of the upper limb according to the ABILIHAND, DASH, French Arm Test scales. For all the studied parameters, the patients of both groups showed a statistically significantly better result compared to the initial data (p <0.05). However, the patients of the main group showed a better result than the patients of the control group (p <0.05). Conclusion. The developed program of physical therapy with the predominant using of active rehabilitation means revealed a statistically significant better effect on the indicators of the neurological and functional status of the hand in persons with compression neuropathy of the median nerve as a postimmobilization complication of fractures of the distal forearm bones

Repair of an open forearm fracture and extensive bony loss (case report)

Introduction Repair of a double open comminuted fracture of forearm bones with extensive bony loss is challenging due to a high risk of infection and the need to address a significant bony defect. Neither internal fixation nor open reduction could be considered due to substantial bone loss and severely impaired circulation with a high risk of soft tissue necrosis and infection. We report staged management of forearm fracture using avascular autologous graft to repair the defect and maintain the forearm length. Objective Demonstrate the successful management of the double open comminuted fracture of forearm bones with extensive bony loss using Ilizarov external fixation, classical autologous grafting harvested from fibula and intramedullary (IM) nailing. Results and discussion The limb was temporarily fixed with Ilizarov frame in an extra-focal manner. An autogenous fibular graft of 11 cm was used to fill in the gap. Intramedullary nailing of the radius and ulna was produced and ulnar defect was repaired with autogenous fibular graft. IM nails were removed once the bones consolidated. The limb function was completely regained, anatomical length of the segment maintained and metal constructs removed. Conclusion Combination of different bone fixation modalities, classical autografting technique and intramedullary nailing provided complete recovery of the broken limb maintaining the function and bringing down the risk of complications to ensure a good clinical result.

Arm and Forearm Bones of the Adult Blue Bull (Boselaphus tragocamelus): A Morphological and Morphometrical Study

Background: There is scanty information on the morphology and morphometry of the arm and forearm bones (humerus, radius, ulna) of the adult blue bull; therefore, the present study was designed to provide details on the morphology and morphometry of the arm and forearm bones of adult blue bull.Methods: The present study was conducted on the arm and forearm bones of six adult blue bull of either sex (n=6, male and n=6, female). The bone specimens were collected from Jodhpur zoo after taking official permission from the Principal Chief Conservator of Forest (PCCF), Government of Rajasthan. The collected bones were processed as per the standard hot water maceration technique. The macerated bones were soaked in 3% hydrogen peroxide followed by five days of sun-drying.Result: The humerus and radius was the long bones, whereas the ulna was aborted long bone. The humerus was a long, less twisted and strong bone with two extremities and four surfaces. The radius was fused to the ulna in the entire length, except for two interosseous spaces, namely, proximal interosseous spaces and distal interosseous spaces. The present study revealed that all the obtained parameters of arm and forearm bones (humerus, radius, ulna) showed a significant statistical difference (p less than 0.05*) between the males and females of adult blue bull. It can be concluded that the bones of the arm and forearm of the adult blue bull resembled that of small and large ruminants; however, they differed from other domestic and wild animals.

A computer tomography-based anthropomorphic study of forearm osteology: implications for prosthetic design

ABSTRACT BACKGROUND: The aim of this study was to accurately establish the variability in the anatomy of the radius and ulna in the context of the design of an intramedullary nail for both bones METHODS: Forearm computed tomography scans were used to measure the specific internal and external anatomy of the radius and ulna in adult patients. Patients with fractures or dislocations involving either the radius and/or ulna were excluded RESULTS: A total of 97 scans, comprising 84% male and 16% female patients, were included. The mean radius length was 238.43±18.38 mm (95% CI 234.60-241.74 mm). The mean curvature was an arc with a radius of 561.43±93.49 mm (95% CI 543.09-580.78 mm). The smallest measurement of the canal width was 5.17 mm (95% CI 4.87-5.47 mm). The ulna showed a mean length of 259.90±19.88 mm (95% CI 255.89-263.91 mm). The smallest measurement of the canal width was 4.80±1.30 mm (95% CI 4.53-5.87 mm). The mean proximal shaft angle was 11.39±3.30° (95% CI 10.76-12.82° CONCLUSION: This computed tomography scan-based anthropomorphic study has identified novel anatomical features and associations of human forearm bones. This information will be used in the design and manufacture of anatomic intramedullary devices to better manage radius and ulna fractures or pathology Level of evidence: Level 4 Keywords: radius, ulna, anatomy, osteology, radius of curvature, intramedullary design