Mathematical modeling of the osteosynthesis of the lower leg bones using a titanium mesh for their congenital pseudoarthrosis in the lower third

Background. Congenital pseudarthrosis of the lower leg bones belongs to the group of orphan diseases and manifests itself in non-union (pseudarthrosis) of the lower leg bones, which leads to the formation of deformity and shortening of the limb, and, as a result, is accompanied by a persistent violation of the limb’s supportability. To date, the question of choosing a surgical technique and optimal fixation in the surgical treatment of congenital pseudarthrosis of the lower leg bones remains unresolved. The purpose was to investigate the stress-strain state of the shin model with pseudarthrosis of its bones in the lower third during their osteosynthesis using a titanium mesh. Materials and methods. Osteosynthesis was simulated with an intramedullary nail, wires, and a block of bone grafts on both shin bones with the imposition of a titanium mesh over the grafts under the influence of two types of compression and torsion loads. Results. Studies have shown that additional fixation of the bone graft block with a titanium mesh allows reducing the stress level at almost all control points of the model of osteosynthesis of the lower leg bones in their congenital pseudarthrosis, both under compression and torsion. As the most positive changes, we can note a decrease in the stress values on the tibia around the nonunion line. This can be explained by the fact that the bone graft block reinforced with a titanium mesh takes on a great load. The same fact contributes to the increase in the level of stress at the lower border of the graft block and tibia. The negative factors include an increase in the level of stress along the line of non-union of the fibula. This is also explained by an increase in the modulus of elasticity of the bone graft block, which further loads the fibula. Conclusions. The use of a titanium mesh for additional fixation of the shin bones in the treatment of their congenital pseudarthrosis has a positive effect on the stress-strain state of the model, which is confirmed by a decrease in the stress level at almost all control points of the model, both under compression and torsion loads. The most positive changes are observed along the line of non-union of the tibia.

Morphometric Parameters of Lower Leg Tissues and Their Correlation with Laboratory Data in Patients with Post-Traumatic Osteomyelitis

Background. Knowledge about the pathological processes in the tissues of the limb is necessary for the targeted optimization of their course, the expectation of certain treatment results. The aim of the study was to determine the ratio of different severity cases and the correlation between individual clinical, laboratory and morphometric indicators of the tissues state in patients with trophic disorders in the extremity.Materials and Methods.The material was fragments of the lower leg tissues (bones, soft tissues, skin) of 38 patients with chronic post-traumatic osteomyelitis. Gradation morphometric indicators reflecting the tissues state in the lesion focuses were used. Frequency analysis of semiquantitative indicators and correlation analysis of the relationships between clinical, laboratory and morphometric indicators with the evaluation of the association coefficient were carried out. Results.Trophic disorders in the limb tissues (bones, soft tissues, muscles, skin), observed in patients with lower leg bones post-traumatic osteomyelitis, do not represent a group of well-defined pathological processes. They form a complex of dyscirculatory, ischemic, necrotic, dystrophic, atrophic, inflammatory, reparative and regenerative changes, which are combined in tissues in different proportions. This involves the use of a number of quantitative and semi-quantitative, gradation indicators: clinical, laboratory, and pathomorphological. Pathomorphological changes in the lesions in patients with chronic posttraumatic osteomyelitis of the lower leg bones with clinical signs of trophic disorders do not differ qualitatively from the changes usually detected in chronic post-traumatic osteomyelitis. In the bones, the most frequent are destructive focuses with a predominance of exudative and productive inflammation of high activity, sequestration and osteonecrosis. In paraossal soft tissues, more common are focuses, in which mature fibrous tissue and productive inflammation of low activity predominate. In the skin near the chronic post-traumatic osteomyelitis focuses, there is dermis fibrosis and productive inflammation of low activity.Conclusion. A number of correlations between clinical and laboratory parameters, on the one hand, and morphological parameters, on the other, have been established. The closest and most stable connections for different sites are the following indicators: blood leukocytes (negative dependence for affected bone, soft tissue and skin tissues), ESR (positive dependence for soft tissues), C-reactive protein (positive dependence for soft tissues and skin), agglutination with a polyvalent strain of Staphylococcus aureus (negative dependence for affected bones and skin).

Improvement of transosseous osteosynthesis with ring fixators in the treatment of tibial nonunions

Background. Treatment of tibial nonunions is not a fully resolved problem. The use of ring fixators (RF) for this pathology is competitive in modern conditions. However, there are also disadvantages. Improvement of RF treatment technology is a promising direction for improving the results of treatment of this severe pathology. Purpose of work was to improve the results of the treatment of nonunions of the shin bones based on improving the technique of using RF taking into account the problematic issues of their use; to determine their effectiveness. Materials and methods. According to the proposed method, 42 patients with tibial nonunions were treated. Spoke-rod devices were used with the improvements we proposed — sharpening, modes of conducting and arrangement of spokes in a ring at angles in different planes. In the ring, which was used to bring the osteotomized segment down du-ring distraction osteosynthesis, the outward pins were inserted to prevent it from tipping over. Semi-closed osteotomy (minimally traumatic and safe) was performed with fan-shaped with a chisel from a cross section up to 2 cm, with the formation of a comminuted fracture. External fusion Softcast/Scotchcast allowed avoi-ding deformation of the regenerate and creating optimal conditions for the fusion of fragments. Results. The following results were obtained for the treatment of patients with nonunions of the lower leg bones using RF with our proposed modes of use according to the Modified Functional Evaluation System by Karlstrom-Olerud. Good results were obtained in 20 patients — 55.6 %. In 4 patients (11.1 %), the results were assessed as good with elements of mode-rate dysfunction. They were 22.000 ± 1.323 points. Satisfactory results were obtained in 7 patients (19.4 %), estimated at 28.0 ± 0.125 points. Bad, unsatisfactory results were observed in 1 case (2.8 %); excellent functional status — in 4 (11.1 %). Conclusions. Bearing in mind the severity of the lesion, we find this result encouraging. Given the insufficient number of observations, it is necessary to recommend the use of the proposed improvements in the use of RF for the treatment of tibial nonunions after fractures and further study of their effectiveness.

KERANGKA MANUSIA DARI SITUS GUA JAUHARLIN 1, KOTA BARU, KALIMANTAN SELATAN [THE HUMAN SKELETON FROM GUA JAUHARLIN 1, KOTA BARU, KALIMANTAN SELATAN]

Penelitian di situs Gua Jauharlin 1 telah dilakukan selama dua tahun, pada 2018 dan 2019. Pada tahun kedua diperoleh temuan kerangka manusia. Kondisinya hampir lengkap, tanpa bagian kaki, dan diberi kode GJL 1.1. Akan tetapi, di dekat cranium GJL 1.1, ditemukan sepasang tulang kaki manusia yang diduga milik individu GJL 1.1. Tujuan penelitian ini adalah menentukan identitas rangka GJL 1.1 berkaitan dengan data individu dan analisis konteks kuburnya. Penelitian ini menggunakan metode analisis makroskopis untuk data individu GJL 1.1, serta pendekatan arkeotanatologi untuk analisis konteks kuburnya. Analisis makroskopis menghasilkan informasi profil biologis GJL 1.11, yang mengindikasikan individu berjenis kelamin laki-laki, umur 26,9-42,5 tahun, tinggi badan 155,1 cm–165 cm, dan memiliki afiliasi dengan populasi Asia. Aktivitas mengunyah sirih pinang terindikasi berdasarkan fitur warna kuning kecoklatan pada permukaan labial dan buccal gigi individu GJL 1.1. Hasil analisis arkeotanatologi menunjukkan arsitektur kubur peletakan-penimbunan mayat GJL 1.1, serta tipe kubur yang bersifat primer. Hasil uji short tandem repeat combined deoxyribonucleic acid index system (STR CODIS) dengan menggunakan sampel dari sepasang tulang kaki dan rangka GJL 1.1, menunjukkan bahwa keduanya adalah individu yang berbeda. The two-season researches in Gua Jauharlin 1 site were carried out in 2018 and 2019. A human skeleton, sans its lower limbs, was discovered during the second season of excavation and coded GJL 1.1. However, a pair of human leg bones were found close to the cranium of GJL 1.1, which was suggested to belong to the individual of GJL 1.1. The research objective was to determine the identity of the GJL 1.1 in association with its individual attribute and the analysis of its burial context. This study uses a macroscopic analysis method to obtain individual data of GJL 1.1, as well as an archeothanatology approach to analyse the burial context. The macroscopic analysis yielded information on the biological profile of GJL 1.11 suggesting the individual is male, aged 26.9-42.5 years, height 155.1-165 cm, and has an affiliation with the Asian population. The brownish-yellow stain on the labial and buccal surface of human teeth of GJL 1.1 indicate betel nut chewing. The result of archeothanatological analysis suggests the architecture of the burial of GJL 1.1 with regard to laying-covering corpses and a primary burial. The results of the short tandem repeat combined deoxyribonucleic acid index system (STR CODIS) test, using samples from a pair of leg bones and the GJL 1.1 skeleton, indicate that the two came from different individuals.

Treatment of Pelvic Ring Injury with 3D Printed Patient-Specific Implant: Case Report

Rationale. The development of 3D printing technology allows the manufacture of individual implants to treat the patients with diseases and consequences of musculoskeletal system injuries. However, the use of additive technologies in the patients with multiple trauma in the acute period is limited. The purpose of study was to demonstrate the possibility of using individual implants for the definitive fixation of the anterior pelvic ring in a patient with multiple trauma.Patient concerns. A 22-year-old patient was admitted after an injury as a result of a fall from the 5th floor. The treatment was carried out in accordance with the ATLS protocol. Diagnosis: multiple trauma; closed chest, pelvis and limbs injuries; fracture of the left 2nd to 5th ribs; pelvic bones fracture AO/ OTA: 61-C1.3a; fracture of both bones of the left lower leg AO/OTA: 42-B3b; 2nd degree shock.Interventions. An emergency external fixation of the pelvis and lower leg bones was performed. An individual implant for pubic bone fixation was made using 3D printing. On the 8th day, the definitive fixation of the pelvic and left lower leg bones was performed. The patient is activated on the 1st day after the surgery.Outcomes. The early postoperative period was uneventful. The functional result on the Majeed scale in 6 months by remote filling out the questionnaire was 84 points. Lessons. The custom-made implants make it possible the successful fixation of the anterior pelvic ring. The use of 3D printing technologies for the osteosynthesis of pelvic fractures is promising, although requires further study.

A pilot study on a potential relationship between leg bone length and sprint performance in sprinters; Are there any event-related differences in 100-m and 400-m sprints?

Objective: This study examined the relationship between leg bone length and sprint performance in sprinters. The leg bone lengths in 28 100-m specialized sprinters and 28 400-m specialized sprinters were measured using magnetic resonance imaging. The lengths of the upper and lower leg bones were assessed by calculating the lengths of the femur and tibia, respectively. To minimize differences in body size among participants, both bone lengths were normalized to body height. The ratio of the tibial length to femoral length was calculated to evaluate the interaction between the lengths of the upper and lower leg bones. International Amateur Athletic Federation (IAAF) scores, based on the personal best times of the sprinters in each group were used as parameters for sprint performance. Results: There were no significant correlations between absolute and relative lengths of the femur and tibia and IAAF scores in both 100-m and 400-m sprinters. By contrast, the ratio of the tibial length to femoral length correlated significantly with IAAF score in 400-m sprinters (r = 0.445, P = 0.018), but not 100-m sprinters. These findings suggest that the leg bone lengths may play an important role in achieving superior long sprint performance in 400-m specialized sprinters.

A Middle Pleistocene steppe bison find within the Dürnstein Castle (Wachau, Lower Austria)

In the course of foundation works in the Dürnstein Castle cervical and front leg bones of a large Bison priscus bull were discovered in fluvial sediments. The small city of Dürnstein with its medieval centre is part of the UNESCO Wachau Cultural Landscape and is built mainly on Palaeozoic basement rocks. The find location is completely overbuilt, but remnants of fluvial sediments on the bones together with the altitude of the site approximately 17 m above the Danube point to a Middle Pleistocene fluvial aggradation level not younger than ca. 240,000 years, and the maximum age is 400,000 years. The fossil bearing location is interpreted as a small sandy bay of the Pleistocene Danube, protected from later degradation and erosion. Morphometric comparisons and taphonomic analyses of the bones allow the reconstruction of a scenario in which the bison probably had drowned in a flood and its carcass was buried quickly before destruction by scavengers or erosion. The study includes a comparison with bison specimens of an unpublished small megafaunal assemblage from adjacent Krems-Kreuzbergstraße. Processing marks on parts of these bones point to an anthropogenic Middle Palaeolithic influence and translocation. In addition, a tentative chronological sketch of the regional Bison species succession (B. menneri, B. schoetensacki, B. priscus) from the Early to the Late Pleistocene is presented.

An early Oligocene stem Galbulae (jacamars and puffbirds) from southern France, and the position of the Paleogene family Sylphornithidae

Together, puffbirds (Bucconidae) and jacamars (Galbulidae) form the suborder Galbulae, sister group of all other Piciformes. Hitherto, the Galbulae had no ascertained pre-Pleistocene fossil record, and all previous alleged candidates have been refuted, except possibly the Sylphornithidae. Here we describe a wing of a tiny fossil bird from the early Oligocene of the Luberon region (southern France), which we assign to the Galbulae, as a new genus and species. Several characters, especially of the ulna and wing phalanx 1 of digit II, exclude the Passeriformes and Zygodactylidae, and indicate a representative of the Piciformes. Among Piciformes, absence of papillae remigales caudales and several characters of the wing phalanx 1 of digit II make it possible to assign the fossil to the Galbulae, and exclude all other clades. The fossil Sylphornithidae, with the carpometacarpus of Sylphornis being available, show some similarity with the Luberon fossil. The combination of features of the wing elements leads to the placement of the new fossil as stem Galbulae, and tentatively within the family Sylphornithidae. As such, it fills a gap and permits to better assign the whole enigmatic tiny sylphornithids, otherwise essentially known from leg bones. This yields the first firm pre-Pleistocene fossil record for the Galbulae. Today, both the Bucconidae and Galbulidae live exclusively in tropical America. The presence of stem Galbulae in the Oligocene of Europe, and probably the late Eocene, is a new example of a present-day Neotropical clade that had stem representatives in the Paleogene of Europe.

A pilot study on a potential relationship between leg bone length and sprint performance in sprinters; Are there any event-related differences in 100-m and 400-m sprints?

Objective: This study examined the relationship between leg bone length and sprint performance in sprinters. The leg bone lengths in 28 100-m specialized sprinters and 28 400-m specialized sprinters were measured using magnetic resonance imaging. The lengths of the upper and lower leg bones were assessed by calculating the lengths of the femur and tibia, respectively. To minimize differences in body size among participants, both bone lengths were normalized to body height. The ratio of the tibial length to femoral length was calculated to evaluate the interaction between the lengths of the upper and lower leg bones. International Amateur Athletic Federation (IAAF) scores, based on the personal best times of the sprinters in each group were used as parameters for sprint performance. Results: There were no significant correlations between absolute and relative lengths of the femur and tibia and IAAF scores in both 100-m and 400-m sprinters. By contrast, the ratio of the tibial length to femoral length correlated significantly with IAAF score in 400-m sprinters ( r = 0.445, P = 0.018), but not 100-m sprinters. These findings suggest that the leg bone lengths may play an important role in achieving superior long sprint performance in 400-m specialized sprinters.

PENGARUH PEMBERIAN VARIAN HERBAL JAHE (Zingiber officinale) DENGAN AUTOMATIC FEEDER TERHADAP PANJANG TUNGKAI (FEMUR, TIBIA, METATARSO) PADA ITIK (Anas javanicus)

This study aims to determine the effect of giving ginger elephant and ginger empiric herbs by using automatic feeder or manual feed tool to the length of the leg bones (femur, tibia, metatarso) in ducks. This study used randomized randomized controlled trials with four treatments and three repetitions. GP1 (Feed + Automatic Feeder + Elephant Ginger 2%), GP2 (Feed + Manual + Elephant Ginger 2%), EP1 (Feed + Automatic Feeder + Emprit Ginger 2%), EP 2 (Feed + Manual + Empritic Ginger 2%). The parameters measured were the length of the leg bones (femur, tibia, metatarso) of ducks. The results of the analysis showed that the total bone length of the femur was 6.51 cm with Fcount (0.038) <Ftable (5.32), the total length of the total tibia bone was 11.9 cm with Fcount (1,313) <Ftable (5, 32), and the results of the total length of the metatarso bone are 6.67 cm with Fcount (0.668)> Ftable (5.32). These results indicate that the effect of giving ginger elephant and empirical ginger using a feed device Automatic feeder or manually has no significant effect (P> 0.05) on the length of the leg bones (femur, tibia, metatarso) of ducks. The results are not significantly different which causes the Automatic feeder tool to be a new breakthrough for replacing the manual feed tool for feeding ducks