Morphological Variation of the Proximal Femur in Selected Skeletal Remains
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Blount, Anteversion and Torsion: What's It All About?
Blount, Anteversion and Torsion: What’s it all about? Arthur B. Meyers, MD Assistant Professor of Radiology Children’s Hospital of WisConsin/ MediCal College of WisConsin Disclosures • Author for Amirsys/Elsevier, reCeiving royalGes Lower Extremity Alignment in Children • Lower extremity rotaGon – Femoral version / Gbial torsion – Normal values & CliniCal indiCaGons – Imaging • Blount disease – Physiologic bowing – Blount disease Lower Extremity RotaGonal Alignment Primarily determined by: 1. Femoral version 2. Tibial torsion 3. PosiGon of the foot Rosenfeld SB. Approach to the Child with in-toeing. Up-to-date. 2/2014 Lower Extremity RotaGonal Alignment Primarily determined by: 1. Femoral version 2. Tibial torsion 3. PosiGon of the foot Rosenfeld SB. Approach to the Child with in-toeing. Up-to-date. 2/2014 Femoral Version The rotaGon of the femoral neCk in relaGon to the long axis of the femur (posterior Condylar axis of the distal femur) Femoral Version The rotaGon of the femoral neCk in relaGon to the long axis of the femur (posterior Condylar axis of the distal femur) Femoral Version The rotaGon of the femoral neCk in relaGon to the long axis of the femur (posterior Condylar axis of the distal femur) Femoral Version The rotaGon of the femoral neCk in relaGon to the long axis of the femur (posterior Condylar axis of the distal femur) Femoral Version The rotaGon of the femoral neCk in relaGon to the long axis of the femur (posterior Condylar axis of the distal femur) Femoral Version The rotaGon of the femoral neCk in relaGon to the long -
Arthroscopic and Open Anatomy of the Hip 11
CHAPTER Arthroscopic and o'pen Anatomy of the Hip Michael B. Gerhardt, Kartik Logishetty, Morteza lV1eftah, and Anil S. Ranawat INTRODUCTION movements that they induce at the joint: 1) flexors; 2) extensors; 3) abductors; 4) adductors; 5) external rotators; and 6) interI12 I The hip joint is defined by the articulation between the head rotators. Although some muscles have dual roles, their primary of the femur and the aeetahulum of the pelvis. It is covered by functions define their group placem(:)nt, and they all have ullique :l large soft-tissue envelope and a complex array of neurovascu- neurovascular supplies (TIt ble 2-1). lar and musculotendinous structures. The joint's morphology The vascular supply of tbe hip stems from the external and anu orientation are complex, and there are wide anatomi c varia- internal iLiac ancries. An understanding of the course of these tions seen among individuals. The joint's deep location makes vessels is critical fo r ,lVo iding catasu"ophic vascular injury. fn both arthroscopic and open access challenging. To avoid iatro- addition, the blood supply to the fel11()ra l head is vulnerahle to genic injury while establishing functional and efficient access, both traumatic and iatrogenic injury; the disruption of this sup- the hip surgeon should possess a sound ana tomic knowledge of ply can result in avascular necrosis (Figure 2-2). the hip. T he human "hip" can be subdivided into three categories: I) the superficial surface anatomy; 2) the deep femoroacetabu- la r Joint and capsule; and 3) the associated structures, including the muscles, nerves, and vasculature, all of which directly affeet HIP MUSCULATURE its function. -
List: Bones & Bone Markings of Appendicular Skeleton and Knee
List: Bones & Bone markings of Appendicular skeleton and Knee joint Lab: Handout 4 Superior Appendicular Skeleton I. Clavicle (Left or Right?) A. Acromial End B. Conoid Tubercle C. Shaft D. Sternal End II. Scapula (Left or Right?) A. Superior border (superior margin) B. Medial border (vertebral margin) C. Lateral border (axillary margin) D. Scapular notch (suprascapular notch) E. Acromion Process F. Coracoid Process G. Glenoid Fossa (cavity) H. Infraglenoid tubercle I. Subscapular fossa J. Superior & Inferior Angle K. Scapular Spine L. Supraspinous Fossa M. Infraspinous Fossa III. Humerus (Left or Right?) A. Head of Humerus B. Anatomical Neck C. Surgical Neck D. Greater Tubercle E. Lesser Tubercle F. Intertubercular fossa (bicipital groove) G. Deltoid Tuberosity H. Radial Groove (groove for radial nerve) I. Lateral Epicondyle J. Medial Epicondyle K. Radial Fossa L. Coronoid Fossa M. Capitulum N. Trochlea O. Olecranon Fossa IV. Radius (Left or Right?) A. Head of Radius B. Neck C. Radial Tuberosity D. Styloid Process of radius E. Ulnar Notch of radius V. Ulna (Left or Right?) A. Olecranon Process B. Coronoid Process of ulna C. Trochlear Notch of ulna Human Anatomy List: Bones & Bone markings of Appendicular skeleton and Knee joint Lab: Handout 4 D. Radial Notch of ulna E. Head of Ulna F. Styloid Process VI. Carpals (8) A. Proximal row (4): Scaphoid, Lunate, Triquetrum, Pisiform B. Distal row (4): Trapezium, Trapezoid, Capitate, Hamate VII. Metacarpals: Numbered 1-5 A. Base B. Shaft C. Head VIII. Phalanges A. Proximal Phalanx B. Middle Phalanx C. Distal Phalanx ============================================================================= Inferior Appendicular Skeleton IX. Os Coxae (Innominate bone) (Left or Right?) A. -
Femur Pelvis HIP JOINT Femoral Head in Acetabulum Acetabular
Anatomy of the Hip Joint Overview The hip joint is one of the largest weight-bearing HIP JOINT joints in the body. This ball-and-socket joint allows the leg to move and rotate while keeping the body Femoral head in stable and balanced. Let's take a closer look at the acetabulum main parts of the hip joint's anatomy. Pelvis Bones Two bones meet at the hip joint, the femur and the pelvis. The femur, commonly called the "thighbone," is the longest and heaviest bone of the body. At the top of the femur, positioned on the femoral neck, is the femoral head. This is the "ball" of the hip joint. The other part of the joint – the Femur "socket" – is found in the pelvis. The pelvis is a bone made of three sections: the ilium, the ischium and the pubis. The socket is located where these three sections fuse. The proper name of the socket is the "acetabulum." The head of the femur fits tightly into this cup-shaped cavity. Articular Cartilage The femoral head and the acetabulum are covered Acetabular with a layer of articular cartilage. This tough, smooth tissue protects the bones. It allows them to labrum glide smoothly against each other as the ball moves in the socket. Soft Tissues Several soft tissue structures work together to hold the femoral head securely in place. The acetabulum is surrounded by a ring of cartilage called the "acetabular labrum." This deepens the socket and helps keep the ball from slipping out of alignment. It also acts as a shock absorber. -
Isolated Lesser Trochanter Fracture Associated with Leukemia
A Case Report & Literature Review Isolated Lesser Trochanter Fracture Associated With Leukemia Jake P. Heiney, MD, MS, and Mark C. Leeson, MD, FACS solated lesser trochanteric fractures are rare1; few cases Erythrocyte sedimentation rate was slightly elevated (23 have been reported in the literature. When an isolated mm/h). Radiographs of the right hip and pelvis showed an lesser trochanteric fracture occurs in a patient with isolated lesser trochanteric avulsion fracture and no signs closed growth plates, it is thought to be pathognomonic of a pathologic process (Figure 1). Given the patient’s Ifor neoplasm.2-4 inability to ambulate and need for pain control and further To our knowledge, this is the first report of a case of iso- workup, she was admitted. As MRI could not be performed lated lesser trochanteric fracture associated with leukemia. that night without her case being declared an emergency, The other 18 reported cases of this fracture were associated with metastatic carcinoma (breast, pancreatic, thyroid, colon, prostate, lung, squamous cell), synovial cell sarcoma, non- Hodgkin lymphoma, or primary plasmacytoma.2-8 CASE REPORT A woman in her late 40s presented to the emergency department with right hip pain after twisting with a slight slip in her kitchen. The patient stated that she had not fallen but was having terrible groin pain that inhibited her from ambulating. She said there had been no groin pain before the incident. She had been seeing an orthopedic surgeon for knee pain on the ipsilateral side for some time. The knee pain was global but had increased tenderness in the medial joint line. -
Entry Point Related Outcome in Antegrade Femoral Nailing Experimental and Clinical Studies
C.M.S. Moein Ansari experimental and clinical studies clinical and experimental Entry Point Related Outcome Outcome Related Point Entry in Antegrade Femoral Nailing Femoral Antegrade in Entry Point Related Outcome in Antegrade Femoral Nailing experimental and clinical studies C.M.S. Ansari Moein Entry Point Related Outcome in Antegrade Femoral Nailing experimental and clinical studies C.M.S. Ansari Moein ENTRY POINT RELATED OUTCOME IN ANTEGRADE FEMORAL NAILING Experimental and clinical studies C.M.S. Ansari Moein The Robert Mathys Foundation, Bettlach, Switzerland and the AO Foundation, Davos, Switzerland financially supported the studies presented in this thesis. Kind contribution for the publication of this thesis by: Erasmus Medical Centre Dept. of Surgery Trauma Research Unit Erasmus MC (TRUE) Parnassia Academy ABN AMRO Bank PsyQ Maatschap Plastische Chirurgie Midden Brabant THP Financial Guidance Post Notariaat Cover illustration by Rob Veen Printing and lay-out by Optima Grafische Communicatie, Rotterdam, The Netherlands ISBN 978-94-6169-867-4 © 2016. Copyright by CMS Ansari Moein Entry Point Related Outcome in Antegrade Femoral Nailing experimental and clinical studies Entreeplaats gerelateerde uitkomst van antegrade mergpen ostheosynthese bij femurfracturen experimentele en klinische studies Proefschrift ter verkrijging van de graad van doctor aan de Erasmus Universiteit Rotterdam op gezag van de rector magnificus Prof. Dr. H.A.P. Pols en volgens besluit van het College voor Promoties De openbare verdediging zal plaatsvinden op vrijdag 20 mei 2016 om 13.30 uur door Chloé Mahsima Ansari Moein geboren te Tehran, Iran Promotiecommissie promotoren: Prof. dr. M.H.J. Verhofstad Prof. dr. H.J. Ten Duis overige leden: Prof. -
06 Bolanowski.P65
Folia Morphol. Vol. 64, No. 3, pp. 168–175 Copyright © 2005 Via Medica O R I G I N A L A R T I C L E ISSN 0015–5659 www.fm.viamedica.pl The occurrence of the third trochanter and its correlation to certain anthropometric parameters of the human femur Wojciech Bolanowski1, Alicja Śmiszkiewicz-Skwarska2, Michał Polguj1, Kazimierz S. Jędrzejewski1 1Department of Normal Anatomy, Medical University, Łódź, Poland 2Department of Anthropology, University of Łódź, Poland [Received 16 May 2005; Accepted 20 June 2005] The purpose of the study was to analyse the occurrence of the third trochanter and its correlation with the morphology of the human femur. The third tro- chanter was found in 38 of 622 (6.2%) human femora taken from 3 excavation sites. 36 of these were included in the study and were compared to the femora without the third trochanter. The bones with the third trochanter were charac- terised by a greater superior sagittal diameter and diaphysis platymetry index as well as a larger greater trochanter. These results suggest that the third trochant- er is not a progressive morphological feature of the skeleton. Rather it is con- nected with an altered gluteal muscle function. Key words: osteometry, human skeleton, third trochanter, femur INTRODUCTION ses studies have revealed significant differences The third trochanter (trochanter tertius, Fig. 1) among ethnic groups as well as between male and of the human femur is a descriptive term for the female skeletons of the same population. A higher prominent structure frequently localised under the incidence of the third trochanter in females has been greater trochanter in the superior part of the gluteal reported in many studies on various human popula- tuberosity. -
A New Caenagnathid Dinosaur from the Upper Cretaceous Wangshi
www.nature.com/scientificreports OPEN A new caenagnathid dinosaur from the Upper Cretaceous Wangshi Group of Shandong, China, with Received: 12 October 2017 Accepted: 7 March 2018 comments on size variation among Published: xx xx xxxx oviraptorosaurs Yilun Yu1, Kebai Wang2, Shuqing Chen2, Corwin Sullivan3,4, Shuo Wang 5,6, Peiye Wang2 & Xing Xu7 The bone-beds of the Upper Cretaceous Wangshi Group in Zhucheng, Shandong, China are rich in fossil remains of the gigantic hadrosaurid Shantungosaurus. Here we report a new oviraptorosaur, Anomalipes zhaoi gen. et sp. nov., based on a recently collected specimen comprising a partial left hindlimb from the Kugou Locality in Zhucheng. This specimen’s systematic position was assessed by three numerical cladistic analyses based on recently published theropod phylogenetic datasets, with the inclusion of several new characters. Anomalipes zhaoi difers from other known caenagnathids in having a unique combination of features: femoral head anteroposteriorly narrow and with signifcant posterior orientation; accessory trochanter low and confuent with lesser trochanter; lateral ridge present on femoral lateral surface; weak fourth trochanter present; metatarsal III with triangular proximal articular surface, prominent anterior fange near proximal end, highly asymmetrical hemicondyles, and longitudinal groove on distal articular surface; and ungual of pedal digit II with lateral collateral groove deeper and more dorsally located than medial groove. The holotype of Anomalipes zhaoi is smaller than is typical for Caenagnathidae but larger than is typical for the other major oviraptorosaurian subclade, Oviraptoridae. Size comparisons among oviraptorisaurians show that the Caenagnathidae vary much more widely in size than the Oviraptoridae. Oviraptorosauria is a clade of maniraptoran theropod dinosaurs characterized by a short, high skull, long neck and short tail. -
Percutaneous Reduction Techniques
AAOS 2016 Specialty Day Orthopaedic Trauma Associacion (OTA) Percutaneous Reduction Techniques Christian Krettek Trauma Department, Hannover Medical School, Germany [email protected] www.mhh-unfallchirurgie.de Short segment tibial fractures can be stabilized using different implants like plates, screws, external fixators and nails. This syllabus deals mainly with reduction techniques in the context of the use of intramedullary nails. 1.1 PREOPERATIVE PLANNING AND MANAGEMENT 1.1.1 Primary shortening and secondary overdistraction eases definitive nailing In the acute setting primary shortening of a shaft fracture is a helpful strategy to de- crease soft tissue tension and intra-compartmental pressure. However, reduction gets more difficult and more time consuming, the longer the fracture is kept in a shortened position. The concept of primary shortening (acute phase) and secondary (after 3 or 4 days) overdistraction eases definitive nailing. Using a electro-mechanical load cell, our group has compared the reduction forces in patients undergoing femoral nailing after Damage Control in shortend vs overdistracted fracture configuration. In the overdistrac- tion group, the reduction forces were lower (200 N +/-43.1 N vs. 336 N +/- 51.9 N, p = 0.007) and the reduction time was shorter (5.8 min +/-4.0 min vs. 28.3 min +/-21.8 min, p = 0.056). It was concluded, that DCO with the fracture shortened leads to higher restrai- ning forces & prolonged reduction time. Overdistraction should be performed as soon as possible under careful soft-tissue monitoring [1a, 2a]. Primary shortening and secondary overdistraction eases definitive nailing Example of a femoral shaft fracture stabilized in shortening first with an external fixator. -
Epiphyseal Closure of Femur, Tibia and Fibula of the Paca
Journal of Veterinary Science & Animal Husbandry Volume 5 | Issue 4 ISSN: 2348-9790 Research Article Open Access Epiphyseal Closure of Femur, Tibia and Fibula of the Paca (Cuniculus Paca, Linnaeus, 1766) Lippi ICC, Oliveira RGS, Smargiassi NF, Machado MRF, Sasahara THC, Rocha TASS and Oliveira FS* Department of Animal Morphology and Physiology, São Paulo State University (UNESP), Jaboticabal, SP, Brazil *Corresponding author: Oliveira FS, Department of Animal Morphology and Physiology, São Paulo State University (UNESP), Via de Acesso Paulo Donato Castelane – 14884-900 - Jaboticabal, SP, Brazil, E-mail: [email protected] Citation: Lippi ICC, Oliveira RGS, Smargiassi NF, Machado MRF, Sasahara THC, et al. (2017) Epiphyseal Closure of Femur, Tibia and Fibula of the Paca (Cuniculus Paca, Linnaeus, 1766). J Vet Sci Ani Husb 5(4): 403. doi: 10.15744/2348-9790.5.403 Received Date: October 29, 2017 Accepted Date: December 27, 2017 Published Date: December 29, 2017 Abstract After capybara, paca (Cuniculus paca) is the largest rodent in the neotropical region and the body weight varies from 5 to 10 kg, and may reach up to 14 kg. They are animals that reach sexual maturity at around 10 months of age. The aim of this research is to examine, through radiography, the femur, tibia and fibula of the paca. The animals were anaesthetized for radiographic exams. At 6 months of age, the growth line of the femoral proximal epiphysis ceases to perform its functions. At 12 months of age, there is the closure of the line growth of distal femoral epiphysis. At the paca’s tibia, at 12 months old, there was the closure of the growth of the proximal epiphysis. -
Incidence of Third Trochanter and Hypotrochanteric Fossa in Human Femora in Indian Population
Page 1 of 4 Research study Incidence of third trochanter and hypotrochanteric fossa Anatomy in human femora in Indian population. S Ghosh1*, M Sethi1, N Vasudeva1 Abstract The knowledge of the occurrence stabilization and control of the thigh Introduction would be crucial for the diagnosis and indicating medio-lateral reinforcement Third trochanter is described as an management of pertrochanteric to resist high mechanical stress in erect 5 oval tubercle at the superior end of fractures and also in the study of posture and locomotion. Different the gluteal tuberosity. The importance microevolutionary trends in the varieties of impressions are seen at the of the third trochanter in anthropometric and comparative site of the insertion of gluteus maximus studies of humans. ranging from rounded or oblong pertrochanteric fractures have been recently hypothesized to be correlated tubercle, Third Trochanter, to a ridge or with the fracture break lines in Introduction a prolonged elevation, Gluteal pertrochanteric fractures. The third In many anthropometric studies the tuberosity, or a groove known as trochanter may function to provide third trochanter and the Hypotrochanteric Fossa. Most increased skeletal mass as a hypotrochanteric fossa are commonly commonly seen gluteal tuberosity is reinforcement mechanism for the used non metric variations of the well described in textbooks of anatomy. proximal diaphysis in response to postcranial skeleton. They serve for Hence the study analysed the presence increased ground reaction force. The descriptive purposes of the proximal of third trochanter and hypotrochanteric fossa is considered end of the femur in various ethnic hypotrochanteric fossa in an Indian population. to be a varied manifestation of the groups. -
Comparison of Hip Structure Analysis and Grip Strength Between Femoral Neck and Basicervical Fractures Yong-Han Cha1 and Jun-Il Yoo2*
Cha and Yoo BMC Musculoskeletal Disorders (2021) 22:461 https://doi.org/10.1186/s12891-021-04363-w RESEARCH Open Access Comparison of hip structure analysis and grip strength between femoral neck and basicervical fractures Yong-Han Cha1 and Jun-Il Yoo2* Abstract Background: The purpose of this study was to analyze differences in geometrical properties of the proximal femur and predict the occurrence of basicervical fractures through a comparative study of femoral neck and basicervical fractures in patients undergoing hip structural analysis (HSA). Methods: All patients with hip fractures who were at least 65 years old and admitted to our hospital between March 2017 and December 2019 were eligible for this study. During the study period, 149 femur neck fractures (FNF) and basicervical fractures (intertrochanteric fractures of A31.2) were included in this study. Fifty-nine patients were included in the final analysis. Factors considered to be important confounders affecting the occurrence of basicervical hip fractures were chosen for propensity-score analysis. A logistic model with basicervical hip fracture as the outcome and age, sex, weight, spinal T-score, hip T-score, and vitamin D levels as confounders was used to estimate the propensity score. Results: The cross-sectional moment of inertia (CSMI) of the intertrochanter was significantly lower in patients with basicervical hip fracture (HF) than in patients with FNF (p = 0.045). However, there was no significant differences in any other HSA variable between the two groups. Receiver operating characteristic (ROC) analysis showed that cutoff point for HSA was 100 for hip axis length (HAL) (AUC = 0.659, p < 0.001) and 5.712 for CSMI of the intertrochanter (AUC = 0.676, p < 0.001).