Biodiversity of the Thoracic Limb Skeleton in Coypu
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Fractures Long Bones, Upper Limb (Includes Hand)
Ministry of Defence Synopsis of Causation Fractures Long Bones, Upper Limb (includes hand) Author: Mr John A Dent, Ninewells Hospital and Medical School, Dundee Validator: Mr Sheo Tibrewal, Queen Elizabeth Hospital, London September 2008 Disclaimer This synopsis has been completed by medical practitioners. It is based on a literature search at the standard of a textbook of medicine and generalist review articles. It is not intended to be a meta-analysis of the literature on the condition specified. Every effort has been taken to ensure that the information contained in the synopsis is accurate and consistent with current knowledge and practice and to do this the synopsis has been subject to an external validation process by consultants in a relevant specialty nominated by the Royal Society of Medicine. The Ministry of Defence accepts full responsibility for the contents of this synopsis, and for any claims for loss, damage or injury arising from the use of this synopsis by the Ministry of Defence. 2 1. Definition 1.1. A bone breaks as a result of a variety of injuring forces. The fracture produced in a long bone may be of its shaft or diaphysis; towards one of its ends where the bone widens (metaphysis); or of the end of the bone, where it forms a joint with the next bone (Figure 1). Fractures near a joint may involve the joint surface causing intra-articular fractures. 1.2. It must always be remembered that the soft tissues surrounding the bone will also be damaged to a varying extent by the injuring force. -
What Is a Scaphoid Fracture?
Sussex Hand CONDITION Surgery Scaphoid Fractures CONDITION The scaphoid is one of the small What is a bones that make up your wrist. It is the commonest wrist bone Scaphoid Fracture? to break. Normal Wrist Xray Sometimes the diagnosis is delayed, Sometimes an operation is often by months or years. In this recommended. The exact situation xrays, MRI and CT scans approach will depend on the type might all be required to make a full of injury. Commonly a screw is Rest of the Thumb assessment of what is needed. placed down the centre of the metacarpal wrist bones scaphoid to keep the fragments (8 small bones lined up and still whilst the bone in total) The scaphoid What treatment is heals. This can sometimes be bone needed for a scaphoid done in a minimally invasive way fracture? with very small incisions (see Distal ulna This depends on a great many ‘Percutaneous screw fixation of Distal radius things. Some important factors are: Scaphoid Fractures’). Later on 1. How old is the injury? Fresh bigger operations might be A fracture of the scaphoid fractures have better healing necessary to re-align a bent potential scaphoid and put new bone into 2. Which part of the scaphoid is the old fracture (see ‘ORIF of broken? The nearer the fracture is Scaphoid Fractures +/-bone to end of the scaphoid next to the grafting’). radius (proximal pole) the more Very obvious chance there is of problems with What is the outcome fracture in the healing. This is to do with the blood following a scaphoid middle (waist) supply to the scaphoid bone which fracture? of the scaphoid is not good in the proximal pole. -
Isolated Trapezoid Fractures a Case Report with Compilation of the Literature
Bulletin of the NYU Hospital for Joint Diseases 2008;66(1):57-60 57 Isolated Trapezoid Fractures A Case Report with Compilation of the Literature Konrad I. Gruson, M.D., Kevin M. Kaplan, M.D., and Nader Paksima, D.O., M.P.H. Abstract as an axial load5,6 or bending stress7 transmitted indirectly Isolated fractures of the trapezoid bone have been rarely to the trapezoid through the second metacarpal. We present reported in the literature, the mechanism of injury being a case of an acute, isolated trapezoid fracture that resulted an axial or bending load transmitted through the second from direct trauma to the distal carpus and that was treated metacarpal. We report a case of an isolated, nondisplaced nonoperatively. Additionally, strategies for diagnosis and trapezoid fracture that was sustained by direct trauma treatment, as well as a synthesis of the published results and subsequently treated successfully in a short-arm cast. for both isolated and concomitant trapezoid fractures, are Diagnostic and treatment strategies for isolated fractures presented. of the trapezoid bone are reviewed as well as the results of operative and nonoperative treatment. Case Report A 25-year-old right-hand dominant male presented to the ractures of the carpus most commonly involve the emergency room (ER) complaining of isolated right-wrist scaphoid,1 with typical physical examination findings pain and swelling of 1 day’s duration. The patient stated Fof “snuffbox” tenderness. This presentation is fre- that a heavy metal door at work had closed onto the back quently the result of the patient falling onto an outstretched of his wrist causing an immediate onset of swelling and hand. -
Osteoid Osteoma of the Trapezoid Bone
'-DIDUL)1DMG0D]KDU Case Report Osteoid Osteoma of the Trapezoid Bone Dawood Jafari MD1)DULG1DMG0D]KDU0'1 Abstract Osteoid osteoma is a benign, bone-forming tumor that rarely involves the carpal bones. We report a case of osteoid osteoma of the trap- H]RLGFDUSDOERQHZLWKH[WHQVLRQWRWKHDGMDFHQWVHFRQGPHWDFDUSDOERQH&KURQLFZULVWSDLQDQGORFDOWHQGHUQHVVZHUHWKHPDMRUFOLQLFDO signs and symptoms. In chronic wrist pain osteoid osteoma and the possibility of extension to the adjacent bones should be considered. Keywords: &DUSDOERQHPHWDFDUSDORVWHRLGRVWHRPDWUDSH]RLG Cite the article as: Jafari D, Najd Mazhar F. Osteoid Osteoma of the Trapezoid Bone. Arch Iran Med. 2012; 15(12): 777 – 779. Introduction RSV\WKURXJKDGRUVDODSSURDFK:HXVHGDVPDOOGULOOELWDQG¿QH osteotome to remove the involved area, which included the adjacent steoid osteoma is a benign bone tumor that rarely localizes articular surface of the trapezoid. The biopsy specimen had a highly to the carpal bones.1,2 Wrist pain usually is the main com- vascular reddish nidus embedded in normal bone (Figure 5). We no- O plaint and because it rarely involves the carpal bone, diag- ticed that the articular surface of the second metacarpal was eroded nosis is often delayed. It has been reported in the scaphoid and lu- and softened (Figure 6). Following curettage, we sent the specimen nate areas; however, the trapezoid is an exceedingly rare location from the base of the second metacarpal in a separate container for for osteoid osteoma. Bifocal involvement of adjacent carpal bones pathologic analysis. The results of the histologic examinations of has been reported previously but to the best of our knowledge ex- both biopsy specimens indicated osteoid osteoma (Figure 7). Since tension of osteoid osteoma through the joint to adjacent bone has we had only one nidus at the CT scan and involvement of both trap- not been mentioned in the literature. -
Osteoblastoma of the Trapezoid Bone and Triquetral Bone: Report of Two Cases
CASE REPORT Acta Orthop Traumatol Turc 2013;47(5):376-378 doi:10.3944/AOTT.2013.3081 Osteoblastoma of the trapezoid bone and triquetral bone: report of two cases ‹brahim KAYA1, Burak BOYNUK2, Caner GÜNERBÜYÜK3, Ak›n U⁄RAfi4 1Department of Orthopedics and Traumatology, Haseki Training and Research Hospital, ‹stanbul, Turkey; 2Department of Orthopedics and Traumatology, Bak›rköy Ac›badem Hospital, ‹stanbul, Turkey; 3Department of Orthopedics and Traumatology, 29 May›s Hospital, ‹stanbul, Turkey; 4Department of Orthopedics and Traumatology, ‹stanbul Medipol University, School of Medicine, ‹stanbul, Turkey Osteoblastoma is a benign local aggressive tumor mostly localized in the vertebra or long bones. Carpal location and recurrence are extremely rare. Treatment options include either curettage or wide en bloc resection which causes functional disability in the hand and wrist and should be reserved only for recurrence. We present a case of recurrent trapezoid osteoblastoma previously treated with curet- tage of the trapezoid bone and a case of primary triquetral osteoblastoma. Key words: Curettage; osteoblastoma; trapezoid bone; triquetral bone. Osteoblastoma is a benign primary bone tumor first pain increased at night and had a good response to non- described as “giant osteoid osteoma” by Dahlin and steroidal analgesic drugs. Radiographs, computerized Johnson in 1954.[1] Later, in 1956, Lichtenstein and Jaffe tomography and magnetic resonance imaging (MRI) named this tumor “osteoblastoma” in two different arti- revealed findings resembling avascular necrosis of the cles.[2] It is an uncommon benign but locally aggressive trapezoid bone, periosteal reaction at the second tumor, most commonly located in the vertebral column metacarpal and generalized edema in the dorsal com- or metaphysis of long bones. -
Carpal Fractures
CURRENT CONCEPTS Carpal Fractures Nina Suh, MD, Eugene T. Ek, MBBS, PhD, Scott W. Wolfe, MD CME INFORMATION AND DISCLOSURES The Review Section of JHS will contain at least 3 clinically relevant articles selected by the Provider Information can be found at http://www.assh.org/Pages/ContactUs.aspx. editor to be offered for CME in each issue. For CME credit, the participant must read the Technical Requirements for the Online Examination can be found at http://jhandsurg. articles in print or online and correctly answer all related questions through an online org/cme/home. examination. The questions on the test are designed to make the reader think and will occasionally require the reader to go back and scrutinize the article for details. Privacy Policy can be found at http://www.assh.org/pages/ASSHPrivacyPolicy.aspx. The JHS CME Activity fee of $30.00 includes the exam questions/answers only and does not ASSH Disclosure Policy: As a provider accredited by the ACCME, the ASSH must ensure fi include access to the JHS articles referenced. balance, independence, objectivity, and scienti c rigor in all its activities. Disclosures for this Article Statement of Need: This CME activity was developed by the JHS review section editors and review article authors as a convenient education tool to help increase or affirm Editors reader’s knowledge. The overall goal of the activity is for participants to evaluate the Ghazi M. Rayan, MD, has no relevant conflicts of interest to disclose. appropriateness of clinical data and apply it to their practice and the provision of patient Authors care. -
The Differential Diagnosis of Bone Marrow Edema on Wrist MRI
Skeletal Radiology (2019) 48:1525–1539 https://doi.org/10.1007/s00256-019-03204-1 REVIEW ARTICLE Review article: the differential diagnosis of bone marrow edema on wrist MRI WanYin Lim1,2 & Asif Saifuddin3,4 Received: 5 December 2018 /Revised: 1 February 2019 /Accepted: 5 March 2019 /Published online: 22 March 2019 # ISS 2019 Abstract There is a large variety of conditions that can result in ‘bone marrow edema’ or ‘bone marrow lesions’ (BML) in the wrist on magnetic resonance imaging (MRI). The combination of clinical history and the distribution of the BML can serve as a valuable clue to a specific diagnosis. This article illustrates the different patterns of BML in the wrist to serve as a useful guide when reviewing wrist MRI studies. Imaging artefacts will also be briefly covered. Keywords MRI . Wrist . Marrow edema . Bone marrow lesion Introduction The etiology of BMLs can also be confusing due to the non-specific appearance, MRI demonstrating poorly defined Bone marrow lesions (BML), or marrow signal reduced T1-weighted spin echo (T1W SE) marrow signal in- hyperintensity on fluid-sensitive magnetic resonance im- tensity (SI) (Fig. 1a) with corresponding hyperintensity on aging (MRI) sequences, are observed in up to 36% of short tau inversion recovery (STIR), fat-suppressed T2W fast patients undergoing wrist MRI [1]. With regard to def- spin echo (FS T2W FSE), and fat-suppressed proton density- inition, the term ‘bone marrow lesion’ (BML) used in weighted fast spin echo (FS PDW FSE) sequences (Fig. 1b). this manuscript is synonymous with ‘edema-like marrow There may also be overlapping patterns between different en- signal’, ‘marrow edema-like signal’ or ‘bone marrow tities, but the combination of clinical history and lesion loca- edema pattern’ [2]. -
The Structure and Movement of Clarinet Playing D.M.A
The Structure and Movement of Clarinet Playing D.M.A. DOCUMENT Presented in Partial Fulfilment of the Requirements for the Degree Doctor of Musical Arts in the Graduate School of The Ohio State University By Sheri Lynn Rolf, M.D. Graduate Program in Music The Ohio State University 2018 D.M.A. Document Committee: Dr. Caroline A. Hartig, Chair Dr. David Hedgecoth Professor Katherine Borst Jones Dr. Scott McCoy Copyrighted by Sheri Lynn Rolf, M.D. 2018 Abstract The clarinet is a complex instrument that blends wood, metal, and air to create some of the world’s most beautiful sounds. Its most intricate component, however, is the human who is playing it. While the clarinet has 24 tone holes and 17 or 18 keys, the human body has 205 bones, around 700 muscles, and nearly 45 miles of nerves. A seemingly endless number of exercises and etudes are available to improve technique, but almost no one comments on how to best use the body in order to utilize these studies to maximum effect while preventing injury. The purpose of this study is to elucidate the interactions of the clarinet with the body of the person playing it. Emphasis will be placed upon the musculoskeletal system, recognizing that playing the clarinet is an activity that ultimately involves the entire body. Aspects of the skeletal system as they relate to playing the clarinet will be described, beginning with the axial skeleton. The extremities and their musculoskeletal relationships to the clarinet will then be discussed. The muscles responsible for the fine coordinated movements required for successful performance on the clarinet will be described. -
Capitate-Trapezoid Synostosis: Analysis of an Early Bronze Age Case and Review of the Literature P
Folia Morphol. Vol. 76, No. 2, pp. 149–156 DOI: 10.5603/FM.a2016.0068 R E V I E W A R T I C L E Copyright © 2017 Via Medica ISSN 0015–5659 www.fm.viamedica.pl Capitate-trapezoid synostosis: analysis of an Early Bronze Age case and review of the literature P. Saccheri1, G. Sabbadini2, E. Crivellato1, A. Canci3, F. Toso4, L. Travan1 1Department of Experimental and Clinical Medicine, Section of Anatomy, University of Udine, Italy 2Department of Medical, Surgical and Health Sciences, University of Trieste, Italy 3Department of History and Preservation of the Cultural Heritage, University of Udine, Italy 4Department of Diagnostic Imaging, University Hospital of Udine, Italy [Received: 22 July 2016; Accepted: 2 September 2016] Background: Carpal synostoses are congenital defects characterised by com- plete or incomplete coalition of two or more carpal bones. Although most of these defects are discovered only incidentally, sometimes they become clinically manifest. Among the different types of carpal coalition, the synostosis between capitate and trapezoid bones is quite rare, with only sparse data available in the literature. The aim of this report was to describe a case of capitate-trapezoid synostosis (CTS) observed in an ancient human skeleton, as well as to scrutinise the pertinent literature in order to assess for the characteristics of this type of defect, including its potential relevance to clinical practice. Materials and methods: We studied the skeletal remains of an Early Bronze Age male warrior affected by incomplete CTS. Macroscopic and radiological examina- tion of the defect was carried out. We also performed a comprehensive PubMed search in the Medline and other specialty literature databases to retrieve and analyse data relevant to the subject under consideration. -
The Appendicular Skeleton the Appendicular Skeleton
The Appendicular Skeleton Figure 8–1 The Appendicular Skeleton • Allows us to move and manipulate objects • Includes all bones besides axial skeleton: – the limbs – the supportive girdles 1 The Pectoral Girdle Figure 8–2a The Pectoral Girdle • Also called the shoulder girdle • Connects the arms to the body • Positions the shoulders • Provides a base for arm movement 2 The Clavicles Figure 8–2b, c The Clavicles • Also called collarbones • Long, S-shaped bones • Originate at the manubrium (sternal end) • Articulate with the scapulae (acromial end) The Scapulae Also called shoulder blades Broad, flat triangles Articulate with arm and collarbone 3 The Scapula • Anterior surface: the subscapular fossa Body has 3 sides: – superior border – medial border (vertebral border) – lateral border (axillary border) Figure 8–3a Structures of the Scapula Figure 8–3b 4 Processes of the Glenoid Cavity • Coracoid process: – anterior, smaller •Acromion: – posterior, larger – articulates with clavicle – at the acromioclavicular joint Structures of the Scapula • Posterior surface Figure 8–3c 5 Posterior Features of the Scapula • Scapular spine: – ridge across posterior surface of body • Separates 2 regions: – supraspinous fossa – infraspinous fossa The Humerus Figure 8–4 6 Humerus • Separated by the intertubercular groove: – greater tubercle: • lateral • forms tip of shoulder – lesser tubercle: • anterior, medial •Head: – rounded, articulating surface – contained within joint capsule • Anatomical neck: – margin of joint capsule • Surgical neck: – the narrow -
17 Radial Styloidectomy David M
17 Radial Styloidectomy David M. Kalainov, Mark S. Cohen, and Stephanie Sweet xcision of the radial styloid gained recognition osteotomy removed 92% of the radioscaphocapitate in 1948 when Barnard and Stubbins1 reported on and 21% of the long radiolunate ligament origins. The Eten scaphoid fracture nonunions treated with transverse osteotomy was the most invasive, detach- bone grafting and radial styloidectomy. The procedure ing 95% of the radioscaphocapitate and 46% of the has since been advocated to address radioscaphoid long radiolunate ligament origins. arthritis developing from a variety of injuries, includ- In another cadaveric model, Nakamura et al19 ex- ing previous fractures of the radial styloid and scaphoid, amined the effects of increasingly larger oblique sty- and arthritis related to posttraumatic scapholunate loidectomies on carpal stability. They concluded that instability.2–8 the procedure should be limited to a 3- to 4-mm bony Resection of the radial styloid has also been a use- resection. With axial loading, significantly increased ful adjunct to other procedures where there is poten- radial, ulnar, and palmar displacements of the carpus tial for impingement between the styloid process and were detected after removing 6-mm and 10-mm sty- distal scaphoid or trapezium.9–15 Authors have in- loid segments. The 6-mm cut violated the radio- cluded discussion of successful radial styloidectomy scaphocapitate ligament origin, whereas the 10-mm in descriptions of proximal row carpectomy, mid- cut removed the radioscaphocapitate and a portion of carpal arthrodesis, and triscaphe fusion procedures. the long radiolunate ligament origins. Only an in- On occasion, an individual may be too physically un- significant change in carpal translation was detected fit or unwilling to undergo an extensive operation to after a 3-mm osteotomy. -
Treatment of Scaphoid Nonunion with Olecranon Bone Graft and Compression Screw
DOI: http://dx.doi.org/10.1590/1413-785220162403155935 ORIGINAL ARTICLE TREATMENT OF SCAPHOID NONUNION WITH OLECRANON BONE GRAFT AND COMPRESSION SCREW ANTONIO TUFI NEDER FILHO1, EDUARDO TRALDI FRANCESCHINI2, ARLINDO GOMES PARDINI JÚNIOR2, MARCELO RIBERTO3, NILTON MAZZER3 1. Hospital Lifecenter, Belo Horizonte, MG, Brazil. 2. Hospital Ortopédico, Belo Horizonte, MG, Brazil. 3. Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto. Ribeirão Preto, SP, Brazil. ABSTRACT of the handgrip strength of the non-affected side, which was Objective: To evaluate the outcome of olecranon bone graft 37 kgf. The DASH score averaged 5 points. Conclusion: We and compression screw for the treatment of nonunion of believe that the use of bone graft obtained from the olecranon the Lichtman type I scaphoid. Method: We evaluated 15 pa- and secured with cannulated screw is a resolute technique for tients of 32 who underwent surgical treatment for nonunion cases of linear nonunion of the Lichtmann type I scaphoid. It of the Lichtman type I scaphoid with olecranon bone graft has the advantages of a new anesthesia for removal of the and screw compression. Results: We obtained 100% con- graft and the access is easy, providing a good exposure for solidation in our sample. The mean flexion of the wrist on removal and good aesthetic results. Level of evidence IV. the affected side was 68° and 75° on the non-affected side. Case series. The average extension was 63° and 72°, respectively. The average grip strength was 35 kgf. This corresponds to 98% Keywords: Scaphoid bone. Pseudarthrosis. Bone transplantation. Citation: Neder Filho AT, Franceschini ET, Pardini Junior AG, Riberto M, Mazzer N.