Hemilateral bone longitudinal transport technique for the treatment of hemilateral defects of long bones of lower limbs / 中国骨伤

OBJECTIVE@#To explore clinical efficacy of Ilizarov hemilateral bone longitudinal transport technique in treating hemilateral bone defects associated with chronic osteomyelitis of lower extremity long bones.@*METHODS@#Clinical data of 13 patients with hemilateral bone defects caused by chronic osteomyelitis of lower extremity long bones and treated by Ilizarov hemilateral bone longitudinal transport technique were retrospective analyzed, including 10 males and 3 female, aged from 14 to 55 years old;4 patients occurred femoral and 9 patients occurred tibial;10 patients were diagnosed as traumatic osteomyelitis and 3 patients as hematogenous osteomyelitis. The anatomical classification of Cierny-Mader in 13 patients was type Ⅲ. Bone and wound healing, postopertaive complication, and bony and functional results were observed by Paley evaluation standard.@*RESULTS@#After removing external fixator, all patients were followed up from 6 to 70 months. Transporting time ranged from 54 to 158 d. And the time in external fixation ranged from 6.8 to 19.5 months. External fixation index (EFI) ranged from 1.23 to 1.6 months/cm. According to Paley's evaluation criteria, bony results were excellent in 13 patients;functional results showed excellent in 12 patients and good in 1 patient. Two patients occurred poor union on the docking sites and healed with autogenous iliac bone graft. The callus at the extended area was poorly mineralized and improved significantly when treated with low-intensity pulsed ultrasound in one patient. All patients had good wound healing without recurrence of osteomyelitis and refracture. There was no vascular and nerve injury and axial deviation in all patients and they were satisfied with the appearance and function of lower limbs. The range of motion of knee and ankle joint before operation was 120 ° to 150 ° and 35 °to 80 ° respectively, and at the latest follow-up was 110 ° to 140 ° and 30 ° to 75 ° .@*CONCLUSION@#Ilizarov hemilateral bone longitudinal transport technique is effective in treating infective hemilateral bone defects of lower extremity long bones, which could not only simplify architecture of external fixation, but also reduce the number of fixation pins, shorten the time in external fixator and decrease the incidence of pin tract infection. However, this technique is highly demanding, and the growth of callus in extended region and healing of bone apposition should be noticed.

Stature estimation from radiographic measurements in adult Anatolian population / Estimación de la estatura a partir de mediciones radiográficas en una población adulta de anatolia

SUMMARY: The purpose of the present study was to create a regression equation for measuring stature using measurements obtained from the long bone radiographs of adult individuals in Anatolian population. In this study, the maximum length measurements of the six long bones in the upper and lower limbs of 167 healthy individuals were determined from radiographic images. Single and multiple regression equations were created to predict the stature of the individuals from the maximum bone stature. From these equations, the standard error of estimate was determined in the range of 1.68-4.09 cm. As a result of this study, the obtained regression equations resulted in highly reliable and successful results in terms of predicting stature. These equations will provide convenient and predictive accuracy in the estimation of stature from skeletal remains obtained from societies that lived and living in Anatolia. Besides, we anticipate that it will guide researchers working in the fields of Forensic Anthropology, Forensic Medicine and Anatomy.

RESUMEN: El propósito del presente estudio fue crear una ecuación de regresión para medir la estatura utilizando medidas obtenidas de las radiografías de huesos largos de individuos adultos en la población de Anatolia. En este estudio, las medidas de longitud máxima de los seis huesos largos en los miembros superiores e inferiores de 167 individuos sanos se determinaron a partir de imágenes radiográficas. Se crearon ecuaciones de regresión única y múltiple para predecir la estatura de los individuos a partir de la estatura ósea máxima. A partir de estas ecuaciones, se determinó el error estándar de estimación en el rango de 1,68 a 4,09 cm. Como resultado de este estudio, las ecuaciones de regresión obtenidas dieron resultados altamente confiables y exitosos en términos de predecir la estatura. Estas ecuaciones proporcionarán una precisión conveniente y predictiva en la estimación de la estatura a partir de restos óseos obtenidos de sociedades que vivieron y viven en Anatolia. Además, anticipamos que guiará a los investigadores que trabajan en los campos de Antropología Forense, Medicina Forense y Anatomía.

Study of Organisms Causing Osteomyelitis in a Tertiary Care Hospital.

BACKGROUND The term osteomyelitis (OSM) was first used by the French surgeon Edouard Chassaignac in 1852, who defined the disease as an inflammatory process accompanied by bone destruction caused by an infecting microorganism.The clinical manifestation and the natural history of OSM depend on several factors. OSM mostly affects the growing ends of long bones.We wanted to study the organisms causing osteomyelitis and their antimicrobial susceptibility pattern.METHODSPus and bone aspirate were collected from 115 diagnosed patients of osteomyelitis and were processed for isolation of organisms by standard microbiological techniques. Isolates were identified by various biochemical reactions and were subjected to antimicrobial susceptibility test as per CLSI guidelinesby Kirby-Bauer disk diffusion technique on Mueller Hinton agar (MHA). Data collected in the questionnaire was entered and analysed in Epi Info software version 7.2.RESULTSIn 101 samples, 116 organisms were isolated. In 14 samples no organism was isolated, which can be attributed to the viral aetiology, parasites and anaerobes. Acute Osteomyelitis (AOSM) was found to be more common in the age group of 1-10 years, whereas chronic osteomyelitis (COSM) was found more commonly in 21-30 and 31-40 years age group. Male to Female ratio was 2.2:1. Bones involved in AOSM and COSM were mostly femur followed by tibia and humerus. S. aureus was the most predominant isolate. All the isolates of S. aureus showed 100% sensitivity to Vancomycin, Amikacin, Netilmicin, Chloramphenicol. Out of 48 isolates of S. aureus, 37.50% were MRSA, 6.25% were ICR, 14.58% were MRSA+ICR found.CONCLUSIONSOsteomyelitis is found to be highest in third decade, with the males being predominantly affected. Acute osteomyelitis is predominantly seen in children, whereas chronic osteomyelitis in adults. Even though Staphylococcus aureus has always remained the most common etiological agent of osteomyelitis, increasing infections due to Gram negative bacilli and even poly-microbial infections are gaining importance. MRSA infection is known to increase post-operative complications. Introduction of MBL or carbapenemase production in Gram negative bacilli is a matter of great concern. Timely knowledge of aetiology and antimicrobial resistance pattern of osteomyelitis isolates can help in rational use of antibiotics and control of drug resistance.

Osteogénesis Imperfecta. A propósito de un caso tipo II / Osteogenesis Imperfecta. About a type II case

RESUMEN El síndrome de Osteogénesis Imperfecta (OI) tipo II está dentro del grupo de trastornos del tejido conectivo de origen genético-hereditario que se caracteriza por fragilidad ósea, fracturas múltiples, huesos largos anchos y acortados, además de una pobre mineralización ósea. Su frecuencia de aparición se calcula en aproximadamente 1: 55.000 nacidos vivos y es el resultado de mutaciones de dos genes que codifican las cadenas de colágeno tipo 1. El riesgo de recurrencia es alrededor de 6 % pero si ambos padres fueran heterocigotos, aumentaría a 10-25 %. También se han reportado casos esporádicos por mutación de novo. El diagnóstico se suele realizar por los hallazgos ecográficos en el segundo trimestre o en ecografías previas si los hallazgos son muy evidentes. Las pruebas invasivas son útiles sobretodo en casos de antecedentes familiares con formas leves de OI. En nuestro caso, encontramos durante la ecografía de las 20 semanas una notable hipomineralización de la calota fetal sospechada por hiporrefringencia de la misma, acortamiento de extremidades superiores e inferiores con múltiples fracturas óseas, arcos costales cortos, arqueados y una desproporción toraco-abdominal. En los casos en donde se prosigue con el embarazo más de 60% de los recién nacidos mueren el primer día de vida, el resto lo hace durante el primer mes y la sobrevivencia más allá de un año es rara. La principal causa de muerte postnatal suele ser por falla respiratoria.

SUMMARY Osteogenesis Imperfecta (OI) type II is within the group of connective tissue disorders hereditary genetic-origin characterized by bone fragility, multiple fractures, broad long bones and shortened, and a poor bone mineralization. Their frequency is estimated at approximately 1: 55,000 live births, and is the result of mutations of genes which encoding chains of type 1 collagen. The risk of recurrence is around 6% but if both parents were heterozygous, increase to 10-25%. There has also been reported sporadic cases with de novo mutation. The diagnosis is usually made by ultrasound findings in second trimester or previously if the findings are very obvious. Invasive tests are useful especially in cases of family history with mild forms of OI. In our case, we found during ultrasound 20 weeks a remarkable hypomineralization of fetal calvarial, shortening of upper and lower extremities with multiple bone fractures and short costal arches, arched and thoracoabdominal disproportion. In cases where continued pregnancy more than 60% of newborns die during the first day of life, 80% die in the first month and survival beyond one year is rare. Death can occur prenatally or postnatamente from respiratory failure.

Widespread osteonecrosis of long bones following pregnancy

Background: Oral cancer being one of the most common malignancies in the low-income group in India. It usually presents in an advanced stage limiting treatment options. The mainstays of treatment being surgery and radiotherapy both being lifestyle changing procedures. Aims and objectives: The purpose of this study is to evaluate the quality of life for oral cancer survivors after surgery in comparison with radiotherapy using ICF questionnaire Materials and methods: Oral cancer patients who underwent surgery (25 patients) and Radiotherapy (25 patients) in Stanley medical college for stage 1 and stage 2 lesions of oral carcinoma for past 3 Years (2013-2015) were enrolled. Results: The study showed that surgery as primary therapy provided a better quality of life than radiotherapy alone in the treatment of oral cancer patients. Conclusion: After comparing the results primary surgery for oral malignancy seems to be the treatment of choice as long as the tumor is amenable to surgical resection. Radiotherapy though resulting in a lower quality of life is very efficacious for unresectable tumors.

Treatment Strategy of Infected Nonunion

The management of infected nonunion is based on a detailed evaluation of patients, the involved bone and soft tissues, stability of fixation, and type of bacterial pathogens. Preoperative surgical planning and strategies for each step is mandatory for the successful treatment of infected nonunion. The radical debridement of infected tissues, including the unstable implant, is one of the most important procedures. Adequate soft tissue coverage should be considered for the appropriate management of infection; a reconstructive procedure and stable skeletal stabilization by internal or external fixation is also necessary later. A restoration of bone defects and bony union can be accomplished with bone grafting, distraction osteogenesis, vascularized fibular grafting, and induced membrane technique.

Treatment Strategy of Infected Nonunion

The management of infected nonunion is based on a detailed evaluation of patients, the involved bone and soft tissues, stability of fixation, and type of bacterial pathogens. Preoperative surgical planning and strategies for each step is mandatory for the successful treatment of infected nonunion. The radical debridement of infected tissues, including the unstable implant, is one of the most important procedures. Adequate soft tissue coverage should be considered for the appropriate management of infection; a reconstructive procedure and stable skeletal stabilization by internal or external fixation is also necessary later. A restoration of bone defects and bony union can be accomplished with bone grafting, distraction osteogenesis, vascularized fibular grafting, and induced membrane technique.

Anatomical study of nutrient foramina in long bones of human upper limbs.

Background: An opening into the bone shaft for passage of blood vessels to the medullary cavity of a bone for its nourishment and growth is called as nutrient foramen. There is always a need for a greater understanding of nutrient foramina in upper limb bones such as the humerus, radius and ulna. So the aim of present study was to record the location, number and direction of nutrient foramina in long bones of the upper limb. Material and methods: A total number of 120 long bones (40 humeri, 40 radii and 40 ulnae) were used for the study. Results: In the results, 66% of the humeri had a single foramen, 18% had double foramina and 26% had no foramen. For the radii, 68% had a single nutrient foramen and 32% had no nutrient foramen 78% of the ulnae had a single nutrient foramen and 22% had no nutrient foramen. All the foramina except one (in the radius) were directed away from the growing end, that is, they were directed towards the elbow Conclusion: Information and details about nutrient foramina is of clinical importance, especially in surgical procedures like bone grafting and bone transplantation.

A Study Of Diaphyseal Nutrient Foramina In Human Lower Limb Long Bones.

Abstracts: Background & Objectives: Nutrient foramen is a natural opening into the shaft of a bone, allowing for passage of blood vessels into the medullary cavity. This study aims to determine the number, location, size and direction of nutrient foramina of long bones of the lower limb. Which information is very important in orthopedic surgical procedures. Methodology: This study consisted of 120 adult human cleaned and dried bones of the lower limbs. They were divided into three groups 40 bones of each. Were studied above mentioned. Measurements were taken with Vernier Caliper. Results: Number: 40% of the femurs had a single foramen, 60% had double foramina. For the tibia, 100% had a single nutrient foramen. 80% of the fibula had a single nutrient foramen and 20% had double nutrient foramen. Position: femur: Of the total 48 foramina, 8(16.6%) were in the proximal third (Type-1) and 40(83.3%) in the middle third (Type-2). Tibia: Of the total 30 foramina, 27(90%) were in the proximal third (Type-1) and 3(10%) were in the middle third (Type-2). There were no foramina in the distal third (Type- 3).Fibula: Of the total 36 foramina, 35(97.2%) existed in the middle third (Type-2) and 1(2.7%) were in the distal third (Type-3). There were no foramina in the proximal third (Type-1).In femur all foramina directed proximally & in tibia all are directed distally while in fibula total 36 nutrient foramina observed out of them, 28 (77.71%) was directed distally; while 8(22.2%) was proximally. Conclusion: The study confirmed previous reports regarding the number and position of the nutrient foramina in the long bones of the lower limbs. Information and details about these foramina is of clinical importance, especially in surgical procedures like bone grafting and microsurgical vascularized bone transplantation.

Morphometric Analysis of Nutrient Foramina in Human Typical Long Bones Of Upper Limb.

The major blood supply to long bones occurs through the nutrient arteries, which enter through the nutrient foramina. This supply is essential during the growing period, during the early phases of ossification, and in procedures such as bone grafts, tumor resections, traumas, congenital pseudoarthrosis, and in transplant techniques in orthopaedics. The present study analyzed the location, direction, size and the number of nutrient foramina in the diaphysis of 180 long bones of the upper limbs of adults: 60 humerus, 60 radius, 60 ulna. The location of the nutrient foramina is predominant on the anterior aspect of the upper limb long bones. The majority of the bones studied had a single nutrient foramen, which may represent a single source of blood supply. The mean foraminal index for the upper limb bones was 55.4% for the humerus, 34.7% for the radius, and 36.0% for the ulna. This study recorded data that may help in surgical procedures and in the interpretation of radiological images.

Percutaneous autologous bone marrow injection in the treatment of delayed and non-union of long bones.

Context: Bone marrow has been shown to contain osteo-progenitor cells. Percutaneous autologous bone marrow injection (PABMI) encourages early treatment of delayed union and non-union to expedite healing and minimize complications from prolong immobilization. Aims and objectives: To assess the outcome of PABMI treatment in delayed and non-union of long bones. Study design: Prospective study Participants and procedures: 24 cases (33 bones) of Delayed and non-union of long bones were selected. Percutaneous autologous bone marrow injection treatment was adopted for fracture healing. Change in pattern of union was followed after 12 weeks by clinical and radiological study. Results: 90% of tibial fractures, 66.66% of radial fractures and 50% of ulna fractures show clinical and radiological union. 100% of the fractures with no gap at the fracture site united, where the gap was less than 1 cm, 85% of bone united, in only 1 case the gap was more than 1 cm and it failed to unite. 7 out of 9 bones in hypertrophic non-union united, whereas 4 out of 6 bones in atrophic non-union united. Conclusion: Percutaneous autologous bone marrow grafting is an effective and safe method for the treatment of diaphyseal non union. We strongly believe that an injectable preparation that combines marrow with osteoinductive and osteoconductive agents should virtually eliminate the need for open harvesting and operative grafting of the problems associated with fracture healing.

Ultrasonic guided waves in long bones based on finite-difference time-domain method / 医用生物力学

Objective To discuss the effects of elastic modulus on propagation characteristics of ultrasonic guided waves in long bones based on finite-difference time-domain (FDTD) method, so as to provide the theoretical references for evaluating bone fatigue damage at the early stage. Methods A cylinder was used to model the long bone, and FDTD method was used to simulate the long bone with different elastic modulus. Then, the propagation characteristics of different guided wave modes were calculated, including the phase velocity, the group velocity, the central frequency and the energy. ResultsThe elastic modulus of long bones was closely related with the propagation characteristics of ultrasonic guided waves. The phase velocity, the group velocity, the central frequency and the energy were all reduced with the decrease in elastic modulus, and the variation tendency of L(0,5) mode was the most obvious. Conclusions The propagation of ultrasound guided waves can reflect the variation of elastic modulus of long bones, which provides a possible way to evaluate the fatigue damage at the early stage in long bones.

Geometry and evolutionary parallelism in the long bones of cavioid rodents and small artiodactyls.

Morphological parallelism between South American cavioid rodents and small artiodactyls from the Old World has been postulated for a long time. Our study deals with this question from the point of view of biomechanical characteristics of the long bones. For this, cross-sectional area, second moment of the area, polar moment, athletic ability indicators and strength were calculated for the long bones (i.e. humerus, radius, femur and tibia) of five species of cavioids and two species of artiodactyls. Regressions of all these variables to body mass were established. Regarding the cross-sectional area, the confidence intervals show that the exponents calculated are not significantly different from the geometrical predicted value. The exponents obtained for the second moment of area and the polar moment are not significantly different from the geometrical prediction, except for the humerus. The two indicators of athletic ability scaled as expected, but the bending indicator of athletic ability of the femur was not correlated to body mass. The exponent calculated for femur strength is not different from zero, while the strength of the humerus decreases slightly with the body mass. Additional statistical tests (ANCOVAs) showed no difference between the values of these variables calculated for the samples studied of artiodactyls and rodents. The present results are consistent with the hypothesis that there is significant evolutionary parallelism between cavioid rodents and small artiodactyls.

Enfermedades osteocondensantes con compromiso de huesos largos: presentación de dos casos y revisión de la literatura / Sclerosing bone diseases with involvement of long bones: report of two cases and literature review

Las enfermedades osteocondensantes son un grupo de patologías poco frecuentes que se caracterizan por aumento de la masa ósea, comprometiendo tanto a huesos largos como a huesos planos. Tradicionalmente, la radiología simple ha permitido su diagnóstico al identificar patrones de afectación ósea característicos de cada enfermedad. Actualmente, la caracterización molecular y genética ha facilitado la comprensión del sustrato fisiopatológico y la expresión fenotípica de estás patologías, sin embargo, la radiología simple continua teniendo un valor inconmesurable en el reconocimiento de las enfermedades osteocondensantes.

Sclerosing bone disorders are a rare group of diseases characterized by increased bone mass in both long and flat bones. Traditionally, plain radiography has allowed the diagnosis of these diseases identifying characteristic patterns of bone involvement. At present, the molecular and genetic characterization of these diseases has provided a better understand of their pathophysiology and phenotypic expression, however plain radiography continues to have an important role in the recognition of sclerosing bone disorders.

Original research paper correlation of stature of adult with the length of clavicle.

Forensic anthropology can play an important role in the identification process. Besides determination of race, sex and age of the unknown individual, estimation of stature enhances the reliability of identification. It is easier to get those data when the whole body or entire skeleton is available to the forensic anthropologist. However, in cases of deliberate mutilation and disposal in parts, interference by wild animals and bomb blast by terrorist attack, recovery of the whole body or complete skeleton may not be possible. In those cases, the forensic anthropologists have to give his opinion based upon the available supplied skeletal remains. Although approximate stature of the individual can be estimated from most of the long bones using either multiplication factors or regression formulae, studies on estimation of stature from clavicle are limited. In the present autopsy based study, an attempt has been made to correlate stature of individual with the length of clavicle.

Nutrient Foramina in the Upper and Lower Limb Long Bones: Morphometric Study in Bones of Southern Brazilian Adults / Forámenes Nutricios en los Huesos Largos de los Miembros Superiores e Inferiores: Estudio Morfométrico en Huesos de Adultos del Sur de Brasil

The major blood supply to long bones occurs through the nutrient arteries, which enter through the nutrient foramina. This supply is essential during the growing period, during the early phases of ossification, and in procedures such as bone grafts, tumor resections, traumas, congenital pseudoarthrosis, and in transplant techniques in orthopedics. The present study analyzed the location and the number of nutrient foramina in the diaphysis of 885 long bones of the upper and lower limbs of adults: 174 humeri, 157 radii, 146 ulnae, 152 femora, 142 tibiae and 114 fibulae. The location of the nutrient foramina is predominant on the anterior aspect of the upper limb long bones, and on the posterior aspect of the lower limb long bones. The majority of the bones studied had a single nutrient foramen, which may represent a single source of blood supply. The mean foraminal index for the upper limb bones was 55.2 percent for the humerus, 35.7 percent for the radius, and 37.9 percent for the ulna, and for the lower limb bones, 43.7 percent for the femur, 32.7 percent for the tibia and 46.1 percent for the fibula. This study recorded data related to the population of Southern Brazil, providing ethnic data to be used for comparison and that may help in surgical procedures and in the interpretation of radiological images.

El importante aporte de sangre para los huesos largos se produce a través de las arterias nutricias, que penetran por los forámenes nutricios. Este suministro es esencial durante el período de crecimiento, las primeras fases de osificación y en los procedimientos como injertos óseos, resecciones tumorales, traumas, pseudoartrosis congénita y en las técnicas de trasplante en ortopedia. El estudio determina la ubicación y el número de forámenes nutricios en las diáfisis de 885 huesos largos de los miembros superiores e inferiores pertenecientes a individuos adultos. Fueron estudiados 174 húmeros, 157 radios, 146 ulnas, 152 fémures, 142 tibias y 114 fíbulas. La ubicación de los forámenes nutricios era predominante en la parte anterior de la diáfisis de los huesos largos del miembro superior y en la parte posterior de los huesos largos del miembro inferior. La mayoría de los huesos estudiados tenía un solo foramen nutricio, representando una sola fuente de suministro de sangre. El índice medio foraminal en los huesos del miembro superior fue de 55,2 por ciento para el húmero, 35,7 por ciento para el radio, y 37,9 por ciento para el ulna; en los huesos del miembro inferior fue 43,7 por ciento para el fémur, 32,7 por ciento para la tibia y 46,1 por ciento para la fíbula. Este estudio registró datos relativos a la población del Sur de Brasil, proporcionando antecedentes étnicos que además puedan servir de ayuda en los procedimientos quirúrgicos y en la interpretación de imágenes radiológicas.

Diaphysial nutrient foramina in long bones and miniature long bones.

Background: Nutient foramen is an opening into the bone shaft which gives passage to the blood vessels of the medullary cavity of a bone. The knowledge of nutrient foramen is important in surgical procedures like bone grafting and more recently in microsurgical vascularised bone transplantation. Aim: to determine the number, direction, position of nutrient foramen and whether the nutrient foramina obey the general rule that is, directed away from the growing end of the bone. Materials and methods: The present study has been undertaken to review 1000 long bones including clavicle and miniature long bones. Results 6.8% of bones showed no foramen while 10% of bones had double foramen. Conclusion: Majority of the bones followed the growing end theory. Clavicle showed more variation as to the surface on which nutrient foramen was present. None of the earlier workers have done compiled study of all types of long bones in a single study.

Comparative osteometric study of long bones in Yankasa sheep and red Sokoto goats / Estudio osteométrico comparativo de los huesos largos entre oveja Yankasa y las cabras rojas Sokoto

A morphometric study was undertaken on the long bones in the two predominant breeds of small ruminant in Northern Guinea Savanna zone of Nigeria, to determine their anatomical differences and thus, provide a means of differentiating the remains of these two species during zooarchaeological studies and gross anatomy practical session. The pelvic and pectoral limbs from thirty animals (15 Yankasa sheep and 15 Red Sokoto goats) of both sexes were used for this study. The long bones of the pectoral limbs considered were the humerus, radius, ulna and metacarpal III while those of the pelvic limbs were the femur, tibia and metatarsal III. The parameters considered were the mean weights, lengths and diameters of the proximal extremity, mid-shaft and distal extremities of these bones. The result of this study showed that there is a very high statistically significant difference (p < 0.001) in the length of long bones between the two species, with that of the Yankasa sheep being significantly longer than the Red Sokoto goat. Also, the differences in weights as well as diameters of the proximal, middle and distal shafts of the tibia between the two species are of a very high statistical importance (p < 0.001). Conversely, the differences in the proximal and distal diameters of the femur between the two species are not statistically significant (p > 0.05). Factors that may be responsible for these differences were discussed. It is concluded that the bones of the Yankasa sheep and Red Sokoto goat can be differentiated by the disparity in the length of these long bones or the disparity in the entire morphometry of the tibia bone.

Se realizó un estudio morfométrico en los huesos largos en las dos razas predominantes de pequeños rumiantes del norte de Guinea, zona de Sabana de Nigeria, para determinar sus diferencias anatómicas y proporcionar un medio de que permita diferenciar los restos, de estas dos especies, durante los estudios zooarqueológico y en además en práctica de anatómica. Se utilizaron los miembros pélvicos y pectorales de treinta animales (15 ovejas Yankasa y 15 cabras rojas de Sokoto) de ambos sexos. Los huesos largos de los miembros pectorales considerados fueron: húmero, radio, ulna y III metacarpiano, mientras que en los miembros pélvicos fueron: fémur, fíbula y el III metatarso. Los parámetros considerados fueron los pesos medios, longitudes y diámetros de la extremidad proximal y tercios medio y distal de estos huesos. Los resultados mostraron que existe una diferencia altamente significativa (p <0,001) en la longitud de los huesos largos entre las dos especies. Los huesos en las ovejas Yankasa son significativamente más largos que los de la cabra roja de Sokoto. Además, de las diferencias en el peso, así como los diámetros de los ejes proximal, media y distal de la fíbula entre las dos especies son estadísticamente significativos (p <0,001). Por el contrario, las diferencias en los diámetros proximal y distal del fémur entre las dos especies no son estadísticamente significativas (p> 0,05). Fueron discutidos los factores que pueden ser responsables de estas diferencias. Se concluye que los huesos de las ovejas y cabras Yankasa Red Sokoto, se pueden diferenciar por la disparidad en la longitud de los huesos largos o en la morfometría de la tibia.

Tratamiento de la pseudoartrosis de los huesos largos mediante fijación externa / Treatment of long bones pseudoarthrosis using external fixation

INTRODUCCIÓN. Desde principios del siglo XX, con la aparición de nuevas técnicas quirúrgicas para el tratamiento de las fracturas, aumentó el número de complicaciones postquirúrgicas, entre ellas las infecciones y la pseudoartrosis. A pesar del adelanto científico de la ortopedia en los últimos 20 años, la pseudoartrosis continúa siendo una complicación frecuente en pacientes que han sufrido lesiones de gran complejidad, y la mayoría de las veces se debe a una mala aplicación de las técnicas quirúrgicas. El objetivo de este trabajo fue mostrar la validez de la aplicación de los principios biomecánicos de Ilizarov en el tratamiento de la pseudoartrosis de los huesos largos. MÉTODOS. Se realizó un estudio prospectivo de corte longitudinal donde fueron analizados 11 pacientes con pseudoartrosis de huesos largos, todas secuelas de tratamientos de fracturas (4 de ellas infectadas). El tratamiento consistió en fijación externa, aplicando el fijador externo de Gabriel Ilizarov (modelo circular) y el fijador externo de tipo RALCA®, diseñado por el profesor Rodrigo Álvarez Cambras (modelo biplanar). Fueron tratadas 10 pseudoartrosis de tibia y 1 de fémur.RESULTADOS. La consolidación se obtuvo como promedio en 5 meses en las pseudoartrosis simples y en 8 meses en las infectadas. Las complicaciones más frecuentes fueron la osteítis del trayecto del alambre y las rigideces articulares parciales, secuelas de los tratamientos previos. CONCLUSIONES. Dados los buenos resultados obtenidos, consideramos útil brindar nuestros resultados basados en los principios de Ilizarov, como un procedimiento más para la solución de este tipo de afección

INTRODUCTION. Since onset of XX century, with appearance of new surgical techniques for fractures treatment, the number of complications increased including the infections and the pseudoarthrosis. Despite the scientific advance of Orthopedics in past 20 years, the pseusoarthoris remains to be a frequent complication in patients undergone very complex lesions and most of time it is caused by a wrong application of biomechanical principles of Ilizarov in treatment of long bones pseusoarthrosis. METHODS. A prospective and longitudinal study was conducted to analyze the case of 11 patients with long bone pseudoarhtosis as sequelae of fracture treatments (4 of them infected). Treatment included external fixation using the Gabriel Ilizarov's external fixation (circular model) and the external fixation type RALCA® designed by the professor Rodrigo Alvarez Cambras (biplane model). Ten pseudoarthrosis of tibia and one of femur were treated. RESULTS. As average consolidation was achieved at 5 months in simple pseudoarthrosis and at 8 months in those infected. The more frequent complications were the osteitis in the wire trajectory and the partial articular rigidities caused by previous treatments. CONCLUSIONS. Given the good results obtained, it was considered useful to show our results based on the IIizarov'v principles as another procedure to solve this type of affection

INTRODUCTION. Depuis le dÚbut du XXe siÞcle, le nombre de complications postchirurgicales, telles que les infections et la pseudarthrose, a augmentÚ avec l'apparition de nouvelles techniques chirurgicales pour le traitement des fractures. MalgrÚ le dÚveloppement scientifique de l'orthopÚdie dans ces derniers 20 ans, la pseudarthrose demeure une complication frÚquente chez des patients ayant souffert des lÚsions trÞs complexes, dues le plus souvent Ó une mauvaise application des techniques chirurgicales. Le but de ce travail est de montrer la validitÚ des principes biomÚcaniques d'Ilizarov dans le traitement de la pseudo-arthrose des os longs. MÉTHODES. Une Útude prospective et longitudinale de 11 patients atteints de pseudo-arthrose des os longs, Útant toutes des sÚquelles des traitements de fractures (dont 4 Útaient infectÚes), a ÚtÚ rÚalisÚe. Le traitement a rÚsidÚ en la fixation externe par fixateur externe de Gabriel Ilizarov (modÞle circulaire) et fixateur externe type RALCA®, dessinÚ par le professeur Rodrigo Álvarez Cambras (modÞle biplan). Toutes les pseudarthroses (10 pseudarthroses du tibia et 1 seul pseudarthrose de fÚmur) ont ÚtÚ traitÚes. RÉSULTATS. On a obtenu une consolidation des pseudarthroses simples en 5 mois et des pseudarthroses infestÚes en 8. Les complications les plus souvent trouvÚes ont ÚtÚ l'ostÚite du trajet du fil et la rigiditÚ articulaire partielle, Útant des sÚquelles des traitements prÚalables. CONCLUSIONS. Étant donnÚs les bons rÚsultats obtenus, nous considÚrons utile de faire conna¯tre nos rÚsultats basÚs sur les principes d'Ilizarov comme un autre procÚdÚ pour donner solution Ó ce type d'affection

Disnea súbita después del terremoto / After the earthquake sudden dyspnea

Fat embolism syndrome (FES) remains a diagnostic challenge for physicians. It is commonly as associated with fractures of long bones and it is a major source of morbidity and mortality inpatients with multiple injuries. Overall mortality is between 5-15 percent in all studies. These facts motivate us to present the case of a young woman suffering bone fractures in both legs during the earthquake in Chile on February 27, 2010. She presented a FES 72 hours later. It is important to understand this syndrome, as it can be confused with other serious diseases that require different management. We should be able to have a high FES suspicion in the appropriate context, in as much as an early diagnosis, and treatment may improve the prognosis of this severe condition.

El síndrome de embolia grasa (SEG) sigue siendo un reto diagnóstico para los médicos. Se asocia fundamentalmente en fracturas de los huesos largos y es una importante fuente de morbilidad y mortalidad en pacientes politraumatizados. La mortalidad general se encuentra entre el 5 a 15 por ciento en todos los estudios. Esto nos motiva a presentar el caso de una mujer joven que 72 horas después de fracturas sufridas durante el terremoto ocurrido en Chile el 27 de febrero del 2010, presentó un SEG. Es importante conocer este síndrome, ya que se puede confundir con otras patologías graves que requieren un manejo distinto y al tener una alta sospecha en el contexto adecuado, se permite un diagnóstico oportuno, tratamiento precoz y mejorar el pronóstico.