Clinical and radiographic changes of carpi, tarsi and interphalangeal joints of beef zebu bulls on semen collection regimen / Mudanças clínicas e radiográficas das articulações carpo, tarso e interfalangeana de touros de corte zebuínos em regime de colheita de sêmen

Osteoarthritis and osteochondrosis are highly correlated to reproductive failure in bulls. This study aimed to evaluate the carpal, tarsal and interphalangeal lesions in beef zebu bulls on semen collection regimen. Twenty-one beef cattle bulls, in a total of forty-one animals, were split into three age-based groups: animals from two to four years old (GI), from more than four to eight years old (GII) and above eight years old (GIII). The clinical findings were conformational changes of limbs, synovial effusion, peripheral venous engorgement of joints and prolonged decubitus. The total population showed moderate clinical manifestation and radiographic score. The GIII presented more severe joint lesions. Carpi and tarsi regions had discrete to difuse osteophytosis, subchondral cysts, cartilaginous flaps, bone incongruence and fragmentation, osteitis, and ankylosis. Interphalangeal joints presented osteophytosis, distal phalanx osteitis and enthesophytosis. The digital radiographic examination allowed full identification of articular lesions and their clinical correspondences, besides the positive correlation between age, body weight and radiographic score.(AU)

Osteoartrite e osteocondrose estão altamente correlacionados à falha reprodutiva em touros. Este estudo teve como objetivo avaliar as lesões do carpo, tarso e interfalangianas em touros zebuínos de corte em regime de coleta de sêmen. Vinte e um bovinos de corte, touros, provenientes de um total de 41 animais, foram divididos em três grupos baseados na idade, sendo eles: animais de dois a quatro anos (GI), de mais de quatro a oito anos (GII) e acima de oito anos de idade (GIII). Os sinais clínicos encontrados foram mudanças de conformação dos membros, derrame sinovial, ingurgitamento venoso periférico das articulações e decúbito prolongado. A população total avaliada apresentou manifestação clínica e escore radiográfico de grau moderado. Os touros mais velhos apresentaram maior gravidade nas lesões articulares. O GIII foi o que apresentou as lesões articulares mais severas. Identificou-se nos carpos osteofitose de discreta a difusa, cistos subcondrais, "flaps" cartilaginosos, fragmentação óssea, perda de congruência óssea, osteíte e anquilose; as lesões társicas obedeceram ao mesmo padrão. As articulações interfalangeanas apresentaram somente osteofitose, osteíte nas falanges distais e entesiofitose. O exame radiográfico digital permitiu a identificação completa das lesões articulares e suas correspondências clínicas, além da correlação positiva entre a idade, o peso corporal e o escore radiológico.(AU)

Comparative kinematic gait analysis in young and old Beagle dogs

Age-related involution in dogs involves loss of muscle mass and changes in connective tissue and articular cartilage. The aim of this study was to examine whether an age-related influence on joint mobility can be detected in the absence of disease. Five young (mean age 2.0 years) and five old (mean age 10.4 years) healthy and sound Beagle dogs underwent computer-assisted gait analysis during locomotion on a treadmill. Shoulder, elbow, carpal, hip, stifle, and tarsal joint angles including joint angle progression curves, minimum and maximum joint angles, and range of motion (ROM) in degrees were analyzed. The old group had a smaller maximum joint angle (p = 0.037) and ROM (p = 0.037) of the carpal joint; there were similar tendencies in the shoulder, elbow, and carpal joints. Descriptive analysis of the progression curves revealed less flexion and extension of the forelimb joints. The results indicate restricted joint mobility of the forelimb in old dogs, primarily of the carpal joint. Results in the joints of the hindlimb were inconsistent, and the contrasting alterations may be due to a compensatory mechanism. As most alterations were found in the distal joints, these should receive particular attention when examining elderly dogs.

The carpal joint of the donkey (Equus asinus): morphological investigation / Articulación del carpo del asno (Equus asinus): investigación morfológica

The current study has been achieved to be an essential resource for all veterinary practitioners that deal with the anatomy of the carpal joint of the donkey. Ten adult donkeys of both sexes were used in the current study. The topographical approach to the carpal joint was investigated in this study. Radiography and computed tomography (CT) of the carpus delineated the articulations of the carpal joint: radiocarpal, intercarpal, and carpometacarpal. The carpal ligaments were well delineated and the carpal canal was demonstrated with its content such as superficial digital flexor tendon (SDFT) and deep digital flexor tendon (DDFT). The contrast radiography visualized that the radiocarpal joint outpouched proximal to the accessory carpal bone by large palmarolateral pouch and small palmaromedial pouch, however the intercarpal joint outpouched distal to the accessory carpal bone by two small palmarolateral and palmaromedial pouches. The carpometacarpal joint showed medial and lateral palmarodistal outpouchings in distal direction between the corresponding 2nd and 4th metacarpal bones and the 3rd metacarpal bone. Scanning electron microscopy (SEM) displayed two types of synoviocytes macrophages type A cells and fibroblast like type B cells at the cellular lining of the synovial membrane of the joint capsule.

Este estudio constituye un recurso esencial para todos los veterinarios que se ocupan de la anatomía de la articulación del carpo del asno. Fueron utilizados diez asnos adultos, de ambos sexos. Se analizó la articulación del carpo desde un enfoque topográfico. Se realizaron estudios por radiografía y tomografía computarizada para identificar las articulaciones del carpo en su conjunto: radiocarpiana, intercarpiana y carpometacarpiana. Los ligamentos del carpo se encontraron bien delineados y en el canal carpiano se identificó su contenido, como el tendón del flexor digital superficial y el tendón del flexor digital profundo. La radiografía de contraste permitió visualizar que la articulación radiocarpiana se articula proximalmente con el hueso accesorio del carpo a través una larga evaginación palmarolateral y una pequeña evaginación palmaromedial; sin embargo, la articulación intercarpiana se relaciona distalmente con el hueso accesorio del carpo por medio de dos pequeñas evaginaciones, palmarolateral y palmaromedial. La articulación carpometacarpiana mostró evaginaciones palmarodistales, medial y lateral, en dirección distal entre los correspondiente 2 y 4 huesos metacarpianos y el 3 hueso metacarpiano. La microscopía electrónica de barrido muestra dos tipos de células: células A, correspondientes a sinoviocitos macrófagos y células B, correspondientes a fibroblastos, en el revestimiento celular de la membrana sinovial de la cápsula articular.

Lesión severa de mano por proyectil de arma de fuego de alta energía con artrodesis del carpo e injerto sintético de hueso más fijadores externos: Reporte de un caso / Severe hand injury due to a high-energy gunshot projectile treated with arthrodesis of the carpus, synthetic bone graft and external fixators.: Case report

Antecedentes: La incidencia de heridas por proyectil de arma de fuego en mano de pacientes civiles se ha incrementado en los últimos años, lo cual es causa de incapacidades prolongadas o definitivas con un impacto personal, social y económico. Las lesiones severas de mano incluyen: afección del arco palmar mayor, fractura de dos o más huesos del carpo, luxaciones palmares irreductibles, fracturas articulares de radio distal y lesiones neurovasculares, los cuales requieren de múltiples procedimientos quirúrgicos para el manejo de tejidos blandos y musculoesqueléticos. Métodos: Se describe el reporte de un paciente con fractura de los huesos del carpo derecho, expuestos grados IIIB de Gustillo y Anderson por proyectil de arma de fuego, el cual fue tratado con artrodesis del carpo mediante injerto sintético, fijación externa y rotación de colgajo fasciocutáneo. Resultados: Paciente que fue sometido a tratamiento quirúrgico de la lesión del carpo consistente en fractura de todos los huesos del carpo, expuestos grados IIIB de Gustillo y Anderson por proyectil de arma de fuego quien fue sometido a tratamiento quirúrgico mediante artrodesis del carpo con injerto sintético, estabilización con fijador externo y cobertura con colgajo fasciocutáneo, obteniendo una evolución clínica mediante la escala de DASH con un score de 14.2 y Michigan Hand score de 70 puntos con un seguimiento de 12 meses. Conclusiones: El tratamiento con fijación externa más artrodesis del carpo con injerto sintético y cobertura cutánea con colgajo proporcionó un resultado funcional bueno para un paciente con lesión por proyectil de arma de fuego.

Background: The incidence of hand gunshot wounds in civil patients has increased in recent years; it causes long-term or permanent disability and has a personal, social and economic impact. Severe hand injuries include: involvement of the greater palmar arch, fracture of two or more carpal bones, irreducible palmar dislocations, articular fractures of the distal radius, and neurovascular injuries. All of these injuries require multiple surgical procedures for the management of soft and musculoskeletal tissues. Methods: We report the case of a patient with a Gustilo and Anderson grade IIIB open fracture of the right carpal bones caused by a gunshot projectile. He was treated with arthrodesis of the carpus using a synthetic graft, external fixation and rotation of a fasciocutaneous flap. Results: The patient underwent surgical treatment of the carpal injury that consisted of Gustilo and Anderson grade IIIB open fracture of all carpal bones caused by a gunshot projectile. Surgery included arthrodesis of the carpus with a synthetic graft, stabilization with an external fixator, and a fasciocutaneous graft as skin cover. The clinical course according to the DASH scale had a score of 14.2 and the Michigan Hand score was 70, with a 12-month follow-up. Conclusions: Treatment with external fixation plus arthrodesis of the carpus with a synthetic graft and skin cover using a flap provided a good functional result in a patient who sustained a gunshot wound.

Staple fixation for the treatment of hamate metacarpal joint injury / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the effcacy of the staple fixation for the treatment of hamate metacarpal joint injury.</p><p><b>METHODS</b>From May 2009 to November 2012,16 patients with hamate metacarpal joint injury were treated with staple fixation including 10 males and 6 females with an average age of 33.6 years old ranging from 21 to 57 years. Among them, 11 cases were on the fourth or fifth metacarpal base dislocation without fractures, 5 cases were the fourth or fifth metacarpal base dislocation with avulsion fractures of the back of hamatum. Regular X-ray review was used to observe the fracture healing, joint replacement and position of staple fixation. The function of carpometacarpal joint and metacarpophalangeal joint were evaluated according to ASIA (TAM) system evaluation method.</p><p><b>RESULTS</b>All incision were healed well with no infection. All patients were followed up from 16 to 24 months with an average of (10.0 +/- 2.7) months. No dislocation recurred, the position of internal fixator was good,no broken nail and screw withdrawal were occurred. Five patients with avulsion fracture of the back of hamatum achieved bone healing. The function of carpometacarpal joint and metacarpophalangeal was excellent in 10 cases,good in 5 cases, moderate in 1 case.</p><p><b>CONCLUSION</b>The application of the staple for the treatment of hamatometacarpal joint injury has the advantages of simple operation, small trauma, reliable fixation, early postoperative function exercise and other advantages, which is the ideal operation mode for hamatometacarpal joint injury.</p>

Descripción de los estadios de maduración ósea según Bjork mediante radiografía del carpo en niños y adolescentes de dos grupos de distinta ascendencia étnica / Description of the stages of bone maturation by Bjork ́s carpal radiography of children and adolescents in two groups of different ethnic ancestry

Objective: This study described the stages of bone maturation according to Bjork ́s method through carpal radiography in chil - dren aged 8-15 year-old belonging to the indigenous population Ticuna (Amazonas) and the black population of Puerto Tejada (Cauca). Materials and methods: 72 children Ticuna indigenous community, located in Leticia (Amazonas) and 80 children of African descent in the municipality Puerto Tejada (Cauca) were studied. Children tested aged 8 to 15 year-old. Children were transferred to a specialized radiology center where car - pal radiographs of both hands were taken. The height and weight measurements were obtained by using a digital scale and Conair ® brand plastic tape, which was placed on the wall. For analysis of bone maturation, was used the method of Björk. Results: It was observed that there is a significant relationship between bone deve - lopment and sex (p=0.001), ie, that women are more likely to have more advanced stages of bone maturation that men. When bony maturation stages according to ethnic groups were related, they find that people of African descent have a higher bone deve- lopment that indigenous. It was evidenced that children at older ages presented higher bone maturation stages. Conclusion: It was determined that the African descent was significantly related to bone development (p=0.005), as com- pared to children of Amerindian descent. In addition, it was determined that there is a relation between bone development and women (p=0.001) and age groups (p=0.000). In general, when comparing these two populations was found that the ancestry, age and gender are factors that affect bone development of children and should be taken into account when starting any treatment...(Au)

Objetivo: En este estudio se describen los estadios de maduración ósea según Bjork mediante radiografía del carpo en niños de 8 a 15 años pertenecientes a la población indígena Ticuna (Amazonas) y la población afrodescendiente de Puerto Tejada (Cauca). Materiales y métodos: Se estudiaron 72 niños de la comunidad indígena Ticuna, ubicada en Leticia (Amazonas) y 80 niños afrodescendientes del municipio Puerto Tejada (Cauca). Todos los niños evaluados tenían edades entre 8 a los 15 años. Los niños y niñas fueron trasladados hasta un centro radiológico especializado, donde se tomaron las radiografías carpales de las dos manos. Las medidas de talla y peso fueron obtenidas antes de la hora de almuerzo mediante el empleo de una báscula digital marca Conair® y cinta métrica plástica, la cual fue colocada en la pared. Para el análisis de la maduración ósea se utilizó el método de Björk. Resultados: Se evidenció que existe una relación significativa entre el desarrollo óseo y el sexo (p=0.001), es decir, que las mujeres presentan una mayor probabilidad de tener estadios de maduración más avan- zados que los hombres. Cuando se relacio - naron los estadios de maduración óseos en función de los grupos étnicos, se encontró que los afrodescendientes tienen a pre - sentar un desarrollo óseo más alto que los indígenas. También se pudo evidenciar que los niños con mayores edades presentaron los mayores estadios de maduración ósea. Conclusión: Se pudo corroborar que el tipo de ascendencia se relaciona significativa - mente con el desarrollo óseo (p=0.005), es decir, que los niños de ascendencia afro descendiente presentan un desarrollo ósea más avanzado que los niños de ascendencia amerindia...(Au)

Multi-ligaments reconstruction with single tendon with for the treatment of acute joint dislocation of the first carpometacarpal / 中国骨伤

<p><b>OBJECTIVE</b>To explore the clinical outcomes of multi-ligaments reconstruction with single tendon in treating acute joint dislocation of the first carpometacarpal.</p><p><b>METHODS</b>From December 2008 to October 2012, 4 patients with acute dislocation of the first carpometacarpal were treated with single carpi radialis longus tendon to reconstruct periarticular four ligaments, which included dorsal ligament, palmar ligament, dorsal radiocarpal ligament, and intermetacarpal ligament between the first and second. There were 3 males and 1 female aged from 22 to 63 years old with an average of 38.7. X-ray, JAMAR grid strength testing, range of motion of carpometacarpal joint and VAS score were used to evaluate clinical outcomes.</p><p><b>RESULTS</b>All patients were followed up from 6 to 40 months with an average of 19 months. The wound were healed well at stage I. No dislocation of the first carpometacarpal joint and signs of joints degeneration occurred on X-ray at 1, 3 and 6 months after operation. JAMAR grip strength recovered from 60 percent to 90 percent of health wide. The results of ROM showed 3 cases recovered flexion and extension of joints and 1 case limited adduction. VAS score was 0 to 1.</p><p><b>CONCLUSION</b>For acute dislocation of the first carpometacarpal joint, reconstruction four ligaments with single carpi radialis longus tendon can be considered the selected treatment,which can restores joint stability and improve joint function.</p>

Intra-Articular Injury Associated with Distal Radius Fracture / 대한정형외과학회잡지

Distal radius fractures are commonly associated with intra-articular injuries such as carpal ligament injuries and triangular fibrocartilage complex (TFCC) injuries. Such injuries occurring in elderly patients with a low-energy distal radius fracture can be treated successfully with cast immobilization and do not usually lead to clinical problems. However, despite healing of the fracture, some intra-articular injuries, especially in active patients with a high-energy fracture, can result in persistent pain and disability. In addition, the current trend of internal fixation and early use of the wrist may actually increase instability due to inadequate healing of the ligament injuries. Due to a lack of typical symptoms and physical findings in acute fracture settings, detection of these injuries is not easy. Arthroscopic examination, as well as radiographs and intraoperative fluoroscopic findings, are useful in detection of carpal ligament injuries. Complete ruptures of intercarpal interosseous ligaments warrant temporary interosseous fixation using K-wires. In TFCC injuries, distal radioulnar joint (DRUJ) instability should be assessed after anatomical reduction and fixation of a distal radius fracture. Operative treatments such as open or arthroscopic repair of TFCC to the fovea can guarantee greater stability of the DRUJ. For optimal results, early detection and appropriate treatment of intra-articular injuries associated with distal radius fractures is critical.

Histopathological and biochemical findings of congenital copper deficiency: are these similar to those of caprine arthritis-encephalitis?

This study was done after identifying animals with a twisted carpal joint in goat herd. These included a kid goat walking on its articulus carpii and a newborn goat with a stiff leg. Necropsies of the diseased goats revealed swollen carpal joints that were twisted backwards. Arthritis was observed during microscopic examination of the carpal joints. Very low levels of eosinophil, leucocyte, and lymphocyte cell infiltration were found in the central nervous system and meninges. Serum copper levels were significantly decreased in most of the animals. All of these results led us to diagnose the animals with swayback disease.

Scaphoid-capitate-hamate-triquetrum Fusion in the Advanced Kienbock's Disease

PURPOSE: To evaluate clinical and radiological results of SCHT(scapho-capito-hamato-triquetral) fusion in Lichtman stage IIIB or IV Kienbock's disease. MATERIALS AND METHODS: The result of eight cases, operated and followed since December 2002, were analyzed retrospectively. The indication of SCHT fusion was the advanced Kienbock's disease, in Lichtman stage IIIB or IV, with severe fragmentation of lunate. The fragmented lunate was excised and the intercarpal joint between scaphoid and capitate, capitate and hamate, hamate and triquetrum were fused with joint resection, bone graft and multiple K-wires, to make an horse-shoeshaped carpal bone block. The clinical results were evaluated by wrist pain, ROM, any radiologic changes of wrist at last follow-up and Kuschner's method. RESULTS: There were 3 cases of Stage IIIB and 5 cases of stage IV. Mean follow-up period was 28.9 (range 15-53) months, and mean age at the time of operation was 49.4 (range 33~66) years. Two cases were minus ulnar variance, 4 cases were positive and 2 cases were neutral. The wrist range of motion was decreased from 121.8degreesto 90.6degrees(25%). Carpal height ratio was decreased in 1 case. The last follow-up results according to Kuschner's method revealed 4 excellent, 3 good and 1 fair. CONCLUSIONS: SCHT fustion was considered as one of the favorable salvage procedure for the advanced Kienbock's disease. However, biomechanical study using cadaver, long-term follow-up & accumulation of more cases would be needed to confirm its definitive usefulness in the future.

Scapholunate dissociation: a rare presentation of TB wrist in a case of multi-focal skeletal tuberculosis.

Tuberculosis rarely involves wrist joint and is usually diagnosed in arthritic stage. Early presentations are easily confused with traumatic event and commonly missed. We describe a case presenting with scapholunate dissociation initially, which later progressed to full blown arthritis. Similar presentation has never been documented.

Studies on the normal synovial fluid from the carpal joints of Iranian water buffaloes: physical and biochemical parameters

Reports on the physical and biochemical parameters ofsynovial fluid in buffaloes are limited. This study was conducted to evaluate the normal parameters ofsynovial fluid on buffaloes that can be very helpful in diagnosis of arthropathy. Synovial fluid of carpal joints was collected by arthrocentesis of the right and left forelimbs in 21 water buffaloes immediately after slaughtering of animals in abattoir. The quality of mucin clot and viscosity were normal in 100% of animals. The synovial fluid was colorless in 50% of cases and the other 50% had a yellowish color. Only 77.5% of samples were transparent and 22.5% were semitransparent. The range of values for different measured parameters were: AST: [27.65 +/- 5.9] IU/L, ALT: [15.08 +/- 2.75] IU/L, LDH: [36.55 +/- 13.28] IU/L, glucose: [59.25 +/- 3.39] mg/dL, total protein: [0.89 +/- 0.055] g/dL, urea nitrogen: [7.96 +/- 1] mg/dL. There was no significant difference between groups according to age, sex and side [left and right forelimbs] for all parameters except ALT and LDH which differed according to sex, ALT and LDH were significantly [P<0.05] greater in females

A Clinical Study of Carpal Scaphoid Fracture and Perilunat Dislocation / 대한정형외과학회잡지

The wrist consists of a complex structure, including 8 tiny carpal bones and their adjoining soft tissue. Recently the number of injuries of carpal joint is on the increase by accident in leisure or by industrial accident. Carpal bone fracture or dislocation is often mistakably identified as a sprain, which is liable to lead its opportune time to care. So, we analyzed 39 cases to which long-term follow-up was available, among 44 cases which were treated at the department of orthopedic surgery, Yonsei University medical college. The results were as follows; l. Of all 44 cases, 42 were males, and males in 30, 40 decades numbered 32 cases, forming 73 % of all. 2. Of 29 scaphoid fractures, 22 cases were mid 1/3 fractures, and of 15 perilunate dislocation, 10 cases were dorsal transscaphoid perilunate dislocations. 3. Among 39 cases which long-term follow-up was available in the classification by Soto-Hall, 18 cases were acute, in 21 cases treatment was started beyond 2 weeks later after injury. 4. The more delayed diagnosis, the longer period needed bone union for scaphoid fracture. 5. All scaphoid fractures including transscaphoid perilunate dislocation, showed a union rate of 94.3%, and were complicated by 2 non-unions, 3 avascular necrosis, 1 osteoarthritis and one case accompanied an incomplete median nerve injury. So, initial careful evaluation is needed to good prognosis of scaphoid fracture.

Replantation of the Amputated hand: A Case Report / 대한정형외과학회잡지

Replantation of a severed limb is an elective procedure and, as such, the decision to carry it out must be assessed anew in each case. The arm is progressively more valuable from shoulder to fingers, the leg, on the contrary, is progressively of less significance. Especially, the replantation of severed hand at the level of carpal bones or wrist joint is technically more difficult than at the level of forearm or arm. We have a successful case of replanted hand at the level of intercarpal joint without bony shortening.