Prevalence, coincidence and distribution patterns of sesamoid bones of the hand / Patrones de prevalencia, coincidencia y distribución de los huesos sesamoideos de la mano

SUMMARY: The aim of this study is to identify the prevalence and distribution patterns of sesamoid bones at the metacarpophalangeal (MCP) and interphalangeal (IP) joints and to determine if there is an association between the distribution patterns and age, gender, and hand side. Patients who had a direct radiograph of the hand obtained between 2019-2020 were retrospectively evaluated. All radiographs were evaluated in terms of the prevalence, coincidence, and distribution patterns of sesamoid bones. Presence of an association between distribution patterns and age, sex and side was also assessed. A total of 1501 hand radiographs were included into the study. There were 12 different patterns of sesamoid bone distribution. The most common distribution pattern was the presence of sesamoid bone at the first MCP joint only (25.8 %). There was a positive correlation between the second and third MCP, second and fifth MCP, second and first IP, third and fourth MCP and fifth MCP and first IP joints. The pattern with a sesamoid bone at the first MCP joint only was more prevalent among males, whereas the pattern involving coincidence of sesamoid bones at the first, second, fifth MCP and first IP joints was more prevalent among females (p<0.001, p=0.031). A positive correlation was observed between age and the number of MCP joints with sesamoid bones (p<0.001). The number of MCP joints with sesamoid bones was found to be higher in females (p<0.001). This study is important in that it provided anatomical data that can be guiding for clinicians in terms of diagnosis and management of hand disorders.

RESUMEN: El objetivo de este estudio fue identificar la prevalencia y los patrones de distribución de los huesos sesamoideos en las articulaciones metacarpofalángicas (MCF) e interfalángicas (IF) y determinar si existe una asociación entre los patrones de distribución y la edad, el sexo y el lado de la mano; fueron evaluadas retrospectivamente radiografías de la mano obtenidas en 2019- 2020. Todas las radiografías se evaluaron en términos de prevalencia, coincidencia y patrones de distribución de los huesos sesamoideos. También se evaluó la presencia de una asociación entre los patrones de distribución y la edad, el sexo y el lado. Se incluyeron en el estudio un total de 1501 radiografías de mano. Se observaron 12 patrones diferentes de distribución de los huesos sesamoideos. El patrón de distribución más común fue la presencia de hueso sesamoideo solo en la primera articulación MCF (25,8 %). Hubo una correlación positiva entre la segunda y la tercera MCF, la segunda y la quinta MCP, la segunda y la primera IF, la tercera y cuarta MCF y la quinta MCF y las primeras articulaciones IF. El patrón con un hueso sesamoideo en la primera articulación MCF fue más prevalente entre los hombres, mientras que el patrón de coincidencia de los huesos sesamoideos en la primera, segunda, quinta articulación MCF y la primera articulación IF fue más prevalente entre las mujeres (p <0.001, p = 0,031). Se observó una correlación positiva entre la edad y el número de articulaciones MCF con huesos sesamoideos (p <0,001). El número de articulaciones MCF con huesos sesamoideos era mayor en las mujeres (p <0,001). Este estudio es importante debido a que proporcionó datos anatómicos que pueden ser una guía para los médicos en el diagnóstico y tratamiento de los trastornos de la mano.

Relationship between fabella and posterolateral knee pain and common peroneal nerve injury / 中国骨伤

OBJECTIVE@#To analyze the incidence and characteristics of fabella in the Chinese population and its correlation with pain in the posterolateral region of the knee joint and common peroneal nerve palsy.@*METHODS@#Total 732 patients including 405 males(450 knees) and 327 females(383 knees) who underwent unilateral or bilateral knee MR imaging from September 2015 to July 2019 were retrospectively evaluated. The basic information of all patients was extracted from the hospital's his system. The patient's medical records were checked by telephone follow-up or his system, and the number of patients with posterolateral knee pain and common peroneal nerve paralysis were recorded.@*RESULTS@#The overall prevalence of fabella was 48.38%, 23.53% in men and 24.85% in women, there was no significant difference between them (@*CONCLUSION@#The prevalence of fabella us in Chinese population is 48.38%. There is no relationship between the incidence of gastrocnemius and gender, but the incidence of fabella is positively correlated with age, pain in the posterolateral region of the knee joint and the occurrence of common peroneal nerve symptoms.

Presencia y biometría del os peroneum en individuos chilenos: estudio radiológico / Presence and biometry of os peroneum in Chilean individuals: radiological study

RESUMEN: El esqueleto está formado por 206 huesos constantes (200 huesos axiales y apendiculares más los 6 osículos del oído). Sin embargo, aparte de éstos existen otros huesos que pueden ser inconstantes, los que se denominan accesorios y sesamoideos. Basado en lo anterior, el objetivo fue identificar el os peroneum, que es uno de los huesos sesamoideos que podría estar presente en el pie humano, relacionando su presencia con el sexo, grupos etarios y dominancia, registrando también mediciones de cada hueso encontrado. Se realizó un estudio de tipo descriptivo, en donde se utilizaron radiografías de 200 pacientes, de ambos sexos, chilenos, de la IX región de La Araucanía, 50 de sexo masculino y 150 de sexo femenino, con edades entre 15 y 90 años. De los 200 pacientes estudiados, se encontraron 28 (14 %) con presencia de Os peroneum, 23 del sexo femenino y 5 de sexo masculino. En 16 (57,1 %) individuos se determinó que los huesos eran bilaterales. Los registros biométricos del hueso en estudio se muestran en tablas. Los datos obtenidos complementarán el conocimiento morfológico y médico acerca de este hueso en la población chilena, ya que el dolor en la zona lateral del pie puede ser causado por un espectro de etiologías, y con los datos obtenidos, caracterizar a nuestra población, aportando otra posible causa al dolor lateral de pie.

SUMMARY: The skeleton is made up of 206 constant bones (200 bones and the 6 ossicles of the ear). However, apart from these there are other bones that can be inconstant, which are called accessories and sesamoids. Based on the above, the objective was to identify to the Os peroneum, which is one of the sesamoid bones that could be present in the human foot, relating its presence with sex, age groups and dominance, also recording measurements of each bone found. A descriptive study was carried out, in which radiographs of 200 patients of both sexes were used, Chilean, from the IX region of La Araucanía, 50 male and 150 female, aged between 15 and 90 years. Of the 200 patients studied, 28 (14 %) were found with the presence of peroneal bone, 23 of the female sex and 5 of the male sex. In 16 (57.1 %) individuals it was determined that the bones were bilateral. The biometric records of the bone under study are shown in tables. The data obtained will complement the morphological and medical knowledge about this bone in the Chilean population, since the pain in the lateral zone of the foot can be caused by a spectrum of etiologies, and with the data obtained, characterize our population, providing another possible cause to lateral standing pain.

Presencia, localización y biometría de la fabela en individuos chilenos: estudio radiológico / Presence, location and biometry of the fabella in Chilean individuals: radiological study

RESUMEN: Entre los huesos sesamoideos del cuerpo humano, se encuentra la fabela, hueso asociado al tendón de la cabeza lateral del músculo gastrocnemio. El objetivo del presente estudio fue localizar a este hueso, ya unilateral o bilateral, en relación al género y grupos etarios, además de registrar su longitud y anchura. Se utilizó una muestra de radiografías de 200 personas, de ambos sexos, 44 de sexo masculino y 156 de sexo femenino, cuyas edades fluctuaron entre los 10 y los 90 años. Del total de casos (200 personas), la presencia de la fabela fue observada en 75 (37,5 %), de las cuales 9 (12 %) eran del sexo masculino y 66 (88 %) del femenino. Su mayor presencia se observó en las personas con edades entre los 51 y 60 años, en las cuales se presentaron en 25 casos (18 de sexo femenino) y entre los 61 y 70 años con 29 casos (27 de sexo femenino). Los datos obtenidos complementarán el conocimiento morfológico acerca de este hueso sesamoídeo en la población Chilena.

SUMMARY: Among the sesamoid bones of the human body is fabela, a bone associated with the tendon of the lateral head of the gastrocnemius muscle. The objective of the present study was to locate this bone, either unilateral or bilateral, in relation to gender and age groups, in addition to recording its length and width. A sample of radiographs of 200 people, of both sexes, 44 male and 156 female, whose ages ranged from 10 to 90 years were used. Of the total cases (200 people), the presence of fabela was observed in 75 (37.5%), of which 9 (12%) were male and 66 (88%) female. Their greatest presence was observed in people aged between 51 and 60 years, in which they occurred in 25 cases (18 females) and between 61 and 70 years with 29 cases (27 females). The data obtained will complement the morphological knowledge about this sesamoid bone in the Chilean population.

Luxación de la articulación interfalángica proximal del hallux con interposición de un hueso sesamoideo: una revisión bibliográfica / Dislocation of the proximal hallux interphalangeal joint with interposition of a sesamoid bone: a blibliographic review

Resumen: La luxación irreductible de la articulación interfalángica del hallux es una patología poco frecuente y hay pocos casos descritos. Se presenta como una luxación dorsal con interposición del sesamoideo; éste puede ser radiológicamente indetectable. Reportamos el caso de un paciente de 29 años que tras un traumatismo deportivo presentó una luxación interfalángica del hallux que pasó desapercibida hasta el octavo día. Al igual que en varios casos descritos en la literatura, no se pudo realizar una reducción cerrada, por lo que se procedió a una reducción abierta por una incisión dorsal. Una revisión bibliográfica revela que existen varias opciones terapéuticas, al igual que múltiples tipos de abordajes, y que estas lesiones generalmente presentan un buen pronóstico.

Abstract: The irreducible dislocation of the hallux interphalangeal joint is an infrequent condition and only a few cases have been described. It presents as dorsal dislocation with interposition of the sesamoid bone, which has the possibility of being radiologically undetectable. We present the case of a 29 year-old patient who, after a sports trauma sustained a hallux interphalangeal dislocation that went unnoticed for eight days. Since, closed reduction was not possible, as occurred in several cases reported in the literature, open reduction was performed through a dorsal incision. Based on a bibliographic review, it is possible to state that there are several treatment options and multiple approaches, and that these lesions usually have a good prognosis.

Fabella Syndrome: A Rare Cause of Common Peroneal Nerve Palsy / 대한정형외과학회잡지

The fabella has been considered to have a minor clinical significance. However, there have been a few reports describing the fabella as one of the causes of peroneal nerve palsy (PNP). This report describes a 66-year-old farmer who complained of acute neurologic symptoms involving the fabella. Surgical extirpation was performed and neurologic function was recovered dramatically. Recently, there have been no published reports on fabella syndrome with common PNP. Here, we report an unusual case of common PNP with the fabella as a cause.

Two unreported cartilagines sesamoidea in the elbow of the dog / Dos cartílagos sesamoideos no reportados en el codo del perro

Two unreported sesamoid cartilages were found inside tendon of insertion of both muscle biceps brachii and muscle brachialis in the dog. This find adds remarkable facts envolving Anatomy, Comparative Anatomy and Clinic and Biomechanics of the elbow joint in the dog. Statistics also emphasize the importance of traumatological incidences on elbow joint in veterinary.

Dos cartílagos sesamoideos no reportados se encontraron en el interior del tendón de inserción de los músculos bíceps braquial (M. Biceps brachii) y Braquial (M. Brachialis) en el perro. Este hallazgo se suma a importantes hechos que comprometen la Anatomía, Anatomía Comparada, Clínica y Biomecánica de la articulación del codo en el perro. Además, la casuística veterinaria también hace hincapié en importantes incidencias traumatológicas en dicha articulación.

Effect of Radial Extracorporeal Shock Wave Therapy in Patients With Fabella Syndrome

The fabella is a small sesamoid bone generally located in the tendon of the lateral head of the gastrocnemius behind the lateral condyle of the femur. Fabella syndrome is the occurrence of posterolateral knee pain associated with the fabella. It is a rare cause of knee pain that is often misdiagnosed. Fabella syndrome can be managed with conservative or surgical treatment. We applied radial extracorporeal shock wave therapy as a new treatment strategy for fabella syndrome and achieved a successful outcome.

Painful Osteochondroma of the Hallucal Sesamoid: A Case Report / 대한족부족관절학회지

Osteochondroma is one of the most common bone tumors. It can occur anywhere, although it is most frequent mainly around the metaphysis of long bones. Prediction sites are distal femur, proximal humerus, proximal tibia, and so on. However, osteochondroma in sesamoid is very rare. Herein, we report a case of a 56-year-old woman with symptomatic extra-articular osteochondroma in hallucal sesamoid with a brief literature review.

Estudio histoquímico de la distribución de las fibras de colágeno en hueso sesamoídeo distal de equinos con y sin síndrome navicular / Histochemical study of the distribution of collagen fibers on distal sesamoid bone in equine with and without navicular syndrome

La significancia funcional de cualquier relación que exista entre la orientación de las fibras de colágeno y la tensión ejercida sobre una estructura ósea dependerá de la influencia de estos parámetros microestructurales sobre las propiedades biomecánicas del hueso y su capacidad de adaptarse. Se estudió la localización del colágeno en el hueso sesamoídeo distal (HSD) de la mano en equinos con Síndrome Navicular para observar cómo este refleja las demandas biomecánicas ejercidas por la tensión que ejerce el tendón del músculo flexor digital profundo sobre la articulación interfalángica distal. Se utilizaron las tinciones hematoxilina-eosina-azul alcián, y Rojo Picrosirius de Junqueira. La birrefringencia de colágeno óseo fue determinada utilizando microscopía de luz polarizada. La remodelación del HSD resultó en la formación de osteonas secundarias transversales orientados en una dirección lateral a medial y el colágeno óseo se orientó de manera similar. Estos resultados proporcionan evidencia de la existencia de una relación entre la función mecánica de un hueso con su arquitectura, incluso demuestra que esta se extiende hasta el nivel molecular.

The functional significance of any relationship exists between the orientation of the collagen fibers and the strain on a bone structure depend on the influence of these microstructural parameters on the biomechanical properties of bone and its ability to adapt. Localization of collagen was studied in the distal sesamoid bone (DSB) in in equine foot with Navicular Syndrome to see how this reflects the biomechanical demands by the tension exerted by the tendon of the deep digital flexor muscle on the joint distal interphalangeal. Hematoxylin-eosin-alcian blue staining, and Red Picrosirius of Junqueira were used. The birefringence of bone collagen was determined using polarized light microscopy. The remodeling of DSB resulted in the formation of transverse secondary osteons oriented lateral to medial and bone collagen was oriented in similar direction. These results provide evidence for the existence of a relationship between the mechanical function of a bone with the architecture, and shows further that this extends up to the molecular level.

Skeletal maturation in individuals with Down's syndrome: Comparison between PGS curve, cervical vertebrae and bones of the hand and wrist

INTRODUCTION: This study was conducted with the aim of adapting the methods developed by Martins and Sakima to assess skeletal maturation by cervical vertebrae in the pubertal growth spurt (PGS) curve. It also aimed to test the reliability and agreement between those methods and the method of hand and wrist radiograph when compared two by two and all together. METHODS: The sample comprised 72 radiographs, with 36 lateral radiographs of the head and 36 hand-wrist radiographs of 36 subjects with Down's syndrome (DS), 13 female and 23 male, aged between 8 years and 6 months and 18 years and 7 months, with an average age of 13 years and 10 months. RESULTS AND CONCLUSIONS: Results revealed that adapting the methods developed by Martins and Sakima to assess skeletal maturation by cervical vertebrae in the curve of PGS is practical and useful in determining the stage of growth and development of individuals. The stages of maturation evaluated by cervical vertebrae and ossification centers observed in radiographs of the hand and wrist were considered reliable, with excellent level of agreement between the methods by Hassel and Farman as well as Baccetti, Franchi and McNamara Jr and Martins and Sakima. Additionally, results revealed an agreement that ranged between reasonable to good for the three methods used to assess the skeletal maturation, showing statistical significance. .

INTRODUÇÃO: esse estudo foi realizado com o propósito de adaptar os métodos para avaliação da maturação óssea por meio das vértebras cervicais na curva do Surto de Crescimento Puberal (SCP)de Martins e Sakima, assim como testar a confiabilidade e a concordância existente entre eles e o método para a radiografia de mão e punho, quando comparados 2 a 2, e entre todos, conjuntamente. MÉTODOS: a amostra constou de 72 radiografias, sendo 36 telerradiografias em norma lateral da cabeça e 36 radiografias de mão e punho, de 36 indivíduos com Síndrome de Down (SD), sendo 13 do sexo feminino e 23 do masculino, na faixa etária entre oito anos e seis meses até 18 anos e sete meses, com média de 13 anos e dez meses. CONCLUSÃO: de acordo com os resultados obtidos, concluímos que as adaptações dos métodos para a avaliação da maturação óssea por meio das vértebras cervicais na curva de SPC de Martins e Sakima resultaram em uma ferramenta prática e útil na determinação do estágio de crescimento e desenvolvimento dos indivíduos. Os estágios de maturação avaliados por meio das vértebras cervicais e os centros de ossificação observados nas radiografias de mão e punho foram considerados confiáveis, com excelente grau de concordância entre os métodos de diversos outros autores, e uma concordância de razoável a boa entre os três métodos para avaliação da maturação óssea quando comparados conjuntamente, sendo estatisticamente significativa. .

Huesos sesamoideos en la mano humana / Sesamoid bones in the human hand

Los huesos sesamoideos se desarrollan en el espesor de ciertos tendones o de la cápsula fibrosa que envuelve ciertas articulaciones. La prevalencia y distribución de los huesos sesamoideos en la mano es variable entre diferentes grupos poblacionales y étnicos. Basados en esta premisa realizamos un estudio para determinar su presencia en las diferentes articulaciones metacarpo-falángicas (AMF) de dos grupos de individuos. Analizamos 34 radiografías de manos de adultos, chilenos, de ambos sexos, así como 19 radiografías pertenecientes a manos de niños y adolescentes. También se estudiaron 41 radiografías de manos de adultos, Brasileños, de ambos sexos, así como 16 radiografías de niños y adolescentes. En cada observación consideramos el número de huesos sesamoideos y su localización. En el grupo de individuos chilenos se observó la presencia de dos huesos sesamoideos, radial y ulnar, localizados a nivel de la AMF del pulgar en 94,1% de los casos; 44,1% tenían un hueso sesamoideo a nivel de la parte radial de la AMF del dedo indicador. A nivel de la AMF del dedo mínimo, se observó un hueso sesamoideo en 11,8%. Del análisis de 19 radiografías de manos de niños y adolescentes, se visualizó 42% con huesos sesamoideos a nivel de la AMF del pulgar. En el grupo de individuos brasileños, se observó que todas las manos tenían huesos sesamoideos a nivel de la AMF del pulgar; 90,2% tenían dos huesos. En 17,1% se encontró un hueso sesamoideo a nivel de la parte ulnar de la articulación interfalángica del pulgar. En 26,8% se observó un hueso sesamoideo en la parte radial de la AMF del indicador y en el mismo porcentaje a nivel de la parte radial de la AMF del dedo mínimo. De las 16 radiografías de manos de niños y jóvenes brasileños, ninguna de ellas presentó tales huesos. Los datos aportados dejan en evidencia las diferencias que existen entre grupos poblacionales y étnicos.

Sesamoid bones develop in certain tendons or thickness of the fibrous capsule which surrounds certain joints. The prevalence and distribution of sesamoid bones in the hand is variable among different populations and ethnic groups. Based on this premise we conducted a study to determine its presence in different metacarpophalangeal joints (MPJ) of two groups of individuals. We analyzed 34 radiographs of adult hands, Chileans, of both sexes, and 19 radiographs belonging to the hands of children and adolescents. Radiographs of 41 hands of adult Brazilians people, of both sexes, as well as radiographs of 16 children and adolescents were also studied. In each observation we consider the number of sesamoid bones and their location. In the group of Chilean individuals, we observed the presence of two sesamoid bones, located at the level of MPJ thumb in 94.1% of cases; 44.1% had one sesamoid bone in the radial side of MPJ of the index finger. At the level of the MPJ of the little finger, one sesamoid bone was observed in 11.8%. An analysis of 19 radiographs of the hands of children and adolescents, in 42% of the cases we found sesamoid bones at MPJ of the thumb. In the group of Brazilian individuals, we observed that all hands had sesamoid bones at the level of MPJ of the thumb; 90.2% had two bones. In 17.1% one sesamoid bone at the ulnar side of the interphalangeal joint of the thumb was found. In 26.8% one sesamoid bone in the radial part of the MPJ of the index finger and the same percentage in the radial side of the MPJ of the little finger was observed. We not observed such bones in the radiographs of the hands of children and young Brazilians. The data provided are evidence of differences between populations and ethnic groups.

Morfometría, planimetría y estereología en el hueso sesamoídeo distal en manos de equinos con y sin síndrome navicular / Morphometry, planimetry and stereology in the distal sesamoid bone in equine foot with and without navicular syndrome

El Síndrome Navicular (SN) es una patología claudicógena bilateral crónica, degenerativa y progresiva, que compromete alhueso sesamoídeo distal (HSD), labolsa podotroclear, ligamentosy a las superficies adyacentes al tendón del músculo flexor digitalprofundo en manos de equinos. La hipótesis de que las características morfológicas del HSD en la mano de equinos varían en aquellos que presentan SN fue evaluada en este estudio. Para determinar cambios morfológicos en el HSD en manos de equinos con SN se realizó un estudio morfométrico, planimétrico y estereológico. Fueron evaluados dos grupos: No Afectadas (n=11) y Síndrome Navicular (n=11). Se evaluaron variables tales como peso, volumen, mediciones lineales, área y parámetros estereológicos tales como densidad de número (NA), volumen (VV) y superficie (SV). Los resultados obtenidos indican que a pesar de existir un proceso patológico e inflamatorio en la región del HSD que induce cambios mesoscópicos y microscópicos atribuibles a SN, no lograrían modificar sus características macroscópicas.

Navicular Syndrome (NS) is a chronic, degenerative and progressive bilateral claudication pathology, compromising the distal sesamoid bone (DSB), the podotrochlear bursa, ligaments and adjacent surfaces of the tendon of the deep digital flexor muscle of equine foot. The hypothesis that morphological characteristics of HSB in hand of horses vary in those with SN was evaluated in this study. A study was carried out to determine the morphological changes in the DSB in 22 left foot of horses with NS. We realized morphometrical, planimetrical and stereological studies in two groups of horses feet: Not Affected (n=11) and Navicular Syndrome (n=11). The following variables were quantified: weight, volume, linear measurements, area and stereological parameters: densities of number (NA), volume (VV) and surface (SV). Results indicate that although there is a pathological and inflammatory process in the region of DSB which induces mesoscopic and microscopic changes attributable to SN, their gross morphological features were not modified.

The gem in gastrocnemius: the fabella -Anatomical and radiological perspective.

Background: Sesamoid bones are small seed like bones which can be found in the hand, knee, and foot. Their unique structure works to protect the tendon, and to increase its mechanical effect. Examples of sesamoid bones include the os acromiale, os styloideum, metacarpal and hallux sesamoids, patella, os trigonum, os calcaneus secundarius, accessory navicular, os peroneum, and os intermetatarseum. The Sesamoid bones are so named because they resemble a sesame seed. WE present a brief description about Fabella , a small Sesamoid bone occasionally found in the lateral head of Gastrocnemius muscle, its surgical and medicl importance. Presence of Fabella can be confused with certain Orthopedic Problems.

Symptomatic Hallucal Interphalangeal Sesamoid Bones Successfully Treated with Ultrasound-guided Injection: A Case Report

The hallucal interphalangeal sesamoid bone is usually asymptomatic, but it is not uncommon for it to be symptomatic in cases of undue pressure, overuse, or trauma. Even in symptomatic cases, however, patients often suffer for extended periods due to misdiagnosis, resulting in depression and anxiety that can steadily worsen to the extent that symptoms are sometimes mistaken for a somatoform disorder. Dynamic ultrasound-guided evaluations can be an effective means of detecting symptomatic sesamoid bones, and a simple injection of a small dose of local anesthetics mixed with steroids is an easily performed and effective treatment option in cases, for example, of tenosynovitis.

Intractable Plantar Keratoses due to Interphalangeal Sesamoid Bone of the Hallux (A Case Report) / 대한족부족관절학회지

A sesamoid bone can occasionally be found under the interphalangeal joint of the hallux. These had anatomical variants and usually remain asymptomatic, it is uncommon for symptomatic cases of painful plantar keratoses or irreducible dislocation of interphalangeal joint of the hallux with incarcerated sesamoid. While the latter has a few cases, the former has not reported in Korea. We experienced a rare case of intractable plantar keratoses due to interphalangeal sesamoid bone of the hallux which may reqire excision.

Prevalence and distribution of sesamoid bones of the hand: a radiographic study in Turkish subjects / Prevalencia y distribución de los huesos sesamoideos de la mano; un estudio radiográfico en sujetos turcos

The purpose of this study was to examine the plain anteroposterior radiographs of the hands in Turkish subjects in order to determine the prevalence of sesamoid bones and their distribution. A total of 923 hand radiographs from 459 men and 464 women with a mean age of 43.76±14.8 years (range, 18-85 years) were examined. Two sesamoid bones (ulnar and radial) were always present at the metacarpophalangeal (MCP) joint of the thumb (100 percent). One sesamoid bone in the thumb interphalangeal (IP) joint was observed in 21.3 percent of the cases. The prevalence of sesamoid bone of the index and little MCP joint were 36.6 percent and 53.2 percent respectively. Sesamoid bones palmar to the MCP joints of the middle finger and ring finger were rare; the incidence for these locations being 1.3 percent (12 hands) and 0.9 percent (8 hands), respectively. There were no significant differences between left and right hand digits. The distribution of sesamoid bones in different locations between male and female subjects were statistically similar in 1st IP joint (p=0.530), 4th MCP (p=0.631), 5th MCP (p=0.067) joints. However, the sesamoid bones in 2nd MCP and 3rd MCP joints were statistically more frequent in female subjects (p=0.024 and p=0.018 respectively). The present study represents the first report on the prevalence and distribution of sesamoid bones in the hand in Turkish subjects. The prevalence of sesamoid bones in Turkish population is considerably different from the Africans and Europeans, but rather resembles Mediterranean and Arab populations...

El objetivo de este estudio fue examinar radiografías anteroposteriores de manos en sujetos turcos para determinar la prevalencia y distribución de los huesos sesamoideos. Fueron examinadas 923 radiografías de mano, 459 hombres y 464 mujeres, con edad media de 43,76 ± 14,8 años (rango, 18-85 años). Dos huesos sesamoideos (ulnar y radial) estuvieron siempre presentes en la articulación metacarpofalángica (MCF) del primer dedo de la mano (100 por ciento). Un solo hueso sesamoideo en la articulación interfalángica (IP) del primer dedo de la mano se observó en el 21,3 por ciento de los casos. La prevalencia del hueso sesamoideo, índice y articulación MCP fueron fue de 36,6 por ciento y 53,2 por ciento respectivamente. Los huesos sesamoideos palmares a las articulaciones metacarpofalángica del dedo medio y dedo anular eran poco frecuentes, su incidencia fue 1,3 por ciento (12 manos) y 0,9 por ciento (8 manos), respectivamente. No hubo diferencias significativas entre los dígitos izquierdos o derechos. La distribución de los huesos sesamoideos en diferentes lugares entre los sujetos de ambos sexos fueron estadísticamente similares entre las articulaciones primera interfalángica (p = 0,530), cuarta MCP (p = 0,631) y quinta MCP (p = 0,067). Sin embargo, los huesos sesamoideos en las articulaciones segunda MCP y tercera MCP fueron estadísticamente más frecuentes en el sexo femenino (p = 0,024 y p = 0,018, respectivamente). El presente estudio representa el primer informe sobre la prevalencia y distribución de los huesos sesamoideos en la mano en sujetos turcos. La prevalencia de los huesos sesamoideos en la población turca es considerablemente diferente de los africanos y los europeos, pero se asemeja a las poblaciones mediterráneas y árabes...

Morphological analyisis of the fabella in Brazilians / Análisis morfológico de la fabela en brasileños

Among the present`s sesamoids in the human body, the fabella can be found in the posterior part of the knee in low incidence. This report is quite controverted in the classic anatomical literature as well as its constitution. Its fixation is on the tendon of the gastrocnemius lateralis, close to its origin, in the posterior part of condilus femuralis lateralis. However, when its occurs, generally induces in the knee the absence of arcuate ligament with the presence of fabellofibular ligament. The prevalence is larger in male individuals. Few studies discuss the histology of the fabella. Some authors suggest that the fabella basically formed by bone tissue and others describe it as a fibrocartilaginous. The aim of this study is to analyze the incidence of the fabella, its histological structure and its association with presence or absence of fabellofibular ligaments through macro and microscopic study. Sixty-two Brazilian´s knees were dissected and the fabella was found in two diferent specimens. The tissue had been removed and fixed in 4 percent formaldehyde for microscopic evaluation. The fabella is a sesamoid bone that appears on knee in a small frequency in Brazilians. Its presence provokes absence of the arcuate ligament and the presence of the fabellofibular ligament. The histological study demonstrated bone tissues on its constitution without osteoclasts.

Entre los huesos sesamoideos que están presentes en el cuerpo humano, la fabela puede encontrarse en la cara posterior de la rodilla. Los reportes de su incidencia son bastante controvertidos en la literatura anatómica clásica, como también su constitución. Hay autores que mencionan a la fabela como tejido óseo, mientras otros la describen como una estructura fibrocartilaginosa. El sitio anatómico de ubicación es el tendón del gastrocnemio lateral, próximo de su origen, en la cara posterior del condilo femoral lateral. La prevalencia es más grande en individuos del sexo masculino. En presencia de este, se observa en rodilla la ausencia del ligamento poplíteo arqueado y la aparición del ligamento fabelo-fibular. Hay pocos trabajos que discuten la anatomía del compartimiento póstero-lateral de la rodilla con la Fabela, así como su constitución. Este trabajo tiene el propósito de analizar la incidencia de la fabela, su estructura histológica, asociándola con la presencia u ausencia de los ligamientos popliteo arqueado y fabelo-fibular a través del estudio macro y microscópico. Fueron disecados sesenta y cuatro cadáveres, sin causa mortis definida. Después fueron disecados. La fabela cuando estuvo presente fue retirada y fijada en formaldehido al 4 por ciento para su evaluación microscópica. De las sesenta y dos rodillas estudiadas dos presentaron fabela. La primera tuvo 1,6 cm de diámetro, ligeramente cóncava en su cara en contacto con cóndilo femoral lateral, bordes poco irregulares. La segunda tuvo 1,3 cm de diámetro con las mismas características estructurales. La fabela és un hueso sesamoideo que surge en la rodilla con baja frecuencia. Su aparición se acompañó de la ausencia del ligamento poplíteo-oblicuo y la presencia del ligamento fabelo-fibular. El estudio histológico determinó tejido óseo en su constitución sin osteoclastos.

Incomplete Reduction that Influence Reduction of Sesamoid as a Cause for Recurrence of Hallux Valgus / 대한족부족관절학회지

PURPOSE: The incomplete reduction of the sesamoid has lately been issued as cause for recurrence. In this study, we analysed factors that may influence reduction of sesamoid. MATERIALS AND METHODS: The study consists of 50 cases operated by single surgeon. Eighteen cases were done by proximal chevron osteotomy, and 32 cases were done by scarf osteotomy. Hallux valgus (HV) angle and intermetatarsal (IM) angle were measured before and three months after the surgery. Sesamoid position (SP) was classified according to Hardy and Clapham grade system. RESULTS: After the proximal chevron osteotomy, the correction of the mean HV angle was 19.5degrees, and IM angle was 6.2degrees. SP was changed from 5.6 to 3.4 grade. After the Scarf osteotomy, the correction of the mean HV angle was 25 degree, and IM angle was 9degrees. SP was changed from 5.5 to 2.8 grade. There was difference of sesamoid's correction between two different method of surgery (p=0.127). However, better correction of sesamoid was witnessed with bigger correction angle regardless of method of surgery (p=0.002, 0.001). CONCLUSION: We believe surgical method do not effect sesamoid's correction but more correction angle can result in better correction of sesamoid position.

Incomplete Reduction that Influence Reduction of Sesamoid as a Cause for Recurrence of Hallux Valgus / 대한족부족관절학회지

PURPOSE: The incomplete reduction of the sesamoid has lately been issued as cause for recurrence. In this study, we analysed factors that may influence reduction of sesamoid. MATERIALS AND METHODS: The study consists of 50 cases operated by single surgeon. Eighteen cases were done by proximal chevron osteotomy, and 32 cases were done by scarf osteotomy. Hallux valgus (HV) angle and intermetatarsal (IM) angle were measured before and three months after the surgery. Sesamoid position (SP) was classified according to Hardy and Clapham grade system. RESULTS: After the proximal chevron osteotomy, the correction of the mean HV angle was 19.5degrees, and IM angle was 6.2degrees. SP was changed from 5.6 to 3.4 grade. After the Scarf osteotomy, the correction of the mean HV angle was 25 degree, and IM angle was 9degrees. SP was changed from 5.5 to 2.8 grade. There was difference of sesamoid's correction between two different method of surgery (p=0.127). However, better correction of sesamoid was witnessed with bigger correction angle regardless of method of surgery (p=0.002, 0.001). CONCLUSION: We believe surgical method do not effect sesamoid's correction but more correction angle can result in better correction of sesamoid position.