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BACKGROUND: With the increasing number of joint replacement surgeries, periprosthetic joint infection (PJI) has become a significant concern in orthopedic practice, making research on PJI prevention paramount. Therefore, the study will aim to compare the effect of combined usage of povidone-iodine and topical vancomycin powder to the use of povidone-iodine alone on the PJI incidence rate in patients undergoing primary total hip (THA) and total knee arthroplasty (TKA). METHODS: The prospective randomized clinical trial will be conducted in two independent voivodeship hospitals with extensive experience in lower limb arthroplasties. The studied material will comprise 840 patients referred to hospitals for primary THA or TKA. The patients will be randomly allocated to two equal groups, receiving two different interventions during joint replacement. In group I, povidone-iodine irrigation and consecutively topical vancomycin powder will be used before wound closure. In group II, only povidone-iodine lavage irrigation will be used before wound closure. The primary outcome will be the incidence rate of PJI based on the number of patients with PJI occurrence within 90 days after arthroplasty. The occurrence will be determined using a combined approach, including reviewing hospital records for readmissions and follow-up phone interviews with patients. The infection will be diagnosed based on Musculoskeletal Infection Society criteria. The chi-square test will be used to compare the infection rates between the two studied groups. Risk and odds ratios for the between-groups comparison purposes will also be estimated. Medical cost analysis will also be performed. DISCUSSION: A randomized clinical trial comparing the effect of combined usage of povidone-iodine irrigation and vancomycin powder to the use of povidone-iodine irrigation alone in preventing PJIs after primary arthroplasty is crucial to advancing knowledge in orthopedic surgery, improving patient outcomes, and guiding evidence-based clinical practices. TRIAL REGISTRATION: ClinicalTrials.gov NCT05972603 . Registered on 2 August 2023.
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Administração Tópica , Antibacterianos , Anti-Infecciosos Locais , Artroplastia de Quadril , Artroplastia do Joelho , Povidona-Iodo , Infecções Relacionadas à Prótese , Ensaios Clínicos Controlados Aleatórios como Assunto , Irrigação Terapêutica , Vancomicina , Humanos , Antibacterianos/administração & dosagem , Antibacterianos/efeitos adversos , Anti-Infecciosos Locais/administração & dosagem , Artroplastia de Quadril/efeitos adversos , Artroplastia do Joelho/efeitos adversos , Incidência , Estudos Multicêntricos como Assunto , Povidona-Iodo/administração & dosagem , Pós , Estudos Prospectivos , Infecções Relacionadas à Prótese/prevenção & controle , Infecções Relacionadas à Prótese/epidemiologia , Irrigação Terapêutica/métodos , Resultado do Tratamento , Vancomicina/administração & dosagemRESUMO
The aim of the present study was to examine the growth dynamics of the two ossification centers of the body of sphenoid bone in the human fetus, based on their linear, planar and volumetric parameters. The examinations were carried out on 37 human fetuses of both sexes aged 18-30 weeks of gestation, which had been preserved in 10% neutral formalin solution. Using CT, digital image analysis software, 3D reconstruction and statistical methods, we evaluated the size of the presphenoid and postsphenoid ossification centers. The presphenoid ossification center grew proportionately in sagittal diameter, projection surface area and volume, and logarithmically in transverse diameter. The postsphenoid ossification center increased logarithmically in sagittal diameter, transverse diameter and projection surface area, while its volumetric growth followed proportionately. The numerical findings of the presphenoid and postsphenoid ossification centers may be considered age-specific reference values of potential relevance in monitoring the normal fetal growth and screening for congenital disorders in the fetus. The obtained results may contribute to a better understanding of the growing fetal skeleton, bringing new numerical information regarding its diagnosis and development.
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Feto , Osteogênese , Osso Esfenoide , Humanos , Osso Esfenoide/diagnóstico por imagem , Osso Esfenoide/embriologia , Osso Esfenoide/crescimento & desenvolvimento , Feminino , Osteogênese/fisiologia , Masculino , Feto/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Desenvolvimento Fetal/fisiologia , Imageamento Tridimensional , Idade GestacionalRESUMO
The present article concentrates on an innovative analysis that was performed to assess the development of the femur in human fetuses using artificial intelligence. As a prerequisite, linear dimensions, cross-sectional surface areas and volumes of the femoral shaft primary ossification center in 47 human fetuses aged 17-30 weeks, originating from spontaneous miscarriages and preterm deliveries, were evaluated with the use of advanced imaging techniques such as computed tomography and digital image analysis. In order to ensure the data representativeness and to avoid introducing any hidden structures that may exist in the data, the entire dataset was randomized and separated into three subsets: training (50% of cases), testing (25% of cases), and validation (25% of cases). Based on the collected numerical data, an artificial neural network was devised, trained, and subject to testing in order to synchronously estimate five parameters of the femoral shaft primary ossification center, thus leveraging fundamental information such as gestational age and femur length. The findings reveal the formulated multi-layer perceptron model denoted as MLP 2-3-2-5 to exhibit robust predictive efficacy, as evidenced by the linear correlation coefficient between actual values and network outputs: R = 0.955 for the training dataset, R = 0.942 for validation, and R = 0.953 for the testing dataset. The authors have cogently demonstrated that the use of an artificial neural network to assess the growing femur in the human fetus may be a valuable tool in prenatal tests, enabling medical doctors to quickly and precisely assess the development of the fetal femur and detect potential anatomical abnormalities.
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Inteligência Artificial , Desenvolvimento Fetal , Gravidez , Recém-Nascido , Feminino , Humanos , Estudos Transversais , Feto/diagnóstico por imagem , Fêmur/diagnóstico por imagem , Redes Neurais de ComputaçãoRESUMO
Introduction Age-specific reference intervals for the extensor digiti minimi muscle (EDMM) in the human fetus may be relevant in the detailed evaluation of the musculoskeletal systems with potential relevant aspects for surgical treatment. The aim of the study was to examine the age-specific reference intervals and growth dynamics of the EDMM in relation to its length, width, projection surface area and volume. Material and methods The examined material included 70 human formalin-fixed fetuses of both sexes (37â, 33â) aged from 17 to 29 weeks. With the use of anatomical dissection every EDMM was visualized, recorded in a form of JPG formats and analyzed by the digital image analysis system and statistical methods. Results No variability of the EDMM was found. All the morphometric parameters of the EDMM revealed neither sex nor laterality differences. With fetal age most linear parameters of the EDMM concerning its examined lengths and widths increased in accordance with natural logarithmic functions. The only two exceptions to this referred to the belly width of EDMM measured at its mid-length and the tendon width of EDMM measured proximal to the extensor retinaculum of wrist, which both followed square root functions. The projection surface areas of the EDMM followed natural logarithmic functions, while the volumetric growth of the EDMM was proportionate to fetal age. Conclusions The variability of the EDMM in the human fetus is minimal. The morphometric data of the EDMM represents age-specific reference intervals of clinical significance. Morphometric parameters of the EDMM reveal neither sex nor laterality differences. The EDMM displays three different growth dynamics: from gradual growth deceleration according to both natural logarithmic functions (total length of the muscle and its tendons, belly length, tendon lengths, belly width at its origin, tendon width at its insertion, and projection surface areas) and square root functions (belly width at its mid-length and tendon width in the pre-retinacular segment) to a proportionate growth (total volume).
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The popliteal fossa presents an extensive diamond-shaped topographical element on the posterior aspect of the knee. With the use of classical anatomical dissection, digital image analysis of NIS Elements AR 3.0 and statistics we morphometrically analyzed the size of the popliteal fossa in human fetuses aged 17-29 weeks of gestation. Morphometric parameters of the popliteal fossa increased logarithmically with fetal age: y = -44.421 + 24.301 × ln (Age) for length of superomedial boundary, y = -41.379 + 22.777 × ln (Age) for length of superolateral boundary, y = -39.019 + 20.981 × ln (Age) for inferomedial boundary, y = -37.547 + 20.319 × ln (Age), for length of inferolateral boundary, y = -28.915 + 15.822 × ln (Age) for transverse diameter, y = -69.790 + 38.73 × ln (Age) for vertical diameter and y = -485.631 + 240.844 × ln (Age) for projection surface area. Out of the four angles of the popliteal fossa the medial one was greatest, the inferior one the smallest, while the lateral one was somewhat smaller than the medial one and approximately three times greater than the superior one, with no difference with fetal age. In terms of morphometric parameters the popliteal fossa in the human fetus displays neither male-female nor right-left differences. In the popliteal fossa, growth patterns of its four boundaries, vertical and transverse diameters, and projection surface area all follow natural logarithmic functions. All the morphometric data is considered age-specific reference intervals, which may be conducive in the diagnostics of congenital abnormalities in the human fetus.
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Detailed numerical data about the development of primary ossification centers in human fetuses may influence both better evaluation and early detection of skeletal dysplasias, which are associated with delayed development and mineralization of ossification centers. To the best of our knowledge, this is the first report in the medical literature to morphometrically analyze the primary ossification center of the squamous part of temporal bone in human fetuses based on computed tomography imaging. The present study offers a precise quantitative foundation for ossification of the squamous part of temporal bone that may contribute to enhanced prenatal care and improved outcomes for fetuses with inherited cranial defects and skeletodysplasias. The examinations were carried out on 37 human fetuses of both sexes (16 males and 21 females) aged 18-30 weeks of gestation, which had been preserved in 10% neutral formalin solution. Using CT, digital image analysis software, 3D reconstruction and statistical methods, the size of the primary ossification center of the squamous part of temporal bone was evaluated. With neither sex nor laterality differences, the best-fit growth patterns for the primary ossification center of the squamous part of temporal bone was modelled by the linear function: y = -0.7270 + 0.7682 × age ± 1.256 for its vertical diameter, and the four-degree polynomial functions: y = 5.434 + 0.000019 × (age)4 ± 1.617 for its sagittal diameter, y = -4.086 + 0.00029 × (age)4 ± 2.230 for its projection surface area and y = -25.213 + 0.0004 × (age)4 ± 3.563 for its volume. The CT-based numerical data and growth patterns of the primary ossification center of the squamous part of temporal bone may serve as age-specific normative intervals of relevance for gynecologists, obstetricians, pediatricians and radiologists during screening ultrasound scans of fetuses. Our findings for the growing primary ossification center of the squamous part of temporal bone may be conducive in daily clinical practice, while ultrasonically monitoring normal fetal growth and screening for inherited cranial faults and skeletodysplasias.
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Carcinoma de Células Escamosas , Desenvolvimento Fetal , Masculino , Feminino , Humanos , Gravidez , Idade Gestacional , Osteogênese , Feto/diagnóstico por imagem , Feto/anatomia & histologia , Osso Temporal/diagnóstico por imagemRESUMO
Dislocations of the sacroiliac joint (SIJ) are treated with iliosacral screws or anterior plating. The study aimed to investigate the course of the lumbosacral trunk with reference to SIJ and determine whether is there sufficient space for two screws through the sacrum while performing anterior plating. Sixty patients, who underwent an MRI of the lumbar spine were included in our study. The three transverse LT-SIJ distances were measured at the three points (A, B, and C). We also analyzed 60 CT pelvic scans at points A, B, and C in order to measure: the vertebral canal-to-SIJ distance, the sacrum's pelvic-to-dorsal surface sagittal distance, and the median plane-to-SIJ angle. The mean transverse LT-SIJ distances at points A, B, and C were 20.0 ± 3.05 mm, 17.9 ± 3.20 mm, and 12.3 ± 2.49 mm, respectively. Based on CT analyses, the vertebral canal-to-SIJ distances were 30.5 ± 7.65 mm at point A, 21.4 ± 5.05 mm at point B and 15.7 ± 6.05 mm at point C. The sacrum's pelvic-to-dorsal surface sagittal distances reached values: 35.1 ± 11.62 mm at point A, 52.5 ± 10.58 mm at point B, and 57.5 ± 7.79 mm at point C. The median plane-to-SIJ angles measured 31.4 ± 4.82 degrees at point A, 26.6 ± 3.77 degrees at point B and 21.3 ± 3.25 mm at point C. Proximally, the safe zone for applying an anterior plate of SIJ is 20.0 mm. Since both the safe zone and safe corridor taper distally, surgeons may securely use one screw of gradually increased length towards the distal direction of SIJ, with inclination of 30 degrees in relation to the median plane of the lesser pelvis.
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Pelve , Articulação Sacroilíaca , Humanos , Articulação Sacroilíaca/diagnóstico por imagem , Articulação Sacroilíaca/cirurgia , Pelve/diagnóstico por imagem , Sacro/diagnóstico por imagem , Sacro/cirurgia , Tomografia Computadorizada por Raios X , Parafusos ÓsseosRESUMO
CT-based quantitative analysis of any ossification center in the cranium has not previously been carried out due to the limited availability of human fetal material. Detailed morphometric data on the development of ossification centers in the human fetus may be useful in the early detection of congenital defects. Ossification disorders in the cranium are associated with either a delayed development of ossification centers or their mineralization. These aberrations may result in the formation of accessory skull bones that differ in shape and size, and the incidence of which may be misdiagnosed as, e.g., skull fractures. The study material comprised 37 human fetuses of both sexes (16â, 21â) aged 18-30 weeks. Using CT, digital image analysis software, 3D reconstruction and statistical methods, the linear, planar and spatial dimensions of the occipital squama ossification center were measured. The morphometric characteristics of the fused ossification center of the occipital squama show no right-left differences. In relation to gestational age, the ossification center of the occipital squama grows linearly in its right and left vertical diameters, logarithmically in its transverse diameters of both the interparietal and supraoccipital parts and projection surface area, and according to a quadratic function in its volume. The obtained numerical findings of the occipital squama ossification center may be considered age-specific references of relevance in both the estimation of gestational age and the diagnostic process of congenital defects.
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Desenvolvimento Fetal/fisiologia , Feto/diagnóstico por imagem , Osso Occipital/diagnóstico por imagem , Osteogênese/fisiologia , Feminino , Idade Gestacional , Humanos , Masculino , Tomografia Computadorizada por Raios XRESUMO
PURPOSES: Detailed morphometric data on the development of ossification centers in human fetuses is useful in the early detection of skeletal dysplasias associated with a delayed development of ossification centers and their mineralization. Quantitative analysis of primary ossification centers of cranial bones is sporadic due to limited availability of fetal material. MATERIAL AND METHODS: The size of the primary ossification center of the frontal squama in 37 human (16 males and 21 females) spontaneously aborted human fetuses aged 18-30 weeks was studied by means of CT, digital-image analysis and statistics. RESULTS: With neither sex nor laterality differences, the best-fit growth dynamics for the primary ossification center of the frontal squama was modelled by the following functions: y = 13.756 + 0.021 × (age)2 ± 0.024 for its vertical diameter, y = 0.956 + 0.956 × age ± 0.823 for its transverse diameter, y = 38.285 + 0.889 × (age)2 ± 0.034 for its projection surface area, and y = 90.020 + 1.375 × (age)2 ± 11.441 for its volume. CONCLUSIONS: Our findings for the primary ossification center of the frontal squama may be conducive in monitoring normal fetal growth and screening for inherited faults and anomalies of the skull in human fetuses.
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Feto Abortado/embriologia , Desenvolvimento Fetal , Osso Frontal/embriologia , Osteogênese/fisiologia , Aborto Espontâneo , Feminino , Osso Frontal/diagnóstico por imagem , Idade Gestacional , Humanos , Masculino , Tomografia Computadorizada por Raios XRESUMO
This study aimed to examine age-specific reference intervals and growth dynamics of the best fit for liver dimensions on the diaphragmatic surface of the fetal liver. The research material consisted of 69 human fetuses of both sexes (32â, 37â) aged 18-30 weeks. Using methods of anatomical dissection, digital image analysis and statistics, a total of 10 measurements and 2 calculations were performed. No statistical significant differences between sexes were found (p>0.05). The parameters studied displayed growth models that followed natural logarithmic functions. The mean value of the transverse-to-vertical diameter ratio of the liver throughout the analyzed period was 0.71±0.11. The isthmic ratio decreased significantly from 0.81±0.12 in the 18-19th week to 0.62±0.06 in the 26-27th week, and then increased to 0.68±0.11 in the 28-30th week of fetal life (p<0.01). The morphometric parameters of the diaphragmatic surface of the liver present age-specific reference data. No sex differences are found. The transverse-to-vertical diameter ratio supports a proportionate growth of the fetal liver. Quantitative anatomy of the growing liver may be of relevance in both the ultrasound monitoring of the fetal development and the early detection of liver anomalies.
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Diafragma/crescimento & desenvolvimento , Desenvolvimento Fetal/fisiologia , Fígado/crescimento & desenvolvimento , Pesos e Medidas Corporais , Diafragma/diagnóstico por imagem , Feminino , Feto/diagnóstico por imagem , Idade Gestacional , Humanos , Lactente , Fígado/diagnóstico por imagem , Masculino , Tomografia Computadorizada por Raios XRESUMO
PURPOSE: The medical literature still lacks studies on the size of the radial shaft primary ossification center, thus preventing us from potentially relevant data in diagnosing skeletal dysplasias, i.e., TAR syndrome, VATER syndrome, Holt-Oram syndrome, Fanconi anemia and Edwards syndrome, frequently characterized by disrupted or retarded fetal growth. MATERIALS AND METHODS: The size of the radial shaft primary ossification center in 47 (25 males and 22 females) spontaneously aborted human fetuses aged 17-30 weeks was studied by means of CT, digital image analysis and statistics. RESULTS: With neither sex nor laterality differences, the best-fit growth dynamics for the radial shaft primary ossification center was modeled by the following functions: y = - 10.988 + 1.565 × age ± 0.018 for its length, y = - 2.969 + 0.266 × age ± 0.01 for its proximal transverse diameter, y = - 0.702 + 0.109 × age ± 0.018 for its middle transverse diameter, y = - 2.358 + 0.203 × age ± 0.018 for its distal transverse diameter, y = -189.992 + 11.788 × (age)2 ± 0.018 for its projection surface area, and y = - 798.174 + 51.152 × age ± 0.018 for its volume. CONCLUSIONS: The morphometric characteristics of the radial shaft primary ossification center show neither sex nor bilateral differences. The radial shaft primary ossification center grows proportionately in length, transverse dimensions and volume, and quadratically in its projection surface area. The obtained numerical findings of the radial shaft ossification center are considered age-specific reference of relevance in both the estimation of fetal ages and the diagnostic process of congenital defects.
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Desenvolvimento Fetal , Modelos Biológicos , Osteogênese , Rádio (Anatomia)/embriologia , Feto Abortado/diagnóstico por imagem , Aborto Espontâneo , Determinação da Idade pelo Esqueleto , Anormalidades Congênitas/diagnóstico por imagem , Feminino , Idade Gestacional , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Gravidez , Rádio (Anatomia)/diagnóstico por imagem , Fatores Sexuais , Fatores de Tempo , Tomografia Computadorizada por Raios XRESUMO
PURPOSES: Skeletodysplasiae and hereditary dysostoses constitute a group of over 350 disorders of the skeletal system. Knowledge about development of the pubic primary ossification center may be useful in both determining the fetal stage and maturity, and for detecting congenital disorders. The present study was performed to quantitatively examine the pubic primary ossification center with respect to its linear, planar, and volumetric parameters. MATERIALS AND METHODS: Using methods of computed tomography (CT), digital-image analysis and statistics, the size of the pubic primary ossification center in 33 spontaneously aborted human fetuses (18 males and 15 females) aged 22-30 weeks was studied. RESULTS: With no sex and laterality differences, the best-fit growth dynamics for the pubic primary ossification center was modeled by the following functions: y = - 13.694 + 0.728 × age ± 0.356 for its sagittal diameter, y = - 3.350 + 0.218 × age ± 0.159 for its vertical diameter, y = - 61.415 + 2.828 × age ± 1.519 for its projection surface area, and y = - 65.801 + 3.173 × age ± 2.149 for its volume. CONCLUSIONS: The size of the pubic primary ossification center shows neither sex nor laterality differences. The growth dynamics of the vertical and sagittal diameters, projection surface area, and volume of the pubic ossification centers follow proportionately to fetal age. The obtained numerical findings of the pubic ossification center are considered age-specific reference data with clinical implications in the diagnostics of congenital defects.
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Feto Abortado/diagnóstico por imagem , Desenvolvimento Fetal/fisiologia , Osteogênese/fisiologia , Osso Púbico/diagnóstico por imagem , Doenças do Desenvolvimento Ósseo/diagnóstico por imagem , Feminino , Idade Gestacional , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Gravidez , Segundo Trimestre da Gravidez/fisiologia , Terceiro Trimestre da Gravidez/fisiologia , Osso Púbico/fisiologia , Fatores Sexuais , Tomografia Computadorizada por Raios XRESUMO
PURPOSES: Details concerning the normal growth of the pelvic girdle in the fetus are of importance in the early detection of congenital defects. This study was executed to quantitatively evaluate the primary ossification center of the ischium with relation to its linear, planar and volumetric parameters. MATERIALS AND METHODS: Using methods of CT, digital-image analysis, and statistics, geometrical dimensions of the ischium's primary ossification center in 42 spontaneously aborted human fetuses (21 â and 21 â) aged 18-30 weeks were calculated. RESULTS: With no sex and laterality differences, the best fit growth dynamics for the ischium's primary ossification center were displayed by the following functions: y = - 10.045 + 0.742 × age ± 0.013 (R2 = 0.97) for its vertical diameter, y = - 5.212 + 0.385 × age ± 0.008 (R2 = 0.97) for its sagittal diameter, y = - 36.401 + 0.122 × (age)2 ± 45.534 (R2 = 0.96) for its projection surface area, and y = - 1052.840 + 368.470 × ln(age) ± 12.705 (R2 = 0.91) for its volume. CONCLUSIONS: Neither male-female nor right-left differences are found for any of the morphometric parameters of the ischium's primary ossification center. With relation to fetal ages in weeks, the ischium's primary ossification center grows proportionately in vertical and sagittal diameters, second-degree polynomially in projection surface area, and logarithmically in volume. The quantitative findings of the ischium's primary ossification center are considered age-specific reference data of relevance in the diagnostics of innate defects.
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Ísquio/diagnóstico por imagem , Ísquio/embriologia , Osteogênese/fisiologia , Tomografia Computadorizada por Raios X/métodos , Cadáver , Feminino , Desenvolvimento Fetal , Idade Gestacional , Humanos , MasculinoRESUMO
PURPOSES: Precise morphometric data on the development of ossification centers in human fetuses may be useful in the early detection of skeletal dysplasias associated with delayed ossification center development and mineralization. The present study was performed to quantitatively examine the primary ossification center of the fibular shaft with respect to its linear, planar and volumetric parameters. MATERIALS AND METHODS: Using methods of CT, digital-image analysis (Osirix 3.9 MD) and statistics (Student's t-test, Shapiro-Wilk, Fisher's test, Tukey's test, Kruskal-Wallis test, regression analysis), the size of the primary ossification center of the fibular shaft in 47 spontaneously aborted human fetuses (25 â and 22 â) aged 17-30 weeks was studied. In each fetus, the assessment of linear dimensions (length, transverse diameters for: proximal end, middle part and distal end), projection surface area and volume of the fibular shaft ossification center was carried out. RESULTS: With no sex and laterality differences, the best fit growth dynamics for the primary ossification center of the fibular shaft was modelled by the following functions: y = - 13.241 + 1.567 × age ± 1.556 (R2 = 0.94) for its length, y = - 0.091 + 0.063 × age ± 0.073 (R2 = 0.92) for its proximal transverse diameter, y = - 1.201 + 0.717 × ln(age) ± 0.054 (R2 = 0.83) for its middle transverse diameter, y = - 2.956 + 1.532 × ln(age) ± 0.090 (R2 = 0.89) for its distal transverse diameter, y = - 69.038 + 4.699 × age ± 4.055 (R2 = 0.95) for its projection surface area, and y = - 126.374 + 9.462 × age ± 8.845 (R2 = 0.94) for its volume. CONCLUSIONS: The ossification center in the fibular shaft follows linear functions with respect to its length, proximal transverse diameter, projection surface area and volume, and natural logarithmic functions with respect to its middle and distal transverse diameters. The obtained morphometric data of the fibular shaft ossification center is considered normative for their respective prenatal weeks and may be of relevance in both the estimation of fetal age and the ultrasound diagnostics of congenital defects.
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Fíbula/embriologia , Osteogênese/fisiologia , Cadáver , Feminino , Desenvolvimento Fetal , Fíbula/crescimento & desenvolvimento , Idade Gestacional , Humanos , Imageamento Tridimensional , Masculino , Tomografia Computadorizada por Raios XRESUMO
PURPOSES: Tibial shaft ossification in terms of its size and growth may be criticalin describing both the fetal stage and maturity, and in identifying innate disorders. The present study was executed to quantitatively assess ossification of the tibial shaft, taking its morphometric linear, planar and volumetric parameters into account. MATERIALS AND METHODS: With the use of methods of CT, digital-image analysis and statistics, the evolutionof tibial shaft ossification in 47 spontaneously aborted human fetuses at the age of 17-30 weeks was studied. RESULTS: Without any male-female and right-left morphometric differences, the best fit growth dynamics fortibial shaft ossification was modelled by the following functions: y = 5.312 + 0.034 × (age)2 ± 0.001 (R2 = 0.89) for its length, y = - 2.855 + 0.307 × age ± 0.009 (R2 = 0.96) for its proximal transverse diameter, y = - 0.758 + 0.153 × age ± 0.005 (R2 = 0.88) for its middle transverse diameter, y = - 1.844 + 0.272 × age ± 0.09 (R2 = 0.90) for its distal transverse diameter, y = - 40.263 + 0.258 × (age)2 ± 0.007 (R2 = 0.94) for its projection surface area, and y = - 287.996 + 1.186 × (age)2 ± 0.037 (R2 = 0.92) for its volume. The femoral-to-tibial ossification length ratio was 1.15 ± 0.1. CONCLUSIONS: The size of tibial shaft ossification displays neither sex nor laterality differences. Tibial shaft ossification follows quadratic functions with respect to its length, projection surface area and volume, and linear functions with respect to its proximal, middle and distal transverse diameters. The obtained morphometric data of tibial shaft ossification are considered normative age-specific references of relevance in both the estimation of fetal ages and the ultrasound diagnostics of congenital defects.
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Desenvolvimento Fetal/fisiologia , Osteogênese/fisiologia , Tíbia/diagnóstico por imagem , Tíbia/embriologia , Cadáver , Estatura Cabeça-Cóccix , Feminino , Idade Gestacional , Humanos , Masculino , Gravidez , Tomografia Computadorizada por Raios XRESUMO
PURPOSE: There has been little information in the medical literature regarding the growing ulna in the human fetus, though such knowledge appears to be potentially useful in diagnosing skeletal dysplasias, characterized by a disrupted or completely halted growth of the fetus. Therefore, longitudinal measurements of long bones are extremely conducive in assessing both pregnancy and fetal anatomy. MATERIALS AND METHODS: Using methods of CT, digital-image analysis and statistics, the size of the ulna's shaft primary ossification center in 48 (26 males and 22 females) spontaneously aborted human fetuses aged 17-30 weeks was studied. RESULTS: With no sex differences, the best fit growth dynamics for the ulna's shaft primary ossification center was modeled by the following functions: y = - 8.476 + 1.561 × age ± 0.019 for its length, y = - 2.961 + 0.278 × age ± 0.016 for its proximal transverse diameter, y = - 0.587 + 0.107 × age ± 0.027 for its middle transverse diameter, y = - 2.865 + 0.226 × age ± 0.295 for its distal transverse diameter, y = - 50.758 + 0.251 × (age)2 ± 0.016 for its projection surface area, and y = - 821.707 + 52.578 × age ± 0.018 ± 102.944 for its volume. CONCLUSIONS: The morphometric characteristics of the ulna's shaft primary ossification center show neither sex nor bilateral differences. The ulna's shaft primary ossification center grows linearly with respect to its length, transverse dimensions and volume, and follows a quadratic function with respect to its projection surface area. The obtained morphometric data of the ulna's shaft primary ossification center is considered normative for respective prenatal weeks and may be of relevance in both the estimation of fetal ages and the diagnostic process of congenital defects.
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Feto/embriologia , Osteogênese/fisiologia , Tomografia Computadorizada por Raios X/métodos , Ulna/embriologia , Cadáver , Feminino , Desenvolvimento Fetal , Humanos , Masculino , GravidezRESUMO
PURPOSE: An understanding of the development of the ilium's primary ossification center may be useful in both determining the fetal stage and maturity, and for detecting congenital disorders. This study was performed to quantitatively examine the ilium's primary ossification center with respect to its linear, planar and volumetric parameters. MATERIALS AND METHODS: Using methods of CT, digital-image analysis and statistics, the size of the ilium's primary ossification center in 42 spontaneously aborted human fetuses of crown-rump length (CRL) ranged from 130 to 265 mm (aged 18-30 weeks) was studied. RESULTS: With no sex and laterality differences, the best fit growth dynamics for the ilium's primary ossification center was modelled by the following functions: y = - 63.138 + 33.413 × ln(CRL) ± 1.609 for its vertical diameter, y = - 59.220 + 31.353 × ln(CRL) ± 1.736 for its transverse diameter, y = - 105.681 + 1.137 × CRL ± 16.035 for its projection surface area, and y = 478.588 + 4.035 × CRL ± 14.332 for its volume. The shape of the ilium's primary ossification center did not change over the study period, because its transverse -to- vertical diameter ratio was stable at the level of 0.94 ± 0.07. Conclusions The size of the ilium's primary ossification center displays neither sex nor laterality differences. The ilium's primary ossification center grows logarithmically with respect to its vertical and transverse diameters, and linearly with respect to its projection surface area and volume. The shape of the ilium's primary ossification center does not change throughout the examined period. The obtained quantitative data of the ilium's primary ossification center is considered normative for respective prenatal weeks and may contribute to the prenatal ultrasound diagnostics of congenital defects.
Assuntos
Feto Abortado/anatomia & histologia , Desenvolvimento Fetal/fisiologia , Idade Gestacional , Ílio/crescimento & desenvolvimento , Osteogênese/fisiologia , Feto Abortado/diagnóstico por imagem , Feminino , Doenças Fetais/diagnóstico por imagem , Humanos , Ílio/diagnóstico por imagem , Processamento de Imagem Assistida por Computador , Masculino , Diagnóstico Pré-Natal , Fatores Sexuais , Tomografia Computadorizada por Raios X , Ultrassonografia Pré-Natal/métodosRESUMO
BACKGROUND: The inferior lumbar triangle of Petit is bounded by the iliac crest, lateral border of the latissimus dorsi and the medial border of the external oblique. OBJECTIVES: In the present study, we aimed to quantitatively examine the base, sides, area, and interior angles of the inferior lumbar triangle in the human fetus so as to provide their growth dynamics. MATERIAL AND METHODS: Using anatomical dissection, digital image analysis (NIS-Elements AR 3.0), and statistics (Student's t-test, regression analysis), we measured the base, 2 sides, area and interior angles of Petit's triangle in 35 fetuses of both sexes (16 male, 19 female) aged 14-24 weeks. RESULTS: Neither sex nor laterality differences were found. All the parameters studied increased commensurately with age. The linear functions were computed as follows: y = -0.427 + 0.302 × age for base, y = 1.386 + 0.278 × age for medial side, y = 0.871 + 0.323 × age for lateral side, and y = -13.230 + 1.590 × age for area of the Petit triangle. CONCLUSIONS: In terms of geometry, Petit triangle reveals neither male-female nor right-left differences. An increase in both lengths and area of the inferior lumbar triangle follows proportionately. The Petit triangle is an acute one in the human fetus.
Assuntos
Feto/anatomia & histologia , Região Lombossacral/anatomia & histologia , Músculos Superficiais do Dorso/embriologia , Músculos Superficiais do Dorso/crescimento & desenvolvimento , Adolescente , Adulto , Feminino , Lateralidade Funcional , Humanos , Masculino , Análise de Regressão , Adulto JovemRESUMO
PURPOSES: The purpose of the study was to quantitatively evaluate the size of the quadratus lumborum and to precisely display its growth dynamics in the human foetus. MATERIALS AND METHODS: Using anatomical dissection, digital-image analysis (NIS Elements AR 3.0) and statistical analysis (Student's t test, regression analysis), the length, width, surface area, and cross-sectional area of the quadratus lumborum were measured, and the width-to-length ratio was calculated in 58 human foetuses of both sexes (26â, 32â) aged 16-27 weeks. RESULTS: Neither sex nor right-left significant differences were found in relation with the numerical data of the growing quadratus lumborum. The length, width, and cross-sectional area of the quadratus lumborum muscle increased logarithmically, while its surface area increased proportionately to fetal age. The following growth models were computed for the quadratus lumborum: y = -70.397 + 68.501 × ln(age) ± 1.170 for length, y = -20.435 + 8.815 × ln(age) ± 0.703 for width, y = -196.035 + 14.838 × age ± 13.745 for surface area, and y = -48.958 + 20.909 × ln(age) ± 1.100 for cross-sectional area. CONCLUSIONS: The fetal quadratus lumborum reveals neither sex nor bilateral differences. An increase in length and width of the growing quadratus lumborum follows in a commensurate fashion. The quadratus lumborum grows logarithmically with respect to its length, width, and cross-sectional area, and proportionately to age with respect to its surface area.
Assuntos
Músculos do Dorso/anatomia & histologia , Feto/anatomia & histologia , Feminino , Idade Gestacional , Humanos , Masculino , Valores de ReferênciaRESUMO
PURPOSE: Early clinical distinction of congenital defects in the femur is extremely important, as it determines the prognosis of the development of the lower limb. This study was performed to quantitatively examine the primary center of ossification in the femoral shaft with respect to its linear, planar, and volumetric parameters. MATERIALS AND METHODS: Using methods of CT, digital-image analysis, and statistics, the size of the primary ossification center of the femoral shaft in 47 spontaneously aborted human fetuses aged 17-30 weeks was studied. RESULTS: With no sex and laterality differences, the best fit growth dynamics for femoral shaft ossification center was modelled by the following functions: y = 5.717 + 0.040 × (age)2 ± 2.905 (R 2 = 0.86) for its length, y = -3.579 + 0.368 × age ± 0.529 (R 2 = 0.88) for its proximal transverse diameter, y = -1.105 + 0.187 × age ± 0.309 (R 2 = 0.84) for its middle transverse diameter, y = -2.321 + 0.323 × age ± 0.558 (R 2 = 0.83) for its distal transverse diameter, y = -50.306 + 0.308 × (age)2 ± 18.289 (R 2 = 0.90) for its projection surface area, and y = -91.458 + 0.390 × (age)3 ± 92.146 (R 2 = 0.88) for its volume. CONCLUSIONS: The size of the femoral shaft ossification center displays neither sex nor laterality differences. The ossification center in the femoral shaft follows quadratic functions with respect to its length and projection surface area, linear functions with respect to its proximal, middle, and distal transverse diameters, and a cubic function with respect to its volume. The obtained morphometric data of the femoral shaft ossification center are considered normative for respective prenatal weeks and may be of relevance in both the estimation of fetal ages and the ultrasound diagnostics of congenital defects.