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At least 217 records · Page 12Linked to original sources
PubMed1997

[Effects of bisphosphonates on the mechanical efficiency of normal and osteopenic bones].

Bone mechanical competence (stiffness, strength) at organ level is determined by mechanical quality (intrinsic stiffness) and spatial distribution (macro-architecture) of bone material in cortical tissue (in every bone) and trabecular network (in vertebral bodies). These properties are inter-related and controlled according to mechanical usage by a feed-back mechanism known as mechanostat. Therefore, the effects on bone fragility of any treatment should be evaluated concerning the way they may have affected bone material or geometric properties as well as the mechanostatical interactions between them. Standard densitometry does not provide the necessary data, but some alternative methodologies (as peripheral quantitative computed tomography, pQCT) are being developed to complement or even substitute SPA, DPA or DXA determinations. Bisphosphonate (BP) effects on bone biomechanics have been studied only in animal models. Many sources of variation of results (type of compound, dose, mode of administration, species, race, sex, age, age since menopause, type of bone, remodeling ability of the skeleton, endocrine-metabolic status, interactions with other treatments, etc.) have been reported. In general terms, BPs are beneficial concerning cortical bone strength in purely modeling species (rodents) and trabecular strength in remodeling mammals (dogs, baboons). This positive action at organ level depends on independent improvements in bone macro-architecture (mainly affected by bone modeling) and material stiffness (chiefly affected by bone composition and remodeling). On one hand, bone macro-architecture has been positively affected by BPs in normal (not in ovariectomy (OX), steroid- or disuse-induced osteopenic) animals. On the other, bone material quality has been improved in the latter but not in the former. Mechanostatic interrelationships have been differently affected according to the compound employed. Results reported by ours and other laboratories concerning the three derivatives available nowadays in Argentina were reviewed and summarized. Pamidronate improved small rodents' cortical bone strength and geometric properties at low doses but impaired mineralization, material properties and strength at toxic doses. In normal, remodeling animals it improved mechanical properties in vertebral bodies but not in long bones. It also prevented the negative impact of OX-, steroid- or disuse-induced osteopenia in rats by improving bone material properties without affecting normal mechanostatic interrelationships. Olpadronate exerted positive effects on long-bone strength at any dose in normal rats and mice by improving cross-sectional properties and preserving both mineralization and material properties. These effects were highly dependent upon bone deformability, body weight, and mechanical usage of the limb as an evidence of an anabolic interaction induced on bone modeling and mechanostatic interrelationships. This compound also prevented the OX- or disuse-induced impairment in rat cortical long-bone strength and recovered rat cortical bone when given since 3 months after OX by improving only bone material quality. No interaction with bone mechanostat was detected in these studies. Alendronate effects on bone biomechanics in normal rats and dogs were positive only in long treatments. They were highly dependent on body weight of the animals, hence a positive interaction with bone mechanostat should be hypothesized. It also prevented the negative impact of OX in rat femurs by improving cortical material quality with no effect on cross-sectional properties, i.e., exerting an anti-catabolic interaction with bone mechanostat. The effects of all the three compounds were found positive for bone health, yet their mechanisms of action varied with type of bone and subject condition. A striking dissociation between (positive) effects on bone strength and (variable) effects on bone stiffness was repeatedly observed in these studies. Also an enla

Animals↗
PubMed2001

Bone loss from the hand in women following distal forearm fracture.

Bone loss occurs after distal forearm fracture, but it is unclear if this bone loss is fully recovered. We designed a cross-sectional study to evaluate the time course of the bone loss from the hand after distal forearm fracture. We identified 40 women who had a fracture of the distal forearm within the previous 4.5 years. Their ages ranged from 42 to 81 (mean 64 years) and time since fracture 6 to 54 (mean 28 months). These were compared with 95 women (mean age 67, range 57 to 80 years) from a population-based cohort. Lumbar spine (LS) and hand bone mineral density (BMD) were measured in all subjects using a Hologic QDR 1000/W densitometer. Ultrasound of the fingers of both hands was measured in the forearm fracture group using a DBM Sonic 1200 R model. Compared to controls, LS BMD was decreased by 6.4% (p<0.001), non-fractured hand by 3.2% (p<0.001) and the fractured hand by 6.1% (p<0.001) in the forearm fracture group. The mean difference in bone density between the fractured and non-fractured hand was 0.0207 g/cm2, the average value for the non-fractured hand being 0.304 g/cm2. The decement in hand BMD was equivalent to 6.2% (p<0.0001). The difference in hand BMD between the fractured and non-fractured side was greatest when the time since fracture was short; there was no further difference in hand BMD after 2 years. Ultrasound showed a mean difference of 18.7 m/s in amplitude-dependent speed of sound (AD-SoS) with the average value being 1893 m/s. A 1.0% decrease was observed in the fractured hand AD-SoS (p<0.05). A strong relationship was observed between AD-SoS and BMD in both hands (r = 0.70, p<0.001). We conclude that distal forearm fracture results in a significant decrease in hand BMD that is partially reversible. The decrease in hand BMD is reflected in the ultrasound properties of the finger phalanx.

Absorptiometry, Photon↗
PubMed1987

Biomechanics of small bone fixation.

When the correct techniques are used, fixation with plates and screws is biomechanically the strongest fixation available for small bone (hand) fractures. With appropriate preoperative planning and surgical application, plate and screw fixation is rigid enough to withstand the stresses of early use. It is therefore a useful and reliable technique when early motion is desired after open reduction and internal fixation of small bone fractures.

Biomechanical Phenomena↗
PubMed1993

[Measurement of bone mineral density of metacarpal and phalangeal bones of the hand by dual X-ray absorptiometry].

Bone mineral density (BMD) of the metacarpal and phalangeal bones of the hand was evaluated using dual X-ray absorptiometry (DXA) in 104 healthy subjects, 35 patients with rheumatoid arthritis (RA) and 6 young male volunteers with a short arm cast. BMD was positively correlated with the bone volume of metacarpal and phalangeal bones in skeletal specimens. In healthy subjects, the mean values for BMD of metacarpals of the index and middle fingers were significantly higher than those of the ring and little fingers (p < 0.001). The BMD of the middle proximal phalanx was the highest among the proximal phalanges. The BMD of the middle phalanges was the same pattern as in the proximal phalanges. There was no significant difference in the BMD of the distal phalanges between the fingers. In 62 healthy women aged from 22 to 82 years, BMD was at its peak in the metacarpal and proximal phalangeal bones in their thirties, and in the distal phalanges in their forties. Thereafter, BMD decreased linearly with age. In contrast, age-related changes in BMD were not shown in 42 healthy men aged from 22 to 76 years. BMD of the metacarpal and phalangeal bones in RA markedly decreased with disease stage. Four-week immobilization of the hand by a short arm cast affected BMD of the metacarpal bones in 6 healthy volunteers. The mean change in BMD was -4.1% after 4 weeks of immobilization, followed by a return to the initial value in 12 weeks after removal of the plaster. We concluded that the bone mineral measurement of metacarpal and phalangeal bones could be useful for evaluation of age-related bone loss and the deterioration of bone in metabolic disorders.

Absorptiometry, Photon↗
PubMed2006

Primary internal fixation and bone grafting for open fractures of the hand.

Primary bone grafting and internal fixation is a reliable option for the treatment of segmental hand defects resulting from high-energy crush or avulsion injuries. Immediate reconstruction can be performed safely if radical debridement and adequate soft tissue coverage of bone can be achieved. When these two criteria cannot be met, staged reconstruction should be performed. The low infection rate (0%), the high union rate (92%), and the return to full, unrestricted, previous employment for all patients in the authors' series supports the use of primary bone grafting in an acute setting. This single-stage approach to fracture management also permits earlier and more aggressive hand therapy that, in turn, can lower the high functional morbidity so often associated with these injuries.

Adult↗
PubMed2000

Giant cell tumor of the bones of the hand and foot.

BACKGROUND: Giant cell tumor of the small bones of the hand and foot is suspected of having some peculiar features compared with giant cell tumor in other sites. Moreover, it could share some features with other giant cell rich lesions involving the hand and foot, and this may affect the differential diagnosis. The aim of this study was to analyze the features of lesions such as these in the files of the Rizzoli Orthopedic Institute. METHODS: The incidence of giant cell tumors of the bones of the hand and foot seen at the Rizzoli Orthopedic Institute over 50 years (1947-1997) was taken into consideration. There were 8 lesions of the hand and 21 of the foot. Clinical information and follow-up of the patients were studied and updated. Radiographs were studied and radiographic features analyzed. Histopathologic material was thoroughly reviewed and histologic features analyzed. RESULTS: Although the location of tumor was helpful information, radiographic features were not specific. Giant cell tumors of the small bones of the hand and foot showed a predominance in females, younger patients and more aggressive behavior than giant cell tumors of large bones. The authors did not observe multicentricity or pulmonary metastases. CONCLUSIONS: Because the radiographic features of giant cell tumor of the hand and foot overlap those of other giant cell rich lesions in these locations, histologic diagnosis is mandatory, although it may be difficult and require the establishment of diagnostic criteria for giant cell tumor. As this tumor tends to be more aggressive than other giant cell rich lesions, treatments of choice are aggressive curettage or resection.

Adolescent↗
PubMed1984

Giant cell tumor of the small bones of the hands and feet.

Giant cell tumor of bone uncommonly occurs in the bones of the hands and feet. Previous reports suggested that the giant cell tumors in these locations occur in younger patients, are more commonly multifocal, and are associated with a higher risk for local recurrence and pulmonary metastasis than those at the ends of the long bones. A review of our experience with 43 patients having giant cell tumors in small bones is presented. Radiologic and histologic comparison is made with aneurysmal bone cyst and giant cell reparative granuloma (giant cell lesion) of the small bones. Followup information indicates that giant cell tumors of the small bones do occur in younger patients and appear to have a greater propensity for local recurrence than those of the long bones. As the lesions may be multifocal, a patient with documented giant cell tumor of the small bones should have a skeletal survey to search for other lesions.

Adolescent↗
PubMed2005

Association between physique characteristics and hand skeletal aging status.

The aim of the present study was to evaluate the association between skeletal aging traits (obtained from evaluation of hand radiographs) and physique characteristics, including indices of obesity, skeletal size, muscular development, and the somatotypes of Heath and Carter (1967) and of Deriabin (1985). To achieve our aims, we used multiple regression analysis, and Pearson's and canonical correlation analyses. The studied population comprised 629 males and 561 females aged 18-90 years, all members of the Chuvasha (Russian Federation). The present study provides evidence for a connection between hand bone aging traits and physique characteristics. The cortical index showed a small but significant correlation with adiposity and the index of overall physique, but bone mineral density (BMD) traits were not correlated with the index of overall physique. Deriabin's set of somatotypes was significantly correlated with BMD, but could explain only 2% of its variation. Significant correlations of the hand osteoarthritis trait were observed with indices of adiposity. Also observed were statistically significant canonical correlations with both sets of somatotypes, which enabled us to predict 2-3% of hand osteoarthritis variation by a combination of somatotype components. Osseometric score evinced statistically significant correlations with most indices of physique as well as with a combination of somatotype components. These findings may prove helpful in epidemiological studies, because they show that body composition is the factor that is statistically significantly associated with skeletal aging.

Adipose Tissue↗
PubMed1982

Atelosteogenesis.

The name atelosteogenesis is proposed for a lethal chondrodysplasia characterized by deficient ossification of various bones, notably the humerus, femur, thoracic spine, and hand bones. Clinically, the patients have micromelic dwarfism with incurvated legs, club feet, often dislocation of the elbows, and, rarely, a cleft palate. The most characteristic radiographic signs are incomplete ossification of the vertebral bodies with coronal clefts of the lumbar and hypoplasia of the upper thoracic vertebral bodies, a distal hypoplasia and club shape of the humerus and the femur, and the lack of ossification of single phalanges and metacarpals in most patients. Histologically, there are clusters of chondrocytes surrounded by fibrous capsules and, more frequently, degeneration zones containing degenerated chondrocytes and copious amounts of metachromatic material in the epiphyses and the basal zone of the growth plate.

Abnormalities, Multiple↗
PubMed1977

Dentine dysplasia with sclerotic bone and skeletal anomalies inherited as an autosomal dominant trait. A new syndrome.

Patients with teeth showing all of the clinical, radiographic, and histologic features of radicular dentine dysplasia (type I) have been found to have dense sclerotic bone and skeletal anomalies of the wrists and hand bones. The association of these defects of teeth and bone was found to be transmitted as an autosomal dominant trait over four generations. Review of theliterature failed to disclose a previous description of this disorder.

Adolescent↗
PubMed2005

The cross-sectional geometry of the hand and foot bones of the hominoidea and its relationship to locomotor behavior.

Cheiridia are valuable indicators of positional behavior, as they directly contact the substrate, but systematic comparison of the structural properties of both metacarpals and metatarsals has never been carried out. Differences in locomotor behavior among the great apes (knuckle-walking vs. quadrumanous climbing) can produce biomechanical differences that may be elucidated by the parallel study of cross-sectional characteristics of metacarpals and metatarsals. The aim of this work is to study the cross-sectional geometric properties of these bones and their correlation with locomotor behavior in large-bodied hominoids. The comparisons between bending moments of metacarpals and metatarsals of the same ray furnished interesting results. Metacarpals III and especially IV of the knuckle-walking African apes were relatively stronger than those of humans and orangutans, and metatarsal V of humans was relatively stronger than those of the great apes. Interestingly, the relative robusticity of the metacarpal IV of the quadrumanous orangutan was between that of the African apes and that of humans. The main conclusions of the study are: 1) cross-sectional dimensions of metacarpals and metatarsals are influenced by locomotor modes in great apes and humans; 2) interlimb comparisons of cross-sectional properties of metacarpals and metatarsals are good indicators of locomotor modes in great apes and humans; and 3) the results of this study are in accord with those of previous analyses of plantar pressure and morphofunctional traits of the same bones, and with behavioral studies. These results provide a data base from which it will be possible to compare the morphology of the fossils in order to gain insight into the locomotor repertoires of extinct taxa.

Analysis of Variance↗