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At least 271 records · Page 15Linked to original sources
PubMed2001

Anatomical consideration of reverse-flow island flap transfers from the midpalm for finger reconstruction.

Primary soft-tissue coverage for large palmar defects of the fingers is a difficult problem for cases in which homodigital or heterodigital flaps cannot be used. The aim of this study was to explore the vascular and neural anatomy of the midpalmar area to assess the possibility of reverse island flaps from this area. In 24 cadaver hands perfused with a silicone compound, the arterial pattern of the superficial palmar arch and common palmar digital artery was examined. The cutaneous perforating arteries and nerve branches supplying the midpalmar area were dissected, and the number, location, and arterial diameter of these branches were measured. In six other specimens, the common palmar digital artery was injected to determine the skin territory supplied by the artery. The superficial palmar arch contained the three common palmar digital arteries and its terminal branch coursed along the radial margin of the index metacarpus. This terminal branch had three to six cutaneous perforators (diameter range, 0.1 to 0.5 mm) and supplied the radial aspect of the midpalmar area located over the ulnar half of the adductor pollicis muscles. The midpalmar area was divided into two regions-the proximal and distal-according to the vascular distributions. The proximal region contained dense aponeurosis and thin subcutaneous tissue, and the cutaneous perforators were rather sparse (between three and nine) and had a small diameter (0.1 to 0.3 mm). The distal region, which had loose aponeurosis and abundant subcutaneous tissue, had a rich vascular supply from the common and proper digital artery. Perforating arteries of this region coursed frequently in an oblique fashion and the number of perforators (between eight and 15) and their arterial diameters (diameter range, 0.1 to 0.5 mm) were higher than those of the proximal region. The area of skin perfused by the common palmar digital artery was 5 x 3 cm at the distal midpalmar region. There were three to five cutaneous nerve branches from the palmar digital nerve supplying the midpalmar area. From this study, two different reverse flaps were proposed. First, a 5 x 2 cm flap from the distal midpalmar region was elevated on the basis of the common and proper palmar digital artery. Measurement of the rotation arc revealed that the pivot point of this flap was located at the proximal interphalangeal joint level and could cover the finger pulp of the digits. The second flap candidate was that from the radial aspect of the midpalm, which was supplied by the terminal branch of the superficial palmar arch. In studies with cadaver hands, connection of this artery with the deep arterial system enabled this flap to reach the thumb pulp. These flaps may be a useful reconstruction option for significant palmar soft-tissue loss of the fingers.

Adult↗
PubMed2002

Rehabilitation process and functional results of patients with amputated fingers.

Digit amputation is a physical and psychological trauma that can influence the daily living of a person. The rehabilitation of patients with digit amputation is a complex process and should take into consideration all influencing factors, such as the functional, emotional, social, and professional profile of the patient. This study was conducted to evaluate the functional level of patients with amputated fingers and to understand the factors that influence their rehabilitation. Fifty patients (42 male and 8 female with an age ranging from 7 to 84 years) who had digit amputation(s) between January of 1990 and December of 1998 at the level of the metacarpus or distal to it and who had at least 6 months of follow-up were examined. The patients were divided into three different study groups: patients with distal amputation were compared with patients who had proximal amputation, patients with one finger amputation were compared with patients who had multiple finger amputations, and patients who suffered finger amputations caused by work-related accidents were compared with those who suffered amputations caused by other incidents. In addition, the time lapse from the amputation was checked as an influencing factor for different functional levels. The results showed that patients with distal amputation reached a higher motor and sensory functional level than patients with proximal amputation. Patients with one-finger amputation reached higher motor, sensory, and activities of daily living functional levels than patients with multiple amputations, and the level of motor and sensory function of patients with finger amputations caused by work-related accidents was lower than that of patients who suffered amputations in other incidents. Time was proven to be an important factor in the process of motor and emotional recovery.

Accidents, Occupational↗
PubMed2006

Near East mtDNA haplotype variants in Roman cattle from Augusta Raurica, Switzerland, and in the Swiss Evolène breed.

Typical Near East mitochondrial haplotypes of the T2 lineage were found in one cattle metacarpus sample from the Roman period and in two present-day Evolène cattle in Switzerland. Sequences from eight additional Evolène and four Raetian Grey aligned to the European haplotype T3. Analysis of nucleotide diversity within the mitochondrial D-loop of both studied Swiss cattle breeds revealed high haplotype diversity and similar diversity to a European cattle reference group. Mitochondrial T3 haplotypes radiated star-like from two similarly frequent haplotypes, possibly indicating two different expansion routes. The breed structure of Evolène cattle can be explained either by an introduction of diverse female lineages from the domestication centre or by later admixture. The introduction of the Near East lineage to Switzerland must have happened during the Roman time or earlier.

Animals↗
PubMed1992

Hereditary peromelia in Mohair goats.

The occurrence of a new congenital defect of the appendicular skeleton in Mohair goats is described. The malformation is peromelia and occurs in a familiar pattern. The defect seems to have an autosomal recessive mode of inheritance with variation in the expressivity of the genotype. The pathological abnormalities were described in 8 cases, all characterized by agenesia of the phalanges and parts of the metacarpus or metatarsus affecting one or more limbs. In some cases additional skeletal defects were found. Furthermore, 5 cases were reported by the owners with a description of the limb affected and 1 case was examined clinically. Predisposition for pelvic limbs to be affected was observed. The defect, which does not seem to have been described in goats previously, is phenotypically similar to and possibly also genetically homologous to a defect described in sheep.

Animals↗
PubMed2004

Evaluation of a new oscillometric blood pressure monitor in isoflurane-anesthetized dogs.

OBJECTIVE: This study was conducted to evaluate the performance of a new veterinary oscillometric noninvasive blood pressure (NIBP) monitor in anesthetized dogs. STUDY DESIGN: Assessment was made to determine how closely indirect measurements were associated with direct measurements, and if there were statistically significant differences between the measurements by site. ANIMALS: Six mongrel dogs weighing 27.8 +/- 2.9 kg. METHODS: Dogs were anesthetized with thiopental and maintained with isoflurane, which was delivered with controlled ventilation. Direct pressure measurements were obtained via a percutaneously placed arterial catheter. A range of systolic arterial pressures (SAP) were achieved by changing the isoflurane concentrations. Sites of cuff placement for indirect measurements were identified as metacarpus, metatarsus, and anterior tibial. RESULTS: At pressures below 80 mm Hg, indirect systolic measurements averaged 4 +/- 3 mm Hg, higher than the direct values. At normal and high levels, indirect systolic measurements underestimated direct values by 18 +/- 6 and 23 +/- 6 mm Hg, respectively. Diastolic and mean pressure measurements followed the same trend, with indirect values being lower than the direct arterial pressures. Systolic, diastolic and mean arterial pressure measurements differed by cuff-placement site. CONCLUSIONS: When analyzed by site and level, indirect systolic and mean arterial blood pressures during hypotension were essentially the same as direct pressures. However, at pressures within the normal or high range, indirect measurements underestimated the direct pressures. CLINICAL RELEVANCE: Noninvasive blood pressure measurements with a new oscillometric monitor provided an excellent means of detecting arterial hypotension in anesthetized dogs. The metatarsal site for cuff placement was slightly better than the metacarpal or anterior tibial site, considering that the regression line was closest to complete equality between the indirect and direct measurements for SAP.

Anesthesia↗
PubMed2005

Effect of medetomidine and its antagonism with atipamezole on stress-related hormones, metabolites, physiologic responses, sedation, and mechanical threshold in goats.

OBJECTIVE: To evaluate the effects of medetomidine and its antagonism with atipamezole in goats. STUDY DESIGN: Prospective randomized crossover study with 1 week between treatments. ANIMALS: Six healthy 3-year-old neutered goats (three male and three female) weighing 39.1-90.9 kg (60.0 +/- 18 kg, mean +/- SD). METHODS: Goats were given medetomidine (20 microg kg(-1), IV) followed, 25 minutes later, by either atipamezole (100 microg kg(-1), IV) or saline. Heart and respiratory rate, rectal temperature, indirect blood pressure, and mechanical threshold were measured, and sedation and posture were scored and blood samples obtained to measure epinephrine, norepinephrine, free fatty acids, glucose, and cortisol concentrations at baseline (immediately before medetomidine), 5 and 25 minutes after medetomidine administration, and at 5, 30, 60, and 120 minutes after the administration of antagonist or saline. Parametric and nonparametric tests were used to evaluate data; p < 0.05 was considered significant. RESULTS: Medetomidine decreased body temperature, heart rate, and respiratory rate and increased mean arterial blood pressure, cortisol, and glucose. Recumbency occurred 89 +/- 50 seconds after medetomidine administration. All goats were standing 86 +/- 24 seconds after atipamezole administration whereas all goats administered saline were sedate and recumbent at 2 hours. Tolerance to compression of the withers and metacarpus increased with medetomidine. From 5 to 120 minutes after saline or atipamezole administration, there were differences in body temperature, glucose, and cortisol but none in heart rate or blood pressure. Three of the six goats receiving saline developed bloat; five of six urinated. After atipamezole, four of six goats developed piloerection and all goats were agitated and vocalized. CONCLUSION: At the doses used, atipamezole antagonized the effects of medetomidine on recumbency, sedation, mechanical threshold, and the increase in glucose. Atipamezole increased the rate of return of cortisol toward baseline, and prevented further decline in rectal body temperature. CLINICAL RELEVANCE: Atipamezole may be used to antagonize some, but not all effects of medetomidine.

Adrenergic alpha-Agonists↗
PubMedDate not supplied

Stress protection afforded by a cast on plate fixation of the distal forelimb in the horse in vitro.

Six forelimb specimens from three adult horses had the fetlock joint fused by application of a dorsal plate and by a screw placed in lag fashion through the metacarpus to each proximal sesamoid bone. Five specimens were instrumented on the central dorsal surface of the plate with a single rosette strain gage, and the plate of the sixth specimen was instrumented with four longitudinally oriented single-axis strain gages. The specimens were loaded axially in compression to 4,000 N in a cast (test 1), in a cast with a heel block (test 2), and uncast (test 3). The principal angle of strain in all specimens, in all tests, closely approximated the vertical axis at loads < 1,000 N. The principal angle in uncast specimens was significantly different at loads > 1,000 N than the cast specimens (P < .05). At loads > 3,000 N, the principal angle in test 3 closely approximated the horizontal axis, indicating a change from tension to compression on the dorsal surface of the plate, whereas the principal angle of the cast specimens was unchanged. Specimens in a cast (tests 1 and 2) suffered less surface deformation than did uncast specimens (test 3). Therefore, the cast changed the direction and extent of bending at the point of fixation, and thereby decreased the deformation of the plate. This effect would lead to greater fatigue life of the implant in the cast specimens compared with the uncast specimens.

Animals↗
PubMedDate not supplied

Effect of focused and radial extracorporeal shock wave therapy on equine bone microdamage.

OBJECTIVES: To determine whether bone microcracks are altered after application of focused and radial extracorporeal shock wave therapy (ESWT) to the equine distal limb. STUDY DESIGN: An ex vivo experimental model. SAMPLE POPULATION: A contralateral limb specimen was obtained from 11 Thoroughbred racehorses with a unilateral catastrophic injury. Distal limb specimens were also obtained from 5 non-racing horses. METHODS: Three separate skin-covered bone segments were obtained from the mid-diaphysis of the metacarpus (MC3) or metatarsus (MT3). Focused (9,000 shockwaves, 0.15 mJ/mm2, 4 Hz) and radial (9,000 shockwaves, 0.175 mJ/mm2, 4 Hz) ESWT treatments were randomized to the proximal and distal segments and the middle segment was used as a treatment control for pre-existing microcracks. After treatment, bone specimens were bulk-stained with basic fuchsin and microcracks were quantified in transverse calcified bone sections. RESULTS: ESWT had small but significant effects on microcracks. Microcrack density (Cr.Dn) and microcrack surface density (Cr.S.Dn) were increased after focused ESWT, whereas Cr.Le was increased after radial ESWT. In racing Thoroughbreds, Cr.Le increased with increased number of races undertaken. Cr.Dn and Cr.S.Dn were not significantly influenced by the number of races undertaken. CONCLUSION: ESWT has small but significant effects on bone microcracking ex vivo. CLINICAL RELEVANCE: These preliminary data suggest that ESWT has the potential to increase bone microcracking in equine distal limb bone in vivo. Such effects may be more pronounced in Thoroughbreds that are actively being raced, because in vivo microcracking increases with increased number of races undertaken.

Animals↗
PubMedDate not supplied

Spatial and temporal expression of types I and II receptors for transforming growth factor beta in normal equine skin and dermal wounds.

OBJECTIVE: To describe immunolocalization of TGF-beta receptors (RI and RII) in normal equine skin and in thoracic or limb wounds, healing normally or with exuberant granulation tissue (EGT). STUDY DESIGN: Group A: six wounds on one metacarpus and one midthoracic area. Group B: six wounds on both metacarpi, one of which was bandaged to stimulate EGT. Immunohistochemistry was used to detect RI and RII expression in wound margins. ANIMALS: Eight horses, randomly assigned to one of two study groups. METHODS: Neutralizing polyclonal anti-rabbit RI and RII antibodies were used to detect spatial expression of RI and RII in biopsies obtained before wounding, at 12 and 24 hours, and 5, 10 and 14 days after wounding. RESULTS: RI and RII were co-localized in both unwounded and wounded skin. There were no differences in cell types staining positively between tissues obtained from the limb and the thorax, or from normally healing limb wounds and limb wounds with EGT, at any time. Because of increased cellularity within EGT, staining intensity of limb wounds with 'proud flesh' was greater than limb wounds healing normally, and thoracic wounds, during the proliferative phase of repair. CONCLUSIONS: Strong expression of RI and RII, particularly in limb wounds with EGT, suggested that signalling for stimulation of matrix proteins is in place to contribute to scarring. CLINICAL RELEVANCE: This information may help determine the appropriate time for using receptor antagonists to prevent scarring of limb wounds of horses.

Animals↗
PubMedDate not supplied

Effects of extracorporeal shock wave therapy on bone.

Extracorporeal shock waves have been used for 30 years to fragment uroliths for nonsurgical treatment for urolithiasis in humans. Applied to bone, shock waves delivered at the appropriate energy and pulse number, can stimulate osteogenesis. In Europe, shock waves are routinely used to treat nonunions in humans despite poor understanding of the mechanism of action. Shock wave therapy has also been used clinically in horses. Preliminary experimental studies indicate that shock wave therapy does not damage soft tissue in the distal aspect of the equine limb and can stimulate osteogenesis throughout the depth of the near cortex of the metacarpus and metatarsus.

Animals↗
PubMedDate not supplied

A new approach for perineural injection of the lateral palmar nerve in the horse.

OBJECTIVE: To evaluate the accuracy of a new technique for perineural injection of the lateral palmar nerve and to determine frequency of inadvertent injection into the carpal synovial sheath with this technique. STUDY DESIGN: Prospective experimental study. ANIMALS: Thirty equine cadaver forelimbs. METHODS: Each of 3 clinicians injected 0.5 mL of a 1% aqueous solution of new methylene blue as a marker at the medial aspect of the accessory carpal bone of 10 limbs. Immediately after each injection, the lateral palmar nerve was identified by dissection of and inspected for proximity of dye, and the carpal synovial sheath was inspected for the presence of dye. RESULTS: New methylene blue solution was observed to surround the nerve (29 limbs) or to lie within 2 mm of it (1 limb). Dye was not found in the carpal synovial sheath of any specimen. CONCLUSIONS: Using this technique, perineural injection of the lateral palmar nerve can be consistently achieved, and the carpal synovial sheath is unlikely to be penetrated by the needle during the procedure. CLINICAL RELEVANCE: The technique described provides an accurate and simple method for perineural injection of the lateral palmar nerve proximal to the origin of its deep branch. This technique can be used to anesthetize the lateral palmar nerve for diagnosis of pain originating in the palmaroproximal aspect of the metacarpus without risk of inadvertently desensitizing structures within the carpal synovial sheath.

Animals↗
PubMedDate not supplied

Radiographic study of distal radial physeal closure in thoroughbred horses.

Monthly radiography was performed to study distal radial physeal closure in ten male and ten female Thoroughbred horses. The height, thoracic circumference and metacarpus circumference were also measured. Distal radial physeal closure time was sooner in females than males, and took 701 +/- 37 and 748 +/- 55 days respectively.

Aging↗
PubMed1997

Osteomyelitis and arthrosynovitis associated with Leishmania donovani infection in a dog.

A 10-month-old male maremma shepherd dog was presented with chronic diarrhoea, moderate polyuria/polydipsia, lethargy, dysorexia and stiffness. Pain was elicited in the distal parts of all four limbs. Radiographs of the limbs showed increased endomedullary radiopacity and lysis, with thick periosteal proliferations at the metadiaphyseal areas of each radius-ulna and tibia and of the distal metacarpus on one side. Polyclonal hypergammaglobulinaemia was documented and a similar electrophoretic protein pattern was also found in the synovial fluid. Leishmania amastigotes were found in the macrophages in a bone marrow aspirate performed at the level of a distal radius and in a synovial fluid sample obtained from a carpal joint. An indirect immunofluorescence test confirmed the infection. Treatment with N-methyl-glucamine antimoniate was successful and the osteoarticular changes progressively disappeared.

Animals↗
PubMed1997

Treatment of rupture of suspensory ligament and superficial flexor tendon in a bull.

Rupture of the suspensory ligament at the insertions on the proximal sesamoid bones, and of the superficial flexor tendon of the left fore limb, occurred in an adult Angus bull as a result of fighting. There was severe hyperextension of the metacarpophalangeal (MCP) joint with the dewclaws almost touching the ground. Radiographs revealed severe hyperextension of the MCP joint with the sesamoid bones aligned directly distal to the metacarpus. Initially, a full length fiberglass cast was applied with the limb partially flexed within the cast and the heels elevated. The cast was replaced twice. The cast was removed after 136 days and the bull was bearing full weight on the limb. Prolonged immobilisation of the limb produced new bone in the area (a normal response in cattle) to cause ankylosis of the traumatized MCP joint and partial ankylosis of the carpus. The bull was being used for pasture breeding one year after the injury.

Animals↗
PubMed1999

Effect of topical rh-TGF-beta 1 on second intention wound healing in horses.

OBJECTIVE: To investigate the effects on wound healing of transforming growth factor-beta 1 as a topical treatment to full-thickness, excisional wounds of the distal limb of horses. DESIGN: A randomised block study using four horses, each with wounds assigned to four treatment groups. ANIMALS: Four adult Standardbred geldings. PROCEDURE: Four, 4 cm2, full-thickness wounds were created on the dorsomedial and dorsolateral aspect of the metacarpus or metatarsus of each limb of four horses, giving a total of 64 wounds. For each limb, wounds were randomly assigned to four treatment groups: no treatment (control), carrier (Methyl Cellulose gel), 50 ng/wound rhTGF-beta 1 in carrier, and 500 ng/wound rhTGF-beta 1 in carrier. Wounds were treated on day 0 and day 8. Effects of treatment were evaluated on the basis of the presence of exuberant granulation tissue requiring excision, number of times excision was required, total wound area, area of epithelialisation, area of granulation, and histological evaluation of biopsy samples of wounds on day 8 and excised wounds on day 21. RESULTS: Topical application of TGF-beta 1 at the two concentrations studied had no significant effect on the total area of wounds (P = 0.7), the area of granulation tissue (P = 0.78), the area of epithelialisation (P = 0.92), histological assessment or subjective clinical assessment of wounds. CONCLUSION: TGF-beta 1 had no beneficial effects on wound healing. Additional trials are needed to test if it has value for wound treatment in horses.

Administration, Cutaneous↗
PubMed1988

Non-invasive measurement of bone: a review of clinical and research applications in the horse.

The current methods for non-invasive measurement of bone quality are reviewed. In the horse this has traditionally involved the use of radiography, but there are now two other modalities available for the critical evaluation of cortical bone quality and strength. These utilise single photon absorptiometry and ultrasound velocity. Photon absorptiometry gives a direct measurement of bone mineral content, by using a monoenergetic radionuclide source, and transverse ultrasound velocity in bone gives a measure of bone stiffness or elasticity. They can both be used conveniently on the metacarpus of the conscious horse. Both ultrasound velocity and bone mineral content can be used as accurate indicators of skeletal maturity. In addition, the effects of disuse on bone and certain types of lameness can be monitored accurately. Preliminary data show an association with exercise in young and mature horses. There also appears to be considerable scope for in vivo research of bone changes in horses produced by immobilisation, weightlessness, exercise and nutrition.

Absorptiometry, Photon↗
PubMed1990

A quantitative analysis of skin displacement in the trotting horse.

Skin displacement was investigated at 16 sites in the front and hind limbs of four Dutch Warmblood horses at the trot. For visualisation of the bone under the skin, a measuring device mounted on a Steinmann pin driven into the bone under investigation, was employed. Mean displacements ranged from 8 mm (X-displacements proximal and distal metacarpus) to 142 mm (Y-displacement caudal part of greater trochanter). When compared with previously determined skin displacement patterns at walk, mean displacements at trot were of the same magnitude whereas the shape of the time-displacement curve was different. The latter may be attributed to differences in relative duration of stance and swing phases between the walk and the trot.

Animals↗
PubMed1991

Desmitis of the accessory ligament of the deep digital flexor tendon: 27 cases (1986-1990).

Desmitis of the accessory ligament of the deep digital flexor tendon (ALDDFT) was diagnosed in 27 horses between September 1986 and December 1990. The first observed clinical sign in four horses was localised swelling in the proximal metacarpus. Twenty horses became lame suddenly during a work period and most developed swelling within 24 h of exercise. The injury was confirmed by ultrasonographic examination. Ten of 13 horses with uncomplicated desmitis of the ALDDFT resumed full work, within three to nine months of the onset of clinical signs, without recurrence of clinical signs in the period of follow-up (nine months to four years). Three horses presented with concurrent acute desmitis of the ALDDFT and superficial digital flexor (SDF) tendonitis and two horses had a history of SDF tendonitis; none of these resumed full work.

Animals↗