[Subluxation of the navicular bone of the hand].
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Carpal Bones↗
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[Osteolysis after open dislocation-fracture of the scaphoid bone of the hand].
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Adult↗
[The use of intraosseous wire sutures in the fixation of fractures of the tubular bones of the hand].
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Fracture Fixation, Internal↗
Incidence and ossification of sesamoid bones in the hands and feet: a radiographic study in an Arab population.
The incidence and ossification of sesamoid bones in the hands and feet were studied in 922 radiographs (400 hands and 522 feet) in an Arab population from Bahrain, 5-83 years of age and consisting of 549 adults (393 men and 156 women) and 373 children (286 boys and 97 girls). All radiographs of the hand and foot in the adult population showed two sesamoid bones in the thumb metacarpophalangeal (MCP) joint and in the hallucal metatarsophalangeal (MTP) joint, respectively. Only 2.3% and 1.5% of hands showed sesamoids at the MCP joints of the middle and ring fingers respectively compared to a reported incidence of 7.1% for each digit in Caucasians. The incidence of sesamoids in the MTP joints of third and fourth toes (0.6% each) and inferior to the hallucal interphalangeal joint (3.1%) is probably the lowest reported so far in the literature. In the hands, ossification commenced first in the thumb sesamoids, at the age of 10 years in females and 11 years in males and was completed by the age of 13 and 14 years, respectively. In the feet, ossification began first in the hallucal sesamoids at the age of 8 years in females and 9 years in males and was completed by the age of 10 years in both sexes. The incidence and ossification of sesamoids in the hands and feet in the Arab population from Bahrain seem to differ considerably from reports in other populations. The clinical significance of our findings is discussed.
Adolescent↗
[Fractures of the sesamoid bones of the hand and foot].
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Adult↗
[Bone metastases in breast cancer and its risk factor--follow up study by bone scintigraphy].
Breast cancer is considered to often involve bone metastasis. Early detection and treatment of bone metastasis are essential in improving the prognosis of this disease. In 47 patients with bone metastasis confirmed with bone scintigraphy, we examined the appearance time of bone metastasis; bone metastasis was frequently observed with the progress of stage, but no association with the appearance time was found. Age was not associated with the incidence of bone metastasis but was found to be closely related to its appearance time. That is to say, patients with breast cancer below 40 years of age showed relatively early bone metastasis. Bone scintigraphy is required every 6 months at least for 3 years after the operation. In patients over 40 years of age, on the other hand, bone scintigraphy is required only once a year but has to be continued for 5 years or more, because they often show relatively late bone metastasis.
Adult↗
Methyl-methacrylate bone cement surface does not promote platelet aggregation or plasma coagulation in vitro.
Leakage of viscous bone cement into venous blood possibly resulting in pulmonary embolism may occur during percutaneous vertebroplasty. Our aim was to study if bone cement surface or cement liquid component could induce platelet aggregation or plasma coagulation in vitro. Two types of commonly used methyl-methacrylate bone cement, Palacos (Heraeus Kulzer, Germany) and Vertebroplastic (DePuy, Acro Med, England), were smeared on thin glass slides that were inserted over the bottom of cuvettes immediately or after 24 h, and platelet aggregation was recorded over 10 min. Bone cement liquid component, containing methyl-methacrylate monomer and N,N-dimethyl-p-toluidine, was tested in 2% and 4% final concentration. Partial thromboplastin time (PTT) was determined by the hook method in the presence of bone cement-smeared glass slides or 6% bone cement liquid. Both types of bone cement, either fresh or aged, did not promote platelet aggregation, whereas collagen-coated glass slides induced substantial platelet aggregation (65 +/- 37%). On the other hand, bone cement liquids reduced platelet aggregation induced by collagen solution to an average of less than 15% (p < 0.01). Bone cement, fresh or aged, had no effect on PTT, but bone cement liquids significantly prolonged PTT: median and 1st-3rd interquartile range 149 (96-171) s for Vertebroplastic and 132 (99-194) s for Palacos, p = 0.03 for both comparisons with normal pool plasma without additives that had PTT of 69 (62-71) s. We conclude that the surface of fresh or aged bone cement is not thrombogenic in vitro. The bone cement liquid inhibits platelet aggregation and plasma clotting in relatively high concentrations that cannot be expected in vivo.
Blood Coagulation↗
[X-ray densitometry and biochemical parameters of bone tissue metabolism in patients with vibration disease].
To reveal systemic and local osteoporosis, the authors studied biochemical markers of bone metabolism in vibration disease patients. The vibration disease patients appeared to have the most frequent and marked osteoporosis in peripheral bones--hands (in 90% of cases) and forearms (in 66.7%). Prevalence of systemic osteoporosis and osteopenia reached 11.7 and 48.3% in the select respectively. According to biochemical markers, bone reconstruction state was characterized by moderately intensified bone resorption and diminished bone formation.
Absorptiometry, Photon↗
[Analysis of the murine autologous mixed lymphocyte reaction. II. Role of thymus in maturation of the responder T cells].
Bone marrow chimera mice sharing an identical H-2 K end as the donor were able to respond in an autologous mixed lymphocyte reaction (AMLR). On the other hand, bone marrow chimera made from histoincompatible partners or partners having identical D end of the H-2 were unable to respond. In the secondary responses of the AMLR primed cells from semiallogeneic bone marrow chimera, T cells responded specifically only to the cells which shared identical H-2 haplotypes with the recipient. AMLR primed cells from F1 T cell deprived mice (F1 At X BM mice) transplanted with the thymus grafts were able to respond only to the cells bearing identical H-2 haplotypes with the thymus grafts. It therefore becomes clear that responder cell activity of the AMLR is genetically restricted by the MHC along the pathway of their maturation through the thymus microenvironment. However, an experiment using athymic nude mice suggests the presence of another pathway for being restricted to the stimulator cells, because nude mice which were unable to respond in the AMLR could generate the reaction after thymic grafting from allogeneic donor.
Animals↗
Immediate autografting of bone in open fractures with bone loss of the hand: a preliminary report. Case reports.
Three patients with open fractures of the hand associated with bone loss were treated within four to six hours of injury by corticocancellous bone grafting and soft tissue coverage after meticulous debridement, copious irrigation of the wounds, and broad-spectrum antibiotics given intravenously. Long term follow-up was uneventful and showed that the graft had taken and healed well with early and full restoration of function and a good cosmetic result. Immediate corticocancellous bone grafting of an injured hand could be used in selected cases with well-debrided, surgically clean wounds as long as there is a rich blood supply. Adequate bone fixation, soft tissue coverage, and broad-spectrum antibiotics given intravenously will remove the risk of infection. Hand architecture is corrected while wound contracture and secondary deformity are avoided. Both patients' discomfort and hospital costs are considerably reduced.
Adult↗
Communalities for rates of diaphyseal elongation of short bones of the hand of children with Down syndrome.
Communality indices for rates of elongation of diaphyses of short bones of the hand were computed from serial data for children with Down syndrome, 7 to 14 years of age. Communalities were larger for adjacent than for nonadjacent bones and also larger for bones grouped in rows rather than rays of the hand. This pattern is similar to that reported for normal children. Communality indices for rates of diaphyseal elongation for girls with Down syndrome were lower than those of boys with Down syndrome and normal children.
Anthropometry↗
Minimal fixation in the treatment of open hand and foot bone fractures caused by explosive devices: case series.
AIM: To evaluate minimal fixation method with Kirschner's wires in the treatment of open fractures of the hand and foot short bones, caused by explosive devices. METHOD: There were 270 wounded persons with open fractures of hand and foot short bones, who were surgically treated at the Department of Surgery at the Osijek University Hospital. The stabilization of an unstable open fracture was performed with intramedullary positioned Kirschner's wires. In a few cases, satisfactory stabilization was achieved with Kirschner's wires positioned percutaneously alongside the wound and perpendicularly through the fracture. In the rest of the wounded, plaster immobilization was sufficient after surgical treatment and fracture reposition. RESULTS: Among 270 persons with 412 open hand and foot bone fractures, 49% had fracture only in the feet, 27% only in the hands, and 24% in both hands and feet. Unstable short bone fractures were found in 56 patients (21%). Such fractures were stabilized with Kirschner's wires (n=71). In 58 patients (21%) partial hand and foot amputations had to be performed. Reconstructive operations to improve pseudarthrosis after minimal osteosynthesis were performed on 5 short bones (7%). Osteitis was found on four short bones (6%) after minimal osteosynthesis. CONCLUSION: Minimal osteosynthesis with Kirschner's wires is a reliable and adequate method of the treatment of open unstable short bone fractures caused by explosive devices.
Blast Injuries↗
Malignant tumours of the bones of the hand (from the records of the Rizzoli Institute).
The authors present ten cases of malignant neoplasm of the bones of the hand, four primary tumours and six solitary metastatic tumours, from the case material of the Rizzoli Institute. They stress the importance of differential diagnosis of these rare neoplasms, in particular from benign neoplastic or hyperplastic lesions, which are common in the hand.
Adolescent↗
Epithelioid hemangioendothelioma of the phalanx: a case report.
Epithelioid hemangioendothelioma (EH) of a hand bone is extremely rare. We describe a patient with a phalangeal EH. This was treated by resection of the entire middle phalanx with no recurrence within a 10-year postsurgical follow-up period. We recommend wide resection as the safest treatment for EH of the hand phalanx.
Bone Neoplasms↗
Application of in vivo activation analysis to the compartmental study of sodium in the hand.
Sodium kinetics were studied in the hands of 14 subjects by local in vivo neutron activation analysis. Hands were irradiated with 252 Cf sources giving absorbed doses of 8 cGy. The variation in 24Na radioactivity was plotted against time, and each curve fitted to a function that was the sum of two exponentials. Two pools were identified, one corresponding to fast turnover, with a half-life of about one hour, the other to a slower turnover process with a half-life averaging 79 h if the calcium concentration of the hand bones is normal, and 35 h if it is subnormal. The mean ratio of calcium to slowly exchangeable sodium is estimated to be 47.7, and the ratio of quickly exchangeable sodium to slowly exchangeable sodium to be 0.65. These various parameters should be of interest in bone pathology.
Activation Analysis↗
Amount and composition of bone minerals in chronic liver disease.
Alterations in bone mineral are a common complication of chronic liver disease. The aim of the current study was to assess bone mineral status in patients with chronic liver disease not treated with corticosteroids and to investigate any possible correlation with the histological stage of liver disease. Bone mineral status in 27 patient with chronic active hepatitis, and 17 with active cirrhosis was compared to that of matched controls. Partial body neutron activation analysis was applied for measuring hand bone phosphorus, single-photon absorptiometry for measuring forearm bone mineral content, and dual-energy x-ray absorptiometry for measuring spinal bone mineral density. These noninvasive measurements were supplemented with data obtained by high resolution radiography and biochemistry. Decreased metacarpal cortical thickness was found in five patients, all in the cirrhotic group. In addition, both mean intact parathyroid hormone and 25-hydroxyvitamin D levels were reduced in this group of patients. The mean values of the quantities assessed by the in vivo techniques in patients in the early stages of the hepatic disease did not differ statistically from those of matched normal controls. On the contrary, these quantities were reduced by 9% in the patients at the late stages relative to controls. In conclusion, only the late stages of liver disease are associated with an increased risk of fractures.
Absorptiometry, Photon↗
Granulocyte-colony stimulating factor primed bone marrow and granulocyte-colony stimulating factor mobilized peripheral blood stem cells are equivalent for engraftment: which to choose?
The first reported bone marrow transplant was published in 1939, although it was deemed unsuccessful. Between 1957 and 1965, numerous reports of bone marrow transplants, many of which were successful, were published for patients with irradiation injury, aplastic anemia, leukemia, lymphoma, and myeloma. Sources of marrow were autologous, isologous, and homologous (often unrelated, including cadaveric) donors. Bone marrow infusion was shown to be safe. It was also demonstrated that an aliquot of marrow, removed (harvested) from the ileum, had sufficient hematopoietic stem cells (SC) to repopulate the marrow and restore blood counts after myeloablation. For about 20 yr, bone marrow was the only source of hematopoietic stem cells (HSC) for transplantation. The first reported autologous peripheral blood HSC transplant was recorded in 1981 using chemotherapy 'mobilized' SC collected by leukapheresis. Mobilization is defined for these purposes to be any treatment that enhances the number of HSC in the blood such that the collection contains sufficient HSC to repopulate the marrow and restore blood counts after myeloablation. Since the early 1990s, SCT using blood-derived stem cells has become very popular and very common. The principal reason is that mobilized (whether by H growth factor or during recovery after chemotherapy) blood-derived stem cells engraft more rapidly than do marrow-derived stem cells. On the one hand, bone marrow was always harvested in the resting, unperturbed state (steady state). On the other hand, blood stem cells (BSC) were virtually always collected after mobilization, usually with granulocyte-colony stimulating factor (G-CSF). There is one report of collection of steady state BSC used for transplantation, and slow engraftment was documented. Bone marrow was never harvested after either chemotherapy or growth factor (priming). It is the mobilization (most often with G-CSF alone or after chemotherapy) of BSC that produces more rapid engraftment than for steady state marrow stem cells (MSC). This contribution shows the data that changes the old paradigm to a new paradigm which states bone MSC and BSC engraft identically if collected after the same pretreatment of the donor with growth factor.
Bone Marrow Transplantation↗
[The more efficacious acupoints of Zusanli and Sanyinjiao than that of non-acupoints on bone mass in osteopenic ovariectomized rats].
OBJECTIVE: To clarify whether the acupoints of Zusanli (ST36) and Sanyinjiao (SP6) have specific actions other than non-acupoints to bone. METHODS: Forty Sprague-Dawley female rats were divided into five groups: Sham operated (sham) group; Ovariectomized (OVX, model) group; non-acupuncture group; OVX, needling on Zusanli and Sanyinjiao (Acp-A) group; OVX, needling on the reverse sides of Zusanli and Sanyinjiao (Acp-B) group; OVX, periostineal stimulation on the same height as points of Zusanli and Sanyinjiao (Acp-C) group. The experiment was continued for 23 weeks and then all animals were sacrificed. RESULTS: OVX had a significantly higher body weight and lower bone mineral density (BMD) on the lumbar vertebrae, total femora and tibiae than sham rats, however, Acp-A showed a higher BMD compared with the other OVX groups. On the other hand, bone weights, bone strength and bone morphometry such as trabecular volume, trabecular separation, labeled width and bone formation rate also showed the same improvements in Acp-A as compared to the other OVX rats. CONCLUSION: The stimulation on Zusanli and Sanyinjiao specifically prevented the development of osteopenic rats compared with non-acupoints.
Acupuncture Points↗