[Bridge arthrodesis on the hand bones].
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Arthrodesis↗
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Genetic variation of circulating leptin is involved in genetic variation of hand bone size and geometry.
Leptin is secreted primarily by the adipocytes and plays an important role in the regulation of food intake and energy expenditure. In addition to its adipostatic function, it has been demonstrated that leptin directly enhances stromal cell differentiation to osteoblasts, and since such precursor cells are potential targets for leptin, the latter could possibly mediate the relationship between obesity and bone mass and size. To address this question, we studied phenotypic and genetic correlations between the circulating levels of leptin and hand bone size (BS) and geometry (BG) of the radiographic hand in a healthy and ethnically homogeneous sample of pedigrees. We also attempted to evaluate to what extent potential leptin/BS/BG correlations are modified by an individual's obesity traits, specifically his/her BMI. Our research has shown that leptin, BMI and the corresponding bone measures are clearly inherited traits (0.46+/-0.11, 0.35+/-0.16, 0.62+/-0.12 and 0.51+/-0.09, respectively). The bivariate variance component analysis revealed very strong and significant genetic and environmental correlations between circulating leptin and BMI ( r(G)=0.86+/-0.09, r(E)=0.75+/-0.05, P<0.001). Furthermore, genetic correlations between leptin and hand bone characteristics proved inverse and statistically significant ( r(G)=-0.35+/-0.01 and -0.45+/-0.10 for BS and BG, respectively), while corresponding environmental correlations were low ( r(E)=-0.14+/-0.15 and -0.07+/-0.14) and they could be constrained to zero without significant deterioration of the model fit to the data ( P>0.10). However, despite the extremely strong relationship between leptin and BMI, we failed to detect phenotypic or genetic correlations between BMI and our two hand bone measures. Thus our study provided evidence that plasma leptin levels may be statistically significant predictor of hand bone size and geometry, and may play a physiological role in maintaining bone mass as well as in regulation of hand bone proportions.
Adolescent↗
[Mineral saturation of the hand bones of adolescent and young adult boxers of Khabarovsk].
By the method of standard linear roentgenodensitometry worked out by M. A. Kornev the effect of boxing on mineralization degree of the hand bones in young boxers has been studied, as well as dependence between dynamic of mineralization and ossification and synostosis processes in the bones mentioned. Boxing has been stated to result in certain adaptive-compensatory changes in the structure and development in the young boxer hand skeleton. They are revealed as an increased mineral component in the hand bones and as delayed ossification and synostosis processes in these bones.
Absorptiometry, Photon↗
[Osteosynthesis in hand bone fractures in children].
At 12 preparations of the upper extremities of still-born fetuses has been studied microcirculatory channel of long bones of a hand. Clinical confirmation of the experimental results is based on the analysis of data obtained in process of treatment of 54 children with instable fractures of phalanges and metacarpal bones. An arterial channel of long bones of a hand is formed by the branches of finger arteries and vessels of the surrounding tissues. Epiphysis, metaphysis and growth cartilage have common circulatory system. The types of phalanx epiphysiolysis determine the terms of the open reposition realization. Comparison of morphological data and clinical observations demonstrated that the optimal methods of fixation of instable fractures of long bones of a hand are as follows: diafixation by means of wires, intramedullary osteosynthesis and perosseous compressive-distractive osteosynthesis.
Arteries↗
Advantage of hand bone calcium content measurement by local neutron activation analysis for following up hemodialysis patients.
Hand bone calcium content [Ca] has been measured by local neutron analysis in hemodialyzed patients free of signs of osteomalacia before and 6-12 months after treatment with vitamin D metabolites, and it has been compared to some iliac bone histomorphometric parameters. With 1,25-(OH)2D3 alone, [Ca] increases significantly at the 6th month of treatment (p less than 0.001) but not from the 6th to the 12th month. With 1 alpha-(OH)D3 + 25-(OH)D3 the same phenomenon is observed at the 6th and 12th months of treatment. Before treatment, [Ca] was correlated negatively with the osteoid surfaces (OS) (r = -0.62, p = 0.01) and the number of osteoclasts per square millimeter (Ocl/mm2) (r = -0.79, p less than 0.001). At the 6th month of treatment, [Ca] was still correlated negatively with OS (r = -0.42, p = 0.05) and with Ocl/mm2 (r = -0.60, p less than 0.005). At the 12th month, the two negative correlations decreased but remained significant (r = -0.42, p = 0.05; r = -0.45, p = 0.05). These data suggest that (1) hand bone calcium analysis by neutron activation permits to follow up the peripheral bone mineral content in hemodialyzed patients and (2) the [Ca] increase only observed during the first months of treatment with vitamin D metabolites probably result from an attenuation of secondary hyperparathyroidism.
Adult↗
[Mineral saturation, ossification and synostosis of the hand bones in adolescents and youth].
The results on X-ray densitometric studies of the hand bones in adolescent and young people at the age of 10--17 years (369 persons in all) are presented in the work. Processes of mineralization, ossification and synostosis, as the investigation has demonstrated, are closely connected with each other. From the beginning of ossification in the pisiform and sesamoid bones of the first metacarpophalageal joint (11--12 years of age) up to the completion of synostosis in short tubular bones of the hand (15--16 years of age), a decrease of mineral salts is noted in osseous tissue. Hence, accumulation of mineral salts in skeleton of children and adolescent persons does not occur smoothly, but rather distinctly reflects those functional changes which take place in the adolescent organism when the genital glands begin their increased activity.
Absorptiometry, Photon↗
[Morphologic features of the structure of the hand bones of young volley ball players].
By means of roentgenography method with subsequent roentgenogramometry and roentgenodensitometry, morphological peculiarities of structure and mineralization of the hand bones in sportsmen-volley-ball players and in schoolchildren who do not go in for sports, at the age of 14-19 years have been studied. Systematic training in volley-ball produces certain increase in dimentions of the hand bones, prolongation of their synostosis time, intensification in development of the sesamoid bones and increasing amount of mineral salts in their bones.
Adaptation, Physiological↗
[The use of external fixation apparatus in injuries to the hand bones].
An analysis of experimental studying the stability of osteosynthesis and clinical application of apparatuses of external fixation in 282 patients with fractures and sequellae of traumas of the bones and joints of the hand is presented. Main conditions influencing stability of fixation of the hand bones were determined. A universal complex of details is recommended which allows to make the optimum construction of the device as applied to the specific kind of trauma. It was proved that choice of the individual construction of the apparatus considerably widened the scope of using the method of external fixation and improved results of the treatment.
Equipment Design↗
Longitudinal study of hand bone densitometry in rheumatoid arthritis.
OBJECTIVE: To measure hand bone mineral content (BMC) by dual x-ray absorptiometry and to seek clinical correlates in patients with rheumatoid arthritis (RA), in a prospective, longitudinal study. METHODS: Eighty-one patients with non-steroid-treated RA were assessed at baseline and at month 12, for hand BMC and for disease activity and severity. Hand BMC in patients was compared with that in a control group of 95 normal volunteers, and rate of loss was compared with that in 37 controls. RESULTS: At the initial assessment, male and female patients with RA had lower hand BMC than controls, after correction for age, height, and weight (mean reduction 7.5% in men [P = 0.003] and 7.8% in women [P = 0.01]). After 1 year, there was a further loss of hand BMC in patients (median loss 3.25% in men [P = 0.001] and 1.46% in women [P = 0.05]), but normal controls did not have significant changes in their hand BMC. In patients with disease duration of < 2 years at study entry, the parameters of disease activity improved over 1 year, but they lost significant amounts of hand BMC. Hand BMC loss correlated with baseline C-reactive protein levels. In those with RA of > 2 years duration at entry, the Health Assessment Questionnaire scores and Larsen scores had worsened after 1 year, but there was no significant loss of hand BMC. CONCLUSION: Patients with RA had low hand BMC compared with normal controls, even within 2 years of disease onset. The rate of loss was highest in patients with early disease and correlated with measures of initial disease activity. This loss continued despite clinical improvement.
Absorptiometry, Photon↗
Measurement of hand bone mineral content using single-photon absorptiometry.
A single photon absorption imaging technique has been developed to assess the bone mass of the hand, especially in patients with rheumatoid arthritis or bronchial asthma. A modified rectilinear scanner images the hand by transmission scanning in a water bath with a 7.4 GBq 125I source. A microcomputer is used to calculate the bone mineral distribution, and the total bone mineral content (BMC) of the hand is determined from that distribution. The precision (coefficient of variation) of the measurement is 1.9%. A control population of 20 men and 58 women has been studied to determine normal variations in hand bone mineral content with age, sex, body size, hand volume and years since menopause. The normal men are found to have an average hand BMC of 25.1 g with a coefficient of variation (CV) of 22%, which is reduced to 12% by normalising for body size using span. The normal women had an average hand BMC of 18.0 g +/- 15%. The CV is reduced to 13% by normalising for span and years post-menopause.
Adult↗
Use of the hand bones roentgenographs in the prediction of age in nine human populations.
The major aim of this study was to develop an accurate method of age prediction for a wide range of ages, based on the roentgenographic assessment of the hand bones, for use in paleoanthropology and forensic medicine. The roentgenographs of the hand bones were assessed in 5756 individuals, 2683 males and 3073 females, aged 17-93 and 17-89, respectively, belonging to 9 ethnic groups from the former USSR, Israel, and Sinai peninsula (Egypt). For each roentgenogram an equidistant osteographic score (OSS) including the descriptive criteria of bone age, such as (1) osteophytes or nodes of Heberden in the periarticular regions and at sites of tendon attachment, (2) manifestations of osteoporosis, (3) signs of sclerosis, and (4) non-traumatic articular deformities, was estimated. Regression analysis, that included linear, non-linear, logistic, and stochastic models, was used to evaluate the relationships between age and OSS. This relationship was best described by a logistic regression function. Results of the logistic regression analysis clearly indicate that OSS is a strong predictor of an individual's age, with r2 values ranging from 0.671 to 0.901 (p < 0.001). Our standard errors of estimate were ranging from +/- 4.2 to +/- 7.3 years, comparing favorably with most known methods of bone age assessment. This study provides an efficient method of age prediction, which allows to extend the upper limit of prediction to the age of 70 years with acceptable accuracy.
Adolescent↗
Measurement of hand bone mineral content by dual energy x-ray absorptiometry: development of the method, and its application in normal volunteers and in patients with rheumatoid arthritis.
OBJECTIVES--To develop a method of measuring hand bone mineral content (BMC) by dual energy x ray absorptiometry (DXA); to apply this method of measuring hand BMC to normal volunteers to ascertain causes of variability; and to measure hand BMC in patients with rheumatoid arthritis (RA) of varying duration and severity. METHODS--The x ray beam of the Hologic QDR 1000 dual energy x ray absorptiometer was hardened by introducing a perspex-aluminium plate and the analysis software altered to allow for the small tissue bulk of the hand compared with the torso. Ninety five volunteers (46 men age 24-81 and 49 women age 20-83) had scans of both hands. Eight volunteers were assessed repeatedly to establish reproducibility and effect of hand position. Fifty six patients (22 men, 34 women, age range 25-86 years) with RA of differing duration and severity, had hand BMC measurement by DXA. RESULTS--The precision of BMC measurement was 2.3% with no additional variation due to hand position. Hand dominance had no significant effect on BMC. In men, hand BMC correlated with height (r = 0.57, p < 0.0001), weight (r = 0.58, p < 0.0001), forearm span (r = 0.5, p = 0.0006) and hand volume (r = 0.66, p < 0.0001). In women hand BMC correlated with height (r = 0.66, p < 0.0001), weight (r = 0.4, p = 0.003), forearm span (r = 0.3, p = 0.03) and hand volume (r = 0.49, p = 0.0008). After correcting for all these variables, male volunteers had significantly higher hand BMC than female volunteers (p = 0.01) and patients with RA had lower hand BMC than normal volunteers (total hand BMC in male volunteers 90.9 gms, 95% CI 86.9-95, in male patients 81.7 gms, 95% CI 73.7-89.6, p < 0.004, total hand BMC in female volunteers 62.2 gms 95% CI 59.8-64.5, female patients 52.3 gms, 95% CI 48.1-56.5, p < 0.005). In patients with RA, the hand BMC showed an inverse correlation with age (r = -0.44, p = 0.01), disease duration (r = -0.62, p = 0.0003), Larsen's grades (r = -0.62, p = 0.0002) and modified Sharp's method score (r = -0.69, p < 0.0001) in female patients only. CONCLUSIONS--A new, sensitive and reproducible technique of measurement of hand bone mineral content by DXA, has been developed and this method has been applied to normal volunteers and patients with RA. Hand dominance had no significant effect on hand BMC. After correcting for physical size, men have higher hand BMC than women. Hand BMC inversely correlates in women patients with disease duration and other validated methods of assessing radiological outcome in RA. Longitudinal studies are needed to establish its role in monitoring disease progression.
Absorptiometry, Photon↗
The relationship between osteoarthritis of the hands, bone mineral density, and osteoporotic fractures in elderly women.
To study the relationship between osteoarthritis (OA) and osteoporosis (OP), radiographic osteoarthritis lesions of the hands (HOA) were quantified in 300 healthy women, aged 75 years or more, as a subgroup of a cohort originally recruited for a multi-centre study of risk factors for femoral neck fracture. The HOA combined score (i.e. the sum of the grades of joint-space narrowing, osteophytes, erosions and joint misalignment), the osteophytosis score and the joint-space narrowing score were calculated on a radiograph of both hands. Bone mineral density (BMD) was measured using dual-energy X-ray absortiometry (Lunar DPX) at the femoral neck, Ward's triangle and the total body. BMDs of the total spine, lumbar spine, and the upper and lower limbs were derived from the regional analyses of the total body measurement. Correlations between bone mass, HOA scores and other variables were explored by multiple linear regression and stepwise logistic regression analysis. The HOA combined score was positively correlated with increasing age but not with body mass index. In the multiple regression analyses the HOA combined score positively correlated with BMD and the joint-space narrowing score. According to stepwise logistic regression and after off adjustment of BMD for age, women with an HOA combined score higher than 20 had significantly higher BMD values at all skeletal sites. Sixty-nine women (23%) reported a history of osteoporotic fracture; among them, 20 (6.6%) reported a history of vertebral fracture. The OA score of both subgroups was significantly lower than that of women with no history of fracture. These data suggest that in elderly women the severity of HOA is positively correlated with bone mass and that women with a higher score of HOA more rarely report a history of osteoporotic fracture.
Aged↗
[A new method of age determination by age-related changes in the hand bone].
An anthropological method designed for determining the age is under discussion; it is based on the point-evaluation of age-related changes observed in the hand bones by X-Ray, i.e. osteophytes, osteoporosis, osteosclerosis and joint deformations. The method was made use of to elaborate a new modified point-based assessment of the above changes in the hand bones with respect to their severity.
Adolescent↗
Relationship between grip strength and hand bone mineral density in healthy adults.
The aim of this study was to assess site-specific relationship of hand bone mineral density (BMD) with hand size, pinch and grip strength in healthy people aged 19-50 years. A total of 143 healthy volunteers participated in the study (mean age: 34 years). One hundred-six were premenopausal women (mean age: 34 years) and 37 were men (mean age: 34 years). Grip and pinch strength was measured by a Jamar dynamometer (Jamar, Irvington, NY). Second, third and fourth middle phalanx BMD were measured on a MetriScan densitometer (Hayward, CA) and mean value of these three phalanxes were used in the analysis. There was not a significant correlation between hand BMD and grip, pinch strength or hand size in premenopausal women. A significant correlation between hand BMD and grip strength was found in men (right hand; r=0.44, p=0.007, left hand; r=0.33, p=0.05). Hand size was not correlated with hand BMD both in men and in women. The short-term precision for RA was estimated as 0.44%. This is the first report of a site-specific relationship of BMD measured by radiographic absorptiometry with hand size, pinch and grip strength in healthy men and premenopausal women. Our results revealed that there is a moderate correlation between hand-grip strength and hand BMD in men. Hand size does not predict hand BMD both in men and women. Radiographic absorptiometry is a practical and reproducible method to detect bone mineral density of hands and may be a valuable screening tool for osteoporosis.
Adult↗
Correlation of hand bone mineral density with the metacarpal cortical index and carpo:metacarpal ratio in patients with rheumatoid arthritis.
This study proposed an assessment of the correlation of hand bone mineral density measured by dual energy x-ray absorbtiometry (DXA) with the carpo:metacarpal (C:MC) ratio and metacarpal cortical index (CI) in patients with rheumatoid arthritis (RA). The correlation of total hand BMD, CI and C:MC ratio with BMD at other sites, the Health Assessment Questionnaire (HAQ) and Larsen scores were also examined. The hand and axial BMD of 30 female patients were also compared with 29 age-matched healthy female controls. Total hand BMD values of patients were significantly lower than the control group. There was no significant difference between groups in axial measurements. CI correlated moderately with the second metacap (II.MC) midshaft and total hand BMD. The C:MC ratio correlated with II.MC midshaft and total hand BMD. Total hand BMD correlated moderately with the AP spine (L2-L4) and femoral neck BMD. Larsen scores showed weak negative correlation with II.MC midshaft BMD and CI. Grip strength correlated weakly only with total hand BMD. The results indicated that CI may reflect cortical bone mass of the hand accurately and did not predict bone density of the spine or hip in patients with RA. The C:MC ratio is a useful method for evaluating progression of wrist involvement and may be related to the loss of hand bone mineral density associated with disease process.
Adult↗
[Relationship between late adolescent growth of mandible and maturity indicators--mandibular third molar, hand bones, body height--in Japanese boys].
The study was undertaken to investigate the individual growth timing of the mandible during late adolescent period. Materials used in this study were lateral cephalometric X-rays, hand bones X-rays, panorama X-rays and data of standing height of eighteen Skeletal Class I Japanese boys, all were longitudinally taken from 15 to 18 years old. Results were as follows: 1. Mandibular growth was continued to increase until 18 years old, but annual growth rate was decreased every year. 2. Growth increments of mandibular length was widely varied during 15 to 18 years old. 3. Ossification timing of MP3u and R-IJ stage were tended to delay in cases, represented large amount of growth. 4. Cases showing large amount of growth in the mandible tended to have large increments in body height. 5. There was less correlation between mandibular growth timing and maturation of lower third molars. In conclusion, the growth behavior of hand bones and body height could be used as indicators for predicting mandibular growth potentiality during late adolescent period.
Adolescent↗
Pattern profile analysis of hominid and chimpanzee hand bones.
In a study designed to complement morphological research on hominid hand bones, length and width measurements of the thumb, index, and middle rays were obtained from radiographs of modern human hands. These rays are primary in precision-gripping postures and are therefore the ones most relevant for investigating evolutionary changes in fine manipulation. Pattern profile analysis allows individuals or samples to be plotted against a reference sample in standard deviation units, or Z-scores. It provides an indication of how different measurements are from modern human averages, while taking into consideration the degree of variation present within modern human samples. A pattern profile for chimpanzees is clearly distinct from humans but quite similar to that of a bonobo, demonstrating the promise of pattern analysis. Partial pattern profiles of several of the more complete early hominid bones from Hadar, Swartkrans, and Olduvai (O.H. 7) are presented and compared. Hadar bones are long and wide at midshaft relative to articular widths; both body-size effects and functional differences are likely. Thumb distal phalanges from Swartkrans and Olduvai both have relatively small base widths, but they differ in other proportions. Two first metacarpals from Swartkrans show distinct patterns. The profiles of La Ferrassie I and Shanidar IV show the characteristically large Neanderthal distal phalanges. Profiles of Skhul IV and Predmost III are alike in some regions with reference to modern North American white males, though they are less similar overall than are those of the two Neanderthals.
Adult↗