Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Metaphysics”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,513 records · Page 84Linked to original sources
PubMed1991

Imaging of the skeleton and soft tissue in children.

Normal metaphyses in infants contain a step-off not to be confused with child abuse. Extension of physeal lucency into the metaphyses can be a sign of healing child-abuse fracture of experimental physeal fracture, as well as deferoxamine overdose. Sonography can reveal costochondral dislocation, the pattern of healing fracture callus, the patellar tendon in jumper's knee, synovium of rheumatoid arthritis, sequestrum in advanced osteomyelitis, the unossified dislocated patella, and, even after 2 years of age, the dislocated femoral head. Further developments concern bone scanning, MR imaging, CT, and plain films of specific trauma, tumor, and infectious, metabolic, and orthopaedic conditions. Ultrasound has been proven useful for radiologist removal of soft tissue foreign bodies, whereas CT can be helpful for osteoid osteoma nidus removal under imaging control.

Bone Diseases↗
PubMed1991

[Mechanical changes in the femur induced by a joint prosthesis. Comparative extensometric studies].

This study using electrical extensometry is aimed at comparing the relative deformations of the same fresh femur before and after the successive implantation of the following titanium prostheses: a cement-free prosthesis with metaphyseal endocortical support, a cemented prosthesis with, then without collar, and finally a screwed titanium prosthesis. The 56 deformation measurement paths produce an overall exploration of the behavior of the femur. The results applied to the same straight section of the femur are different from those of earlier works. The density of the measurement areas has particularly been increased in the upper metaphysis by the use of bidirectional gages. The loading device ensures the absence of variations of the external stress torsion transmitted to the femur between the individual prostheses. The results recorded with the cement-free prosthesis with metaphyseal endocortical support and with the collar-free cemented prosthesis are very similar. The incidence of the "collar effect" is very low in spite of optimal in vitro implantation conditions ensuring good contact between the collar and the neck of the femur. The screwed prosthesis is the implant that most stiffens the upper end of the femur. The testing procedure chosen has allowed recording the deformations caused by the mere insertion of the implants and the bone. The importance of the upper metaphysea endocortical support of the cement-free, screwless implant contributes in ensuring a better primary anchorage, producing stresses that will then foster the secondary anchorage through endosteal osteogenesis.

Biomechanical Phenomena↗
PubMed1991

Long-bone radiographic abnormalities as a sign of active congenital syphilis in asymptomatic newborns.

Metaphyseal abnormalities are present in greater than 90% of infants with symptomatic congenital syphilis. The incidence of these lesions in asymptomatic newborns in the present epidemic is not known. To determine the incidence of bone lesions at birth in asymptomatic congenital syphilis, long-bone films were obtained for all babies born during a 9-month period with a positive perinatal serology. Of 2544 newborns, 61 had a positive maternal serology and 40 also had a positive cord serology. Two symptomatic babies had abnormal radiographs and 12 of 59 asymptomatic newborns had metaphyseal changes consistent with congenital syphilis. It is concluded that long-bone radiographs are abnormal in approximately 20% of asymptomatic newborns with positive perinatal treponemal serology. With the increasing incidence of congenital syphilis, radiologic studies should be included in the assessment of all newborns with a positive serology. Indeed, those patients with any sign of active disease should be carefully followed because even treated infants remain at some risk for developing the late sequelae of congenital syphilis.

Bone Diseases↗
PubMed1991

Computer simulations of chondrocytic clone behaviour in rabbit growth plates.

The growth behaviour of chondrocytic clones in the cell columns of the proximal tibial growth plates of young rabbits was modelled in computer simulations. Simulations were performed, modelling either clones in large groups of columns or clones in one single column. The former were based on morphological data and measurements of cell columns from an earlier study while the latter utilised previous findings of cellular kinetics in rabbit growth plates. Simulation results that resembled most closely the actual observations on rabbit growth plates were those in which a distribution of values was assumed both for clone length (ranging from 1000 to 2000 microns) and for the lengths of the discontinuities between clones. When the assumption was made in the models that the disappearing (metaphyseal) end of an 'old' clone moved more rapidly than the developing (epiphyseal) end of a 'new' clone, replacing the former, the length of the discontinuity between these two clones increased with time. This assumption, which could be modelled in the simulations of clones in a single column based on cell growth behaviour, was found to provide an explanation for an earlier finding that there are more short columns at the epiphyseal side than at the metaphyseal side of a growth plate.

Animals↗
PubMed1990

[The role of osteotomy in the therapy of the arthritic genu varum].

The good results achieved with osteotomy in the treatment of arthritic varus knee lead the authors to pinpoint some frequently controversial aspects that are important for the attainment of an excellent outcome. The study consisted of 46 patients, each subjected to valgus osteotomy. The site of the tibial osteotomy should be above the insertion point of the patellar tendon in order to better guarantee stability and healing. For mechanical reasons, high metaphyseal peroneal osteotomy is preferred over other methods such as diaphyseal osteotomy, excision of the peroneal head, and proximal tibioperoneal syndesmotomy. Both osteotomies can be done through a single anterolateral incision, without risking injury to the lateral popliteal sciatic nerve. The preferred method of osteotomy is to cut a noncuneiform linear rima with the osteotome and perform the angular correction at the joint of the metaphyseal spongy bone. The osteotomy is then stabilized with staples and a cast for a period of 40 days. Overcorrection past the physiological valgus deformity is necessary in order to move the weight-bearing axis onto the lateral hemirima; the degree of surgical correction should be calculated on the basis of orthostatic radiographs. Good clinical results are always accompanied by the following radiographic developments: opening of the medial articular hemirima, improvement of the subchondral bone sclerosis, and reappearance of the outlines of both the spongy bone and the subchondral bone lamina; all these are signs of good bone adjustment made possible by the reinstatement of mechanical equilibrium in the knee.

Arthritis↗
PubMed1990

[Normal radiologic anatomic variants and X-ray findings of hypervitaminosis D of the ulna, radius and carpal bones in children].

The forearm and wrist radiographs in 400 children with age ranging from 2 months to 2 1/2 years were analyzed. Comparatively, x-ray films and their correlated macrosections of the wrist of 14 children's cadavers about the same age were studied. Alternate lines of increased, decreased, and increased density at the distal metaphysis of the ulna and radius were accountable. All these are normal variants of the development of the ulna and radius of infants. A series of abnormal x-ray signs were demonstrated in children administered over 100,000 IU of vitamin D every month on the average. These signs are blurred cortical bone with linear periosteal reaction, disorganization of the cortical bone, osteoporosis, cortical thickening and sclerosis of the ulna and radius, dense and thick calcified ring of ossification nuclei of the carpale, and dense metaphyseal band of the ulna and radius. The more vitamin D was administered, the more frequently abnormal x-ray signs occurred. These signs coincide with the results of radiopathologic and microangiographic correlations of hypervitaminosis D in animals, an experiment we had made before. The x-ray findings of hypervitaminosis D are very complicated. Only based on a series of x-ray signs rather than a single dense metaphyseal band could a radiologic diagnosis of hypervitaminosis D be made.

Bone and Bones↗
PubMed1990

Metastatic calcification within bone. The main cause of osteosclerosis in hypervitaminosis D3. Radiologic-pathologic correlation.

Because the pathogenesis of osteosclerosis in hypervitaminosis D is still not well elucidated, the authors experimentally studied hypervitaminosis D3 in 66 rabbits by injecting different doses of vitamin D3. Contact radiographs of bone specimens showed various signs of osteosclerosis, including dense epiphyses and metaphyses, thickened bony articular surfaces, dense metaphyseal bands, modeling defects at the metaphysis, and dense and thickened cortical bone. The corresponding pathologic sections showed that conspicuous metastatic calcification coated the trabeculae and filled bone marrow cavity and caverns in the original but porotic cortical and periosteal new bone. Rather than being resorbed, the metastatic calcifications were embedded in a thick layer of newly formed bone 6 to 14 weeks after vitamin D3 withdrawal. This study suggests that in hypervitaminosis D3, the osteoblasts and bone marrow undergo degeneration, leading to necrosis and calcification. After vitamin D3 withdrawal, osteoblasts reappear and become overactive, leading to overossification.

Animals↗
PubMed1990

Orthopaedic manifestations of blastomycosis.

The cases of seventy-two patients who had blastomycosis and were seen between 1926 and 1988 were retrospectively reviewed for involvement of the musculoskeletal system. Most patients were from rural rather than urban areas (almost a 2:1 ratio), and an especially large number were from northwestern Ontario or were native Indians (primarily Ojibwa). Bone was the second most common site of involvement (seventeen patients); in approximately one-half of these patients, the osseous site did not cause symptoms. Metaphyses of long bones and small bones were involved the most; the metaphyseal lesions tended to be eccentric, well circumscribed, and lytic. There were two deaths--the most recent, more than twenty years ago--of patients who had involvement of bones and joints; these patients, by modern standards, had had inadequate treatment. Treatment with amphotericin B and, more recently, with ketoconazole, in conjunction with operative treatment, was very effective.

Amphotericin B↗
PubMed1990

[Which distal radius fractures can be treated conservatively?].

Roughly 80% of distal radial fractures can be treated conservatively. To decide which fractures should be treated surgically and which can be treated conservatively we divide them into four categories; metaphyseal bending-fractures, epiphyseal buckle-fractures, avulsion-fractures of the articular rim and fractures of the growing skeleton. Metaphyseal bending-fractures with dorsal inclination of the distal fragment (Colles' fracture) can generally be treated conservatively, those with palmar slanting of the distal fragment (Smith's fracture) must be stabilized surgically. The intraarticular fractures (avulsion-fractures and epiphyseal buckle-fractures) must be reduced anatomically and stabilized by osteosynthesis. In the growing skeleton Aitken 0 and I respectively Salter I and II fractures can be treated conservatively.

Casts, Surgical↗
PubMed1989

Interporous hydroxyapatite as a bone graft substitute in tibial plateau fractures.

The metaphyseal defects in 40 patients with displaced tibial plateau fractures necessitating surgical repair were filled with either cancellous autograft or interporous hydroxyapatite. Roentgenographic and clinical assessments at follow-up periods averaging 15.4 months (autograft) and 34.5 months (hydroxyapatite) demonstrated no significant differences in the two groups. Interporous hydroxyapatite is a safe, effective alternative to autogenous cancellous bone for the filling of metaphyseal defects associated with tibial plateau fractures.

Adolescent↗
PubMed1989

[Some problems concerning the radiologic diagnosis of eosinophilic granuloma of the bone].

125 eosinophilic granulomas of the bone in 61 cases were reported. The radiologic manifestations may be summarized as follows: (1) Multiple lesions may occur with vertebra plana; (2) Epiphyseal lesion may be primary or secondarily involved by extension from metaphyseal lesion; (3) Metaphyseal lesion usually presents as an eccentric cystic area or central oval area of lucency; (4) The diaphyseal lesion manifests a "hole within hole" appearance; (5) The tarsal bone may exhibit a "bone within bone" sign; (6) Periosteal Codman triangle may be present.

Bone Diseases↗
PubMedDate not supplied

Supracondylar fractures of the humerus in children.

Thirty-five children were evaluated at a mean of 2 years, 3 months following treatment of supracondylar fractures of the humerus. Elbow motion, clinical carrying angle, and roentgenographic measurements including Baumann's angle, humeral-ulnar angle, and metaphyseal-diaphyseal angle were determined for both the normal and the involved extremities. The humeral-ulnar angle best correlated with the final clinical carrying angle, followed by Baumann's angle and the metaphyseal-diaphyseal angle. We recommend postreduction measurement of the humeral-ulnar angle in fractures that have been surgically stabilized and Baumann's angle in those fractures treated by cast immobilization alone to determine the adequacy of reduction.

Child↗
PubMedDate not supplied

Oblique tibial osteotomy in the correction of tibial deformity in children.

A new method of oblique tibial metaphyseal osteotomy that uses a single osteotomy cut has been used to allow correction of multiplanar rotational deformities in children. Graphs are used to predict the necessary angle of osteotomy. The osteotomy is performed through a 1-cm incision in the proximal tibial metaphysis, using multiple drill holes and an osteotome. Correction is maintained by casting with or without internal fixation. Fourteen such osteotomies have been followed an average of 27 months without major complications. This osteotomy allows maximal maintenance of length, stability, and metaphyseal contact through a small, cosmetically acceptable incision. Minimal soft-tissue dissection is necessary.

Child, Preschool↗
PubMed1989

Physeal growth arrest of the distal radius treated by the Ilizarov technique. Report of a case.

Growth arrest of the distal radius may follow a severe injury to the growth plate. When the growth of the distal radius ceases in the child, continuing ulnar growth results in radial deviation of the hand and dislocation of the distal radioulnar joint. Treatment options in such a limb-length discrepancy are resection of the physeal bony bridge, lengthening of the shaft of the radius with bone graft using the principle of the Wagner technique, resection or epiphysiodesis of the distal ulna, and lengthening through a metaphyseal corticotomy without the use of bone graft. We report a case of metaphyseal lengthening of the radius employing the Ilizarov external fixator for controlled distraction osteogenesis.

Bone Diseases, Developmental↗
PubMed1989

Load transfer characteristics of a noncemented total knee arthroplasty.

This study evaluated load transfer characteristics of femoral and tibial components of a total knee prosthesis that was designed to achieve distal femoral and proximal tibial compressive load-bearing. Strain gauge readings were highest on the cortex of the tibial metaphyseal flare. Roentgenograms of 110 patients with noncemented total knee arthroplasty (TKA) with follow-up periods of 12-24 months were evaluated. Cancellous bone hypertrophy bridging from the undersurface of the tibial component to the metaphyseal cortical bone was noted on all roentgenograms at six months, suggesting stress transfer through cancellous bone to this area. Anterolateral sinking was noted in six of the first 46 patients but was not seen again in the series after a design change was made to more rigidly fix the stem in the bone of the upper tibia. Roentgenograms of the femoral components demonstrated distal bone hypertrophy suggesting compressive load bearing. None of the femoral components migrated or sank.

Bone Cements↗
PubMed1989

Supracondylar-intercondylar fractures of the femur. Treatment by internal fixation.

The records on fifty-two supracondylar-intercondylar fractures of the femur were reviewed twenty to 120 months after injury. More than one-third of the fractures had been open. All of the fractures were treated in a single trauma center, using: (1) a single lateral incision, (2) internal fixation with ASIF interfragmentary screws and plates, (3) bone-grafting of comminuted metaphyseal segments, (4) impaction of comminuted metaphyseal segments in osteoporotic elderly patients, and (5) repair of any associated torn ligaments and patellar fractures. Postoperatively, early active motion of the knee was encouraged, and for selected patients a brace was used only to protect the repair of associated disruptions of ligaments or of the extensor mechanism. The fractures were classified by the ASIF system, with C1 being a simple Y pattern, C2 having additional supracondylar comminution, and C3 having intra-articular comminution. The final results were rated using the system that was described by Neer et al. for fractures of the distal end of the femur. The average time between the operation and full weight-bearing (healing) was 13.6 weeks and ranged from 12.3 weeks for C1 fractures (as graded using the ASIF classification) to 15.4 weeks for C3 fractures. The average final arc of motion of the knee was 107 degrees, ranging from 113 degrees for C1 fractures to 99 degrees for C3 fractures. C1 fractures had a better outcome (92 per cent excellent and good results) than did C2 and C3 fractures (77 per cent excellent and good results). Two amputations and one arthrodesis were done to treat infection, and infection accounted for three of the four poor results. Age did not influence the final results, although elderly patients had a longer period of hospitalization. Supracondylar-intercondylar fractures of the femur should be analyzed separately from other fractures of the distal end of the femur because of their intra-articular involvement and associated ligamentous injuries and patellar fractures. Rigid internal fixation permits early functional rehabilitation of the patient and decreases the incidence of malunion, non-union, and loss of fixation.

Adult↗
PubMed1988

Traumatic separation of epiphyses. An experimental study in rats.

Four types of physeal fracture-separations, defined by the Salter-Harris classification, were created experimentally in the proximal physis of the right tibia of immature rats. The four types are: Type I, pure epiphyseal separation; Type II, separation of the epiphysis with a metaphyseal fracture; Type III, partial epiphyseal separation with a vertical fracture of the epiphysis; and Type IV, vertical epiphyseal and metaphyseal fractures. A sham operation performed on the left tibia served as the control. The animals were killed at various intervals up to 25 days after the operation. The findings were assessed by roentgenographic, histologic, and vessel injection methods. For Types I and II morphometric analyses were also performed. The influence of various types of lesions on the growth rate and the healing process was documented. For Types I and II lesions there was a transitory growth arrest and an increased thickening of the zone of hypertrophic cells. The alterations regressed after Day 15, and by day 25, a nearly normal plate was seen. For Type III lesions an angular deformity of the tibia occurred that increased with time. For Type IV lesions, a step-off developed on the articular surface that became more severe with time. Early vascular anastomoses between the epiphysis and the metaphysis led to the formation of bone bridges in Type III and Type IV lesions.

Animals↗
PubMedDate not supplied

[Lethal syndromes with thin bones].

The authors report six cases from six different families of lethal brittle bone disease with narrow diaphyses and thin ribs. This phenotype should be dissociated from the lethal forms of osteogenesis imperfecta and encompass two diseases. In the first, autosomal recessive, the metaphyses of long bones are narrow, with a membranous ossification, without cartilagenous residue. Cultured fibroblasts demonstrate a marked increase in type V collagen. In the second type, the metaphyses are enlarged and the babies have a facial dysmorphism with hypoplasia of the eyebrows, frontal bossing and a small mouth.

Bone Diseases, Developmental↗