Search

Purpose: To assess the use of bone marrow aspirate (BM) and bone marrow aspirate concentrate (BMAC) in the treatment of long-bone nonunion and to understand mechanism of action. Methods: A systematic review of PubMed and EBSCOHost was completed to identify studies that investigated the use of BM or BMAC for the diagnosis of delayed union and/or nonunion of long-bone fractures. Studies of isolated bone marrow-mesenchymal stem cells (BM-MSCs) and use in non-long-bone fractures were excluded. Statistical analysis was confounded by heterogeneous fracture fixation methods, treatment history, and scaffold use. Results: Our initial search yielded 430 publications, which was screened down to 25 studies. Successful treatment in aseptic nonunion was reported at 79–100% (BM) and 50–100% (BMAC). Septic nonunion rates were slightly better at 73–100% (BM) and 83.3–100% (BMAC). 18/24 studies report union rates > 80%. One study reports successful treatment of septic nonunion with BMAC and no antibiotics. A separate study reported a significant reduction in autograft reinfection rate when combined with BMAC (P = 0.009). Major adverse events include two deep infections at injection site and one case of heterotopic ossification. Most studies note transient mild donor site discomfort and potential injection site discomfort attributed to needle size. Conclusion: The current literature pertaining to use of BM/BMAC for nonunion is extremely heterogeneous in terms of patient population and concomitant treatment modalities. While results are promising for use of BM/BMAC with other gold standard treatment methodologies, the literature requires additional Level I data to clarify the impact of role BM/BMAC in treating nonunion when used alone and in combination with other modalities. Level of evidence: Level III. [ABSTRACT FROM AUTHOR]

Heavy animals incur large forces on their limb bones, due to the transmission of body weight and ground reaction forces, and the contractions of the various muscles of the limbs. This is particularly true for rhinoceroses, the heaviest extant animals capable of galloping. Several studies have examined their musculoskeletal system and the forces their bones incur, but no detailed quantification has ever been attempted. Such quantification could help understand better the link between form and function in giant land animals. Here we constructed three‐dimensional musculoskeletal models of the forelimb and hindlimb of Ceratotherium simum, the heaviest extant rhino species, and used static optimisation (inverse) simulations to estimate the forces applied on the bones when standing at rest, including magnitudes and directions. Overall, unsurprisingly, the most active muscles were antigravity muscles, which generate moments opposing body weight (thereby incurring the ground reaction force), and thus keep the joints extended, avoiding joint collapse via flexion. Some muscles have an antigravity action around several joints, and thus were found to be highly active, likely specialised in body weight support (ulnaris lateralis; digital flexors). The humerus was subjected to the greatest amount of forces in terms of total magnitude; forces on the humerus furthermore came from a great variety of directions. The radius was mainly subject to high‐magnitude compressive joint reaction forces, but to little muscular tension, whereas the opposite pattern was observed for the ulna. The femur had a pattern similar to that of the humerus, and the tibia's pattern was intermediate, being subject to great compression in its caudal side but to great tension in its cranial side (i.e. bending). The fibula was subject to by far the lowest force magnitude. Overall, the forces estimated were consistent with the documented morphofunctional adaptations of C. simum's long bones, which have larger insertion areas for several muscles and a greater robusticity overall than those of lighter rhinos, likely reflecting the intense forces we estimated here. Our estimates of muscle and bone (joint) loading regimes for this giant tetrapod improve the understanding of the links between form and function in supportive tissues and could be extended to other aspects of bone morphology, such as microanatomy. [ABSTRACT FROM AUTHOR]

Introduction: Bone growth is a fascinating process, primarily due to its complexity. Equally engaging is the history of its study, which, however, remains unknown to most anatomists and surgeons. Materials and methods: A literature search was performed in original publications and historical sources. Results: The early history of bone growth study may be divided into two periods. Firstly, the experimental one, between 1722 and 1847, which consisted in the study of bone growth by the drilling of benchmark holes into the diaphysis, and examination of growing bones in madder-fed animals. In the course of one century, four French scientists (Henri-Louis Duhamel du Monceau, Marie-Jean-Pierre Flourens, Gaspard Auguste Brullé and Frédéric Léopold Hugueny) and one British researcher (John Hunter) proved experimentally that the longitudinal growth of long bones occurred only at its epiphyseal ends and their final shape resulted from apposition and resorption processes taking place simultaneously both on the periosteal and intramedullary surfaces of the bone. In the second, the microscopic period (1836–1875), the physeal growth cartilage was discovered and described in detail, including its importance for the longitudinal growth of long bones. The first description of growth cartilage was published by a Swiss anatomist Miescher in 1836. Subsequently, this structure was studied by a number of English, German and French anatomists and surgeons. This whole period was concluded by Alfred Kölliker´s extensive study of bone resorption and its significance for typical bone shapes and Karl Langer´s study of the vascular supply of the growing and mature bone. Conclusion: Research by French, English, German and Swiss scientists between 1727 and 1875 yielded fundamental insights into the growth of long bones, most of which are still valid today. [ABSTRACT FROM AUTHOR]

Objectives: Growth and developmental studies have been a prominent theme in bioarchaeology. These works traditionally focus on metric measurements of long bone length and age‐at‐death or cross‐sectional geometric studies with the use of computed tomography scans for questions on growth and mobility. However, teasing apart aspects of size and shape have been difficult due to the cylindrical nature of immature long bones. This research investigates the methodological use of surface geometries from linear measurements and geometric morphometric methods (GMM) to answer questions on mobility and allometry during childhood. Materials and Methods: Left femora were selected from 42 individuals ranging from fetal to 12 years of age from medieval St Gregory's Priory, Canterbury, UK. Femora were digitized with structured‐light‐scanning for auto3dgm analysis and measurements were obtained from physical caliper measurements. Individuals were put into age groups based on biomechanical milestones during this age range. Results: Ratio and GMM confirm hypotheses of allometry and biomechanical milestones. Geometric morphometrics, however, detects more subtle differences in mobility at each age group. Discussion: The findings of this preliminary study support the potential use of GMM of immature femora, while indicating that the extent in range of mobility that can occur varies at different biological milestones. [ABSTRACT FROM AUTHOR]

Background Intercalary reconstruction for patients with short residual bone segments remains challenging. Three‐dimensional (3D)‐printed custom‐made porous implants are a promising technique for short‐segment fixation in these patients. This study aims to evaluate the efficiency of 3D‐printed custom‐made porous components (3DCPCs) for short‐segment fixation, focusing on prosthesis survivorship, radiographic results, and potential complications. Methods This retrospective study involved 39 patients who underwent intercalary prosthetic reconstruction with 3DCPCs after tumor resection of the femur, tibia, or humerus from June 2015 to October 2020. Segment bone loss involved the femur (n = 15), tibia (n = 16), and humerus (n = 8), leaving 78 residual bone segments. There were 46 short segments requiring 46 3DCPCs and 32 segments with the ability to accommodate 32 off‐the‐shelf standard uncemented stems for prosthesis fixation. Clinical and functional outcomes were evaluated. Prosthesis‐overall survivorship and prosthesis‐specific survivorship were analyzed using Kaplan–Meier survival analysis. Radiographic results and modes of failure of using this technique were also examined. Results The mean follow‐up was 41 months. The prosthesis‐overall survivorship was 87.2% and 84.6% at 2 and 5 years, respectively. The prosthesis‐specific survivorship was 92.1% and 89.5% at 2 and 5 years, respectively. There was not a substantial difference in prosthesis survivorship among the femur, tibia, and humerus. The average MSTS score was 26.2, ranging from 22 to 28. The radiographic evaluation results revealed excellent or good interface (38/46) in most of the 46 porous components. A total of 38 of 46 bone segments’ remolding demonstrated no change. In total, seven patients (16.3%) had complications requiring further surgery. Conclusion The prosthesis survivorship of using 3DCPCs for short‐segment fixation is similar or better compared to other studies involving intercalary prosthetic reconstruction with short‐segment fixation. Radiographic evaluation revealed good osteointegration and avoidance of stress shielding. Overall, intercalary prosthetic reconstruction with 3DCPC is a feasible modality for patients with short residual bone segments after tumor resection.

Background: Intercalary reconstruction for patients with short residual bone segments remains challenging. Three‐dimensional (3D)‐printed custom‐made porous implants are a promising technique for short‐segment fixation in these patients. This study aims to evaluate the efficiency of 3D‐printed custom‐made porous components (3DCPCs) for short‐segment fixation, focusing on prosthesis survivorship, radiographic results, and potential complications. Methods: This retrospective study involved 39 patients who underwent intercalary prosthetic reconstruction with 3DCPCs after tumor resection of the femur, tibia, or humerus from June 2015 to October 2020. Segment bone loss involved the femur (n = 15), tibia (n = 16), and humerus (n = 8), leaving 78 residual bone segments. There were 46 short segments requiring 46 3DCPCs and 32 segments with the ability to accommodate 32 off‐the‐shelf standard uncemented stems for prosthesis fixation. Clinical and functional outcomes were evaluated. Prosthesis‐overall survivorship and prosthesis‐specific survivorship were analyzed using Kaplan–Meier survival analysis. Radiographic results and modes of failure of using this technique were also examined. Results: The mean follow‐up was 41 months. The prosthesis‐overall survivorship was 87.2% and 84.6% at 2 and 5 years, respectively. The prosthesis‐specific survivorship was 92.1% and 89.5% at 2 and 5 years, respectively. There was not a substantial difference in prosthesis survivorship among the femur, tibia, and humerus. The average MSTS score was 26.2, ranging from 22 to 28. The radiographic evaluation results revealed excellent or good interface (38/46) in most of the 46 porous components. A total of 38 of 46 bone segments' remolding demonstrated no change. In total, seven patients (16.3%) had complications requiring further surgery. Conclusion: The prosthesis survivorship of using 3DCPCs for short‐segment fixation is similar or better compared to other studies involving intercalary prosthetic reconstruction with short‐segment fixation. Radiographic evaluation revealed good osteointegration and avoidance of stress shielding. Overall, intercalary prosthetic reconstruction with 3DCPC is a feasible modality for patients with short residual bone segments after tumor resection. [ABSTRACT FROM AUTHOR]

Worldwide and in South African Stone Age contexts, much research has been done on the relationship between stature of past populations and general well-being, as well as trends and patterns in stature through time. This research is aimed at collating and assessing all available stature and long bone data for Bantu-speaker individuals living in the South African Iron Age. Data for only 25 female and 32 male individuals, dating from circa AD 550 to AD 1823, could be found. In general, methods used to reconstruct stature were inconsistent and data were poorly reported. From the available data, no clear trends or patterns in stature through time could be observed and stature seems to be on a par relative to those of early twentieth century individuals. Recommendations are made as to which methods to use in stature estimations in this context. The data provided in this research can serve as reference material for future similar studies and can assist in interpreting individual stature estimations from bioarcheological research in the region. [ABSTRACT FROM AUTHOR]

Sex estimation from skeletal remains is one of the crucial issues in forensic anthropology. Long bones can be a valid alternative to skeletal remains for sex estimation when more dimorphic bones are absent or degraded, preventing any estimation from the first intention methods. The purpose of this study was to generate and compare classification models for sex estimation based on combined measurement of long bones using machine learning classifiers. Eighteen measurements from four long bones (radius, humerus, femur, and tibia) were taken from a total of 2141 individuals. Five machine learning methods were employed to predict the sex: a linear discriminant analysis (LDA), penalized logistic regression (PLR), random forest (RF), support vector machine (SVM), and artificial neural network (ANN). The different classification algorithms using all bones generated highly accuracy models with cross-validation, ranging from 90 to 92% on the validation sample. The classification with isolated bones ranked between 83.3 and 90.3% on the validation sample. In both cases, random forest stands out with the highest accuracy and seems to be the best model for our investigation. This study upholds the value of combined long bones for sex estimation and provides models that can be applied with high accuracy to different populations. [ABSTRACT FROM AUTHOR]

The skeletal system of young animals undergoes a series of intensive and rapid changes. In this study, we aimed to verify the hypothesis that geese exhibit a distinct pattern of bone growth compared to gallinaceous species. Specifically, we hypothesised that geese would experience an accelerated growth rate in the humerus bone, which can be attributed to the increased wing mobility facilitated by their rearing in free-range systems. This need for access to both ground and water environments contributes to the unique demands placed on their skeletal development. We focused on evaluating the mechanical properties and geometry of the humerus as the forelimb bone, and the tibia as the hindlimb bone. The 320 geese used in this study were divided into 12 groups according to sex (females and males) and age (0-,1-,3-,6-,8-,12-,14-week-old). To assess bone mechanical properties, a three-point bending test was performed, along with densitometry and morphological measurements. The tibiae of the geese showed the most intensive growth until 6 weeks of age and then stabilised. The wing bones (humerus) showed only slight changes in the first weeks after hatching, and then a rapid growth between the third and sixth week, both in terms of mechanical and morphological properties. This is most likely due to a change in the geese's living environment during this period, i.e., allowing them to leave their enclosures and enter open space, which gives them the opportunity to use their wings, resulting in the rapid growth of the wing bones to support increasing muscle mass in this area. This study increases our understanding of bone growth and development in domesticated birds, specifically waterfowl species, and highlights the importance of rearing methods on the proper bone development and functionality of the entire skeletal system, and thus, on their welfare.

Background. Bones as an organ are one of the most common targets for tumor metastasis. Currently, the number of patients undergoing surgical treatment for metastatic bone lesions is steadily increasing. In most patients, after surgical treatment, the manifestation of clinical symptoms decreases, primarily pain syndrome, which improves their quality of life. However, it should be noted that the number of patients with bone metastases who underwent revision surgery is also increasing. This article retrospectively analyzes the factors leading to revision after surgical treatment of metastases in long bones. The aim of this study was to identify factors leading to revision after surgical treatment of patients with metastases in long bones. Methods. A retrospective medical records analysis of 247 patients who underwent surgical treatment for metastases in long bones on the basis of the P.A. Herzen Moscow Research Institute of Oncology in 20062020 was performed. Of these, 33 patients underwent revision surgery. The median age was 62 years. The localization of the primary tumor was as follows: breast cancer 10 cases, kidney cancer 13, lung cancer 3, prostate cancer 2, rectal cancer 3, liver cancer and Ewings sarcoma with bone metastases 1 case each. Results. The following factors led to revision surgery: mistakes in preoperative diagnosis (3 patients); postoperative infectious complication (6 patients); dislocation of the endoprosthesis (4 patients); continued growth of solitary metastasis after osteosynthesis (5 cases); aseptic instability after intramedullary osteosynthesis (14 patients); traumatic fracture of the endoprosthesis stem (1 patient). Conclusions. Revision after surgical treatment of metastases in long bones, in addition to postoperative complications, lead to mistakes in diagnosis and incorrect choice of surgical treatment method. To reduce the risk of revision surgical interventions, a multidisciplinary approach is needed with the development of surgical treatment tactics in consultation and the use of specialized scales of oncological prognosis.

Simple Summary: Ewing's sarcoma is a highly aggressive malignant small round-cell tumor that mainly affects children and adolescents. A raised level of C-reactive protein (CRP) seems to be an indicator of poor prognosis in several cancers. The purpose of the present study was to evaluate the prognostic role of CRP in children with Ewing's sarcoma in relation to previously cited variables, including age, gender, tumor volume, tumor site, chemotherapy-induced necrosis, and other inflammatory biomarkers. The identification of reliable prognostic factors could help to identify high-risk patients, which may require a different treatment and follow up. The purpose of the present study was to evaluate the prognostic role of C-reactive protein (CRP) in children with Ewing's sarcoma. We conducted a retrospective study on 151 children undergoing multimodal treatment for Ewing's sarcoma in the appendicular skeleton from December 1997 to June 2020. Univariate Kaplan-Meier analyses of laboratory biomarkers and clinical parameters showed that CRP and metastatic disease at presentation were poor prognostic factors associated with overall survival and disease recurrence at 5 years (p < 0.05). A multivariate Cox regression model showed that pathological CRP (≥1.0 mg/dL) [HR of 3.67; 95% CI, 1.46 to 10.42] and metastatic disease [HR of 4.27; 95% CI, 1.58 to 11.47] were associated with a higher risk of death at 5 years (p < 0.05). In addition, pathological CRP (≥1.0 mg/dL) [HR of 2.66; 95% CI, 1.23 to 6.01] and metastatic disease [HR of 2.56; 95% CI, 1.13 to 5.55] were associated with a higher risk of disease recurrence at 5 years (p < 0.05). Our findings demonstrated that CRP was associated with the prognosis of children with Ewing's sarcoma. We recommend pre-treatment measurement of the CRP in order to recognize children with Ewing's sarcoma who are at greater risk of death or local recurrence. [ABSTRACT FROM AUTHOR]

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Introduction It is known that the function and structure of the muscles of the thigh and lower leg are closely related to the function of the lower limb, which is impaired to one degree or another in all patients with chronic osteomyelitis. However, the nature of structural changes in the muscles, which, in turn, affect the condition of the bones, has not been well studied. Purpose of the work To study the features of changes in the muscles of the thigh and lower leg in patients with chronic osteomyelitis according to MSCT data. Material and methods The study is retrospective conducted at a single centre of Evidence level IV. Multislice computed tomography (MSCT) was used in 112 patients with chronic osteomyelitis of long bones of the lower extremities to study the radiological morphology of the muscles of the thigh and lower leg, including density, muscle belly area, and anatomical features. Twenty patients had chronic osteomyelitis in the area of transosseous elements (pins). The mean age of the patients was 48.5 ± 9.8 years. Males prevailed among the patients (87.5 %). The cause of osteomyelitis in 107 cases was trauma or surgery, five patients had consequences of hematogenous osteomyelitis. Results The results of the study showed that the muscles of the thigh and lower leg in patients with chronic osteomyelitis have pronounced dystrophic changes. In 89.4 % of patients, they were manifested by an increase in the density of the anterior tibial muscle, long extensor of the toes (84.7 %), peroneal muscles (78.5 %) and a decrease in the density of the head of the gastrocnemius muscle (91.3 %). In 10.6 % of the patients, there was a decrease in the density of the anterior tibial muscle, the long extensor of the fingers. In all patients with chronic osteomyelitis of the femur, the density of the muscles of the anterior and posterior groups was reduced, except for the musculus vastus intermedius of the thigh that was characterized by fibrotic changes with an increase in density. Conclusion The data obtained indicate that radiological morphological changes in muscles occur in all patients with chronic osteomyelitis of the femur and lower leg. The most pronounced alterations in the architectonics were in the anterior tibial and gastrocnemius muscles, and the intermediate broad muscle of the thigh.

This work presents the newly updated csg-toolkit package for GNU Octave, a user-friendly virtual osteology software that can compute and visualize the diaphyseal cross-sectional geometric (CSG) properties of the long bones of the lower and upper limbs. The CSG properties of the diaphysis have been extensively used for mechanical loading studies and have recently shown promising results in research topics of forensic anthropology, such as skeletal activity markers, sex estimation, and osteometric sorting. The csg-toolkit optimizes the computation of the CSG properties by integrating existing 3D technologies and novel computational geometry methods in osteology, so that they can be embedded in forensic applications. This new version supports a number of additional options regarding the computation and visualization of those properties, such as placement customization for the cross-sections, automatic registration and identification of the specific bone model and its alignment points, and visual inspection of the cross-sections upon generation. Additional improvements have been made that minimize the effort and time needed for analyzing a long bone. The csg-toolkit is a reliable alternative to the traditional Latex Cast Method. Overall, the csg-toolkit provides a simple, flexible, and computationally accurate method for 3D virtual long bone analysis and its free and open-source implementation can facilitate the utilization of cross-sectional geometry in forensic contexts.

Healing problems of segmental fractures of long bones are some of the most common complications. The purpose of this study is to review the incidence and pathogenesis of healing problems of segmental fractures of long bones. This is a simple literature review using the Pubmed database. Papers were searched with the use of the following keywords: ("segmental fractures") AND ("femur" OR "femoral" OR "tibia" OR "tibial" OR "humerus" OR "humeral" OR "forearm" OR "radius" OR "ulna). Moreover, the reference lists of the included papers were scanned for additional studies. Prospective or retrospective evaluating union rate and healing problems after the management of segmental fractures in long bones (femur, tibia, humerus, forearm) were included in this review. The search retrieved a total of 118 papers. After application of exclusion criteria, 30 studies were left in the present review. Successful healing of segmental fractures of long bones depends on the initial condition of the fracture, and surrounding soft tissues, since these high energy injuries may compromise the bone fragments blood supply. The rate of non-union is higher in open and severely comminuted fractures. Intramedullary nailing of segmental fractures of long bones seems to be the surgical option with the least healing problems. [ABSTRACT FROM AUTHOR]

Abstract Background Long-bone non-unions after intramedullary nailing can be treated by nail dynamization or focused high-energy extracorporal shock wave therapy (fESWT). The objective of this study was to assess the effect of the combination therapy of nail dynamization and fESWT on long-bone non-unions. Materials and methods 49 patients with long-bone non-unions (femur and tibia) after nailing were treated with nail dynamization (group D, n = 15), fESWT (group S, n = 17) or nail dynamization in addition to fESWT (group DS, n = 17). Patients were followed up for 6 months retrospectively. Furthermore, age, sex, Non-Union Scoring System (NUSS) score, time intervals from primary and last surgery until intervention and smoking status were analysed for their correlations to bone union. Results Union rates were 60% for group D, 64.7% for group S and 88.2% for group DS, with a significant difference between group D and DS (p = 0.024). Successful treatment was correlated with high age (OR 1.131; 95% CI 1.009–1.268; p = 0.034), female gender (OR 0.009; 95% CI 0.000–0.89; p = 0.039), low NUSS score (OR 0.839; 95% CI 0.717–0.081; p = 0.028) and negative smoking status (OR 86.018; 95% CI 3.051–2425.038; p = 0.009). Conclusions Data from the present study indicate that the combination therapy of nail dynamization and fESWT leads to a higher union rate than dynamization or fESWT alone. Level of evidence Level 3.

In contrast to cranial gunshot trauma, diagnosis and interpretation of gunshot trauma to long bones remains difficult and controversial. The aim of this study is to review the published literature on fracture patterns resulting from gunshot trauma in human long bones, and to use the described characteristics to provide practical guidance for the forensic anthropologist. In order to achieve this, medical and forensic publications on this topic were reviewed. Several types of fractures, such as linear, oblique, comminuted and butterfly fractures, have been observed in either the shaft or the ends of long bones. Indirect fractures that are not caused by bullets striking bone directly but by bullet-induced forces to the surrounding soft tissue have been found as well. Some of these fractures are related to a specific context or mechanism which might help in the forensic reconstruction of events. It is recommended that future research should focus on available medical data to provide more detailed descriptions on fracture patterns for forensic purposes. Experimentation with bone surrogates and computer modelling might also provide better and more realistic reconstructions of gunshot trauma in the future and provide valuable insights for its diagnosis and interpretation in forensic anthropology. [ABSTRACT FROM AUTHOR]

Currently, principles of tissue engineering and implantology are uniformly applied to all bone sites, disregarding inherent differences in collagen, mineral composition, and healing rates between craniofacial and long bones. These differences could potentially influence bone quality during the healing process. Evaluating bone quality during healing is crucial for understanding local mechanical properties in regeneration and implant osseointegration. However, site-specific changes in bone quality during healing remain poorly understood. In this study, we assessed newly formed bone quality in sub-critical defects in the maxilla and femur, while impairing collagen cross-linking using β-aminopropionitrile (BAPN). Our findings revealed that femoral healing bone exhibited a 73 % increase in bone volume but showed significantly greater viscoelastic and collagen changes compared to surrounding bone, leading to increased deformation during long-term loading and poorer bone quality in early healing. In contrast, the healing maxilla maintained equivalent hardness and viscoelastic constants compared to surrounding bone, with minimal new bone formation and consistent bone quality. However, BAPN-impaired collagen cross-linking induced viscoelastic changes in the healing maxilla, with no further changes observed in the femur. These results challenge the conventional belief that increased bone volume correlates with enhanced tissue-level bone quality, providing crucial insights for tissue engineering and site-specific implant strategies. The observed differences in bone quality between sites underscore the need for a nuanced approach in assessing the success of regeneration and implant designs and emphasize the importance of exploring site-specific tissue engineering interventions. STATEMENT OF SIGNIFICANCE: Accurate measurement of bone quality is crucial for tissue engineering and implant therapies. Bone quality varies between craniofacial and long bones, yet it's often overlooked in the healing process. Our study is the first to comprehensively analyze bone quality during healing in both the maxilla and femur. Surprisingly, despite significant volume increase, femur healing bone had poorer quality compared to the surrounding bone. Conversely, maxilla healing bone maintained consistent quality despite minimal bone formation. Impaired collagen diminished maxillary healing bone quality, but had no further effect on femur bone quality. These findings challenge the notion that more bone volume equals better quality, offering insights for improving tissue engineering and implant strategies for different bone sites., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.)

A prospective clinical study consisting of six bovines (200–300 kg body weight) undergoing open tibial fractures was carried out, to evaluate the use of circular and hybrid external skeletal fixation (ESF) systems for open tibial fracture repair in large ruminants. The ESF systems consisting of 4 full rings (n = 2), 8 half-rings (n = 1), 2 full rings with 2 sidebars (n = 2) or 2 full rings with 4 sidebars (n = 1) were used to treat open tibial fractures. The healing progress of the animals was evaluated based on different clinical and radiographic examinations. The level of fracture reduction, alignment, and fixation ranged between satisfactory to adequate in all the animals. The fixators were well tolerated and maintained by the animals till the complete repair of the fracture. Adequate fracture healing with satisfactory functional recovery was observed in all the animals in about 3–4 months. The different designs of ESFs were found to provide adequate stability in open tibial fractures in animals weighing 200–300 kg. However, the fixators need to be evaluated in numerous clinical cases to establish their suitability in routine clinical settings. [ABSTRACT FROM AUTHOR]

Aims: Aneurysmal bone cysts (ABCs) are locally aggressive lesions typically found in the long bones of children and adolescents. A variety of management strategies have been reported to be effective in the treatment of these lesions. The purpose of this review was to assess the effectiveness of current strategies for the management of primary ABCs of the long bones. Methods: A systematic review of the published literature was performed to identify all articles relating to the management of primary ABCs. Studies required a minimum 12-month follow-up and case series reporting on under ten participants were not included. Results: A total of 28 articles meeting the eligibility criteria were included in this review, and all but one were retrospective in design. Due to heterogeneity in study design, treatment, and outcome reporting, data synthesis and group comparison was not possible. The most common treatment option reported on was surgical curettage with or without a form of adjuvant therapy, followed by injection-based therapies. Of the 594 patients treated with curettage across 17 studies, 86 (14.4%) failed to heal or experienced a recurrence. Similar outcomes were reported for 57 (14.70%) of the 387 patients treated with injection therapy across 12 studies. Only one study directly compared curettage with injection therapy (polidocanol), randomizing 94 patients into both treatment groups. This study was at risk of bias and provided low-quality evidence of a lack of difference between the two interventions, reporting success rates of 93.3% and 84.8% for injection and surgical treatment groups, respectively. Conclusion: While both surgery and sclerotherapy are widely implemented for treatment of ABCs, there is currently no good quality evidence to support the use of one option over the other. There is a need for prospective multicentre randomized controlled trials (RCTs) on interventions for the treatment of ABCs.

The purpose of the present study was to evaluate the prognostic role of C-reactive protein (CRP) in children with Ewing’s sarcoma. We conducted a retrospective study on 151 children undergoing multimodal treatment for Ewing’s sarcoma in the appendicular skeleton from December 1997 to June 2020. Univariate Kaplan-Meier analyses of laboratory biomarkers and clinical parameters showed that CRP and metastatic disease at presentation were poor prognostic factors associated with overall survival and disease recurrence at 5 years (p < 0.05). A multivariate Cox regression model showed that pathological CRP (≥1.0 mg/dL) [HR of 3.67; 95% CI, 1.46 to 10.42] and metastatic disease [HR of 4.27; 95% CI, 1.58 to 11.47] were associated with a higher risk of death at 5 years (p < 0.05). In addition, pathological CRP (≥1.0 mg/dL) [HR of 2.66; 95% CI, 1.23 to 6.01] and metastatic disease [HR of 2.56; 95% CI, 1.13 to 5.55] were associated with a higher risk of disease recurrence at 5 years (p < 0.05). Our findings demonstrated that CRP was associated with the prognosis of children with Ewing’s sarcoma. We recommend pre-treatment measurement of the CRP in order to recognize children with Ewing’s sarcoma who are at greater risk of death or local recurrence.

Background: Long-bone non-unions after intramedullary nailing can be treated by nail dynamization or focused high-energy extracorporal shock wave therapy (fESWT). The objective of this study was to assess the effect of the combination therapy of nail dynamization and fESWT on long-bone non-unions.Materials and Methods: 49 patients with long-bone non-unions (femur and tibia) after nailing were treated with nail dynamization (group D, n = 15), fESWT (group S, n = 17) or nail dynamization in addition to fESWT (group DS, n = 17). Patients were followed up for 6 months retrospectively. Furthermore, age, sex, Non-Union Scoring System (NUSS) score, time intervals from primary and last surgery until intervention and smoking status were analysed for their correlations to bone union.Results: Union rates were 60% for group D, 64.7% for group S and 88.2% for group DS, with a significant difference between group D and DS (p = 0.024). Successful treatment was correlated with high age (OR 1.131; 95% CI 1.009-1.268; p = 0.034), female gender (OR 0.009; 95% CI 0.000-0.89; p = 0.039), low NUSS score (OR 0.839; 95% CI 0.717-0.081; p = 0.028) and negative smoking status (OR 86.018; 95% CI 3.051-2425.038; p = 0.009).Conclusions: Data from the present study indicate that the combination therapy of nail dynamization and fESWT leads to a higher union rate than dynamization or fESWT alone.Level Of Evidence: Level 3. [ABSTRACT FROM AUTHOR]

The problem of treating fractures of the long bones of the limbs (FLB) does not lose its relevance, since among all injuries of the locomotor system, they occur most often and are accompanied by various complications. According to the literature, in 38 % of patients, disability from injuries of the locomotor system is due to its functional disorders, and in most cases it can be prevented by following the correct rehabilitation measures. Objective. To analyze and determine the most important factors for the formation of a rehabilitation program for patients with FLB and to evaluate the effectiveness of these measures. Methods. A medico-social analysis of the results of treatment of 63 patients (41 men and 22 women) with FLB, including those with flammability, who received treatment at the «Sitenko Institute of Spine and Joint Pathology NAMS of Ukraine» in 2020‒2021. Of them, 63.5 % had multiple injuries, in 2020 -- 64.3 %, in 2021 -- 62.8 %. The results. The clinical and functional state of the patients was analyzed, taking into account the nature of the injury and the location of the fractures, depending on the level of rehabilitation potential. The main organizational principles of providing medical assistance and rehabilitation to victims of FLB have been defined and formulated. The rehabilitation groups of patients are characterized, the main factors affecting the rehabilitation potential and rehabilitation prognosis are determined. The main principles that must be taken into account when drawing up an individual rehabilitation program for patients with FLB are formulated. Conclusions. The conducted studies showed that the proposed principles of creating a medical rehabilitation program for patients with fractures of the long bones of the limbs made it possible to more objectively substantiate the scope and terms of restorative treatment at all stages of rehabilitation and specify the structure of rehabilitation measures for every case, that, finally, made it possible to develop individual rehabilitation programs for these patients and improve the results of their treatment. [ABSTRACT FROM AUTHOR]

Objective: To construct fetal limb bone nomograms in the Chinese ethnic population., Methods: This was a prospective cross-sectional study on singleton pregnancies between 12 and 37 weeks of gestation. Femur, tibia, fibula, humerus, ulna, radius, and foot length were measured in a standardized manner by one of the three sonographers. Each fetus's measurements were only included once and those who developed maternal or fetal complications were excluded. Fractional polynomial regression model was used to obtain the 3rd, 10th, 50th, 90th, and 97th centiles for each of the limb measurement. Z -score for the 50th centile of each fetal limb measurement was then compared with published nomograms derived from other populations., Results: Of the 843 scans performed, 775 were included in analysis after excluding conditions such as pre-eclampsia, chromosomal abnormalities, single umbilical artery and skeletal dysplasia. Comparison with other populations showed that Chinese had shorter fetal limb bone lengths than the Caucasian and Afro-Caribbean populations., Conclusion: This study established nomograms for all the fetal limb bones in the Chinese ethnic population, which showed lengths comparatively shorter than Caucasian and Afro-Caribbean nomograms. This would reduce the false alarm of short fetal limb bone lengths and its consequent anxiety and intervention.

Internal remodeling of Bone models describes the process by which bone adapts its histological structure to change in the long duration of mechanical load areas. In orthopedics, wave propagation over bone is used in monitoring the rate of fracture healing. The present problem studies the effect of initial stress, rotation and magnetic field on wave propagation in long dry bones. A dry long bone has been considered as an orthotropic hollow cylinder. The equation of motion is solved in terms of displacements. Bisection method has been used to calculate the phase velocity of harmonic wave and frequencies of vibration in anisotropic long bone. Peculiar effects of rotation, initial stress, surface span and magnetic field on vibrations in long bone medium have been investigated and presented through graphs. The present study finds its applications in wave propagation and vibration test to determine the vivo properties of long bones. As an outcome, there is a significant effect of initial stress on long bone structure as compared to rotation and magnetic parameter. Findings may also be useful for theoretical development of orthopedic studies related to cylindrical poroelastic long bones. [ABSTRACT FROM AUTHOR]

Introduction Analysis of the literature and our own data confirm that changes in bone structure in chronic osteomyelitis vary in extension and severity, the boundaries of which are very difficult to determine. Purpose To analyze the extension of the lesion and the depth of bone structure destruction with the method of MSCT in various types of osteomyelitis and variants of its location. Materials and methods The study is retrospective and single-center. The method of polypositional radiography and multislice computed tomography (MSCT) was used to study the features of the X-ray morphology of the femur and tibia with a quantitative assessment of the density of various bone areas in 235 patients with chronic osteomyelitis. Results Chronic osteomyelitis was mostly located in the diaphysis of the femur (33) and tibia (52). Osteomyelitis in all cases was post-traumatic or post-surgical. Fourteen patients had pseudarthrosis or bone defect as a result of a long duration of the disease. Analysis of MSCT data showed that anatomical changes in the femur and tibia in chronic osteomyelitis were individual in all patients. Radiographic morphological manifestations consisted of general symptoms (osteoporosis, osteosclerosis, disorders in architectonics). However, the severity, extension and nature of the structural changes were extremely diverse. The change in bone density featured large deviations. Conclusion The data obtained indicate that the “imaging reality” in the diagnosis of chronic osteomyelitis is computed tomography as it enables to determine the extension and nature of bone changes, to detail various changes in anatomy and architectonics, indicating the “multifaceted character” of chronic osteomyelitis.

Abstract Background Malignant fibrous neoplasms (MFN) of long bones are rare lesions. Moreover, the prognostic determinants of MFN of long bones have not been reported. This study aimed to present epidemiological data and analyse the prognostic factors for survival in patients with MFN. Materials and methods The Surveillance, Epidemiology, and End Results (SEER) programme database was used to screen patients with malignant fibrous neoplasms (MFN) of long bones from 1973 to 2015, with attention to fibrosarcoma, fibromyxosarcoma, periosteal fibrosarcoma and malignant fibrous histiocytoma. The prognostic values of overall survival (OS) and cancer-specific survival (CSS) were assessed using the Cox proportional hazards regression model with univariate and multivariate analyses. The Kaplan–Meier method was used to obtain OS and CSS curves. Results A total of 237 cases were selected from the SEER database. Malignant fibrous histiocytoma was the most common form of lesion in long bones. Multivariate analysis revealed that independent predictors of OS included age, stage, tumour size and surgery. Age, stage, tumour size and surgery were also independent predictors of CSS. Additionally, the most significant prognostic factor was whether metastasis had occurred at the time of initial diagnosis. Conclusion Among patients with MFN of long bones, age (> 60 years), tumour size (> 10 cm), distant stage, and non-surgical treatment are factors for poor survival.

Аbctract. Treatment of long bones fractures of the extremities has a particular relevance in modern traumatology due to their high frequency, as well as a large number of deaths in patients with polytrauma. It is dangerous to perform an urgent final osteosynthesis in severe patients because of the possibility of shock and the deterioration of the condition of the injured. Therefore, the principle of Damage control with urgent fixation of damaged segments by external fixation and their subsequent replacement (converse) to intramedullary osteosynthesis had a particular relevance in the treatment of patients with long bones fractures. Purpose: Improving treatment outcomes for patients with long bones fractures. Materials and methods. In the present study, a retrospective analysis of using conversion osteosynthesis in the treatment of 120 patients with long bones extremities fractures in a multidisciplinary hospital was carried out. For a better analysis of the results of treatment, we divided the patients into two groups: The first group 44 patients with fractures of the long bones with polytrauma according to the ISS severity scale> 17. The second group consists of 76 patients with closed isolated unstable comminuted fractures of the long bones with severe post-traumatic edema, who have a high risk of significant trauma of soft tissues. Results. The most optimal time for conversion osteosynthesis to patients with polytrauma was 7-12 days, which prevented the occurrence of traumatic shock; and for patients with closed isolated unstable fractures of long bones with significant of post-traumatic edema for conversion osteosynthesis, the optimal time was 3-7 days after injury, which prevented the occurrence of inflammatory complications in the postoperative period. Conclusion. The study confirmed the feasibility of conversion osteosynthesis in the treatment of patients with diaphyseal fractures. The use of the technique of transferring the fixation of fragments by the external fixation device to the internal osteosynthesis (conversion) contributed to a reduction in the duration of inpatient treatment of patients with fractures of the long bones.

The morphological evolution of the appendicular skeleton may reflect the selective pressures specific to different environments, phylogenetic inheritance, or allometry. Covariation in bone shapes enhances morphological integration in response to ecological specializations. In contrast to previous multivariate studies using classical linear morphometry, we use a geometric morphometric approach to explore the morphological diversity of long bones and examine relationships between ecological categories and morphological characters in a species-rich and ecomorphologically diverse group of rodents. We examined the humerus, ulna, femur, and tibiofibula of 19 sigmodontine species with different locomotor types (ambulatory, quadrupedal-saltatorial, natatorial, semifossorial and scansorial) to investigate the influence of locomotor type and phylogeny on limb bone shape and morphological integration of the appendicular skeleton. This study represents the most detailed examination of the morphological diversity of long bones in sigmodontines, employing geometric morphometrics within an ecomorphological framework. Our results indicate that functional demands and evolutionary history jointly influence the shape of forelimb and hindlimb bones. The main variation in bone shape is associated with a slenderness-robustness gradient observed across all ecological categories. Quadrupedal-saltatorial species, with their need for agility, possess slender and elongated limbs, while natatorial and semifossorial species exhibit shorter and more robust bone shapes, suited for their respective environments. This gradient also influences bone covariation within limbs, demonstrating interconnectedness between elements. We found functional covariation between the ulna-tibiofibula and humerus-tibiofibula, likely important for propulsion, and anatomical covariation between the humerus-ulna and femur-tibiofibula, potentially reflecting overall limb structure. This study demonstrates that the versatile morphology of long bones in sigmodontines plays a critical role in their remarkable ecological and phylogenetic diversification., (© 2024 American Association for Anatomy.)

Introduction: The surgery of the fracture of the long bones is inherent to certain complications, one being nonunion. As various modalities are proposed, we aim in our study to compare the clinical and radiographic outcomes after the treatment with the Limb Reconstruction System (LRS) fixator and Ilizarov for the infected tibia with nonunion considering the bone gap quantifications. Materials and Methods: We conducted an observational prospective study among 40 subjects with tibial nonunion. They were grouped equally to be treated by the LRS fixator and Ilizarov. Clinical and radiographic outcomes were compared using the "Chi-squared and independent Student's t-test," deliberating P < 0.05 as significant. Results: We observed no significant difference for both the groups in the clinical union and functional and radiographic outcome for the various gaps of the nonunion. There was no significant difference for the groups when the time of healing was compared. Conclusion: Comparable results are seen for both the treatment modalities. However, IL fixator performed better clinically, while the LRS was easily accepted by the patients. [ABSTRACT FROM AUTHOR]

Pseudarthrosis is a dreadful condition because it is very difficult to treat even for the orthopedic surgeons. The best thing to do is always to prevent it. The purpose of our study was to determine the prevalence and risk factors for traumatic long-bone pseudarthrosis in the city of Butembo. We conducted a retrospective study of 36 patients with traumatic pseudarthrosis. Data were collected from the hospital records of 968 patients with long-bone fractures at the Matanda Hospital, in the town of Butembo, eastern Democratic Republic of the Congo from 01/06/2016 to 31/05/2019. We calculated the rate of pseudarthrosis and used a single- and multiple logistic regression model to investigate factors associated with pseudarthrosis. The rate of pseudarthrosis was 3.72%. The most common type of pseudarthrosis included floating injuries (69.44%). Risk factors were: working as a rickshaw driver (aOR: 4.60; aCI 95% 1.04-15.21; p = 0.023) and a cultivator (aOR: 2.31; aCI 95% 1.17-4.68; p = 0.008), malnutrition (aOR: 5.83; aCI 95% 1.87-15.62; p = 0.004), tobacco poisoning (aOR: 6.70; aCI 95% 1.84-20.11; p = 0.003) and tobacco+ alcohol consumption (aOR: 4.74; aCI 95% 2.17-9.89; p < 0.001); gunshot injuries (aOR: 6.70; aCI 95% 1.84-20.11; p = 0.003), open fractures (aOR: 4.35; aCI 95% 2.17-9.12; p < 0.001), fracture site infections (aOR: 3.10; aCI 95% 1.03-7.95; p = 0.023); traditional healer (aOR: 12.18; aCI 95%: 5.74-25.37; p < 0.001), general practitioner (aOR: 8.33; aCI 95% 1.77-30.31; p = 0.006) initial absence X-ray assessment (aOR: 12.21; aCI 95% 5.92-24.96; p < 0.001). Long bone pseudarthroses are common in Butembo. The most effective way to prevent them is to know and avoid risk factors. [ABSTRACT FROM AUTHOR]

Introduction: The Double-spurred francolin (Francolinus bicalcaratus) also known as African Bush Fowl, is a popular bird found in all the geological zones of West Africa. The bird is closely related to galliformes like jungle fowls and cortunix feeding on insects, seeds and vegetable matter. We investigated the pelvic and long bones in Francolinus bicalcaratus to determine the differetianting features as well as the depth of sexual dimorphism in these bones. Methods: Skeleton from five males and five females Francolinus bicalcaratus were acquired using standard evisceration methods. Linear parameters were measured using a Digital Vernier Caliper (Neiko® China, sensitivity of 0.01mm,). A Protractor was used to determine the angles. All morphometric data obtained were subjected to one-way analysis of Variance (ANOVA) at a p <0.05. Results: The two foramina in the male pelvic bone had higher mean values compared to the female, but the acetabulum was non-significantly wider in the female The adult male birds bore two tibio-tarsal spurs. The first (closer to the distal end of the bone) was longer than the second. The mean values of pelvic bone parameters were wider in female than male except for the pelvic length, and pubic bone length. The femur, tibiotarsal and tarsometatarsal length of male was not significantly wider relative to female. The male had longer femur but the female epiphyseal ends of the bone were wider in mean values. The male also had a significantly higher greater trochanter compared to the female. The tarsometatarsal bone that bore the spurs in male was also longer than in female. In the female, the epiphyseal end is wider but with no significant variant (p>0.05) compared to the male epiphyseal end. Significance: The observations made in the course of this study will provide baseline data and other foundational information relevant to the conservation of this animal. [ABSTRACT FROM AUTHOR]

Abstract Background Sufficient data on outcome of patients with clinically and radiologically aggressive enchondromas and atypical cartilaginous tumors (ACT) is lacking. We therefore analyzed both conservatively and surgically treated patients with lesions, which were not distinguishable between benign enchondroma and low-grade malignant ACT based upon clinical and radiologic appearance. Methods The series included 228 consecutive cases with a follow-up > 24 months to assess radiological, histological, and clinical outcome including recurrences and complications. Pain, satisfaction, functional limitations, and the musculoskeletal tumor society (MSTS) score were evaluated to judge both function and emotional acceptance at final follow-up. Results Follow-up took place at a mean of 82 (median 75) months. The 228 patients all had comparable clinical and radiological findings. Of these, 153 patients were treated conservatively, while the other 75 patients underwent intralesional curettage. Besides clinical and radiological aggressiveness, most lesions were histologically judged as benign enchondromas. 9 cases were determined to be ACT, while the remaining 7 cases had indeterminate histology. After surgery, three patients developed a recurrence, and a further seven had complications of which six were related to osteosynthesis. Both groups had excellent and almost equal MSTS scores of 96 and 97%, respectively, but significantly less functional limitations were found in the non-surgery group. Further sub-analyses were performed to reduce selection bias. Sub-analysis of histologically diagnosed enchondromas in the surgery group found more pain, less function, and worse MSTS score compared to the non-surgery group. Sub-analysis of smaller lesions ( 4.4 cm: MSTS score: 94.0% versus 97.3%, p = 0.007; pain 2.3 versus 0.8, p = 0.001). The majority of lesions treated surgically was filled with polymethylmethacrylate bone-cement, while the remainder was filled with cancellous-bone, without significant difference in clinical outcome. Conclusion Feasibility of intralesional curettage strategies for symptomatic benign to low-grade malignant chondrogenic tumors was supported. Surgery, however, did not prove superior compared to conservative clinical and radiological observation. Due to the low risk of transformation into higher-grade tumors and better functional results, more lesions might just be observed if continuous follow-up is assured.

Background and Aim Nutrient foramina form important landmarks on human bones as they form portal of entry for nutrient artery. Nutrient artery is an important source of blood supply for a growing bone. Different parameters of nutrient foramina are important in various procedures such as vascularized bone grafting, tumor resections, fracture repair, and other surgical procedures in orthopedics. The objective of the present study was to report the number, position, direction, size, and foraminal index of nutrient foramen in the femur, tibia, and fibula. Materials and Methods The present study analyzed the location, direction, size, and the number of nutrient foramina in the diaphysis of 180 long bones of the lower limbs of adults: 60 femurs, 60 tibiae, and 60 fibulae. Result The location of the nutrient foramina is predominant on the posterior aspect of the lower limb long bones. Single nutrient foramen found in the tibia (100%), femur (48.3%), and fibula (60%) may represent as a single source of blood supply. The majority of the femur (50%) and few fibulae (5%) had a double nutrient foramen. The mean foraminal index for the lower limb bones was 40.5% for the left and 38.2% for the right side of the femur, 31.69% for the left and 32.3% for the right side of the tibia, and 32.7% for the left and 31.7% for the right side of the fibula. Conclusion The present study provides information on the number, size, position, and direction of nutrient foramina of the femur, tibia, and fibula bones.

To evaluate the bone microstructure of autogenous graft bone in elderly people (mean age, 66 years), we compared the bone volume/total volume and bone mineral density of four donor sites that are commonly harvested for maxillofacial surgery and dental implant treatments, using X-ray micro-computed tomography. Eighteen Japanese cadavers were included in this study. Overall, 66 harvested bones (mandibular symphysis, mandibular ramus, ilium, and tibia) were studied. Micro-computed tomography scans of four sites were performed to analyze the trabecular structures, bone mineral density, and bone volume/total volume in these bones. The mandibular symphysis bones showed the highest bone volume/total volume and bone mineral density at the four sites. There was a significant difference in the bone volume/total volume between the mandibular symphysis and tibia groups. There was also a significant difference in bone mineral density between the mandibular symphysis group and the ilium and tibia groups. In the three-dimensional observations, the structures of the mandibular trabecular were plate-type. The structures of the tibial bone were mixtures of plate- and rod-types. In the ilium, most trabecula were rod-shaped. Mandibular symphysis and ramus had a higher bone volume/total volume and bone mineral density of the four sites and did not show regressive changes in our findings. Mandibular bone is the most suitable source of autogenous graft bone material because of its superior bone quality and quantity. [ABSTRACT FROM AUTHOR]

Deep learning, one of the most popular topics of recent years, is frequently used in the biomedical field. Disease and fracture detection, data estimation, tissue and organ segmentation, and many other applications are successfully carried out with deep learning algorithms. However, while these applications are valid for human medicine, veterinary medicine is left behind. So, the deficiency in the literature about animal's X-Ray images processing has been the biggest motivation for this study. In this work, a comprehensive dataset containing dog X-Rays taken from Ankara Metropolitan Municipality Stray Animals Temporary Nursing Home, was processed with deep learning algorithms. It is aimed to determine the type of long bone. Like many other studies, Convolutional Neural Networks'(CNN) architectures are utilized in this study, too. Transfer learning was carried out with AlexNet, GoogLeNet and VGG-19 deep learning models, and the classification performance was tested with Support Vector Machines (SVM). [ABSTRACT FROM AUTHOR]

Objectives: This study describes and demonstrates the functionalities and application of a new R package, morphomap, designed to extract shape information as semilandmarks in multiple sections, build cortical thickness maps, and calculate biomechanical parameters on long bones. Methods: morphomap creates, from a single input (an oriented 3D mesh representing the long bone surface), multiple evenly spaced virtual sections. morphomap then directly and rapidly computes morphometric and biomechanical parameters on each of these sections. The R package comprises three modules: (a) to place semilandmarks on the inner and outer outlines of each section, (b) to extract cortical thicknesses for 2D and 3D morphometric mapping, and (c) to compute cross‐sectional geometry. Results: In this article, we apply morphomap to femora from Homo sapiens and Pan troglodytes to demonstrate its utility and show its typical outputs. morphomap greatly facilitates rapid analysis and functional interpretation of long bone form and should prove a valuable addition to the osteoarcheological analysis software toolkit. Conclusions: Long bone loading history is commonly retrodicted by calculating biomechanical parameters such as area moments of inertia, analyzing external shape and measuring cortical thickness. morphomap is a software written in the open source R environment, it integrates the main methodological approaches (geometric morphometrics, cortical morphometric maps, and cross‐sectional geometry) used to parametrize long bones. [ABSTRACT FROM AUTHOR]

Fracture is defined by the loss of bone or cartilage continuity, either total or partial. Diabetes mellitus (DM) is a group of metabolic diseases characterized by hyperglycaemia resulting from defects in insulin secretion, insulin action, or both. HbA1c could be used as a diagnostic tool and determines the glycaemic control of DM patients. This study aimed to investigate the correlation between serum HbA1c levels and the healing process of postoperative fractures in DM patients. This was an observational study with a retrospective cohort design. The study population was DM patients who were admitted to the Department of Emergency, Dr. Wahidin Sudirohusodo General Hospital, Makassar due to long bone fracture within the period of September 2019-February 2020. The bone fractures healing was evaluated based on the radiographic union scale in tibial fractures (RUST) scores. The results are analysed using the Chi-square test. A total of 70DM patients who underwent fracture reduction surgery were involved in this study. Out of 35 patients with controlled DM (HbA1c 7%), and there were 13 (37.1%) patients and 22 (62.9%) patients with good and delayed union, respectively. The Chi-square test showed a significant relationship (p= 0.008). It can be concluded that the increase in HbA1c levels was related to the obstacles in bone fractures healing. Moreover, an infection contributes to the healing status of bone fractures.

Lumentxa is a classic site in Basque Prehistory, excavated in three different phases during the 20th century, which has yielded evidence of both Pleistocene and Holocene occupations. In this article, we present a detailed study of the human remains from this site including paleobiological, taphonomic, biomechanical and chronological perspectives. The human assemblage comprises of a minimum number of seven individuals: three subadult and four adults, with both sexes represented, although part of the human collection is currently lost. We have obtained C14 dates from 4 of these 7 individuals indicating a prolonged funerary use of the cave from the Early Neolithic until the Bronze Age. We observed some biases in the skeletal representation which could be due to differences in the excavation methods between field seasons and/or the action of carnivores, the latter being evident in at least three of the individuals. The taphonomic modifications are typical off those found in the post-abandonment phases in cave funerary contexts. The relatively low number of individuals compared with other sites in the region and extended timespan over which the remains were deposited suggest that the cave was used only sporadically for funerary purposes. We report the first biomechanical data for a Neolithic individual from the Iberian Peninsula, which show greatest overall similarity to the Neolithic sample from France and Italy. Finally, the broad time period covered by the direct dates and the more complex taphonomic history than was previously assumed for such sites indicate that caution is warranted when assigning sepulchral caves to cultural periods in the Western Pyrenees when no direct radiocarbon dates have been obtained. [ABSTRACT FROM AUTHOR]

An inverse relationship between bone marrow (BM) adiposity and bone mass has been described in different physiological and pathological conditions, including osteoporosis (OP). In osteoporotic patients, lower bone mass density is indeed associated with higher BM fat content, suggesting a potential role for bone lipids in the OP pathogenesis. Nevertheless, some questions remain. Is that BM adiposity a cause or a consequence of the bone loss? What kinds of lipids are involved? Human data are somehow contradictories regarding bone lipid signature related to OP, and animal data are needed to support on one or another way the human observations. Bone lipid signature associated to OP needs to be clarified if we want to understand better their roles in OP. In that context, by using an ovariectomy-induced OP murine model and looking at lipids in two bone compartments: BM and mineralized tissue (MT), our first challenge was to identify local lipid changes in relation to OP, in view to explore later the mechanisms by which those compounds could alter bone quality, particularly during the mineralization process. As the most striking data, long-term OP resulted in an accumulation of triglycerides, reduced levels of arachidonic and docosahexaenoic acids, an increase of stearoyl-CoA desaturase indices and a reduction of sphingomyelin in the MT, and potential consequences on bone properties and cell activities are discussed. The reader will appreciate that we are at an early stage of understanding the roles of lipids in the OP development and more investigations will be necessary. • Bone loss is associated to an increased bone marrow adiposity in OP human. • Triglyceride level and stearoyl-CoA desaturase indexes are elevated in OP murine femurs. • Local arachidonic acid reduction might reflect an increased PGE2 demand for bone repair during OP. • OP-associated sphingomyelin catabolism in the mineral tissue need more attention in the future. [ABSTRACT FROM AUTHOR]

Mustelidae, a carnivoran clade that includes for instance weasels, badgers, otters and martens, has undergone several evolutionary transitions of lifestyle, resulting in specializations for fossorial, natatorial and scansorial locomotion, in addition to more generalized species. The family is therefore regarded as offering an adequate framework for morpho-functional analyses. However, the architecture of the epiphyseal trabecular bone, which is argued to be particularly responsive to the biomechanical environment, has never been studied. Here, we quantify trabecular bone parameters of the proximal and distal epiphyses of the humerus and femur in 29 species of mustelids and assess the differences of these parameters among groups defined a priori based on the aforementioned locomotor types. The parameters are assessed in a phylogenetic framework, taking into account the potential effect on an individual's body mass. The range of variation described by the acquired parameters is relatively restricted when compared to that of other clades. Generalists, however, are featuring a wider range of variation than the other types. While clear discrimination of locomotor types is difficult, some differences were highlighted by our analysis, such as a greater bone fraction associated with the natatorial taxa, which we discuss in a functional context.

Introduction: In Forensic Medicine, the estimation of the stature often has a crucial role in the reconstruction phase of disjointed populations. The femur, being the longest bone in the human body, is usually the most reliable source in height estimation. However, in these populations, intact femurs are hardly ever found, making it necessary to use femur fragments for the same purpose. Aim: This investigation aims to estimate the stature of the catastrophic population concerning the earthquake that occurred in Lisbon, in 1755. Materials and Methods: The study was conducted on 8 whole femurs and 21 fragments, which were measured and weighted. These measurements were applied in a regression formula, obtained from the gathered research, in order to estimate the stature of the population. Results: The results showed that, for the whole femur, the corresponding height varies between 147.96 cm and 168.82 cm. For the fragments, the obtained estimates vary between 151.96 cm and 174.96 cm. Conclusion: The methods used proved to be reliable in estimating the length of the femur, as well as in deducting the height of individuals through this bone, allowing the study of these parameter's evolution in generations. [ABSTRACT FROM AUTHOR]

Bone is a nonlinear, inhomogeneous and anisotropic material. To predict the behavior of bones expert systems are employed to reduce the computational cost and to enhance the accuracy of simulations. In this study, an artificial neural network (ANN) was used for the prediction of displacement in long bones followed by ex-vivo experiments. Three hydrated third metacarpal bones (MC3) from 3 thoroughbred horses were used in the experiments. A set of strain gauges were distributed around the midshaft of the bones. These bones were then loaded in compression in an MTS machine. The recordings of strains, load, load exposure time, and displacement were used as ANN input parameters. The ANN which was trained using 3,250 experimental data points from two bones predicted the displacement of the third bone (R2 ≥ 0.98). It was suggested that the ANN should be trained using noisy data points. The proposed modification in the training algorithm makes the ANN very robust against noisy inputs measurements. The performance of the ANN was evaluated in response to changes in the number of input data points and then by assuming a lack of strain data. A finite element analysis (FEA) was conducted to replicate one cycle of force-displacement experimental data (to gain the same accuracy produced by the ANN). The comparison of FEA and ANN displacement predictions indicates that the ANN produced a satisfactory outcome within a couple of seconds, while FEA required more than 160 times as long to solve the same model (CPU time: 5 h and 30 min). [ABSTRACT FROM AUTHOR]

Background: Malignant fibrous neoplasms (MFN) of long bones are rare lesions. Moreover, the prognostic determinants of MFN of long bones have not been reported. This study aimed to present epidemiological data and analyse the prognostic factors for survival in patients with MFN.Materials and Methods: The Surveillance, Epidemiology, and End Results (SEER) programme database was used to screen patients with malignant fibrous neoplasms (MFN) of long bones from 1973 to 2015, with attention to fibrosarcoma, fibromyxosarcoma, periosteal fibrosarcoma and malignant fibrous histiocytoma. The prognostic values of overall survival (OS) and cancer-specific survival (CSS) were assessed using the Cox proportional hazards regression model with univariate and multivariate analyses. The Kaplan-Meier method was used to obtain OS and CSS curves.Results: A total of 237 cases were selected from the SEER database. Malignant fibrous histiocytoma was the most common form of lesion in long bones. Multivariate analysis revealed that independent predictors of OS included age, stage, tumour size and surgery. Age, stage, tumour size and surgery were also independent predictors of CSS. Additionally, the most significant prognostic factor was whether metastasis had occurred at the time of initial diagnosis.Conclusion: Among patients with MFN of long bones, age (> 60 years), tumour size (> 10 cm), distant stage, and non-surgical treatment are factors for poor survival. [ABSTRACT FROM AUTHOR]

A sample of 6098 published prehistoric skeletons consisting of long bone lengths, stature estimated from them using three different methods, as well as recalculated stature data created with other methods, was used to model tempo-spatial variance of stature in the Holocene prehistory of the Near East and Europe. Bayesian additive mixed modeling with errors-in-variables was applied, fitting a global spatiotemporal trend using a tensor product spline approach, a local random effect for the archaeological sites and corrections for mismeasurement and misclassification of covariates to obtain stature isoline maps for various time slices and diachronic stature trend curves for various regions. Models calculated for maximum long bone lengths and for stature are all largely consistent with each other, so Bayesian errors-in-variables models can be regarded as a viable means of smoothing regional and temporal variance in skeletal data as well as in estimation methods so that only robust trends become manifest. In addition to a general northwest-southeast gradient in stature, tallest stature in Eurasia and declining stature in Iberia confirms archaeogenetic insights. Transition to farming shows stable, decreasing, or even increasing stature depending on the region and the mode of Neolithization, putting into question the common assumption of a general negative effect of Neolithic lifeways on physical health. Particularly, Northern Europe experienced a rise in stature after the 4th millennium BC. Likely caused by both genetics as well as generally improving living conditions, our findings date the origin of the modern NW-SE gradient in stature to around 3000 BC. [ABSTRACT FROM AUTHOR]