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Paediatric hand fractures account for approximately 25% of hand-related emergency department visits, making them the second most common childhood fractures after distal forearm fractures. These injuries are more prevalent in boys and peak ages between 9 and 14 years. Hand fractures in children are primarily caused by crushing injuries and, increasingly in older children, by sports-related activities. The little finger (52%) and thumb (23%) are the most frequently fractured digits, with phalangeal fractures, especially of the proximal phalanx, being common. Metacarpal fractures are more prevalent in adolescents (13–16 years) compared to younger children. Accurate diagnosis in the paediatric population is complicated by difficult clinical examinations and the presence of growth plates, leading to an 8% misdiagnosis rate, mainly due to misinterpretation of the ossification centres and physes. High-quality radiographic evaluation combined with a thorough clinical assessment is critical for correct diagnosis and appropriate management. The robust periosteum and high remodelling potential of paediatric bones allow most hand fractures to be managed non-operatively with splinting or casting. However, fractures with significant angulation, rotation, intra-articular involvement or open wounds may require surgical intervention, such as closed or open reduction and internal fixation with Kirschner wires. Most paediatric hand fractures heal well with excellent functional outcomes due to the high remodelling capacity of paediatric bones. Early mobilisation and appropriate immobilisation are key to preventing stiffness. Despite the generally favourable prognosis, certain fractures remain challenging to diagnose and treat, highlighting the need for specialised care. The aim of this review article is to discuss the epidemiology, fracture patterns, diagnostic challenges and management strategies essential for optimising functional outcomes and minimising long-term complications in treating paediatric hand fractures. Level of Evidence: Level V (Therapeutic) [ABSTRACT FROM AUTHOR]

The main purpose of our study was to evaluate satisfaction, recurrence, bone union and other complications after a minimum of two years follow-up in patients who had percutaneous claw and hammer (CHT) second toe correction utilizing a novel distal and bicortical proximal phalanx osteotomy (DBPPO). A minimum two-year follow-up prospective cohort study was conducted on consecutive patients with symptomatic CHT deformities of the second toe corrected with percutaneous surgery. Primary outcomes included satisfaction, recurrence, bony union, and other complication rates specific to the second toe deformity correction. Secondary outcomes included Metatarsophalangeal-Interphalangeal AOFAS scale and Visual Analogue Scale (VAS). Between January and October 2020, 34 patients (43 feet) were clinically and radiologically evaluated pre and postoperatively at a mean of 26.6 months. Thirty-eight feet (88.4 %) were satisfied or very satisfied with their second toe deformity correction and 41 feet (95.3 %) would undergo surgery on this toe again. No deformity recurrence requiring revision was found. There were two complications (4.7 %): one toe (2.3 %) with persistent numbness and one (2.3 %) had a simple infection that resolved with oral antibiotics. All 43 s toe osteotomies demonstrated bony consolidation. Stiffness was reported in nine second toes (20.9 %), seven of them (77.8 %) having a rigid pre-operative deformity. Secondary outcomes demonstrated significant improvement in the mean (± standard deviation) AOFAS score which increased from 47.5 ± 17.9 preoperatively to 95.7 ± 7.7 postoperatively (p <.001). Mean VAS significantly improved from 4.9 ± 2.5 preoperatively to 0.3 ± 1.3 postoperatively (p <.001). Percutaneous treatment of claw and hammer second toe deformities utilizing a DBPPO resulted in high levels of satisfaction with bony consolidation, no recurrence and low complication rates at two years follow-up.Level of evidence: Level II – Prospective cohort study [ABSTRACT FROM AUTHOR]

Objectives: We developed the deep neural network (DNN) model to automatically measure hallux valgus angle (HVA) and intermetatarsal angle (IMA) on foot radiographs. The objective is to assess the accuracy of the model by comparing to the manual measurement of foot and ankle surgeons. Materials and methods: A DNN was developed to predict the bone axes of the first proximal phalanx and all metatarsals from the first to the fifth in foot radiographs. The dataset used for model development consisted of 1798 radiographs collected from a population-based cohort and patients at our foot and ankle clinic. The retrospective validation cohort comprised of 92 radiographs obtained from 92 consecutive patients visiting our foot and ankle clinic. The mean absolute error (MAE) between automatic measurements by the model and the median of manual measurements by three foot and ankle surgeons was compared to 3° using one-tailed t-test and was also compared to the inter-rater difference in manual measurements among the three surgeons using two-tailed paired t-test. Results: The MAE for HVA was 1.3° (upper limit of 95% CI 1.6°), and this was significantly smaller than the inter-rater difference of 2.0 ± 0.2° among the surgeons, demonstrating the superior accuracy of the model. In contrast, the MAE for IMA was 0.8° (upper limit of 95% CI 1.0°) that showed no significant difference from the inter-rater difference of 1.0 ± 0.1° among the surgeons. Conclusion: Our model demonstrated the ability to measure the HVA and IMA with an accuracy comparable to that of specialists. [ABSTRACT FROM AUTHOR]

This document, titled "Swollen and painful distal phalanx," discusses a case of an 11-year-old male with a swollen and erythematous digit. The patient had a history of trauma with a subungual hematoma that was drained 4 years prior. The document includes various images, such as ultrasound, X-ray, and CT-scan images, which show a defect in the distal phalanx of the finger. The authors declare no competing interests, and the work has not been previously published elsewhere. [Extracted from the article]

We present the clinical and radiological characteristics of phalangeal microgeodic syndrome in a cluster of five children during the second peak of COVID-19 pandemic in the UK. Each child presented with phalangeal swelling and erythema, prompting a comprehensive multi-disciplinary team review to analyse the clinical presentation, blood test results and imaging. The cohort's average age was 14.1 years, ranging from 10.4 to 16.6 years, with two girls and three boys. Four children experienced phalangeal involvement in the hands, whilst one was affected solely in the feet. A rheumatological work-up was performed for all. Hand X-rays performed on three children revealed distinct radiographic features like microgeodes, subperiosteal bone resorption and rarefaction in two cases. However, further MRI showed extensive changes closely correlated with the clinical signs of cutaneous vasculopathic rashes. The MRI abnormalities were notable, encompassing marrow oedema primarily affecting metaphyses and epiphyses, displaying broad transition zones. Soft tissue swelling and cortical erosions were also observed. These MRI features proved more pathognomonic in the acute clinical context. The study concluded that phalangeal microgeodic syndrome, characterised by digital swelling and erythema, might not be adequately assessed by plain X-rays. The more comprehensive MRI features, including marrow oedema and soft tissue abnormalities, appeared to be more indicative in diagnosing the condition. Considering the rarity of this syndrome and its temporal association with the COVID-19 pandemic, the study hypothesised that COVID-related thrombophilia and immune-mediated vasculopathy might act as crucial triggers for the active bony manifestations seen in this syndrome. Key points: • PMS is a rare, predominantly paediatric condition, of unknown aetiology which affects the digits. • Laboratory investigations are generally negative; however, in the appropriate clinical context, the X-ray findings of microgeodes and pattern of bone marrow oedema seen on MRI are pathognomonic. • Considering the rarity of PMS and temporal association with the COVID-19 pandemic, COVID vasculopathy may represent a previously unrecognised aetiology for PMS [ABSTRACT FROM AUTHOR]

Background and Objectives: To investigate postoperative courses after hemi-percutaneous epiphysiodesis using transphyseal screws (PETS) for genu varum. We especially focused on the degree of skeletal maturation that results in undercorrection. Materials and Methods: We identified patients with idiopathic genu varum treated with hemi-PETS at the proximal tibia and followed-up to the completion of skeletal maturation. The acceptable correction was defined as the (1) final deformity < varus 1.0° or (2) final correction angle obtained by surgery (f-CA) > mean value of preoperative deformity. Results: In our cohort of 29 patients and their 29 lower limbs (one side was randomly selected in bilateral cases), the mean hip–knee–ankle (HKA) alignment was varus 6.5 ± 1.3° at the time of hemi-PETS. The mean f-CA was 5.8 ± 2.0° with a rebound of 0.3 ± 1.0°. Ten patients showed the finding of partial or complete fusion of the epiphysis of distal phalanges in the hand at the time of hemi-PETS (the fusion group, FG). Their f-CA was 4.0 ± 1.9° (with preoperative deformity of 6.9 ± 1.4°), which was significantly smaller than that (6.7 ± 1.3°, p = 0.001) of remaining 19 patients (the open group, OG). The acceptable correction was obtained in all 19 patients of the OG. Otherwise, it was obtained in two patients in the FG (p < 0.001). The other two patients in the FG preoperatively showed a complete epiphyseal fusion of the distal phalanges in the hand, and their f-CA was 0.7 and 1.1°, respectively. Conclusions: The degree of skeletal maturation corresponding to epiphyseal fusion of distal phalanges in the hand results in undercorrection after the hemi-PETS performed at the proximal tibia for genu varum. [ABSTRACT FROM AUTHOR]

The generation of pressure perturbations in matter stimulated by pulsed light is a method widely recognized as the photoacoustic or light‐induced thermoelastic effect. In a series of psychophysical experiments, the robustness of the tactile perception generated with a variety of light sources is examined: a diverging pulsed laser used for photoacoustic tomography optical parameter oscillation (OPO), a miniature diode laser (MDL), and a commercial digital light processing (DLP) projector. It is demonstrated that participants can accurately detect, categorically describe the sensations, and discern the direction of pulsed light travel. High detection accuracy is reported as follows: (d′ = 4.95 (OPO); d′ = 2.78 (modulated MDL); d′ = 2.99 (DLP)) of the stimulus on glabrous skin coated with a thin layer of dye absorber. For all light sources, the predominant sensation is felt as vibration at the distal phalanx (i.e., fingertip, 55.21–57.29%) and the proximal phalanx (41.67–44.79%). At the fingertip, thermal sensations are perceived less frequently than mechanical ones. Moreover, these haptic effects are preserved under a wide range of pulse widths, spot sizes, optical energies, and wavelengths of the light sources. This form of sensory stimulation demonstrates a generalizable non‐contact, non‐optogenetic, in situ activation of the mechanosensory system. [ABSTRACT FROM AUTHOR]

Osteochondral fragments within equine joints are commonly encountered and may predispose to lameness and limitation to sport purposes. Factors leading to this condition include genetic, nutritional and environmental conditions. However, few studies have evaluated the impact of conformation traits and their correlation with osteochondrosis. This study, based on the radiographic screenings of young horses born in Wallonia (266 individuals, 532 forelimbs), evaluated the correlation between foot, fetlock conformations of the front limb, height at the withers and presence of osteochondral fragments. Moreover, for all traits significantly associated with the presence of osteochondral fragments, a Receiver Operator Characteristic (ROC) curve, area under the curve and optimal cut-off value were calculated to predict the occurrence of fragments. Mean dorsal hoof wall angle was 52.36°, dorsal and palmar angle of the third phalanx were respectively 49.83° and 2.99°, and dorsal metacarpophalangeal angle 147.99°. Moreover, the prevalence of upright feet, defined as having an inclined profile of >2° steeper in relation to its contralateral counterpart, was 24%. Increased palmar angle of the distal phalanx was significantly correlated (P < 0.05) with presence of fragments located at the dorso-proximal margin of the proximal phalanx. The associated area under the curve was 0.623 (95% CI: 0528–0.717, P < 0.05) and the optimal cut-off value to predict fragment occurrence was 2.95° (sensitivity 77.3%; specificity 52.9%). Furthermore, the third metacarpal bone diameter of the left forelimb and height at the withers were significantly (P < 0.05) correlated with the presence of osteochondral fragments in general and within tarsocrural and metatarsophalangeal joints specifically. The area under the curve was 0.585 (95% CI: 0.513–0.656, P < 0.05) with an optimal cut-off value of 152.5 cm (sensitivity 85.1%; specificity 31.2%) for height at the withers to predict presence of osteochondral fragment; to predict the occurrence of osteochondral fragment in any joint on the basis of the third metacarpal bone diameter, the area under the curve was 0.595 (95% CI: 0.524–0.667, P <0.05) and the optimal cut-off value 34.9 mm (sensitivity 52.5%; specificity 64.9%). This study provides information about phenotypic traits associated with osteochondral fragments in horses. Although the diagnostic accuracy of these traits to detect osteochondral fragment was limited, the identification of more phenotypic characteristics could, in the future, make it possible to generate models for accurately identifying individuals at high risk of osteochondral fragments on the basis of their phenotype. [ABSTRACT FROM AUTHOR]

Introduction. Bone metastases occurring distally to the elbow or knee joint are called acrometastases. Acrometastases make up only 0.1% of all bone metastases, but only 0.007% to 0.3% occur in the bones of the foot or hand. In 10% of patients, bone metastases occur as the first sign of a previously undiagnosed primary tumor. Case report. A 64-year-old male reported to the hospital due to painful swelling and redness of the fifth finger of the dominant hand. Osteolysis of the proximal phalanx of the fifth finger was diagnosed radiographically. A working diagnosis of osteomyelitis and phlegmon of the proximal phalanx was made. After incisional drainage, a tumor mass was observed intraoperatively. Amputation of the finger was performed at the level of the metacarpophalangeal joint. Pathohistological analysis revealed squamous cell carcinoma metastasis. After a computed tomography scan and bronchoscopy with biopsy, a diagnosis of squamous cell carcinoma of the bronchus was made. The patient was given chemotherapy. During the application of the second cycle, there was a fatal outcome. Conclusion. Pathohistological verification and determination of the location of the primary tumor are important when acrometastasis is found because starting novel immunotherapy and targeted therapy in a timely manner could change the median survival of these patients. [ABSTRACT FROM AUTHOR]

Simple Summary: "Declawing" is the surgery in which the bone underneath the claw is removed entirely or in part. This has been shown to have substantial effects on the forearm muscles of members of the cat family, but no one has previously examined how it affects other species or the hindlimb. In this study, we examine the leg and forearm muscles of a kinkajou (a Central/South American tree-climbing relative of the raccoon) that was declawed on all four limbs and compare it to several kinkajous that were not declawed and to the previous cat findings. As expected, some of the declawed kinkajou's muscles were substantially different from those of the intact specimens, and as was seen in the cats, the muscles that normally attach to its claw bones appear to have been weaker. Surprisingly, the declawed kinkajou had larger forearm muscles and, even though its toe claws had also been removed, its hindlimb muscles were not very different—possibly because kinkajous rely more on their hands than their feet. Future studies should examine other declawed kinkajous and how this surgery affects other species, like kinkajou relatives that don't climb as much or other species, like monkeys, that do climb like kinkajous. Recently, onychectomy, the "declaw" surgery in which all or part of the distal phalanges are removed, has been shown to have significant effects on the forearm muscles of felids. While this surgery should clearly affect the limb muscles (especially those that insert on the removed or modified bone), these effects have not been studied beyond felids or in the hindlimb. To that end, we herein evaluated the muscle architecture of a kinkajou (Potos flavus) that was declawed on all four of its limbs and compared its anatomy to that of intact specimens and the felid findings. As expected, some of the declawed kinkajou's muscles were substantially different from those of the intact specimens, and as was seen in felids, its digital muscles appear to have been weaker. However, unlike in the felids, the declawed kinkajou had relatively larger forearm muscles. Also, contrary to expectation, the leg muscles of the declawed kinkajou were not substantially different, perhaps reflecting important differences in limb use. Future analyses should examine this anatomy in other declawed kinkajou specimens and also look at the effects of this surgery in other taxa, for instance, non-arboreal relatives of the kinkajou as well as other arboreal taxa. [ABSTRACT FROM AUTHOR]

Background/Objectives: Rock climbing is becoming more popular, leading to an increased focus on diagnosing and treating related injuries. Finger pulley and flexor tendon injuries are common among climbers, with the A2 pulley being the most frequently affected. High-resolution ultrasound (US) is the preferred method for detecting pulley injuries. This study aimed to determine the reliability and validity of US in identifying anatomical landmarks for diagnosing A2 pulley ruptures. Methods: This study was cross-sectional, involving 36 fingers from 4 cadaver arms. A Canon Aplio i800 US machine was used to measure two anatomical landmarks: the midpoint of the proximal phalanx and the distal edge of the A2 pulley. For the first anatomical landmark, the length of the proximal phalanx (PP distance), and for the second landmark, the distance between the distal edges of the proximal phalanx and the A2 pulley ("A" distance), were measured. Measurements were performed by two sonographers and compared to a digital caliper measurement taken post-cadaver dissection. Observers were blinded during measurements to ensure unbiased results. Results: Overall PP distance measured by US (O1: 37.5 ± 5.3 mm, O2: 37.8 ± 5.4 mm) tended to be shorter than caliper measurements (O3: 39.5 ± 5.5 mm). The differences between sonographers were minimal, but larger when compared to caliper measurements. High reliability for PP distance measurement was observed, especially between sonographers, with an ICC average of 0.99 (0.98, 1.00). However, reliability was lower for the "A" distance, with significant differences between US and caliper measurements. Regarding validity, US measurements were valid when compared to caliper measurements for PP distance, but not as reliable for the "A" due to wider confidence intervals. While US can substitute caliper measurements for PP distance (LR, Y:O2, X:O3, −0.70 (−3.28–1.38), 0.98 (0.93 ± 1.04)), its validity for "A" distance is lower (LR, Y:O2, X:O3, −2.37 (−13.53–4.83), 1.02 (0.62–1.75)). Conclusions: US is a reliable and valid tool in identifying anatomical landmarks for diagnosing A2 pulley ruptures, particularly for detecting the midpoint of the proximal phalanx. This is important to differentiate between complete and partial A2 pulley tears. However, the measurement of the "A" distance requires further refinement. These findings support efforts to standardize US examination protocols and promote consensus in diagnostic methodology, though further research is needed to address the remaining challenges. [ABSTRACT FROM AUTHOR]

Due to the simplicity, low cost and benefit of avoiding long-term joint immobilization, extension block pinning could be a suitable option for treating the volar base fractures of the middle phalanges. The aim of the present study was to evaluate the outcomes of using extension block pinning in chronic volar base fractures of the middle phalanges. In total, 26 patients with chronic closed volar base fractures of the middle phalanges were included our study. The mean age was 37 years (SD 11.59), and the mean follow-up time was 35 months (SD 19.41). The mean active range of motion (ROM) after surgery was 93° (SD 12.9). There was a negative correlation between the age and the ROM of the injured proximal interphalangeal joint after surgery. ROM did not correlate with the articular surface involvement or the interval between injury and surgery. We obtained a satisfactory result from extension block pinning for volar base fractures of the proximal interphalangeal joint in patients with chronic injuries. Level of evidence: IV [ABSTRACT FROM AUTHOR]

We describe a new species of leaflitter frog of the genus Noblella from southern Ecuador, province of Zamora Chinchipe. The new species is diagnosed from all its congeners by having one or two tubercles on the upper eyelids; distal phalanges strongly T-shaped; phalangeal formula on hands 2-2-3-3; phalangeal formula on feet 2-2-3-4-3; heel with a small subconical tubercle; disc on all toes with papillae; dorsum brown or brown with gray, with V-shaped inverted or scattered irregular darker marks. We include a detailed description of its osteology and a study of its phylogenetic relationships. Finally, we evaluate its conservation status and discuss the threats that are currently impacting at the type locality. [ABSTRACT FROM AUTHOR]

Macrodactyly, a rare congenital anomaly characterised by localised gigantism of one or more digits, presents significant challenges in therapeutic management due to the absence of established guidelines. The present case report explored the surgical management of an 18-year-old female patient with macrodactyly of the second digit, addressing discomfort, footwear issues and psychological distress. The study adapts techniques from prior paediatric cases to suit adult care needs, particularly focusing on middle phalangectomy as a feasible treatment option for isolated macrodactyly. Clinical examination and radiographic assessments confirmed primary macrodactyly affecting the patient’s left second toe. The surgical intervention involved middle phalangectomy, debulking of fibrofatty tissue, joint capsule and tendon repair, along with a Winograd wedge resection procedure. Postoperative care included pain management and wound dressing. Despite encountering delayed wound healing and mild necrotic changes, the patient reported manageable pain levels and expressed satisfaction with the cosmetic outcome and improved footwear options at the six-month follow-up. The present case report contributes valuable insights into the management of macrodactyly, highlighting the efficacy of middle phalangectomy in adult patients. Preoperative assessment for peripheral arterial disease is emphasised to mitigate neurovascular complications. Proactive patient counseling regarding potential postoperative complications is crucial for informed decision-making. Overall, the findings underscore the importance of tailored surgical approaches in addressing macrodactyly and improving patients’ quality of life.

Fetal age in Quarter Horses can be predicted within 2 weeks from 100- to 200- days of gestation using femur length, biparietal diameter (cranium diameter) and eye approximated volume. However, as pregnancy advances, the femur and cranium become too large to be imaged in their entirety using ultrasound and the corresponding biometric parameters can no longer be measured. In this longitudinal study, the proximal phalanx (P1) was evaluated as a novel biometric parameter for late gestation to predict fetal age and bone maturation. Transrectal ultrasound was performed in ten pregnant mares with known ovulation dates, every two weeks from 240- days of gestation until parturition. P1 was imaged in 69 % of the examinations. Inability to image P1 was due to obstructive positioning such as carpal or fetlock flexion, or posterior presentation of the fetus. Advancing fetal age did not affect visibility of P1. P1 length correlated significantly with days of gestation and a correlation equation was established: y = 0.3837x -69.55 where y is the predicted value of P1 length and x is the day of gestation (with day 0 being the day of ovulation). When P1 length was equal to or larger than the width of the ultrasound image (52.5 mm), 90 % of mares (9/10) were above 300- days of gestation. Ossification of the proximal and distal epiphysis of P1 typically appeared between 277- and 303 -days of gestation (mean: 288 days). The proximal epiphysis did not close before parturition whereas the distal one closed between 306- and 333-days of gestation (mean: 320 days). P1 epiphyseal appearance and closure occurred chronologically reflecting bone maturation. Radiographic findings at birth and prenatal ultrasound findings were in agreement, apart from timing of P1 distal epiphyseal closure. In conclusion, P1 length can be used as a new fetal biometric parameter to assess fetal age and growth after 240- days of gestation. The knowledge of P1 bone maturation process in utero as a marker for fetal bone development, may also be valuable in clinical decision-making when considering inducing parturition in the mare. [ABSTRACT FROM AUTHOR]

Background: Even though tuberculosis is a common disease among children in developing countries, tuberculous dactylitis is an uncommon form of Skeletal tuberculosis specially with involvement of both the hands and feet. Case Presentation: A one-and-a-half-year-old previously healthy female Ethiopian toddler presented to our pediatric outpatient clinic with a history of two-month duration of painful multiple swellings over both her hands and feet. The swelling involved the proximal phalanx of the left index finger, dorsum of the right hand, and dorsum of both feet over the first metatarsal bone. Physical examination, radiologic findings, and histopathology suggested tuberculous dactylitis. The patient was treated with anti-tuberculosis drugs for one year and she showed clinical and radiologic improvement and recovery. Conclusion: Tubercular dactylitis should be considered in the differential diagnosis of children from endemic areas presenting with bone and joint pain or swelling. Our experience of a twelve-month course of antitubercular treatment, which is in line with WHO recommendations, for skeletal tuberculosis, showed excellent outcomes. [ABSTRACT FROM AUTHOR]

With the current reassessment of the phylogeny of Pandanales, revealing the peculiarities of fruit structure of representatives of the order, as well as determination of apomorphies and plesiomorphies of the families included in the order are of importance. With the aim to fill in gaps in the data on fruit structure and to determine principal trends of fruit morphogenesis in Pandanaceae, the present study focused on pericarp anatomy in the genus Freycinetia , fruits of which are traditionally referred to as berries. The present investigation confirmed the lack of a continuous sclerenchymatous zone in the pericarp of Freycinetia species, and the fruit is treated as a superior paracarpous berry of Nuphar type. Fusiform groups of longitudinally elongated sclereids are revealed in the mesocarp of Freycinetia palawanensis (incertae sedis) and F. graminifolia (section Solmsiella). Since this character is treated as specific for the subgenus Gaudichaudiella , the inclusion of these two studied species in this subgenus is proposed. The principal carpological plesiomorphies and apomorphies of the family are outlined, and two scenarios for fruit morphogenesis, from berries to 'drupaceous' fruits and vice versa, are proposed. [ABSTRACT FROM AUTHOR]

Studies have shown that the first metatarsal contributes to hallux valgus. The proximal phalanx, another factor that defines the hallux valgus angle, also contributes to the development of hallux valgus. There have been no reports on the use of computed tomography to evaluate bone morphology of the proximal phalanx. The purpose of this study was to analyze the morphology and deformity of the proximal phalanx and its relationship to hallux valgus using computed tomography, and to consider the indications for proximal phalanx surgery in hallux valgus. Patients who consulted at our clinic for foot and ankle disorders and underwent both weight-bearing radiography and computed tomography between May 2019 and March 2022 were included in the study. The hallux valgus angle, sesamoid subluxation, first metatarsal length, proximal phalanx length, metatarsal-proximal phalanx ratio, proximal phalanx valgus angle, metatarsal-proximal phalanx angle, proximal phalanx rotation angle, and distal phalanx-proximal phalanx angle were measured. These parameters were compared between the hallux valgus and control groups. In the hallux valgus group, the hallux valgus and proximal phalanx valgus angles were measured and compared using weight-bearing radiographs. A total of 83 feet in 65 patients were diagnosed with hallux valgus (hallux valgus group; mean age of 68.0 ± 13.8 years) and 30 feet in 22 patients without hallux valgus (control group; mean age of 67.0 ± 25.8 years) were included in the study. The proximal phalanx length, metatarsal-proximal phalanx ratio and angle, and distal phalanx-proximal phalanx angle were significantly greater in the hallux valgus group than in the control group. However, the proximal phalanx valgus and rotation angles were not significantly different between the groups. Since there was no significant difference in the proximal phalanx morphology, except length, between the hallux valgus and control groups, the indications for osteotomy of the proximal phalanx should be carefully considered. [ABSTRACT FROM AUTHOR]

Summary: This case series describes three cases of osseous cyst‐like lesions of the proximal phalanx (P1), which were associated with a complete fracture. The fractures and osseous cyst‐like lesions were analysed through radiographic and computed tomographic (CT) images for fracture configuration and prodromal factors, such as subchondral sclerosis and periosteal new bone formation. Internal stabilisation was performed in all cases through placing transcortical bone screws under CT guidance. In conclusion, the presence of osseous cyst‐like lesions in the proximal P1 as well as the addition of prodromal markers, such as localised periosteal new bone formation and subchondral bone sclerosis, suggest pathological subchondral bone with the potential to fracture and stabilisation should be prioritised. [ABSTRACT FROM AUTHOR]

The article discusses the challenges in understanding the extensor tendon system in the hand and the discrepancies in the descriptions of extensor zones in different sources. The author conducted a study and proposes a new classification based on the presence of the extensor retinaculum, suggesting that the future definition of Zone 7 should be clearly stated as the area covered by the extensor retinaculum, without referring to the wrist joint. The author also presents an alternative method of zone division for the extensors, which corresponds to the number of flexor zones and may simplify treatment discussions. However, the author acknowledges the potential confusion that may arise from introducing a new classification. [Extracted from the article]

Hemi-hamate arthroplasty is a method used to reconstruct complex fracture-dislocations of the proximal interphalangeal joint of the fingers. Other graft sites, including the toe second and third phalanges, have been proposed as alternatives to hemi-hamate arthroplasty due to variable clinical outcomes and anatomy. Through a prospective magnetic resonance imaging (MRI)-based study in asymptomatic individuals, we aimed to characterize the anatomy of the proximal interphalangeal joint and compare this with the hamate, second and third toes to determine the closest anatomical match using pre-determined measurements. Our results show that the second and third toes have greater anatomical similarity to the proximal interphalangeal joint of the fingers compared to the hamate. High-resolution MRI is a reliable method of characterizing the anatomy of these structures and could be a useful clinical tool in determining reconstructive options in the management of this challenging injury. Level of evidence: II [ABSTRACT FROM AUTHOR]

In this study we describe an adult left first pollical (thumb) proximal phalanx (I2-104) from the Baume de Moula-Guercy (Ardèche, France) and we evaluate its taxonomic status. We first describe this bone in detail, taking into account its pathology, before comparing it, through multivariate analyses, with a diverse sample of recent and fossil humans. Based on metric and morphological comparisons, we show that this phalanx belongs to a Neandertal individual who suffered from osteoarthritis. Osteoarthritis can have different origins, including overuse, degeneration, trauma and infection. Each of these possible etiologies is explored in our study. Although the cause is difficult to identify, the pathology in this individual may represent an inflammatory reaction caused by repeated and intense vibrations provoked by the high-frequency knapping of the left hand over time. [ABSTRACT FROM AUTHOR]

The present study reports the formation of claws in lizards and their cornification. From a flat epidermis with lose mesenchyme, the skin forms undulations that become symmetric domes and later asymmetric for the elongation of their proximal part that gives rise to the outer scale surface. At the tip of digits claws develop in association with a mesenchyme that surrounds the cartilage of the last phalange. Beta‐cells of claws appear 2–3 embryonic stages before those of scales formed in other body regions, including digital scales. The epidermis of the developing claw initially forms 3–4 embryonic layers under which elongated beta‐cells accumulate long bundles of corneous material, immunopositive for CBPs. Claw beta‐keratinocytes incorporate tritiated proline and accumulate numerous, oriented corneous bundles that rapidly occupy the entire cell. The bundles are electron‐dense under transmission electron microscopy, suggesting that, in association to CBPs, other proteins are synthesized and increase the mechanical resistance of claws. Immunolabelling for cysteine‐rich IFKs, HA and HB, shows that these keratins co‐localize with CBPs only in claws but are low to absent in digital scales and adhesive setae. This indicates that the hardness of claws mainly depends from the association between these different proteins rich in glycine and cysteine. [ABSTRACT FROM AUTHOR]

Introduction This article aims to establish the relative thumb length in comparison to the index finger in central Indian adults. Materials and Methods Five hundred normal adult hands (1,000 thumbs), 316 men and 184 women, mean age 30 years, were included in the study. The relative length of the thumb was measured using the length of the proximal phalanx of the index finger (thumb–proximal phalanx index) and the distance between the proximal digital crease and proximal interphalangeal crease of the index finger (thumb–digital crease index). Results The tip of a normal adducted thumb extends to 69% of the length of the proximal phalanx of the index finger and 38% of the distance between the two proximal creases of the index finger. The tip of a normal adducted thumb extends to 68% for male and 69% for female of the length of the proximal phalanx of the index finger. For the dominant hand the tip of a normal adducted thumb extends to 68%, while for nondominant hand it reaches 71% of the length of the proximal phalanx of the index finger. The difference between the laterality, gender, and hand dominance was not statistically significant. Conclusion The tip of a normal adducted thumb extends to 69% of the length of the proximal phalanx of the index finger and 38% of the distance between the two proximal creases of the index finger. Relative normal thumb length is independent of gender, laterality, or hand dominance. [ABSTRACT FROM AUTHOR]

Summary Background Objectives Study design Methods Results Main limitations Conclusion Short incomplete parasagittal fractures of the proximal phalanx are common injuries described in racehorses and also horses not used for racing. Computed tomographic (CT) features have been described in horses not used for racing, but not in a racehorse population.To describe CT features of short incomplete parasagittal fractures of the proximal phalanx in a group of Thoroughbred racehorses.Retrospective observational study.CT images of 59 Thoroughbred racehorses diagnosed with 60 short incomplete parasagittal fractures of the proximal phalanx examined between January 2014 and February 2023 were reviewed retrospectively. Horse signalment and clinical features were retrieved from hospital records.50/60 fractures were dorsally biased unicortical fractures. Mean proximodistal fracture extension in forelimbs (13.6 mm ± 3.4) was less than in hindlimbs (17.4 mm ± 4.4) (p = 0.0019). There was no difference in fracture extension in the proximodistal direction according to age or gender. Fractures in 2‐year‐olds were shorter in dorsopalmar/−plantar direction (17.4 mm ± 6.3) than in 3‐year‐olds and older horses (21.7 mm ± 7.4) (p = 0.015). Periosteal new bone was present in 91.2% of fractures and endosteal new bone in 75%.Conclusions from this study can only confidently be applied to similar populations of racing Thoroughbred horses.Short incomplete parasagittal fractures of the proximal phalanx in Thoroughbred racehorses most commonly involve only the dorsal cortex and adjacent subchondral and cancellous bone. The distribution of fracture configurations differs from that described in horses not used for racing. [ABSTRACT FROM AUTHOR]

The salt marsh harvest mouse (Reithrodontomys raviventris) is an endangered species, endemic to the San Francisco Bay Estuary, that co‐occurs with the more broadly distributed species, the western harvest mouse (Reithrodontomys megalotis). Despite their considerable external morphological similarities, the northern subspecies of salt marsh harvest mice have relatively longer and thicker tails than do western harvest mice, which may be related to their abilities to climb emergent marsh vegetation to avoid tidal inundation. We used micro‐CT to compare post‐cranial skeletal anatomy between the salt marsh and western harvest mouse, to examine whether the salt marsh harvest mouse's restriction to brackish marshes is associated with skeletal adaptations for scansorial locomotion. We found that salt marsh harvest mice exhibited a deeper 3rd caudal vertebra, a more caudally located longest tail vertebra, craniocaudally longer tail vertebrae, and a longer digit III proximal phalanx than western harvest mice. These phalangeal and vertebral characteristics are known to decrease body rotations during climbing, increase contact with substrates, and decrease fall susceptibility in arboreal mammals, suggesting that the salt marsh harvest mouse may be morphologically specialized for scansorial locomotion, adaptive for its dynamic wetland environment. [ABSTRACT FROM AUTHOR]

Bizarre parosteal osteochondromatous proliferations (BPOPs) are distinct clinical–pathological entities that demonstrate combinations of atypical-appearing osseous and chondromatous tissues. These lesions are usually reactive in nature. Histopathologically, 'bizarre' cartilage is a characteristic feature of this lesion. BPOPs usually represent slow-growing painless bony hard protuberances that arise from the surface of affected bone cortices, typically the metacarpals, metatarsals, and phalanges. The occurrence of these lesions in the skull and jaws is sporadic. This case report highlights the clinical presentation, histopathological characteristics, and management of BPOP arising from the supraorbital rim in a 61-year-old female patient. [ABSTRACT FROM AUTHOR]

A new troodontid dinosaur, Hypnovenator matsubaraetoheorum gen. et sp. nov., is described based on an articulated postcranial skeleton recovered from the fluvial deposits of the Albian Ohyamashimo Formation of the Sasayama Group in Tambasasayama City, Hyogo Prefecture, Japan. Hypnovenator is distinguished from other troodontids by four autapomorphies and a combination of additional features. Our phylogenetic analysis positions Hypnovenator as the oldest and one of the most basal troodontines, forming a clade with Gobivenator mongoliensis. The discovery of Hypnovenator suggests that small-bodied maniraptorans with a sleeping posture were common not only in environments with volcanic and eolian events or alluvial systems but also in fluvial systems. Geometric morphometric analysis of manual ungual phalanges shows that manual ungual phalanges I and III of Hypnovenator exhibit considerable morphological variation but are functionally similar, which differs from those of non-troodontine troodontids, reflecting the transition of manual motion within Troodontinae. Hypnovenator also has mosaic features in the pes related to cursoriality. This study reveals that asymmetrical arctometatarsus occurred by the Albian, and some morphological changes, such as shorter digit IV than digit III and non-ungual phalanges of digits III with roller joints and digit IV with weakly ginglymoid articulation, arose during the early Late Cretaceous. [ABSTRACT FROM AUTHOR]

Vascularized bone grafts of the wrist and hand help to achieve bone union in various clinical settings such as bone fusion or nonunion treatment. Among the multiple possible donor sites, the base of the second metacarpal is convenient because of its relatively straightforward harvesting, lack of impairment of the hand vascularization, sufficient bone supply for small joint fusion and phalanx or metacarpal nonunion management. The flap is versatile as it can reach any carpal and metacarpal bone as well as the proximal phalanx of all fingers. The arc of rotation of the flap depends on which side of the dorsal intercarpal arch it is based, either radially or ulnarly. It can also be pedicled distally by a retrograde flow through the second dorsal metacarpal artery. The robust vascularization of the flap allows for reliable healing. We present five new indications in various clinical settings that illustrate the versatility of the arc of rotation of the flap. [ABSTRACT FROM AUTHOR]

This article describes the treatment and evolution of a 76-year-old patient who suffered a fracture of the scapula and the proximal phalanx of the second finger after a bicycle accident. The medical and physiotherapeutic intervention is detailed, especially the second one, focusing on the recovery of the injured shoulder. The physiotherapy treatment shows how a simple intervention based on the combination of several rehabilitative techniques such as magnetic therapy, electrostimulation and manual therapy, are more than enough to provide a full functional recovery. [ABSTRACT FROM AUTHOR]

There are a few mammalian lineages secondarily adapted to life in water throughout their evolutionary history. Of them, only sirenians and cetaceans evolved as fully aquatic organisms. This transition was accompanied by changes in swimming mode, from foot paddling to tail-powered propulsion, with the forelimbs acting as efficient hydrofoils and the gradual loss of external hindlimbs. Here, we describe an isolated limb from the Middle Eocene of Ukraine, 43–42 Mya, identified as a hindlimb of a fully aquatic cetacean and being the earliest cetacean reported from Europe. It is represented by flattened, jointly articulated bones, identified as the tibia and fibula with a partly reduced knee joint and loose connection to the pes, and by flattened phalanges. This anatomy reveals a hitherto only presumed cetacean morphotype, showing that some of the early fully aquatic cetaceans were four-legged animals with functional hindlimbs that could be involved in advanced styles of swimming. They used either body undulation or lift-based propulsion powered by the tail or feet and could also use a transitional swimming style combining these modes. [ABSTRACT FROM AUTHOR]

This study aims to analyze the changes in dermal thickness in patients with systemic scleroderma (SSc) in comparison with normal skin and also compare clinical forms with diffuse and limited cutaneous involvement. The study group consisted of female patients diagnosed with SSc with a disease history not exceeding 5 years. The areas of interest for ultrasound examination included the proximal phalanx of the third finger, the second intermetacarpal space, and the extension surface of the lower third of the forearm. The study included 20 patients diagnosed with SSc and 14 controls. SSc patients were subdivided into two subgroups based on the clinical form. Compared to the control group, patients with SSc had higher mean measurements in all three skin areas, with statistically significant differences in the hand and forearm areas. Patients with diffuse SSc displayed, on average, higher skin thickness compared to limited SSc in all skin areas examined, with a statistically significant difference only in the forearm area. Based on disease manifestations, significant differences were observed only with regard to the presence of pulmonary hypertension in the diffuse SSc group. In conclusion, skin ultrasound is a useful and accessible imaging method for diagnosing and quantifying dermal fibrosis in systemic scleroderma. [ABSTRACT FROM AUTHOR]

During the last decades several miniaturized frogs have been described from different parts of the world. Those frogs, measuring less than 25 mm, show similar miniaturization features as the loss of phalanges in both the anterior and posterior limbs and the reduction of bone elements. However, there seems to be a limit regarding the minimum size of frogs and here we wanted to find an answer to the question: which is the smallest amphibian in the world? In 2019, an endemic species of toad known only from two localities in southern Bahia, Brazil, was studied. When we compared the size of adult representatives of this species with those of other species discovered in various parts of the world in the last decade, we observed that individuals of Brachycephalus pulex are the amphibians with the smallest total length recorded, thus qualifying them to bear the title of the tiniest anuran amphibian, and also tiniest vertebrate in the world. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Babylon Center for Humanities Studies is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Hind limb of the animals are playing major role to bear the weight as they are playing important role in locomotion and gait determination. Present study was designed to elucidate the gross morphological characteristics of bones of Gluteal, Thigh, Stifle, Crural and Pes region of a female calf of Indian Rhinoceros. Bony pelvis was formed by the right and left hip bones consisted of three bones Ilium, Ischium and Pubis. Ilium was a triangular bone situated at the craniaolateral aspect of the pelvis. Ischium was roughly quadrilateral plate of bone situated behind the pubis and forms part of the pelvic floor. Pubis was a small triangular plate of bone situated at the antero medial aspect of the pelvic floor. Femur was largest bone in the skeleton directed downward and forward in an oblique manner. This bone articulate with the hip bone above to form hip joint and with tibia, fibula and patella to form the stifle joint. Third trochanter was present at the lateral part of the lateral border, in the form of an extra prominence curved anteriorly. Lateral border of the lateral groove of tibia attached with the distal end of the fibula. Fibula was long and thin bone extended the whole length of the tibia. There were six tarsals, three metatarsals, three digits bearing three phalanges each. [ABSTRACT FROM AUTHOR]

The document discusses the importance of consistent terminology in the Journal of Hand Surgery to ensure clarity and facilitate comparisons between articles. It provides a list of preferred terms and alternatives to be avoided, emphasizing the use of correct terminology for popular topics like trapeziometacarpal joint and distal radial fractures. Authors are advised to use names of digits, phalanges, and metacarpal bones instead of numbers to prevent confusion, and to define abbreviations when first used in the manuscript. The document also addresses the confusion surrounding the term 'volar' and suggests using 'palmar' for the palmar surface of the hand. [Extracted from the article]

Objective: The objective of this study was to evaluate the long-term outcomes of trans-articular intramedullary fixation using cannulated headless screws for proximal phalanx fractures in the hand. Background: Various surgical techniques have been described for the fixation of proximal phalanx fractures, with Kirschner wires, plates, and screws being commonly used. The objective of this study was to evaluate the long-term outcomes of trans-articular intramedullary fixation using cannulated headless screws for proximal phalanx fractures in the hand. Methods Eight patients, with nine proximal phalanx fractures, treated with intramedullary screw fixation, were included for a follow-up visit three years post-surgery. Subjective and objective outcome measures were assessed using the Michigan Hand Questionnaire (MHQ), active range of motion (aROM), grip strength, conventional X-rays, and digital tomosynthesis images. Methods: Eight patients, with nine proximal phalanx fractures, treated with intramedullary screw fixation, were included for a follow-up visit three years post-surgery. Subjective and objective outcome measures were assessed using the Michigan Hand Questionnaire (MHQ), active range of motion (aROM), grip strength, conventional X-rays, and digital tomosynthesis images. Results: We observed a mean MHQ score of 83%, a total aROM of 216.4°, and a Jamar grip strength of 29.9 kg in the injured hand. Digital tomosynthesis revealed complete fracture consolidation in all cases. Joint arthrosis was detected in only one case, attributed to a misplaced screw. Conclusions: Our findings indicate favorable long-term clinical outcomes, including range of motion, grip strength, patient satisfaction, and prevention of joint damage, with the use of intramedullary headless screw fixation. Level of evidence: Level IV, Therapeutic [ABSTRACT FROM AUTHOR]

Purpose: We aimed to determine whether the clinical outcomes of antegrade and retrograde extra-articular Kirschner wire (K-wire) pinning differed in proximal phalanx base fractures. Methods: This retrospective study investigated 73 patients aged ≥18 years with extra-articular proximal phalanx base fractures that were treated by closed K-wire pinning between January 2014 and June 2023. Patients were analyzed according to whether the K-wire fixation was antegrade or retrograde. We analyzed demographics, injury characteristics, the number of K-wires applied, surgical duration, the interval before implant removal, and when physical therapy was started. Radiological outcomes included the amount of time required for radiographically confirmed bone union. Clinical outcomes consisted of complications, total active motion (TAM), and the Michigan Hand Outcomes Questionnaire (MHQ). Results: We treated 29 and 44 patients using antegrade and retrograde K-wire fixation, respectively. The overall complication rate was higher in the antegrade group than in the retrograde group (13.8% vs. 9.1%), although this difference was not statistically significant. Similarly, no significant between-group differences were detected in the length of time required for bone union and implant removal, TAM, and MHQ scores. Conclusion: Proximal phalanx base fractures were equally and effectively treated by antegrade and retrograde K-wire fixation. Therefore, the direction of K-wire fixation can be chosen based on surgeons' preferences and experience. [ABSTRACT FROM AUTHOR]

Simple Summary: Magnetic resonance imaging (MRI) and computed tomography are increasingly used in the diagnosis of fetlock region pain in sports horses and racehorses. To establish an accurate diagnosis, it is paramount to be familiar with abnormalities that can be seen in horses in full work and without relevant lameness. The aim of this study was to describe MRI, computed tomographic (CT) and radiographic findings in the front fetlocks of showjumpers who were in full training and competing regularly. Thirty-one horses without previous fetlock disease or current lameness were included. The most common finding was densification (bone hardening) in the region just under the joint surface in the cannon bone and long pastern bone. These changes likely reflect an adaptive response to exercise. Small indentations and focal decrease or loss of bone density were seen in multiple locations and might reflect early stages of disease or might be incidental. In conclusion, MRI and CT abnormalities previously associated with lameness were seen in the front fetlocks of showjumpers in full work and without relevant lameness. This should be considered when interpreting imaging studies of lame horses. There is a limited description of magnetic resonance imaging (MRI) and no information on computed tomographic (CT) findings in the fetlock of non-lame, non-racing sports horses. This study aimed to document comparative CT, MRI and radiographic findings in the metacarpophalangeal joints of showjumpers in full work. Clinical and gait assessments, low-field MRI, fan-beam CT and radiographic examinations of both metacarpophalangeal joints were performed on 31 showjumpers. Images were analysed descriptively. In most limbs (53/62, 85.5%), there were CT and MRI changes consistent with densification in the sagittal ridge and/or condyles of the third metacarpal bone (McIII). Hypoattenuation (subchondral bone resorption) was seen in CT reconstructions in the metacarpal condyle dorsoproximally (n = 2) and dorsodistally (n = 1), in the sagittal groove (n = 2) and medial fovea (n = 1) of the proximal phalanx. The McIII resorptive lesions were detected on MR images but not the proximal phalanx lesions. None were identified on radiographs. In conclusion, MRI and CT abnormalities previously associated with lameness were seen in the front fetlocks of showjumpers without relevant lameness. Densification in the sagittal ridge and the metacarpal condyles likely reflects an adaptive change to exercise. Subchondral bone resorption may indicate an early stage of disease; follow-up information is needed to establish its clinical significance. [ABSTRACT FROM AUTHOR]

Objectives: Reconstruction of fossil hominin manual behaviors often relies on comparative analyses of extant hominid hands to understand the relationship between hand use and skeletal morphology. In this context, the intermediate phalanges remain understudied. Thus, here we investigate cortical bone morphology of the intermediate phalanges of extant hominids and compare it to the cortical structure of the proximal phalanges, to investigate the relationship between cortical bone structure and inferred loading during manual behaviors. Materials and Methods: Using micro‐CT data, we analyze cortical bone structure of the intermediate phalangeal shaft of digits 2–5 in Pongo pygmaeus (n = 6 individuals), Gorilla gorilla (n = 22), Pan spp. (n = 23), and Homo sapiens (n = 23). The R package morphomap is used to study cortical bone distribution, cortical thickness and cross‐sectional properties within and across taxa. Results: Non‐human great apes generally have thick cortical bone on the palmar shaft, with Pongo only having thick cortex on the peaks of the flexor sheath ridges, while African apes have thick cortex along the entire flexor sheath ridge and proximal to the trochlea. Humans are distinct in having thicker dorsal shaft cortex as well as thick cortex at the disto‐palmar region of the shaft. Discussion: Variation in cortical bone distribution and properties of the intermediate phalanges is consistent with differences in locomotor and manipulative behaviors in extant great apes. Comparisons between the intermediate and proximal phalanges reveals similar patterns of cortical bone distribution within each taxon but with potentially greater load experienced by the proximal phalanges, even in knuckle‐walking African apes. This study provides a comparative context for the reconstruction of habitual hand use in fossil hominins and hominids. [ABSTRACT FROM AUTHOR]

The study aims to analyse the normal anatomical and radiographical features of the Manus of the southern Aswanian‐adapted Arabian one‐humped camel, providing crucial data for diagnosing and treating various ailments. Our study was applied to 10 cadaver forelimbs of adult male one‐humped camels (4–5 years old) for an explanation of the gross anatomy of the bones of the Manus region from under the carpal bones by using traditional techniques, including the gross anatomical, radiographic and x‐ray (at the dorsopalmar and lateral planes) of the preparation of Manus bones. Our results showed that the large fused (third and fourth) metacarpal bones, in which the fusion extended along the entire length of the bone except at the distal end, diverged to form separate articulations with cross‐ponding digits. As described in all ruminant species, especially the camel, there were two digits, and each digit consisted of three phalanges and two proximal sesamoid bones. Our radiographic x‐ray data revealed that the complete radiopaque septum that completely divided the medullary cavity into two separate parts was clear from the dorsopalmar view, while the lateral view showed the proximal sesamoid bones that were placed over each other and located palmar to the head of the large metacarpal bone. In conclusion, our study reveals the adaptations of the Arabian one‐humped camel to Egyptian conditions, aiding in the early diagnosis of lameness and digit problems and enabling veterinarians and camel owners to better address these issues, thereby improving the overall health and well‐being of these animals. [ABSTRACT FROM AUTHOR]

A new somphospondylan titanosauriform from the Lower Cretaceous of Spain is described from the remains found at the Sant Antoni de la Vespa site (upper Barremian Arcillas de Morella Formation) located in Morella. Garumbatitan morellensis gen. et sp. nov. is diagnosed by 11 autapomorphies and eight local autapomorphies; and our phylogenetic analyses suggest that Garumbatitan morellensis might correspond to an early-branching somphospondylan. The presence of several somphospondylan traits in Garumbatitan morellensis supports the somphospondylan hypothesis. The phylogenetic distribution of some titanosauriform and somphospondylan novelties in the femur (markedly developed lateral bulge, high shaft eccentricity, linea intermuscularis cranialis, and trochanteric shelf) is discussed. The tarsus and pes of Garumbatitan morellensis are distinctive, being characterized by the loss of the calcaneum, relative slenderness of the metatarsals II, III, and IV when compared to the retracted metatarsals I and V, three pedal phalanges in digit IV, and reduced ungual III. The sauropod fauna of the Iberian Peninsula during the Hauterivian–Aptian shows a complex phylogenetic mosaic, including forms with Laurasian affinities, mainly titanosauriforms (Soriatitan , Garumbatitan , and possibly Tastavinsaurus and Europatitan), and Gondwanan affinities, the rebbachisaurid Demandasaurus. Faunal exchange during the Early Cretaceous between the Europe, North America, East Asia, and Africa is plausible. [ABSTRACT FROM AUTHOR]

Objectives. The aim of this study was to determine the relation)ship between the vertical mandibular ramus asymmetry and the hand measurements asymmetry in growing patients. Material and Methods. Panoramic radiographs and comparative radiographs of the right and left hands of 40 patients (14 males and 26 females) between 6 and 16 years old (mean age of 11.35±1.99 years) were evaluated. The total height of the mandibular ramus was measured, and the asymmetry index was calculated. The lengths of the proximal, middle and distal phalanges and the metacarpals of the five digits of both hands were measured and the absolute differences R-L were calculated for each one. Results. A statistically significant association between the presence of vertical mandibular ramus asymmetry and the presence of phalanges asymmetry FPII (p=0.016), FPIII (p=0.016), FPIV (p=0.033), FMIII (p=0.031) and FMIV (p=0.016) was observed. Conclusions. Mandibular asymmetry appears not to be isolated but also present in other body districts such as the phalanx bones. The total vertical asymmetry of the mandibular ramus showed an association with the asymmetry of the lengths of the FPIII, FMIII, FPIV, FMIV and FPII in growing individuals, with association between the side of mandibular asymmetry and the side of the phalanx’s asymmetry. The asymmetry of this phalanges increases with increasing index of vertical mandibular ramus asymmetry. [ABSTRACT FROM AUTHOR]

Background: Fractures of hands and feet are common in children, but relevant epidemiological studies are currently lacking. We aim to study the epidemiological characteristics of hand and foot fractures and growth plate injuries in children and provide a theoretical basis for their prevention, diagnosis, and treatment. Methods: We retrospectively analyzed the data of children with hand and foot fractures who were hospitalized at Shenzhen Children's Hospital between July 2015 and December 2020. Data on demographic characteristics, fracture site, treatment method, etiology of injury, and accompanying injuries were collected. The children were divided into four age groups: infants, preschool children, school children, and adolescents. The fracture sites were classified as first-level (the first–fifth finger/toe, metacarpal, metatarsal, carpal, and tarsal) and second-level (the first–fifth: proximal phalanx, middle phalanx, distal phalanx, metacarpal, and metatarsal) sites. The changing trends in fracture locations and injury causes among children in each age group were analyzed. Results: Overall, 1301 children (1561 fractures; 835 boys and 466 girls) were included. The largest number of fractures occurred in preschool children (n = 549, 42.20%), with the distal phalanx of the third finger being the most common site (n = 73, 15.57%). The number of fractures in adolescents was the lowest (n = 158, 12.14%), and the most common fracture site was the proximal phalanx of the fifth finger (n = 45, 29.61%). Of the 1561 fractures, 1143 occurred in the hands and 418 in the feet. The most and least common first-level fracture sites among hand fractures were the fifth (n = 300, 26.25%) and first (n = 138, 12.07%) fingers, respectively. The most and least common first-level foot fracture locations were the first (n = 83, 19.86%) and fourth (n = 26, 6.22%) toes, respectively. The most common first-level and second level etiologies were life related injuries (n = 1128, 86.70%) and clipping injuries (n = 428, 32.90%), respectively. The incidence of sports injuries gradually increased with age, accounting for the highest proportion in adolescents (26.58%). Hand and foot fractures had many accompanying injuries, with the top three being nail bed injuries (570 cases, 36.52%), growth plate injuries (296 cases, 18.96%), and distal severed fracture (167 cases, 10.70%). Among the 296 growth plate injuries, 246 occurred on the hands and 50 on the feet. Conclusions: In contrast to previous epidemiological studies on pediatric hand and foot fractures, we mapped the locations of these fractures, including proximal, shaft, distal, and epiphyseal plate injuries. We analyzed the changing trends in fracture sites and injury etiologies with age. Hand and foot fractures have many accompanying injuries that require attention during diagnosis and treatment. Doctors should formulate accident protection measures for children of different ages, strengthen safety education, and reduce the occurrence of accidental injuries. [ABSTRACT FROM AUTHOR]