Retrograde intramedullary nailing of the radius in children : A pilot magnetic resonance imaging study of soft-tissue findings

Peer reviewe

Gravidity, parity and knee breadth at midlife: a population-based cohort study

Gestation increases the biomechanical loading of lower extremities. Gestational loading may influence anthropometrics of articular surfaces in similar means as bone diaphyseal properties. This study aimed to investigate whether gravidity (i.e. number of pregnancies) and parity (i.e. number of deliveries) is associated with knee breadth among middle-aged women. The study sample comprised 815 women from the Northern Finland Birth Cohort 1966. The median parity count of our sample was 2 and the median gravidity count 3. At the age of 46, questionnaires were used to enquire gravidity and parity, and posteroanterior knee radiographs were used to obtain two knee breadth parameters (tibial plateau mediolateral breadth (TPML) and femoral condylar mediolateral breadth (FCML)) as representatives of articular size. The associations of gravidity and parity with knee breadth were analyzed using general linear models with adjustments for height, weight, leisure-time physical activity, smoking, and education years. Individuals with osteoarthritic changes were excluded from our sample. The mean TPML in our sample was 70.3 mm and the mean FCML 71.6 mm respectively. In the fully adjusted models, gravidity and parity showed positive associations with knee breadth. Each pregnancy was associated with 0.11–0.14% larger knee breath (p < 0.05), and each delivery accounted for an increase of 0.20% in knee breadth (p < 0.01). Between-group comparisons showed that multiparous women had 0.68–1.01% larger knee breath than nulli- and primiparous women (p < 0.05). Pregnancies and deliveries seem to increase the mediolateral breadth of the knee. This increase is potentially associated with increased biomechanical loadings during gestation.Peer reviewe

Fame after Death: The Unusual Story of a Finnish Mummy and Difficulties Involving its Study

The cool, ventilated milieus beneath the floors of old Finnish churches are responsible for the natural mummification in church graves. One good example of such preservation are the remains of an early 17th-century vicar of Kemi parish, Nikolaus Rungius. He died in 1629 and was put to rest under the old Keminmaa Church in Finnish Lapland. The parish began exhibiting his preserved body in the 18th century after which Vicar Rungius – a locally revered man of cloth in life – gained wide posthumous fame. His dead body became a powerful means to encourage and strengthen people’s faith. The mummy has maintained a human form but has lost its right forearm. On top of that the computed tomography scanning conducted in 2011 revealed that the head was not normally attached. It is unclear when it happened or how but a suspicion arose that once the neck was damaged the head could have fallen to the ground and shattered. A serious concern was whether the head of the mummy was really that of Vicar Rungius as a headless vicar would undoubtedly have prompted a substitution with another mummified head in order to maintain a powerful incentive to the parishioners’ faith.Kuolemanjälkeisestä maineesta: epätavallinen tarina suomalaisesta muumiosta ja sen tutkimiseen liittyvistä ongelmista Viileä, hyvin tuulettuva ympäristö vanhojen suomalaisten kirkkojen lattioiden alla luo olosuhteet luonnolliselle muumioitumiselle kirkkohaudoissa. Hyvänä esimerkkinä tällaisesta säilymisestä voidaan pitää 1600-luvun alkupuolella eläneen Kemin seurakunnan kirkkoherran Nikolaus Rungiuksen muumiota. Kirkkoherra kuoli vuonna 1629 ja hänet haudattiin Suomen Lapissa sijaitsevan Keminmaan vanhan kivikirkon alle. Hänen muumioitunut ruumiinsa on seurakunnan toimesta ollut näytteillä 1700-luvulta lähtien, minkä jälkeen kirkkoherra Rungius – jo eläessään paikallisten kunnioittama kirkonmies – saavutti laajalle levinneen kuolemanjälkeisen maineen. Hänen ruumistaan tuli merkittävä keino rohkaista ja lujittaa ihmisten uskoa. Muumio on säilyttänyt ihmismuotonsa, mutta menettänyt oikeanpuoleisen kyynärvartensa. Sen lisäksi vuonna 2011 suoritettu tietokonetomografia paljasti, ettei muumion pää ollut normaalisti kiinni torsossa. On epäselvää, milloin ja miten pää on irronnut, mutta sen irtoaminen herätti epäilyksen, että niskan vahingoituttua pää oli saattanut pudota maahan ja rikkoontua. Olikin pohdittava, onko muumion pää todellakin kirkkoherra Rungiuksen, sillä kirkkoherran päättömyys olisi epäilemättä nopeasti johtanut pään korvaamiseen jollain toisella muumioituneella päällä seurakuntalaisten uskon vaikutusvaltaisen kannustimen säilyttämiseksi

Randomized Controlled Trial of the Clinical Recovery and Biodegradation of Polylactide-co-glycolide Implants Used in the Intramedullary Nailing of Children's Forearm Shaft Fractures with at Least Four Years of Follow-Up

The preferred surgical fixation of forearm shaft fractures in children is Elastic Stable Intramedullary Nailing (ESIN). Due to known disadvantageous effects of metal implants, a new surgical method using biodegradable polylactide-co-glycolide (PLGA) intramedullary nails has been developed but its long-term outcomes are unclear. The aim of this study was to compare the long-term outcomes of Biodegradable Intramedullary Nailing (BIN) to ESIN and assess the biodegradation of the study implants via magnetic resonance imaging (MRI). The study population of the prospective, randomized trial consisted of paediatric patients whose forearm shaft fractures were treated with BIN (n = 19) or ESIN (n = 16). Forearm rotation at minimally four years' follow-up was the main outcome. There was no clinically significant difference in the recovery of the patients treated with the BIN as compared to those treated with the ESIN. More than half of the implants (57.7%, n = 15/26) were completely degraded, and the rest were degraded almost completely. The PLGA intramedullary nails used in the treatment of forearm shaft fractures in this study resulted in good function and anatomy. No unexpected disadvantages were found in the degradation of the implants. However, two implant failures had occurred in three months postoperatively.Peer reviewe

Randomized Controlled Trial of the Clinical Recovery and Biodegradation of Polylactide-co-glycolide Implants Used in the Intramedullary Nailing of Children's Forearm Shaft Fractures with at Least Four Years of Follow-Up

The preferred surgical fixation of forearm shaft fractures in children is Elastic Stable Intramedullary Nailing (ESIN). Due to known disadvantageous effects of metal implants, a new surgical method using biodegradable polylactide-co-glycolide (PLGA) intramedullary nails has been developed but its long-term outcomes are unclear. The aim of this study was to compare the long-term outcomes of Biodegradable Intramedullary Nailing (BIN) to ESIN and assess the biodegradation of the study implants via magnetic resonance imaging (MRI). The study population of the prospective, randomized trial consisted of paediatric patients whose forearm shaft fractures were treated with BIN (n = 19) or ESIN (n = 16). Forearm rotation at minimally four years' follow-up was the main outcome. There was no clinically significant difference in the recovery of the patients treated with the BIN as compared to those treated with the ESIN. More than half of the implants (57.7%, n = 15/26) were completely degraded, and the rest were degraded almost completely. The PLGA intramedullary nails used in the treatment of forearm shaft fractures in this study resulted in good function and anatomy. No unexpected disadvantages were found in the degradation of the implants. However, two implant failures had occurred in three months postoperatively.Peer reviewe

PLS3Mutations Cause Severe Age and Sex-Related Spinal Pathology

Objective:Mutations in the X-chromosomalPLS3-gene, encoding Plastin 3, lead to severe early-onset osteoporosis, suggesting a major role for PLS3 in bone metabolism. However, the consequences of abnormal PLS3 function in bone and other tissues remain incompletely characterized. This study evaluated spinal consequences of aberrant PLS3 function in patients withPLS3mutations. Design:A cross-sectional cohort study with spinal magnetic resonance imaging of 15PLS3mutation-positive (age range 9-77 years) and 13 mutation-negative (9-70 years) subjects. Images were reviewed for spinal alignment, vertebral heights and morphology, intervertebral disc changes and possible endplate deterioration. Results:Vertebral changes were significantly more prevalent in the mutation-positive subjects compared with the mutation-negative subjects; they were most abundant in upper thoracic spine, and in all age groups and both sexes, although more prominent in males. Difference in anterior vertebral height reduction was most significant in T5 and T6 (p= 0.046 andp= 0.041, respectively). Mid-vertebral height reduction was most significant in T3 and T5 (p= 0.037 andp= 0.005, respectively), and, for male mutation-positive subjects only, in T4 and T6-10 (p= 0.005-0.030 for each vertebra). Most of the abnormal vertebrae were biconcave in shape but thoracic kyphosis or lumbar lordosis were unchanged. Vertebral endplates were well-preserved in the mutation-positive subjects with even fewer Schmorl nodes than the mutation-negative subjects (10 vs. 16). Conclusions:Compromised PLS3 function introduces severe and progressive changes to spinal structures that are present already in childhood, in both sexes and most abundant in upper thoracic spine. Cartilaginous structures are well-preserved.Peer reviewe

Lannerangan rappeumaperäisten välilevymuutosten nimikkeistö yhtenäiseksi

Lannenikamavälilevylle ja sen rappeumaperäisille muutoksille tarvitaan yhtenäinen nimikkeistö. Termien tulisi olla niin ymmärrettäviä ja johdonmukaisia, jotta muutosten luonne selviää toiselle lääkärille. Yhtenäinen nimikkeistö on perusta varsinkin kliinikoiden ja radiologien yhteistyölle. Välilevyrappeuman morfologisille muutoksille ehdotamme termejä välilevyn kuivuminen, fibroosi, välilevytilan madaltuminen, välilevyn pullistuminen, halkeamat, syyrustoisen renkaan rappeutuminen, välilevyn sisäinen kaasu, nikamasolmun apofyysin reunakerrostumat, sytokiinien välittämät inflammaatiomuutokset ja päätelevyn kalkkeutuminen