Injuries to the distal tibial epiphysis

No Abstract

Guided Growth in Skeletal Deformity Associated with DNA-Confirmed Ollier Disease

Abstract: Ollier disease (Spranger type I) is a rare, non-hereditary skeletal dysplasia characterized by asymmetrically distributed enchondromas. We report a case of an eight-year-old female presenting with left lower limb shortening and varus deformity. Radiographic evaluation revealed multiple osteolytic lesions typical of the disease. For the first time in early-stage diagnosis, targeted next-generation sequencing (NGS) was applied, identifying a heterozygous pathogenic IDH1 variant (c.394C>T; p.Arg132Cys), thus enabling prompt molecular confirmation. Surgical management combined guided growth via proximal tibial epiphysiodesis with intraoperative bone biopsy in a single session, reducing anesthetic exposure and hospitalization time. The early application of molecular genetic testing in this case contributed to improved diagnostic accuracy and more effective treatment planning, ultimately supporting better patient outcomes in skeletal dysplasia

The preparation of a sound filmstrip portraying radiographs as an audio-visual teaching aid in anatomy

Thesis (Ed.M.)--Boston University, 1949. This item was digitized by the Internet Archive

Obrzęk szpiku u biorców przeszczepu nerki leczonych inhibitorami kalcyneuryny : opis przypadków

Background: Transient acute musculoskeletal pain syndrome occurs predominantly within the first several months after renal transplantation. Its pathogenesis is not well understood. The toxic effect of calcineurin inhibitors or steroids on bone metabolism has been suspected. Almost all reported cases were associated with the use of cyclosporin A. The pain typically involves distal part of lower extremities and arises in the feet, ankles, or knees. Case report: Two cases are presented of renal allograft recipients who developed severe lower-limb pain in the early period after transplantation while receiving calcineurin-inhibitor (cyclosporin A and tacrolimus). Results: We observed typical clinical and radiological symptoms. The final diagnosis was based on MRI scans. Relief from pain was observed during rest and elevation of the affected extremities. Clinical symptoms and MRI abnormalities resolved spontaneously within a few months

Assessing the Role of the Domestic Dog as a Native American Food Resource in the Middle Missouri Subarea AD 1000 - 1840

The journals of early European explorers and fur traders, as well as ethnographic records, document the integral part domestic dogs played in the village life and economy of the Plains Villagers in the Middle Missouri Subarea. Early travelers on the plains also remarked on the consumption of dog meat in association with certain rituals and ceremonies, and noted the use of dogs as an emergency food resource. This study focuses on nearly 7000 large canid skeletal elements from six Plains Village sites in the Middle Missouri Subarea dating from approximately A.D. 1000 to 1840. Two indicators of the continued importance of domestic dogs in Native American economy are explored. They are the use of dogs for traction, and the use of dogs as food. Osteoarthritic changes to joint substructures, particularly those of the shoulder and vertebral column - areas most directly subject to stress during load bearing or pulling, are identified in the canid assemblages. Further evidence of travois pulling is the multiple instances, in at least six Middle Missouri assemblages, of distortion and apparent stress fracturing of the cranial portion of the scapular blade, with at least partial healing and remodeling of the area of fracture. The dual role of these animals in village economy is illustrated by cutmarks indicative of disarticulation and filleting which appear on many of the affected scapulae. At least three butchering operations or goals are indicated by cutmarks inflicted on the large canid skeletal materials. These include skinning, disarticulation, and filleting. Observed indicators of changing emphasis through time on dogs as a food resource include 1) a general increase in the frequency of cutmarks on skeletal elements, and 2) increases in the frequency of filleting marks, particularly those on the scapular blade and vertebrae. In the two early sites, cutmarks occur on approximately 15% of all large canid skeletal elements. In three Post Contact Coalescent sites, cutmarks frequencies, particularly filleting marks, increase to approximately 30%. In the Historic assemblage, cutmarks occur on approximately 40% of canid skeletal materials. Cutmarks on canid bones from earlier Initial Middle Missouri assemblages indicate that dogs were regularly used as food throughout the Plains Village Period. Increases in cutmark frequencies on large canid skeletal remains through time in the Middle Missouri assemblages support a model of more intensive exploitation of large canids as a food resource during the Coalescent and Historic Periods. During the Coalescent and Historic periods populations of native game animals were reduced or displaced due to the hunting pressures of the fur and hide trade, and traditional Native American subsistence patterns were disrupted by increased intertribal conflict and repeated waves of epidemic diseases which devastated Native American populations. In these later periods, domestic dogs became increasingly important as a food resource, as evidenced by patterns of greater cutmark frequencies, and increased filleting marks on canid bones

Biology and technology in the surgical treatment of malignant bone tumours in children and adolescents, with a special note on the very young

Purpose: The main challenge in reconstruction after malignant bone tumour resection in young children remains how and when growth-plates can be preserved and which options remain if impossible.Methods: We describe different strategies to assure best possible long-term function for young children undergoing resection of malignant bone tumours.Results: Different resources are available to treat children with malignant bones tumours: a) preoperative planning simulates scenarios for tumour resection and limb reconstruction, facilitating decision-making for surgical and reconstructive techniques in individual patients; b) allograft reconstruction offers bone-stock preservation for future needs. Most allografts are intact at long-term follow-up, but limb-length inequalities and corrective/revision surgery are common in young patients; c) free vascularized fibula can be used as stand-alone reconstruction, vascularized augmentation of structural allograft or devitalized autograft. Longitudinal growth and joint remodelling potential can be preserved, if transferred with vascularized proximal physis; d) epiphysiolysis before resection with continuous physeal distraction provides safe resection margins and maintains growth-plate and epiphysis; e) 3D printing may facilitate joint salvage by reconstruction with patient-specific instruments. Very short stems can be created for fixation in (epi-)metaphysis, preserving native joints; f) growing endoprosthesis can provide for remaining growth after resection of epi-metaphyseal tumours. At ten-year follow-up, limb survival was 89%, but multiple surgeries are often required; g) rotationplasty and amputation should be considered if limb salvage is impossible and/or would result in decreased function and quality of life.Conclusion: Several biological and technological reconstruction options must be merged and used to yield best outcomes when treating young children with malignant bone tumours.Orthopaedics, Trauma Surgery and Rehabilitatio

the treatment of snakebite

No Abstract

Hereditary multiple exostosis : a study in abnormal bone growth

Hereditary multiple exostosis is a generalised, heritable disorder of bone, characterised by the appearance of numerous cartilagecappecl exostoses at the juxta-epiphysial regions of the endochondral skeleton. The condition was apparently known even in Hunter's day and most of its characteristic features were described before the end of the nineteenth century. Nevertheless, the evolution of these curious lesions, their unusual distribution and the associated abnormalities of growth are still incompletely defined and largely unexplained