Estimation of the femur length from its proximal measurements in Anatolian Caucasians by artificial neural networks

Femora are a well preserved section of the skeleton after death. Therefore, they are commonly used in the field of forensic sciences, physical anthropology and anatomy. In addition, femur morphometry is helpful in finding sex or side (left or right) differences. The femur also shows characteristics of certain populations. Femur length is important for calculation of individual stature. In this study, the artificial neural network method was used to estimate femur length. In total, 230 femora exemplar were used. The three input parameters of the method were the distance between trochanter major top point and trochanter minor bottom point, the diameter of caput femoris and the diameter of collum femoris. By using these parameters, the artificial neural network estimation on femur length was performed. The results show that the method is capable of performing this estimation. In addition, sex discrimination was performed and achieved with 82% accuracy. As well as the identification of sex or side differences, morphometry of the proximal femur is necessary and important for surgical procedures.     

Mechanical and neuromuscular changes with lateral trunk lean gait modifications

Lateral trunk lean (LTL) is a proposed intervention for knee osteoarthritis but increased muscular demands have not been considered. The objective was to compare lower extremity and trunk muscle activation and joint mechanics between normal and increased LTL gait in healthy adults. Participants (n = 20, mean age 22 years) were examined under two gait conditions: normal and increased LTL. A motion capture system and force plates sampled at 100 and 2000 Hz respectively were used to determine joint angles and external moments including LTL angle and external knee adduction moment (KAM). Surface electromyography, sampled at 2000 Hz, measured activation of six trunk/hip muscles bilaterally. Peak LTL angle, peak KAM, gait speed, and mean values from electromyography waveforms were compared between normal and LTL conditions using paired t-tests or 2-way analysis of variance. There was a significant (p < 0.05) increase in peak LTL angle, decrease in first but not second peak KAM, and decrease in gait speed during LTL gait. There were significant (p < 0.01) increases in external oblique and iliocostalis muscle activation during LTL gait. There was no change in activation for internal oblique, rectus abdominis, longissimus, and gluteus medius. LTL gait decreased early/mid-stance KAM demonstrating its ability to decrease medial compartment knee loading. Increases in external oblique and iliocostalis activation were present but small to moderate in size and unlikely to lead to short term injury. Longitudinal studies should evaluate the effectiveness of increased LTL for knee osteoarthritis and if the increase in muscular demands leads to negative long term side effects.     

股骨近端锁定钢板内固定治疗老年股骨转子间骨折的临床疗效

目的:研究分析股骨近端锁定钢板(LPFP)内固定治疗老年股骨转子间骨折(IF)的临床疗效. 方法:选择2011年6月至2014年5月接受治疗的老年IF患者124例作为研究对象. 64例接受LPFP 术式,纳入观察组;另60例接受动力髋螺钉( DHS)术式,纳入对照组,对比两组患者的手术及住院相关指标,随访1 年,对比两组手术疗效以及手术后的并发症情况. 结果:观察组的术程、出血量、住院时间以及术后负重的时间均分别显著少于对照组,差异均有统计学意义(均P<0.05). 观察组经手术治疗后的优良率是82.81%,显著高于对照组的66.67%,差异有统计学意义( P<0.05). 观察组手术后总并发症的发生率为1.56%,显著低于对照组的15.00%,差异有统计学意义( P<0.05). 结论:LPFP 术式治疗老年IF,疗效较好,恢复快,且并发症较少,值得进行推广应用.     

Spatial variation in osteon population density at the human femoral midshaft: histomorphometric adaptations to habitual load environment

Intracortical remodeling, and the osteons it produces, is one aspect of the bone microstructure that is influenced by and, in turn, can influence its mechanical properties. Previous research examining the spatial distribution of intracortical remodeling density across the femoral midshaft has been limited to either considering only small regions of the cortex or, when looking at the entirety of the cortex, considering only a single individual. This study examined the spatial distribution of all remodeling events (intact osteons, fragmentary osteons, and resorptive bays) across the entirety of the femoral midshaft in a sample of 30 modern cadaveric donors. The sample consisted of 15 males and 15 females, aged 21–97 years at time of death. Using geographic information systems software, the femoral cortex was subdivided radially into thirds and circumferentially into octants, and the spatial location of all remodeling events was marked. Density maps and calculation of osteon population density in cortical regions of interest revealed that remodeling density is typically highest in the periosteal third of the bone, particularly in the lateral and anterolateral regions of the cortex. Due to modeling drift, this area of the midshaft femur has some of the youngest primary tissue, which consequently reveals that the lateral and anterolateral regions of the femoral midshaft have higher remodeling rates than elsewhere in the cortex. This is likely the result of tension/shear forces and/or greater strain magnitudes acting upon the anterolateral femur, which results in a greater amount of microdamage in need of repair than is seen in the medial and posterior regions of the femoral midshaft, which are more subject to compressive forces and/or lesser strain magnitudes.     

探讨关节镜辅助下微创治疗外侧胫骨平台骨折的临床疗效

目的：探讨关节镜辅助下微创治疗外侧胫骨平台骨折的疗效。方法随机选取2014年1月—2015年7月该院收治的外侧胫骨平台骨折患者80例,按照治疗方法分为观察组与对照组。对照组行传统切开复位内固定治疗;观察组以关节镜下辅助微创法治疗,对比两组患者的治疗效果。结果观察组治疗优良率为90%;对照组为70%,比较差异有统计学意义(P﹤0.05)。观察组术后即刻与末次随访塌陷高度评分显著低于对照组(P<0.05)。观察组并发症发生率显著低于对照组(P﹤0.05)。结论以关节镜下辅助微创治疗临床疗效较好,更快促进患者尽快康复。     

直接前入路与外侧入路全髋关节置换术的临床对比研究

目的 对比分析直接前入路与外侧入路行全髋关节置换术的临床疗效.方法 回顾性分析2013年1月至2015年12月收集的120例行全髋关节置换患者的临床资料,其中60例采用直接前入路,60例采用外侧入路.记录两组手术时间、术中出血量及住院时间,术后随访时对两组患者行VAS评分和Harris评分.结果 两组一般资料比较,差异均无统计学意义(P＞0.05);直接前入路组手术时间较外侧入路组长,出血量较外侧入路组少,住院时间较外侧入路组短,两组相比,差异均有统计学意义(P＜0.05);末次随访时,直接前入路组Harris评分较外侧入路组高,且差异有统计学意义(P＜0.05);两组VAS评分相比,差异无统计学意义(P＞0.05).两组不良反应发生率比较,差异无统计学意义(P＞0.05).结论 直接前入路对软组织损伤少,患者围术期恢复较快,其治疗效果优于外侧入路.     

股骨大转子长斜形截骨联合人工全髋关节置换术治疗成人高脱位DDH的疗效分析

目的探讨股骨大转子长斜形截骨在治疗成人高脱位发育性髋关节脱位(developmental dislocation of hip DDH)中的临床疗效。方法实验组:选取2012年2月至2015年2月本院收治的11例高脱位DDH患者的临床资料,11例患者均采用全髋人工关节假体置换联合股骨大转子长斜形截骨钢丝内固定术。其中,男3例,女8例。年龄45～72岁,平均56.5岁,术后末次随访體关节功能按改良Merle d'Aubingne-Postel评分系统评估。对照组:通过医院病历管理平台获得自2009年1月至2012年1月本院采用全髋人工关节假体置换联合股骨大转子下横形截骨术治疗17例患者的临床资料,最后电话得到随访的有12例,获取病历数据得知12例患者的平均手术时间、出血量等相关数据。将实验组与对照组的数据进行对比分析。结果实验组11例患者均得到随访,随访时间12～18个月,平均15.8个月。平均手术时间(120.05±32.50) min,术中出血量(270.15±72.50) mL,末次随访髋关节功能按改良Merle d'Aubingne-Postel评分系统来评估:优7例,良3例,可1例,差0例,优良率90.91%。无1例发生坐骨神经损伤。对照组平均手术时间(160.08±95.50) min,术中出血量(380.02±75.70) mL,优良率91.67%。有1例坐骨神经损伤,末次随访时已恢复。两组病例治疗效果的优良率通过χ~2检验,P0.05。手术时间及出血量通过t检验,p0.05。结论采用股骨大转子长斜形截骨能够获得与转子下横形截骨相同的临床效果,但其手术时间、术中出血量明显减少,术中手术创伤减小、手术操作难度降低。     

Ontogenetic changes of geometrical and mechanical characteristics of the avian femur: a comparison between precocial and altricial birds

The mechanical performance of limb bones is closely associated with an animal's locomotor capability and is thus important to our understanding of animal behaviour. This study combined a geometrical analysis and three‐point bending tests to address the question of how the mechanical performance of the femurs of Japanese quail (Coturnix coturnix japonica) and pigeon (Columba livia domestica) respond to changing functional demands during ontogeny. Results showed that hatchling quails had stiff bone tissues, and the femoral ultimate loads scaled negatively with body mass, corresponding to high functional demands during early growth. The hatchling pigeon femora had weak material properties but they showed a dramatic increase in Young's modulus during growth. Consequently, although femoral cross‐sectional geometry showed negative allometry, the ultimate loads scaled positively with body mass. Older pigeons had more circular bone cross‐sections than younger pigeons, probably due to load stimulation changes occurred shortly after the onset of locomotion. Negative allometry and isometry of the cross‐sectional geometry of hind limb bones were observed in flying birds and ground‐dwelling birds, respectively. The correspondence between geometrical change and locomotor pattern suggests that ontogenetic changes in cross‐sectional geometry may be an effective indicator of avian locomotor behaviour.     

股骨头缺血性坏死的CT诊断及手术抉择

目的探讨CT在股骨头缺血坏死病人诊断中的应用.方法对50例(70髋)股骨头缺血坏死(ANFH)病人及30例(40髋)正常人进行CT检查,并将其结果与MRI及X线平片分期进行对比分析.结果50例中Ⅰ期者X平片为40例,CT为25例;Ⅱ期者X平片为15例,CT为30例;余10例Ⅲ～Ⅳ期者X线平片与CT相同.结论虽然CT诊断不如MRI灵敏,但在显示股骨头骨折方面明显优于MRI及X线平片.因此,CT诊断可以提高疾病分期级别,有助于治疗方案的选择.     

优选序列MRI测量胎儿股骨长度

目的 评价M RI测量胎儿股骨长度(FL)的价值,并选择最优序列.方法 回顾性分析205胎胎儿股骨M RI,包括弥散加权成像(DWI)、单次激发快速自旋回波(SSFSE)、快速稳态梯度回波(FIESTA)及快速反转恢复运动抑制(FIRM)序列图像及超声资料,对各序列图像质量进行评分,比较所测FL与超声测值的差异.结果 ...