目的:评价X线放射吸收法(Radiographic Absorptiometry,RA)测定指骨骨密度与双能X线吸收法(Dual energy X-ray radiogrammetry,DEXA)测定腰椎和股骨颈骨密度在诊断绝经后女性骨质疏松症的一致性。方法:选取65名绝经后女性,均用RA测定指...目的:评价X线放射吸收法(Radiographic Absorptiometry,RA)测定指骨骨密度与双能X线吸收法(Dual energy X-ray radiogrammetry,DEXA)测定腰椎和股骨颈骨密度在诊断绝经后女性骨质疏松症的一致性。方法:选取65名绝经后女性,均用RA测定指骨骨密度和DEXA测定腰椎和股骨颈骨密度,用线性回归分析比较两种方法所测的骨质量(Bone mineral density,BMD),用Bland-Altman(B-A)作图法分析比较两种方法所测T值。结果:RA测定指骨BMD与DEXA测定腰椎和股骨颈BMD呈线性关系,相关系数R2分别为0.64、0.56(P<0.01)。B-A分析法显示两种方法检测T值的一致性较好。结论:RA指骨骨密度测定法可应用于绝经后女性骨质疏松症的筛查。展开更多
Objective: The aim of the present study is to discriminate functions for sex determination in a subjected sample of the Egyptian population using the morphology of metacarpals and phalanges for gender comparison. Furt...Objective: The aim of the present study is to discriminate functions for sex determination in a subjected sample of the Egyptian population using the morphology of metacarpals and phalanges for gender comparison. Furthermore, the measurements discussed in this study will aid in predicting the differentiation independently and guaranteeing sex determination in the subjected population individually. Methods: Forty measurements were taken from the right metacarpals and phalangeal bones of 100 subjects, whose ages ranged from 19 to 60. Moreover, the measurements of nine metacarpals and four phalangeal bones were used for sex discrimination in each sample population. Results: Males had significantly greater mean values (P < 0.05) for the lengths of the metacarpals and the proximal phalangeal bones of all right-hand fingers than females. The cut-off value and the accuracy percentage for precise sex classification of males and females using individual and grouped bones showed that a value higher than the marking point classified an individual as male and that a lower value suggested female. Besides, the multiple stepwise discriminant functional analysis of the most predictable internal variables of the metacarpals revealed a cross-validated sex classification accuracy of 100%. In contrast, the most predictable internal variables of the phalanges showed a cross-validated sex classification accuracy of 93%. Conclusion: The results revealed a new forensic suggestion for the determination of sex based on the measurements of the metacarpals and the phalanges. Moreover, various discriminant equations were applied for the declaration of this conceivable recommendation.展开更多
Phalangeal neck fractures occur almost exclusively in children. We present the case of a 49 years old man with a dislocated fracture of the neck of the middle phalanx with the distal fragment rotated at 180~, due to a...Phalangeal neck fractures occur almost exclusively in children. We present the case of a 49 years old man with a dislocated fracture of the neck of the middle phalanx with the distal fragment rotated at 180~, due to a traumatic circular saw injury to the left index, which was solved by anatomical reduction and bone fixation with two 1.5 mm Synthes screws and a temporary transarticular K- wire at the distal interphalangeal joint. Zone I flexor digitorum profundus repair was performed using a modification of the Kessler 4-strands core suture and a full-thickness skin graft from the hypothenar eminence was taken to cover the skin gap. At 6-month follow-up the patient was pain-free and with a total active movement equivalent to 190~. No radio-logical signs of avascular necrosis of the head of the middle phalanx or nonunion of the distal fragment was detectable with recovery to the previous manual work. Owing to the position of the phalangeal head maintained in position by the collateral ligaments an anatomic reduction from dorsal approach is difficult to be performed and a longitudinal trac- tion can render the reduction harder too. The volar approach permits an easier reduction of the fracture through a derotation of the distal fragment facing palmar.展开更多
BACKGROUND Chondrosarcoma of the foot is a rare malignant bone tumour,and it is even rarer when it originates in a toe bone.Surgical excision is the only effective treatment.The osteolytic destruction of the tumour se...BACKGROUND Chondrosarcoma of the foot is a rare malignant bone tumour,and it is even rarer when it originates in a toe bone.Surgical excision is the only effective treatment.The osteolytic destruction of the tumour severely affects limb function and carries the risk of distant metastasis.Most such tumours are removed surgically to minimize local recurrence and distant metastases,maximize limb function,and prolong the patient’s tumour-free survival time.The main objective of this article is to present the case of a chondrosarcoma that invaded the first phalanx of the left foot and formed a large phalangeal mass with osteolytic destruction of the distal bone.CASE SUMMARY A 74-year-old man suffered from swelling of his left toe for six months,with pain and swelling for two months.Computed tomography and magnetic resonance imaging showed that the tumour on the first phalanx of the left foot was approximately 54.9 mm×44.6 mm,surrounded by a significant soft tissue signal mass,with osteolytic destruction of the distal phalanx and a speckled bone-like highdensity shadow within it.CONCLUSION Chondrosarcoma occurring in a toe bone is extremely rare.In this case,extensive surgical resection of the large low-grade chondrosarcoma,which showed osteolytic destruction and invaded the distal metatarsal bone,was safe and effective.展开更多
文摘目的:评价X线放射吸收法(Radiographic Absorptiometry,RA)测定指骨骨密度与双能X线吸收法(Dual energy X-ray radiogrammetry,DEXA)测定腰椎和股骨颈骨密度在诊断绝经后女性骨质疏松症的一致性。方法:选取65名绝经后女性,均用RA测定指骨骨密度和DEXA测定腰椎和股骨颈骨密度,用线性回归分析比较两种方法所测的骨质量(Bone mineral density,BMD),用Bland-Altman(B-A)作图法分析比较两种方法所测T值。结果:RA测定指骨BMD与DEXA测定腰椎和股骨颈BMD呈线性关系,相关系数R2分别为0.64、0.56(P<0.01)。B-A分析法显示两种方法检测T值的一致性较好。结论:RA指骨骨密度测定法可应用于绝经后女性骨质疏松症的筛查。
文摘Objective: The aim of the present study is to discriminate functions for sex determination in a subjected sample of the Egyptian population using the morphology of metacarpals and phalanges for gender comparison. Furthermore, the measurements discussed in this study will aid in predicting the differentiation independently and guaranteeing sex determination in the subjected population individually. Methods: Forty measurements were taken from the right metacarpals and phalangeal bones of 100 subjects, whose ages ranged from 19 to 60. Moreover, the measurements of nine metacarpals and four phalangeal bones were used for sex discrimination in each sample population. Results: Males had significantly greater mean values (P < 0.05) for the lengths of the metacarpals and the proximal phalangeal bones of all right-hand fingers than females. The cut-off value and the accuracy percentage for precise sex classification of males and females using individual and grouped bones showed that a value higher than the marking point classified an individual as male and that a lower value suggested female. Besides, the multiple stepwise discriminant functional analysis of the most predictable internal variables of the metacarpals revealed a cross-validated sex classification accuracy of 100%. In contrast, the most predictable internal variables of the phalanges showed a cross-validated sex classification accuracy of 93%. Conclusion: The results revealed a new forensic suggestion for the determination of sex based on the measurements of the metacarpals and the phalanges. Moreover, various discriminant equations were applied for the declaration of this conceivable recommendation.
文摘Phalangeal neck fractures occur almost exclusively in children. We present the case of a 49 years old man with a dislocated fracture of the neck of the middle phalanx with the distal fragment rotated at 180~, due to a traumatic circular saw injury to the left index, which was solved by anatomical reduction and bone fixation with two 1.5 mm Synthes screws and a temporary transarticular K- wire at the distal interphalangeal joint. Zone I flexor digitorum profundus repair was performed using a modification of the Kessler 4-strands core suture and a full-thickness skin graft from the hypothenar eminence was taken to cover the skin gap. At 6-month follow-up the patient was pain-free and with a total active movement equivalent to 190~. No radio-logical signs of avascular necrosis of the head of the middle phalanx or nonunion of the distal fragment was detectable with recovery to the previous manual work. Owing to the position of the phalangeal head maintained in position by the collateral ligaments an anatomic reduction from dorsal approach is difficult to be performed and a longitudinal trac- tion can render the reduction harder too. The volar approach permits an easier reduction of the fracture through a derotation of the distal fragment facing palmar.
文摘BACKGROUND Chondrosarcoma of the foot is a rare malignant bone tumour,and it is even rarer when it originates in a toe bone.Surgical excision is the only effective treatment.The osteolytic destruction of the tumour severely affects limb function and carries the risk of distant metastasis.Most such tumours are removed surgically to minimize local recurrence and distant metastases,maximize limb function,and prolong the patient’s tumour-free survival time.The main objective of this article is to present the case of a chondrosarcoma that invaded the first phalanx of the left foot and formed a large phalangeal mass with osteolytic destruction of the distal bone.CASE SUMMARY A 74-year-old man suffered from swelling of his left toe for six months,with pain and swelling for two months.Computed tomography and magnetic resonance imaging showed that the tumour on the first phalanx of the left foot was approximately 54.9 mm×44.6 mm,surrounded by a significant soft tissue signal mass,with osteolytic destruction of the distal phalanx and a speckled bone-like highdensity shadow within it.CONCLUSION Chondrosarcoma occurring in a toe bone is extremely rare.In this case,extensive surgical resection of the large low-grade chondrosarcoma,which showed osteolytic destruction and invaded the distal metatarsal bone,was safe and effective.
