scholarly journals Comparison of Computed Tomography Articular Surface Geometry of Male Versus Female Thumb Carpometacarpal Joints

Hand ◽  
2017 ◽  
Vol 13 (1) ◽  
pp. 33-39
Author(s):  
Jessica G. Shih ◽  
James G. Mainprize ◽  
Paul A. Binhammer
Keyword(s):  
Sex Differences ◽  
Articular Surface ◽  
Joint Space ◽  
Joint Surface ◽  
Surface Geometry ◽  
Significant Difference ◽  
The Mean ◽  
Joint Congruence ◽  
Cmc Joint ◽  
Space Volume

Background: Given the predilection of first carpometacarpal (CMC) joint osteoarthritis in women compared with men, we aim to determine the differences in first CMC joint surface geometry and congruence between young healthy males and females. Methods: Wrist computed tomographic scan data of 11 men and 11 women aged 20 to 35 years were imported into 3-dimensional software programs. The first metacarpal and the trapezium were aligned in a standardized position according to landmarks at key points on Gaussian and maximum curvature maps. Measurements of joint congruence and surface geometry were analyzed, including joint space volume, distance between the bones at the articular surface edges, area of the joint space, and radii of curvature in the radial-ulnar and volar-dorsal planes. Results: The mean thumb CMC articular space volume was 104.02 ± 30.96 mm3 for females and 138.63 ± 50.36 mm3 for males. The mean first metacarpal articular surface area was 144.9 ± 10.9 mm2 for females and 175.4 ± 25.3 mm2 for males. After normalizing for size, the mean thumb CMC articular space volume was 119.4 ± 24.6 mm3 for females and 117.86 ± 28.5 mm3 for males. There was also no significant difference for the articular space volume, articular surface distances, articular space, and mean radii of curvatures. Conclusions: This study found that there are sex differences in the first CMC joint articular volume without normalizing for size; however, there are no sex differences in first CMC joint articular volume, curvature characteristics, or joint congruence of young, healthy patients after normalizing for joint size.

scholarly journals Anatomy of the Intermetatarsal Facets of the Fourth and Fifth Metatarsals

2021 ◽  
Vol 6 (1) ◽  
pp. 247301142097570
Author(s):  
Mossub Qatu ◽  
George Borrelli ◽  
Christopher Traynor ◽  
Joseph Weistroffer ◽  
James Jastifer
Keyword(s):  
Articular Cartilage ◽  
Digital Imaging ◽  
Articular Surface ◽  
Implant Design ◽  
Joint Surface ◽  
Fracture Classification ◽  
Articular Damage ◽  
Metatarsal Fracture ◽  
Metatarsal Fractures ◽  
The Mean

Background: The intermetatarsal joint between the fourth and fifth metatarsals (4-5 IM) is important in defining fifth metatarsal fractures. The purpose of the current study was to quantify this joint in order to determine the mean cartilage area, the percentage of the articulation that is cartilage, and to give the clinician data to help understand the joint anatomy as it relates to fifth metatarsal fracture classification. Methods: Twenty cadaver 4-5 IM joints were dissected. Digital images were taken and the articular cartilage was quantified by calibrated digital imaging software. Results: For the lateral fourth proximal intermetatarsal articulation, the mean area of articulation was 188 ± 49 mm2, with 49% of the area composed of articular cartilage. The shape of the articular cartilage had 3 variations: triangular, oval, and square. A triangular variant was the most common (80%, 16 of 20 specimens). For the medial fifth proximal intermetatarsal articulation, the mean area of articulation was 143 ± 30 mm2, with 48% of the joint surface being composed of articular cartilage. The shape of the articular surface was oval or triangular. An oval variant was the most common (75%, 15 of 20 specimens). Conclusion: This study supports the notion that the 4-5 IM joint is not completely articular and has both fibrous and cartilaginous components. Clinical Relevance: The clinical significance of this study is that it quantifies the articular surface area and shape. This information may be useful in understanding fifth metatarsal fracture extension into the articular surface and to inform implant design and also help guide surgeons intraoperatively in order to minimize articular damage.

scholarly journals Evaluating the Subtalar Joint in Tibiotalocalcaneal Nail

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0040
Author(s):  
Megan Reilly ◽  
Kurosh Darvish ◽  
Soroush Assari ◽  
John Cole ◽  
Tyler Wilps ◽  
...  
Keyword(s):  
Surface Area ◽  
Subtalar Joint ◽  
Articular Surface ◽  
Joint Surface ◽  
Central Dome ◽  
Below The Knee ◽  
Joint Surfaces ◽  
Circular Surface ◽  
The Mean ◽  
Pass Through

Category: Hindfoot Introduction/Purpose: In tibiotalocalcaneal nails for arthrodesis, the path of the nail through the subtalar joint has not been well documented. Ideally, the defect caused by reaming and the nail does not pass through the joint surface so that the amount of bony contact between the talus and calcaneus is maintained in order to optimize fusion. Our hypothesis is that the TTC nail does not destroy a significant amount contact area between the talus and calcaneus. However, using larger diameter nails (which are inherently stronger) will have more of an effect on the contact surface. Methods: Five cadaveric below the knee specimens were obtained. The ankle was disarticulated on each specimen. Subsequently, a guidepin was drilled from the central dome of the talus down to the calcaneus. The 11 mm reamer was then passed over the guidepin through the calcaneus to simulate retrograde reaming of a TTC nail. Then, the subtalar joint was dissected open and the articular surface was documented in comparison with the area that was reamed out. Measurements were then made, using software that calculated two dimensional surface area to determine the percentage of actual subtalar joint area that was reamed out. The mean percentage of articular area that was removed with the reamer was then calculated. Results: Among the five specimens, in the calcaneus, the mean total articular area was 599mm2±113 and the mean drilled articular area was 21mm2±16. The percentage of the calcaneal articular surface that was removed with the reamer was 3.4%±1.9. In the talus, the mean total articular area was 782mm2±130 and the mean drilled articular area was 39mm2±18. The percentage of the talar articular surface that was removed with the reamer was 5.0%±2.3. Additionally, an 11 mm reamer makes a circular surface area of 95mm2, and the statistics above indicate that a significant portion of the reamed area is nonarticular, within the calcaneal sulcus or the talar sulcus. Conclusion: In a tibiotalocalcaneal nail the subtalar joint is typically incompletely visualized, however this anatomic study demonstrates that the 11 mm reamer eliminates about 3.4% of the calcaneal articular surface and about 5% of the talar articular surface. Therefore, the majority of the articular surface is left intact, which is ideal in optimizing arthrodesis outcomes. Furthermore, this study could extrapolate the effects of a larger nail on the availability of joint surface. It could also be used to argue for cartilage stripping of the affected joint surfaces in arthrodesis preparation, because the majority of the articular surface is, in fact, left intact.

Sex Differences in Adults on a Test of Logical Reasoning

1956 ◽  
Vol 2 (3) ◽  
pp. 227-230
Author(s):  
Antonia Bell Morgan
Keyword(s):  
Sex Differences ◽  
Logical Reasoning ◽  
Formal Logic ◽  
Government Employment ◽  
Significant Difference ◽  
Males And Females ◽  
The Mean

The Morgan Test of Logical Reasoning, which is entirely verbal in form, was given to 133 males and 35 females. All Ss were in their 20s and applicants for government employment. All had the BA or BS degree but no other, and none had had any training in formal logic. No significant difference was found between the mean scores of males and females on this test, nor between the distribution and variation of scores.

scholarly journals A novel dynamic distraction external fixator for proximal interphalangeal joint fracture dislocation

2019 ◽  
Vol 47 (4) ◽  
pp. 1628-1635 ◽  
Author(s):  
Hua-Zhu Wang ◽  
Jian-Yong Zhao ◽  
Zhi-Sheng Zhang
Keyword(s):  
Grip Strength ◽  
External Fixator ◽  
Articular Surface ◽  
Joint Space ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Fracture Dislocation ◽  
X Rays ◽  
Joint Fracture ◽  
The Mean

Objective To evaluate the efficacy of a novel dynamic distraction external fixator for proximal interphalangeal joint (PIPJ) fracture-dislocation. Methods From March 2005 to March 2014, 20 patients with PIPJ fracture-dislocation were treated with our technique. Function scores according to the Michigan Hand Outcome Questionnaire (MHQ) score, union time, grip strength, and range of motion (ROM) were recorded before and after treatment. Results All patients completed a mean follow-up of 22 months (range, 12–60 months). All patients achieved fracture union and joint reduction. The mean union time was 3 months (range, 2–6 months). The mean postoperative MHQ score was 88.00 ± 3.42 (range, 84.00–92.00). Postoperative grip strength of the affected sides was 92% of the contralateral sides. X-rays showed that the fracture line disappeared completely with a good joint contour. The range of extension in the PIPJ was −5° (range, −10°–0°). The range of flexion in the PIPJ was 89.40° ± 9.79° (range, 75°–100°). Postoperatively, four patients had slight narrowing of the joint space and two had an uneven articular surface. Pin breakage, loosening, and tract infection were not observed. Conclusions The novel dynamic distraction external fixator is a promising option for PIPJ fracture-dislocation.

scholarly journals Arthroscopic-Guided Balloon Tibioplasty in Schatzker III Tibial Plateau Fracture

Joints ◽  
2018 ◽  
Vol 06 (04) ◽  
pp. 220-227 ◽  
Author(s):  
Fabrizio Cuzzocrea ◽  
Eugenio Jannelli ◽  
Alessandro Ivone ◽  
Simone Perelli ◽  
Alberto Fioruzzi ◽  
...  
Keyword(s):  
Ct Scan ◽  
Tibial Plateau ◽  
Case Series ◽  
Clinical Score ◽  
Joint Surface ◽  
X Rays ◽  
Level Of Evidence ◽  
Significant Difference ◽  
The Mean

Abstract Purpose The study aims to present the results at a mean 28-months follow-up of arthroscopic-guided balloon tibioplasty and to spot some technical tricks and some practice using tools and materials. Methods The study relates to six patients with tibial plateau fractures type Schatzker III with tibial plateau depression more than 4 mm at preoperative computed tomography scan (CT-scan). The follow-up period ranged from 22 to 33 months, with a mean of 28 months. No patients were lost to follow-up. The patients were evaluated clinically using the Rasmussen score system and Lysholm score systems at 6 to 12 and 24 months, postoperatively. Radiographic evaluations (standard X-rays) were done preoperatively at 1, 3, and 12 months postoperatively while a CT-scan with 3D reconstruction was performed preoperatively, at the first day and 6 months, postoperatively. Results The mean Rasmussen clinical score at 6 months postoperatively was 26.3 while at 1-year postoperatively the mean Rasmussen clinical score was 28.33. At 2-year postoperatively the mean Rasmussen clinical score was 28.83. Statistically significant difference was found in 6-months and 2-years results (p < 0.05). CT-scan achieved the first postoperative day showed the recovery of approximately 70% of the area of the interested tibial plateau, restoring of the joint surface without articular bone free fragments. Conclusion The described surgical procedure, if correctly performed with proper indications (Schatzker III), respect the principles mentioned above and the clinical and radiological results confirm our purpose. Level of Evidence This is a therapeutic case series, level IV study.

scholarly journals A Comparative Study between Lateral Approach Alone and Combination of Medial and Lateral Approaches for Intra-Articular Calcaneal Fractures with Displaced Sustentaculum Fragment

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0024
Author(s):  
Naohiro Hio ◽  
Masanori Taki
Keyword(s):  
Comparative Study ◽  
Inclination Angle ◽  
Subtalar Joint ◽  
Lateral Approach ◽  
Joint Surface ◽  
Calcaneal Fractures ◽  
Significant Difference ◽  
The Mean ◽  
Type 3

Category: Hindfoot; Trauma Introduction/Purpose: In intra-articular calcaneal fractures, the sustentaculum fragment, which is the reference for reduction, often undergoes varus plantar flexion displacement and requires accurate reduction. Although the lateral approach is generally used as a surgical approach, it is considered that the use of the combination of medial and lateral approaches can achieve more accurate reduction. Here we report a comparative study of between the group with the lateral approach alone (L-group) and the group with the combination of the medial and lateral approaches (ML-group) for calcaneal fractures with displacement of sustentaculum fragment. Methods: L-group included 11 feet, six feet of which were categorized as Sanders classification type 2, four as type 3, one as type 4. ML-group included 14 feet, ten as type 2, two as type 3, two as type 4. In both groups, small incision such as sinus tarsi approach were used for lateral approach and screws and/or plates were used for fixation. We assessed Creighton-Nebraska scale, pre- and postoperative width and height of the calcaneal body, step of subtalar joint surface and inclination angle of the sustentaculum fragment. Results: The mean postoperative clinical evaluation for the L-group / ML-group was 90.5+-7.9 points / 87.2+-9.6 points respectively. The pre- and postoperative image assessments showed improvements in the mean width from 123.4+-15.3% to 110.3+-14.1% / 129.9+-23.1% to 109.9+-14.1%, in the mean height from 88.1+-5.2% to 98.1+-3.7% / 86.0+-9.6% to 95.4+-5.9%, in the step of subtalar joint surface from 9.0+-6.3mm to 0.9+-1.1mm / 10.0+-8.0mm to 0.7+-1.0mm, and in the inclination angle of sustentaculum fragment from 10.3+-5.1 ° to 5.5+-5.0 ° / 12.1+-7.5 ° to 0.5+-1.0 °, respectively. There was a significant difference between the two groups in the inclination angle of the sustentaculum fragment, but no significant difference was observed in the other assessments. Complications were more common with ML-group. Conclusion: Displacement of the sustentaculum fragment in calcaneal fractures can be more reduced accurately by using the combination of medial and lateral approaches, although there is no significant difference in clinical results.

Open Reduction and Screw Fixation of Mallet Fractures

2004 ◽  
Vol 29 (2) ◽  
pp. 135-138 ◽  
Author(s):  
S. C. KRONLAGE ◽  
D. FAUST
Keyword(s):  
Open Reduction ◽  
Screw Fixation ◽  
Articular Surface ◽  
Joint Space ◽  
Satisfactory Outcome ◽  
Loss Of Reduction ◽  
Secondary Procedures ◽  
Distal Interphalangeal ◽  
The Mean ◽  
Extensor Lag

Twelve patients with mallet fractures treated by open reduction and internal fixation with small screws were reviewed at an average of 31 months after surgery. The indication for surgery was a fracture involving more than one-third of the distal phalanx articular surface or with subluxation of the distal interphalangeal joint. Loss of reduction occurred in one patient and in another one screw loosened slightly without loss of reduction. There were no nail deformities, infections, or secondary procedures. The mean range of motion was from 6° (range, 0–30°) (extensor lag) to 70° (range, 60–90°) flexion. Ten patients had no evidence of degenerative changes, one had minor joint space narrowing and one had significant deformity. Open reduction and screw fixation with small screws can lead to satisfactory outcome in appropriate patients.

scholarly journals Transverse olecranon osteotomy with Gigli saw: A fast and reliable technique

2021 ◽  
Vol 6 (1) ◽  
pp. 17-21
Author(s):  
Bulent Karslioglu
Keyword(s):  
Range Of Motion ◽  
Articular Surface ◽  
Distal Humerus ◽  
Chevron Osteotomy ◽  
Elbow Fractures ◽  
Significant Difference ◽  
Transverse Osteotomy ◽  
Humerus Fractures ◽  
The Mean ◽  
Distal Humerus Fractures

Objective. Distal humerus fractures constitute of approximately 2% of all fractures and 30% of elbow fractures. Olecranon osteotomy provides excellent exposure of distal humerus and articular surface. In this study, we aimed to compare transverse osteotomy with gigli saw and classical chevron osteotomy techniques in terms of osteotomy duration and clinical results. Materials and Methods. 40 elbows of 40 patients with Type B intraarticular distal humerus fractures according to AO classification were included in our study. Patients were divided into 2 groups as transverse or chevron osteotomy groups. Patients were evaluated in terms of intraoperative osteotomy time, postoperative time to union, range of motion in the elbow joint and Quick Dash scores at 6th, 12th and 24th months. Results. The mean age of the patients was 45.6 years (19-62). 40% of the patients (8 patients) in the Chevron group had more than 2 mm stepping at articular surface, while this rate was 10% (2 patients) in the gigli saw group. Union was obtained in all patients for both techniques. There was no significant difference between the mean QuickDASH scores and range of motion of the elbow joints except flexion in both groups. Range of motion of flexion was statistically better in the gigli saw group (p<0.05). Conclusions. Transverse osteotomy technique significantly reduces osteotomy and fixation time and will not cause problems in fracture union. It may be preferred because it is simpler and faster to apply than chevron osteotomy and because intra-articular stepping is less common.

Scaphotrapezoid Assessment during Thumb Carpometacarpal Arthroplasty: A Cadaveric Study

2021 ◽  
Author(s):  
Brianna R. Fram ◽  
Bryan Hozack ◽  
Asif M. Ilyas ◽  
Christopher Jones ◽  
Michael Rivlin
Keyword(s):  
Surface Area ◽  
Articular Surface ◽  
Total Surface Area ◽  
High Rate ◽  
Joint Surface ◽  
Level Of Evidence ◽  
Large Variability ◽  
Thumb Carpometacarpal ◽  
Intraoperative Visualization ◽  
Cmc Joint

Abstract Background Due to limited sensitivity of radiographs for scaphotrapeziotrapezoid (STT) arthritis and the high rate of concurrence between thumb carpometacarpal (CMC) and STT arthritis, intraoperative visualization of the STT joint is recommended during CMC arthroplasty. Purpose We quantified the percentage of trapezoid facet of the scaphotrapezoid (ST) joint that could be visualized during this approach, and compared it to the degree of preoperative radiographic STT arthritis. Methods We performed dorsal surgical approach to the thumb CMC joint after obtaining fluoroscopic anteroposterior, lateral, and oblique wrist radiographs of 11 cadaver wrists. After trapeziectomy, the ST joint was inspected and the visualized portion of the trapezoid articulation marked with an electrocautery. The trapezoid was removed, photographed, and the marked articular surface area and total surface area were independently measured by two authors using an image analysis software. The radiographs were analyzed for the presence of STT arthritis. Results The mean visualized trapezoid surface area during standard approach for CMC arthroplasty was 60.3% (standard deviation: 24.6%). The visualized percentage ranged widely from 16.7 to 96.5%. There was no significant correlation between degree of radiographic arthritis and visualized percentage of the joint (p = 0.77). Conclusions: On average, 60% of the trapezoid joint surface was visualized during routine approach to the thumb CMC joint, but with very large variability. Direct visualization of the joint did not correlate with the degree of radiographic STT arthritis. Clinical Relevance A combination of clinical examination, pre- and intraoperative radiographs, and intraoperative visualization should be utilized to assess for STT osteoarthritis and determine the need for surgical treatment. Level of Evidence This is a Cadaveric Research Article.

Sex Differences in Mathematics Achievement and Attitude toward Mathematics

1997 ◽  
Vol 80 (2) ◽  
pp. 603-608 ◽  
Author(s):  
Nosisa P. Nyangeni ◽  
Michael J. Glencross
Keyword(s):  
South Africa ◽  
Sex Differences ◽  
Mathematics Achievement ◽  
Positive Attitude ◽  
Attitudes Toward Mathematics ◽  
Attitude Questionnaire ◽  
Significant Difference ◽  
The Mean ◽  
Senior Secondary Schools ◽  
Senior Secondary

In a study of sex differences in mathematics achievement and attitude toward mathematics, a sample of 278 Standard 10 (Grade 12) students (95 boys and 183 girls) from seven senior secondary schools in the Umtata district of Transkei, South Africa, wrote tests in algebra and geometry and completed an attitude questionnaire. Analysis showed no significant difference between the mean scores of boys and girls in algebra but a significant difference between scores in geometry, with the mean score of boys being greater than that of girls. There was no significant difference between the mean scores of boys and girls on the Attitude Toward Mathematics scale, although boys had a significantly more positive Attitude Toward Geometry than girls. Significant low correlations were found between scores on Attitudes Toward Mathematics and scores in mathematics and between scores on Attitudes Toward Geometry and scores in geometry.

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