Left Tibia Research Articles

Functional outcome of comminuted upper metaphyseal tibial fracture treated with circular external fixators

<p class="abstract"><strong>Background:</strong> High speed motor vehicle accidents are on the rise over the past few years. These are responsible for most of the complex fractures of the tibial metaphysic. Proper treatment of these fractures is of paramount importance. The use of circular fixators for the definitive treatment of such fractures entails a minimally invasive technique of insertion that gives good fracture reduction and stability combined with minimal postoperative complications.</p><p class="abstract"><strong>Methods:</strong> This study was prospective and conducted over 22 patients diagnosed with upper comminuted metaphyseal tibial fracture treated with circular external fixator.</p><p class="abstract"><strong>Results:</strong> In this series, all 22 patients (100%) were male. Fourteen cases (64%) involved the left tibia and eight (36%) fractures were on right. The mean patient age was 49.5 years (range 26-75). Road traffic collisions accounted for most of the injuries (n=14), while fall from bike (n=8). In this study, using knee society score evaluation, excellent results (KSS>80) were seen in 8 patients (36.36%), good results (KSS 70-79) were seen in 10 patients (45.45%), fair (KSS 60-69) in 4 patient (18.18%) and poor (KSS< 60) in 0 patient (0%). Complication seen was pin tract infection in 2 patients (9.9%), which was managed by regular pin site dressings. Another complication was non-union in 1 patient (4.54%). No other complication was encountered.</p><p class="abstract"><strong>Conclusions:</strong> Circular external fixation is a promising modality for surgical treatment of comminuted upper metaphyseal tibial fractures. It allows satisfactory realignment of the fractured fragments and their stabilization, besides early mobilization of the joints and care of associated soft tissue injuries, without significant complications.</p>

A new robotically assisted system for total knee arthroplasty: A sheep model study.

We investigated the accuracy and safety of a new HURWA robotic-assisted total knee arthroplasty (TKA) system in a sheep model. Ten male small-tailed Han sheep were used in this study. Sheep were imaged by computed tomography scan before and after bone resection and the cutting errors between actual bone preparation and preoperative planning of the femur and tibia in three dimensions were measured. The overall accuracies after surgery compared with that from preoperative surgical planning of the left and right femurs were 1.93±1.02° and 1.93±1.23°, respectively. Additionally, similarly high overall accuracies for the left and right tibia of 1.26±1.04 and 1.68±0.92°, respectively, were obtained. The gap distances of the distal cut, anterior chamfer, anterior cut, posterior chamfer and posterior cut on the medial side were 0.47±0.35mm, 0.41±0.37mm, 0.12±0.26mm, 0.41±0.44mm and 0.12±0.23mm, respectively. No intraoperative complications, such as intraoperative fracture, massive bleeding or death, occurred. This new HURWA robotic-assisted TKA system is an accurate and safe tool for TKA surgery based on the sheep model.

Assessment of the Tissue Response to Modification of the Surface of Dental Implants with Carboxyethylphosphonic Acid and Basic Fibroblastic Growth Factor Immobilization (Fgf-2): An Experimental Study on Minipigs.

Simple SummaryThis study aimed to evaluate the efficacy of treating the surface of dental implants with carboxyethylphosphonic acid for the immobilization of FGF-2, the influence of FGF-2 on cortical bone in close contact with dental implants, new bone formation around dental implants in the presence of FGF-2 and the influence of FGF-2 on the interthread bone area of dental implants during the healing period after insertion.The aim of this study was to evaluate the effect of implant surface treatment with carboxyethylphosphonic acid and fibroblast growth factor 2 on the bone–implant interface during the osseointegration period in vivo using an animal model. The present research was carried out in six minipigs, in whose left tibia implants were inserted as follows: eight implants with a standard surface treatment, for the control group, and eight implants with a surface treatment of carboxyethylphosphonic acid and immobilization of FGF-2, for the test group. At 4 weeks after the insertion of the implants, the animals were sacrificed for the histomorphometric analysis of the samples. The means of the results for the implant–bone contact variable (BIC) were 46.39 ± 17.49% for the test group and 34.00 ± 9.92% for the control group; the difference was not statistically significant. For the corrected implant–bone contact variable (BICc), the mean value of the test group was 60.48 ± 18.11%, and that for the control group, 43.08 ± 10.77%; the difference was statistically significant (p-value = 0.035). The new bone formation (BV/TV) showed average results of 27.28 ± 3.88% for the test group and 26.63 ± 7.90% for the control group, meaning that the differences were not statistically significant (p-value = 0.839). Regarding the bone density at the interthread level (BAI/TA), the mean value of the test group was 32.27 ± 6.70%, and that of the control group was 32.91 ± 7.76%, with a p-value of 0.863, while for the peri-implant density (BAP/TA), the mean value of the test group was 44.96 ± 7.55%, and that for the control group was 44.80 ± 8.68%, without a significant difference between the groups. The current research only found a significant difference for the bone–implant contact at the cortical level; therefore, it could be considered that FGF-2 acts on the mineralization of bone tissue. The application of carboxyethylphosphonic acid on the surface of implants can be considered a promising alternative as a biomimetic coating for the immobilization of FGF-2. Despite no differences in the new bone formation around the implants or in the interthread or peri-implant bone density being detected, the biofunctionalization of the implant surface with FGF-2 accelerates the mineralization of the bone–implant interface at the cortical level, thereby reducing the osseointegration period.

Primary malignant giant-cell tumor of bone: Case report of a rare clinical condition with an atypical clinical course

Introduction: A primary malignant giant-cell tumor of bone (PMGCT) is an extremely rare disease and usually presents with a better prognosis than its secondary counterpart does (secondary malignant giant-cell tumor of bone or SMGCT). Case Report: We present a case of a highly atypical PMGCT of the proximal left tibia, with extremely fast progression, pathological fracture, fungation, and patient death. Conclusion: This clinical case is an example of the most extreme and aggressive biological behavior that could arise with a PMGCT. These usually have a better prognosis than most, among malignant giant-cell tumors. This case highlights the need for a low threshold of suspicion for malignant transformation when giant-cell tumors have an unusual presentation.

A new record of Paramylodon harlani (Owen 1840) (Xenarthra, Pilosa, Mylodontidae) from the late Pleistocene of Valsequillo, Puebla, with comments on its paleobiogeography and paleoecology in Mexico

Paramylodon harlani was a large ground sloth recorded across North America, from Canada to Mexico. In Mexico, it is known from several late Pleistocene localities, but most of these records just mention the taxon in passing and few specimens have been described or illustrated. In this work, we describe a left tibia from the Valsequillo Basin, Puebla state. Its morphology and measurements allowed us to identify it as Paramylodon harlani, adding a new record for Mexico. In Mexico, P. harlani occurred mainly in the Trans-Mexican Volcanic Belt, central Mexico, with some records in the north and southeastern part of the country. Most localities are located between 1500 to 2000 m.a.s.l. Paleoenvironmental and paleoclimatic inference in some localities of Mexico where P. harlani occurred, showed heterogenous vegetation dominated by grasslands, and agree with the preferred habitat proposed for this species based on localities in the United States. This indicates that P. harlani could inhabit different environments, from grasslands to more wooded areas, and this adaptation allowed it to extend its range from the north to the southeast of Mexico.

Osteofibrous dysplasia of the tibia: A case report

Osteofibrous Dysplasia is an uncommon condition of childhood (< 10 years), most often affecting the tibial diaphysis confining to the cortices. Also known as Ossifying fibroma and Campanacci lesion. Histologically and radiologically OFD resembles fibrous dysplasia and adamantinoma respectively and differentiating the conditions might at times become challenging due to their overlapping features. Choosing a right way to manage, also becomes an important aspect in deciding the quality of life post operatively. We describe the case of a 4 year old male with an alleged history of fall which led to an incidental diagnosis of OFD of left Tibia. Radiographs were s/o OFD and we tried to manage it surgically by marginal excision along with application of synthetic bone graft under general anesthesia. Earlier literature and research on OFD was preoccupied with differentiating it from other conditions and whether or not it takes a benign course. But, we would here like to concentrate on various other important aspects like requirement of a high index of suspicion for diagnosis and its diverse management.

External skeletal fixation of tibial fracture in a domesticated rabbit

Present case reports a successful diagnosis and surgical management fractured left tibia bone through linear external skeletal fixation system (LESF) in a 1.5 year old male rabbit. Surgery was performed under general anaesthesia. A Rabbit presented in Veterinary clinical complex, CVAS, RAJUVAS, Bikaner, with a history of fall from height and clinical as well as radiographic examination revealed compound, segmental fracture of diaphysis of left tibia bone. LESF was done and owner was advised for further follow-up at regular interval. ESF assembly as well as weight bearing status was evaluated as objective of this study.

Greater Osseointegration Potential with Nanostructured Surfaces on TiZr: Accelerated vs. Real-Time Ageing.

Surface chemistry and nanotopography of dental implants can have a substantial impact on osseointegration. The aim of this investigation was to evaluate the effects of surface chemistry and nanotopography on the osseointegration of titanium-zirconium (TiZr; Roxolid®) discs, using a biomechanical pull-out model in rabbits. Two discs each were placed in both the right and left tibiae of 16 rabbits. Five groups of sandblasted acid etched (SLA) discs were tested: (1) hydrophobic without nanostructures (dry/micro) (n = 13); (2) hydrophobic with nanostructures, accelerated aged (dry/nano/AA) (n = 12); (3) hydrophilic without nanostructures (wet/micro) (n = 13); (4) hydrophilic with nanostructures, accelerated aged (wet/nano/AA; SLActive®) (n = 13); (5) hydrophilic with nanostructures, real-time aged (wet/nano/RTA). The animals were sacrificed after four weeks and the biomechanical pull-out force required to remove the discs was evaluated. Adjusted mean pull-out force was greatest for group wet/nano/RTA (64.5 ± 17.7 N) and lowest for group dry/micro (33.8 ± 10.7 N). Multivariate mixed model analysis showed that the pull-out force was significantly greater for all other disc types compared to the dry/micro group. Surface chemistry and topography both had a significant effect on pull-out force (p < 0.0001 for both), but the effect of the interaction between chemistry and topography was not significant (p = 0.1056). The introduction of nanostructures on the TiZr surface significantly increases osseointegration. The introduction of hydrophilicity to the TiZr implant surface significantly increases the capacity for osseointegration, irrespective of the presence or absence of nanotopography.

Histomorphometric analysis of implant osseointegration using hydrophilic implants in diabetic rats.

To evaluate peri-implant bone formation of titanium implants using an in vivo rat model with and without uncontrolled diabetes mellitus (DM) to evaluate osseointegration of hydrophobic (Neoporos®) and hydrophilic (Acqua®) surfaces. 54 rats were divided into two groups: DM group (DMG) (streptozotocin-induced diabetes) and a control group (CG). Implants with hydrophobic (Neoporos®) and hydrophilic surfaces (Acqua®) were placed in the left or right tibia of animals. Animals were further divided into three groups (n = 9) euthanized after 7, 14, or 28 days. Bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO) were assessed in total, cortical, and medullary areas. The DMG group, after a 7-day healing period, yielded with the Acqua implants presented significantly higher total BIC (+37.9%; p=0.03) and trabecular BIC (%) (+46.3%; p=0.02) values in comparison to the Neoporos implants. After 28 days of healing, the CG yielded that the cortical BAFO of Acqua implants to be significantly, 14%, higher (p=0.04) than Neoporos implants. The positive effects of the Acqua surface were able to counteract the adverse impact of uncontrolled DM at early osseointegration periods. After 28 days in vivo, the metabolic systemic impairment caused by DM overcame the surface treatment effect, leading to impaired osseointegration in both hydrophilic and hydrophobic implants. The adverse effects of diabetes mellitus with respect to bone healing may be minimized by deploying implants with strategically modified surfaces. This study evaluated the effects of implants with Acqua® and Neoporos® surfaces in both diabetic and healthy animals. During the initial healing period in diabetic animals, the hydrophilic surface was demonstrated to have beneficial effect on osseointegration in comparison to the hydrophobic surface. The results provide an insight into early healing, but the authors suggest that a future short-term and long-term clinical study is needed to assess the possible benefit of the Acqua® implant as well as in increasing the predictability of implant osseointegration.

Estimation of Stature from Living Adult Females belonging to Tamil Population using Percutaneous Tibial Length

Establishment of the identity of an individual from dismembered remains or skeletal remains is a commonproblem encountered by the Forensic Pathologist and can be a challenging task. In addition to age and sex,stature is an anthropological parameter that is indispensable in establishing the identity of an individual.In the present study, we have analyzed the relationship between stature and percutaneous Tibial lengths(PCTL) and derived a regression equation for a specific population. The parameters namely, the statureand percutaneous Tibial lengths (PCTL) of both lower limbs were measured in 115 females belonging toTamil population and recorded. The subjects were in the age group of 21-30 years. Analysis of the resultsinvolved the use of the Pearson’s correlation to derive the relationship between the parameters and establishthe dependence of the stature on the length of the left and right Tibia respectively in the study subjects. Theresults from this present study attest to the utility of the percutaneous Tibial lengths (PCTL) in determinationof the stature in females belonging to the Tamil population.

The TRPA1 Channel Mediates Mechanical Allodynia and Thermal Hyperalgesia in a Rat Bone Cancer Pain Model.

Background: Bone cancer pain (BCP) significantly affects patient quality of life, results in great bodily and emotional pain, and creates difficulties in follow-up treatment and normal life. Transient receptor potential ankyrin 1 (TRPA1) is an essential transduction ion channel related to neuropathic and inflammatory pain. However, the role of TRPA1 in BCP remains poorly understood. This study aimed to explore the relationship between TRPA1 and BCP.Methods: A BCP model was induced by Walker256 cells to the left tibia. The sham group was induced by normal saline to the left tibia. Thereafter, pain behaviors and TRPA1 expression between the BCP group and the sham group were observed on the 14th day of modeling. The TRPA1 antagonist A967079 (10 mg/kg) was injected via tail vein. TRPA1 antisense oligodeoxynucleotide (AS-ODN, 5 nmol/10 μl) and missense oligodeoxynucleotide (MS-ODN, 5 nmol/10 μl) were intrathecally delivered via a mini-osmotic pump for 5 consecutive days to assess the effect of TRPA1 on BCP. Behavioral tests were assessed preoperatively and postoperatively. Real-time quantitative PCR and western blot analyses were used to measure TRPA1 levels among the different groups.Results: The BCP model was successfully established via X-ray and pathological sections at 14 days. Compared to the sham group, the BCP group was more sensitive to mechanical stimuli, cool stimuli and hot stimuli. Intravenously injected A967079 can relieve paw mechanical withdrawal threshold and paw withdrawal thermal latency in rats with BCP. Moreover, AS-ODN can relieve paw mechanical withdrawal threshold and paw withdrawal thermal latency in rats with BCP. Additionally, relative mRNA and protein expression of TRPA1 in the BCP group were much higher than those in the sham group (14.55 ± 1.97 vs. 1 ± 0.04, P < 0.01). Compared to the BCP group, the relative mRNA and protein expression of TRPA1 in the BCP+AS-ODN group was reduced (14.55 ± 1.97 vs. 2.59 ± 0.34, P < 0.01).Conclusions: The TRPA1 channel mediates mechanical allodynia and thermal hyperalgesia in a rat BCP model.

Relación entre la angulación de los dispositivos de anclaje temporario y su desplazamiento. Estudio experimental

The purpose of this study is to assess how the insertion angle influence the stability mini-implant when loaded with 200cNe in this study, 2mini-screws were implanted in male rabbits’ (n=25) tibia in a 6weeks interval between the firstone and the second one. The second mini-implants were placed at different angles with respect to the cortical bone: -20° in the direction of the force e (GroupI), perpendicular to the force (GroupII) and 30° in the opposite direction of the force (GroupIII). These experimental implants were immediately loaded (right tibias). The Tad`s on the left tibias were regarded as control. The animals were sacrificed six weeks after the first surgery. Linear distances between the two Tad`s were measured with a digital caliper at the time of placement, and after the sacrifice, then were compared. The displacements were: GroupI, 2.96mm ±1.05; GroupII, 0.27mm ±0.36; and GroupIII, 0.29 mm ±0.26. The controls remained. The values for the micro-implants of GroupI showed statistically significant differences (p≤0.05) compared to GroupsII y III. Based on these data, we can conclude that mini-implants inclined towards the direction of the force applied induce more displacement than the ones placed perpendicular to theforce or in the opposite direction of the force

Prediction of Stature in Males of Tamil Population from Measurements of Percutaneous Tibial Length

Forensic experts are often in confrontation with the challenging task of determination of stature along withrace, age etc. for the purpose of establishing the identity of the deceased individual in those circumstanceswhere only skeletal remains, mutilated or dismembered body parts, extremely decomposed body parts etc.are provided by investigating authorities. In the current study, a genuine attempt has been made to arriveat the population specific regression equation for stature prediction from the percutaneous length of Tibia.The subjects chosen for this study include 120 adult males belonging to Tamil population falling withinthe age range of 21 to 30 years. Stature and percutaneous lengths of right and left Tibia from each subjectwere precisely recorded following standard protocols using appropriate instruments and analysis of thedata collected was done applying Pearson correlation through SPSS software version 26 to arrive at theregression equations for stature assessment based on percutaneous right and left Tibial lengths respectively.By comparing the regression formulae obtained from the present study with those derived from variouspopulation specific studies done on Indian population, our regression equations found to be distinctive toTamil population and therefore can be authentically applied for calculation of stature of deceased frompercutaneous Tibial length in males of Tamil population whenever skeletal remains are available.

Defining the Ideal "Nail Exit Path" of a Tibial Intramedullary Nail-A Computed Tomography Analysis of 860 Tibiae.

To identify the ideal distal nail position in the distal tibia, using a computed tomography analysis. Three-dimensional models of 860 left tibiae were analyzed using the Stryker Orthopaedic Modeling and Analytics software (SOMA, Stryker, Kiel, Germany). The nail axis was defined by 7 center points at the middle of the inner cortical boundary. The point where this line fell relative to the center of the tibial plafond in both the anteroposterior and mediolateral planes was calculated. The mean mediolateral offset of the tibial nail exit path was 4.4 ± 0.2 mm (95% confidence interval) lateral to the center of the tibial plafond. The mean anteroposterior offset of the tibial nail exit path was 0.6 ± 0.1 mm anterior to the center of the tibial plafond. We have presented an anatomic study analyzing the ideal nail exit path using computed tomography scans of 860 tibiae. We defined that the ideal nail exit path of a tibial nail is lateral with respect to the center of the tibial plafond. This is supported by previous clinical studies and has significant implications for preventing malalignment when treating distal tibial fractures with intramedullary nailing.

Abstract PO030: A novel integrin-targeted therapeutic agent for prostate cancer

Abstract Disintegrins are disulfide-rich peptides, many containing an Arg-Gly-Asp (RGD) motif. They hold significant translational potential as anti-cancer agents based on their high-affinity/high-specificity interaction with tumor integrins and desirable pharmacological attributes. The integrin-binding activity of disintegrins depends on a mobile 11-amino acid loop displaying the RGD tripeptide motif or some other tripeptide motif. They bind only to the activated conformation of integrins on motile cancer cells and angiogenic endothelial cells. We designed a sequence-engineered RGD-disintegrin, vicrostatin (VCN), that can be produced at ~200mg/L from cell lysates of a bacterial recombinant system. VCN, a monomer (MW=7146), inhibits tumor cell adhesion and dissemination, and angiogenic endothelial cell invasion and tube formation. Integrins are cell surface adhesion receptors (containing a and b chains) operating at the interface between the extracellular matrix and cytoskeletal apparatus. A sub-group of integrins recognize the RGD sequence present in key extracellular matrix proteins involved in prostate cancer (PC) growth and dissemination. Integrins are involved in bi-directional signaling interactions that alter cellular functions. Among these interactions are those involved in PC growth, metastasis and angiogenesis. Integrin avb3 plays an important role in the development of bone metastases, supporting our belief that it, as well as other RGD-integrins, are important therapeutic targets in advanced PC. We examined the effect of treatment of a xenograft model of human PC using a liposomal formulation of VCN (LVCN). PC3 cells were implanted subcutaneously in 5-week old male nude mice. LVCN and VCN (100µg VCN equivalent per dose) administration was initiated IV when tumors became palpable (14 days). Tumor size was measured weekly by caliper in a blinded study. There was a 75% reduction in tumor growth in LVCN-treated animals compared to controls. VCN displayed little anti-tumor activity most likely due to its lack of availability to the PC cells. We also examined the anti-angiogenic activity of LVCN in this model using CD31/PECAM immunohistochemistry and observed a significant decrease in tumor-associated microvessel density. We then evaluated therapeutic efficacy of LVCN in treating bone metastases. CWR22rV1 PC cells were suspended in a solution of matrigel and injected into a drilled hole in the proximal left tibia of immunodeficient mice (100,000 cells/10µL). Following injection, the diameters of both tibias were measured by caliper twice weekly. Since CWR22rV1 cells are androgen dependent, animals received daily injections of testosterone. Tumors grew slowly initially, but at 20 days tumors were evident and treatment began. LVCN and VCN were administered twice weekly via IV injection (100µg per dose) for 5 weeks. LVCN displayed ~81% inhibition of tumor growth compared to VCN, PBS or empty liposomes. Our findings provide strong support for the effectiveness of LVCN as an inhibitor of PC growth and metastases. Citation Format: Francis S. Markland, Stephen Swenson, Radu Minea, Jacek Pinski. A novel integrin-targeted therapeutic agent for prostate cancer [abstract]. In: Proceedings of the AACR Virtual Special Conference on the Evolving Tumor Microenvironment in Cancer Progression: Mechanisms and Emerging Therapeutic Opportunities; in association with the Tumor Microenvironment (TME) Working Group; 2021 Jan 11-12. Philadelphia (PA): AACR; Cancer Res 2021;81(5 Suppl):Abstract nr PO030.

Influence of Different Herbal-Mix Feed Additives on Serological Parameters, Tibia Bone Characteristics and Gut Morphology of Growing Pigs

Abstract A sixteen-week study was carried out in order to investigate the effects of different herbal-mix feed additives (Moringa, Basil and Neem) on serological parameters, tibia bone characteristics and gut morphology of growing pigs. Eighty-one Large White breed of pigs with a mean weight of 15.35 ± 1.07 were grouped on weight equalization basis into three treatments with 9 replicates per treatment and 3 pigs per replicate in a completely randomized design. Pigs on treatment 1 were fed a ration without integration of herbal-mix feed additives, those in treatments 2 and 3 were offered a diet that contained moringa-basil leaf meal and neem-basil leaf meal respectively. Blood samples were collected from the experimental pigs on the 12th week of the study for the determination of serum levels, while 1 pig from each replicate group whose weight was close to the mean replicate weight was chosen at the end of the study, fasted for 12 hours, sacrificed and the small intestine and left tibia bone were harvested and used for gut and bone morphology evaluation. These data generated from the study were subjected to a 1-way analysis of variance (ANOVA). The results indicated that herbal-mix feed additives influenced some of the serological parameters, i.e., globulin, glucose, total cholesterol, high- and low-density lipoproteins, and aspartate aminotransferase. These parameters decreased with integration of different herbal-mix in the pigs’ diets except high density lipoprotein that increased statistically. The tibia characteristics such as tibia breaking strength, medial thickness and lateral thickness were also positively impacted by the dietary inclusion of the herbal-mix. Likewise, the villus height of the jejunum was positively enhanced by dietary inclusion of the herbal-mix feed additives. This study concluded that herbal-mix feed additives can be utilized in pigs’ nutrition in enhancing some serological parameters, tibia bone and gut characteristics of growing pigs.

Development of a rodent high-energy blast injury model for investigating conditions associated with traumatic amputations.

AimsIn recent conflicts, most injuries to the limbs are due to blasts resulting in a large number of lower limb amputations. These lead to heterotopic ossification (HO), phantom limb pain (PLP), and functional deficit. The mechanism of blast loading produces a combined fracture and amputation. Therefore, to study these conditions, in vivo models that replicate this combined effect are required. The aim of this study is to develop a preclinical model of blast-induced lower limb amputation.MethodsCadaveric Sprague-Dawley rats’ left hindlimbs were exposed to blast waves of 7 to 13 bar burst pressures and 7.76 ms to 12.68 ms positive duration using a shock tube. Radiographs and dissection were used to identify the injuries.ResultsHigher burst pressures of 13 and 12 bar caused multiple fractures at the hip, and the right and left limbs. Lowering the pressure to 10 bar eliminated hip fractures; however, the remaining fractures were not isolated to the left limb. Further reducing the pressure to 9 bar resulted in the desired isolated fracture of the left tibia with a dramatic reduction in the fractures to other sites.ConclusionIn this paper, a rodent blast injury model has been developed in the hindlimb of cadaveric rats that combines the blast and fracture in one insult, necessitating amputation. Experimental setup with 9 bar burst pressure and 9.13 ms positive duration created a fracture at the tibia with total reduction in non-targeted fractures, rendering 9 bar burst pressure suitable for translation to a survivable model to investigate blast injury-associated diseases.Cite this article: Bone Joint Res 2021;10(3):166–173.

High doses of phytase on growth performance, bone mineralization, diet utilization, and plasmatic myo-inositol of turkey poults

An experiment was conducted to evaluate the growth performance, bone mineral composition, diet utilization, and plasmatic concentration of myo-inositol (MYO) in turkeys fed different phytase doses from 1 to 28 d. A total of three hundred and twenty 1-day-old turkeys were distributed in a completely randomized design with 4 treatments and 8 replicates of 10 birds each. Treatments included a basal diet without phytase; reduced diet (reduced −0.15% available P and −0.18% Ca) without phytase; reduced diet + 2,000 units of phytase (FYT)/kg; and reduced diet + 4,000 FYT/kg. From day 26 to 28, partial excreta collection was conducted, and on day 28, 7 birds per replicate were euthanized for collection of ileal content and left tibia bones were removed from 2 of the same euthanized birds. Feed, excreta, and ileal digesta samples were analyzed to determine nutrient digestibility and metabolizability, ileal digestible energy, and AME. Tibia bones were analyzed for ash, Ca, and P content, and calculation of Seedor index. On day 28, blood samples were collected from 2 turkeys per replicate to analyze plasmatic MYO concentration. Feed conversion ratio was not affected, but phytase supplementation resulted in higher feed intake and body weight gain compared to turkeys fed the reduced diet (P < 0.05), and both doses were similar to the basal diet. Increasing the phytase dose had a linear effect (P < 0.05) on ileal digestibility of P and metabolizability of DM, CP, Ca, and Na, and also on AME. P content in the tibia bone increased linearly (P < 0.05) with phytase supplementation, and the same linear increase (P < 0.05) was observed for plasmatic MYO. In conclusion, the supplementation of turkey poult's diets with high levels of phytase up to 4,000 FYT/kg improves diet utilization by increasing P digestibility and dietary metabolizability, leading to higher P content in the bone and enhancing MYO provision and absorption.

Osteosarcoma in a dog eight years after tibial plateau leveling osteotomy with an angle stable implant

An 11-year-old, 41-kg female spayed mixed-breed dog was examined for a chronic left hind limb lameness, with swelling of the proximal left tibia. A tibial plateau leveling osteotomy (TPLO) using an angle stable implant had been performed 8 years earlier at the site. Initial radiography showed mild degenerative signs in the stifle joint and osteolytic lesions in the proximal tibial metaphysis. Three weeks later, the clinical and radiographic changes had worsened. A transition from a moth-eaten pattern to permeative bone lysis was radiographically evident, along with an extensive increase of soft tissue swelling. Ultrasonographically-guided fine needle aspiration of the epiperiosteal tissue and lymph nodes, CT with pre-and post-contrast scans, and an incisional biopsy were performed. The radiographic and CT findings were consistent with an aggressive and monostotic bone lesion at the site of previous TPLO. The cytology and histology confirmed the diagnosis of an osteosarcoma (OSA) with a chondroid differentiation. Three months after a palliative hind limb amputation, the dog was euthanased. CONCLUSION We believe that this is the first report of implant-related OSA at the site of a previous TPLO with a new generation angle stable implant

Langerhans cell histiocytosis of the left tibia bone: A case report

Langerhans cell histiocytosis (LCH) is a rare group of disorders including single lesion to widespread disseminated disease. The incidence of this disorder is around 5–6 cases per million children per year with more than 50% of cases are diagnosed between 1 and 15 years old and peaks between 1 and 4 years old. This case report describes a rare case of a 2-year-old boy patient with a single lesion LCH in the left tibia. The diagnosis was challenging as the presenting symptom was not specific and the radiograph examination mimicked osteomyelitis. The diagnosis was then confirmed with immunohistochemistry (IHC) S-100 staining. The patient had a surgical curettage, application of bone graft and plate, and screw fixation. At 9 months follow-up, the patient was able to walk without gait disturbance and there was no new lesion reported. This case report pointed out that in the diagnosis of LCH, physical, and radiological examination mimicked other more common diseases and IHC S-100 staining had confirmed the diagnosis of LCH. It also showed that for a small single lesion of LCH, minimal intervention leads to a good outcome.