Long Bones Of Upper Limbs Research Articles

Variability of BMP-2 content in DBM products derived from different long bone.

Demineralized bone matrix (DBM) has been regarded as an ideal bone substitute as a native carrier of bone morphogenetic proteins (BMPs) and other growth factors. However, the osteoinductive properties diverse in different DBM products. We speculate that the harvest origin further contributing to variability of BMPs contents in DBM products besides the process technology. In the study, the cortical bone of femur, tibia, humerus, and ulna from a signal donor were prepared and followed demineralizd into DBM products. Proteins in bone martix were extracted using guanidine-HCl and collagenase, respectively, and BMP-2 content was detected by sandwich enzyme-linked immunosorbent assay (ELISA). Variability of BMP-2 content was found in 4 different DBM products. By guanidine-HCl extraction, the average concentration in DBMs harvested from ulna, humerus, tibia, and femur were 0.613 ± 0.053, 0.848 ± 0.051, 3.293 ± 0.268, and 21.763 ± 0.344, respectively (p < 0.05), while using collagenase, the levels were 0.089 ± 0.004, 0.097 ± 0.004, 0.330 ± 0.012, and 1.562 ± 0.008, respectively (p < 0.05). In general, the content of BMP-2 in long bones of Lower limb was higher than that in long bones of upper limb, and GuHCl had remarkably superior extracted efficiency for BMP-2 compared to collagenase. The results suggest that the origin of cortical bones harvested to fabricate DBM products contribute to the variability of native BMP-2 content, while the protein extracted method only changes the measured values of BMP-2.

Comparative Evaluation of the Efficacy of Shallakyadi Plaster and Standard POP in the Management of Simple Fractures of Long Bones of the Upper Limb: A Research Protocol

Introduction: Fracture management is one of the wellestablished concepts in Ayurveda with numerous fracture healing drugs mentioned for topical application. The present study is an attempt to form a compound of few of those drugs which can be used as a plaster cast. The effect of this Herbomineral ayurvedic plaster cast on fractures would be studied both in aspects of immobilisation and fracture healing. Shallakyadi plaster which is a novel compound composed of resin of Boswellia serrata Roxb, resin of Acacia nilotica (Linn.) Willd.ex Del, root of Glycirrhiza glabra Linn, whole plant of Cissus quadrangularis Linn, Stem of Rubia cordifolia Linn, bark of Terminalia arjuna Wight &amp; Arn (W&amp;A), resin of Commiphorawightii Arn, Kaolinite (phyllosilicate of aluminium) and hydrated magnesium silicate can be used as a herbomineral ayurvedic compound for the healing of fractures. Need of Study: Standard Plaster of Paris (POP) cast has no therapeutic role on healing of fracture other than the purpose of immobilisation, whereas the drugs in Shallakyadi Plaster have known effects on bone healing and also provide the adequate immobilisation provided by Standard POP cast. Hence, the present study will compare the efficacy of Shallakyadi Plaster and Standard POP in the management of simple fractures of long bones of upper limb. Aim: To study and compare the efficacy of Shallakyadi plaster and standard POP in the management of simple fractures of long bones of upper limb. Materials and Methods: The present study is designed as a randomised control trial which would be conducted in Mahatma Gandhi Ayurveda College Hospital and Research Centre (MGACHRC), Salod Hirapur (H), Maharashtra, India for three months, in which 60 patients will be enrolled. Standard POP Plaster or Shallakyadi plaster will be applied for local application over the fractured area. Parameters like pain, swelling, loss of function, tenderness would be studied subjectively and callus formation would be taken as the objective parameter. Statistical analysis would be done using GraphPad Prism 7.0 V software and statistical tests- Chi-square test, Wilcoxon’s rank sum test and Wilcoxon’s signed rank test will be applied with level of significance as 0.05.

Effects of ultrasound-guided brachial plexus block in combination with sevoflurane general anesthesia via laryngeal mask on upper limb tumor and fracture surgery for children based on inflammatory stress response

Sevoflurane is used successfully for general anesthesia via laryngeal mask on upper limb tumors like osteosarcoma and Ewings sarcoma and fractures in orthopedic care centers. With the advancement in interventional radiology, many procedures are now available to support surgeons to carry out such procedures without complications. In this study, we tried to evaluate the effects of ultrasound-guided brachial plexus block in combination with sevoflurane general anesthesia via laryngeal mask for upper limb tumor (osteosarcoma in the metaphysic of long bones of upper limb and Ewing sarcoma-second most malignant tumor in children) and fracture surgery in children based on inflammatory stress response. Eighty-six children who were admitted to undergo surgery for upper limb tumor and fractures from June 2018 to November 2019 were selected and divided into control and study groups according to anesthesia methods (n= 43). The control group received only sevoflurane superficial general anesthesia via laryngeal mask, besides which the study group received ultrasound-guided brachial plexus block. The surgical, anesthetic outcomes and adverse reactions were compared. Pain was assessed by the visual analogue scale (VAS) 4 h, 8 h and 12 h after surgery. The serum levels of interleukin-1β (IL-1β), IL-10, C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), epinephrine (E), norepinephrine (NE), cortisol (Cor) and insulin (Ins) were measured before surgery, on the day of surgery and 3 days after surgery, respectively. Compared with the control group, the surgical time and recovery time of the study group were shorter, the pain occurred later, the intraoperative respiration was slower, and the incidence rate of adverse reactions was significantly lower. The VAS scores of the study group were significantly lower than those of the control group 4 h, 8 h and 12 h after surgery. The IL-1β, IL-10, CRP, TNF-α, E, NE, Cor, and Ins levels of the study group were also significantly lower than those of the control group on the day of surgery and 3 days after surgery. Observations of this study suggest that sevoflurane superficial general anesthesia via laryngeal mask in combination with brachial plexus block can be used in the upper limb tumor removal and fracture surgery for children. This strategy has the advantages of short recovery time, few adverse reactions, obvious sedative and analgesic effects, and low inflammatory stress response.

Morphological Study of Nutrient Foramina in Long Bones of Upper Limb among North Gujarat Population

Introduction: Main source of nutrition to long bone during growth and ossification is nutrient artery. Nutrient canal opens as nutrient foramen on the surface of shaft which conducts the nutrient artery and the peripheral nerves to bones. Nutrient artery provides more than 60-70% of blood supply to long bone, 30- 40% through periosteal, metaphyseal and epiphyseal blood vessels. Aim: To determine number of nutrient foramina, its position on surface of shaft, size and direction of nutrient foramina either towards proximal end or distal end and find out foraminal index from the position of nutrient foramina. Materials And Methods: A cross-sectional study was performed in 177 dry bones (60 humerus, 60 radius, 57 ulna) of upper limb, available at Anatomy Department, GMERS Medical College Himmatnagar, during September 2021. All bones were observed for number, position and direction of nutrient foramina. Size of foramen was measured by needles of different size. Mean Foraminal index was calculated for each long bone of upper limb by using Epi Info™ for windows, CDC, Atlanta, version 7.2. Results: Majority of bones had single nutrient foramina, all foramina were directed towards the elbow joint. All nutrient foramina were on flexor surfaces of bone, except one bone (radius). Majority of nutrient foramina were situated on middle 3rd of the shaft. Size of nutrient foramen was range from 22 to 28 gauge of needle. Conclusion: Information on nutrient foramina of long bones of upper limb will be useful in many orthopedic surgeries like microvascular bone grafting and many plastic reconstructive surgeries. During surgeries like fracture repair, bone graft or muscle graft care should be taken, not to damage these nutrient vessels to keep intact blood supply of bone.

An autopsy-based correlation study about developing standards for estimation of staturein females from distance between two anterior superior iliac spines in Central India region, Madhya Pradesh

Stature is the vertical distance between the top of vertex and the heel of the feet. Stature is one of the important parameters for establishing the identity of unknown corpse. Sometimes, the identification becomes very hard if the body is destroyed or mutilated in fire, explosions, murders, natural mass disasters like earthquakes, tsunamis, cyclones, floods and many others. In these situations, the need of forensic expert arises for establishing the identity of an individual from the amputated, mutilated and decomposed body fragments. Hence the aim of present study was developing standards for estimation of stature in females from distance between two anterior superior iliac spines in central India Region, Madhya Pradesh belonging to the age group of 20–60 years in the department of Forensic Medicine & Toxicology, M.G.M. Medical College and M.Y. Hospital, Indore (M.P). Among 258 females, the mean stature was 158.87±5.27, whereas the mean percutaneous inter anterior superior iliac spinous distance was found to be 22.02±1.36. Regression equation with significant correlation was derived. Multiplication factor for percutaneous inter anterior superior iliac spine was found to be 7.21. Even though stature can be calculated with the long bones of upper limbs and lower limbs but intact long bone may not be present all the time or only part of torso or pelvis is brought for autopsy, in this situation inter spinous distance can be used to estimate stature.

Хирургическое лечение пациентов с опухолями длинных трубчатых костей верхних конечностей с использованием индивидуальных имплантатов из костнозамещающего материала, созданных по технологиям 3D-печати

Purpose To evaluate outcomes of surgical treatment of patients with tumors of long bones of upper limbs using a single-stage repair of bone defects with tailored bone substitute implants manufactured with 3D printing technique. Materials and methods Clinical and radiological assessment of 22 patients with tumors of long bones of upper limbs was produced after surgical treatment that included removal of neoplasm and one-stage bone plasty using a tailored implant manufactured with three-dimensional printing (Patent RU 2598769). Bone cement and Recost bone substitute (Patent RU 2518753) were used to produce an implant. All patients were evaluated preoperatively and at 12-month follow-up using the 36-item Short Form Health Survey (SF-36), Musculoskeletal Tumor Society (MSTS) Rating Scale and visual analogue scale (VAS). Results Postoperatively, all patients showed pain reduction and improved function of the upper limb. No radiographic evidence of implant migration was observed throughout the followup. Evaluation of benign patients at one year after surgical intervention showed average 71.4 ± 6.6 of SF-36, 2.5 ± 1.5 of VAS, and 65.1 ± 8.3 % of MSTS scoring system; malignant cases demonstrated average figures of SF-36 39.2 ± 4.3, VAS 4.8 ± 1.4, and 41.8 ± 5.2 % at MSTS rating scale. Conclusion Surgical treatment of patients with tumors of the humerus, ulna and radius using one-stage plasty of bone defects with tailored 3D-printed bone substitute implants has shown to be an efficient method in improving an affected upper limb function and patient’s quality of life. The use of 3D printing to manufacture implants allows for precise and single-stage repair of bone defects of any shape, size and complexity with the technique making surgery easier to perform.

Pattern of fatal injury in fall from height cases- a medicolegal study

Introduction: In occupational settings, the most common type of fatal accident is fall from a height. The skull, brain, spinal cord and extremities are the most commonly injured systems. Falls from more than 20 feet have historically been triaged to trauma centers but even low-level falls can cause serious head injuries and death. Objectives: The objective of this study was to find out the pattern of injuries and related medico-legal issues among the victims of fall from height. Methods: This retrospective study was conducted among the victims of fall from height at Dhaka Medical College morgue during the period of January to December 2008.Various data were collected from inquest reports submitted by the investigating officers. Specific points regarding injuries were noted during autopsy examinations. Results: A total 2714 autopsies were performed during the study period out of which 93(3.43%) were cases of fall from height. Among them 66(70.97%) were male and 27(29.03%) victims were female. Most of the victims 23(24.73%) were day labourer/ construction workers. Minimum level of height of fall was from 2nd floor 7(7.52%) and maximum number of victim have fallen from 5th to 10th floor 47(50.53%). Considering timing, highest incidents occurred during day time 57(61.29%). Ages of maximum victims were between 21-30 years 34(36.56%). All the victims had multiple abrasions and bruises in their body, followed by laceration 74(79.56%), fracture of skull 57(61.29%) 80 JAFMC Bangladesh. Vol 10, No 1 (June) 2014 intra cranial haemorrrhage 85(91.40%), injury to long bones of lower limbs 47(50.54%), injury to long bones of upper limbs 31(33.33%), injury to abdominal organs like liver, spleen, kidney 51(54.84%), fracture of pelvis 37(39.78%). In skull, linear fracture was the commonest one 48(51.61%), Temporal bone was the commonest bone to fracture 57(61.29%) and most of the victims 57(61.29%) had sub dural haemorrhage. Conclusion: Death due to fall from height is an unforeseen and unfortunate occurrence. Installation of window guard, modification of physical environment, maintenance of safety as per building construction code, parental counseling to children can reduce this economical burden and protect vulnerable groups of people of our country from this type of incidents. DOI: http://dx.doi.org/10.3329/jafmc.v10i1.22930 Journal of Armed Forces Medical College Bangladesh Vol.10(1) 2014

Asymmetry in length, Weight&amp; Circumference of Upper Limb Bones in Telangana State

The lack of uniformity in the length, weight and mid shaft circumference of long bones of upper limb can be attributed to the type of movements performed by individual during life. The present study reports the positive evidence of Right sided dominance in the weight, length and circumference of 15 pairs of upper limb bones collected from skeletons of Telangana population in south Indian Region of India. Length was measured on an osteometric Board and weight measured on Automatic Balance. Mean length of Humerus, Radius and Ulna was greater on the right side than the left side. Mean weight of humerus, radius and ulna are also greater on right side. Mean circumference of mid part of shaft of humerus was greater on right side and for radius and ulna on right side. In overall the present study reveals that right dominance in Telangana population.

Handedness and directional asymmetry in the long bones of the human upper limb

AbstractThe long bones of the human upper limb usually show lateral asymmetries of length. This pattern can be attributed either to the mechanical consequences of handedness bias or to genetic or hormonal factors acting directly on longitudinal bone growth. Length data was obtained from the long bones of the upper limbs of a large skeletal assemblage from Wharram Percy, Yorkshire (England), predominantly deriving from the 11th‐16th centuries A.D. The Wharram Percy adult skeletons had a population distribution of lateral asymmetries of length in the humerus and in the humerus‐plus‐radius (a proxy arm length index) which closely parallels the pattern of behavioural handedness found in modern populations. This pattern was developing in the skeletons from the infant and juvenile age ranges, but was absent in the neonates (of whom 12 out of 14 had longer left humeri). We argue that this supports the environmental hypothesis that the ontogeny of long bone length asymmetry is consequent to the earlier development of lateral bias in mechanical loading of the upper limbs.