Sesamoid Research Articles

Dislocation of the First Metacarpophalangeal Joint Complicated by the Interposition of the Thumb Sesamoid Bones: A Case Report

Dislocation of the First Metacarpophalangeal Joint Complicated by the Interposition of the Thumb Sesamoid Bones: A Case Report

Deciphering the influence of evolutionary legacy and functional constraints on the patella: an example in modern rhinoceroses amongst perissodactyls.

In mammals, the patella is the biggest sesamoid bone of the skeleton and is of crucial importance in posture and locomotion, ensuring the role of a pulley for leg extensors while protecting and stabilizing the knee joint. Despite its central biomechanical role, the relation between the shape of the patella and functional factors, such as body mass or locomotor habit, in the light of evolutionary legacy are poorly known. Here, we propose a morphofunctional investigation of the shape variation of the patella among modern rhinoceroses and more generally among perissodactyls, this order of ungulates displaying a broad range of body plan, body mass and locomotor habits, to understand how the shape of this sesamoid bone varies between species and relatively to these functional factors. Our investigation, relying on three dimensional geometric morphometrics and comparative analyses, reveals that, within Rhinocerotidae and between the three perissodactyl families, the shape of the patella strongly follows the phylogenetic affinities rather than variations in body mass. The patellar shape is more conservative than initially expected both within and between rhinoceroses, equids and tapirs. The development of a medial angle, engendering a strong mediolateral asymmetry of the patella, appears convergent in rhinoceroses and equids, while tapirs retain a symmetric bone close to the plesiomorphic condition of the order. This asymmetric patella is likely associated with the presence of a "knee locking" mechanism in both equids and rhinos. The emergence of this condition may be related to a shared locomotor habit (transverse gallop) in both groups. Our investigation underlines unexcepted evolutionary constraints on the shape of a sesamoid bone usually considered as mostly driven by functional factors.

Influence of the Vertek aiming device on the surgical accuracy of computer-assisted drilling of the equine distal sesamoid bone-An experimental cadaveric study.

To determine the effect of the Vertek aiming device (VAD) on the surgical accuracy of navigated drilling of the distal sesamoid bone (DSB). Experimental cadaveric study. A total of 30 paired equine cadaveric limbs from 15 horses. Each specimen was placed in a purpose-built frame (PBF). Preoperative cone beam computed tomography (CBCT) images were acquired with an imaging unit coupled with a surgical navigation system. In the DSB of each specimen, a 4.5 mm glide hole and a 3.2 mm thread hole were drilled under navigation guidance, to simulate drilling for the repair of a mid-sagittal DSB fracture. In the VAD group navigated drilling was assisted by using the VAD. In the free-hand drilling group navigated drilling was performed without the VAD. Pre-and postoperative CBCT scans were merged and surgical accuracy aberrations (SAA) between the planned drill corridor and the created bone tunnel were measured. Descriptive statistics and repeated-measures analyses of variance (rep.-meas. ANOVA) were performed to compare SAA measurements between the study groups. The SAA measurements ranged from 0 to 2.9 mm in the free-hand group and from 0 to 2.8 mm in the VAD group. The median overall SAA was lower in the VAD group than in the free-hand navigated group (0.6 mm ± [0.5-0.7] vs. 0.8 mm ± [0.7-1], rep.-meas. ANOVA p = .007). The additional use of the VAD in the described set-up for navigated drilling significantly improved surgical accuracy. The combined use of the VAD and PBF may help improve surgical accuracy in navigated lag screw repair of DSB fractures.

447 - Prevalence and variations of sesamoid bones in the hands of patients visiting teaching hospital of kaski district: A retrospective study

447 - Prevalence and variations of sesamoid bones in the hands of patients visiting teaching hospital of kaski district: A retrospective study

Mineralization of equine proximal sesamoid bones precedes articular cartilage and fibrocartilaginous enthesis maturation in early postgestational development.

To describe the development and maturation of equine proximal sesamoid bones (PSBs) in fetuses and young horses using radiography, microcomputed (micro)-CT, and histology. A descriptive study. Forelimb PSBs from 12 equids ranging in age from 105 days of gestation to 540 days postgestation were evaluated. Radiography was used for preliminary assessment of metacarpophalangeal joint and PSB mineralization, and micro-CT imaging was performed to assess mineralized PSBs. Tissue volume, bone volume fraction, height, width, depth, trabecular thickness, and anisotropy were quantified from midplanar micro-CT sections in 3 dimensions. Midsagittal PSB histologic sections stained with H&E and Safranin O/Fast Green were used to determine the ratio of ossification center to cartilage template size and to describe the formation and development of the cartilage template, ossification center, spherical growth plate, articular cartilage, and entheses. Mineralization of equine PSBs is associated with cartilage canals and a spherical growth plate that undergoes endochondral ossification during the late gestation to early postgestational period. The apical, flexor, basilar, and articular ossification fronts demonstrate morphologic variability. Structural organization of the articular cartilage and entheses occurs concurrently with the development of an underlying plate of compact bone. At 540 days postgestation, the fibrocartilaginous entheses of the flexor cortex of the PSB had yet to mature. Equine PSBs mineralize predominantly by endochondral ossification during the late gestation to early postgestational period. Mineralization precedes maturation of the articular cartilage and fibrocartilaginous entheses. The postgestational maturation of the PSB and its surrounding tissues may predispose young horses to developing lesions at these sites, such as apical avulsion fractures, warranting further investigation.

Easy to gain but hard to lose: the evolution of the knee sesamoid bones in Primates-a systematic review and phylogenetic meta-analysis.

Sesamoids are variably present skeletal elements found in tendons and ligaments near joints. Variability in sesamoid size, location and presence/absence is hypothesized to enable skeletal innovation, yet sesamoids are often ignored. Three knee sesamoids-the cyamella, medial fabella and lateral fabella-are present in primates, but we know little about how they evolved, if they are skeletal innovations, or why they are largely missing from Hominoidea. Our phylogenetic comparative analyses suggest that sesamoid presence/absence is highly phylogenetically structured and contains phylogenetic signal. Models suggest that it is easy to gain but difficult/impossible to lose knee sesamoids and that the fabellae may have similar developmental/evolutionary pathways that are distinct from the cyamella. Sesamoid presence/absence is uncorrelated to the mode of locomotion, suggesting that sesamoid biomechanical function may require information beyond sesamoid presence, such as size and location. Ancestral state reconstructions were largely uninformative but highlighted how reconstructions using parsimony can differ from those that are phylogenetically informed. Interestingly, there may be two ways to evolve fabellae, with humans evolving fabellae differently from most other primates. We hypothesize that the 're-emergence' of the lateral fabella in humans may be correlated with the evolution of a unique developmental pathway, potentially correlated with the evolution of straight-legged, bipedal locomotion.

Enhancing Forensic Diagnostics: Structured Reporting of Post-Mortem CT versus Autopsy for Laryngohyoid Complex Fractures in Strangulation.

The purpose of this study was to establish a standardized structured workflow to compare findings from high-resolution, optimized reconstructions from post-mortem computed tomography (pmCT) with autopsy results in the detection of fractures of the laryngohyoid complex in strangulation victims. Forty-two strangulation cases were selected, and pmCT scans of the laryngohyoid complex were obtained. Both pmCT scans and autopsy reports were analyzed using a structured template and compared using Cohen's kappa coefficient (κ) and the McNemar test. The study also compared the prevalence of ossa sesamoidea and non-fusion of the major and minor horns of the hyoid bone between both diagnostic methods. The detection of fractures showed a very good correlation between autopsy and pmCT results (κ = 0.905), with the McNemar test showing no statistically significant difference between the two methods. PmCT identified 28 sesamoid bones, 45 non-fusions of the major horns, and 47 non-fusions of the minor horns of the hyoid bone, compared to four, six, and zero, respectively, identified by autopsy (p < 0.0001). Autopsy and pmCT findings correlate well and can be used in a complementary manner. PmCT is superior to autopsy in identifying dislocations and detecting anatomical variations in the laryngohyoid complex, which can lead to misinterpretations during autopsy. Therefore, we do not advocate replacing autopsy with pmCT but propose using a structured workflow, including our standardized reporting template, for evaluating lesions in the laryngohyoid complex.

Interphalangeal Sesamoid Bone as a Rare Cause of Bilateral Trigger Thumb

Interphalangeal Sesamoid Bone as a Rare Cause of Bilateral Trigger Thumb

Comparative anatomical characteristics of the distal parts of bear and human limbs

BACKGROUND: The comparative morphology of the human and animal skeletons has been incompletely described in the forensic medical and anthropological literature. Moreover, bones of the distal parts of bear limbs are anatomically similar to those of humans. Together with some features of the bear’s skeleton, poor preservation, absence of claws, and incomplete remains, difficulties and errors may occur during identification. AIM: To create an illustrative material describing morphological features important for the identification of each element of the distal parts of bear limbs in comparison with humans. MATERIALS AND METHODS: Preparations of the distal parts of the right thoracic and right pelvic extremities of the bear were made using osteological materials. The missing talon phalanges of a bear and bones of a human hand and foot were taken from the institute collections. The International Veterinary Anatomical Nomenclature was used to describe the anatomical features of bear bones, and the latest recommendations of International Anatomical Terminology were considered for human bones. RESULTS: Each bone of the bear’s hand and foot was described in comparison with a similar human bone. For greater versatility, descriptions were made in terms of the international zoological nomenclature. For all bones, except for distal sesamoid bones, high-quality photos are provided for aspects that are important for identification. Comparative anatomical analysis showed that the bones of the wrist differ to a greater extent, whereas all tarsal bones, which are part of the human foot, had analogs in the bear foot and had closer measurements. The articular surfaces of the heads of the metacarpals and metatarsals showed specific ridges articulating with the cutouts at the bases of the proximal phalanges of the fingers. In addition, the bear’s hand and foot contained numerous inset sesamoid bones and claw-like processes on the distal phalanges of the fingers. CONCLUSION: Comparative anatomical analysis showed similarities in the structures of the bones of the hand and foot of a brown bear and a human caused by foot walking. Owing to the morphological similarity, bone identification can be difficult. The set of features described in the article, which are specific to bear bones, in combination with illustrative material will help in identifying bones more accurately, even for individual bones.

Large Human Fabella Bone

Fabella bone is identified as an accessory and evolutionary sesamoid bone in humans. It was noticed as an irregular shape located within the lateral head of gastrocnemius in the posterolateral capsule of the left knee of a 55-year-old male. Another smaller fabella was noted and both were kept in a safe place Measurements were taken after a week and their length was 2.7 cm and 1.8 cm respectively. The size of fabella usually ranges from 5mm-20mm in diameter, but in this study, the length of the larger one was 2.7 cm. Fabella originated as a small cartilaginous nodule and underwent endochondral ossification. It helps to reduce resistance within tendons and redirect muscle forces. In humans, gastrocnemius acts to flex the knee and plantar flex the foot. Fabella function was thought to stabilize the femoral complex and medial femoral condyle. Patients with fabella pain syndrome usually complain of increased posterolateral pain during the full extension of the knee joint. Fabella pain syndrome could be treated with physical therapy, local anaesthetics injection, radial extracorporeal shock wave therapy or fabellectomy. It has been observed that there has been an increase in the prevalence of fabella in recent years. Larger moments acting on the knee and increasing muscle or tendon strain could produce stimuli essential to encourage fabella formation.

Leukocyte-Rich Platelet-Rich Plasma for Osteonecrosis of Sesamoid in a Performing Artist: A Case Report.

Introduction: Sesamoid bones absorb and disperse weight from the metatarsal bones. Sesamoid injuries occur primarily in dancers and runners, with nonoperative management as the first line of treatment. Due to the lack of secondary blood supply, the sesamoids are at risk for osteonecrosis and nonunion fractures. The literature supporting orthobiologics for the treatment of sesamoid injuries is limited. Methods: In this case, a 28-year-old female dancer with sesamoid osteonecrosis underwent a leukocyte-rich platelet-rich plasma (LR-PRP) injection to the fibular sesamoid. Results: The patient reported significant improvement in pain at the 2-month follow-up and returned to regular auditions at the 3-month follow-up. At 2-year follow-up, the patient's symptoms returned to baseline. Conclusion: This is the first known case of sesamoid osteonecrosis treated with LR-PRP. LR-PRP should be considered in the treatment of sesamoid osteonecrosis in those who show limited improvement with standard conservative measures.

Concurrent radiological and ultrasonographical findings in the forelimb proximal sesamoid bones and adjacent suspensory ligament branches in yearling and 2-year-old Thoroughbred sales horses.

Changes in the proximal sesamoid bones (sesamoids) and the insertional region of the adjacent suspensory ligament branch (branch) are of particular importance in young Thoroughbreds sold at public auction. Little is known about the prevalence of concurrent ultrasonographical branch change, relative to the various grades of radiological sesamoid appearance. To examine the existence of concurrent radiological and ultrasonographical findings in individual sesamoid-branch units in sales horses; to determine whether there are any radiological findings that are consistently accompanied by a particular degree of insertional branch change, and to provide practical recommendations as to when suspensory branch ultrasonography may be warranted in a sales environment. Prospective cohort study using an enrolled sample. Horses were enrolled with consignor permission from a large Thoroughbred yearling sale and five 2-year-old Thoroughbred sales the following year. Data from the radiological evaluation of forelimb sesamoids and the ultrasonographical examination of the adjacent forelimb suspensory branches were described. A total of 2204 yearling forelimb sesamoid-branch units and 1336 2-year-old forelimb sesamoid-branch units were included, from 551 sales yearlings and 334 sales 2-year-olds. The proportion of yearling sesamoids with grade ≤1 vascular channels that had adjacent grade ≥2 fibrillar branch change was 1.2%. The same proportion for 2-year-olds was 3.8%, with medial forelimb sesamoids with grade 1 vascular channels overrepresented in 2-year-olds in this category. In yearlings, 31% of sesamoids with grade 2 vascular channels had adjacent grade ≥2 fibrillar branch change and 59% of sesamoids with grade 3 vascular channels had adjacent grade ≥2 fibrillar branch change. In 2-year-olds, 47% of sesamoids with grade 2 vascular channels had adjacent grade ≥2 fibrillar branch change and 67% of sesamoids with grade 3 vascular channels had the same. Only one yearling sesamoid and one 2-year-old sesamoid with radiological abaxial concavity had grade ≥2 fibrillar branch change. Hindlimbs were not included. Clinical examinations were not performed and the status of any past or present inflammatory process at the sesamoid-branch enthesis could not be inferred from radiographs and ultrasonographic images alone. The existence and prevalence of concurrent radiological and ultrasonographical findings in the proximal sesamoid bones and adjacent suspensory ligament branches in yearling and 2-year-old Thoroughbred sales horses has been established. General recommendations have been made for selective branch ultrasonography on the basis of radiological sesamoid appearance. The results support a separate aetiology for radiological sesamoid abaxial concavity that does not primarily involve the suspensory branch insertion.

Effectiveness of minimally invasive treatment of hallux valgus with small incision external articular osteotomy

To compare the effectiveness of small incision external articular minimally invasive osteotomy and traditional Chevron osteotomy in the treatment of hallux valgus. A retrospective analysis was conducted on the clinical data of 58 patients (58 feet) with hallux valgus who were admitted between April 2019 and June 2022 and met the selection criteria. Among them, 28 cases were treated with small incision external articular minimally invasive osteotomy (minimally invasive group), and 30 cases were treated with traditional Chevron osteotomy (traditional group). There was no significant difference in baseline data such as age, gender, disease duration, Mann classification, and preoperative inter metatarsal angle (IMA), hallux valgus angle (HVA), distal metatarsal articular angle (DMAA), forefoot width, tibial sesamoid position (TSP) score, American Orthopaedic Foot and Ankle Society (AOFAS) forefoot score, visual analogue scale (VAS) score, psychological score (SF-12 MCS score) and physiological score (SF-12 PCS score) of short-form 12 health survey scale, and range of motion (ROM) of metatarsophalangeal joint between the two groups ( P>0.05). The incision length, operation time, intraoperative blood loss, intraoperative fluoroscopy frequency, weight-bearing walking time, fracture healing time, and incidence of complications were recorded and compared between the two groups; as well as the changes of imaging indexes at last follow-up, and the clinical function score and ROM of metatarsophalangeal joint before operation, at 6 weeks after operation, and at last follow-up. All patients were followed up 11-31 months, with an average of 22 months. The incision length and intraoperative blood loss in the minimally invasive group were significantly less than those in the traditional group ( P<0.05), and the intraoperative fluoroscopy frequency and operation time in the minimally invasive group were significantly more than those in the traditional group ( P<0.05); but no significant difference was found in weight-bearing walking time and fracture healing time between the two groups ( P>0.05). There was 1 case of skin injury in the minimally invasive group and 3 cases of poor incision healing in the traditional group; all patients had good healing at the osteotomy site, and no complication such as infection, nerve injury, or metatarsal head necrosis occurred. At last follow-up, the imaging indexes of the two groups significantly improved when compared with those before operation ( P<0.05). The changes of DMAA and TSP score in the minimally invasive group were significantly better than those in the traditional group ( P<0.05), and there was no significant difference in the changes of IMA, HVA, and forefoot width between the two groups ( P>0.05). The clinical scores and ROM of metatarsophalangeal joint significantly improved in the two groups at 6 weeks after operation and at last follow-up when compared with preoperative ones ( P<0.05), and the indicators in the minimally invasive group were significantly better than those in the traditional group ( P<0.05). Compared with traditional Chevron osteotomy, small incision external articular minimally invasive osteotomy can effectively improve HVA, IMA, and forefoot width, correct foot deformities, and has less trauma. It can better correct the first metatarsal pronation deformity and restore the anatomical position of the sesamoid bone, resulting in better effectiveness.

Ultrasonography of the suspensory ligament branches in yearling and 2-year-old Thoroughbred sales horses: Prevalence, progression of findings and associations with racing performance.

Equine suspensory ligament branch (branch) ultrasonography is becoming increasingly commonplace presale. No ultrasonographical branch reference data exists for Thoroughbred sales horses. To define the prevalence of ultrasonographical findings in the forelimb suspensory branches of yearling and 2-year-old sales Thoroughbreds and to analyse associations with racing performance. To track changes in branch findings between 1 and 2 years of age in horses that present for sale at both ages. Prospective cohort study using an enrolled sample. Horses were enrolled from a 2016 yearling sale and five 2017 2-year-old sales with consignor permission. Ultrasonography was performed immediately prior to the sales. Ultrasonographical findings relating to branch size, fibrillar pattern, the presence of hyperechoic foci, periligamentar tissue thickness and the adjacent proximal sesamoid bone surface were examined. Associations with racing performance from 2 to 4 years of age were investigated using multivariate regression analyses. Clinical follow-up was sought to ascertain why horses that did not race never started. A total of 593 sales yearlings and 367 2-year-olds had forelimb branch ultrasonography performed. Grade ≥2 fibrillar branch change was present in 8.9% of yearlings and 14.4% of 2-year-olds. A 0.25 cm increase in branch width was associated with a 49-day delayed start to racing careers (P < 0.001, 95% confidence interval (95% CI): 21-77 days). The presence of grade 2 hyperechoic foci was associated with significantly lower total earnings (P = 0.01, 95% CI: $2000-$16 022) and lower earnings per start (P = 0.003, 95% CI: $349-$1718) in United States Dollars. Grade 3 fibrillar branch change had clinically important reductions in the probability of racing, the calibre of racing performance and earnings. Grade 1 fibrillar pattern was associated with significantly higher earnings per start (P = 0.004, 95% CI: $2641-$5759). The findings are applicable to horses prepared for public auction and deemed fit to be entered for sale. The results may underestimate the proportion of severe lesions in horses not entered for sale. Reference values specific to young Thoroughbreds have been established. Grade 1 fibrillar branch change should be regarded as an acceptable appearance in sales yearlings and 2-year-olds. Approximately one-third of grade 2 yearling branches progressed to a grade 3 lesion. Evidence of enlarged branch width and grade 2 hyperechoic foci at 2-year-old sales constitute a risk to racing performance.

Prevalence of Jumpers Knee in Basketball Players

Jumpers knee is a painful condition caused due to small tears in the patellar tendon. it mainly occurs in sports requiring strenuous activities which results in localized pain and tenderness of patella .It is also known as patellar tendinopathy, which is an overuse injury caused due to extensor mechanism it complies of a complex structure formed by quadriceps muscle and tendon, the patella and patellar tendon and the ligaments that surround and stabilize the knee (the quadriceps muscles are connected to the inferior pole of the patella by the common quadriceps tendon through a sesamoid bone, the patella.. Key Words: Jumpers knee, Overuse Injury, Knee extensor mechanism, Quaadriceps.

X-ray Imaging Versus Anatomical Dissection for Identification of the Fabella.

Reported prevalence rates of the fabella sesamoid bone vary widely, particularly between studies based on either X-ray imaging or anatomical dissection approaches. The purpose of this study was to directly compare these two methodologies in their detection of fabellae and investigate whether variability in the density of fabellae could explain any discrepancies. Fifty cadaveric knee segments were examined for the presence of a fabella by both X-ray imaging and anatomical dissection. The relative density of each excised fabella specimen was then quantified using a separate set of radiographs. Results: Fabellae were detected in 40% of the sample knees via a manual dissection approachbut in just 12% of those same specimens using X-ray imaging. Relative density measurements confirmed that fabellae identifiable only via dissection were significantly less dense than fabellae visible in whole knee radiographsbut denser than the surrounding tissue. Radiology cannot reliably detect cartilaginous or incompletely ossified fabellae, which were found in 28% of the study population. Clinicians should consider the potential occurrence of a fabella when diagnosing posterolateral knee pain, even if it may not be visible via X-ray.

Differences in running biomechanics and tibiotalar cartilage T2 relaxation time between runners with and without asymptomatic tibial sesamoid bone marrow edema – clinical case series

ABSTRACT The impact of asymptomatic bone marrow edema (BME) in sesamoids on running biomechanics remains largely unknown, but exploring this relationship could aid early detection of forefoot-related injuries with cost-effective modalities. This study aimed to compare the running biomechanics of runners with asymptomatic BME in the tibial sesamoids with that of healthy controls. Four runners with asymptomatic BME in tibial sesamoids and four healthy runners participated. Lower extremity joint kinetics and kinematics were assessed along with plantar pressure while running at a self-selected speed. The T2 relaxation time of the tibiotalar cartilage was measured using MRI-derived T2 maps. Compared to the non-injured group, the injured group exhibited significantly lower plantar pressure under the hallux (p = 0.001), increased peak ankle rotation angles (p = 0.025), reduced ankle power generation (p = 0.049), and increased knee extension torque (p = 0.015). No significant differences in T2 values of the tibiotalar cartilage were observed. It appears that runners with asymptomatic BME adapted their running strategies by modifying their ankle biomechanics and reducing plantar pressure, even in the absence of pain. While the precise implications of these biomechanical alterations warrant further investigation, this study provides valuable insights into the relationship between asymptomatic BME and running biomechanics.

Arthroscopy-Assisted Open Fabella Excision With Medial Meniscus Revision Repair

Background: The fabella is a sesamoid bone that is a normal anatomic variant yet a rare cause of pathology in the posterolateral portion of the knee. The fabella can cause chronic knee pain in patients with knee osteoarthritis and athletes at all levels and in rare cases can cause neuropathy. Initially, treatment for a painful fabella includes conservative measures, with surgical intervention after conservative treatments have failed. This technique describes our arthroscopic-assisted fabella removal technique with a concomitant medial meniscus revision repair. Indications: The goal of treatment is to relieve pain and numbness. Conservative measures (i.e., nonsteroidal anti-inflammatory drugs [NSAIDs], range of motion exercises, heel cord stretching, etc.) are the initial step in treatment. Patients are treated surgically after conservative measures have failed. The surgical approach involves an open incision, arthroscopy, or a combination. Technique Description: With the patient in the supine position, a physical examination is performed under anesthesia to compare to validate clinical findings. An open lateral knee approach helps to locate the fabella which is grasped with an Alice clap. An arthroscopy is performed, and viewing posterolaterally will confirm that the fabella is within the grips of the Alice clamp. After repair of the meniscus, the surgical bed is repositioned to identify the fabella properly. Excision of the fabella is performed sharply from the lateral gastrocnemius tendon, and palpation is demonstrated to ensure complete removal. Caution is essential to avoid complications including damage to nearby anatomic structures, such as the lateral gastrocnemius tendon, and incomplete fabella removal. Results: A clinical study by Dekker et al reported that 80% of patients were able to return to full activities and postoperative patient-reported outcomes improved from preoperative to postoperative. Fabella excision is recommended for patients with fabella pain who do not respond to conservative treatment. Discussion: We describe a technique for removing the fabella with arthroscopic assistance. Patients who have not responded appropriately to conservative treatment for a painful fabella should consider surgical intervention. With the early initiation of rehabilitation, patients will have an increased likelihood of decreased pain, resolution of symptoms, and reduced knee stiffness. Patient Consent Disclosure Statement: The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.

Distribution and Pattern of Sesamoid Bones of the Hand in Saudi Arabia- a Retrospective Study

Background: Injuries or inflammation of the sesamoid bones can be very painful. In order to properly diagnose and treat problems affecting the hand, it is necessary to have a thorough grasp of the number and location of sesamoid bones in the hand. This study was carried out with an objective to study the distribution and pattern of sesamoid bones of the hand in the Saudi population. Materials and Methods: This three-month retrospective study was conducted from May 2023 to July 2023 in orthopedics and radiology departments of Saudi Arabia's Medical Centre, Majmaah University. The study analyzed 200 patients who had sesamoid bones in their hand by radiographs. Patients underwent two radiological examinations. All patients had posteroanterior (PA) and oblique direct hand radiographs. The radiologists and orthopedic surgeons examined the hand sesamoid bones, including at the metacarpophalangeal (MCP) and interphalangeal (IP) joints. Radiologists analyzed X-rays of hand injury patients using demographic data and imaging tests. The patients' sesamoid bone distributions and locations were meticulously recorded. Data were analyzed in SPSS Version 23, and the Chi-square test was applied to test the statistical significance. A p-value of &lt;0.05 was considered significant. Results: Total 200 patients had sesamoid bones examined in their first radiological examination of MCP. Among them, 72 (36%) patients had , , and MCP followed by MCP in 58 (29%), and MCP in 45 (22.5%), and MCP in 43 (21.5%) with the average age of sesamoid bone at MCP joint as 47.71±17.09, 41.76±18.08, 48.16±15.76, and 42±14.77 respectively. Sesamoid bone was reported , , and MCP in 1 (0.5%) and , , , and MCP in 1 (0.5%) patients in the first radiological examination. The second radiological examination in the same patients showed, 64 (32%) patients had , , and MCP followed by MCP in 47 (23.5%), and MCP in 43 (21.5%), and MCP in 17 (8.5%) with the average age of 48.38±17.13, 41.09±16.72, 49.02±16.59, and 38.24±14.59 respectively at MCP joint. The association between the first radiological examination and the second radiological examination of sesamoid bone at MCP was statistically significant (chi-square 623.73, p value &lt;0.001). Conclusion: This is the first radiological assessment with two imaging evaluations in the same 200 patients who had sesamoid bone in hand. In the first and second imaging evaluations, we recorded 7 and 9 sesamoid bone distribution patterns respectively. , , and metacarpophalangeal (MCP) sesamoid bones pattern was seen in patients. Trauma victims rarely have hand sesamoid bones, which are typically misdiagnosed when they appear elsewhere. This study provides orthopedic surgeons with anatomical data to help diagnose and treat patients.

Clinical and Radiological Evaluation of Racehorses with Sesamoiditis: Case Series

Background: Sesamoiditis causes intermittent lameness in horses and is characterized by the enlargement of vascular channels, local osteolysis, osteophyte and enthesophyte formation on radiography. This study aimed to report the relationship between the clinical and radiological findings of racehorses diagnosed with sesamoiditis, the treatment applied and long-term results. Methods: The study included a total of 30 Arabian and Thoroughbred racehorses aged 2-7 years diagnosed with sesamoditis based on clinical and radiological examinations. These horses were treated and followed for nine months. Result: Radiographic examination revealed different numbers of enlarged vascular channels in the proximal sesamoid bones in all the cases and osteophytosis (n=3), enthesophytosis (n=9), osteolysis (n=3) and fractures (n=6) in some cases. In addition, low heels were important in 27 cases. The body conformation and low-heeled hoof structure play a role in the development of sesamoiditis in horses and should be considered. As a result, body structure and low heel structure play a role in the development of sesamoiditis in horses and should be considered. This situation should be tried to be corrected by farriers during the foaling period. Sesamoiditis can have a positive prognosis with appropriate treatment and adequate rest, for this reason, treatment should be started in the early period.