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Cricket fast bowling training and research are often conducted on artificial turf, while matches are played on natural grass. It is unknown if technique differs between the different surfaces; therefore, the aim of this study was to explore if fast bowling technique differed between surfaces. Shoe slip distance and kinematic and temporal parameters previously associated with ball release velocity and lumbar bone stress injury were determined for eight male sub-elite fast bowlers using three-dimensional motion analysis on grass and artificial surfaces. Paired t-test and statistical parametric mapping were used to identify differences in technique between surfaces. Significantly greater slip distance was observed during back and front foot contact on the artificial surface compared to bowling on the grass surface. No kinematic or temporal parameter significantly differed between surfaces, therefore fast bowling technique is likely similar between grass and artificial surfaces, and previous research utilising artificial surfaces in fast bowling research is likely to be valid. [ABSTRACT FROM AUTHOR]

To determine if posteromedial tibial plateau (PMTP) bone bruising on pre-operative MRI is significantly associated with a ramp lesion identified during arthroscopy in patients with concomitant ACL ruptures. PubMed, CINAHL, Scopus, Web of Sciences, EMBASE, and Cochrane Library were searched systematically for studies that investigated the association between PMTP bone bruises on preoperative MRI and ramp lesions confirmed during arthroscopy. Eight studies met inclusion criteria. The Methodological Index for Nonrandomized Studies (MINORS) checklist was used to assess quality. A meta-analysis was performed to analyze odds of a ramp lesion after PMTP bone bruising identified on magnetic resonance imaging (MRI). Publication bias was assessed by funnel plot and Egger's linear regression test. There are 2.05 greater odds of medial meniscal ramp lesions in patients with an ACL rupture when PMTP bone bruising is found on preoperative MRI (95% CI, 1.29–3.25; p = 0.002). Heterogeneity of the pooled studies may be substantial (I2 = 65%; p = 0.006). Funnel plot analysis and Egger's linear regression test (p > 0.5) determined no publication bias among the studies included in the meta-analysis. Patients with acute ACL injuries and PMTP bone bruising on MRI have 2.05 times greater odds of a concomitant medial meniscal ramp lesion than those without this bone bruise pattern. [ABSTRACT FROM AUTHOR]

For the treatment of bone injuries and defects, when PLA and 3D printer technology are combined with its features, it promises great hope in personalized treatment. The average pore size is one of the cornerstones of the success of bone tissue engineering studies. In this study, five different tissue scaffolds with average pore sizes ranging from 100 to 550 μm were printed using a 3D printer and characterized by DSC, FT-IR, BF, SEM, contact angle measurement, mechanical, and degradation analysis for their structural, chemical and mechanical properties. Subsequently, in vitro studies were initiated and the differentiation capacity of mesenchymal stem cells isolated from rat bone marrow and their use in bone tissue engineering applications were investigated by MTS, Live-Dead, Pico Green, ALP assays, and von Kossa staining. In conclusion, it was seen that the most ideal results were obtained in scaffolds with a pore size of 370–460 μm in terms of cell retention, proliferation, and differentiation. Based on extensive experimental data, 3D printed PLA scaffold with a 60% filling rate has been found to be a promising scaffold for BTE applications compared with the 50, 70, 80, and 90% filling rate scaffolds. [ABSTRACT FROM AUTHOR]

Yogasana cures many diseases, one of which is a musculoskeletal disorder that may cause severe pain, bone injury, and so on. Here, Trikonasan, Uttanasan, Vrikshasana, Balasan, Tadasan and Virabhadrasan are the six different Yogasans considered for the treatment of musculoskeletal disorder, where acquiring better accuracy is still a challenge. Hence, this research introduces an efficient Yogasan classification method using the hybrid optimisation-based multiclass Support Vector Machine classifier (Cervus trail-multiSVM), in which the hybrid kernel function is designed using the proposed Cervus-trail optimisation to enhance the classificationaccuracy. The sproposed Cervus-Trail optimisation algorithm is modelled through integrating the rumbling and striving characteristic behaviour of the Cervus with the trailing behaviour of the Maritimus. The effectiveness of the classification relies on defining the kernel fusion factors of the multiSVM classifier with the proposed Cervus trail optimisation. Importantly, in this research, the Yogasan classification is performed using the yogasan videos that could render an effective diagnosis for the musculoskeletal disorder. The performance of the proposed method in terms of accuracy, F-Measure, precision, recall, and sensitivity is found to be 93.08%, 92.94%, 92.91%, 96.33% and 92.97%, respectively. [ABSTRACT FROM AUTHOR]

Bone metabolism constitutes the intricate processes of matrix deposition, mineralization, and resorption. Any imbalance in these processes leads to traumatic bone injuries and serious disease conditions. Therefore, bone remodeling plays a crucial role during the regeneration process maintaining the balance between osteoblastogenesis and osteoclastogenesis. Currently, numerous phytobiologics are emerging as the new therapeutics for the treatment of bone-related complications overcoming the synthetic drug-based side effects. They can either target osteoblasts, osteoclasts, or both through different mechanistic pathways for maintaining the bone remodeling process. Although phytobiologics have been widely used since tradition for the treatment of bone fractures recently, the research is accentuated toward the development of osteogenic phytobioactives, constituent-based drug designing models, and efficacious delivery of the phytobioactives. To achieve this, different plant extracts and successful isolation of their phytoconstituents are critical for osteogenic research. Hence, this review emphasizes the phytobioactives based research specifically enlisting the plants and their constituents used so far as bone therapeutics, their respective isolation procedures, and nanotechnological interventions in bone research. Also, the review enlists the vast array of folklore plants and the newly emerging nano-delivery systems in treating bone injuries as the future scope of research in the phytomedicinal orthopedic applications. [ABSTRACT FROM AUTHOR]

A healthy musculoskeletal system requires complex functional integration of bone, muscle, cartilage, and connective tissues responsible for bodily support, motion, and the protection of vital organs. Conditions or injuries to musculoskeeltal tissues can devastate an individual's quality of life. Some conditions that are particularly disabling include severe bone and muscle injuries to the extremities and amputations resulting from unmanageable musculoskeletal conditions or injuries. Monitoring and managing musculoskeletal health is intricate because of the complex mechanobiology of these interconnected tissues. For this article, we reviewed literature on implantable biosensors related to clinical data of the musculoskeletal system, therapeutics for complex bone injuries, and osseointegrated prosthetics as example applications. As a result, a brief summary of biosensors technologies is provided along with review of noteworthy biosensors and future developments needed to fully realize the translational benefit of biosensors for musculoskeletal health. Novel implantable biosensors capable of tracking biophysical parameters in vivo are highly relevant to musculoskeletal health because of their ability to collect clinical data relevant to medical decisions, complex trauma treatment, and the performance of osseointegrated prostheses. [ABSTRACT FROM AUTHOR]

We investigated work-related-musculoskeletal-injuries (WMSI) over 15-years in professional modern dancers to determine injury rate and pattern differences due to sex and professional-experience. Injuries were coded to allow analyses by tissue-type, body-region, severity, setting, mechanism, action-causation, and repertory-style. Injury prevalence (IP) was defined as average risk of injury/dancer. Injury incidence rate (IIR) was calculated per 1000-hrs exposure/block. Negative binomial logistic regression analyses were conducted with exposure-hrs to determine IIR, p < 0.05. Multinomial logistic regressions determined differences in tissue-type, body-region, action-causation and repertory-style; Poisson loglinear regressions determined differences in severity and mechanism, p < 0.05. Females were 15-times more likely to sustain bone-injuries, p = 0.016; males 8- and 15-times more likely to sustain muscle/tendon-injuries or lacerations/contusions, p ≤ 0.016. Females were more likely to sustain severe injury resulting in more lost-workdays and missed-performances, p < 0.001. In both sexes, more time-loss-injuries (TL-inj) occurred in performance , were traumatic in nature, with an action-causation of jumping/stomping/relevé. Dancers of moderate professional-experience were 1.3-times more likely to sustain TL-inj, p = 0.026;. Identifying context-specific activities and repertory–style relationships to injury can provide insight into casting and rehearsal scheduling. Comprehending sex-specific musculoskeletal health needs allows improved dancer health management and injury prevention planning. [ABSTRACT FROM AUTHOR]

Bone stress injury (BSI) is prevalent in female distance runners. Menstrual disturbances are associated with impaired bone health in endurance athletes. This study aimed to investigate the association between menstrual function and BSI and explore whether plyometric training may protect against BSI in individuals with menstrual disturbances. Competitive female distance runners (n = 183) aged 18–40 years were surveyed for training habits, menstrual function, and BSI, during the previous 12 months. Oligo/amenorrhoea during the previous 12 months (<9 menses) was deemed to indicate menstrual disturbance; hormonal contraceptive users and those previously diagnosed with a pathology that impacted menstrual function were excluded. BSI incidence rate was 2.25 (p = 0.02, 95% CI: 1.14–4.41) times greater in oligo/amenorrhoeic than eumenorrhoeic runners. BSI incidence rate was similar in oligo/amenorrhoeic and eumenorrhoeic runners that did plyometric training, but 3.78 (p = 0.001, 95% CI: 1.68–8.5) times greater in oligo/amenorrhoeic versus eumenorrhoeic runners that did not. However, the effect of plyometrics was non-significant (menstrual function × plyometric training interaction, p = 0.06; main effect, p = 0.89). Conventional plyometric training may not reduce BSI incidence in female distance runners, but menstrual disturbances and prolonged periods of low energy availability should be avoided. [ABSTRACT FROM AUTHOR]

As more new fossils are discovered, a great number of extraordinary specimens have greatly enhanced our understanding of bone features in dinosaurs. The fracture patterns of dinosaur bones are distinctive and easily identifiable, and thus have received increasing attention. Some pioneering modern medical studies have categorised two types of bone fractures, including traumatic (a broken bone caused by an injury) and pathologic (a broken bone caused by a disease) fractures. Here, we investigated two fossil specimens collected from Yangchuanosaurus hepingensis and Gigantospinosaurus sichuanensis, respectively, which were both uncovered in the Sichuan Basin, southwestern China. These specimens were subjected to osteological examination, CT scanning and spectral data analysis. Thus, multiple lines of evidence indicate that the bone fracture in the two dinosaurs is attributed to different factors. [ABSTRACT FROM AUTHOR]

In sports competitions, bone tissue injury seriously affects athletes' exercise levels, and some even cause lifelong regrets. With the continuous development of modern medicine, sports medicine has also been rapidly improved, and many tissue engineering techniques have been applied in the field of sports medicine. Used for the treatment of sports injuries, but the repair of bone injuries has always been a thorny issue in the medical field. This article mainly studies the compatibility of composite bio-nanomaterials in the repair of bone tissue damage in sports competitions. The method of constructing bone tissue engineering scaffolds is used to repair bone tissue damage, and the use of protein adsorption and wireless sensor compatibility methods to achieve composite bio-nanomaterials compatible, after 15 days of culture of PCL/PLA/HA nano scaffolds in vitro, stain the protein and observe the binding peptide sequence of the protein, and test the absorbance value. The results of the study showed that the growth rate of surface-bound peptides of nanomaterials was 1.2%, the absorbance value was 540 nm, and the hemolysis value of the experimental group was less than 5%. Biological compatibility is mainly related to the binding peptides on the cell surface, through intracellular and extracellular molecular signal transduction, and has a clear spatiotemporal sequence to optimize bone repair and recovery functions. Therefore, the use of synthetic nanomaterials to repair bone damage is a future trend, and biocompatibility is the key to this research. [ABSTRACT FROM AUTHOR]

The many types of material currently used to treat bone injuries (caused by various reasons) have undergone changes over time. From the initial metal implants of stainless steel or titanium to those made of ceramics and polymers (which are now widely used), each material has its own advantages, disadvantages, and suitable uses. Artificial bone material needs to be selected according to the different stress conditions of the body part in which it will be used, and the characteristics of the different materials need to be studied before a reasonable selection of the material can be made. This article reviews the artificial bone materials that have been studied so far, including metals, inorganic nonmetallic materials, polymers, and composites. Their advantages, disadvantages, and development status undergo comprehensive analysis, and the basis for future material selection is provided. An examination of publications shows that the future trend in developing bone materials for treating bone defects is to combine the above-mentioned materials with growth factors and bioactive proteins. This article may be helpful for choosing the right materials. [ABSTRACT FROM AUTHOR]

Thermal injuries inflicted during bone drilling significantly affect the success rate of surgery, hence, it is important to control thermal injury through temperature reduction. Low-frequency vibration-assisted drilling (LFVAD) is proposed here to reduce thermal injury to bones. Subsequently, the effectiveness of this process is experimentally verified. Based on the trajectories of the cutting edge in LFVAD, the duty ratio and maximum uncut chip thickness are analyzed by varying the amplitude and feed per tooth. A special fixture is designed and the temperature field is measured using an infrared thermography camera. Furthermore, a verification experiment is performed on the machine tool using a low-frequency vibration tool holder. The maximum temperature rise is used to evaluate the drilling temperature, and a thermal injury factor is proposed to evaluate the size of the thermal injury area. Results show that LFVAD effectively reduced thermal injury during bone drilling. The non-cutting effect during LFVAD interrupted the continuous accumulation of cutting heat and promoted the dissipation of cutting heat. Under the experimental parameters used in this study with LFVAD, the maximum temperature rise reduced up to 29.7% and the thermal injury factor reduced up to 18.3%, as compared to those of conventional drilling. [ABSTRACT FROM AUTHOR]

Extensive burn injury mainly affects children, and hypermetabolic state can lead to growth delay. This study aimed to investigate bone histopathological and morphometric aspects, collagen fibers network and the immunoexpression of biological markers related to bone development in a young experimental model for extensive burn. A total of 28 male Wistar rats were distributed into Control (C) and subjected to scald burn injury (SBI) groups. Sham or injured animals were euthanized 4 or 14 days post-lesion and proximal epiphyses of the femur were submitted to histological, morphometric (thickness epiphyseal plate), and RUNX-2 and receptor activator of nuclear factor kappa- β ligand (RANK-L) immunoexpression methods. Histopathological femoral findings showed delayed appearance of the secondary ossification center in SBI, 14 days post-injury. Collagen fibers 4 days after injury were observed in articular cartilage as a pantographic network with a transversally oriented lozenge-shaped mesh, but this network was thinner in SBI. Fourteen days after the injury, the pantographic network of collagen presented square-shaped mesh in C, but this aspect was changed to a wider mesh in SBI. Morphometric analysis of epiphyseal plate revealed that the SBI group had less thickness than the respective controls (p<0.05). RUNX-2 showed no difference between groups, but RANK-L score was higher in all SBI groups. Extensive burn injury causes delayed bone growth and morphological changes. Alterations in collagen network and enhancement in immunoreactivity of RANK-L result in increased osteoclastogenesis. [ABSTRACT FROM AUTHOR]

In the natural process of bone repair, matricryptic peptides were activated by up-regulated ECM-degrading enzymes and properly released at bone injury sites, which plays critical roles in bone self-healing. Inspired by this natural process, here, matricryptic peptide-inspired (MPI) hydrogels were designed to promote osteogenic differentiation. MPI hydrogels can be degraded by enzymes and during this time, the masked bioactive components were released to promote osteogenic differentiation. These MPI hydrogels which normally serve as structural support for cell proliferation while promote osteogenic differentiation using embedded osteogenic BFP-1 peptides after degradation may provide a novel design for bone regeneration materials. [ABSTRACT FROM AUTHOR]

Magnesium alloy is one of the most promising biomaterials in vascular clogging and bone injury. But it still has some defects to overcome and the key task is to control the degradation velocity. In this study, the reaction between NaCl solution and MgO is simplified as the first stage of the degradation of magnesium alloy stent, and the adsorption properties of NaCl solution on the MgO surface are investigated by MD simulation. The distribution of each component of the solution perpendicular to the MgO surface is analysed and the diffusion coefficient is calculated. Besides, a parameterised analysis is carried out. The results show that there is a solution layer formed at the surface of the MgO, and the existence of metal oxide restricts the diffusion of the solution. The adsorption capacity and the diffuse rate have an opposite variation tendency with the change of temperature, concentration and velocity. The self-diffusion coefficient of the solution increases with the increase in temperature as well as velocity, inversely adsorption capacity decreases with the increase in velocity. Besides, the influence of temperature on the adsorption capacity is small. What is more, the diffusion coefficient decreases while the adsorption capacity increases with the increase in concentration. [ABSTRACT FROM AUTHOR]

Background: This article aimed to examine and compare the frequency of occurrence of a broad range of non‐suicidal self‐injury (NSSI) behaviours in an international sample of women. Methods: Female participants with NSSI (n = 464) were recruited via a range of websites and completed a questionnaire examining 17 different types of NSSI types and their frequency, severity, and duration. Results: Prevalent acts were cutting, scratching, and word carving; cutting and scratching occurred frequently, whilst word carving most often occurred as a single episode. Analyses revealed significant differences between Australian and U.S. participants, with U.S. participants having significantly higher rates of cutting, wound interference, carving, scratching, and sharp object sticking. Participants also reported on other self‐harm methods not assessed by the questionnaire. Conclusions: Word carving may be qualitatively different from other forms of NSSI. More severe NSSI methods (e.g., bone breaking) are less prevalent than less dangerous methods (e.g., scratching). Participants considered a range of indirectly harmful or suicidal behaviours as self‐injury contrary to researcher or clinician understanding. Finally, there may be cultural differences in relation to NSSI between countries where such behaviours are common, although further research is required to determine this. [ABSTRACT FROM AUTHOR]

The bone drilling process is indispensable in orthopaedic surgeries and treating bone breakages. It is also very important in dentistry and bone sampling operations. Bone is a very complex material and the process of drilling is very sensitive. Thus, bone drilling is one of the most important, common in the field of biomedical engineering. The bone drilling process can be promoted using automatic drilling machines and surgery-assisting robots. The problematic issue during operation is the high increase in drilling process temperature (higher than 47 °C) which leads to the so-called ‘thermal necrosis’ or cell death, and local burn in bone tissue. Furthermore, imposing higher forces to bone might yield to breaking or cracking, and consequently causes serious damages in bone. In this paper, the tool rotational speed, feed ratio and tool diameter were taken into account as process input parameters, and process temperature and thrust force were taken as output parameters. Design of experiments using response surface methodology was followed. Then, second linear governing equation was assigned to the model and its accuracy was evaluated. Later, Sobol statistical sensitivity analysis was used to ascertain the effect of process input parameters on process temperature and force. The results showed that among all effective input parameters, the tool rotational speed, feed rate and tool diameter have the highest influence respectively on process temperature and force. The behaviour of each output parameter with variation in each input parameter was further investigated. [ABSTRACT FROM PUBLISHER]

Bio-based polymers have been widely used to be as scaffolds for repairing the bone defects. However, the polymer scaffolds are generally lack of bioactivity and cell recognition site. Seeking effective ways to improve the bioactivity and interaction between materials and tissue or cells is clinically important for long-term performance of bone repair materials. In this work, polylactide-b-poly(ethylene glycol)-b-polylactide (PLA-PEG-PLA, PLEL) tri-block copolymers were firstly synthesized by ring-opening polymerization of lactide using PEG with various molecular weights. Inspired by excellent adhesion of dopamine (DA), a facile and effective method was developed to fabricate polydopamine (PDA) and polydopamine/nano-hydroxyapatite (PDA/n-HA) modified PLEL scaffolds by deposition of PDA and PDA/n-HA coating. The surface structure, degradation rates and mineralization of the modified PLEL scaffolds were investigated, and obviously improved after immobilization of PDA and PDA/n-HA coatings. Moreover, the biocompatible results showed a significant increase in cells viability and adhesion. Therefore, the surface modification with PDA and PDA/n-HA could not only adjust the properties of scaffolds, but also reinforce the interfacial adhesion between the PLEL and cells. [ABSTRACT FROM PUBLISHER]

Intraarticular calcaneal fractures can result in poor prognosis. Although operative fixation can improve the functional outcomes in most cases, surgical complications such as loss of reduction and wound healing problems may increase the risk of reoperation. Hence, this study aimed to design calcaneal locking plate with a lower profile and better biomechanical performance   and to compare the redesigned plate with the traditional calcaneal plate via the finite element method. A Sanders’ type II-C intraarticular calcaneal fracture was simulated. Two fixation models utilising the branch-like calcaneal locking plate and the full plate were constructed. Topology optimisation was conducted to generate a new calcaneal plate design. A biomechanical comparison among the three groups of plates was performed using the finite element method. For the fracture simulated in this study, the optimised plate was superior to the traditional plate in terms of fixation stability and safety but was reduced in volume by approximately 12.34%. In addition, more rational stress distributions were observed in the redesigned plate, underscoring the superiority of this new design in terms of fatigue strength. These results demonstrate that the topology optimisation can be used to design a new implant with a minimised profile and no loss of fixation stability. [ABSTRACT FROM PUBLISHER]

Repair of the bone injury remains a challenge in clinical practices. Recent progress in tissue engineering and therapeutic gene delivery systems have led to promising new strategies for successful acceleration of bone repair process. The aim of this study was to create a controlled-release system to slowly release the arginine–chitosan/plasmid DNA nanoparticles encoding BMP-2 gene (Arg-CS/pBMP-2 NPs), efficiently transfect osteoblastic progenitor cells, secrete functional BMP-2 protein, and promote osteogenic differentiation. In this study, chitosan was conjugated with arginine to generate arginine–chitosan polymer (Arg-CS) for gene delivery. Mix the Arg-CS with pBMP-2 to condense pBMP-2 into nano-sized particles.In vitrotransfection assays demonstrated that the transfection efficiency of Arg-CS/pBMP-2 nanoparticles and the expression level of BMP-2 was obviously exceed control groups. Further, PELA microspheres as the controlled-release carrier for the nanoparticles were used to encapsulate Arg-CS/pBMP-2 NPs. We demonstrated that the Arg-CS/pBMP-2 NPs could slowly release from the PELA microspheres at least for 42 d. During the co-culture with the PELA microspheres, the content of BMP-2 protein secreted by MC3T3-E1 reached the peak at 7 d. After 21d, the secretion of BMP-2 protein still maintain a higher level. The alkaline phosphatase activity, alizarin red staining, and osteogenesis-related gene expression by real-time quantitative PCR analysis all showed the PELA microspheres entrapping with Arg-CS/pBMP-2 NPs can obviously induce the osteogenic differentiation. The results indicated that the Arg-CS is a suitable gene vector which can promote the gene transfection. And the novel PELA microspheres-nanoparticle controlled-release system has potential clinical application in the future after further research. [ABSTRACT FROM AUTHOR]

Objective:The hand-eye calibration is used to determine the transformation between the end-effector and the camera marker of the robot. But the robot movement in traditional method would be time-consuming, inaccurate and even unavailable in some conditions. The method presented in this article can complete the calibration without any movement and is more suitable in clinical applications.Methods:Instead of solving the classic non-linear equation AX = XB, we collected the points on X and Y axes of the tool coordinate system (TCS) with the visual probe and fitted them using the singular value decomposition algorithm (SVD). Then, the transformation was obtained with the data of the tool center point (TCP). A comparison test was conducted to verify the performance of the method.Results:The average translation error and orientation error of the new method are 0.12 ± 0.122 mm and 0.18 ± 0.112° respectively, while they are 0.357 ± 0.347 mm and 0.416 ± 0.234° correspondingly in the traditional method.Conclusions:The high accuracy of the method indicates that it is a good candidate for medical robots, which usually need to work in a sterile environment. [ABSTRACT FROM PUBLISHER]

Background: Lower urinary tract symptoms (LUTS) have been associated with falls in studies either exclusively or predominantly of women. It is, therefore, less clear if LUTS are risk factors for falls in men.Methods: We conducted a systematic review of the literature on the association between LUTS and falls, injuries, and fractures in community-dwelling older men. Medline, Embase, and Cinahl were searched for any type of observational study that has been published in a peer-reviewed journal in English language. Studies were excluded if they did not report male-specific data or targeted specific patient populations. Results were summarized qualitatively.Results: Three prospective cohort studies and six cross-sectional studies were identified. Incontinence, urgency, nocturia, and frequency were consistently shown to have weak to moderate association with falls (the point estimates of odds ratio and relative risk ranged from 1.31 to 1.67) in studies with low risk of bias for confounding. Only frequency was shown to be associated with fractures.Conclusions: Urinary incontinence and lower urinary tract storage symptoms are associated with falls in community-dwelling older men. The circumstances of falls in men with LUTS need to be investigated to generate hypotheses about what types of interventions may be effective in reducing falls. [ABSTRACT FROM AUTHOR]

This study developed a parametric methodology to robustly predict occupant injuries sustained in real-world crashes using a finite element (FE) human body model (HBM). One hundred and twenty near-side impact motor vehicle crashes were simulated over a range of parameters using a Toyota RAV4 (bullet vehicle), Ford Taurus (struck vehicle) FE models and a validated human body model (HBM) Total HUman Model for Safety (THUMS). Three bullet vehicle crash parameters (speed, location and angle) and two occupant parameters (seat position and age) were varied using a Latin hypercube design of Experiments. Four injury metrics (head injury criterion, half deflection, thoracic trauma index and pelvic force) were used to calculate injury risk. Rib fracture prediction and lung strain metrics were also analysed. As hypothesized, bullet speed had the greatest effect on each injury measure. Injury risk was reduced when bullet location was further from the B-pillar or when the bullet angle was more oblique. Age had strong correlation to rib fractures frequency and lung strain severity. The injuries from a real-world crash were predicted using two different methods by (1) subsampling the injury predictors from the 12 best crush profile matching simulations and (2) using regression models. Both injury prediction methods successfully predicted the case occupant's low risk for pelvic injury, high risk for thoracic injury, rib fractures and high lung strains with tight confidence intervals. This parametric methodology was successfully used to explore crash parameter interactions and to robustly predict real-world injuries. [ABSTRACT FROM PUBLISHER]

Computed tomography (CT) provides both anatomical and density information about tissues. Bone is segmented by raw images and Finite Element Method (FEM) voxel-based meshing technique is achieved by matching each CT voxel to a single finite element (FE). As a consequence of the automated model reconstruction, unstable elements – i.e. elements insufficiently anchored to the whole model and thus potentially involved in partial rigid body motion – can be generated, a crucial problem in obtaining consistent FE models, hindering mechanical analyses. Through the classification of instabilities on topological connections between elements, a numerical procedure is proposed in order to avoid unconstrained models. [ABSTRACT FROM AUTHOR]

The paper argues that our current understanding of the animal bones from causewayed enclosure sites in Britain is flawed. During the 1980–90s, a number of key interpretations, still frequently espoused, were based more upon anecdote and theory-driven assertion than on empirical evidence. An example is that evidence of bone processing (butchery and bone fracture) does not feature heavily in the faunal record from causewayed enclosures. Using data from the sites of Etton and Staines, this view must now be questioned. Both butchery and peri-mortem bone fracture are present in these assemblages in substantial quantities. These sites are compared with Ludwinowo 7, a Linearbandkeramik settlement site in Poland and there are considerable similarities between the three different sites. This suggests possibility that the broader economic utility of animal bone assemblages at causewayed enclosures has been underestimated, having been, up to now, regarded as ‘not indicative of domestic settlement’. [ABSTRACT FROM PUBLISHER]

Many commonly prescribed medications, such as selective serotonin reuptake inhibitors, proton pump inhibitors, thiazolidinediones, aromatase inhibitors, and androgen deprivation therapy, have been associated with adverse skeletal effects. The levels of evidence in support of a causal relationship between drug use and the development of bone loss and fractures are variable. For some drugs, a causal relationship is suspected (but not proven) based on observational studies, while in others causality is firmly established with randomized, controlled clinical trials. The mechanism of action for skeletal damage is poorly understood for some drugs and well known for others. Guidelines for managing bone health in patients taking some medications with potential skeletal toxicity have been developed using the best available evidence and expert opinion. This is a review of selected medications that have been associated with bone loss and fractures, with recommendations for clinical care. [ABSTRACT FROM PUBLISHER]

Fracture fixation techniques, fracture management, and orthopedic trauma care have evolved, and various advancements have been made in the last 50 years. Minimally invasive biological osteosynthetic devices have the potential of transforming the prospects of orthopedic treatment. Internal fixation techniques offer tremendous advantages in the management of bone fractures. The main objective of this study was to fabricate a novel auxetic polymeric bone stent with potential applications in internal fixation procedures. A new “connected stars” geometry has been used for the fabrication of this device. After fabrication, the mechanical characterization of the auxetic bone stent was also carried out to study its properties and deformation behavior. The research work undertaken also assesses the potential for auxetic behavior of these tubular structures. [ABSTRACT FROM PUBLISHER]

Flexible fixation or the so-called 'biological fixation' has been shown to encourage the formation of fracture callus, leading to better healing outcomes. However, the nature of the relationship between the degree of mechanical stability provided by a flexible fixation and the optimal healing outcomes has not been fully understood. In this study, we have developed a validated quantitative model to predict how cells in fracture callus might respond to change in their mechanical microenvironment due to different configurations of locking compression plate (LCP) in clinical practice, particularly in the early stage of healing. The model predicts that increasing flexibility of the LCP by changing the bone-plate distance (BPD) or the plate working length (WL) could enhance interfragmentary strain in the presence of a relatively large gap size (>3 mm). Furthermore, conventional LCP normally results in asymmetric tissue development during early stage of callus formation, and the increase of BPD or WL is insufficient to alleviate this problem. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented regarding two cases of CD19-negative B lymphoblastic leukemia (B-ALL) associated with lytic bone lesions, hypercalcemia, and aleukemic presentation.

Prevention and treatment of osteoporosis rely on understanding of the micromechanical behaviour of bone and its influence on fracture toughness and cell-mediated adaptation processes. Postyield properties may be assessed by nonlinear finite element simulations of nanoindentation using elastoplastic and damage models. This computational study aims at determining the influence of yield surface shape and damage on the depth-dependent response of bone to nanoindentation using spherical and conical tips. Yield surface shape and damage were shown to have a major impact on the indentation curves. Their influence on indentation modulus, hardness, their ratio as well as the elastic-to-total work ratio is well described by multilinear regressions for both tip shapes. For conical tips, indentation depth was not statistically significant (p < 0.0001). For spherical tips, damage was not a significant parameter (p < 0.0001). The gained knowledge can be used for developing an inverse method for identification of postelastic properties of bone from nanoindentation. [ABSTRACT FROM AUTHOR]

Bone is a structural and hierarchical composite that exhibits remarkable ability to sustain complex mechanical loading and resist fracture. Bone quality encompasses various attributes of bone matrix from the quality of its material components (type-I collagen, mineral and non-collagenous matrix proteins) and cancellous microarchitecture, to the nature and extent of bone microdamage. Microdamage, produced during loading, manifests in multiple forms across the scales of hierarchy in bone and functions to dissipate energy and avert fracture. Microdamage formation is a key determinant of bone quality, and through a range of biological and physical mechanisms, accumulates with age and disease. Accumulated microdamage in bone decreases bone strength and increases bone's propensity to fracture. Thus, a thorough assessment of microdamage, across the hierarchical levels of bone, is crucial to better understand bone quality and bone fracture. This review article details multiple imaging modalities that have been used to study and characterize microdamage; from bulk staining techniques originally developed by Harold Frost to assess linear microcracks, to atomic force microscopy, a modality that revealed mechanistic insights into the formation diffuse damage at the ultrastructural level in bone. New automated techniques using imaging modalities, such as microcomputed tomography are also presented for a comprehensive overview. [ABSTRACT FROM AUTHOR]

Background. Hypertonic saline (HTS) has been reported as a treatment for sever traumatic brain injury and hemorrhagic shock and current clinical guidelines recommend it. Intraosseous (IO) infusion is often needed in the pre-hospital and combat settings to administer life-saving treatments. However, the safety of IO HTS infusion is not clear. The aim of our study was to evaluate the clinical and histological outcome of HTS IO infusion into the extremity of a large animal model. Methods. We conducted a randomized comparative study of adult pigs that were infused intraosseously with one of the following solutions: 7.5% HTS, 3% HTS or normal 0.9% isotonic saline. The animals were observed daily for infection, necrosis and gait (5 point Tarlov score) up to 5 days. Five days after infusion, necropsy and histological analysis was performed using a validated scale of tissue necrosis. Results. The mean Tarlov gait scores were similar in all arms and all animals showed a score of 4 (normal ambulation) by day 5. During the 5 day observation period, there were no signs of infection or tissue abnormalities. Histological examinations showed no indication of necrosis, or abnormal bone and muscle healing (p < 0.05). Conclusion. We observed regular tissue morphology and normal gait scores over the 5 day observation period. There was an absence of gross tissue necrosis and microscopic ischemia post IO HTS infusion in this swine model. This data confirms the clinical safety of IO HTS infusion and highlights its use as an alternative lifesaving treatment. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the study was the presentation of osteoporotic fracture prediction in men. Methods: Eight-hundred and one men at the mean age of 70.8 ± 9.31 years were examined. The 10-year fracture prediction was established, using the FRAX™ calculator and Garvan nomogram. Results: The mean value for any fracture and hip fracture probabilities for FRAX were 7.26 ± 5.4% and 3.68 ± 4.25%, respectively. For Garvan fracture, risk values were 26.44 ± 23.83% and 12.02 ± 18.1%. The mean conformity for any fracture and hip fracture prediction for threshold of 20% (any fracture) and 3% (hip fracture) between Garvan and FRAX values was 55.8% (κ 0.041) and 79.65% (κ 0.599), respectively. ROC analyses showed the following areas under the ROC curves (AUC) for any fractures: FRAX 0.808 and Garvan nomogram 0.843 ( p = 0.059). The AUC values for hip fractures were 0.748 for Garvan nomogram and for 0.749 FRAX, and did not differ. On the base of ROC data, the cut-off values with best accuracy to predict fractures for both methods were established. The conformity between methods for thresholds indicated by ROC analysis was 72.5% (κ 0.435) for any and 77.7% (κ 0.543) for hip fractures. Conclusion: The conformities between FRAX and Garvan in regard to hip fracture prediction were acceptable for a threshold of 3% and thresholds derived by ROC analysis, while for any fracture we recommend to use thresholds established by ROC analysis. This may suggest that the use of 'universal' cut-off points is probably misleading. [ABSTRACT FROM AUTHOR]

1. The prevalence of keel bone deformities in laying hens is high and is partly associated with unsuitable perch designs, which impose a risk of injury due to an unstable footing. 2. Over two experiments, 9 or 10 hens of each of three layer lines (Lohmann Selected Leghorn (LSL), Lohmann Tradition (LT) and Lohmann Brown (LB) ) were filmed while landing on three different perch types, including steel perches of various diameters, a commercial mushroom-shaped plastic perch and a newly developed prototype perch with a soft surface material. S. Data on landing behaviour (safe vs. unsafe or failed landing) following downward jumps were collected for 25, 50 and 60 cm vertical distances and 75 cm horizontal distance between a wooden start perch and the different destination perches. 4. The highest proportion of safe landings occurred on the prototype perch, whereas least safe landings were observed on steel perches, irrespective of their diameter. The mushroom-shaped perch was intermediate with regard to the safeness of landing. 5. A threshold of 50 cm vertical distance (34° slope) was identified as the optimum for downward jumps on perches in order to reduce the risk of unsafe or failed landings. Above this threshold, the proportion of safe landings declined significantly. 6. Brown shell layer types (LB and LT) had a lower proportion of safe landings compared to the white shell layer type (LSL), whereas no difference was found between LB and LT layer lines. 7. Although steel perches prevail in commercial housing, these perches were found to be least advantageous with regard to landing behaviour. The prototype perch provided the most stable footing on perching and is a promising alternative to replace commercial steel perches, thus helping to reduce the risk of perch-related keel bone injury. [ABSTRACT FROM AUTHOR]

Background Osteoporosis is responsible for fragility fractures, which are associated with decreased physical and social function. The GINERISK study was a cross-sectional epidemiological study conducted in 4157 Spanish postmenopausal women initially diagnosed with osteoporosis according to WHO criteria within the last 2 years. Aim The aim of the study was to explore the impact of osteoporosis on health-related quality of life (HRQoL). Method Menopause-specific and generic HRQoL were assessed, respectively, with the specific Cervantes Scale and the generic SF-12v2 Health Survey. The impact of osteoporosis on HRQoL was ultimately evaluated in 3328 (80.1%) women who had measurements for both bone mineral densitometry (BMD) and HRQoL. Results Menopause-specific or generic HRQoL, respectively, were worse in women with current osteoporosis and prior osteoporotic bone fracture (BF) in comparison with current osteoporosis without BF or whose T-score had increased above −2.5 on the BMD after receiving osteoporosis drug therapy. Impaired HRQoL was found both in Spanish postmenopausal female populations and the Spanish general female population. Women with osteoporosis with BF had physical and mental summary component scores in the 20th and 30th percentiles, respectively, of the Spanish general population. Higher risk for cardiovascular death was also associated with greater HRQoL impairment. The use of selective estrogen receptor modulators in women with a BMD T-score ≤ −2.5 was associated with lower impact of osteoporosis on HRQoL, particularly in the domains of physical health and sexuality. Conclusion The HRQoL analysis results in this study demonstrated a loss of quality of life in postmenopausal women with osteoporosis and confirmed that this loss is greater in women with prior osteoporotic fracture. [ABSTRACT FROM AUTHOR]

HEMA-Lactate-Dextran cryogel scaffolds were produced by cryogelation. Mesencyhmal stem cells (MSC) were isolated from rat bone marrow. Critical sized cranial bone defects were created in rat cranium. Stem cells were injected inside the macropores of the cryogel scaffolds prepared from HEMA-Lactate-Dextran possessing the same dimensions with the defect and placed in the cranial bone. The cryogels placed in the defect without stem cells served as control. After selected time intervals the experimental sites were removed from the animals and new bone formation and tissue integration were investigated by histological analysis. The in vivo results exhibited osseous tissue integration within the implant and mineralized functionally stable bone restoration of the cranial defects. Tissue formation started in the macrospores of the scaffold starting from periphery to the center. A significant ingrowth of connective tissue cells and new blood vessels allowed new bone formation. Histological data demonstrated that new bone per total defect area ratio, were not significantly different in 'scaffold-stem cells' group compared to that of 'scaffold only' group on all time points. However, the blood vessel density was significantly higher in 'scaffold-stem cells' group comparing to that of the 'scaffold only' group on day 30. 'Scaffold-stem cells' given group gave better tissue response score when compared to 'scaffold only' group on day 180. [ABSTRACT FROM AUTHOR]

Recent publications have shown that the combination of α-calcium sulfate hemihydrate, the densest form of hydrates and hydroxyapatite (HA) particles gives good clinical outcome in various applications. It has large potential as bone substitute since the material transforms to bone throughout the entire volume and not only by creeping substitution, from the surface toward the inside. Release of important proteins for osteogenesis has been observed around implanted material and is speculated to be due to fast dissolution of the calcium sulfate phase in combination with the osteoconductive and bioactive nature of HA. In diabetic foot infection, the osteoconductive HA/calcium sulfate material has been successfully used loaded with antibiotics and since it is injectable, the application is minimally invasive, easy and precise. It is a bone substitute for the future. [ABSTRACT FROM AUTHOR]

This review summarizes the macroanatomical changes affecting the navicular bone in terms of mechanisms of bone turnover. Many researchers associate the disorders described in this review with limb overloads occurring periodically during training. As a result of intensified and repetitive biomechanical strains, accumulation of microcracks occurs in the bone tissue. It can disrupt the natural rhythm of tissue regeneration. The rhythm comprises a short resorption stage as well as bone formation stage, which lasts several months in horses. The article also dwells on different forms of macroscopic lesions of the navicular bone, which may occur in the uncoupled Basic Multicellular Unit. They lead to the navicular syndrome, which is irreversible and most often eliminates the horse from sport competitions. [ABSTRACT FROM PUBLISHER]

Tissue engineering has emerged as a possible alternative to current treatments for bone injuries and defects. However, the common tissue engineering approach presents some obstacles to the development of functional tissues, such as insufficient nutrient and metabolite transport and non-homogenous cell distribution. Culture of bone cells in three-dimensional constructs in bioreactor systems is a solution for those problems as it improves mass transport in the culture system. For bone tissue engineering spinner flasks, rotating wall vessels and perfusion systems have been investigated, and based on these, variations that support cell seeding and mechanical stimulation have also been researched. This review aims at providing an overview of the concepts, advantages and future applications of bioreactor systems for bone tissue engineering with emphasis on the design of different perfusion systems and parameters that can be optimized. [ABSTRACT FROM AUTHOR]

Introduction Few longitudinal data about rates of bone loss in women in midlife exist. Fewer still with their reproductive states having been carefully assessed and sequentially followed-up. Methods Complete data from 50 women younger than 60 years (mean age at baseline 48.3±5.4 years) were prospectively collected over 9 years. This was done by standardized interviews, measurement of endocrinological parameters as well as bone markers and repeated bone mineral density (BMD) measurements using quantitative computer tomography (QCT). Women were classified in three groups according to their reproductive characteristics over 9 years. Results Significant BMD loss was found in women going through the menopausal transition. In perimenopause, there was a correlation (multiple regression results, r = −0.396 and r = −0.527) between accelerated bone density loss and increased gonadotropin levels (follicle stimulating hormone, luteinizing hormone). Although significantly higher levels of bone markers (osteocalcin, bone-specific alkaline phosphatase, c-terminal telopeptide cross-linked collagen type I) were measured in postmenopause, the greatest increase in these markers was seen during the menopausal transition. No individual marker's increase, however, was predictive for perimenopausal bone density loss. The major risk factors for rapid bone loss were a lower initial body weight (< 57 kg), a body mass index < 20 kg/m2 as well as a positive family history of fragility fractures. Conclusions Women in the menopausal transition lose trabecular bone at a rapid rate despite intermittently high and usually normal estrogen levels. This is the only prospective study to date that documents trabecular bone changes in women through the entire perimenopause, which may last up to 10 years. [ABSTRACT FROM AUTHOR]

The risk for fragility fracture represents a problem of enormous magnitude. It is estimated that only a small fraction of women with this risk take the benefit of preventive measures. The relationship between estrogen and bone mass is well known as they are the other factors related to the risk for fracture. There are precise diagnostic methods, including a tool to diagnose the risk for fracture. Yet there continues to be an under-diagnosis, with the unrecoverable delay in instituting preventive measures. Women under the age of 70 years, being much more numerous than those older, and having risk factors, are a group in which it is essential to avoid that first fragility fracture. Today it is usual not to differentiate between the treatment and the prevention of osteoporosis since the common aim is to prevent fragility fractures. Included in this are women with osteoporosis or with low bone mass and increased risk for fracture, for whom risk factors play a primary role. There is clearly controversy over the type of treatment and its duration, especially given the possible adverse effects of long-term use. This justifies the concept of sequential treatment, even more so in women under the age of 70, since they presumably will need treatment for many years. Bone metabolism is age-dependent. In postmenopausal women under 70 years of age, the increase in bone resorption is clearly predominant, related to a sharp drop in estrogens. Thus a logical treatment is the prevention of fragility fractures by hormone replacement therapy (HRT) and, in asymptomatic women, selective estradiol receptor modulators (SERMs). Afterwards, there is a period of greater resorption, albeit less intense but continuous, when one could utilise anti-resorptive treatments such as bisphosphonates or denosumab or a dual agent like strontium ranelate. Bone formation treatment, such as parathyroid hormone (PTH), in women under 70 years will be uncommon. That is because it should be used in cases where the formation is greatly diminished and there is a high risk for fracture, something found in much older women. [ABSTRACT FROM AUTHOR]

Minimally invasive percutaneous plate osteosynthesis (MIPPO) was compared with traditional open reduction and internal fixation (ORIF) in treating distal tibial fractures. Patients diagnosed with displaced extraarticular distal tibial fractures during October 2005-June 2007 were randomly assigned to a closed (treated using MIPPO) and an open (treated using ORIF) group. Ninety-four patients with fractures were treated and followed up, of which 42 and 52 patients were enrolled in the open and closed groups, respectively. The 94 fracture cases were classified into three types: Type A, 52 (55.3%); Type B, 24 (25.5%); and Type C, 18 (19.1%). The average follow-up time was 15.6 and 16.2 months for the open and closed groups, respectively. In the open group, 35 fractures healed within six months. Delayed union was observed in three fractures and nonunion in four fractures. Two cases had superficial wound infection after operation. No malunion was observed. In the closed group, 47 fractures healed within six months. Delayed union was observed in four fractures. Locking plate was broken nine months after operation in one case. Malunion was observed in five cases: two rotational and three posterior angular deformities. No statistically significant differences were observed in the healing time of Types A and B between the open and closed groups ( p > .05). The healing time of Type C in the open group was longer than that in the closed group ( p < .05). The first choice for Type C fractures is MIPPO, whereas that for Type A is open reduction. [ABSTRACT FROM AUTHOR]

Introduction: Distally based dorsal metacarpal artery (DMCA) flaps are an established technique for the reconstruction of extensive finger defects. In many cases, such defects also include an injury of the extension tendon over the proximal and distal finger joint, which can lead to a reduced range of motion or finger deformation such as boutonniére deformity. To prevent this, operative techniques are necessary that allow complete defect coverage while simultaneously stabilizing the extension apparatus. Methods: In two cases, DMCA flaps were combined with vascularized extensor indices tendons for the reconstruction of extensive dorsal finger skin and soft tissue defects, particularly when tendon and bone are exposed. Results: After three weeks of postoperative immobilization, physiotherapy could be intensified. In a six months' follow-up, the results obtained from the standpoint of both function and appearance were excellent, the flaps remained viable at all times and full-finger length and sensory function were maintained. Regarding operation time, pain and finger appearance, both patients stated satisfaction. Conclusion: The vascularized tendon incorporated in DMCA flaps provides a sufficient method to restore a satisfactory finger function and prevent finger deformity, arthrodesis, or amputation, especially in cases with severe injuries of the extension apparatus. [ABSTRACT FROM AUTHOR]

Reduction of fractures of the distal radius is often supplemented with percutaneous pinning, but there is little evidence that this affects the clinical outcome. A total of 43 patients with pinned, and 296 with conservatively-treated, fractures were reviewed a mean of 6 (range 3-13) years after injury. We found controls among the conservatively-treated patients who matched 30 of the patients with pinned fractures with respect to age, sex, trauma energy, and radiographic measurements at injury. Clinical and radiological results of the two groups were compared and contrasted. There was a trend for better radiological results in patients with pinned fractures, but not significantly so, and no difference in clinical variables. We identified seven published randomised studies in which pinning was compared with reduction and plaster of Paris alone. Most reported better radiological results at review. The three smallest studies with the shortest follow-up reported better clinical outcome for pinned fractures, while the remaining four studies found no significant clinical benefit from pinning. Although the radiological results were improved by percutaneous pinning in addition to reduction and plaster of Paris, the clinical outcome in extra-articular and simple intra-articular fractures seemed unaffected. [ABSTRACT FROM AUTHOR]

The formation of a fracture callus in vivo tends to form in a structurally efficient manner distributing tissues where mechanical stimulus persists. Therefore, it is proposed that the formation of a fracture callus can be modelled in silico by way of an optimisation algorithm. This was tested by generating a finite element model of a transversal bone fracture embedded in a large tissue domain which was subjected to axial, bending and torsional loads. It was found that the relative fragment motion induced a compressive strain field in the early callus tissue which could be utilised to simulate the formation of external callus structures through an iterative optimisation process of tissue maintenance and removal. The phenomenological results showed a high level of congruence with in vivo healing patterns found in the literature. Consequently, the proposed strategy shows potential as a means of predicting spatial bone healing phenomena for pre-clinical testing. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: The calcaneus is the largest and strongest tarsal bone. It is the most commonly fractured tarsal bone and accounts for about 2% of all fractures. The importance of the calcaneal angles in assessing the fractures of calcaneus and planning treatment has been highlighted. Aim: The purpose of this study was to evaluate the normal calcaneal angles in the Egyptian populations who live in Alexandria and nearby governorates and compare their values to the published data. Methods: Lateral plain radiographs of 220 normal feet and ankles of 103 males and 97 females with age ranged from 20 to 40years, were studied retrospectively at El Hadra University Hospital, Alexandria, Arabrepublic of Egypt between June and December 2010. Three of the normal calcaneal angles (Böhler angle–Gissane’s angle–calcaneal compression angle) were measured and the mean and standard deviation of each angle were calculated. The relationships between each angle and age, sex, side of the body, occupation, weight, height, and residence of examined persons was tested and compared to previous researches and international figures. Results: The mean of Böhler angle in the Egyptian population was 30.14±4.182 ranged from 22° to 40°. The mean of Gissane’s angle was 122.92±6.952 ranged from 108° to 138°, while the mean of calcaneal compression angle was 31.03±3.82 ranged from 24° to 44°. The measured calcaneal angles are not significantly related to age, sex, and side of the body, residence and occupation of the examined persons except there is significant negative correlation between the Böhler angle and the age which not reported in the previous researches and studies. Conclusion: The study showed that difference in the mean of the calcaneal angles from other previous studies that reinforce the importance of establishing the normal range of the calcaneal angles in a given population. [Copyright &y& Elsevier]

Injuries to connective tissues are painful and disabling and result in costly medical expenses. These injuries often require reattachment of an unmineralized connective tissue to bone. The uninjured tendon/ligament-to-bone insertion (enthesis) is a functionally graded material that exhibits a gradual transition from soft tissue (i.e., tendon or ligament) to hard tissue (i.e., mineralized bone) through a fibrocartilaginous transition region. This transition is believed to facilitate force transmission between the two dissimilar tissues by ameliorating potentially damaging interfacial stress concentrations. The transition region is impaired or lost upon tendon/ligament injury and is not regenerated following surgical repair or natural healing, exposing the tissue to risk of reinjury. The need to regenerate a robust tendon-to-bone insertion has led a number of tissue engineering repair strategies. This review treats the tendon-to-bone insertion site as a tissue structure whose primary role is mechanical and discusses current and emerging strategies for engineering the tendon/ligament-to-bone insertion in this context. The focus lies on strategies for producing mechanical structures that can guide and subsequently sustain a graded tissue structure and the associated cell populations. [ABSTRACT FROM AUTHOR]

Purpose. The knowledge regarding the mendosal suture is still on debate in the literature. Though reports of the closure of this childhood suture are variable, a few reports show the presence of the suture in the adults. This study was conducted to determine the occurrence and a better topographic location of the mendosal suture. Methods. We used 129 dry skulls for this study. In the specimens, which were determined to have a mendosal suture, the morphometric traits of the mendosal suture and the angle between the mendosal suture line and lambdoidal suture line (α angle) were measured. Results. We found mendosal suture on 18 specimens, 11 of them were bilateral and 7 were unilateral. The length of these sutures ranged from 10.4 to 23.8 mm on the right side and 10.8 to 31.6 mm on the left side, respectively. The angle between two suture lines ranged from 36 to 68° on the right side and 32 to 75° on the left side. Conclusions. We believe that, these data will be of use to clinicians in order to avoid any misinterpretation of the mendosal suture with cranial fractures. [ABSTRACT FROM AUTHOR]

Objectives: An experimental biomechanical evaluation of an instrumented intramedullary nail (TriGen®® META Nail, Smith&Nephew®®) was undertaken. The objectives were two-fold. The first was to identify the most sensitive strain gauge positions and orientations on the nail, and the second was to demonstrate that the nail was capable of detecting changes in stiffness of the nail--bone composite. The function of the instrumented nail is to quantify fracture healing objectively and directly, and so to predict delayed repair or non-union 2 months before current methods. Methods: Eight flat pockets were machined onto the surface of the nail and three strain gauges attached in each pocket. The instrumented nail was inserted into fourth generation biomechanical grade Sawbones®® tibiae with three different fracture configurations as well as into a non-fractured bone. The nail--bone composite was loaded in three-point bending at five positions to determine the strain changes in each of the eight strain gauge pockets located along the length of the nail. To simulate callus in the simplest way and to increase the stiffness of the nail--bone composite, loops of duct tape in multiples of four were applied over the fracture locus. A three-point loading jig was used to obtain the change in strain with increasing stiffness. Relative displacement of the bone ends was quantified using radiostereometric analysis. Results: There was no single position of greatest strain sensitivity for all fracture types. The greatest change in strain occurred when the strain gauge pocket and fracture line were closest. Applying the loading moment directly over the strain gauge pocket  also maximised its sensitivity. The duct tape callus simulation showed that the instrumented nail was able to detect a change in stiffness of less than 4.1 Nm/°°. Conclusions: It has been shown that the instrumented nail can detect physiologically relevant changes in stiffness, and so to provide a useful function as an objective monitor of fracture repair. [ABSTRACT FROM AUTHOR]

The aim of the study was to evaluate a hospital-based injury recording system on hip fracture registration in elderly persons aged + 65 years from 1994 through 2008, and to examine the agreement between the number of validated fractures and the number of fractures reported to the Norwegian Patient Registry using three different sources: (1) Medical records, (2) Patient administrative system and (3) The hospital's hip fracture record to the Norwegian Patient Registry from 2002 through 2008. The injury recording system included 582 hip fracture events and 535 (92%) were confirmed through the medical records. Reasons for non-verification were different coding failures. Searching the patient administrative system using ICD codes identified 16 hip fractures not included in the fracture registry between 2002 through 2008. The total number was the same as the number of hip fractures reported to the Norwegian Patient Registry using ICD codes alone for identification. The conclusion is that on well-defined diagnosis like hip fractures, local fracture registries may obtain a high degree of reliability if different sources are available for quality control. Well-functioning patient administrative systems may be used to study numbers of hip fractures. [ABSTRACT FROM AUTHOR]