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Background Ankle trauma in children and adolescents is the most common orthopedic injury encountered in pediatric trauma. It has long been recognized that a lateral ankle injury in this population is often a Salter and Harris type I fracture of the distal fibula (SH1). The purpose of this study is to confirm the existence of a lateral ankle sprain and to report the incidence of each pathology of the lateral ankle compartment: SH1 fracture, ATFL injury, and osteochondral avulsions. Methods A systematic review of the literature is done using the database provided by PubMed and Embase. All articles reporting the incidence of imaging modality-confirmed lateral ankle injury (SH1, ATFL injury, osteochondral avulsion) in children and adolescents were included. Exclusion criteria were the following: case reports or articles with less than ten subjects, unspecified imaging modality and articles unrelated to lateral ankle lesions. Thus, 237 titles and abstracts were selected, 25 were analyzed thoroughly, and 11 articles were included for final analysis. Results SH1 fractures were found in 0–57.5% of the cases in all series and 0–3% in the most recent series. A diagnosis of an ATFL injury was found in 3.2–80% and an osteochondral avulsion of the distal fibula in 6–28.1%. The most recent series report 76–80% and 62% for ATFL injury and osteochondral avulsion respectively. Conclusions There is a non-negligible incidence of ATFL sprains and fibular tip avulsions in patients with a suspected SH1 fracture of the distal fibula. According to recent evidence and MRI examinations, the most common injuries of the pediatric ankle are ATFL sprain and osteochondral avulsions. This should be taken into consideration in daily practice when ordering radiological examination and deciding on treatment modalities

International audience; The aim of the present study was to explore the influence of physical activity level on composite indices of femoral neck strength (compression strength index [CSI], bending strength index, and impact strength index) in a group of young overweight men. To do so, we compared composite indices of femoral neck strength in active overweight men and insufficiently active overweight men. They were divided into 2 groups based on their physical activity level: 70 active overweight men (engaging in more than 150 minutes of physical activity per week; 8.7 ± 4.8 h/wk) and 26 insufficiently active overweight men (engaging in less than 150 minutes of physical activity per week; 1.2 ± 0.7 h/wk). Height (m) and weight (kg) were measured, and body mass index (kg/m) was calculated. Bone mineral density was measured by dual-energy X-ray absorptiometry at whole body, lumbar spine, total hip, and femoral neck. Body weight, lean mass, fat mass, and body mass index were not significantly different between the 2 groups. CSI, bending strength index, and impact strength index were significantly higher in active overweight men compared to insufficiently active overweight men. After adjustment for age, physical activity (h/wk) and lean mass, only CSI remained higher in active overweight men compared to insufficiently active overweight men. This study suggests that, in young overweight men, being active (engaging in more than 150 minutes of physical activity per week) is associated with greater composite indices of femoral neck strength. To our knowledge, this is the first study that finds a significant difference regarding composite indices of femoral neck strength between 2 groups of young overweight men with different levels of physical activity.

Resume Introduction La pratique d’activites physiques a des effets benefiques sur la densite minerale osseuse chez les sujets normo-ponderes. Cependant, la relation entre le niveau d’activite physique et les parametres osseux chez les sujets en surcharge ponderale reste a eclaircir. Le but de cette etude etait de comparer les parametres osseux d’hommes sportifs en surcharge ponderale a des hommes sedentaires en surcharge ponderale. Methodes Au total, 40 jeunes hommes [18 a 32 ans] en surcharge ponderale (indice de masse corporelle > 25 kg/m 2 ) ont participe a cette etude. La population a ete divisee en deux groupes : hommes sportifs en surcharge ponderale ( n = 20) et hommes sedentaires en surcharge ponderale ( n = 20). Le poids et la taille des sujets ont ete mesures et l’indice de masse corporelle (IMC) a ete calcule. La composition corporelle, le contenu mineral osseux (CMO), la densite minerale osseuse (DMO) et la section transversale du col femoral (CSA CF) ont ete mesures par absorptiometrie biphotonique a rayons X (DXA). Le volume hebdomadaire d’activite physique a ete evalue par un questionnaire valide. Resultats Le CMO du corps entier (CE), la DMO CE, la DMO du rachis lombaire (L1-L4), la DMO CF et la CSA CF etaient significativement superieurs dans le groupe de sportifs par rapport au groupe de sedentaires. Ces differences ont disparu apres ajustement pour le volume hebdomadaire d’activite physique en utilisant une analyse de covariance. Enfin, dans l’ensemble de l’echantillon, le volume hebdomadaire d’activite physique etait positivement correle au CMO CE, a la DMO CE, a la DMO L1-L4, a la DMO HE, a la DMO CF et a la CSA CF. Conclusion Cette etude suggere que la pratique d’activites physiques ait un effet positif sur le CMO, la DMO et la section transversale du col femoral chez les hommes en surcharge ponderale. Niveau de preuve 3.

The Masquelet procedure proved its efficiency in treating infected nonunion filling bony gaps up to 25 cm. Yet the use of local antibiotics is still questionable in the daily practice with lack of evidence regarding its usefulness in controlling infection. An experimental rat model is put in place to study the antibacterial properties of the induced membrane produced during the first stage of Masquelet. Twenty-three-month-old wistar male rats are inoculated with a 0.5 mL solution of 10^8 CFU/mL MRSA over a critical fracture done on the right femur. Six weeks later, remaining 11 rats exhibiting signs of a chronic infection with a sinus tract and oozing pus along with radiological nonunion are used for a first stage Masquelet procedure. They are randomly divided into two groups with six rats having no local antibiotic in the cement mixture and five rats having 3 g of vancomycin mixed with gentamycin loaded cement. Six weeks later (twelve weeks from baseline), all eleven rats are euthanized and blood samples for C-reactive protein are withdrawn. The induced membrane is identified and resected along with bone fragments and sent for cultures and pathology. MRSA is isolated in the cultures of all six rats in the first group where no local antibiotic was added. Altered polymorphonuclears with abscess and pus are noted on four of six pathology samples. However in the second group where local antibiotics were added, three out of five rats exhibited eradication of MRSA (p = 0.034) and all samples did not exhibit clear infection signs on pathology. A pyo-epithelioid over a foreign body reaction is seen predominantly in this group demonstrating a regenerative process. The induced membrane does not have antimicrobial properties capable of overcoming an infected nonunion on its own. When local antibiotics were added during the first stage of the Masquelet procedure, new bone formation occurred indicating the need to control an infection in order for bone union to occur. Local antibiotics use in adjunction to extensive debridement is advisable during the first stage of a Masquelet procedure for an infected nonunion.

International audience; The purpose of this study was to investigate the relationships between maximal half-squat strength and bone variables in a group of young overweight men. 76 young overweight men (18 to 35 years) voluntarily participated in this study. Weight and height were measured, and body mass index (BMI) was calculated. Body composition, bone mineral content (BMC) and bone mineral density (BMD) and geometric indices of hip bone strength were determined for each individual by Dual-energy X-ray absorptiometry (DXA). Maximal half-squat strength was measured by a classical fitness machine (Smith machine) respecting the instructions of the national association of conditioning and muscular strength (NCSA). Maximal half-squat strength was positively correlated to WB BMC (r = 0.37; p < 0.01), WB BMD (r = 0.29; p < 0.05), L1–L4 BMC (r = 0.43; p < 0.001), L1–L4 BMD (r = 0.42; p < 0.001), TH BMC (r = 0.30; p < 0.01), TH BMD (r = 0.26; p < 0.05), FN BMD (r = 0.32; p < 0.01), FN cross-sectional area (CSA) (r = 0.44; p < 0.001), FN cross-sectional moment of inertia (CSMI) (r = 0.27; p < 0.05), FN section modulus (Z) (r = 0.37; p < 0.001) and FN strength index (SI) (r = 0.33; p < 0.01). After adjusting for lean mass, maximal half-squat strength remained significantly correlated to WB BMC (p = 0.003), WB BMD (p = 0.047), L1–L4 BMC (p < 0.001), L1–L4 BMD (p < 0.001), TH BMC (p = 0.046), FN BMD (p = 0.016), FN CSA (p < 0.001), FN Z (p = 0.003) and FN SI (p < 0.001). The current study suggests that maximal half-squat strength is a positive determinant of BMC, BMD and geometric indices of hip bone strength in young overweight men.

National audience; Introduction La masse osseuse est influencée par de nombreux facteurs comme la génétique, la nutrition, les concentrations de certaines hormones et les contraintes mécaniques (poids du corps et activité physique). Le pic de masse osseuse à 25 ans conditionne la courbe de décroissance de la densité minérale osseuse (DMO) menant à l’ostéoporose. Le but de ce travail était d’étudier les relations éventuelles entre des paramètres de santé facilement mesurables (facteurs anthropométriques, performances physiques et nutrition) et la BUA (Broadband Ultrasound attenuation ou atténuation du signal ultrasonore) mesurée au niveau du calcanéus. Méthodes Au total, 130 sujets (85 femmes et 45 hommes) âgés en moyenne de 21 ans (18 à 38 ans) ont participé à cette étude (Universanté-CEMHaVie). Le poids, la taille, la masse grasse, le tour de hanche et le tour de taille ont été mesurés et l’indice de masse corporelle (IMC) a été calculé. Le niveau de condition physique a été déterminé à l’aide de plusieurs tests : test de Sargent (TS), test de navette (TN) 4 × 10 m et test de force de préhension du poignet (FP). Des questionnaires validés ont été utilisés afin d’évaluer le niveau d’activité physique quotidien (Global Physical Activity Questionnaire [GPAQ]), l’indice de qualité du sommeil de Pittsburgh (IQSP) et la consommation calcique journalière (CCJ). L’atténuation du signal ultrasonique (BUA) a été mesurée au niveau du calcanéum par un appareil de type « Pegasus Smart Medlink® ». Résultats Chez les sujets féminins, le poids (r = 0,46 ; p < 0,001), l’indice de masse corporelle (r = 0,43 ; p < 0,001), la masse grasse (r = 0,27 ; p < 0,01), le tour de hanche (r = 0,25 ; p < 0,01) et le tour de taille (r = 0,31 ; p < 0,01) étaient positivement corrélés à la BUA. En revanche, nous n’avons pas retrouvé de corrélation entre la BUA et la quantité d’activité physique évaluée par le GPAQ, la condition physique (TS, TN et FP) et la consommation calcique journalière. Chez les hommes, aucune corrélation significative n’a été mise en évidence entre les paramètres mesurés et la BUA. Conclusion Les caractéristiques morphologiques mesurées dans notre étude (l’IMC, le poids, la masse grasse, le tour de hanche et le tour taille) semblent des déterminants de santé corrélés à la BUA chez les jeunes femmes mais pas chez les jeunes hommes. Ces corrélations paraissent intéressantes à étudier sur une population plus importante. Niveau de preuve III.

International audience; The aim of this study was to explore the relationships between performances obtained in different physical tests and bone parameters (bone mineral density [BMD], bone mineral content, hip geometry indices, and trabecular bone score [TBS]) in a group of young Lebanese overweight and obese adult men. Fifty-two overweight and/or obese (body mass index > 25 kg/m2) young men whose ages range from 18 to 35 yr participated in this study. Weight and height were measured, and body mass index was calculated. Body composition, BMD, cross-sectional area and section modulus (Z) of the femoral neck (FN), and TBS were measured by dual-energy X-ray absorptiometry. Maximum oxygen consumption (VO2 max, in liter per minute) was determined by direct measurement while exercising on a medical treadmill. One-repetition-maximum half-squat and maximum power (P max) of the lower limbs were measured using validated exercises. Lean mass was a positive determinant of whole-body bone mineral content (r = 0.71, p

6th International Work-Conference on Bioinformatics and Biomedical Engineering (IWBBIO), Granada, SPAIN, APR 25-28, 2018; International audience; The aim of this study was to compare Trabecular Bone Score (TBS) in overweight and normal-weight young women. This study included 14 overweight (BMI > 25 kg/m(2)) and 42 normal-weight (BMI < 25 kg/m(2)) young Lebanese women whose ages range from 18 to 32 years. Body composition, Bone Mineral Content (BMC), Bone Mineral Density (BMD), and lumbar spine (L1-L4) TBS were assessed by dual-energy X-ray asborptiometry (DXA). The DXA measurements were completed for the whole body (WB), the lumbar spine (L1-L4), the total hip (TH) and the femoral neck (FN). Physical activity, daily calcium intake, daily protein intake and sleep quality index were evaluated using validated questionnaires. Maximal oxygen consumption (VO2 max in l/mn) was measured whilst exercising on a bicycle ergometer using a specialized device. Weight, height, BMI, lean mass, fat mass, WB BMC, WB BMD, TH BMD and FN BMD were significantly higher in overweight women compared to normal-weight women. Trabecular Bone Score (TBS) was not significantly different between the two groups (overweight and normal-weight). In the whole population (n = 56), weight, height, BMI, lean mass and fat mass were positively correlated to BMC and BMD values but not to TBS values. VO2 max (l/mn) was positively correlated to BMC, BMD and TBS (p < 0.05). This study suggests that being overweight is not associated with higher trabecular bone score values in young women.

The aim of this study was to explore the relationship between maximal oxygen consumption (VO2 max; mL/mn/kg) and composite indices of femoral neck strength in a group of young women. 41 young women whose ages ranged from 18 to 35 years participated in the present study. Femoral neck bone mineral density was measured by DXA. Composite indices of femoral neck strength (CSI, BSI and ISI) were calculated. VO2 max (mL/mn/kg) of the participants was measured using a Cosmed Fitmate pro device (version 2.20) while exercising on a bicycle ergometer (Siemens-Elema RE 820; Rodby Elektronik AB, Enhorna, Sweden). VO2 max (mL/mn/kg) was positively correlated to CSI (r = 0.52; p < 0.001) and ISI (r = 0.45; p < 0.01). The positive associations between VO2 max (mL/mn/kg) and these two indices (CSI and ISI) remained significant after controlling for body mass index using multiple linear regression models.

International audience

The aim of the current study was to compare compression strength index (CSI), bending strength index (BSI) and impact strength index (ISI) among obese, overweight and normal-weight young women. 117 young women (20 obese, 36 overweight and 61 normal-weight) whose ages range from 18 to 35 years participated in this study. Body composition and BMD were evaluated by dual-energy X-ray absorptiometry (DXA). CSI, BSI and ISI values were significantly lower in obese and overweight women compared to normal-weight women (p < 0.001). In the whole population (n = 117), body mass index (BMI) was negatively correlated to CSI (r = −0.66; p < 0.001), BSI (r = −0.56; p < 0.001) and ISI (r = −0.54; p < 0.001). This study suggests that obesity is associated with lower CSI, BSI and ISI values in young women.

Introduction The aim of this study was to explore the relationships between performances obtained in different physical tests and bone parameters (bone mineral density (BMD) and bone mineral content (BMC)) in a group of young Lebanese adults. Methods One hundred and six young Lebanese adults (45 women and 61 men) whose ages range from 17 to 34 years participated in this study. Weight and height were measured, and body mass index (BMI) was calculated. Daily calcium intake, daily protein intake and physical activity level (h/week) were evaluated using validated questionnaires. The level of physical performance was measured using several physical tests: vertical-jump test, standing long jump test, 3-jumptest, 5-jump-test and 1-RM half-squat. Body composition, bone mineral content (BMC) and BMD at whole body (WB), lumbar spine (L2-L4), total hip (TH) and femoral neck (FN) were measured by dual-energy X-ray absorptiometry (DXA). Results In women, height, lean mass, 1- RM half-squat and performances obtained in three physical tests (vertical jump test, 5-jump-test and 1-RM halfsquat) were positively correlated to BMD and BMC. In men, lean mass and 1-RM half-squat were positively correlated to BMD and BMC. Conclusion This study suggests that lean mass and maximum strength obtained in half-squat are positively correlated to BMD in young adults.

International audience; Letter to the Editor