Radiographic Interpretation of the Third Phalanx, Hoof Wall, and Soft Tissue Structures in the Foot

Author(s):  
Sebastian Halm ◽  
David Haberthür ◽  
Elisabeth Eppler ◽  
Valentin Djonov ◽  
Andreas Arnold

Abstract Introduction This pilot study explores whether a human Thiel-embalmed temporal bone is suitable for generating an accurate and complete data set with micro-computed tomography (micro-CT) and whether solid iodine-staining improves visualization and facilitates segmentation of middle ear structures. Methods A temporal bone was used to verify the accuracy of the imaging by first digitally measuring the stapes on the tomography images and then physically under the microscope after removal from the temporal bone. All measurements were compared with literature values. The contralateral temporal bone was used to evaluate segmentation and three-dimensional (3D) modeling after iodine staining and micro-CT scanning. Results The digital and physical stapes measurements differed by 0.01–0.17 mm or 1–19%, respectively, but correlated well with the literature values. Soft tissue structures were visible in the unstained scan. However, iodine staining increased the contrast-to-noise ratio by a factor of 3.7 on average. The 3D model depicts all ossicles and soft tissue structures in detail, including the chorda tympani, which was not visible in the unstained scan. Conclusions Micro-CT imaging of a Thiel-embalmed temporal bone accurately represented the entire anatomy. Iodine staining considerably increased the contrast of soft tissues, simplified segmentation and enabled detailed 3D modeling of the middle ear.


2016 ◽  
Vol 18 (1) ◽  
pp. 357-385 ◽  
Author(s):  
Will Goth ◽  
John Lesicko ◽  
Michael S. Sacks ◽  
James W. Tunnell

2018 ◽  
Vol 301 (10) ◽  
pp. 1745-1763
Author(s):  
Bradley M. Wood ◽  
Guang Jia ◽  
Owen Carmichael ◽  
Kevin Mcklveen ◽  
Dominique G. Homberger

2020 ◽  
Vol 34 (1) ◽  
pp. 73-86
Author(s):  
F. Neisskenwirth

Abstract Different procedures are proposed in the literature for the rehydration of dried-out specimens. These procedures vary greatly in their efficiency and application. This work describes a new procedure that is inspired by the literature but that avoids heating the specimens. This method was applied to reconditioning dried-out specimens from a historical collection (Swiss freshwater fishes, bird brains, and bird eyes), stored at the Naturhistorisches Museum Bern in Switzerland. The procedure consists of five steps. The first step is the softening of hardened soft tissue with benzaldehyde and demineralized water. The second step is an indirect rehydration with water vapor. The third step is a chemically induced direct hydration using a trisodium phosphate solution that allows the specimen to swell in size before being washed with water to remove all additives. Finally, the rehydrated specimen is transferred into new preserving fluid. Because the dehydrating properties of ethanol as a preservative are problematic, this paper presents the results of an experimental case study using a glycerol solution as a preservation fluid.


2016 ◽  
Vol 04 (03) ◽  
pp. 189-194
Author(s):  
Isha Aggarwal ◽  
Manu Wadhawan

Abstract Introduction: The great variance in soft-tissue drape of the human face complicates accurate assessment of the soft-tissue profile and it is a known fact that facial features of different ethnic groups differ significantly. This study was undertaken to establish soft tissue norms for Himachali ethnic population. Method: The sample comprised lateral cephalograms taken in natural head position of 100 normal subjects (50 males, 50 females). The cephalograms were analyzed by Arnett soft tissue cephalometric analysis for orthodontic diagnosis and treatment planning. The Student t test was used to compare the means of the 2 groups. Results: Statistically significant differences were found between Himachali males and females in certain key parameters. Males have thicker soft-tissue structures than females. Whereas females have greater interlabial gap when compared with Himachali males. When compared with other ethnic groups, Himachali subjects have thicker soft tissue structures. Conclusions: Statistically significant differences were found between Himachali males and females in certain key parameters. Differences were also noted between other ethnic groups and Himachali faces.


2018 ◽  
Vol 5 (1) ◽  
pp. 5
Author(s):  
Jaron Pettis ◽  
Neelam Mulji ◽  
Fernando A. Navarro

Background: Necrotizing fasciitis is a potentially lethal soft tissue infection characterized by rampant necrosis and destruction of subcutaneous tissues. Current estimates of necrotizing soft tissue infections in the United States are 4.3 infections per 100,000 of the population. Although the incidence of necrotizing soft tissue infections has decreased in the last decade, the toxic and lethal nature of the disease process lends utmost importance to accurate diagnosis and immediate management. The purpose of this review article is to report three cases of necrotizing fasciitis and provide literature review in regards to hallmark characteristics, predisposing risk factors and treatment optimization.Case: The first case depicts a newly diagnosed 43-year-old male HIV patient with necrotizing fasciitis infection characterized by Klebsiella, Serratia and anaerobic bacteria cultures. The second case describes the course of a 71-year-old male diagnosed with necrotizing fasciitis in the setting of a complicated anal fistula characterized by B. fragilis, S. anginosus and Prevotella species. The third and final case describes the course of a 44-year-old female diagnosed with necrotizing fasciitis in the setting of Ludwig’s Angina characterized by Klebsiella and Dubliensis species. Treatment was initiated with extensive wound debridement, multiple washouts and broad antibiotic regimens in all three cases. Additional hyperbaric oxygen therapy was administered in the third case.Conclusions: These case reports illustrate the range of severity and settings in which necrotizing fasciitis can occur. Significant morbidity and mortality rates are associated with a delay in treatment initiation. Given this, it is of utmost importance to develop and maintain a high clinical acumen for necrotizing soft tissue infections.


2012 ◽  
Vol 69 (12) ◽  
pp. 1076-1083 ◽  
Author(s):  
Marija Bubalo ◽  
Zoran Lazic ◽  
Smiljana Matic ◽  
Zoran Tatic ◽  
Radomir Milovic ◽  
...  

Background/Aim. A wide range of resorbable and nonresorbable membranes have been investigated over the last two decades. The barrier membrane protects the defect from ingrowth of soft tissue cells and allows bone progenitor cells to develop bone within a blood clot that is formed beneath the barrier membrane. The membranes are applied to reconstruct small bony defect prior to implantation, to cover dehiscences and fenestrations around dental implants. The aim of this study was to evaluate the influence of human resorbable demineralized membrane (RHDM) thickness on bone regeneration. Methods. The experiment, approved by Ethical Committee, was performed on 6 dogs and conducted into three phases. Bone defects were created in all the 6 dogs on the left side of the mandible, 8 weeks after extraction of second, third and fourth premolars. One defect was covered with RHDM 100 ? thick, one with RHDM 200 ? thick, and the third defect left empty (control defect). The histopathological analysis was done 2, 4 and 6 months after the surgery. In the third phase samples of bone tissue were taken and subjected to histopathological analysis. Results. In all the 6 dogs the defects treated with RHDM 200 ? thick showed higher level of bone regeneration in comparison with the defect treated with RHDM 100 ? thick and especially with empty defect. Conclusion. Our results demonstrated that the thicker membrane showed the least soft tissue ingrowths and promoted better bone formation at 6 months compared with a thinner one.


2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Arshad S. Khan ◽  
Girish D. Bakhshi ◽  
Aftab Shaikh ◽  
Ashraf A. Khan ◽  
Adil A. Khan ◽  
...  

Extraskeletal myxoid chondrosarcoma (ESMC) is a rare tumor seen more often in men. It is seen to arise from soft tissue of lower extremity or buttocks. We report a case of soft tissue swelling of left labium majus in a 66-year-old female. Patient underwent wide excision with uneventful postoperative course. Histopathology of specimen confirmed it to be ESMC. Patient refused adjuvant therapy. Followup of 1 year has shown her to be disease- and symptom- free. Only two cases arising from vulva have been reported in literature . This is the third case and first from Indian subcontinent. A brief review of clinical features, diagnosis, treatment, and outcome of patients with extraskeletal chondrosarcoma is presented.


Author(s):  
Eik Siggelkow ◽  
Iris Sauerberg ◽  
Francesco Benazzo ◽  
Marc Bandi

Passive knee kinematics and kinetics following total knee replacement (TKR) are dependent on the topology of the component joint surfaces as well as the properties of the passive soft tissue structures (ligaments and capsule). Recently, explicit computer models have been used for the prediction of knee joint kinematics based on experimental investigations [1]. However, most of these models replicate experimental knee simulators [2], which simulate soft tissue structures using springs or elastomeric structures. New generations of experimental setups deploy industrial robots for measuring kinematics and kinetics in six degrees of freedom as well as the contribution of soft tissue structures. Based on these experiments, accurate soft tissue properties are available for use in computer models to aid more realistic predictions of kinematics. Final evidence of the quality of the kinematic predictions from these computer models can be provided by direct validation of the models against experimental data. Therefore, the objective of this study was to use in vitro robotic test data to develop, verify, and validate specimen specific virtual models suitable for predicting laxity and kinematics of the reconstructed knee.


2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0020
Author(s):  
Cesar de Cesar Netto ◽  
Lauren Roberts ◽  
Alexandre Godoy Dos Santos ◽  
Jackson Staggers ◽  
Sung Lee ◽  
...  

Category: Trauma Introduction/Purpose: Fractures of the talar neck and body can be fixed with percutaneously placed screws directed from anterior to posterior or posterior to anterior. The latter has been found to be biomechanically and anatomically superior. Percutaneous pin and screw placement poses anatomic risks for posterolateral and posteromedial neurovascular and tendinous structures. The objective of this study was to enumerate the number of trials for proper placement of two parallel screws and to determine the injury rate to neurovascular and tendinous structures. Methods: Eleven fresh frozen cadaver limbs were used. 2.0 mm guide wires from the Stryker (Selzach, Switzerland) 5.0-mm headless cannulated set were percutaneously placed (under fluoroscopic guidance) into the distal posterolateral aspect of the ankle. All surgical procedures were performed by a fellowship-trained foot and ankle surgeon. Malpositioned pins were left intact to allow later assessment of soft tissue injury. The number of guide wires needed to achieve an acceptable positioning of the implant was noted. Acceptable positioning was defined as in line with the talar neck axis in both AP and lateral fluoroscopic views. After a layered dissection from the skin to the tibia, we evaluated neurovascular and tendinous injuries, and measured the shortest distance between the closest guide pin and the soft tissue structures, using a precision digital caliper. Results: The mean number of guide wires needed to achieve acceptable positioning for 2 parallel screws was 2.91 ± 0.70 (range, 2 - 5). The mean distances between the closest guide pin and the soft tissue structures of interest were: Achilles tendon, 0.53 ± 0.94 mm; flexor hallucis longus tendon, 6.62 ± 3.24 mm; peroneal tendons, 7.51 ± 2.92 mm; and posteromedial neurovascular bundle, 11.73 ± 3.48 mm. The sural bundle was injured in all the specimens, with 8/11 (72.7%) in direct contact with the guide pin and 3/11 (17.3%) having been transected. The peroneal tendons were transected in 1/11 (9%) of the specimens. The Achilles tendon was in contact with the guide pin in 6/11 (54.5%) specimens and transected in 2/11 (18.2%) specimens. Conclusion: The placement of posterior to anterior percutaneous screws for talar neck fixation is technically demanding and multiple guide pins are needed. Our cadaveric study showed that important tendinous and neurovascular structures are in close proximity with the guide pins and that the sural bundle was injured in 100% of the cases. We advise performing a formal small posterolateral approach for proper visualization and retraction of structures at risk. Regardless, adequate patient education about the high risk of injury from this procedure is crucial.


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