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Higuchi J, Matsumoto T, Kasai T, Takeda R, Iidaka T, Horii C, Oka H, Muraki S, Hashizume H, Yamada H, Yoshida M, Nakamura K, Tanaka S, Yoshimura N. Relationship between medial partite hallux sesamoid and hallux valgus in the general population. Foot Ankle Surg 2023; 29:621-626. [PMID: 37679197 DOI: 10.1016/j.fas.2023.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 06/25/2023] [Accepted: 07/24/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND An association between the medial partite hallux sesamoid (MPHS) and hallux valgus (HV) has been suggested; however, a causal relationship has not been confirmed. This study aimed to determine their causal relationship using a cross-sectional radiographic survey of a large-scale population cohort covering a wide age group. PATIENTS AND METHODS The fifth survey of the Research on Osteoarthritis/Osteoporosis against Disability study involved 1997 participants aged 21-95 years who had undergone anteroposterior radiography of bilateral feet. The presence of MPHS, its morphology, and radiographic parameters related to the HV were assessed using radiographs. Changes in the prevalence of MPHS with age were assessed using trend tests. The relationship between the MPHS and HV was assessed based on sex and age. RESULTS MPHS was found in 508 out of 3994 feet (12.7 %), with a significant difference in prevalence between men and women (10.0 % vs. 13.7 %, p < 0.001). Trend analysis demonstrated a significant decrease in MPHS occurrence with age in both sexes. HV angle was significantly higher in feet with MPHS than in those without (Men: 17.8 ± 7.0° vs. 14.0 ± 5.9°, p < 0.0001; Women: 19.6 ± 7.7° vs. 17.7 ± 7.9°, p < 0.0001). The prevalence of HV angle ≥ 20° was also significantly higher in feet with MPHS than in those without (Men: 33.3 % vs. 14.6 %, p < 0.0001; Women: 46.5 % vs. 34.6 %, p < 0.0001). This association between MPHS and HV was noticeable in younger adults and became less prominent with age. CONCLUSIONS MPHS is associated with HV. The weakening of this relationship and the decreased prevalence of MPHS with age suggest that MPHS is not caused by HV, but is one of the causes of HV, especially in younger adults.
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Affiliation(s)
- Junya Higuchi
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Japan
| | - Takumi Matsumoto
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Japan.
| | - Taro Kasai
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Japan
| | - Ryutaro Takeda
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Japan
| | - Toshiko Iidaka
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical & Research Center, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - Chiaki Horii
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Japan
| | - Hiroyuki Oka
- Division of Musculoskeletal AI System Development, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shigeyuki Muraki
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical & Research Center, Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - Hiroshi Hashizume
- School of Health and Nursing Science, Wakayama Medical University, Wakayama, Japan; Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Hiroshi Yamada
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan
| | - Munehito Yoshida
- Department of Orthopaedic Surgery, Wakayama Medical University, Wakayama, Japan; Sumiya Orthopaedic Hospital, Wakayama, Japan
| | | | - Sakae Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Japan
| | - Noriko Yoshimura
- Department of Preventive Medicine for Locomotive Organ Disorders, 22nd Century Medical & Research Center, Faculty of Medicine, University of Tokyo, Tokyo, Japan
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The hallucal interphalangeal ossicle: anatomy and basis for ultrasound-guided surgical shaving. Sci Rep 2022; 12:4789. [PMID: 35314733 PMCID: PMC8938480 DOI: 10.1038/s41598-022-08805-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 03/03/2022] [Indexed: 11/09/2022] Open
Abstract
Painful lesions on the plantar aspect of the first interphalangeal joint (IPJ) of the hallux can be attributed to structures called ossicles, nodules, or sesamoids. The aims of the present study were first to verify that ultrasonography (US) is a high-sensitivity tool for diagnosing an interphalangeal ossicle (IO), and second to prove that US-guided-shaving surgery ("milling") is a safe and feasible technique for remodeling the IO. The study is divided into three parts. In the first part, the prevalence of IOs was estimated in 12 cadaver feet using US, anatomical dissection, and fluoroscopy. In the second, a detailed US and morphological description of the IO was obtained. In the third, six cadaver feet were subjected to surgical milling. IO prevalence was 41.6% in gross anatomy, 41.6% in US examination and just 16.6% in fluoroscopy. The ossicles had a mean length of 4 mm (± 2 mm) and a width of 7 mm (± 2 mm). The ossicles could be completely shaved in all specimens without injuring important anatomical structures. Our results indicate that US is a more precise tool for diagnosing an IO than X-ray. Moreover, our US-guided mini-invasive surgical technique appears feasible and safe.
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Alcalá Sanz J, Nogales Gómez P. Resolución quirúrgica de un sesamoideo interfalángico del hallux. REVISTA ESPAÑOLA DE PODOLOGÍA 2022. [DOI: 10.20986/revesppod.2022.1645/2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Berthaume MA, Bull AMJ. Cyamella (a popliteal sesamoid bone) prevalence: A systematic review, meta-analysis, and proposed classification system. Clin Anat 2021; 34:810-820. [PMID: 33905585 DOI: 10.1002/ca.23743] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 01/26/2021] [Accepted: 03/01/2021] [Indexed: 01/05/2023]
Abstract
The cyamella is a rare, generally asymptomatic, knee sesamoid bone located in the proximal tendon of the popliteal muscle. Only two studies have investigated cyamella presence/absence in humans, putting ossified prevalence rates at 0.57%-1.8%. We aim to (a) determine cyamella prevalence in a Korean population, (b) examine coincident development of the cyamella and fabella, and (c) perform a systematic review and meta-analysis on the cyamella in humans. Medical computed tomography scans of 106 individuals were reviewed. A systematic review and meta-analysis were performed following PRISMA guidelines. Cyamellae were found in 3/212 knees (1.4%), and presence/absence was uncorrelated to height, age, and sex. The cyamella was not found coincidentally with the fabella, although the statistical power was low. Our systematic review/meta-analysis revealed cyamellae were generally asymptomatic and ossification could occur at 14 years. Cyamellae were equally likely to be found in both sexes, knees, one or both knees, and there appeared to be no global variation in prevalence rates. Cyamellae were found in three distinct locations. There is little support for the role of intrinsic genetic and/or environmental factors in cyamella development in humans. However, the apparent phylogenetic signal in Primates suggests genetics plays a role in cyamella development. We propose a cyamella classification system based on cyamella location (Class I, popliteal sulcus; Class II, tibial condyle; Class III, fibular head) and hypothesize locations may correspond to distinct developmental pathways, and cyamella function may vary with location.
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Affiliation(s)
- Michael A Berthaume
- Department of Bioengineering, Imperial College London, London, UK.,Division of Mechanical Engineering and Design, London South Bank University, London, UK
| | - Anthony M J Bull
- Department of Bioengineering, Imperial College London, London, UK
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Sun T, Li Q, Wang L, Hou X, Zhao H, Niu M, Zhang T, Wu W. Ossification timeline of sesamoid bones at metatarsophalangeal joints. Anat Sci Int 2020; 96:55-61. [PMID: 32632742 DOI: 10.1007/s12565-020-00556-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 06/29/2020] [Indexed: 11/24/2022]
Abstract
Ossification timeline is a critical issue in studies regarding sesamoid bones at metatarsophalangeal (MTP) joints, but actual knowledge is still incomplete. The present study determines the cutoff age of sesamoids ossification at MTP joints. We conducted a retrospective review of radiographs of the feet from 5553 males and 3225 females between November 2005 and September 2012 to identify presence of sesamoids at 5 MTP joints and 3 variations of hallucal sesamoids. Age-specific prevalence of each presence and variations was calculated and clustered to produce latent age groups corresponding to the sesamoid ossification process in males and females, respectively. Males older than 7 years of age were divided into 5 age groups (8-11, 12-15, 16-29, 30-76, and 77-92 years), while females were classified into 4 age groups (8-11, 12-26, 27-76, and 77-92 years). According to the characteristics of sesamoid prevalence in each age group, the pre-ossification stage was defined at age 1-7 years in both genders and the ossifying stage was defined at age 8-29 years in males and 8-26 years in females. We also defined ossified stage as age 30-92 years in male and 27-92 years in females. The ossifying and ossified stages include 2 or 3 substages in both genders. A clustering analysis provided novel cutoff age points as ossification timelines for the sesamoid bones at MTP joints in males and females, which may have an impact on future sesamoid and skeletal development research.
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Affiliation(s)
- Tao Sun
- Department of Orthopaedic Surgery, Hebei Medical University, Third Affiliated Hospital, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, China.
| | - Qian Li
- Health Informatics Institute, University of South Florida, Tampa, FL, 33612, USA
| | - Lingxiang Wang
- Department of Gynecology, Hebei Medical University Fourth Affiliated Hospital and Hebei Provincial Tumor Hospital, Shijiazhuang, 05011, Hebei, China
| | - Xizhi Hou
- Department of Orthopaedic Surgery, Shijiazhuang The Third Hospital, Shijiazhuang, 05017, Hebei, China
| | - Haitao Zhao
- Department of Orthopaedic Surgery, Hebei Medical University, Third Affiliated Hospital, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, China
| | - Mengjing Niu
- Department of Orthopaedic Surgery, Hebei Medical University, Third Affiliated Hospital, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, China
| | - Ting Zhang
- Department of Orthopaedic Surgery, Hebei Medical University, Third Affiliated Hospital, 139 Ziqiang Road, Shijiazhuang, 050051, Hebei, China
| | - Wenjuan Wu
- Department of Radiology, Hebei Medical University, Third Affiliated Hospital, Shijiazhuang, 050051, Hebei, China
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Os Conundrum: Identifying Symptomatic Sesamoids and Accessory Ossicles of the Foot. AJR Am J Roentgenol 2019; 213:417-426. [DOI: 10.2214/ajr.18.20761] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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7
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Abdala V, Vera MC, Amador LI, Fontanarrosa G, Fratani J, Ponssa ML. Sesamoids in tetrapods: the origin of new skeletal morphologies. Biol Rev Camb Philos Soc 2019; 94:2011-2032. [PMID: 31359608 DOI: 10.1111/brv.12546] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 06/24/2019] [Accepted: 06/26/2019] [Indexed: 02/06/2023]
Abstract
Along with supernumerary bones, sesamoids, defined as any organized intratendinous/intraligamentous structure, including those composed of fibrocartilage, adjacent to an articulation or joint, have been frequently considered as enigmatic structures associated with the joints of the skeletal system of vertebrates. This review allows us to propose a dynamic model to account for part of skeletal phenotypic diversity: during evolution, sesamoids can become displaced, attaching to and detaching from the long bone epiphyses and diaphysis. Epiphyses, apophyses and detached sesamoids are able to transform into each other, contributing to the phenotypic variability of the tetrapod skeleton. This dynamic model is a new paradigm to delineate the contribution of sesamoids to skeletal diversity. Herein, we first present a historical approach to the study of sesamoids, discussing the genetic versus epigenetic theories of their genesis and growth. Second, we construct a dynamic model. Third, we present a summary of literature on sesamoids of the main groups of tetrapods, including veterinary and human clinical contributions, which are the best-studied aspects of sesamoids in recent decades. Finally, we discuss the identity of certain structures that have been labelled as sesamoids despite insufficient formal testing of homology. We also propose a new definition to help the identification of sesamoids in general. This review is particularly timely, given the recent increasing interest and research activity into the developmental biology and mechanics of sesamoids. With this updated and integrative discussion, we hope to pave the way to improve the understanding of sesamoid biology and evolution.
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Affiliation(s)
- Virginia Abdala
- Cátedra de Biología General, Facultad de Ciencias Naturales e IML, UNT, Miguel Lillo 205, 4000, San Miguel de Tucumán, Argentina.,Instituto de Biodiversidad Neotropical, CONICET- UNT, Horco Molle s/n Yerba Buena, 4107, Tucumán, Argentina
| | - Miriam C Vera
- Instituto de Biología Subtropical (CONICET-UNaM), Facultad de Ciencias Exactas Químicas y Naturales, Universidad Nacional de Misiones, Félix de Azara 1552, CPA N3300LQF, Posadas, Argentina
| | - Lucila I Amador
- Unidad Ejecutora Lillo, FML-CONICET, Miguel Lillo 251, 4000, San Miguel de Tucumán, Argentina
| | - Gabriela Fontanarrosa
- Instituto de Biodiversidad Neotropical, CONICET- UNT, Horco Molle s/n Yerba Buena, 4107, Tucumán, Argentina
| | - Jessica Fratani
- Unidad Ejecutora Lillo, FML-CONICET, Miguel Lillo 251, 4000, San Miguel de Tucumán, Argentina
| | - María L Ponssa
- Unidad Ejecutora Lillo, FML-CONICET, Miguel Lillo 251, 4000, San Miguel de Tucumán, Argentina
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Berthaume MA, Di Federico E, Bull AMJ. Fabella prevalence rate increases over 150 years, and rates of other sesamoid bones remain constant: a systematic review. J Anat 2019; 235:67-79. [PMID: 30994938 PMCID: PMC6579948 DOI: 10.1111/joa.12994] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2019] [Indexed: 01/13/2023] Open
Abstract
The fabella is a sesamoid bone located behind the lateral femoral condyle. It is common in non-human mammals, but the prevalence rates in humans vary from 3 to 87%. Here, we calculate the prevalence of the fabella in a Korean population and investigate possible temporal shifts in prevalence rate. A total of 52.83% of our individuals and 44.34% of our knees had fabellae detectable by computed tomography scanning. Men and women were equally likely to have a fabella, and bilateral cases (67.86%) were more common than unilateral ones (32.14%). Fabella presence was not correlated with height or age, although our sample did not include skeletally immature individuals. Our systematic review yielded 58 studies on fabella prevalence rate from 1875-2018 which met our inclusion criteria, one of which was an outlier. Intriguingly, a Bayesian mixed effects generalized linear model revealed a temporal shift in prevalence rates, with the median prevalence rate in 2000 (31.00%) being ~ 3.5 times higher than that in 1900 (7.64%). In all four countries with studies before and after 1960, higher rates were always found after 1960. Using data from two other systematic reviews, we found no increase in prevalence rates of 10 other sesamoid bones in the human body, indicating that the increase in fabella prevalence rate is unique. Fabella presence/absence is due to a combination of genetic and environmental factors: as the prevalence rates of other sesamoid bones have not changed in the last 100 years, we postulate the increase in fabella prevalence rate is due to an environmental factor. Namely, the global increase in human height and weight (due to improved nutrition) may have increased human tibial length and muscle mass. Increases in tibial length could lead to a larger moment arm acting on the knee and on the tendons crossing it. Coupled with the increased force from a larger gastrocnemius, this could produce the mechanical stimuli necessary to initiate fabella formation and/or ossification.
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Yammine K. The Relationship Between Digit Independence and Digital Sesamoids in Humans and a Proposal of a New Digital Sesamoid Evolutionary Hypothesis. Anat Rec (Hoboken) 2018; 301:1046-1060. [DOI: 10.1002/ar.23774] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 10/29/2017] [Accepted: 11/06/2017] [Indexed: 11/08/2022]
Affiliation(s)
- Kaissar Yammine
- The Foot & Hand Clinic and The Center for Evidence-based Anatomy, Jdeideh Highway; Beirut Lebanon
- Lebanese American University Medical Center-Rizk Hospital; Achrafieh Lebanon
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Fiacco RC, Ream GM, Wilson C, Tubbs RS, Loukas M, Kozlowski PB, DiLandro AC, Jules KT, D'Antoni AV. Relationship Between the Intersesamoid Ligament and Sesamoid Bones in Cadaveric Feet with Hallux Valgus. Cureus 2017; 9:e1819. [PMID: 29312840 PMCID: PMC5752227 DOI: 10.7759/cureus.1819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
There is heterogeneity in the literature regarding the anatomy, exact location, and definition of the intersesamoid ligament (IL). Anatomic knowledge of the IL and its variations are important for surgeons who undertake corrective surgery for hallux abducto valgus (HAV). The IL was dissected in 16 feet from 32 formalin-fixed cadavers (12 females, four males; mean age at death, 76.6 years) to examine its morphology. The length, width, and thickness of its constituent bands were recorded with a digital caliper. Descriptive and correlational statistics were used to investigate the relationships between band size, age at death, and sex. A literature review was conducted to compare our data to those of previous studies. Results suggest that the size of the sesamoids may change as a result of HAV deforming forces, which may cause lengthening of the IL. The IL stabilizes the sesamoid apparatus of the first metatarsophalangeal joint (MPJ) and should be evaluated in HAV correction. Anatomic knowledge of the complex morphology and relations between the IL and sesamoids is critically important for surgeons correcting HAV deformities.
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Affiliation(s)
| | | | | | | | - Marios Loukas
- Department of Anatomical Sciences, St. George's University School of Medicine, Grenada, West Indies
| | | | - Anthony C DiLandro
- Division of Pre Clinical Sciences, New York College of Podiatric Medicine
| | - Kevin T Jules
- Department of Surgery, New York College of Podiatric Medicine
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Sun T, Zhao H, Wang L, Wu W. Partite hallux sesamoid bones: Relationship with sesamoid bones at other metatarsophalangeal joints. Anat Rec (Hoboken) 2017; 301:34-38. [PMID: 29024479 DOI: 10.1002/ar.23696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 03/27/2017] [Accepted: 04/19/2017] [Indexed: 11/10/2022]
Abstract
Partite hallux sesamoids are clinically meaningful but their association with other sesamoids is not clear. The objective was to relate the prevalence of the partite hallux sesamoid bones to sesamoid bones at other metatarsophalangeal (MTP) joints. We conducted a retrospective review of plain radiographs of 7946 adult feet between November 2005 and September 2012 to identify partite hallux sesamoids and sesamoids at other MTP joints. Coexistence patterns of the partition and extra sesamoids were studied. Presence or absence of sesamoids at other MTP joints as well as sex and laterality were compared between the feet with and without partite hallux sesamoids using Pearson Chi-square test. Association between age and partition was evaluated using Spearman's correlation coefficient. Overall partite prevalence rate is 6.82%, and coexistence with extra MTP sesamoids was 0.42%. One pattern was partition in hallux sesamoid only, and 4 patterns were coexistence with extra sesamoids. The prevalence rates of partite hallux sesamoids were 7.17% (508/7081) and 3.93% (34/865) in feet without and with extra sesamoids, respectively. The relative risk of 1.889 (95% CI, 1.325-2.693) of partite hallux sesamoids was noted in feet without than with extra sesamoids (Χ2 = 12.759, P < 0.001). A negative correlation between age and distribution of partition was identified (r = -0.061, P < 0.001). Partition of hallux sesamoid bones is a developmental variation, it can coexist with sesamoids at other MTP joints following a certain pattern; and its prevalence rate is almost twice higher in feet without than with extra MTP sesamoids. Anat Rec, 2017. © 2017 Wiley Periodicals, Inc. Anat Rec, 301:34-38, 2018. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Tao Sun
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, 050051, China
| | - Haitao Zhao
- Department of Orthopaedic Surgery, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, 050051, China
| | - Lingxiang Wang
- Department of Gynecology, Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, 050011, China
| | - Wenjuan Wu
- Department of Radiology, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, 050051, China
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Koo BS, Song Y, Lee S, Sung YK, Sung IH, Jun JB. Prevalence and distribution of sesamoid bones and accessory ossicles of the foot as determined by digital tomosynthesis. Clin Anat 2017; 30:1072-1076. [DOI: 10.1002/ca.22952] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 07/12/2017] [Indexed: 12/14/2022]
Affiliation(s)
- Bon San Koo
- Department of Internal Medicine; Inje University Seoul Paik Hospital, Inje University College of Medicine; Seoul Republic of Korea
| | - Yoonah Song
- Department of Radiology; Hanyang University Hospital for Rheumatic Diseases; Seoul Republic of Korea
| | - Seunghun Lee
- Department of Radiology; Hanyang University Hospital for Rheumatic Diseases; Seoul Republic of Korea
| | - Yoon-Kyoung Sung
- Department of Rheumatology; Hanyang University Hospital for Rheumatic Diseases; Seoul Republic of Korea
| | - Il-Hoon Sung
- Department of Orthopedics; Hanyang University Hospital for Rheumatic Diseases; Seoul Republic of Korea
| | - Jae-Bum Jun
- Department of Rheumatology; Hanyang University Hospital for Rheumatic Diseases; Seoul Republic of Korea
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Distribution patterns and coincidence of sesamoid bones at metatarsophalangeal joints. Surg Radiol Anat 2016; 39:427-432. [PMID: 27743001 DOI: 10.1007/s00276-016-1759-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 10/10/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE Our aim was to identify the incidence and distribution of sesamoid bones plantar to the metatarsophalangeal (MTP) joints in adults, and to evaluate patterns of coincidence among these sesamoid bones. METHODS We conducted a retrospective review of 7949 plain radiographs obtained from patients evaluated for foot trauma or symptomology. Associations between the distributions of MTP sesamoid bones as well as the association of age, sex, and laterality with identified prevalence, distribution, and coincidence were evaluated using Spearman's correlation coefficient. RESULTS Overall, 17,060 sesamoid bones were identified for 9005 MTP joints, with 16 distinctive distribution patterns. Among possible patterns, we identified a prevalence rate of complete absence of MTP sesamoid of 0.04 %, of a single sesamoid at the hallux of 89.08 % of radiographs; and of sesamoid at ≥2 MTP joints of 10.88 %. The presence of a sesamoid at the hallux was consistent, and was not correlated with the presence or absence of a sesamoid bone at one of the other MTP joints (P > 0.05). However, there was a positive correlation between the presence and absence of sesamoid bones at any two of the other four MTP joints (P < 0.001). Age was positively correlated with both the total number of sesamoids present (P < 0.001) and the number of MTP joints with sesamoids (P < 0.001). CONCLUSIONS Information from this study would assist clinicians in the diagnosis of patients presenting with pain and discomfort of the foot after trauma and overuse, as well as contribute a robust data set for research in forensic science and anthropology.
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Boelch SP, Jansen H, Meffert RH, Frey SP. Six Sesamoid Bones on Both Feet: Report of a Rare Case. J Clin Diagn Res 2015; 9:RD04-5. [PMID: 26436011 DOI: 10.7860/jcdr/2015/12842.6394] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 05/20/2015] [Indexed: 11/24/2022]
Abstract
There is a variation of the total number of distinct bones in the human in the literature. This difference is mainly caused by the variable existence of sesamoid bones. Sesamoid bones at the first MTP are seen regularly. In contrast additional sesamoid bones at the second to fifth MTP are rare. We report a case of additional sesamoid bones at every metatarsophalangeal joint (MTP) of both feet. A 22-year-old female Caucasian presented with weight-dependent pain of the second MTP of the left foot. In the radiographs of both feet additional sesamoid bones at every MTP could be seen. This case reports a very rare variation in human anatomy. A similar case has not been displayed to the academic society and therefore should be acknowledged.
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Affiliation(s)
- S P Boelch
- Faculty, Department of Trauma, Hand, Plastic and Reconstructive Surgery, Würzburg University Hospital, Julius-Maximilians University Würzburg , Oberdürrbacher Straße 6, Würzburg 97080, Germany ; Orthopädische Klinik König Ludwig Haus, Lehrstuhl für Orthopädie, Universität Würzburg , Würzburg, Germany
| | - H Jansen
- Faculty, Department of Trauma, Hand, Plastic and Reconstructive Surgery, Würzburg University Hospital, Julius-Maximilians University Würzburg , Oberdürrbacher Straße 6, Würzburg 97080, Germany
| | - R H Meffert
- Faculty, Department of Trauma, Hand, Plastic and Reconstructive Surgery, Würzburg University Hospital, Julius-Maximilians University Würzburg , Oberdürrbacher Straße 6, Würzburg 97080, Germany
| | - S P Frey
- Faculty, Department of Trauma, Hand, Plastic and Reconstructive Surgery, Würzburg University Hospital, Julius-Maximilians University Würzburg , Oberdürrbacher Straße 6, Würzburg 97080, Germany
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Wilke J, Krause F, Niederer D, Engeroff T, Nürnberger F, Vogt L, Banzer W. Appraising the methodological quality of cadaveric studies: validation of the QUACS scale. J Anat 2015; 226:440-6. [PMID: 25846130 DOI: 10.1111/joa.12292] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2015] [Indexed: 12/26/2022] Open
Abstract
Although systematic reviews are conducted in the field of anatomical research, no instruments exist for the assessment of study quality. Thus, our objective was to develop a valid tool that reliably assesses the methodological quality of observational cadaveric studies. The QUACS scale (QUality Appraisal for Cadaveric Studies) was developed using an expert consensus process. It consists of a 13-item checklist addressing the design, conduct and report of cadaveric dissection studies. To evaluate inter-rater reliability, a blinded investigator obtained an initial pool of 120 observational cadaveric studies. Sixty-eight of them were selected randomly according to sample size calculations. Three independent researchers rated each publication by means of the QUACS scale. The reliability of the total score was estimated using the intraclass correlation coefficient (ICC). To assess agreement among individual items, margin-free kappa values were calculated. For construct validity, two experts (an anatomist and an experienced physician) categorized the quality of 15 randomly selected studies as 'excellent' (4 points), 'moderate to good' (3 points), poor to moderate' (2 points) or 'poor' (1 point). Kendall's tau rank correlation was used to compare the expert ratings with the scores on the QUACS scale. An evaluation of feasibility was carried out during the reliability analysis. All three raters recorded the duration of quality appraisal for each article. Means were used to describe average time exposure. The ICC for the total score was 0.87 (95% confidence interval: 0.82-0.92; P < 0.0001). For individual items, margin-free kappa values ranged between 0.56 and 0.96 with an agreement of 69-97% among the three raters. Kendall's tau B coefficient of the association between expert ratings and the results obtained with the QUACS scale was 0.69 (P < 0.01). Required rating time per article was 5.4 ± 1.6 min. The QUACS scale is highly reliable and exhibits strong construct validity. Thus, it can confidently be applied in assessing the methodological quality of observational dissection studies.
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Affiliation(s)
- J Wilke
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - F Krause
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - D Niederer
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - T Engeroff
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - F Nürnberger
- Department of Anatomy (II), Goethe University Frankfurt, Frankfurt am Main, Germany
| | - L Vogt
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - W Banzer
- Department of Sports Medicine, Goethe University Frankfurt, Frankfurt am Main, Germany
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Lee HI, Koh KH, Kang HJ, Lee JS, Park MJ. Prevalence of sesamoid bones in the hands: 3D-reconstructed CT study. J ANAT SOC INDIA 2014. [DOI: 10.1016/j.jasi.2014.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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