Osteoporosis is a metabolic bone disease that needs to be properly diagnosed. The current diagnosing procedure of osteoporosis is based on the mineral density of bones measured by common methods such as dual energy X-ray absorptiometry (DXA). However, due to the deficiencies and limitations of these common methods, investigations on the utilization of other non-invasive diagnosing methods have been executed. For instance, using vibration measurements seems to be a promising technique in diagnosing metabolic bone diseases such as osteoporosis and also in monitoring fracture healing. Throughout this study, bone structural modal parameters obtained from vibrations experiments with decreasing mineral density are examined and therefore, it is aimed to find a new approach to detect osteoporosis or progressing osteoporosis by investigating a relation between structural dynamic properties and mineral density of bone. The main advantage of this study is that loss factor, which is an inherit property of bone, is investigated since in the previous studies mainly the changes in natural frequency of bones with the state of osteoporosis is examined. In this thesis, both in vitro and in vivo experiments are carried out on human tibia specimens. The measured frequency response functions (FRFs) are analyzed using modal identification techniques to extract the modal parameters of the human tibia. The results obtained from in vitro experiments show that loss factor may be a powerful tool in diagnosing osteoporosis, however due to the difficulties encountered in the case of in vivo experiments makes the use of this parameter as a diagnosing tool difficult. It is also seen from in vivo experiments that there is a weak correlation between the natural frequencies of tibia and BMD measurements of patients. Therefore, in order to investigate the parameters affecting the natural frequencies of tibia, finite element (FE) model of human tibial bone is constructed. Using this FE model tibia, the effect of boundary conditions of experiments and geometry of the bone on natural frequencies of bone is examined. These analyses show that the effect of both boundary conditions and geometry of tibia is very high. Therefore, it is concluded that if the necessary conditions are satisfied, the using natural frequency information of tibia seems to be a possible and practical method that can be used to detect progressing osteoporosis. Also, using the FE model of tibia, the changes of natural frequencies of tibia with the variation in elastic modulus are investigated.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 5 uppsatser.

In the past few decades, an area of skeletal research focusing on shape analyses has gained popularity in the field of physical anthropology, and subsequently forensic anthropology. Known as geometric morphometrics, this type of analysis allows the researcher to place the morphological shape of bones into a statistical framework to answer questions on a variety of topics, including sexual dimorphism. Sex assessment from the long bones has been traditionally conducted using traditional morphometric methods (Iscan and Miller-Shaivitz 1984; Steyn and Iscan 1997), and as a result, relies mainly on size differences and has not considered how joint morphology and shape affect sex. For this project, a geometric morphometric analysis of the proximal tibia in a modern Caucasian American population was conducted using a sample of 100 male and 100 female tibiae from the William M. Bass Donated Skeletal Collection at the University of Tennessee at Knoxville. The proximal tibia's effectiveness as an indicator of sex in a modern American population was evaluated via generalized Procrustes, principal components, and discriminant function analyses. Principal components revealed a lack of separation between males and females in terms of proximal tibia shape. The discriminant function analysis was successful at discriminating males from females, but cross-validation yielded a low total accuracy rate of 58%. The shape of the proximal tibia contributes to sexual dimorphism in a Caucasian American population, but is only slightly useful in a discriminant function. Further research should be conducted on different populations and using different skeletal landmarks.

No description available.

La Osteosíntesis biológica no es un implante, sino un concepto que puede efectuarse con los elementos habituales de osteosíntesis. Pretende dar la estabilidad suficiente con reducción indirecta, sin pretender reducciones anatómicas de fragmentos que pueden dañar la vascularización de ellos y sin tocar el foco de fractura. Se realizó un estudio descriptivo-retrospectivo en el cual se evaluaron los resultados de 15 pacientes con fracturas diafisiarias de fémur (05) y tibia (10) tratados mediante la técnica de Osteosíntesis con plaqueado minimamente invasivo; los cuales fueron tratados durante el periodo Enero 2001 y Diciembre 2002. La edad media fue de 50.2 y 32.5 años respectivamente. Todas las fracturas femorales fueron cerradas, 08 fracturas fueron cerradas y 02 expuestas de I (según Gustillo) entre las fracturas tibiales. De acuerdo a la clasificación AO hubieron, 2 del tipo B2, 1 del tipo C1 y 2 del tipo C2 entre las fracturas de fémur y 3 del tipo B1, 3 del tipo B2, 2 del tipo C2, y 2 del tipo C3 entre las tibiales. El promedio de tiempo de apoyo total para las fracturas de fémur fue de 16.6 semanas y 14 semanas para las de tibia; mientras el promedio de tiempo de unión por radiografía fue de 18.8 semanas y 15.6 semanas respectivamente. Se presentó un caso de infección superficial, un caso de perdida de fijación de fractura y no se presentaron casos de fallas de material de osteosíntesis. Una fractura consolidó con un alineamiento en varo de 10° y recurvatum de 15° y una fractura con recurvatum de 15°, estas pertenecientes al grupo de las fracturas tibiales. Los resultados del tratamiento para fracturas diafisiarias de fémur y tibia obtenidos con ésta técnica compara favorablemente con otras series usando técnicas diferentes sin la morbilidad asociada de grandes abordajes y autoinjerto óseo. Sin embargo la técnica quirúrgica demanda un cuidado especial para restaurar el alineamiento axial.

Die Osteoporose ist als häufigste Knochenerkrankung im Alter die Ursache vieler Beeinträchtigungen. Definiert wird sie über die Knochendichte, die unter anderem mit der peripheren quantitativen Computertomographie (pQCT) bestimmt werden kann. Mit unseren Daten aus Knochendichtemessungen per pQCT am distalen Radius (XCT 2000) und an der distalen Tibia (XCT 3000) konnten wir im Tukey-HSD-Test zeigen, dass die Knochendichteparameter an oberer und unterer Extremität gut miteinander korrelieren. Es wurden die trabekuläre und die totale Dichte sowie der polare stress-and-strain-Index berücksichtigt. Die trabekuläre Knochendichte an der Tibia, dem gewichtstragenden Knochen, ist höher als die am Radius. Einflussnahme auf die Knochendichte konnte mittels Regressionsanalyse für das Alter, das Geschlecht, die Größe, das Gewicht und den BMI nachgewiesen werden. Die altersbedingte Abnahme der Knochendichte ist an der Tibia stärker ausgeprägt als am Radius. Bei der Frau bedingt eine hohe totale Dichte am Radius eine höhere Festigkeit an der Tibia als bei entsprechenden Dichtewerten beim Mann. Unter Mitberücksichtigung des Alters steigt die Festigkeit an der Tibia beim Mann mit den Jahren an. Bei der Frau sinkt sie, wie auch am Radius, mit steigendem Alter. Das Gewicht nimmt signifikanten Einfluss auf die untere Extremität, nicht jedoch auf den Radius. Die Betrachtung des BMI zeigt, dass nicht die reine Gewichtszunahme sondern die Kombination aus Größe und Gewicht diesen positiven Effekt erzielen, Fettleibigkeit ab dem Adipositasgrad aber einen negativen Einfluss auf die Knochendichte und -festigkeit hat. / As a common bone disease in elderly patients osteoporosis is a cause of severe physical impairment. It is defined by bone mineral density (BMD), which can be determined by peripheral quantitative computer tomography (pQCT). Our data from BMD measurements made by pQCT at the distal radius (XCT 2000) and at the distal tibia (XCT 3000) shows through application of the Tukey-HSD-tests that BMD values at the upper and lower extremities correlate with each other. Total and trabecular BMD as well as the polar stress-and-strain index are considered. Trabecular BMD at the body weight bearing distal tibia is higher than at the distal radius. Influence on BMD was verified by regression analysis for age, sex, height, weight and BMI. Age-related decrease of BMD is more distinct at the tibia than at the radius. In women high total BMD accounts for higher strength at the tibia than it does for corresponding values in men. Considering age, strength of the tibia increases in men during the years. In women it decreases, like it does at the radius. Weight has significant influence on the lower extremity, however not on the radius. Regarding the BMI, not just an increase in mass but a combination of weight and height causes this positive effect. Obesity above level I has a negative influence on BMD and bone strength.

O resultado clínico a longo prazo das osteotomias valgizantes da tíbia depende da obtenção do adequado alinhamento do eixo mecânico pelo procedimento cirúrgico. Essa correção do eixo mecânico é obtida pela adição ou subtração de cunhas ósseas. O tamanho das cunhas pode ser planejado pré-operatoriamente ou determinado durante a cirurgia utilizando controle intraoperatório do alinhamento do membro. Modernamente, o controle intraoperatório pode ser realizado com auxílio de equipamentos de navegação cirúrgica computadorizados. Neste estudo, comparamos os valores dos eixos mecânicos e dos tamanhos das cunhas obtidos pelo método de planejamento pré-operatório das osteotomias com cálculo trigonométrico e pelas cirurgias auxiliadas por sistema de navegação intraoperatória. A medida dos eixos mecânicos em imagens radiográficas panorâmicas dos membros inferiores foi realizada por catorze cirurgiões de joelho em treze pacientes. A cirurgia de osteotomia valgizante auxilada por navegação cirúrgica foi realizada pelo mesmo cirurgião nos mesmos treze pacientes, documentando-se o tamanho da cunha de adição medial e os eixos mecânicos do membro inferior. Após as cirurgias, planejamos os tamanhos das cunhas de adição medial, por cálculo trigonométrico, utilizando os dados dos eixos mecânicos medidos nas radiografias. Nós realizamos comparação entre os valores dos eixos mecânicos obtidos nas cirurgias e os valores medidos nas imagens radiográficas e entre os tamanhos das cunhas de adição medial medidos intraoperatoriamente e planejadas nos cálculos trigonométricos. A análise dos dados foi realizada por análise descritiva dos resultados e por gráficos de Bland e Altman. Como resultados, observamos alta correlação entre os valores dos eixos mecânicos medidos nos exames radiográficos e pelo navegador cirúrgico e observamos que os valores planejados para as cunhas de adição são diferentes dos valores medidos durante as cirurgias / The long-term clinical outcome of tibial osteotomy depends on achieving the proper mechanical axis alignment for the surgery. Adding or subtracting bone wedges obtains the mechanical axis correction. The correction size may be planned preoperatively or defined during surgery under limb alignment control. Nowadays, the limb alignment control may be accomplished with the aid of computerized surgical navigation equipment. In this study, we compared the values of the mechanical axes and the wedges sizes obtained by the osteotomies preoperative planning method with trigonometric calculation and those values measured on navigated surgeries. Fourteen knee surgeons performed the measurement of the mechanical axes in panoramic radiographs of the lower limbs of thirteen patients. The same surgeon performed all thirteen surgeries. The wedges sizes and the mechanical axes of the lower limb were measured during surgeries. After surgery, the sizes of the planned addition of medial wedges, for trigonometric calculation, using data from the mechanical axis measured on the radiographs. We carry out comparison between the values of the mechanical axes obtained in the surgeries and the values measured in the radiographs and between the sizes of the wedges and wedge sizes planned in trigonometric calculations. We performed data analyses by descriptive analysis and Bland and Altman. We have observed a high correlation between the values of the mechanical axes measured on radiographs and in navigated surgeries and noticed that the planned values for wedges are different from values measured during surgery

A baixa disponibilidade do ácido fítico para os animais não ruminantes tem incrementado as pesquisas quanto ao uso da enzima fitase. Pesquisas têm sido realizadas com a adição de fitase em rações para frangos de corte e têm demonstrado resultados favoráveis sobre o aproveitamento do fósforo e a digestibilidade de nutrientes como aminoácidos e proteína. Para se avaliar os efeitos do fornecimento de rações contendo níveis reduzidos de proteína bruta e fósforo disponível com adição da enzima fitase sobre o desempenho, excretas e parâmetros ósseos em frangos de corte no período de 1 a 21 dias de idade foram utilizados 504 pintos de corte, machos, de linhagem comercial de frangos de corte, de 1 dia de idade, distribuídos em 12 tratamentos com seis repetições cada. O delineamento foi em blocos casualizados e os tratamentos foram organizados de acordo com um esquema fatorial 2x2x3: dois níveis de fósforo disponível, dois níveis de fitase e três níveis de proteína bruta. Houve um aumento do peso das aves que receberam dietas contendo a enzima fitase embora não tenha afetado a conversão alimentar. O consumo não foi afetado pelos níveis de proteína bruta quando ocorreu a suplementação com fitase. A porcentagem de fósforo nas excretas diminuiu com o nível intermediário de proteína bruta (20,5%) com a adição de fitase (1,15 vs. 1,03%). A proteína bruta excretada foi reduzida com a suplementação de fitase (33,36 vs. 31,83%). A enzima fitase atua de forma significativa na dieta à base de milho e farelo de soja com baixos níveis de proteína bruta e fósforo disponível para frangos de corte. / The low phytic acid availability to nonruminant animals has increased the researches about the phytase enzyme use. Researches have been realized with phytase addition in broiler diets and they demonstrated favorable results on phosphorus utilization and nutrients digestibility as amino acids and protein. To evaluate the effects of feeding low levels of crude protein and available phosphorus diets supplemented with phytase on performance, feces and bone parameters on broiler chickens over a 21 days period, it was used 504 (five hundred four) 1 day old male chicks, of a commercial broiler line, distributed in 12 treatments, with 6 replicates per treatment. The experimental design was casually blocked and treatments were organized in a 2x2x3 factorial arrangement: two phosphorus levels, two phytase inclusion levels and three protein levels. Body weight gain (BWG) was observed in birds fed diets with phytase supplementation although it hasn\'t affected the feed conversion ratio (FCR). Feed intake (FI) wasn\'t affected by the low protein levels with added phytase. Phosphorus percentage in excretion decreased with the intermediary protein level (20.5%) when phytase was added (1.15 vs 1.03%). Crude protein excreted was lower with phytase supplementation (33.36 vs 31.83%). Phytase enzyme acts in a significant way on broilers fed a corn-soybean diet with low levels of crude protein and available phosphorus.

As fraturas do planalto tibial são lesões com um espectro muito variado de manifestação clínica. Diversos sistemas de classificação foram desenvolvidos para facilitar a compreensão e a tomada de decisões no tratamento dessas lesões. O presente estudo teve como objetivo primário avaliar o impacto da tomografia computadorizada na concordância inter e intraobservador da classificação de Schatzker. Além disso, procurou-se avaliar o impacto da tomografia computadorizada na tomada de decisões a respeito da via de acesso cirúrgico ao planalto tibial, utilizando para esta análise a classificação de Schatzker modificada por Kfuri. Um banco de dados com imagens de 70 pacientes, incluindo radiografias, tomografia computadorizada e reconstruções tridimensionais computadorizadas foi oferecido a um grupo de 10 observadores para análise. Como resultados, observou-se que a classificação de Schatzker apresentou coeficiente de concordância moderado, quando baseado no uso de radiografias (k=0,58), e substancial quando esta análise foi complementada por tomografia (k=0,62/0,64). A nova classificação de Schatzker modificada por Kfuri obteve nível moderado de concordância interobservador (k=0,53) e substancial intraobservador (k=0,63). A tomografia computadorizada, elemento básico da nova classificação, influenciou decisivamente os cirurgiões a mudarem a opção pela via de acesso cirúrgico, especialmente em fraturas com orientação no plano coronal. Como conclusão, verificou-se que a classificação de Schatzker modificada por Kfuri demonstrou substancial índice de concordância intraobservador e moderado índice de concordância intraobservador, e devem ser úteis para a prática clínica. / Tibial plateau fractures are lesions with a varied spectrum of clinical presentation. Several classification systems have been developed to facilitate the understanding and decision making in the treatment of these injuries. The present study aimed to evaluate the impact of computerized tomography on the inter and intraobserver correlation of the Schatzker classification. In addition, we sought to evaluate the impact of the computed tomography in the decision making regarding the surgical approaches to the tibial plateau, using the Schatzker classification modified by Kfuri for this analysis. A database of 70 patient images, including radiographs, computerized tomography, and computerized three-dimensional reconstructions were offered to a group of 10 observers for analysis. As a result we observed that the Schatzker classification presents a moderate agreement when based on radiographs (k=0,58) and substantial when this analysis is complemented by tomography (k=0,62/0,64). The new Schatzker classification modified by Kfuri has a moderate level of interobserver agreement (k=0,53) and substantial intraobserver agreement (k=0,63). Computerized tomography, a basic element of the new classification, decisively influenced surgeons to change the option for surgical access, especially in fractures with orientation in the coronal plane. In conclusion, the Schatzker classification modified by Kfuri have a substantial intraobserver and moderate interobserver correlation, and should be useful for clinical practice.

In this study, trabecular architecture is considered as a cellular solid structure, including both intact and damaged bone models. ??Intact?? bone models were constructed based on ideal versions of 25, 60 and 80-year-old specimens with varying trabecular lengths and orientations to 5%, and 10% covariance of variation (COV). The models were also flipped between longer transverse and longer longitudinal trabeculae. With increasing COV of lengths and orientations of trabecular bone, the apparent modulus is linearly decreased, especially in the longer transverse trabeculae lengths. ??Damaged?? bone models were built from the 25 year old model at 5% COV of longer transverse trabeculae, and with removing trabeculae of 5% and 10% of trabecular volume in transverse and longitudinal directions, respectively, as well as in combination to total 10% and 15%. With increasing percent of trabeculae missing, the apparent modulus decreased, especially dramatically when removal was only in the transverse direction. The trabecular bone models were also connected to a cortical shell and it was found that the apparent modulus of an entire slice was increased in comparison to the modulus of trabecular bone alone. We concluded that the architecture of trabecular bone, especially both lengths and percent of trabecular missing in the longitudinal direction, significantly influences mechanical properties.