Bone Diseases, Developmental ; diagnosis ; surgery ; Female ; Humans ; Metacarpal Bones ; diagnostic imaging ; surgery ; Metacarpus ; diagnostic imaging ; surgery ; Middle Aged ; Radiography

OBJECTIVE: To research the connection of the minor's bone age and chronological age and age for penal responsibility, to discuss the application of Gu's Atlas and Li Guozhen's Percent Numeration to measure the bone age in the cases of immature criminals and the applying value. METHODS: 33 healthy youths, 12-19 years old, were selected, whose left wrists were photographed with X-rays. According to the radiographic appearance of the maturity indicators, the bone age of every person was determined respectively by the Gu's Atlas and Li Guozhen's Percent Numeration, and then compared with his/her chronological age. CMH test and Pearson test were used to evaluate precision and accuracy on concluding the immature age for penal responsibility. RESULTS: Li Guozhen's Percent Numeration was more precise than Gu's Atlas on extrapolating the chronological age of the youth, P<0.005. On extrapolating the age for penal responsibility, the accuracy of the former was 90.91%, and the latter was 78.79%, but the statistic result did not show significant difference (P>0.1). CONCLUSION Both measurements can apply in determining the criminal cases of immature youths.
Adolescent ; Adult ; Age Determination by Skeleton/methods* ; Child ; Female ; Forensic Anthropology/methods* ; Hand/diagnostic imaging* ; Humans ; Male ; Metacarpal Bones/diagnostic imaging* ; Wrist/diagnostic imaging*

OBJECTIVE: To describe characteristic of hand-wrist bone development in adolescents of 14 years old in China, and to estimate trend of bone development of them. METHODS: A total of 109 adolescents of 14 years was selected as subjects (males: 53, females: 56). X-rays examination of their left hand-wrist bone were performed and analyzed. The development characteristics of each position in accordance with Gu's mapping of skeletal age were compared with Gu's results and ours. RESULTS: Compared with Gu's, osteoepiphysis of distal radius, the first metacarpal bone, the fourth proximal phalanx were more advanced in boys, osteoepiphysis of distal radius, the second-fifth metacarpal bones, the first-fifth proximal phalanxs, and the second-fifth middle phalanxs were more advanced in girls. CONCLUSION The results suggested that a forward trend of 14 years old adolescents bone development currently exists in our country, especially in girls. As an important age of criminal responsibility, this forward trend of development of bones among adolescents currently should be kept in mind when estimating bone age of criminals.
Adolescent ; Age Determination by Skeleton/methods* ; Bone Development/physiology* ; Female ; Forensic Anthropology ; Humans ; Male ; Metacarpal Bones/diagnostic imaging* ; Radius/diagnostic imaging* ; Wrist Joint/diagnostic imaging*

OBJECTIVE: To study the accurate of Li Guozhen's Percent Numeration and the Development Standard of Chinese Wrist Bone CHN Numeration of age estimation in 14-year-old females. METHODS: Fifty-one 14-year-old females from three middle schools in Loudi City in Hunan were selected randomly, whose left wrists were photographed with X-rays under the same condition. Skeletal age was estimated following the two numerations. The two skeletal ages were compared with each other and with chronological age. RESULTS: The skeletal age from Percent Numeration and CHN Numeration have no significance difference, P > 0.05. And the skeletal ages of the two Numerations have no significance difference either, P > 0.05. CONCLUSION The Percent Numeration and the CHN Numeration are still suited for age estimation in 14-year-old females.
Adolescent ; Age Determination by Skeleton/methods* ; Age Factors ; Body Mass Index ; Carpal Bones/diagnostic imaging* ; China ; Female ; Forensic Anthropology/methods* ; Hand Bones/diagnostic imaging* ; Humans ; Metacarpal Bones/diagnostic imaging* ; Reference Values

Tumor-induced osteomalacia (TIO), or oncogenic osteomalacia (OOM), is a rare acquired paraneoplastic disease characterized by renal phosphate wasting and hypophosphatemia. Recent evidence shows that tumor-overexpressed fibroblast growth factor 23 (FGF23) is responsible for the hypophosphatemia and osteomalacia. The tumors associated with TIO are usually phosphaturic mesenchymal tumor mixed connective tissue variants (PMTMCT). Surgical removal of the responsible tumors is clinically essential for the treatment of TIO. However, identifying the responsible tumors is often difficult. Here, we report a case of a TIO patient with elevated serum FGF23 levels suffering from bone pain and hypophosphatemia for more than three years. A tumor was finally located in first metacarpal bone by octreotide scintigraphy and she was cured by surgery. After complete excision of the tumor, serum FGF23 levels rapidly decreased, dropping to 54.7% of the preoperative level one hour after surgery and eventually to a little below normal. The patient's serum phosphate level rapidly improved and returned to normal level in four days. Accordingly, her clinical symptoms were greatly improved within one month after surgery. There was no sign of tumor recurrence during an 18-month period of follow-up. According to pathology, the tumor was originally diagnosed as "lomangioma" based upon a biopsy sample, "proliferative giant cell tumor of tendon sheath" based upon sections of tumor, and finally diagnosed as PMTMCT by consultation one year after surgery. In conclusion, although an extremely rare disease, clinicians and pathologists should be aware of the existence of TIO and PMTMCT, respectively.
Bone Neoplasms ; blood ; complications ; diagnostic imaging ; pathology ; surgery ; Female ; Fibroblast Growth Factors ; blood ; Follow-Up Studies ; Humans ; Hypophosphatemia ; blood ; diagnostic imaging ; etiology ; pathology ; surgery ; Mesenchymoma ; blood ; complications ; diagnostic imaging ; pathology ; surgery ; Metacarpal Bones ; Middle Aged ; Neoplasms, Connective Tissue ; blood ; complications ; diagnostic imaging ; pathology ; surgery ; Osteomalacia ; blood ; diagnostic imaging ; etiology ; pathology ; surgery ; Phosphates ; blood ; Radiography

OBJECTIVETo retrospective analysis the complications after treatment of metacarpal and phalangeal fractures with internal fixation, and propose measures to prevent or reduce surgical complications.

METHODSFrom July 2007 to October 2009, 342 patients with metacarpal and phalangeal fractures were treated with internal fixation,including 203 males and 139 females with an average age of 30.4 years old ranging from 18 to 56 years. There were 217 right hands and 125 left hands, 38 cases of the first metacarpal fracture, 47 cases of the second metacarpal fracture, 52 cases of the third metacarpal fracture, 40 cases of the forth metacarpal fracture, 39 cases of the fifth metacarpal fracture, 43 cases of the proximal phalangeal fractures, 52 cases of the middle phalangeal fractures, and 48 case of the distal phalangeal fractures. The fractures were fixed with K-wires in 129 patients, mini plates in 153 cases, screws in 48 cases, wires in 12 cases.

RESULTSAll 324 patients were followed up for 3 to 15 months (averaged 8.5 months) and complications occurred in 74 patients (22.84%). The main complication was unhealthy wound healing in 24 patients (7.4%), others was adhesion of tendon in 54 patients (16.67%), malunion in 34 patients (10.49%), nonunion in 13 patients (4.01%) and shortening of metacarpal and phalangeal in 21 patients (7.41%).

CONCLUSIONThe important reasons responsible for complications are iatrogenic factors such as unsuitable implant selection, unskillful surgical technique and improper post-operative functional rehabilitation.

Adolescent ; Adult ; Female ; Finger Phalanges ; diagnostic imaging ; injuries ; physiopathology ; surgery ; Follow-Up Studies ; Fracture Fixation, Internal ; adverse effects ; Fractures, Bone ; diagnostic imaging ; physiopathology ; surgery ; Humans ; Male ; Metacarpal Bones ; diagnostic imaging ; injuries ; physiopathology ; surgery ; Middle Aged ; Postoperative Complications ; prevention & control ; Recovery of Function ; Tomography, X-Ray Computed ; Young Adult