• Applied Microscopy
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• v.26 no.2
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• pp.177-195
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• 1996

Fine structure of the processes of intramembranous ossification and endochondral ossification at the tip of the distal phalanx of human fetuses was studied by electron microscopy. In 50 mm fetus, intramembranous ossification of the tip of cartilaginous phalanx was first noted. The osteoblasts of the perichondral zone of tip of cartilaginous phalanx started to lay down a thick membranous bony lamella. Most of the hypertrophied chondrocytes in the marginal parts of tip of the distal phalanx remained viable after being embeded in mineralized cartilaginous septa. The tuberosity of the distal phalanx was formed by membranous bony trabeculae on the exterior of the subperiosteal cap at 80 mm fetus. At this stage endochondral ossification was first observed in distal extremity of the distal phalanx. The maority of hypertrophied chondrocytes in the center of distal extremity appeared to be disintegrating. Resorption of calcified matrix was undertaken by perivascular cells and chondroclasts. From the periosteum, zone of calcification, vascular sprouts expanded within a recently opened lacunae, and the invading osteoblasts laid down osteoid and bone. After 120 mm fetus, endochondral and subperiosteal ossification proceeded in only one direction, just proximally. These findings demonstrate that intramembranous ossification, calcification, and endochondral ossification start at tip of the distal phalanx instead of at the center of the shaft, as was the case in other long bones.

• The Journal of the Korean bone and joint tumor society
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• v.10 no.2
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• pp.138-141
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• 2004

Osteochomdromas, which are uncommon in the hand, are encountered most frequently with hereditary multiple exostosis. They can occur away from the epiphyseal plate region at the distal end of the proximal and middle phalanges. But little has been written about exostosis that occur at the distal end of the distal phalnges. We report one case of hereditary multiple exostosis that arose at the distal end of the distal phalnges. Complete excision was done and the patient was disease-free of 4 years follow-up.

• Korean Journal of Veterinary Research
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• v.33 no.1
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• pp.1-5
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• 1993

An abnormal female Korean native calf at five months age with five legs was observed macroscopically and radiographically. External features included two normal forelimbs, and hindlimbs, and an abnormal forelimb which was underdeveloped. A rudimentary forelimb, which was attached to the pectoral region, was observed at the right axillary part. The extra forelimb was scapural and humeral meromelia. It consisted of an underdeveloped forearm (antebrachium), several carpal bones (three bones), large metacarpal bone (Mc. 3 + 4), and two digits with two hoofs. The proximal, middle and distal phalanges, proximal and distal sesamoid bones are normal.

• Journal of Veterinary Clinics
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• v.34 no.1
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• pp.61-64
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• 2017

A 5-year-old, 6.2 kg male mixed dog was presented to local animal hospital with a 6-month history of swelling, pain, inflammation, and lameness in the 5th digit of right hind limb. And a 7-year-old, 2.7 kg male Maltese dog was also presented to animal hospital with a 2-month history of nail deformities in the 5th digit of left hind limb. Abnormal growth or degeneration of the distal phalanges was observed at the 5th digit of hind limb in two dogs using radiographic examination. The masses in the digit were excised completely under local anesthesia. On histological examination of the digit masses, large well-circumscribed, unencapsulated round or irregular cystic neoplasms with/without inflammation were occupied in or adjacent area of the distal phalanx. These cysts were lined by stratified squamous epithelium that occasionally had a prominent granular cell layer. Based on the history, clinical signs, radiographic, gross and histopathologic features, these cases were diagnosed as nailbed epithelial inclusion cysts in the digit of dogs.

• Korean Journal of Veterinary Research
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• v.27 no.2
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• pp.167-183
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• 1987

The anatomical structure of the Skeleton of thoracic limb of thirty-one adult Korean native goats(body weight: 14~17kg) was observed after skeletal preparation, and the osteometry was performed in each bone. The results were as follows; 1. The thoracic limb of the Korean native goat was composed of scapula, humerus, radius, ulna, carpal bones, metacarpal bones, phalanges and sesamoid bones. 2. The scapula was flat and triangular in shape. There were no distinct tuber of spine and acromion in the spine. The subscapular fossa was deep and triangular in shape and the vertebral border was sigmoid form. The coracoid bone was formed as the coracoid process at the medial aspect of the supraglenoid tubercle but the clavicle wa.s not observed. The left and right scapular indexes were 57.92 and 58.31 and the glenoid cavity indexes were 89.23 and 86.82, respectively. 3. The greater tubercle of the humerus was devided into cranial and caudal parts. The third tubercle was observed and the face for the infraspinatus muscle was rectangular form. The left and right humerus indexes were 32.44 and 32.63, the head indexes were 94.13, 96.62 and the trochlear-epidondyle indexes were 67.32 and 65.81, respectively. 4. The radius and ulna were fused entirely except at the broad proximal and narrow distal interosseous spaces. The ulna was longer than the radius, and its reduced body and distal end were fused at the caudomedial surface of the radius. 5. The carpal bones were six in number. There were radial, intermediate, ulnar, accessory, second-third and fourth carpal hones in carpal bones. 6. The metacarpal bone was composed of a large metacarpal bone resulted from the fusion of the third and fourth metacarpal bones, and there was a metacarpal tubercle at the dorsolateral part of the proximal end. There were no vestiges of the second and fifth metacarpal bones. 7. The digits were composed of third and fourth digits and each digit was composed of the proximal, middle and distal phalanges. 8. The sesamoid bones were six in number. There were two at the fetlock joint and one at the coffine joint palmarly in each digit. 9. The ratios of the lengths among the scapula, humerus, antebrachium and metacarpal bone were 1.42 : 1.47 : 1.77 : 1.00 in the left and 1.42 : 1.45 : 1.77 : 1.00 in the right, respectively.

• Journal of the korean academy of Pediatric Dentistry
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• v.21 no.2
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• pp.504-509
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• 1994

Achondroplasia is characterized by undergrowth of long bones and cartilages and by low height. The name of this disease had been called classical chondrodystrophy, dyschondroplasia, chondrodystrophy and micromelia before Parrot reported the term of this disease as Achondroplasia. We are reporting in this paper on an 3-year and 4-month-old boy with achondroplasia. The dental findings are as follows: 1. Open bite and relatively mandibular prognathism were observed in the front teeth. 2. The size, number, shape, structure of the teeth were usual and the tongue was a little bigger than the normal. 3. The metacarpal bones were short and broadening. Mesial, distal border of the prox. phalanges were irregular and also trabecular pattern was abnormal in the hand-wrist P-A view. 4. According to lat. cephalometric analysis, the cranial basis was underdeveloped.

• The Journal of the Korean bone and joint tumor society
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• v.18 no.2
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• pp.109-112
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• 2012

A turret exostosis was known a smooth, dome-shaped extracortical collection of subperiosteal bone beneath the extensor apparatus. In most cases, turret exostosis involve middle and distal phalanges compared with involving metacarpal cases have been rarely reported in the literature.

• Journal of Genetic Medicine
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• v.10 no.2
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• pp.117-119
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• 2013

Double trisomy mosaicism of two different cell lines is extremely rare, particularly those that involve constitutional trisomy 8. We report a case of 47,XXX/47,XX,+8 in a 12-year-old female presenting with several skeletal anomalies. She exhibited distinct phenotypic features such as tall stature, deviation of the left middle finger, webbing of both thumbs and flexion deformities of the both third and fifth distal intermediate phalanges. A mild impulse-control disorder was observed, without mental retardation. Chromosomal and fluorescence in situ hybridization analysis demonstrated double trisomy mosaicism both on lymphocytes and buccal epithelial cells.

• Archives of Plastic Surgery
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• v.47 no.6
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• pp.590-596
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• 2020

Background The introduction of the partial second toe pulp free flap has enabled superior aesthetic and functional results for fingertip reconstruction in adults. Children undergoing fingertip amputation for various reasons have limited options for reconstruction. Conventional treatment could shorten the finger, leading to poor cosmesis and function. We report 18 years of our experiences with fingertip reconstruction using partial second toe pulp free flaps in patients in early childhood. Methods Medical charts of children who had undergone fingertip reconstruction using partial second toe pulp free flaps from 2001 to 2018 were retrospectively reviewed. The surgical procedures were identical to those for adults, except for the usage of 11-0 nylon sutures. Patients' demographic data, vessel size, flap dimensions, length of the distal phalanx, and functional outcomes over the course of long-term follow-up were documented. The statistical analysis was performed with the Student t-test, the Mann-Whitney U test, and Pearson correlation analysis. Results Eighteen toe pulp flaps in 17 patients (mean age, 3.0 years) were identified. All the flaps survived without any major complications. In long-term follow-up, the flap-covered distal phalanges showed growth in line with regular development. There was no donor-site morbidity, and all children adapted to daily life without any problems. In two-point discrimination tests, the fingertip sensation recovered to almost the same level as that in the contralateral finger. Conclusions Partial second toe pulp free flaps are an excellent option for fingertip reconstruction in young children, as well as in adults.

• Archives of Plastic Surgery
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• v.34 no.3
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• pp.409-412
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• 2007

Purpose: Percutaneous Kirschner wire fixation is common method for hand fracture. It is simple but has risk of ascending infection through the pin and bony injury by multiple drilling. Ascending infection through pin tract is mostly superficial and can be treated with antibiotics and aseptic dressing. This is a case review of subacute osteomyelitis on phalangeal bones after Kirschner wire fixation with literature review. Methods: A 40-years-old man with distal phalangeal fracture on right second finger is presented. He went to a local clinic and had percutaneous Kirschner wire fixation under local anesthesia. He was transferred to our hospital for ulcerative wound on DIP joint at 4 weeks after operation. Radiography showed osteolytic change around medulla of middle and distal phalanges, leading to diagnosis of a subacute osteomyelitis. We treated it with amputation at the level of shaft of middle phalanx. Results: The postoperative course was uneventful. We thought several possible reasons for osteomyelitis in our case. First, it could resulted from ascending infection through the wire. Second, it could be resulted from a bony burn by repeated drilling. And bony necrosis could be a consequence of arterial insufficiency caused by 2 pin insertion. Conclusion: We suggest that a precise pinning based on accurate anatomical understanding is required for a percutaneous Kirschner wire fixation. The frequency of drilling should be minimized. Careful observation and patient education for pin site care are essential.