#Tibia plates

[siorasurgical-post]

What Are Orthopedic Tibia Plates? A Quick Guide

Orthopedic tibia plates are medical devices used by surgeons to stabilize and promote healing in fractured tibias. These plates are typically made of biocompatible titanium, a strong yet lightweight metal that minimizes the risk of rejection by the body. They come in various shapes and sizes to accommodate different fracture locations and types.

[somecunttookmyurl]

if doctors looked for hypermobility in children you could give them appropriate physical therapy exercises from a young age as their muscles grow, orthotics to correct leg/foot placement, and where necessary additional support like professional k-tape application or other mobility aids before you obtain essentially permanent overtraining injuries from your poor muscles trying their best to stop you comedically collapsing into a pile of bones

but no it's just growing pains. kids don't have things wrong. it'll go away

[swallowtail-ageha]

The putrescence knight in game files is referred to as the gloam eyed queen's knight, making it effectively melina and trina's divorce baby

[artifacts-and-arthropods]

Pill Scarab Beetles: these beetles are covered in plates that perfectly interlock when the beetle folds its limbs, lowers its head, and curls itself into a ball

Above: Eusphaeropeltis sp. (top/bottom left) and Ceratocanthus aeneus (bottom right), two different species of pill scarab beetle

Beetles of the Ceratocanthinae subfamily (also known as pill scarab beetles) rely on a unique form of conglobation to conceal themselves. As the beetle tucks its head down and folds its legs up against its belly, the plates on its head, thorax, abdomen, and legs all come together to form a solid shield; the plates on its legs even have grooves and corresponding ridges that allow them to neatly interlock.

As this blog post explains:

Adult Ceratocanthinae are best known for their ability to conglobate: rolling into a nearly perfect ball. The elytra, pronotum, head, and all six tibiae interlock with each other by means of grooves and corresponding ridges, forming a tightly connected external surface. Many beetles take the form of a tight compact structure when threatened, however in Ceratocanthinae the tibiae of all six legs participate in forming the external hard surface of the sphere, unlike in other beetles.

Above: Ceratocanthus sp.

The Ceratocanthinae subfamily contains many different genera/species, and they are all collectively known as pill scarabs. Many of them have a colorful, metallic appearance; they may be green, red, blue, brown, black, or multicolor.

Above: Germarostes globosus

Sources & More Info:

Gil Wizen: Transformers (Ceratocanthinae Beetles)

Communications Biology: The Evolution of Conglobation in Ceratocanthinae

Arthropod Systematics and Phylogeny: Rolling into a Ball: phylogeny of the Ceratocanthinae

ZooKeys: The Ceratocanthinae of Ulu Gombak

Pavel Krásenský Photography: Scarabaeidae (this site is written in Czech)

[greensurgicals]

Treatment of Fractures in India

The LCP (limited-contact plate) Medial Distal Tibia Plate without Tab is part of the LCP Small Fragment System that merges locking screw technology with conventional plating techniques.

[themeeplord]

TW for broken bones, surgery and cuts!

Put in the tags how many scars you have and how you got them

[siorasurgicalsprivatelimited]

Locking Variable Angle Proximal Lateral Tibia Plate 3.5/4.0mm

Locking Variable Angle Proximal Lateral Tibia Plate is intended to be used for the surgical fixation of proximal tibia fractures like comminuted, simple, and depression in adults & adolescents. Siora Surgicals Pvt. Ltd. manufactures these plates in medical-grade stainless steel and titanium. They can also be availed in left & right directional configurations.

[aealzx]

“Uhm… Yes?...Why?” Don responded, taken a little off guard by the question. They were already borrowing the infirmary weren’t they? Donnie and Lil Mikey were going to stay the rest of the night at least. Leatherhead was already settling Donnie back into the bed he’d been in before, and Raphael was trying to lead Leon over to the other bed for Lil Mikey to sleep on.

But Leon was apparently distracted by something else, leaning away from Raphael halfway and slow to respond. “You have intravenous antibiotics, yeah?” he asked, a mix of feeling rushed and excited making his speech faster as he eventually obeyed Raphael's mildly frustrated coaxing and carefully rested Lil Mikey on the mattress. “And two metal plates, about this big, and screws?” Leon followed up, holding his hands up a short distance apart and then a certain thickness.

The questions immediately caused Don’s mind to start listing possible uses in the context he was given. Injuries that would warrant metal plates, screws and antibiotics filtering into his head as he narrowed his eyes just slightly. “Yes, of course. Why?” Don confirmed and repeated his own question with a little more emphasis, restraining himself from grabbing Leon to check him over. It couldn’t be any of them that were currently there that were injured. The only thing Don could think of was a severe fracture, and if that was the case he didn’t think Leon would be moving as easily as he was.

But luckily Leon answered the question of who without the need of further interrogation.

“My brother has an open compound fractured tibia and fibula. Let me go get him, I’ll be right back.” Leon’s answer came as a rush of syllables accentuated by one of the swirling blue discs opening up next to him. Don flinched back slightly at the revelation, and Raphael was more caught off guard by the portal. The kid hadn’t even moved for that to appear. It was a little disconcerting since they still weren’t quite sure what they did exactly. Before the others could fully register what was going on Leon had slipped through the portal, mask tails nearly being caught by the closing gateway.

Being left in silence, Raphael mentally repeated in his mind what Leon had said. He understood most of it, but he wasn’t familiar enough with the names of bones to know which ones the tibia and fibula were. Something in the leg? Or was it the arm? They sounded familiar enough for him to think they were in one of the more external limbs. Looking over to Don for clarification and possible direction, Raphael let out a smothered snort of amusement. Don’s hands had remained frozen in the air where he’d reached out on reflex, and his expression betrayed his disbelief in what he’d just been told. The revelation caused stress to build to the point it bubbled over in the form of a higher pitched whine slowly escaping his form while his fingers flexed.

“Easy there Doctor Don. We don’t want to scare the kid off now that he’s finally started to trust us,” Raphael cautioned with a mild chuckle, recognizing Don’s mental restraint barely keeping him from chasing Leon down. Speaking up only caused Don to redirect his stress at him though.

“Hhhhhhhhh Raph you can not tell me to take it easy after being told the last one of them has a bone sticking out of his leg! if they’re not back in four hours I’m tracking them and getting them myself, and I make no promises on the four hours,” Don rambled, grabbing Raphael’s shoulders and lightly shaking him in distress.

Raphael could only chuckle, reaching up to still Don’s hands and keep him from shaking his brains up too much as Leo and Master Splinter moved closer. “Then I guess you should keep yourself busy getting the supplies you’ll need?” he suggested. Anything to keep his brother occupied and not giving someone a headache.

“...Duh,” Don huffed, giving Rahael an incredulous squint before breaking away to scurry towards the cabinets. The least he could do was make sure they had everything where Leon and he could easily get to it.

“What’s going on?” Leo asked, having heard pieces of the conversation but not actively followed it. He had a relatively clear guess on what the problem was with Don, but he preferred getting clarification before causing issues out of ignorant guesses.

“Remember when your bone was sticking outta your arm?” Raphael asked, raising his own arm and pointing at it.

“...Yeah?” Leo confirmed, reflexively glancing at the scar running down the length of his arm in memory.

“The kid Leo says his brother has the same thing, and went to get him. Obviously that got Don all worked up,” Raphael explained, jerking a thumb at their brother pilling medical supplies on the rolling surgical tray near the table.

Leo’s brows raised in mild surprise before furrowing in concern. He had been quite distracted when his own arm had been broken, for obvious reasons. But he still remembered Don being just as frantic. Paranoid about bone infection, or being able to properly stabilize it without doing further damage, or preventing it from healing properly. Honestly Leo still thought Don had done an amazing job with it, as always, considering he didn’t notice it anymore. And yet the memories just added yet another thing to the list to explain why Leon had been so upset earlier. “..Did he say anything about needing transport?” Leo asked, tone a little more sullen than before. He was starting to regret the way he’d reacted towards Leon’s actions. They were the wrong actions to take, but Leo was starting to find it hard to hold anything against Leon now.

“Nah. I think he can teleport just fine. Like he was doing when he got here,” Raphael admitted with a shrug. “Don gave him four hours, but I bet he’ll be back in a few minutes.”

“Then let’s make sure we’re ready for them,” Leo directed firmly, moving around Raphael to head towards Don to see if he could help with anything.

Raphael watched Leo go and could only huff in amusement as he folded his arms. “Took him long enough,” he mused, lowering his gaze down to Master Splinter as he stepped next to him.

“Leonardo has always had difficulty thinking clearly when the safety of his family is in question. A trait he has come to manage as he’s gotten older, but also one that I have never faulted him for,” Master Splinter mused with a smile, looking fondly after his boys. Then his gaze shifted, a knowing smile as he looked up to meet Raphael’s eyes. “It would seem this young, other dimension version of my son has the same trait. And you, my son, have gotten much better at recognizing the motivations behind others’ actions.”

Raphael had to snort in mild embarrassment at the compliment, shifting his weight and shrugging his shoulders uncomfortably. “Wasn’t hard. It was written all over his face. Don saw it too,” he brushed off despite forcing down the grin tugging his mouth.

Master Splinter could only chuckle softly, but was unable to add more to the conversation as yet another blue portal swirled into the room in practically the same spot as before. Raphael stepped back to fully face it, and had to chuckle in mild triumph. “See? Just a few minutes.”

—---

 As time crept on at an agonizing pace in the still darkness, April was finding she hated that she’d agreed to wait until noon to look for Leon. It wasn’t only that she was worried about him, but she missed having him there for company in this empty place. Of course having Raph in her lap brought some comfort, for she wasn’t truly alone. But her back was bare other than a light blanket, and she trusted Leon’s medical expertise way more than her own. She wanted her brother’s weight on her back, and his encyclopedia brain ready to address their needs. But she also wanted all four of her brothers there too. Which was the only thing that kept her where she was, staring at the map on her phone as it showed Leon chasing around the city, trying to find their little brothers. Part of April wanted to help look, but she didn’t know how she could. Leon was definitely able to move around way faster than she ever could. And she knew the best help she could give was to stay there and look after Raph. He didn’t handle being alone in a foreign place well at all even when he was healthy. So she had to be there to keep him calm. But his current state wasn’t doing much in the way of keeping her calm.

Thirty minutes after Leon had left Raph had woken up again, asking almost immediately where Leon had gone. Noting how disoriented Raph seemed to be, April had made up the excuse that Leon had gone to the bathroom. Partly because she didn’t want Raph to try and get up, but also because she didn’t want to add any more stress to her biggest little brother even if he behaved and remained laying down. She just knew he would start imagining all the wrong scenarios in his overprotective mind. Probably start talking aloud that everything was fine to reassure himself. Get fidgety, want to check outside, and otherwise just not relax and rest like he needed to. He needed all the rest and care he could get.

When they had settled down in this room Raph had looked relatively okay despite the pain from his broken bones. Just a clenched jaw and furrowed brow behind his bright red mask. But now those rich green cheeks were flushed red, and his forehead was damp from sweat instead of the rain. April knew the signs of fever in all of her brothers, and even without a thermometer she could tell Raph’s temperature was creeping up. Leon had anticipated it, and had already given him a fever reducer that he’d had stolen while gathering supplies. But they weren’t exactly in the best circumstances. The tarp on the floor wasn’t that comfortable. The blankets weren’t that thick. And their sanitized bubble of space wasn’t impenetrable. They needed antibiotics, and a proper bed at the very least. As soon as Raph had shivered once April had wiggled out from under him to crank up their space heater. Then her own blanket was tossed over him before she slipped his bandana off so his face didn’t overheat.

Two hours after Leon had left April couldn’t bring herself to make up another excuse when Raph opened his eyes again amidst her absently rubbing his head. His right eye was always slightly unfocused after the damage it’d sustained from the Krang, but now even his left eye was finding it difficult to register where April was in the dark. Yet despite that it didn’t take much effort at all for him to notice Leon still wasn’t there.

“... Wh’rs Leo now?” Raph asked, slightly mumbled from exhaustion and fever haze. He sounded a little grumpy, but April knew it was just his worry creeping up into his sleepy mumbles.

“...He went to get Donnie and Mikey,” April relented this time, not willing to lie to Raph a third time and shifting her phone so that he could see the screen as well. Leon’s icon had come to a stop with the other two, and April kept telling herself it was because he’d finally located them, and was just taking care of them or something. Checking their physical and mental wellbeing. Catching them up on what had happened. Making sure no one saw them. The usual. His vitals had had a spike in heart rate at one point, but it was calm now. As were Donnie’s and Lil Mikey’s. So they had to be fine. Right?

“...What?” Raph almost wheezed, shifting to sit up and grinding his teeth when even twitching his leg sent stabbing waves of pain up it. 

“Easy there, big guy,” April protested, placing a hand gently on Raph’s chest, pressing lightly to direct him to lay back down.

After halting his movements and giving a slight hiss, Raph looked back to April with a slight squint. “Why didn’t he wake Raph? I should be helping him get the others-”

“You know you’re not in any condition to be moving around,” April interrupted quietly, but firmly. “Don’t make me lecture you. We agreed after the Krang that no one would be doing anymore self sacrifice bull crap, remember? That includes forcing yourself to do what you physically or mentally shouldn’t when there isn’t immediate danger.” Her scolding felt shallow, but the conviction was still there under the sleep worn exterior. No more hiding injuries. No more getting seriously hurt to save others. They were to include themselves when it came to protecting who needed it most.

At first Raph wanted to be belligerent towards April. It was his job to look after his brothers. He was the oldest. It had always been that way. Especially if they were in an unfamiliar place like they were now. If he’d heard Leon correctly, they were apparently in an alternate dimension. And while Raph was probably the least scientifically inclined of them, he’d seen enough sci-fi stories to know what that meant. This was probably the most unfamiliar place they could get. He wanted to be there for his brothers. Not only to rescue Donnie and Lil Mikey, but also to be there to support Leon. But hearing April remind him of their agreement deflated his stubbornness almost instantaneously. He knew he could move on his own if he had to. His ninpo apparition would make it easier to not use his leg. But he didn’t need to move right then. As far as they knew, he was the most injured. So it was his job to behave and not worry the others. And he’d be lying if he said he didn’t also just want to curl up and cry whenever he did move his leg. It was worse than when his shell had been broken.

Seeing Raph almost deflate into obedience, April let out a breath in a tired sigh and returned to rubbing his head. “There you go,” she complimented, grateful for his choice. “He said to wait until noon, and if he wasn’t back here by then to come looking for him,” she added, just so Raph knew they had a plan other than sit and wait endlessly. 

She sounded so tired. And that, combined with everything else caused Raph to let out a small whimper as he shifted to wrap his arms around back around April. “...Okay… Raph will wait,” he agreed quietly, silently wondering what he could do for April in turn. He couldn’t imagine she was comfortable waiting in the dark on her own. So this time Raph stubbornly didn’t let himself fall back to sleep, staying curled around April as they gave each other comfort in the dark. It was hard to pass the time in silence, and unfortunately Raph’s brain felt a little more fuzzy than usual. He didn’t think talking about the others would help either, he knew it wouldn’t help him stay calm. So he ended up pulling himself to other, way less important thoughts. “....Do you think they have Jupiter Jim in this dimension?” 

April couldn’t help snorting at the seemingly random question. But she found the topic was actually incredibly calming. “If they don’t I’m gonna be extremely disappointed,” shifting her attention to her phone with the thought to search for it on the internet. Seeing the tracking screen again though, she paused before looking back to Raph. “Do you have your phone? I’m not sure how to get back into this screen if I exit,” she admitted with a slight grimace.

“Yeah, I still have it,” Raph nodded, moving his hand from his hug just long enough to get his phone from his shell and pass it to April after unlocking it.

Quietly tapping the franchise name into a search engine, April ended up scoffing. “Whaaat? Nothing came up? Okay this dimension officially sucks now. What about your dad, are there any of his movies?” she huffed, immediately switching to the next curiosity.

Raph had to snort at her choice of search, and furrowed his brow. “... I dunno. We’re kind of an oddity…” he mused. He and his brothers were decidedly created by someone, not just a common species. He wasn’t sure how that would factor into consistencies between dimensions if something like Jupiter Jim wasn’t there.

“Euh, you’re right. Nothing came up for his movies either. Laaaaame,” April groaned, rolling her eyes.

Raph could feel the tension slipping out of her frame as she excitedly began looking up other things that were familiar to them. The Nexus Hotel wasn’t there, but surprisingly there was still a pizza chain called Lou Mike Tony’s Pizzeria. The two ended up excitedly making a note to try and get some once everything calmed down so they could compare. It made the next hour much more bearable, and they ended up slightly startled when a familiar blue portal whisked into view near them, momentarily illuminating the room as Leon slipped through before it closed.

“April!- Raph!” Leon blurted when he saw them, including Raph when he saw his big brother was awake this time and had jerked his head to look at him.

“Leo!- GAhhkk” Raph called, his attempt to sit up and greet his brother interrupted by another fierce pain firing up his leg.

“Woah there. Take it easy,” Leon cautioned, rushing over to crouch next to Raph and offer support. Even in the dark it only took him seconds to notice Raph’s flushed cheeks, and a brief expression of worry flashed over Leon’s features as he reached up a hand to Raph’s forehead. “Sss… okay, bit higher than expected…,” Leon hissed more to himself, eyes flicking down to Donnie’s wrist computer on his own arm and swiping the screen over to the vitals. 38.7 degrees celsius for Raph. Not horrible, but not good either. Leon knew they wouldn’t be able to avoid a fever, but he’d been hoping he’d have more time than this. At least he had a good place to take Raph and April too now though.

“Did you find Donnie and Mikey?!” April rushed while Leon checked the wrist screen, wedging next to Raph’s side to act as a prop to hold him if needed and handing his phone back to him. She could see Leon checking all of their vitals, so she knew she didn’t have to tell him about changes in Raph’s condition.

“Yeah!” Leon chirped, a bright smile returning to his features as he looked up to them. “They’re okay- Well, they’re a little banged up, but they’re already taken care of and sleeping. These really great guys from this dimension that are probably pretty much us already found them and took care of them,” he rambled, unable to sit still in his eagerness to get back. “They’re also gonna let me borrow their hella cool infirmary to fix up Raph! April you should see it! It’s like a whole hospital crammed into one room! They even have an MRI machine! At least I think that’s what it was….”

April listened to Leon in mild disbelief, what she was hearing conflicting with what she and Raph had thought more than half an hour ago. “Hold up-,” she paused, raising her hand, palm open. “They have the best ninja turtles ever in this dimension too, but no Lou Jitsu?”

“They don’t have Lou Jitsu here?” Leon repeated, looking borderline offended. “Wow, that sucks. Though I guess it makes sense. Their dad is kinda…. Weird. So quiet and…regal? I dunno. I feel like he’s one of those old dudes that just sits and drinks tea all day,” he mused, scrunching his nose slightly. He didn’t think he’d like not being able to roughhouse with and tease his dad. But that was a topic for later, and he pushed it aside in his mind as he addressed Raph again, leaving April to try and configure an image in her mind of this other version of their dad.

“We’re going to have to move you again Raph. Think you can handle it? I’ll try to make the distance as short as possible,” Leon informed apologetically, shifting around to crouch and wiggle underneath Raph’s arm on the opposite side of April.

“Are we going where Dee and Mikey are?” Raph asked, unable to resist giving Leon a little squeeze hug once he was squished under his arm.

“Yup! They’ll be in the same room. But we’re going to fix your leg before letting you join them, okay?” Leon confirmed after giving a small wheeze squeak and laugh at being squished.

Seeing Leon in such a good mood compared to the last time he saw him, Raph realized wherever they were going it was apparently safe enough for Leon to want to be there. And that was enough to reassure Raph that all of them would probably be alright. “Okay, let’s get going then,” Raph nodded, realizing they needed to get moving before the relief Leon brought washed away all resistance he had to the desire to lay back down. Shifting to help Leon and April lift him to his feet, Raph bit back almost all of his whimpers as the trio heaved the group up as carefully as they could. “Easy. Gently. Sorry,” Leon chattered uneasily, pushing back the heartache bubbling up in his chest. “Don’t put any weight on your leg at all okay?” Leon ordered just in case Raph forgot or wasn’t thinking about it, and adjusted his own position to try and take all of Raph’s weight off his broken leg. He wished he had a better way to move them, but portal dropping him onto the surgery table was risky as well as too jarring. So he just had to keep his heart in his chest, forcing himself to be steady as every noise from Raph made him want to stop moving completely, and gradually help them make their way through the new portal he opened.

___________________

Previous Next

___________________

Iiiiii struggled so freaking hard with this one ;v; Not only because I just couldn't get words to work to give this part the attention I wanted (it's barely acceptable now), but I've been working on a massive collab image, and then also got super distracted by a game's story |DDD oops.

you for your patience <3 Hope you enjoy the Raph snuggles =7=

[cabezadeperro]

fox/cody annnd the hunger games for the movie prompt game maybe?

hiii friend!

this is less a proper hunger games au and more "but wasn't growing up on kamino kind of like the hunger games anyway?"

pre-something, kamino years. ~660w, T.

---

Rainwater pools within the cave entrance and trickles into the slightly drier interior, turning the dirt into mud and filling the air within with its metallic smell. It ate through the bright greens and reds of their shell, and Fox’s nose and throat sting from breathing in the fumes without his bucket. He’ll lose points for that—one of the mission objectives was keeping their shell on for the entirety of the operation. Broken bucket in his lap, Fox follows the crack in the visor with his thumb, the sharp edges threatening to cut through his gloves and find skin.

‘24 stands across from him, just within the cave. His shell is splashed brown and red, and his bucket is still on. Fox can’t see his face, but he doesn’t have to: he’ll be scowling at the wilderness beyond their improvised shelter, like he can make it stop raining, like he can will the world to change if he wants it hard enough.

Fox looks away from him and down at his own lap. He can’t remember where he left his left greave: the fuzzy panic he’s been trying and failing to ignore for the past few hours spikes. He doesn’t know if there was anything in the mission dossier about losing equipment. 

“I think it’s slowing down,” ‘24 says suddenly. Fox ignores him. He focuses on breathing in and out, the air burning like acid. “Should start thinking about how we’re going to make it to our pick up.”

Fox has a broken tibia. He’s not making it anywhere, much less to the shuttle back to Kamino. He glares at ‘24’s still-turned back, fear and dread fighting it out with the familiar frustration.

‘24 exhales, annoyed. He turns around and steps properly inside the cave. 

Fox found it completely by chance. It’s a couple hundred metres from Fox’s lookout. He was planning to spend the night there after eliminating ‘24. 

He should have paid more attention to the terrain—he should have realised how wet and unstable the edge of the cliff was getting, he should have known that acid rain would eat through dirt and rock as easily as it scours paint off plasteel plates.

‘24 closes the distance between them and kneels on the mud next to Fox. He used his own single-use anaesthetic on the mess that is now Fox’s left leg. He doesn’t touch him now, but Fox can feel the weight of his gaze on him despite the bucket. 

“Ten-Ten—?”

Fox turns his face away, pressing his lips together. A part of him just wants to—cry. He is tired and cold and everything hurts, not just his leg, and he’s scared. He’s always known there was a non-zero chance of not making it out of training, but he’s beginning to realise that he never thought that applied to him. 

They might return and pick him up after everyone’s made it back to the shuttle. He doesn’t doubt Seventeen is very capable of leaving him to die there, if only to make a point, but the longnecks hate waste. Fox’s eight, he’s almost trained, and he’s one of the best in the officer track. 

‘24 is still watching him. Fox clenches his jaw and forces himself to look ‘24 in the eye.

If this world’s atmosphere or his broken leg or the wildlife don’t kill him, shame will.

“What are you still doing here,” he spits. ‘24 shifts. “You won.”

‘24’s hands turn into fists.

“I’m not leaving you here,” he replies, too loud. His voice cracks in the middle, slightly ridiculous in the quiet within the cave. Fox has the sudden urge to laugh, something awful bubbling up from his chest.

“I would,” he says. He means it.

The main mission objective was being first. Fox can read between the lines: that means making sure no one makes it back before you do.

‘24 tilts his head. Fox wishes he could see his face. 

“I’m not you.”

[radiojamming]

How do we think John Hartnell got his injuries? They say he had a compressed vertebra, an injured ankle, a foot infection, and a shoulder injury. There doesn't seem to be any record of how these happened, and they didn't mention anything about it during his exhumation.

YES I LOVE THIS QUESTION

So there actually are some records of what happened from his forensic report from the '86 exhumation! Like a lot of things about him, it does take some guesswork until we build a time machine and study him like a bug the way I've always wanted.

Here are some selected parts of the autopsy report, which we can use to reconstruct what might have happened to him:

[About the cervical spine compression:] However, there does appear to be some compression of the superior end-plate of the body of C6, consistent with mild fracture, probably representing subacute injury. Cervical alignment is normal. There are no arthritic changes.

[About his upper shoulders and arms:] On some projections, the left acromion appears slightly tapered, possibly due to old trauma. A small spur off the posterior aspect of the left olecranon is also likely to be post-traumatic.

[About the wrists:] The wrists and hands are unremarkable, except for diffuse muscle wasting. There is mild bilateral negative ulnar variance (the distal ulna lies more proximal than the distal radius at the distal radioulnar articulation; if severe, this misalignment may predispose to avascular necrosis of the lunate). No evidence for fractures or arthritis was found.

[About the lower extremities:] The femurs appear normal. Hip and knee articulations are preserved. However, there is a slight widening of the medial aspect of the left ankle joint, raising the possibility of ligamentous injury. No fractures are noted. The talar dome and tibial plafond show no evidence for osteochondritis dissecans, an occasional sequel to subchondral injury. A few growth recovery lines (Harris lines) are noted in the lower tibial shafts. There is also some spurring off the anterior articular lip of the distal right tibia, and probably post-traumatic in origin. A more curious finding is a possible focus of cortical demineralization in the plantar aspect of the 4th metatarsal shaft of the left foot, best demonstrated on oblique projections. Actual disruption of the cortex may be present and could represent osteomyelitis. However, there were no overlying superficial ulcers or open wounds.

OKAY SO we have some key parts of these selections (parts I omitted included stuff like saying how Hartnell looked better than Braine; RIP buddy), and we also have to consider a few things in addition to these: Jartnell had already been exhumed twice before (1852 and briefly in 1984) and the earliest exhumation had done damage to his body, he had some obvious wasting from being stuck in the ice for 140+ years, and tuberculosis can damage far more than just the lungs.

What we can't be completely sure of is his family medical history, although the Inglefield & Sutherland exhumation attempt remarked that tuberculosis was "a malady to which it was further known that the deceased was prone." I haven't been able to find a clarification for this comment—I took it to either mean it was known that he'd died of TB, or it was known that he'd had TB in the past. (See: what I think his dad died from.) But we also can assume that the Harris lines in his legs show that he'd gone through some period of undernourishment at some early point in his life, which isn't too out of pocket for a Victorian working class person. Granted, he was nearly six foot tall and his brother was 5'8" (both taller than the average Victorian-era man), so his growth wasn't too arrested.

All to say that some of his forensic oddities may have come from an earlier time in his life, like an injury or a previous condition. The injury in his elbow, for instance, sounds like it came from earlier in his life. He had been a sailor on a multi-year voyage on the HMS Volage in the past, and went from a career of a shoemaker (which involved inhaling some gnarly chemicals like green vitriol/copperas, as well as repetitive motion injuries) to a full-time sailor without the benefit of training like his younger brother had. Some of those past injuries might have come from this time—workplace injuries, essentially.

The newer injuries, like the one in his neck, could have come from a wide range of sources. Consider that he did have a zinc deficiency, and some of the symptoms of this include night blindness, fatigue, and poor wound healing. He might have been more susceptible to falls, or had a delayed reaction time. The ankle injury, for instance, sounds like a bad sprain; there are a ton of different ways to screw up your ankle on a ship like that (swinging boom accident? fell off the rigging?? slipped on the ice???). The osteomyelitis in his foot might have had a correlation to this, or might have come from an older, poorly-healed injury.

However, he was healthy enough early in the voyage that he wasn't sent back to England during the check-up near Greenland. Either he hadn't presented all of these symptoms yet, or he was really good at hiding them.

This is all a long-winded, infodumpy way to say that our boy here had a medical history that would make you wince and give a sympathetic "oooooh". He was a working-class Victorian man with working-class Victorian injuries and maladies, and it's completely possible that his family history didn't help.

[oneweirdbookaddict]

Whumptober day eleven!

I finally torture Twi. He gets bear-trapped (but not really). Wars and Four help him out.

923 words

General warnings for (ungraphic) descriptions of broken bones, being in captivity. Let me know if there should be any more!

~~~~

It’s just a patrol, a simple patrol, there’s supposed to be nothing out here, there’s been no hint of any monsters all day so of course something has to come ruin his day. 

He’s walking through the woods, stepping right into a pile of leaves, and his foot nudges something. He freezes, glancing down- 

“Wars?” 

The captain glances back at him, eyebrow raised. He slowly looks back down at his foot, careful not to shift his weight at all. 

He’d stepped… goddess, he’d really stepped in the exact wrong spot. Right on the pressure plate, literally the center of his foot. 

“What is it?” Wars asks, moving back towards him. 

“A trap. A bear trap.” He breathes, chest uncomfortably tight. 

“I’m not seeing-” 

“If I move my foot those things around this plate are going to snap up with enough force to break my tibia into two!” He yells, panic washing over him. 

Wars kneels carefully, inspecting the trap. “Oh… How do I make it so it doesn’t do that?” 

“I don’t know.” He breathes. It’s like he’s right back in that cage, chained to the wall… Midna’s voice laughing at him…

“Twi. Twilight. Hey, I’m gonna need you to stay with me, now. You can’t panic.” 

He nods, taking a shuddering breath. 

Wars studies the trap, eyeing it closely, muttering to himself, slowly touching the chain… 

He works on taking slow, even breaths. He’s seen men lose legs from these things, men with horrific injuries from these things, bone cut clean through skin with the way the bone had snapped, trapped in the woods screaming for help- 

“Twilight!” 

He jumps. Freezes, eyes snapping wide open. The trap remains still. 

He and the captain both breath a slow sigh. 

“I can’t figure this out. I bet… I bet Four will know how to dismantle it. I’ll have to go get him.” 

His chest tightens. “Wars.” 

The captain gives him a look. Almost apologetic. “I’ll be quick.” 

“Don’t- Wars.” He says quickly, and his friend puts a slow hand on his shoulder. 

“Twi. Breathe. You’re not trapped here. We’ll get you out. You’re not trapped.” 

“Yet.” He grumbles, shuddering despite himself.

“Yet.” Wars says quietly. “Will you be ok for five minutes while I run and get Four?” 

He takes another breath. “Yes.” 

“I’ll be quick. Don’t move.” 

“Hardy har.” He mutters, and Wars gives a smile before turning and running back in the direction they’d come from. 

It’s the longest five minutes of his life. It feels like eternity. 

Any noise from the woods makes his heart rate pick up, his breath catch, wondering what’s going to come at him, make him move, make him lose his leg. 

Become trapped. 

Then- “Twi?” “Wars!” He yells, heart pounding again. “Wars!”

“Rancher! There- here, Four! You know how to undo this?” Wars comes into view, Four next to him. 

They both kneel, inspecting the trap. 

“Fascinating.” Four breathes, fingers lightly brushing over the metal. 

He winces. Wars nudges the smith. 

“Oh- I, uh, yeah. Sorry. Yeah, I can undo it. Wars… you see these pins here?” 

“Yep. Want me-” “DO NOT TOUCH THEM.” Four says quickly. Wars freezes. 

He jolts, making them all freeze. The trap stays. He takes a slow breath, looking up at the sky. 

Four takes a slow breath. “Wait. For me. To tell you. What to do. Or Twi loses his leg.” 

“Right. Sorry.” Wars breathes. 

“Ok. Put one finger on it, lightly. Just like that, perfect. Now when I tell you, you’re going to put all the force you can possibly put on that pin, understand?” 

Wars nods. Four takes a deep breath, shifting up to the chain, eyes searching for something- 

The smith’s hand reaches out, moving some leaves carefully, uncovering a small wheel attached to the trap. 

“Wars. Now.” The smith spins the wheel as Wars presses on the pin. 

“Twi. Move. Now.” Four grunts, face flushing with strain. 

He slowly moves his leg up, closing his eyes, trembling- 

No pain. He moves. Steps back. “Wars move.” Four says, and the captain moves back. Four springs away, they all flinch as the trap snaps shut with a loud clang. 

He slowly sinks to the ground. 

Four sits on the ground, eyes lingering on the metal monstrosity that almost took his leg. 

Wars puts a gentle hand on his shoulder as he fights to keep his breathing even. 

“Easy, Rancher… it’s ok. Slow breaths.” The captain mutters to him. 

Four’s eyes find him. They’re all too knowing as he meets his gaze. 

“Twi,” The smith says softly. “This trap wasn’t made for you. You’re not… this isn’t for you. It’s not… karma, it’s not ironic, it isn’t fitting. Repeat it back to me.” 

He takes a slow breath. “It’s not for me.” 

“Say it again like it’s not a question.” 

“It- it’s not for me.” He repeats. Four nods. 

He takes a shuddering breath. Slowly stands, accepting Wars’ hand. 

“Twilight.” Four says softly. He glances at the smith. 

Four puts a hand on his arm briefly, looking up at him. 

“You’re not a monster.” His friend says quietly. Softly enough that Wars likely can’t hear. 

He nods, taking another slow breath. Pulls Four into a hug, the smith stiffening awkwardly before slowly wrapping his arms around him. 

“You’re good. You use your abilities for good. You’re a good person, Twi.” Four says softly. He nods again. 

Takes another shaking breath, letting Four go and stepping back. 

Forces a shaky smile. “Well. That was eventful. Let’s head back, shall we?” 

~~~~

[skvaderarts]

These builds use DLC items, so just a heads up! More details about each build are below if you are curious. Thanks for voting! And if you spread the poll, EXTRA THANK YOU! I appreciate it! A larger sample size makes this more fun!

Saint of the Bud: An Arcane/Faith/Dex Scarlet Rot build using the Antspur Rapier with the Poison Flower Blooms Twice Ash of War and the Poleblade of the Bud. The Ant Skull Plate shield is a great contender for this build. I'll also be using spells such as Pest Threads, Pest-Thread Spears, Scarlet Aeonia, and Rotten Butterflies. Will use the rotten stray summon and makes liberal use of crafted items such as rot pots and fly pots. Wears the Full Bloom Chest piece and the Mushroom Crown for a truly unhinged look. Utilizes Maleina's Great Rune/Rykard's Great Rune.

Finger Witch: A Strength/Intelligence build with a possible touch of Arcane. This build specializes in finger weapons and spells. Uses a dueling shield. Both the Gazing Finger and the Ringed Finger scale best with strength, and despite the scaling of the staff that boosts finger sorceries requiring arcane for a spell class that USES NO ARCANE (Fromsoft stop doing crap like this. I like arcane staffs, but this was a weird one to pick for that) I will be using it and possibly adding the oracle bubble spells so that I have something to do with the Arcane requirement late game. It utilizes all of the finger sorceries such as Glintstone Nail, Glintstone Nails, and Cherishing Fingers as well as both finger weapons. One hammer and one colossal weapon. An interesting combo, to be sure. It will also use the new finger summon and the finger robes which are VERY disturbing looking. Utilizes Morgott's Great Rune/ Radahn's Great Rune.

Blasphemous Knight: A Dexterity/Faith (optional intelligence) build that uses the Blasphemous Blade (Which, funny enough, I've actually never tried despite how popular it is!) and the Spear of the Impaler. It included the now-fixed Messmer's Flame Incantations which include Rain of Fire, Messmer's Orb, and Fire Serpent. It may optionally include Rykard's Rancor (which is where in intelligence requirement would come from since it needs a whopping 40 Intelligence!) and could possibly include the Blood Incantations but only if Arcane is added to the build, so that's not likely. The core build is just the Messmer fire incantations and the two remembrance weapons. Wears the Hoslow/Messmer Knight sets. Utilizes Rykard's Rune. Still seems like a fantastic build!

Putrescent Death Bird: A Strength/Intelligence/Faith/character with an optional touch of Arcane for status build-up. Themed after the Death Birds. Wears the Death Gravebird's Blackquill set. The set boosts jump attacks like the Raptor's Black Feathers set in the base game. They specialize in different types of death sorcery. They can cast spells such as Rykard's Rancor, Ancient Death Rancor, Spectrial Rings of Light, Explosive Ghostflame, and Vortex of Putrescence. Not Tibia's Summons, though. I have standards. Putrescence Cleaver, Helphen's Steeple, and the Spirit Glave. The Eclipse Great Shield would be a good pick. Essentially, It's a very fancy frost build. Utilizes Radahn's Great Rune.

Beastial Tree Sage: A Strength/Faith build focused on pure holy damage. (which is shockingly good in the DLC but more tricky in the late main game due to the number of bosses with extreme Holy resistance.) The weapons consist of two colossal weapons that both scale to Strength and Faith and an optional dagger for a faster option if needed. Those are the Great Club and the Shadow Sunflower Blossom. The dagger is the Cnquedea. The Erdtree Greatbow is also a great fit for this build and will be included as an additional ranged option. They would specialize in Beastial Incantations such as Stone of Gurranq and Gurranq's Beast Claw as well as Holy spells like Wrath of Gold, Elden Stars, Land of Shadow, and Crucible Incantations such as Thorns, Bloom, and Breath. Wears Freya's set and uses Radahn's Great Rune.

Fire Prelate: A build focusing on strength and Faith. Utalizes the Prelate's Inferno Crozier and the Cranial Vessel Candlestand. It also uses the Giant's Flame incantations, such as Giant's Flame Take Thee and Flame Fall Upon Them. Uses either the Hoslow Set or the Fire Prelate set for cosplay purposes. A very powerful and versatile fire build. Uses Radahn/Morgotts/Malenia' Great runes. BONK.

Spellblade Cannoneer: A Strength/Int Build using the Moonrithyll's Knight Sword, the Great Mace with Waves of Darkness, and Rabbath's Cannon. It also may use the Jellyfish Shield, Carian Dueling Shield, or the Cuckoo Great Shield. It utilizes Carian Sword Sorcery such as Magic Glintblade, Greatblade Phalanx, Carian Peircer, and Carian Greatsword. It also contains Glintstone Sorcery such as Gavel of Haima, Cannon of Haima, Spiral Shard, and Loretta's Greatbow, and Moon Sorceries such as Rellana's Twin Moons. It uses Relanna/Loretta's armor sets and Radahn's/Morgott's Great Rune.

SO! Thanks for reading! I appreciate your interest in my builds XD If you want the stat sheet for any of these, just let me know and I'll post them! And if you want to see these builds in action, I'll be streaming them on Twitch. I'm SkvaderStreams. Original, I know lol! But feel free to come and lurk. It's a good time! Thanks again! It's always fun having someone to share my build ideas with. If you ever want one, let me know!

Have a great day!

[radioactiveradley]

It’s SPOOKY SCARY SKELETONS MONTH

So let’s talk about yer bones! Yeah, that’s right, Captian Holt. I said –

An adult has (roughly) 206 bones (I say ‘roughly’! You can have non-pathological anatomical variation, such as lumbarised sacral vertebrae (an extra bone in your back) or accessory sesamoids like the flabella (a little bone at the back of the knee!))

A newborn has (roughly) 300 bones

That's a big difference! Almost 100 bones of difference! Where do they go?

Well, you see - as you get older, every time you come into the hospital we steal more of your bones...

Just kidding.

...Or am I

As an embryo, your skeleton is completely composed of cartilage. This gradually ossifies as you age, until, as an adult, you have a full skeleton, with only the interactive portions of joints being capped with hyaline cartilage.

[Paediatric normal whole leg radiograph, showing epiphyseal plates around the head of the femur, the femoral condyles, the proximal tibia, the distal tibia and the lateral malleoli that can mimic fractures. Courtesy of radiopaedia]

See all those weird blobs? Those are bones in the process of fusing together! The transverse lines that could be mistaken for fractures are actually epiphyseal plates – hyaline cartilage bridges between the shaft of a bone and what will become its tip, which don't attenuate x-rays, and thus appear black on our radiographs! This is where bone growth occurs - the cartilage forms a sort of template matrix that then ossifies into bone.

Compare our paediatric radiograph to the AP knee radiographs of an adult with no visible pathology:

[Adult normal AP knee radiographs, showing fully fused bones. Courtesy of radiopaedia]

See how all those ragged pieces have joined up? That’s endochondral ossification, BABY!

This is how we can figure out the age of a paediatric service user from their bones! Certain bones form at different times.

Let’s check out the carpal bones – all those fiddly little bones in your wrist! Anyone who’s binged Hatecrimes MD – sorry, House MD as often as I have will know the classic acronym for remembering the names of these bones. Moving thumb side to pinkie side, we have…

Scared (Scaphoid - red)

Lovers (Lunate - dark blue)

Hate (Hamate - green)

To (Triquetrum - yellow)

Try (Trapezium - orange)

The (Trapezoid - light blue)

Coolest (Capitate - purple)

Positions (Pisiform - pink)

[Normal adult wrist radiograph, shown with and without coloured carpal bones. Courtesy of radiopaedia.]

But did you know that these bones form at different times?

The Capitate ossifies at 1-3 months

The Hamate ossifies at 2-4 months

The Triquetrum ossifies at 2-3 years

The Lunate ossifies at 2-4 years

The Scaphoid, Trapezium and Trapezoid ossify at 4-6 years

And the Pisiform ossifies at 8-12 years

So, I can look at this picture, and tell you that this child is approximately 3 years old, because their Capitate and Hamate have ossified, and their Triquetrum is just visible, starting to ossify below the thumb (circled!)

[Normal wrist radiograph of a paediatric patient, triquetral ossification centre circled. Courtesy of Radiopaedia.]

Your bones continue to form and fuse until you reach about 25! Your olecranon (the bump of your elbow) starts to ossify at 6-11 years, and fuses at 13-16 years! We can look at the base of your fifth metatarsal to age afab folks who are approx. 10 and amab folks who are approx. 12, as this bone fuses in the 2-4 years following these ages! The medial end of the clavicle can be used to assess your age from approximately 18-22, and your facial bones continue to ossify into adulthood! How cool is that?

If you’re over 25, fret not – there’s still plenty of funky stuff happening to your bones. But we’ll get into all of that next time, when we take a look at the function of osteoblasts and osteoclasts and explore all the cool little jobs that your bones perform within your body - it's more than you might think! So, tune in next time for more Bone facts...

And thank you for reading!

[bionicdogs]

Storm, apparently determined to live up to the bionic dogs username, fractured his tibial growth plate on January 2nd. He had surgery on the 3rd (yesterday) and we brought him home today, now with three new pins securing the growth plate back to the tibia. (I don’t have those rads yet, waiting for the vet to email them)

Sutures out in 12 days, rads in four weeks and again at 8 weeks. Vet is optimistic that he won’t have any long term complications but we’re starting him on joint supplements anyway just to be safe.

Oh, and he was 6 months old and 46 pounds on December 29th.

[reelaroundthedavekan]

So the last week and a half has been filled with some not fun stuff, culminating in Return to Office today. I just need to type all this out so please do not feel obligated to read any of this.

Let me explain in bullet list form...

We had a lovely christmas morning with waffles and a few presents

On christmas afternoon, Peter was on his way to his car when he slipped on a patch of ice, landed badly and broke his leg (fibula, mostly, tibia less so but still). [he is doing ok now, spoiler alert]

It certainly could have been worse, luckily he did not hurt his back or head, but he really fucked up his fibula, pardon my bellicosity.

At the time, we were hoping it was sprained as initially there was no swelling or bruising and he wasn't in a lot of pain and we decided we didn't need to spend christmas night in the ER.

On Boxing day we took him to the urgent care, because it had swollen and bruised overnight. We got to sit in the waiting room for 1.5 hours and watch The Santa Clause 2 (which is a really weird movie as it turns out). We then got to go back to a room and wait for the Dr and x-rays...and got to watch the Santa Clause 2 again.

The Dr came in, took a glance at his ankle and she said "oh that looks broken", so our hopes of sprain were gone quickly.

X-rays confirmed a nasty spiral break of the fibula and a smaller fracture of the tibia. It is usually not good when the Dr says "I haven't seen a break like that before".

She put on a splint and wrapped the hell out of it, sent us home with crutches and referred us to an Ortho Trauma office. Luckily it was the office of a Dr that my mom (long time Orthopedic OR Nurse) had worked with.

My mom was able to call him and he called us back very quickly, which was great because he was on vacation for the week. My mom has pull. He was able to look at the x-rays and also commented on how bad the break was. Talked Peter through everything and had his scheduling coordinator call us. Surgery was schedule for Tuesday, January 2nd...

...which happened to be Peter's 21st birthday [sad trombone]

So the week was spent trying keep him comfortable, managing the pain, figuring how to shower and keep the splint dry.

Yesterday morning he went to the DMV to get his new license and then we were off to the hospital. We got there at 10:15 AM and we left at about 5 PM. The surgery went great (a plate and 9 screws) and we got him home. He'll be in a splint for 2 more weeks and then after the sutures come out will switch to a boot and possibly one of those rollie knee scooters.

He goes back to campus on the 16th, follow up appointment is the 18th. Hopefully he will be able to get around OK.

And then today I got to go into the office and work (Mon/Wed/Thur in office, Tue/Fri at home). I know it is not necessarily a big deal, but I have been working from home for almost 20 years, so it is a weird thing for me.

Plus it is at a very large company with a lot of people all going back at the same time. I haven't sat at a cubicle for closer to 25 years and to have this many people around me all making a lot of noise was really jarring. I don't like it and I am not going to like it and I will be grumpy about it for a while.

[drchristophedelongsblog]

Children's growth

During the course of their growth, children increase in height by around 1m 20, and their weight increases by a factor of 20.

In terms of height, the tibia and femur increase by a factor of 5, and the spine by a factor of 2.

Normal statural growth of the child's body segments

During intrauterine life, the child's growth is globally exponential for the first 5 to 6 months, then begins to decrease.

Between the ages of 0 and 5: the rate of growth is still significant during the first year, with the child gaining 25 cm.

Growth slows progressively over the following years, reaching around 2/3 of the adult rate by the age of 5.

From age 5 to 10: growth continues to slow, with an increase in size of 2/3 for the lower limbs and 1/3 for the spinal limbs.

From age 10 onwards, pubertal peak approaches and there is a reversal in the annual rate of relative growth: 2/3 for the spinal segment and 1/3 for the lower limbs.

From the age of 13 in girls and 15 in boys, there is no longer any growth in the lower limbs, but only in the spine.

Growth of the child's body segments

Growth of the lower limb:

10 growth cartilages contribute to the increase in length of the lower limbs.

femur: the upper chondroepiphysis is responsible for 30% of femur growth, the lower for 70%.

tibia: the upper tibial epiphysis is responsible for 60% of tibial growth, the lower for 40%.

all in all: 65% of lower limb growth takes place in the knee, whose trauma must therefore be treated and monitored carefully and over a long period of time.

Growth of the upper limbs:

humerus: its upper epiphysis is responsible for 80% of humeral growth, the lower epiphysis for only 20%.

radius and ulna: the lower epiphysis is responsible for 80% of growth, while the upper epiphysis accounts for only 20%.

in total: 80% of growth in the child's upper limb is linked to the growth plates of the upper humeral and lower radial and ulnar epiphyses.

Growth of the child's back

Each vertebra has 3 to 4 growth cartilages, and spinal growth therefore depends on the unique ossification of over 100 growth cartilages, hence the multiple spinal deformities that can be observed during childhood growth.

Schematically, each vertebral body is made up of an upper and a lower growth plate, much like the long bones.

These 2 conjugation cartilages tend to ossify towards each other, towards the center of the vertebral body.

Measuring sitting height enables us to assess the spinal growth curve +++.

At ten years of age, the upper and lower marginal listels appear, progressing from front to back, gradually ossifying and fusing with the vertebral body.

Ossification of all vertebrae is not complete until around age 25.

So, what's the bottom line?

Children's growth is complex!

Don't hesitate to consult a real specialist: he or she is there to diagnose, treat and, fortunately, most often reassure!

To find out more

Blaze

0 note